The Emperor of All Maladies. By Siddartha Mukherjee

The Emperor of All Maladies

Siddhartha Mukherjee

Fourth Estate, London, 2011

 It's subtitled 'A Biography of Cancer' and the text is 470 pages long. It's rather surprising that I could read a 'biography' that long, and still come out of it with really no new understanding about the disease. On the whole, the impression is that cancer no longer a completely incurable disease, or at least need not as much dreaded and feared as it used to be. But this is more probably my reaction not to the book, but to the fact that Athan's 'Stage III' lung cancer appears at least temporarily to have been driven into remission by some drugs, modern or ancient. The book itself does not clearly give a picture of the current status of our understanding of the disease. It appears that the author is trying very hard to present overall a positive picture, but does not have sufficient grounds to do so, and is therefore stretching the meager successes that have occurred in the 'war'.  Thus, on the one hand he talks about the 'success' of really brutal surgery or chemotherapy in prolonging patients' lives by an average of a few months, with a few exceptional cases where the disease has disappeared, and then uses these successes to insinuate that we no longer need to fear it, though, of course, according to him, we had to fear it before these treatments came along. On the other hand he warns us that cancer will become the largest (or maybe second largest) cause of death in the US in the next couple of decades. The two positions are contradictory.

   The other thing I dislike about the book is its US-centricity. All discoveries are made in the US. All treatments and drugs are developed in the US. All doctors/scientists who do anything about diagnosis, treatment, palliation, or cure are Americans.... Not even the Europeans get a mention, except very grudgingly, and as for the rest of the world, forget it - it probably doesn't even exist. There is not even the usual anecdote involving some relative or friend in Calcutta, which is apparently mandatory for such books by Bengali expats. 

    But the book is well-written and makes easy, though irritating, reading. Some of his sentence constructions are good. I give a couple of examples below. But before that - I regret the Rs 500/- I spent on the book. The moral: don't believe American reviews of American books, and don't believe the Pulitzer Prize. (The book won the Pulitzer Prize for Non-Fiction 2011)

    Some quotes:

'...mathematicians [are] the archbishops of the arcane...'

'Doing "relevant" research is not necessarily doing "good" research', James Watson would...write. 'In particular we must reject the notion that we will be lucky...Instead we will be witnessing a massive expansion of well-intentioned mediocrity.'

'In science, ideology tends to corrupt; absolute ideology [corrupts] absolutely' - Robert Nisbet.