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

In November 2010, NPR’s Fresh Air featured a story, “An Oncologist Writes a Biography of Cancer.” Oncologist Siddhartha Mukherjee was treating one of his patients, a woman with advanced abdominal cancer who had relapsed multiple times, when she asked him what seemed like a simple question. "She said, 'I'm willing to go on, but before I go on, I need to know what it is I'm battling,' " Mukherjee tells NPR's Terry Gross. But, as Mukherjee explains, describing his patient's illness wasn't so simple. Defining cancer, he says, is something doctors and scientists have been struggling to do since the disease's first documented appearance thousands of years ago. Mukherjee's new book, The Emperor of All Maladies: A Biography of Cancer, grew out of his desire to better understand the disease he treats, through examining the way cancer has been described and treated throughout history. He chronicles the ways therapies evolved, particularly in the 20th century, as more treatment options became available and scientists worked to understand the underlying genetic mutations that caused the disease.

“A breast cancer might turn out to have a close resemblance to a gastric cancer. And this kind of reorganization of cancer in terms of its internal genetic anatomy has really changed the way we treat and approach cancer in general.”

- Siddhartha Mukherjee, author of the book: The Emperor of All Maladies: A Biography of Cancer

“What does it mean to be an oncologist? It means that you get to sit in at a moment of another person’s life that is so hyper-acute, and not just because they’re medically ill. It’s also a moment of hope and expectation and concern. It’s a moment when you get to erase everything that’s irrelevant and ask the most elemental questions — about survival, family, children, legacy.”

- Siddhartha Mukherjee, author of the book: The Emperor of All Maladies: A Biography of Cancer

In November 2010, The Economist published “With hope, farewell fear: The long struggle to understand cancer.” It is said that when the good burghers of Amsterdam were first presented with a rhinoceros—armored, horned, three-toed, with a prehensile lip—spectators shook their heads in disbelief. Cancer provokes a similar bafflement. So protean are its forms and so varied its features that even specialist prognoses of aggressiveness, invasion and response to treatment have typically generated more exceptions than rules. Apparently, identical cancers in two patients may behave so unlike as to appear utterly different diseases. Siddhartha Mukherjee’s “The Emperor of All Maladies” tells of the search for a “unifying theory” of cancer, the common attribute of all types of malignant cell growth that might reveal its cure. The arc of this rich and engrossing book matches Mr. Mukherjee’s personal evolution as an oncologist, beginning on the first day of his hospital residency. It seems that the diversity of this implacable, shape-shifting foe will defeat him. He is faced with dead-end discoveries, therapeutic disasters and revelations that lead only to more mysteries. But with the perceptiveness and patience of a true scientist he begins to weave these individual threads into a coherent and engrossing narrative.

“If there's a seminal discovery in oncology in the last 20 years, it's that idea that cancer genes are often mutated versions of normal genes. And the arrival of that moment really sent a chill down the spine of cancer biologists. Because here we were hoping that cancer would turn out to be some kind of exogenous event — a virus or something that could then be removed from our environment and our bodies and we could be rid of it — but as it turns out, cancer genes are sitting inside each and every one of our chromosomes, waiting to be corrupted or activated.”

- Siddhartha Mukherjee, author of the book: The Emperor of All Maladies: A Biography of Cancer

Antonio Damasio: Self Comes to Mind: Constructing the Conscious Brain

The study of the evolution of emotions dates back to the 19th century. Charles Darwin famously applied the theory of evolution and natural selection to the study of human communication in his 1872 work, The Expression of the Emotions in Man and Animals. Charles Darwin researched the expression of emotions in an effort to support his theory of evolution. He proposed that much like other traits found in humans and animals, emotions, also, evolved and were adapted over time. His work looked at not only facial expressions in both humans and animals, but attempted to point out parallels between behaviors in animals and in humans. It’s this area of science that author and neuroscientist Antonio Damasio has focused on for much of his life. As he has done previously, Antonio Damasio (Descartes' Error: Emotion, Reason, and the Human Brain) explores the process that leads to consciousness. Moreover, as he has also done previously, he alternates between some exquisite passages that represent the best popular science has to offer and some technical verbiage that few will be able to follow. Antonio Damasio draws meaningful distinctions among points on the continuum from brain to mind, consciousness to self, constantly attempting to understand the evolutionary reasons why each arose and attempting to tie each to an underlying physical reality. Antonio Damasio goes to great lengths to explain that many species, such as social insects, have minds, but humans are distinguished by the "autobiographical self," which adds flexibility and creativity, and has led to the development of culture, a "radical novelty" in natural history. Antonio Damasio ends with a speculative chapter on the evolutionary process by which mind developed and then gave rise to self. In the Pleistocene, he suggests, humans developed emotive responses to shapes and sounds that helped lead to the development of the arts.

