The Emperor of All Maladies
22 Even tuberculosis: Edgar Sydenstricker, “Health in the New Deal,” Annals of the American Academy of Political and Social Science 176, Social Welfare in the National Recovery Program (1934): 131–37.
22 The life expectancy of Americans: Lester Breslow, A Life in Public Health: An Insider’s Retrospective (New York: Springer, 2004), 69. Also see Nicholas D. Kristof, “Access, Access, Access,” New York Times, March 17, 2010.
22 Hospitals proliferated: Rosemary Stevens, In Sickness and in Wealth (New York: Basic Books, 1989), 204, 229.
22 As one student observed: Temple Burling, Edith Lentz, and Robert N. Wilson, The Give and Take in Hospitals (New York: Putnum, 1956), 9.
22 Lulled by the idea of the durability: From Newsweek and Time advertisements, 1946–48. Also see Ruth P. Mack, “Trends in American Consumption,” American Economic Review 46, no. 2, (1956):55–68.
23 “illness” now ranked third: Herbert J. Gans, The Levittowners: Ways of Life and Politics in a New Suburban Community (New York: Alfred A. Knopf), 234.
23 Fertility rose steadily: Paul S. Boyer et al., The Enduring Vision: A History of the American People (Florence, KY: Cengage Learning, 2008), 980.
23 The “affluent society”: John Kenneth Galbraith, The Affluent Society (New York: Houghton Mifflin, 1958).
23 In May 1937: “Cancer: The Great Darkness,” Fortune, May 1937.
24 In 1899, when Roswell Park: Robert Proctor, Cancer Wars: How Politics Shapes What We Know and Don’t Know About Cancer (New York: Basic Books, 1995), 20.
24 Smallpox was on the decline: K. A. Sepkowitz, “The 1947 Smallpox Vaccination Campaign in New York City, Revisited,” Emerging Infectious Diseases 10, no. 5 (2004): 960–61. Also see D. E. Hammerschmidt, “Hands: The Last Great Smallpox Outbreak in Minnesota (1924–25),” Journal of Laboratory and Clinical Medicine 142, no. 4 (2003): 278.
24 Between 1900 and 1916: Lucius Duncan Bulkley, Cancer and Its Non-Surgical Treatment (New York: W. Wood & Co., 1921).
24 By 1926, cancer: Proctor, Cancer Wars, 66.
24 In May that year, Life: “U.S. Science Wars against an Unknown Enemy: Cancer,” Life, March 1, 1937.
24 When cancer appeared: “Medicine: Millions for Cancer,” Time, July 5, 1937; “Medicine: After Syphilis, Cancer,” Time, July 19, 1937.
24 American Association for Cancer Research: “AACR: A Brief History,” http://www.aacr.org/home/about-us/centennial/aacr-history.aspx (accessed January 4, 2010).
25 from 70,000 men and women in 1911: “A Cancer Commission,” Los Angeles Times, March 4, 1927.
25 Neely asked Congress: 69th Cong., 2nd sess., Congressional Record, 68 (1927): p3 2922.
25 Within a few weeks: Richard A. Rettig, Cancer Crusade: The Story of the National Cancer Act of 1971 (Lincoln, NE: Author’s Choice Press, 1977), 44.
25 In June, a joint Senate-House conference: “National Cancer Act of 1937,” Office of Government and Congressional Relations, Legislative History, http://legislative.cancer.gov/history/1937 (accessed November 8, 2009).
25 An advisory council of scientists: Shimkin, “As Memory Serves,” 559–600.
26 “The nation is marshaling its forces”: Congressional Record, appendix 84:2991 (June 30, 1939); Margot J. Fromer, “How, After a Decade of Public & Private Wrangling, FDR Signed NCI into Law in 1937,” Oncology Times 28 (19): 65–67.
26 The U.S. Marine Hospital: Ora Marashino, “Administration of the National Cancer Institute Act, August 5, 1937, to June 30, 1943,” Journal of the National Cancer Institute 4: 429–43.
26 “mostly silent”: Shimkin, “As Memory Serves,” 599–600.
26 “programmatic response to cancer”: Ibid.
