It’s taken me a month and half to finish this mammoth of a book, the Middlemarch of medical non-fiction, The Emperor of All Maladies, A Biography of Cancer. It has been one of the most informative reads I’ve ever read. Mukherjee presents a very complex topic in an accessible and interesting way striking the perfect balance in being descriptive without being overbearing & clinical. Though this book is as accessible as a biography of Cancer can possibly get, it still is a very challenging read and certainly not a breeze to get through. So in that sense it feels like an achievement just to have finished it.
In Lewis Carroll’s Through the Looking-Glass, the Red Queen tells Alice that the world keeps shifting so quickly under her feet that she has to keep running just to keep her position. This is our predicament with cancer: we are forced to keep running merely to keep still.
Cancer is personified as the central character, the antagonist, the mysterious harbinger of misfortune, and you come to understand the magnitude of human experimentation that’s gone into demystifying this ancient disease. Threading in case studies from the earliest civilizations and autopsies of archeological remains to the most recent developments, Mukherjee weaves a multifaceted narrative creating almost a four-dimensional view of Cancer. The end result is gripping, informative and eye-opening.
It’s galactic in scope so it is very difficult to capture all that this book covers in a single review. Mukherjee presents a comprehensive look at the evolution of Cancer. The medical war that have been fought against it for centuries, the magnitude of human lives lost in this war. The sheer rigour and lengths doctors, surgeons and oncologists have gone to find a cure, with repeated trials, each more drastic than the last, testing the very limits a human body could endure.
Cancer is an expansionist disease; it invades through tissues, sets up colonies in hostile landscapes, seeking “sanctuary” in one organ and then immigrating to another. It lives desperately, inventively, fiercely, territorially, cannily, and defensively—at times, as if teaching us how to survive. To confront cancer is to encounter a parallel species, one perhaps more adapted to survival than even we are.
From the birth of biochemistry, the impact of the world wars on Cancer research, finding the link between the chemical war gases and its application in chemotherapy, the era of radical surgery, the increased occurrence of lung cancer post-war due to spikes in smoking, the revelation of tobacco as a Cancer causing agent, and political war to ban tobacco, the emergence of the AIDs epidemic, etc. Mukherjee provides incredible context in how all these different events were linked with Cancer in some respect. In the end, you get a very holistic and in-depth view of this ancient disease and medicine as a whole.
Filled with case studies, this book almost reads a like a story, a slow burn thriller, where the adversary is formless, deadly, striking with such power when you least expect, altering one’s life in unprecedented ways. It’s one I’d highly recommend, the only minor complaint, there’s a section two thirds of the way through that slightly dragged.