I want to start 2016 by talking about three related books that I think are worth reading. Two are fairly current while the third is 90 years old. All three books have a common theme: the struggle to penetrate the mysteries of human diseases and to conquer them. The researchers were often guessing when they surmised what was going on – and they were often wrong. And a wrong guess wasn’t just a setback, it was often an early death sentence for the patients who were being treated. Yet somehow those curious explorers refused to give up; they refused to be defeated.
The first book is The Emperor of All Maladies: A Biography of Cancer (2010) by Dr. Siddhartha Mukherjee (also a PBS mini-series). After reading this book, I saw why it won the Pulitzer Prize for General Non-Fiction the year after its publication. Dr. Mukherjee’s writing style makes even the most complex aspects of cancer reasonably understandable to the average reader. His references to subject outside the realm of medicine demonstrate his wide knowledge of fields far beyond medicine, and add greatly to the breadth of this “biography.” His discussions of heartbreaking cases of cancer in both children and adults are difficult to read, but we need to understand this terrible malady that will touch all of us either directly or indirectly during our lifetimes.
Dr. Mukherjee also describes what happens at a cellular level when cancer first forms, and details researchers’ attempts to slow or stop the growth of mutant cells. You will be amazed at how sophisticated cancer treatment has become because of our increasing understand of what goes on at the cellular level. And as I read this book, I kept thinking that research has made even greater progress since the book’s publication five years ago.
For many years there has been a “war on cancer,” and that war will continue indefinitely according to the author. We can now cure some cancer and retard the growth of others, but total victory continues to elude us. Cancer cells that can be kept at bay by chemotherapy for a while sometimes have the ability to mutate so that the treatments no longer stops them from multiplying. And as Dr. Mukherjee point out time and again, those cells multiply at a phenomenally rapid rate. Yet we should be glad that many cancer victims have been able to live extra years – sometimes many extra years – because of the tenacious efforts of researchers. For instance, Dr. Mukherjee writes that because of currently available prostate cancer strategies many elderly men will die with prostate cancer rather than of prostate cancer.
My second book is And the Band Played On: Politics, People and the AIDS Epidemic (1987) by San Francisco Chronicle journalist Randy Shilts. I was reminded of this book a few days ago when I read an article about Baton Rouge, Louisiana (where I live) having the highest rate of AIDS (per 100,000 people) of any city in the United States. If you think AIDS cases have waned, you’re wrong. And though there are treatments for this disease, the necessary medications aren’t available to many of the people who contract it.
I found Shilts’ book to be especially disturbing (maddening might be a better word) because almost everyone connected with this disease – victims, doctors, politicians, religious leaders, blood bank operators, and researchers – were long in denial about the gravity of the disease’s threat, its cause, and its effect on people outside the gay community who contracted it through no fault of their own. Even after it was strongly indicated that AIDS was a disease that spread through sexual intercourse and the exchange of bodily fluids, gay men refused to change their recently liberated lifestyles, politicians refused to address such an unpopular subject, and blood banks refused to admit that their blood recipients (including hemophiliacs and people having routine operations) were contracting and dying because of tainted blood.
Shilts doesn’t spare anyone including the national agencies that fought over the trifling research funding that was available to identify the cause of HIV/AIDS. Rather than cooperate, the various agencies attempted to protect their turf, so to speak, and to save the glory for themselves. One particularly onerous researcher, according to Shilts, was Dr. Robert Gallo who was willing to do anything to gain the distinction of being the discoverer of the AIDS virus. (Alan Alda, the delightful Dr. Hawkeye Pierce in the TV series M*A*S*H, delivered a stunning portrayal of the arrogant Dr. Gallo in the 1993 HBO movie based on Shilts’ book.)
Shilts, by the way, died from AIDS in 1994 at the age of 42.
Both of the above books are quite graphic in details, so beware of this before you decide to read them.
My third book is the one that is 90 years old. It is Microbe Hunters (1926) by microbiologist Paul de Kruif. A blurb on the cover of my current copy (my second) describes the book well: “The classic that reveals the dramatic discoveries of early microbiology and the war against disease—a war being waged with renewed fury today.”
De Kruif begins with the story of Antonie Leeuwenhoek (Antony Leewenhoek in the book) an uneducated Dutchman who was born in 1632. For some reason this dry-goods dealer developed a mania for grinding precise lenses and produced a microscope so fine that he discovered little “beasties” in drops of water and wherever else he looked. As astonishing as it might seem, Leeuwenhoek was invited to submit his findings to the Royal Society in London, and became an esteemed contributor. In fact, he is remembered today as “the Father of Microbiology.”
In a wonderfully readable style de Kruif goes on to discuss other microbe hunters including Robert Koch, Louis Pasteur (he rightfully get two chapters), Theobald Smith, Walter Reed, and Paul Ehrlich to mention a few. As in the other books, you learn that there were no shortcuts. Knowledge had to be earned. And there were plenty of doubters waiting to condemn these pioneers if they were wrong.
For instance, Louis Pasteur had developed a vaccine that could cure dogs infected with rabies if it was administered soon enough, and protect them from getting the horrible disease if they were inoculated yearly. But would it work the same way on humans with rabies? How was he to know? What an outcry there would be if he was wrong. De Kruif writes this of Pasteur’s dilemma:
And you may guess how Pasteur was worried! This was no affair like anthrax, where, if the vaccine was a little, just a shade too strong, a few sheep would die. Here a slip meant the lives of babies . . . Never was any microbe hunter faced with a worse riddle. “Not a single one of all my dogs has ever died from the vaccine,” Pasteur pondered. “All of the bitten ones have been perfectly protected by it. . . . It must work the same way on humans—it must . . . but . . .”
One day he was forced to make a decision. A woman who had heard that Pasteur had a vaccine for rabies in dogs brought her nine year old son to him. The boy had been bitten 14 times by a rabid dog and was sure to die if Pasteur couldn’t save him. Pasteur had to decide immediately if he would use his untried cure for rabies in hopes of saving the child’s life. He decided to use it, but he had to guess at how much of the vaccine he should give the boy each day, and how long he should continue the shots. Luckily for the boy, for Pasteur, and for us his guess was correct.
Microbe Hunters is a wonderful book, but it ends with the discoveries of the first quarter of the twentieth century. There was so much more to be told, but de Kruif, who wrote many other books and lived until 1971, never updated his masterpiece. And yet, we can be happy that he left us this wonderful history of microbiology that is still in print today.
There you have it: my offering to you to begin 2016. I hope to write many more posts during the year, and I hope you will continue to read them.
Happy New Year!