"The time will come when the issue of human responsibility, in general moral terms as well as on matters of justice and its application, will take into account the evolving science of consciousness."

- Antonio Damasio, Self Comes to Mind: Constructing the Conscious Brain

"Emotions proper are merely an integrated crown jewel of life regulation."

"In a generation that has grown up multitasking, in the digital age, the upper limits of attention in the human brain are being rapidly raised, something that is likely to change certain aspects of consciousness in the not-too-distant future, if it has not done so already. Breaking the glass ceiling of attention has obvious advantages, and the associate abilities generated by multitasking are a terrific advantage; but there may be trade-off costs in terms of learning, memory consolidation, and emotion. We have no idea what these costs may be."

- Antonio Damasio, Self Comes to Mind: Constructing the Conscious Brain

"Which kind of consciousness is primordial? Is the self fundamental for consciousness, as Damasio suggests? Or does awareness come when we take in information without having to do anything about it, and is the attending and planning self merely an elaborate construction on top of that, as the Buddhists or David Hume would argue?"

- Alison Gopnik, Slate.com

In November 2010, Alison Gopnik wrote “How Weird Is Consciousness? Scientists may not even be asking the right questions.” for the Slate.com: Antonio Damasio is a neuroscientist who has done illuminating research on emotion, decision-making, and our perception of our own bodies. He was also one of the brave early researchers who tackled the problem of consciousness head-on, and he was rewarded by several successful popular books. Unfortunately, in Self Comes to Mind, Antonio Damasio seems to have jumped the shark. The book doesn't include either the new scientific research of the last 10 years or new philosophical clarity—although the style is readable, if a bit high-flown, it's often hard to make out the arguments. Instead, the book is a rather wandering and digressive restatement, with some minor variations, of Damasio's earlier views on consciousness. […] The trouble with Damasio's hypothesis, as with all the hypotheses about capital-C Consciousness, is figuring out how you could test it. There is only one organism that I'm sure is conscious (namely, me), and there are only a few more organisms that tell me they are also conscious (namely, my fellow humans), though I'm pretty sure that my other fellow animals are conscious, too. Just to make things worse, the more you think about it, the less sure you are about the nature of your own consciousness, let alone that of other organisms. The philosopher Eric Schwitzgebel has collected many examples that shake your belief that you always know about your own experiences. For example, were you conscious a moment ago of the feeling of your feet in your shoes? You are now, of course, but were you before I made you think about it?

"As humans debate the benefits or perils of cultural trends, and of developments such as the “digital revolution,” it may help to be informed about how our flexible brains create consciousness."

- Antonio Damasio, Self Comes to Mind: Constructing the Conscious Brain

Atul Gawande: Better: A Surgeon's Notes on Performance

In 2009, the author wrote this in the New Yorker: McAllen has another distinction, too: it is one of the most expensive health-care markets in the country. Only Miami—which has much higher labor and living costs—spends more per person on health care. In 2006, Medicare spent fifteen thousand dollars per enrollee here, almost twice the national average. The income per capita is twelve thousand dollars. In other words, Medicare spends three thousand dollars more per person here than the average person earns. See that New Yorker piece here. In the video below, the author's giving a talk that involves the topics and subjects of his book, at large, at Google's corporate campus (part of the company's "Authors @Google" series). The second video is of an interview of the author by Charlie Rose.

The Health Show #1184 from The Health Show

At the beginning of the 20th century, the worldwide medical community was searching for the secret to controlling a disease that, at the time, was a death sentence: diabetes. On this week’s Health Show, we’ll talk to an author of a new, fascinating book on that search that centers around the daughter of a man who was, at the time, one of the most well known and powerful men in America. Then we’ll hear about a recent conference on the future of nursing in the US...and our friend Sandy D returns with a holiday un-fairy tale.

Download the podcast here. This book is about Elizabeth Hughes, one of the first diabetics to be treated with insulin, and a daughter of a very powerful man.

An Oncologist Writes 'A Biography Of Cancer' from NPR Podcast Fresh Air

Oncologist Siddhartha Mukherjee was treating one of his patients, a woman with advanced abdominal cancer who had relapsed multiple times, when she asked him what seemed like a simple question. "She said, 'I'm willing to go on, but before I go on, I need to know what it is I'm battling,' " Mukherjee tells NPR's Terry Gross. But, as Mukherjee explains, describing his patient's illness wasn't so simple. Defining cancer, he says, is something doctors and scientists have been struggling to do since the disease's first documented appearance thousands of years ago

Download the podcast here. As usual, the NPR Fresh Air website and webpage for this story, is full featured, and definitely worth the thorough read-through. See also: Unbroken: A World War II Story of Survival, Resilience, and Redemption, Anticancer, A New Way of Life, New Edition, Cancer: 50 Essential Things to Do: Third Edition, Beating Cancer with Nutrition, book with CD