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The Last Word
Siddhartha Mukherjee
Tropic of Cancer
With his felicity with words and empathy for his subjects, it is easy to understand why this biographer of a dreaded affliction won a top American literary honour
Ashish Kumar Sen

Siddhartha Mukherjee defies a neat description. He is a biographer with disease as his subject. He looks at cells through microscope, but feels for the people afflicted with cancer. He does not remove himself from the world to write about it, but scribbles during the breaks that he gets. The physical act of writing, thus, for him is disjointed, but the words that he uses to convey his thoughts are expressed elegantly.

Siddhartha MukherjeeMukherjee was born in New Delhi and went to St Columbas School, where much emphasis was placed on recitation. Perhaps that explains why his first book - ‘The Emperor of All Maladies: A Biography of Cancer’, won the Pulitzer Prize and was described by the Pulitzer board as “an elegant inquiry, at once clinical and personal, into the long history of an insidious disease that despite treatment breakthroughs, still bedevils medical science.”

How the book came into being tells us a lot about the writer. When Mukherjee was training in cancer medicine, one of his patients, Carla Reed, a 30-year-old kindergarten teacher from Massachusetts, suffering from abdominal cancer, told him: “I’m willing to go on with what I’m battling, but I need to know what it is. I need to know it - I need to know its history.”

Mukherjee’s book opens with the story of Carla, who he keeps returning to during the course of his tome. On the morning of May 19, 2004, Carla had woken up with a headache. “Not just any headache,” she would recall later, “but a sort of numbness in my head. The kind of numbness that instantly tells you that something is terribly wrong.”

“I heard about Carla’s case on a train. The sentence that flickered on my beeper had the staccato and deadpan force of a true medical emergency: ‘Carla Reed/New patient with leukaemia/14th Floor/Please see as soon as you arrive’.”

In his book, Mukherjee describes cancer as an “all-consuming presence in our lives”.

“It invaded our imaginations; it occupied our memories; it infiltrated every conversation, every thought. And if we, as physicians, found ourselves immersed in cancer, then our patients found their lives virtually obliterated by the disease,” he writes.

His gripping prose prompted Mukherjee’s publisher, Scribner, to describe the book as a “magnificent, profoundly humane ‘biography’ of cancer... The book reads like a literary thriller with cancer as the protagonist.”

From the Persian Queen Atossa, whose Greek slave cut off her malignant breast, to the 19th century recipients of primitive radiation and chemotherapy to Mukherjee’s own patient, Carla, the book is about the people who have waged inspiring battles against cancer.

Mukherjee writes: “To confront cancer is to encounter a parallel species - one perhaps more adapted to survival than even we are. This image of cancer as our desperate, malevolent, contemporary doppelganger - is so haunting because it is at least partially true. A cancer cell is an astonishing perversion of a normal cell. Cancer is such a phenomenally successful invader and coloniser in part because it exploits the very features that make us successful as a species or an organism.”

Mukherjee (40) works at Columbia University Medical Centre in New York City, where he lives with his wife and two daughters.

Mukherjee has read the works of many poets, most notably but perhaps less ironically given his Bengali roots, Rabindranath Tagore. After school, he went on to major in biology at Stanford University in California and then won a Rhodes Scholarship to Oxford University. After graduation, Mukherjee trained as an internist at Harvard Medical School. His father, Sibeswar, was a manager for Mitsubishi and his mother, Chandana, a schoolteacher.

He believes there is no silver bullet cure for cancer. “But, that said, one shouldn’t be nihilistic about it. There will be many, many advances which will, you know, convert cancers into chronic diseases,” he added.

Mukherjee wrote most of his book in bed. “Instead of saying ‘I’ll get up every day at 5:30’ or, ‘I’ll write from 9 to 12,’ I did the complete opposite,” he told the New York Times. “I said: ‘I will write during the day for five minutes, 10 minutes, whatever. I’ll write in stretches until the book is done.”

With his literary success, Mukherjee joins Atul Gawande, another Indian-American physician and best-selling author.

Mukherjee believes writing the book has been the kind of experience that makes him a better doctor. “One of the most important things that the book made me realise is the narrative aspect of medicine. And if you stop hearing a story, the fundamental activity of medicine will change,” he said in an interview.

Will Mukherjee be a one-book wonder? Only time will tell. For now the author is content to return to his work. We will have to wait to find that out. Second book is still a long way away, he admits. 

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