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Siddhartha Mukherjee: the magic and mystery of the cell

In his latest book, oncologist Siddhartha Mukherjee focuses on our evolving understanding of the body’s smallest unit

The book focuses on the smallest, most basic unit of our being—the cell. (Getty Images)

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In 1929, A. Berry, reviewing a book written by G.H. Hardy, the mathematician who recognised S. Ramanujan’s mathematical genius and brought it to the attention of the world, observed, “he has shown in this book and elsewhere a power of being interesting, which is to my mind unequalled.”

I was reminded of these words several times while reading The Song Of The Cell: An Exploration Of Medicine And The New Human by oncologist and author Siddhartha Mukherjee. The book is informative, evocative, philosophical, awe-inspiring, but mostly it is so interesting that I found myself glued to it just to read a few pages more or find the answer to a question he had raised. Parts of the book, as they say while describing the best mystery novels, are “unputdownable”. The Song Of The Cell is science writing at its best in the hands of a master of the genre.

In his Pulitzer Prize-winning book, The Emperor Of All Maladies (2010), Mukherjee wrote about cancer, the search for cures and the idea of prevention, following it up in 2016 with The Gene: An Intimate History, where he gave us a biography of the master-code that shapes humans. Mukherjee now turns his attention to the smallest, most basic unit of our being which underpins all life—the cell.

 

Siddhartha Mukherjee.
Siddhartha Mukherjee. (Getty Images)

There is no one story of the cell and Mukherjee deals with this complexity and multiplicity by dividing the book into six sections. He begins with when and how the cell was discovered, telling us of the scientists, the rudimentary technology of the 1600s, and the circumstances that enabled the discovery.

Narrative and storytelling are Mukherjee’s particular gifts, and, as with his previous books, he breaks down complex ideas, explaining them in ways science books rarely do and painting a picture for the reader. While explaining the cell membrane or the boundary of a cell that has two layers of lipids (or fat molecules), he writes, “It is a lipid bilayer. Imagine, for a moment, two sheets of paper glued together back to back and then shaped into a three-dimensional object—a balloon say. If the balloon is the cell, then the two sheets of paper form the bilayered cell membrane.”

Threaded through these clear yet imaginative explanations are the somewhat philosophical musings on what a cell means in a being and what a “being” really is. These are questions he returns to throughout the book, for instance when talking about how “alien” entities are recognised and fought off by our body’s defence mechanisms, or how sometimes they are not recognised, as is the case in diseases like cancer, or how these defence mechanisms sometimes turn on the body, for instance when we suffer from an autoimmune disease. Photographs and illustrations (some beautifully done by the author himself) add to the richness of the experience of the book.

'The Song Of The Cell:  An Exploration Of Medicine And The New Human', by Siddhartha Mukherjee, Penguin Random House India,  624 pages,  <span class='webrupee'>₹</span>799.
'The Song Of The Cell: An Exploration Of Medicine And The New Human', by Siddhartha Mukherjee, Penguin Random House India, 624 pages, 799.

Part science history, part cell biology, part philosophy and part autobiography, the book weaves the tale of the tiny yet magnificent cell that organises itself to perform myriad functions in different parts of the body and the various types of cells that respond to external or internal stimuli—to grow, protect, repair, heal, and sometimes, even kill us. He gives us the story and science behind in vitro fertilisation as the beginning of our quest to create “better versions of ourselves”; the first blood transfusion; the first transplant; the first cases of AIDS, which is also a cellular disease, in 1979-80; the frustrations and the progress in controlling HIV and AIDS through the search for a vaccine; multi-drug therapy; and gene editing. Everything ultimately, he shows us, is about cellular therapies.

To read this book is to be caught up in the depth and range of the research and writing, but also to pause to consider what it means to me as a person made up of all these moving, living and so very vulnerable parts. The Song Of The Cell is imbued with surprising facts. Did you know, for instance, that the human retina and testes are less protected by our immune response, and, therefore, an infection in those parts does not normally generate a severe allergic reaction? Or that although the build-up of cholesterol in our arteries leads to a heart attack, it does not directly cause a heart attack by closing the path of the blood flow to the heart. Instead, it is our defence mechanism, our platelets, swarming to repair a broken bit of cholesterol fallen inside our arteries, that form a clot and jam up the artery, stopping the flow of blood and causing a heart attack.

Mukherjee said in an interview that he doesn’t like writing as if he does not exist. As a reader, I am very glad that he doesn’t and that his own experiences infuse the book. His enthusiasm as he looks at blood smears under the microscope every Monday morning before his patients arrive, noting the “number, colour, morphology, shape, size”, is infectious; his agony at losing his long-time friend to cancer is palpable and the description of his interaction with his patients is riveting—sometimes harrowing, yes, but always riveting. I was overwrought while reading about the man with liver failure who haemorrhaged so badly it was like a “spigot had opened in his guts”. After that experience, Mukherjee has never used “the word bloodbath casually”, a sentiment that I wholeheartedly echo after reading his description of the patient. Spoiler—I have to do this—the patient was stabilised.

 

Everything ultimately is about cellular therapies.
Everything ultimately is about cellular therapies. (Getty Images)

The fourth section of the book on covid-19, titled Pandemic, is only a few pages long but sits at the centre of this book on cell biology. In the face of the pandemic, everything we understood about cells had to be “rethought and dissected”. It is humbling to realise how few answers and explanations we have. Given how little we know and understand about SARS-CoV2, I realise that the section had to be short but I would have loved deeper insight into the pandemic through his lens.

The oncologist in Mukherjee then returns to “the cell capable of infinite rebirth: the cancer cell” and ends his song by looking into the future of medicine, and what it will mean for the cell, for individuals, and for the larger community.

This is a book about science and scientists, literature and poetry, philosophy and technology, but, taken together, it is a work of pure artistry that compels us to look at ourselves, and our humanity, in a whole new light.

Vandana Singh-Lal is pursuing her PhD in history of science at the Victoria University of Wellington, New Zealand, and is the author of So All Is Peace.

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