26 “a nice quiet place out here in the country”: Ibid.
26 In the early 1950s, Fanny Rosenow: Jimmie C. Holland and Sheldon Lewis, The Human Side of Cancer (New York: Harper Collins, 2001).
26 In 1946–47, Neely and Senator Claude Pepper: See House Foreign Affairs Committee, House Report 2565, 79th Cong., 2nd sess. Also see Report 1743 to the 79th Cong., 2nd sess., July 18, 1946; “Could a ‘Manhattan Project’ Conquer Cancer?” Washington Post, August 4, 1946.
27 “Leukemia,” as one physician put it: J. V. Pickstone, “Contested Cumulations: Configurations of Cancer Treatments through the Twentieth Century,” Bulletin of the History of Medicine 81, no. 1 (2007): 164–96.
27 If leukemia “belonged” anywhere: Grant Taylor, Pioneers in Pediatric Oncology (Houston: University of Texas M. D. Anderson Cancer Center, 1990).
28 half a pound of chicken liver: George Washington Corner, George Hoyt Whipple and His Friends: The Life-Story of a Nobel Prize Pathologist (Philadelphia: Lippincott, 1963), 187.
28 regurgitated gastric juices: Taylor, Pioneers in Pediatric Oncology, 29; George R. Minot, “Nobel Lecture: The Development of Liver Therapy in Pernicious Anemia,” Nobel Lectures, Physiology or Medicine, 1922–1941 (Amsterdam: Elsevier Publishing Company, 1965).
28 spiced up with butter, lemon, and parsley: Francis Minot Rackemann, The Inquisitive Physician: The Life and Times of George Richards Minot (Cambridge: Harvard University Press, 1956), 151.
28 Minot and his team of researchers: George R. Minot and William P. Murphy, “Treatment of Pernicious Anemia by a Special Diet,” Journal of the American Medical Association, 87 (7): 470–76.
28 conclusively demonstrated in 1926: Minot, “Nobel Lecture.”
28 In 1934, Minot and two of his colleagues: Ibid.
28 in the cloth mills of Bombay: Lucy Wills, “A Biographical Sketch,” Journal of Nutrition 108 (1978), 1379–83.
28 In 1928, a young English physician named Lucy Willis: H. Bastian, “Lucy Wills (1888–1964): The Life and Research of an Adventurous Independent Woman,” Journal of the Royal College of Physicians of Edinburgh 38:89–91.
28 Wills factor: Janet Watson and William B. Castle, “Nutritional Macrocytic Anemia, Especially in Pregnancy: Response to a Substance in Liver Other Than That Effective in Pernicious Anemia,” American Journal of the Medical Sciences 211, no. 5 (1946): 513–30; Lucy Wills, “Treatment of ‘Pernicious Anaemia’ of Pregnancy and ‘Tropical Anaemia,’ with Special Reference to Yeast Extract as a Curative Agent,” British Medical Journal 1, no. 3676 (1931): 1059–64.
29 He called this phenomenon acceleration: Sidney Farber et al., “The Action of Pteroylglutamic Conjugates on Man,” Science 106, no. 2764 (1947): 619–21. Also see Mills et al., “Observations on Acute Leukemia in Children Treated with 4-Aminopteroylglutamic Acid,” Pediatrics 5, no. 1 (1950): 52–56.
30 In his long walks from his laboratory: Thomas Farber, interview with author, November 2007.
30 He had arrived in Boston in 1923: S. P. Gupta, “An Indian Scientist in America: The Story of Dr. Yellapragada Subbarao,” Bulletin of the Institute of Medicine (Hyderabad), 6, no. 2 (1976): 128–43.
