The Emperor of All Blog Entries

I keep coming back in my thoughts to the prologue of Guns, Germs, and Steel by Jared Diamond (1997) as a starting point; in a certain way, my intellectual starting point.  (By this I mean thinking about stuff outside of my specific training, formal education and day-to-day pursuits.)   It’s been a long time since I've read GG&S, but what I recall is that this exploration of apparent global Eurasian domination began with a simple line of questioning from a New Guinea native: Why (does the White Man have) so much stuff? When others, clearly as intelligent, resourceful and hard-working, have so little?  And need so little?  

There was something important in this book (for me); after all, it has stuck with me for 15 years or more.  It was exactly "my kind of book" in that it could have served as a text for a very interesting course as a non-major in a given discipline.  It provided lots to think about, but without the forced rigor of an academic tome.  At the very least it caused me to think, question, and appreciate certain aspects of my fortunate place in this world.  But practically, and specifically for my purposes here, it broadened my readings and made me an easy mark for gift-giving opportunities.  I've been the beneficiary, many times, of gift books that others might not choose to read.

Fast-forward 15 years or so; one of the Christmas presents I received in 2013 was, even by the giver’s admission, a little odd.  It was a book, a biography, of cancer; The Emperor of All Maladies, by Dr. Siddhartha Mukherjee (2010).  Perhaps a bit odd in a supposedly joyous season, but it was offered as a sharing of some interesting in-sight, from a beloved fellow scientist, and so worthy of my time and attention.

(Here, please allow me to interject a necessary statement of humility.  I’m not a writer; I don’t have full vesting in the issue of cancer; I'm not a doctor; I'm currently barely a scientist, and there's probably much in the book that I missed, misunderstood, or misinterpreted.  Anyone can choose to ignore anything here.  But my time with this book was, once again, an opportunity for me to mull some things over and make some tentative connections.)

I’ve let this one simmer for quite a while; In fact, I’ve barely read a book since I completed this one.  I’ve simply not been ready.  I’ve probably forgotten many of the details that were pertinent to my understanding of the disease, of the book, at the time.  But here’s what I know stuck:

• I’m getting older, and like all Americans, Cancer has become a bigger presence in my life.  Not personally (at the moment), but peripherally.  Closer and closer acquaintances and friends are being affected, with increasing frequency.  Knowledge may be power*; the book may simply represent a powerful defense against the fear of an ill fate.  Disease is, after all, biologically interesting.

• On page 116, the author observes that “I had recently noticed that events outside science…had something to do with the setting of science policy."  Like many scientists, I was fully mature before my blind faith in science let me realize this*.  Unlike many scientists, I accept this as truth.  I'm willing to embrace the importance of communication, education, outreach and relationships in advancing the proper use of science.  My scientific skills might be suffering; but I think I'm getting better at certain of these others.

• Medicine and surgery (and local social cliques, and so forth) are such closed “clubs” that they are difficult to change; change has to be initiated and accepted from within the circle.*     Medicine and surgery may represent an extreme, but we all have our clubs and circles; co-workers, partners, business groups, friends and family.   I’m just a single, little cog in each of mine, and I can only do so much.  Maybe I’d be more productive if I first made a little noise; and so if I were more influential within my circles.

• Is it really possible that the simple prevalence and universal social acceptance of smoking in the 50s and 60s masked its role in causing cancer and detriment to public health?  Is it possible for something so obviously obvious to be over-looked? For so long? By so many?  I 'm almost afraid to ask, "What are we over-looking at this very moment?"  

• … because I'm busy with an endeavor designed to protect the environment and public health; and many of my tools are designed to protect to the "one in a million" level of risk.  But about 1 in 3 Americans gets cancer in their allotted time.  So either we’re not effective; or there are other factors overwhelming our efforts (I think it’s the latter.)  And yet, if either scenario is the case (or even the accepted perception), wouldn’t scarce resources get a bigger bang for the buck if they were applied to those other (overwhelming) factors?  These are scary thoughts, especially from within.  And while there are many tangible benefits from programs such as mine, can I really claim to be "protective?"  Shouldn't I best line up these other benefits and tout them as successes should we ever awake to (or perceive) the evidence of the probabilistic health outcome of being a modern American?

• On page 307, the author discusses the importance of “resuscitation” for his patients.  This is not a literal resuscitation in the medical sense, but rather a recovery and re-integration into meaningful life for a patient, once the biggest dramas have passed.  Fortunately (from my perspective), he emphasizes process over outcome.  This has become a more common, recurring theme for me, and openness to this theme seems to be an important key; because, let’s face it, we can somewhat control our participation in a given process; but specific outcomes are often beyond our control. ^^^

So; Presence and Effort; whether it’s at work or C’s, dinner conversation or in the boat, this is my promise (and feel free to dope-slap me if I temporarily forget!)  I can’t promise specific results, but I can promise you my attention, efforts, and respect.  I can contribute positively (to the limits of my ability and resources) to our shared time and interests, but with no guarantees of a specific result.

*****

*I’ve been drafting this for many months, but as I near “completion”, I’ve just started reading another (Christmas 2014) gift book from the same  generous gifter.  And what do you know, the points noted above* seem to be the premise for this most recent gift (The Forgotten Half of Change by Luc de Brabandere.)

^^^It is very likely that this will be further explored a little later.