The Emperor of All Maladies
101 Sidney Farber’s entire purpose: Medical World News, November 25, 1966.
101 “One assistant and ten thousand mice”: George E. Foley, The Children’s Cancer Research Foundation: The House That “Jimmy” Built: The First Quarter-Century (Boston: Sidney Farber Cancer Institute, 1982).
101 “Most of the doctors”: Name withheld, a hospital volunteer in the 1950s to 1960s, interview with author, May 2001.
102 In 1953, when the Braves franchise left: “Braves Move to Milwaukee; Majors’ First Shift since ’03,” New York Times, March 19, 1953.
102 the Jimmy Fund planned a “Welcome Home, Ted” party: “Dinner Honors Williams: Cancer Fund Receives $150,000 from $100-Plate Affair,” New York Times, August 18, 1953.
102 Funds poured in from: Foley, Children’s Cancer Research Foundation.
102 “You can take the child out of the Depression”: Robin Pogrebin and Timothy L. O’Brien, “A Museum of One’s Own,” New York Times, December 5, 2004.
103 “If a little girl got attached to a doll”: “Medicine: On the Track,” Time, January 21, 1952.
103 “Once I discover that almost all”: Jeremiah Goldstein, “Preface to My Mother’s Diary,” Journal of Pediatric Hematology/Oncology 30, no. 7 (2008): 481–504.
104 “Acute leukemia,” he wrote: Sidney Farber, “Malignant Tumors of Childhood,” CA: A Cancer Journal for Clinicians (1953): 3, 106–7.
104 The money that he had raised: Sidney Farber letter to Mary Lasker, August 19, 1955.
PART TWO:
AN IMPATIENT WAR
105 Perhaps there is only one cardinal sin: Franz Kafka, The Great Wall of China and Other Pieces (London: Secker and Warburg, 1946), 142.
105 The 325,000 patients with cancer: Sidney Farber, quoted in Guy B. Faguet, The War on Cancer: An Anatomy of Failure, a Blueprint for the Future (New York: Springer, 2005), 97.
“They form a society”
107 All of this demonstrates why: Michael B. Shimkin, “As Memory Serves—an Informal History of the National Cancer Institute, 1937–57,” Journal of the National Cancer Institute 59 (suppl. 2) (1977): 559–600.
107 I am aware of some alarm: Senator Lister Hill, “A Strong Independent Cancer Agency,” October 5, 1971, Mary Lasker Papers.
107 “Americans of all ages”: Alexis de Tocqueville, Democracy in America (New York, Penguin), 296.
108 a woman who “could sell”: Mary Lasker Oral History Project, Part 1, Session 1, p. 3, http://www.columbia.edu/cu/lweb/digital/collections/nny/laskerm/transcripts/laskerm_1_1_3.html.
109 In 1939, Mary Woodard met Albert Lasker: Ibid., p. 56.
109 “salesmanship in print”: Stephen R. Fox, The Mirror Makers: A History of American Advertising and Its Creators (New York: William Morrow, 1984), 51.
109 they were married just fifteen months after: Mary Lasker Oral History Project, Part 1, Session 3, p. 80.
110 “I am opposed to heart attacks and cancer”: J. Michael Bishop, “Mary Lasker and Her Prizes: An Appreciation,” Journal of the American Medical Association 294, no. 11 (2005): 1418–19.
111 “If a toothpaste”: Mary Lasker Oral History Project, Part 1, Session 7.
111 “the fairy godmother of medical research”: “The Fairy Godmother of Medical Research,” BusinessWeek, July 14, 1986.
111 In April 1943, Mary Lasker visited: Mary Lasker Oral History Project, Part 1, Session 5, p. 136, and Session 16, pp. 477–79.
111 The visit left her cold: Ibid., Session 16, pp. 477–79.
111 Of its small annual budget of: Ibid. Also see Mary Lasker interview, October 23, 1984, in Walter Ross, Crusade, the Official History of the American Cancer Society (Westminster, MD: Arbor House, 1987), 33.
111 “Doctors,” she wrote, “are not administrators”: Mary Lasker Oral History Project, Part 1, Session 7, p. 183.
112 In October 1943, Lasker persuaded a friend: Reader’s Digest, October 1945.
112 “My mother died from cancer”: Letter from a soldier to Mary Lasker, 1949.
112 Over the next months: Richard A. Rettig, Cancer Crusade: The Story of the National Cancer Act of 1971 (Lincoln, NE: Author’s Choice Press, 1977), 21.
112 “A two-pronged attack”: Letter from Cornelius A. Wood to Mary Lasker, January 6, 1949, Mary Lasker Papers, Box 210.
112 Albert Lasker . . . recruited Emerson Foote: Ibid.
112 The “Lay Group”: Letter from Mary Lasker to Jim Adams, May 13, 1945, Mary Lasker Papers.
112 In a single year, it printed 9 million: these numbers are culled from letters and receipts found in the Mary Lasker Papers.
113 “Ladies’ Garden Club”: Charles Cameron, Cancer Control, vol. 3, 1972.
113 “unjustified, troublesome and aggressive”: James T. Patterson, The Dread Disease: Cancer and Modern American Culture (Cambridge, MA: Harvard University Press, 1987), 173. Also see Rettig, Cancer Crusade, 22.
