The Emperor of All Maladies, by Siddhartha Mukherjee

The Emperor of All Maladies: A Biography of Cancer, by Siddhartha Mukherjee.  Scribner, 2010.  571 pp.  978-1-4391-0795-9.

... in which we learn of the history of oncology.

This book was one of the most highly praised non-fiction works of 2010; it made numerous top ten lists made by respectable sources, and its author went home with the 2010 Pulitzer Prize for non fiction.  As such, I went in with high expectations.

Written by a doctor who is both a practicing oncologist and a cancer researcher, the book has two separate narratives woven together.  The dominant thread is the story of how scientists' understanding of cancer has evolved.  Beginning with the ancient Egyptians, and moving through time all the way up to current medical practices, Mukherjee does a nice job of showing not only how oncology has evolved, but also how medicine as a whole has changed in the last 4000 years.  In some parts, he focuses on the people who were behind each breakthrough or new practice, and in other parts, he focuses on the science itself.  I haven't had any classes remotely resembling molecular or cell biology since I was in high school, but I found the science parts to be really clearly laid out for readers who are not biologists or doctors by training.

The second thread involves Mukherjee's own patients.  Stories of them are woven into the main narrative, showing how some of them have benefited hugely from centuries of dedicated research, and how scientific knowledge has fallen short for other patients.  Human anecdotes are usually easier reading than scientific history, and in this case, Mukherjee's personal recollections did a nice job of breaking up the long science passages and reminding the reader of the reason for all of the work on the part of scientists and researchers.

My Sister's Keeper by Jodi Picoult

I don't know what I was expecting from this book, other than I knew it was popular and the premise sounded interesting. It is not really the kind of thing I normally read, but I liked it more or less.


My Sister's Keeper is about a 13 year old girl, Anna, who was conceived using Preimplantation Genetic Diagnosis to be a donor match for her sister, who has had leukemia since age two. The book is mostly about Anna's legal attempt to get medical emancipation from her parents, because she claims they are failing to make decisions based on her best interest. She is frustrated because her entire life has been defined by donating marrow and other bits of her body to her sister.

The book is written from several perspectives including that of Anna, her delinquent brother, each of her parents, and others involved in her case. The tone and voice for each is all pretty much the same, and the stories of the point of view characters are too intertwined for this to be a really effective narration style, in my opinion. Plus, they change the font for different characters. Distracting much?

The book does not add much-needed depth to Anna or her family. They all seem pretty much one-dimensional, with the possible exception of her mother who vacillates between incredibly callous and mean to a perfectly normal sounding mother. Other characters' personalities are not very well fleshed out. I think writing from the perspective of a 13 year old must be remarkably challenging. Picoult fails by making her sound alternately like an incredibly thoughtful adult and really, really juvenile.

All of the characters go back and forth between the present-day trial to random reflections on their past. There are countless recollections from Anna and her brother that boil down to something like "when I was 10 my parents forgot about me because all they care about is my sister's leukemia." Or something. It was annoying when things were actually happening in the book to be switching between the present and past and between characters. It made it seem like Picoult was being paid by the word. Or maybe by the analogy. The characters all provided enough cheesy analogies and shallow metaphors that the only reasonable explanation is Picoult got paid a bonus for each one!

Considering the premise of the book, one gaping hole was the lack of any explanation of the relationship between Anna and her sister. It was almost never mentioned, except "Kate wouldn't let me choose the music we listened to" type complaints from Anna. After finishing the book, I feel like their relationship was left out in an attempt to mislead the reader about the nature of the relationship, leading up to a pair of remarkably contrived twists towards the end of the book.

One of those twists is pretty much the biggest trope of a way to end a story ever. I don't want to completely give it away, but it sucks. The ending of this book sucks balls.

This book was frustrating in several ways but what ultimately redeems it is its study of modern medicine's morality and the contradictions and conundrums it can cause. I am sure there are better fiction and nonfiction takes on this issue, but this books has its own perspective that adds some value. It definitely has me thinking about depressing things like leukemia and organ donation!

Everything Changes, by Kairol Rosenthal

Everything Changes: The Insider's Guide to Cancer in Your 20s and 30s, by Kairol Rosenthal. John Wiley & Sons, 2009. 247 pp. 978-0-470-394902-4.

