The Emperor of All Maladies- a review

Siddhartha Mukherjee’s The Emperor of All Maladies- A Biography of Cancer is a deep dive into the history of cancer, its recorded occurrence and treatment. The book highlights the multitudes of ground-breaking innovations that have helped scientists understand and, to a lesser extent, treat the various kinds of cancers occurring among humans. The book follows a neat sequence where the reader is introduced to a patient being treated by the author himself- prompting the author to ask – what is cancer? After all, knowing the enemy secures half the battle, and cancer might be one of the most prevalent diseases ordinary people such as you or I would know the least about.

Mukherjee examines the history of cancer in Egyptian, Persian, and Greek civilizations. The Egyptian physicist Imhotep, back in 2500 BC, had prepared a treatise on the prevalent diseases and their cures, but for ‘bulging masses within the breast’, he solemnly notes “There is none.” We hear of legends of Queen Atossa, the queen of Persia around 500 BC, having performed one of the world’s first recorded mastectomies, by ordering her breast to be cut off. Hippocrates, after whom the Hippocratic Oath is named, explained all illnesses as forms of imbalance among the four cardinal fluids (or humors) of the human body- blood, phlegm, yellow bile, and black bile. He was also the person to name the disease as cancer, or as it was known then- ‘karkinos’ or crabs, due to the resemblance of the earliest tumors examined with crabs (which is where we get the zodiac sign from). In the year 160 AD, Galen expanded on this idea by noting that cancers were caused due to the excess in black bile in our bodies.

We follow the needle of time through the Renaissance, the first autopsies and anatomies of the human body conducted, the invention of microscopes and the identification of the frenzied, uncontrolled division of cells that is cancer. We explore the roots of chemotherapy, the manic lengths of radical mastectomy, the various conceptions and misconceptions involving the causes of cancer. Mukherjee paints a vivid picture of these scientific innovations, and the failures as well, being pursued. Interestingly, we also read about the political efforts made by the Sidney Farber and Mary Lasker made during the Nixon era to educate and sensitize the voting population and draw the attention of politicians, and the many crucial inventions made by numerous individuals that have allowed us to understand, and in some cases, beat down cancer.

Cancer is a terrifying subject, and even more crucially, is a terrifyingly complex field to understand. However, this book notes and credits the many innovators, chemists, surgeons, and researchers who have developed the weapons we use today to battle cancer. Unsurprisingly, this book does not conclude with a happy ending, and there’s no aspirin-like panacea developed to beat all kinds of cancer today. Our science is not there yet. However, this book serves to educate us in simple terms “in the battle against cancer- where were we, where are we, and what does the future look like?”

This book is a fitting reminder of the mortality of the human body. Mukherjee mentions many survivors of cancer, and many more who couldn’t make it. Reading this book, it is impossible not to reflect on how seemingly random, sudden, and unpredictable cancer. It is a mutation in our very genes, a betrayal or a incorrect development from within. Our life, and our mortality, continues to never be in our control. The Emperor of All Maladies provokes a greater appreciation for the temporary nature of our existence. Lastly, I would like to add a personal note- reflect on your life, your loved ones and your priorities. Cherish, love and rejoice in this marvel. After all, life is never as secure and inalienable as we assume it to be.

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