31 In the 1920s, another drug company: Corner, George Hoyt Whipple, 188.
31 But in 1946, after many failed attempts: Gupta, “Indian Scientist in America.”
Farber’s Gauntlet
32 Throughout the centuries: William Seaman Bainbridge, The Cancer Problem (New York: Macmillan Company, 1914), 2.
32 The search for a way to eradicate this scourge: “Cancer Ignored,” Washington Post, August 5, 1946.
33 Robert Sandler: Biographical details were taken from an article in the Boston Herald, April 9, 1948, referred to in S. P. Gupta, “An Indian Scientist in America: The Story of Dr. Yellapragada Subbarao,” Bulletin of the Institute of Medicine (Hyderabad), 6, no. 2 (1976): 128–43; and S. P. Gupta, interview with author, January 2006. Sandler’s address in Dorchester and his father’s profession are from the Boston directory for 1946, obtained from the Boston Public Library. Sandler’s case (R.S.) is described in detail in Sidney Farber’s paper below.
33 Farber’s treatment of Robert Sandler: Sidney Farber, “Temporary Remissions in Acute Leukemia in Children Produced by Folic Acid Antagonist, 4-Aminopteroyl-Glutamic Acid (Aminopterin),” Ne
w England Journal of Medicine 238 (1948): 787–93.
34 The hospital staff voted: Robert Cooke, Dr. Folkman’s War: Angiogenesis and the Struggle to Defeat Cancer (New York: Random House, 2001), 113.
34 “tucked in the farthest recesses”: Joseph E. Murray, Surgery of the Soul: Reflections on a Curious Career (Sagamore Beach, MA: Science History Publications, 2001), 127.
34 “let them die in peace”: Robert D. Mercer, “The Team,” in “Chronicle,” Medical and Pediatric Oncology 33 (1999): 405–10.
34 “By that time, the only chemical”: Thomas Farber, interview with author.
35 His small staff was housed: Taylor, Pioneers in Pediatric Oncology, 88.
35 Farber’s assistants sharpened their own: Mercer, “The Team.”
35 Two boys treated with aminopterin: Farber, “Temporary Remissions in Acute Leukemia,” 787–93.
35 Another child, a two-and-a-half-year-old: Ibid.
35 By April 1948, there was just enough data: Ibid
36 “with skepticism, disbelief, and outrage”: Denis R. Miller, “A Tribute to Sidney Farber—the Father of Modern Chemotherapy,” British Journal of Haematology 134 (2006): 20–26.
36 “The bone marrow looked so normal”: Mercer, “The Team.”
A Private Plague
37 We reveal ourselves: Stephen Jay Gould, Full House: The Spread of Excellence from Plato to Darwin (New York: Three Rivers Press, 1996), 7.
37 Thus, for 3,000 years and more: “Cancer: The Great Darkness,” Fortune, May 1937.
37 Now it is cancer’s turn: Susan Sontag, Illness as Metaphor and AIDS and Its Metaphors (New York: Picador, 1990), 5.
38 John Keats involuting silently: “John Keats,” Annals of Medical History 2, no. 5 (1930): 530.
38 “Death and disease are often beautiful”: Sontag, Illness as Metaphor, 20.
38 “in every possible sense, a nonconformist”: Sherwin Nuland, How We Die: Reflections on Life’s Final Chapter (New York: Vintage Books, 1995), 202.
39 Edwin Smith papyrus: James Henry Breasted, The Edwin Smith Papyrus: Some Preliminary Observations (Paris: Librairie Ancienne Honoré Champion, Edward Champion, 1922); also available online at http://www.touregypt.net/edwinsmithsurgical.htm (accessed November 8, 2009).
40 Imhotep case forty-five: Breasted, Edwin Smith Papyrus. Also see F. S. Boulos. “Oncology in Egyptian Papyri,” in Paleo-oncology: The Antiquity of Cancer, 5th ed., ed. Spyros Retsas (London: Farrand Press, 1986), 36; and Edward Lewison, Breast Cancer and Its Diagnosis and Treatment (Baltimore: Williams and Walkins, 1955), 3.
41 A furious febrile plague: Siro I. Trevisanato, “Did an Epidemic of Tularemia in Ancient Egypt Affect the Course of World History?” Medical Hypotheses 63, no. 5 (2004): 905–10.
41 leaving its telltale pockmarks: Sergio Donadoni, ed., The Egyptians (Chicago: University of Chicago Press, 1997), 292.
41 Tuberculosis rose and ebbed: Reddy D. V. Subba, “Tuberculosis in Ancient India,” Bulletin of the Institute of Medicine (Hyderabad) 2 (1972): 156–61.
