In his newest ebook, the oncologist and acclaimed author Siddhartha Mukherjee focuses his narrative microscope on the cell, the elementary constructing block from which advanced methods and life itself emerge. It is the coordination of cells that permit hearts to beat, the specialization of cells that create sturdy immune methods, and the firing of cells that kind ideas. “We need to understand cells to understand the human body,” Mukherjee writes. “We need them to understand medicine. But most essentially, we need the story of the cell to tell the story of life and of our selves.”
His account, The Song of the Cell, reads at instances like an artfully written biology textbook and at instances like a philosophical tract. Mukherjee begins with the invention of the microscope and the historic origins of cell biology, from which he dives into mobile anatomy. He examines the risks of international cells like micro organism, and of our personal cells once they misbehave, are hijacked, or fail. He then strikes into extra advanced mobile methods: blood and the immune system, organs, and the communication between cells. “The human body functions as a citizenship of cooperating cells,” he writes. “The disintegration of this citizenship tips us from wellness into disease.”
At every step, he’s cautious to attract a transparent line from the invention of mobile features to the therapeutic potential they maintain. “A hip fracture, cardiac arrest, immunodeficiency, Alzheimer’s dementia, AIDS, pneumonia, lung cancer, kidney failure, arthritis—all could be reconceived as the results of cells, or systems of cells, functioning abnormally,” Mukherjee writes. “And all could be perceived as loci of cellular therapies.”
Understanding how electrical currents have an effect on neurons, for instance, led to experiments utilizing deep mind stimulation to deal with temper issues. And T-cells, the “door-to-door wanderers” that journey by way of the physique and hunt for pathogens, are being skilled to struggle most cancers as medical doctors higher perceive how these wanderers discriminate between international cells and the “self.”
Mukherjee, who received a Pulitzer Prize for his 2010 ebook The Emperor of All Maladies, is a fascinating author. He skillfully picks out the human characters and the idiosyncratic historic particulars that can seize readers and maintain them by way of the drier technical sections. Take, as an example, his lengthy discourse on the beginner and educational scientists who toyed with early microscopes. Among descriptions of lenses and petty educational fights (some issues, it appears, are everlasting), Mukherjee provides the delectably lewd anecdote that within the seventeenth century, the Dutch dealer and microscope fanatic Antonie van Leeuwenhoek skilled his scopes on, amongst different issues, his personal semen and the semen of somebody contaminated with gonorrhea. In these samples, Leeuwenhoek noticed what he known as “a genital animalcule,” and what we now name spermatozoa, “moving like a snake or an eel swimming in water.”
Just as Mukherjee attracts clear connections between scientific discoveries and potential therapeutics, he additionally excels at exhibiting the excessive stakes of those remedies by drawing on case research and vivid examples from sufferers he’s seen over the course of his profession. There is Sam P., who jokes that his fast-moving most cancers will unfold by the point he walks to the toilet; and M.Okay., a younger man ravaged by a mysterious immune dysfunction, whose father trekked by way of the snow to Boston’s North End to purchase his son’s favourite meatballs and ferry them to the hospital.
And there may be Emily Whitehead, who, as a toddler, suffered from leukemia and whose cells are saved inside a freezer named after “The Simpsons” character Krusty the Clown. Some cells had been genetically modified to acknowledge and struggle off Whitehead’s illness. The success of that remedy, known as CAR-T, heralded a change in most cancers remedies and Whitehead turned the miraculously wholesome results of centuries of scientific inquiry. “She embodied our desire to get to the luminous heart of the cell, to understand its endlessly captivating mysteries,” Mukherjee writes. “And she embodied our aching aspiration to witness the birth of a new kind of medicine—cellular therapies—based on our deciphering the physiology of cells.”
As if forays into oncology, immunology, pathology, the historical past of science, and neurobiology weren’t sufficient, Mukherjee additionally will get to essentially huge questions concerning the ethics of mobile therapies, the which means of incapacity, perfectionism, and acceptance in a world the place all bodily options may be altered—and even the character of life itself. “A cell is the unit of life,” he writes. “But that begs a deeper question: What is ‘life?’i”
In some methods, the cell is the proper vessel during which to journey down these many winding, diverging, and intersecting paths. Cells are the location of some unimaginable tales of analysis, discovery, and promise, and Mukherjee offers himself ample room to analyze a various array of organic processes and interventions. But in attempting to embody every part that cells may be and do—each metaphorically and actually—Mukherjee finally ends up failing to totally discover these deep questions in a satisfying manner.
It doesn’t assist that he leans so closely on metaphor. The cell is a “decoding machine,” a “dividing machine,” and an “unfamiliar spacecraft.” He likens cells to “Lego blocks,” “corporals,” “actors, players, doers, workers, builders, creators.” T-cells alone are described as each a “gumshoe detective” and a “rioting crowd disgorging inflammatory pamphlets on a rampage.” Not to say the numerous cell metaphors Mukherjee quotes from others. Creating imagery readers can perceive is a useful a part of any science author’s playbook, however so many photos will also be distracting at instances.
The remaining part grapples with the implications of enhanced people who profit from mobile tinkering. These “new humans” aren’t cyborgs or individuals augmented with superpowers, Mukherjee clarifies. When introducing the concept on the outset of the ebook, he writes, “I mean a human rebuilt anew with modified cells who looks and feels (mostly) like you and me.” But by engineering stem cells in order that an individual with diabetes can produce their very own insulin or implanting an electrode within the mind of somebody struggling with melancholy, Mukherjee posits that we’ve modified them in some basic manner. Humans are a sum of their elements, he writes, however cell therapies cross a border, reworking individuals right into a “new sum of new parts.”
This part echoes a well-known philosophical thought experiment concerning the Ship of Theseus. Theseus left Athens in a picket ship that, over the course of a protracted journey, needed to be repaired. Sailors eliminated rotting wooden and changed the damaged oars. By the time the ship returned, not one of the authentic wooden remained. Philosophers have debated the character of the ship for hundreds of years: Is the repaired ship the identical because the one which left Athens or is it a brand new ship altogether?
The similar query may be requested of Mukherjee’s “new humans.” How many cells should be altered with a view to render us new? Do sure cells matter greater than others? Or do people possess some sort of inherent integrity—a conscience, a soul—that impacts these calculations?
Mukherjee by no means absolutely arrives at a solution, however his ebook’s title could allude to at least one, recalling Walt Whitman’s Song of Myself, an ode to the interconnectedness of beings. Mukherjee urges scientists to desert the “atomism” of inspecting solely remoted models—be they atoms, genes, cells—in favor of a complete method that appreciates the entire of a system, or of a being. “Multicellularity evolved, again and again, because cells, while retaining their boundaries, found multiple benefits in citizenship,” he writes. “Perhaps we, too, should begin to move from the one to the many.”
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Image Credit: Torsten Wittmann, University of California, San Francisco through NIH on Flickr