The Emperor of All Maladies

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Qaasid Muin Ahmad

Author: Siddhartha Mukherjee

Publisher: Simon & Schuster

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Simon & Schuster

“When I began writing this book, in the early summer of 2004, I was often asked how I intended to end it. Typically, I would dodge the question or brush it away. I did not know, I would cautiously say. Or I was not sure. In truth, I was sure, although I did not have the courage to admit it to myself. I was sure that it would end with Carla’s relapse and death.” 

Carla Reed was a thirty-year-old kindergarten teacher from Massachusetts, USA and the mother of three young children. On the morning of 19 May 2004, she developed a severe headache; not the usual headache, but the type that tells you that something is not right. She had been feeling unusual for nearly a month. Eventually her situation was such that from being an active and energetic teacher she began to get extremely tired from walking the flight of stairs at home, to the extent that to get from one room to the other, she would have to crawl on the floor, unable to stand on her legs. 

Carla and her husband began to see a general physician and a nurse over the course of four weeks. However, throughout that time she was not diagnosed with anything. Upon demanding a blood test, she and the practitioner were bewildered. “Watery, pale, and dilute, the liquid that welled out of Carla’s veins hardly resembled blood.”

The author got to know of Carla’s case on 21 May. Whilst driving down the highway on his way to work, his beeper informed him that Carla Reed’s diagnosis was leukaemia. 

Mukherjee, at the time, was an oncologist in training. However, his education and preparation could never have prepared him enough to face the reality. The emotions that come with the all-consuming presence of cancer are demanding. If the physicians succumb to the realities of cancer then the patients would most surely find themselves, as the author puts it, “obliterated”.

However, this book is not just the story of Carla. It is, in fact, the story of many Carlas; millions of Carlas who day in and day out are fighting the emperor itself: Cancer. 

This book is a must-read for all people interested in oncology, cancer-research or the related sciences. It explicitly talks about the various types of cancers, ranging from breast cancer to leukaemia, from Hodgkin Disease to brain cancer. Spanning 470 pages of thorough research and covering 2 millennia, the author has done well to cover every part of the biography of cancer. 

The author narrated to us, quite literally, the biography of cancer and how it has affected humanity since time immemorial. From the very first works on cancer found in the documents of the Egyptian physician, Imhotep (2625 BC), who talks of a disease that cannot be pronounced due to being written as a hieroglyph but as having “no cure”, to the remarkable services rendered by many physicians, among whom is the notable name of Sidney Farber. 

The book emphasises the importance of cancer research in the modern day and also very clearly explains the research of the past hundred or so years since the various forms of cancers, as we know them today, have been discovered. 

Mukherjee, from the outset, clarifies that cancer is not the name of one single disease, rather, many diseases. Everything is categorised under cancer, however the common denominator among all cancers is: the abnormal growth of cells. 

Although cancer has become what some may think a very complex field (no doubt it is), a close study of this book will provide you with not only the basic knowledge on cancer, but also a breath of fresh air for even the medical, surgical and radiation oncologists. 

Mukherjee tells us about the effects of treatment with radiation and says that although it can be cancer-curing, it can be cancer-causing at the same time. He takes us back 70 or so years ago when researchers in cancer sacrificed their health and lives for the sake of cancer research, whilst studying the cure for cancer through x-rays. 

He also narrates the story of AIDS and in doing so, narrates how in March 1981, doctors in New York reported eight cases of an unusual form of cancer among men called Kaposi’s sarcoma. This disease, however, was not new. It had been recognised as a slow-growing tumour that had crept up on elderly Italian men. All of the eight men were homosexuals, and between June and August 1981, many signs of the disease triggered among men. The common factor among them, apart from homosexuality, was the complete collapse of the immune system. Some called the disease the “gay compromise syndrome” while others named it GRID (gay related immune deficiency), or more cruelly, “gay cancer”. Eventually, in July 1982, it adopted its modern name, Acquired Immune Deficiency Syndrome: AIDS. 

A summary of the book, I found, can be taken from the following one-liner: “This War on Cancer may be best ‘won’ by redefining victory.”

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