41 In his sprawling Histories: Herodotus, The Histories (Oxford: Oxford University Press, 1998), pt. VIII.
43 At the Chiribaya site: Arthur Aufderheide, The Scientific Study of Mummies (Cambridge: Cambridge University Press, 2003), 117; Arthur Aufderheide, interview with author, March 2009. Also see Cambridge Encyclopedia of Paleopathology (Cambridge: Cambridge University Press, 1998), 300
43 In 1914, a team: J. L. Miller, “Some Diseases of Ancient Man,” Annals of Medical History 1 (1929): 394–402.
43 Louis Leakey, the archaeologist: Mel Greaves, Cancer: The Evolutionary Legacy (Oxford: Oxford University Press, 2000).
44 “The early history of cancer”: Aufderheide, interview with author, 2009.
44 A leprosy-like illness: Boris S. Ostrer, “Leprosy: Medical Views of Leviticus Rabba,” Early Science and Medicine 7, no. 2 (2002): 138–54.
44 The risk of breast cancer: See, for instance, “Risk Factors You Can’t Control,” Breastcancer.org, www.breastcancer.org/risk/everyone/cant_control.jsp (accessed January 4, 2010). Also see Report No. 1743, International Cancer Research Act, 79th Cong., 2nd Sess.; and “U.S. Science Wars against an Unknown Enemy: Cancer,” Life, March 1, 1937.
45 “captain of the men of death”: William Osler and Thomas McCrae, The Principles and Practice of Medicine: Designed for the Use of Practitioners and Students of Medicine, 9th ed. (New York: D. Appleton and Company, 1921), 156.
45 Cancer still lagged: Report No. 1743, International Cancer Research Act.
45 By the early 1940s, cancer: Life, March 1, 1937, 11.
45 life expectancy among Americans: Shrestha et al., “Life Expectancy in the United States,” CRS Report for Congress, 2006. Also see Lewison, Breast Cancer.
Onkos
46 Black bile without boiling: Jeremiah Reedy, “Galen on Cancer and Related Diseases,” Clio Medica 10, no. 3 (1975): 227.
46 We have learned nothing: Francis Carter Wood, “Surgery Is Sole Cure for Bad Varieties of Cancer,” New York Times, April 19, 1914.
46 It’s bad bile: Mel Greaves, Cancer: The Evolutionary Legacy (Oxford: Oxford University Press, 2000), 5.
46 In some ways disease: Charles E. Rosenberg, “Disease in History: Frames and Framers,” Milbank Quarterly 67 (1989) (suppl. 1, Framing Disease: The Creation and Negotiation of Explanatory Schemes): 1–2.
47 Later writers, both doctors and patients: See, for instance, Henry E. Sigerist, “The Historical Development of the Pathology and Therapy of Cancer,” Bulletin of the New York Academy of Medicine 8, no. 11 (1932): 642–53; James A. Tobey, Cancer: What Everyone Should Know about It (New York: Alfred A. Knopf, 1932).
48 “Of blacke cholor”: Claudius Galen, Methodus Medendi, with a Brief Declaration of the Worthie Art of Medicine, the Office of a Chirgion, and an Epitome of the Third Booke of Galen, of Naturall Faculties, trans. T. Gale (London: Thomas East, 1586), 180–82.
49 “best left untreated”: Emile Littré’s translation of the Hippocratic oath, Oeuvres complètes d’Hippocrate, bk. VI, aphorism 38. Von Boenninghausen, Homeopathic Recorder, vol. 58, nos. 10, 11, 12 (1943). Also see http://classics.mit.edu/Hippocrates/aphorisms.6.vi.html and http://julianwinston.com/archives/periodicals/vb_aphorisms6.php.
49 “Do not be led away and offer”: George Parker, The Early History of Surgery in Great Britain: Its Organization and Development (London: Black, 1920), 44.
49 “Those who pretend”: Joseph-François Malgaigne, Surgery and Ambroise Paré (Norman: University of Oklahoma Press, 1965), 73.
