Last year, I read The Song of the Cell: An Exploration of Medicine and the New Human, also by Siddhartha Mukherjee. While I appreciated the ideas it explored, it didn’t leave quite the same impression. So I approached The Emperor of All Maladies somewhat cautiously, unsure of what to expect after a lukewarm experience with his more recent work. In hindsight, I’m so glad I picked it up. I’m already thinking about revisiting The Song of the Cell with fresh eyes and reading more of Mukherjee’s work.
An Emotional and Scientific Journey
This book is not always an easy read emotionally — cancer is a heavy, deeply human topic. In my undergraduate classes, I learned about the biology of cancer in a clinical, detached way: the mechanisms behind unchecked cell division, oncogenes, and tumour suppressors. But Mukherjee tells the story of cancer through people — patients, doctors, researchers — spanning centuries of history. That perspective made for a much more emotionally powerful and compelling read than any textbook ever could.
Despite the heaviness of the subject, I found the narrative easier to absorb as I read on. Bit by bit, it became not just manageable, but fascinating — and ultimately unforgettable.
The Biography of a Disease
As a “biography” of cancer, the book traces its history from ancient times — when black bile and humoral theory dominated medical thinking — to modern treatments rooted in rigorous scientific research.
Along the way, Mukherjee introduces us to some remarkable historical figures. One that stood out to me was William Halsted — a brilliant but troubled surgeon who pioneered the radical mastectomy. He used himself as a test subject while experimenting with cocaine as an anesthetic, inadvertently becoming addicted. To treat his addiction, he turned to morphine. That says a lot about how little we understood addiction at the time.
Halsted's surgeries were brutal: removing not just the breast, but also the pectoral muscles, lymph nodes, and even parts of the bone in hopes of eradicating cancer. These operations were often unsuccessful, but became standard practice nonetheless. Mukherjee captures the painful irony of this era well — a time when doctors knew that they were often doing harm, but felt they had no choice.
The Birth of Chemotherapy
The book’s account of early chemotherapy is equally compelling. The VAMP trials — a combination of four drugs used to treat childhood leukemia — were especially controversial. Patients often became gravely ill from the treatment itself, and many did not survive. But the thinking behind these trials was groundbreaking: using a multi-drug approach, inspired by bacterial infections, to prevent the cancer from developing resistance. Despite early skepticism, these trials were ultimately successful and helped establish the foundation for modern combination chemotherapy.
Mukherjee also recounts the story of Ella, one of the first survivors of the VAMP trials in the 1960s. Meeting her decades later was incredibly moving — a living testament to the impact of scientific progress.
Farber, “Jimmy,” and the War on Cancer
Another striking part of the book was the story of Sidney Farber and the Jimmy Fund campaign — one of the earliest and most significant public fundraising efforts for cancer research. “Jimmy,” though a fictionalized name, became the symbol of the fight against cancer, inspiring donations across the country.
Farber’s clinic itself was described as part hospital, part Disneyland — a hopeful place for children facing the most terrifying diagnoses, and a strange but inspiring contrast to the sterile wards of the time.
Industry, Cigarettes, and the Politics of Health
Mukherjee also delves into the public health fight against smoking. He details how the tobacco industry worked to suppress evidence linking cigarettes to cancer — a battle that was eventually won through science, policy, and persistent advocacy. Legislation banning cigarette ads and requiring health warnings on packages helped dramatically reduce smoking rates and, in turn, the incidence of lung cancer.
Science, Drugs, and Hope
From the discovery of hormone therapies and the use of drugs like methotrexate and cisplatin, to the conceptual leap that cancer is not one disease but many, Mukherjee carefully explains complex biology without ever losing sight of the human stories behind it.
That balance is what makes this book so exceptional: it’s deeply researched, scientifically thorough, and yet completely accessible. You don’t need a biology degree to be moved, informed, or captivated.
Final Thoughts
The Emperor of All Maladies is a phenomenal work of nonfiction — intellectually rich, emotionally powerful, and incredibly well-written. It covers an enormous amount of ground, yet never feels overwhelming. For me, it redefined what a popular science book can be.
Whether you have a background in science or just an interest in the human story behind medicine, I can’t recommend this book highly enough. It’s one of the best books I’ve read, full stop.
WOW
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