For Siddhartha Mukherjee, science is an art and art is a science, the two cultures married, literally and figuratively, in his life.
Mukherjee is an oncologist, medical researcher, and author of The Emperor of All Maladies: A Biography of Cancer (Scribner). He is married to an artist, MacArthur fellow Sarah Sze, and in comparing the challenges and satisfactions of their respective professions, he sheds light on his work running a research lab doing cutting-edge work in curing cancer. Art and science are "actually incredibly similar,” he says, seated in his office in New York Presbyterian's sprawling hospital complex in Upper Manhattan. "They are about risk taking and question asking.... You make a discovery and that generates another question.” And in both disciplines, "if you are not failing 99% of the time, then you are not doing something right.”
That process of making discoveries that generate still more questions—not to mention the 99% failure rate—are at the core of Mukherjee's new book, a tour de force of research, distillation, and synthesis tracing the search for a cure for a disease whose elusive causes and protean forms have tantalized and frustrated researchers for centuries.
With Emperor, Mukherjee joins an elite if unofficial club of physician-writers who give the lay person entrée into the cloistered world of research laboratories and also into the thoughts and feelings of the doctors who are often masked behind their expertise.
Born in Delhi, India, educated at Stanford, Oxford (as a Rhodes scholar), and Harvard Medical School, Mukherjee entered medicine because, he says, "it's the one place where every single piece of your emotional life, your scientific life, your rational being, your nonrational being, your everything comes together.” And working as both a clinician and researcher in oncology, he continues, is "the most challenging in every way, the cutting edge of technology and science,” but, he adds, also a source of "intense disappointment when that technology and science still doesn't work.”
Mukherjee's own research focuses on leukemia and on finding a new way of treatment by understanding the malignant cell not in isolation but in relation to what he calls its "home”: "The cancer cell doesn't live in a vacuum. It lives in a very specific environment [the bone marrow, in leukemia]—in fact, it modifies its environment very actively. So what we do in the laboratory is we try to design drugs that will not just eradicate cancer cells but will eradicate their homes.”
This high-tech approach, with its laser-sharp focus on the cell, is a far cry from the often bungled past approaches, recounted in The Emperor of Maladies, in which doctors stumbled upon chemicals that appeared to kill cancer cells or chemical and surgical treatments so extreme they seemed to destroy the body in order to save it. But it was a leukemia patient, not lab work, that inspired Mukherjee to write his book. Challenged by repeated relapses, this patient asked, " ‘Where are we going with all this?.... I need to understand what I am battling before I continue the battle.” Mukherjee was amazed to realize that "I couldn't point her to a single book that would answer her very simple question. What is she battling? How old is this? Where is all of this going? Not only in a microcosmic sense but also a macrocosmic sense. I thought this was a very weird vacuum.”
So Mukherjee began what he thought of as a small project, a journal, that mushroomed into a 10-year odyssey into cancer's past, present, and possible future. The story led him into unexpected corners of history, from textile dyes and mustard gas to the politics of medicine in 20th-century America. So grand was the sweep of the story, he says, that while he'd intended to "use history to understand cancer... by the end of the book it was as if I was using cancer to understand history.”
On the human level, though, The Emperor of Maladies is about the obsessive drive of doctors to find a cure for a relentless and vicious disease, a passion that echoes in Mukherjee's conversation and drives his work. As for his family life, with two young daughters of highly accomplished parents: "We have intense dinner conversations.... We love our work. So I think that's the environment. I don't think it's intensive, but I do think it's passionate.”