49 Ambroise Paré described charring tumors: See, for instance, “The History of Hemostasis,” Annals of Medical History 1 (1): 137; Malgaigne, Surgery and Ambroise Paré, 73, 181.
49 “Many females can stand the operation”: See Lorenz Heister, “Van de Kanker der boorsten,” in H. T. Ulhoorn, ed., Heelkundige onderwijzingen (Amsterdam, 1718), 2: 845–856; also quoted in James S. Olson, Bathsheba’s Breast: Women, Cancer, and History (Baltimore: Johns Hopkins University Press, 2002), 50.
50 The apothecary: See, for instance, William Seaman Bainbridge, The Cancer Problem (New York: Macmillan Company, 1914).
Vanishing Humors
51 Rack’t carcasses: John Donne, “Love’s Exchange,” Poems of John Donne, vol. 1, ed. E. K. Chambers (London: Lawrence & Bullen, 1896), 35–36.
51 “Aside from the eight muscles”: Andreas Vesalius, The Fabric of the Human Body [De Fabrica Humani Corporis], trans. W. P. Hotchkiss, preface. See Sourcebook of Medical History (Mineola, NY: Dover, 1960), 134; and The Illustrations from the Works of Andreas Vesalius of Brussels (Mineola, NY: Dover, 1950), 11–13.
51 He needed his own specimens: Charles Donald O’Malley, Andreas Vesalius of Brussels, 1514–1564 (Berkeley: University of California Press, 1964).
52 “In the course of explaining the opinion”: “Andreas Vesalius of Brussels Sends Greetings to His Master and Patron, the Most Eminent and Illustrious Doctor Narcissus Parthenopeus, First Physician to His Impe
rial Majesty,” The Illustrations from the Works of Andreas Vesalius of Brussels, with annotations and translations by J. B. de C. M. Saunders and Charles D. O’Malley (Cleveland, OH: World Publishing Company, 1950), 233.
53 “as large as an orange”: Matthew Baillie, The Morbid Anatomy of Some of the Most Important Parts of the Human Body, 2nd American ed. (Walpole, NH: 1808), 54.
53 “a fungous appearance”: Ibid., 93.
53 “a foul deep ulcer”: Ibid., 209.
“Remote sympathy”
55 In treating of cancer: Samuel Cooper, A Dictionary of Practical Surgery vol. 1 (New York: Harper & Brothers, 1836), 49.
55 “If a tumor is not only movable”: John Hunter, Lectures on the Principles of Surgery (Philadelphia: Haswell, Barrington, and Haswell, 1839).
56 “I did not experience pain”: See a history of ether at http://www.anesthesia-nursing.com/ether.html (accessed January 5, 2010).
56 “It must be some subtle principle”: M. Percy, “On the Dangers of Dissection,” New Journal of Medicine and Surgery, and Collateral Branches of Science 8, no. 2 (1819): 192–96.
57 It “occurred to me”: Joseph Lister, “On the Antiseptic Principle in the Practice of Surgery,” British Medical Journal 2, no. 351 (1867): 246.
57 In August 1867, a thirteen-year-old: Ibid., 247.
58 In 1869, Lister removed a breast tumor: James S. Olson, Bathsheba’s Breast (Baltimore: Johns Hopkins University Press, 2002), 67.
58 Lister performed an extensive amputation: Edward Lewison, Breast Cancer and Its Diagnosis and Treatment (Baltimore: Williams and Walkins, 1955), 17.
58 “The course so far is already”: Harold Ellis, A History of Surgery (Cambridge: Cambridge University Press, 2001), 104.
59 Billroth’s gastrectomy: See Theodor Billroth, Offenes schreiben an Herrn Dr. L. Wittelshöfer, Wien Med Wschr (1881), 31: 161–65; also see Owen Wangensteen and Sarah Wangensteen, The Rise of Surgery (Minneapolis: University of Minnesota Press, 1978), 149.
59 Surgeons returned to the operating table: Owen Pritchard, “Notes and Remarks on Upwards of Forty Operations for Cancer with Escharotics,” Lancet 136, no. 3504 (1890): 864.
A Radical Idea