...in which we hear stories from a variety of young adults on various topics related to cancer in young adulthood.

This is a book I read over a year ago, when it was first released. I'm reviewing it now because a) the last few weeks have been really busy for me and I haven't had time to get any new books finished up and b) it's a useful book, if you are in a position to take advantage of its advice.

Useful (or not so useful) statistic: there are roughly 70,000 adolescents and young adults diagnosed with cancer every year in the United States. Despite this, cancer remains a family of diseases that most people associate with old people, middle aged women, or young children. When the available support groups and advocacy groups are either geared towards children, the elderly, or pink-ribboned-women, it's easy for older teens and young adults to get lost somewhere in the middle. Kairol Rosenthal, the author of this book, traveled around the US to hear the stories of young people with cancer, in order to fill this void.

The book is divided into chapters representing different relevant topics. Each chapter is dominated by one person's story with a different focus. Rosenthal follows each story with a list of resources pertinent to that chapter's topic. The different topics addressed include financial issues and insurance, religion and spirituality, love and sex, fertility and family, employment and careers, mortality, optimism, etc, each presented in a unique context by someone between the ages of 20 and 39.

It is a credit to Rosenthal that she chose to present each person's story in their own words, editing them only for the purposes of length. I think a lot would have been lost if the stories were paraphrased; reading each story with that person's unique style of storytelling gave it a much more personal feel. Many of the stories aren't easy to read; a lot of these people fell through the cracks of the modern medical system. Because they were young and otherwise seemingly healthy, their doctors would initially assume that these young adults were imagining their symptoms and there wasn't anything really wrong with them. As a result, a lot of these people didn't catch their illness and didn't get treatment until it was too late. These are not always stories that are easy to read. These people are often angry and they don't pull their punches, though some maintain some level of optimism. Rosenthal waits til the end of the book to reveal which of her featured storytellers had passed away, and which of them continue to survive.

The strength of this book is really in the stories, but the advice that concludes each chapter is also really useful. She provides helpful links, organization contact info, and other resources that people can turn to for help in each topic presented. Some of the topics, like employment, money issues, sexuality, fertility, etc are going to be very different for people in young adulthood than for people in middle age or older.

I would recommend this book to just about anyone with an interest in cancer, or the modern medical system in America and its weaknesses. Even if you yourself have no personal connection to cancer, it's an interesting peek into an isolated subculture.

My Stroke of Insight by Jill Bolte Taylor, Ph.D.

In which the author enjoys, survives and recovers from a stroke.


Taylor was a brain scientist and activist for brain donation before she woke up and had a massive stroke. About a decade later, she was able to write this book about her complete experience from the perspective of a brain expert. I bought the book because it was on sale at the book store, looked interesting, and was something I don't normally read. I wasn't disappointed!

I think the most valuable insight Taylor offers is what it feels like to have a stroke. She described it vividly, from her first realization that something was seriously wrong to the recovery stages. More than what she feels or where she hurts, Taylor describes her thought processes as her brain freaks out. It is really fascinating! I obviously hope I never have to find out first hand, but she made the stroke itself sound like an incredible experience.

Taylor apparently wrote her book in an attempt to help other stroke victims. If people can figure out what is going wrong and get help quickly (more difficult than you might think!) when they have a stroke, it improves their outlook. Taylor also describes what factors helped (and impaired) her recovery in an attempt to improve the lives of other stroke victims.

What I didn't like about this book was where it delved in to what I would consider pseudo-science. It was very much reminiscent of the movie "What the Bleep" in a questionable blend of science and fantasy. For example, she continuously referred to people she didn't relate well to in her stroked condition as "energy vampires" because apparently they sucked the energy out of her brain. Okay. The last few chapters of the book focus extensively on visualizing stuff to make your brain cells work better. Meh. And thinking about things to improve all kinds of bodily functions. Blah. Not the type of fantasy I enjoy reading.

I would recommend this book, although I wish I could redact chapters 16 through 20. They were just a waste of time. I greatly enjoyed the first 15 chapters though. I would not hesitate to recommend this book to someone who was close to a stroke victim, or was otherwise curious, particularly if they had a higher tolerance for pseudo science than I do.