The Emperor of All Maladies: A Biography of Cancer by Siddhartha Mukherjee

four dragons and a baby dragon aka four and a half dragons
four and a half dragons

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Today we all know that cigarettes cause cancer and other serious health problems. It’s a foregone conclusion, but when my mother and father were born and in their teen years it was still seen as a cool thing to do. Cigarette companies marketed their product towards a variety of different groups and got them hooked. As Mukherjee puts it “like a virus, too, the cigarette mutated, adapting itself to diverse contexts. In the Soviet gulag, it became an informal currency; among English suffragettes, a symbol of rebellion; among American suburbanites, of rugged machismo, among disaffected youth, of generational rift.”

Companies hid information so that their users wouldn’t know the dangers they were facing. My mom and my dad are both avid smokers no matter how many times they’ve tried to quit. My mom lost her mom to cancer and even when she was dying she would go outside and smoke. This wasn’t some kind of defeatist attitude of “well, I’m dying anyway so I might as well” this was the addiction. Mukherjee states that patients going through chemo or waking up after a cancer-related surgery will wander the halls like zombies begging for cigarettes.

“By the early 1960’s, the gross annual sale of cigarettes in America peaked at nearly $5 billion… On average, Americans were consuming nearly four thousand cigarettes per year or about eleven cigarettes per day—nearly one for every waking hour.”

This would have been approximately the time my father started smoking. For years he measured how much he smoked in packs rather than in cigarettes. I hounded him until he was only smoking 11 or so cigarettes a day, but it took time. Most people in this day and age don’t have an excuse to start smoking: we know it is awful for us and may kill us. If you smoke please try to stop and if you don’t smoke yet don’t ever, ever start. If you are desperate for some relaxation read a book, go for a walk, turn on some music, eat chocolate or talk to someone.  

Now, rant aside this book had a lot of feeling. Yes, it was informative and eye-opening about cancer and its treatment through the ages, but it was also heartfelt.

At a meeting with fellow doctors in which they are listing the names of those who have died in their care in the last two years of their fellowship one of the doctors chooses to add a “sentence to each name as a sort of epitaph. It is an impromptu memorial service, and it stirs something in the room. I join in, calling out names of my patients who have died and appending a sentence or two in memory.” There is something so emotive about this. I don’t know the doctors who treated my grandmother, but I liked to imagine that she wasn’t just another face to them, another name on a list to be read and forgotten.

It was also eye-opening in regards to cigarettes and cancer in other countries. Due to increasing lawsuits and dwindling profits “cigarette manufacturers have increasingly targeted developing countries as new markets…Tobacco smoking is now a major preventable cause of death in both India and China” and it was “recently estimated that the number of smoking-related deaths among adults in India would rise to 1 million per year in the 2010’s and continue to rise.” Based on a quick Google search this research has held up. Having just lived in China I can say that smoking was pretty prevalent despite the fact that all packages have some sort of health-related warning. Some had pictures of an x-ray of lungs clearly filled with cancer.

Interesting tidbits in The Emperor of All Maladies

“In 1980, cancer was responsible for 1.824 million lost years of potential life in the United States to age 65. If, however, the cancer mortality rates of 1950 had prevailed, 2.093 million” years would have been lost. We are winning the war on a grand scale, but person to person the truth is still heartbreaking.

Syphillis used to be treated using mercury so a phrase was born: Syphillis “was one night with Venus, followed by a thousand nights with mercury.”

Max Delbruck once dismissively called DNA a “stupid molecule” because at the time is was “disregarded as a form of cellular stuffing with no real function.” My how far we’ve come.

Would Recommend

There a ton of other fun little facts and information on the long march of cancer research. Would recommend this for anyone who is curious about cancer (and doesn’t mind the occasional section of dry writing), and anyone who feels like cancer often takes on the persona of a living villain lurking in the shadows.

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