#Emperor

In part five of an Emperor of all Maladies, we learn about the discoveries that elucidated the mechanisms underlying the biology of cancer. Mukherjee starts the section with a reflection on his time as a medical oncology fellow, reminding the reader of the human costs of cancer as he and the other fellows reflect on the patients they have lost. We also get an update on his leukemia patient Carla, who is now in remission and through the worst of her treatments.

In part three of the Emperor of all Maladies, the treatment of cancer begins to shift from the previously seen extremes to being more patient centered. There is a rift in the field of surgery as surgeons such as Dr. Crile and Dr. Keynes begin to question the radical and disfiguring surgeries relied upon by an entire generation of surgeons to treat cancer.

The second part of Mukherjee’s compelling biography of cancer details the early stages of a war against cancer. The section begins by introducing a new protagonist in our story, Mary Lasker, the “fairy godmother” of cancer research. With friends in high places and an insatiable motivation to pour more money into battling diseases, she was the perfect teammate for Sydney Farber, who was looking to expand his own cancer research efforts.

The book begins with the story of Carla Reed, a 31-year-old kindergarten teacher and mother of three who experiences headaches, strange bruising, white gums, and exhaustion. The author learns about Carla as he is heading into work at Massachusetts General Hospital in Boston. His beeper informs him to see a patient with leukemia when he arrives. Leukemia, a cancer of the white blood cells, is “breathtaking” with regard to its pace and acuity. Ten months into his two-year fellowship in oncology, the author already feels drained and inured to the death around him.