113 The society’s bylaws and constitution were rewritten: Letter from Frank Adair to ACS members, October 23, 1945.
113 “The Committee should not include”: Telegram from Jim Adams to Mary Lasker, 1947, Mary Lasker Papers.
113 “You were probably the first person”: Letter from Rose Kushner to Mary Lasker, July 22, 1988, Rose Kushner Papers, Harvard University.
114 “a penicillin for cancer”: “Doctor Foresees Cancer Penicillin,” New York Times, October 3, 1953.
114 By the early 1950s, she was regularly: See, for instance, letter from John R. Heller to Mary Lasker, October 15, 1948, Mary Lasker Papers, Box 119; and Memorandum on Conversation with Dr. Farber, February 24, 1952, Mary Lasker Papers, Box 76.
114 “scientific treatises”: Letter from Sidney Farber to Mary Lasker, August 19, 1955, Mary Lasker Papers, Box 170.
114 “An organizational pattern is developing”: Ibid.
115 a “regular on the Hill”: Robert Mayer, interview with author, July 2008.
115 “Put a tambourine in [his] hands”: Rettig, Cancer Crusade, 26.
115 “I have written to you so many times”: Letter from Sidney Farber to Mary Lasker, September 5, 1958.
“These new friends of chemotherapy”
116 The death of a man: Czeslaw Milosz, New and Collected Poems: 1931–2001 (New York: Ecco, 2001), 431.
116 I had recently begun to notice: K. E. Studer and Daryl E. Chubin, The Cancer Mission: Social Contexts of Biomedical Research (Newbury Park, CA: Sage Publications, 1980).
116 By February 1952, Albert was confined: Mary Lasker Oral History Project, Part 1, Session 9, p. 260.
116 “It seems a little unfair”: Letter from Lowel Cogeshall to Mary Lasker, March 11, 1952, Mary Lasker Papers, Box 76.
117 Albert Lasker died at eight o’clock: “A. D. Lasker Dies; Philanthropist, 72,” New York Times, May 31, 1952.
117 “We are at war with an insidious”: Senator Lister Hill, “A Strong Independent Cancer Agency,” October 5, 1971, Mary Lasker Papers, Columbia University.
119 “University professors who are opposed”: “Science and the Bomb,” New York Times, August 7, 1945.
120 Science the Endless Frontier: Vannevar Bush, Science the Endless Frontier: A Report to the President by Vannevar Bush, Director of the Office of Scientific Research and Development, July 1945 (Washington, DC: United States Government Printing Office, 1945).
121 The National Science Foundation (NSF), founded in 1950: Daniel S. Greenberg, Science, Money, and Politics: Political Triumph and Ethical Erosion (Chicago: University of Chicago Press, 2001), 167.
121 “long term, basic scientific research”: Ibid., 419.
121 “so great a co-ordination of medical scientific labor”: Stephen Parks Strickland, Politics, Science, and the Dread Disease: A Short History of the United States Medical Research Policy (Cambridge, MA: Harvard University Press, 1972), 16.
121 “Should I refuse my dinner”: Ernest E. Sellers, “Early Pragmatists,” Science 154, no. 3757 (1996): 1604.
121 The outspoken Philadelphia pathologist Stanle
y Reimann: Stanley Reimann, “The Cancer Problem as It Stands Today,” Transactions and Studies of the College of Physicians of Philadelphia 13 (1945): 21.
122 the Cancer Chemotherapy National Service Center: C. G. Zubrod et al., “The Chemotherapy Program of the National Cancer Center Institute: History, Analysis, and Plans,” Cancer Chemotherapy Reports 50 (1966): 349–540; V. T. DeVita, “The Evolution of Therapeutic Research in Cancer,” New England Journal of Medicine 298 (1978): 907–10.
122 Farber was ecstatic, but impatient: Letter from Sidney Farber to Mary Lasker, August 19, 1955, Mary Lasker Papers, Box 170.
122 One such antibiotic came from a rod-shaped microbe: Selman Waksman and H. B. Woodruff, “Bacteriostatic and Bacteriocidal Substances Produced by a Soil Actinomyces,” Proceedings of the Society for Experimental Biology and Medicine 45 (1940): 609.
122 Farber and actinomycin D: Sidney Farber, Giulio D’Angio, Audrey Evans, and Anna Mitus, “Clinical Studies of Actinomycin D with Special Reference to Wilms’ Tumor in Children,” Annals of the New York Academy of Science 89 (1960): 421–25.
123 “In about three weeks lungs previously riddled with”: Giulio D’Angio, “Pediatric Oncology Refracted through the Prism of Wilms’ Tumor: A Discourse,” Journal of Urology 164 (2000): 2073–77.
124 Sonja Goldstein’s recollections: Jeremiah Goldstein, “Preface to My Mother’s Diary,” Journal of Pediatric Hematology/Oncology 30, no. 7 (2008): 481–504.
“The butcher shop”
128 Randomised screening trials are bothersome: H. J. de Koning, “Mammographic Screening: Evidence from Randomised Controlled Trials,” Annals of Oncology 14 (2003): 1185–89.
128 The best [doctors] seem to have a sixth sense: Michael LaCombe, “What Is Internal Medicine?” Annals of Internal Medicine 118, no. 5 (1993): 384–88.
128 Emil Freireich and Emil Frei: John Laszlo, The Cure of Childhood Leukemia: Into the Age of Miracles (New Brunswick, NJ: Rutgers University Press, 1995), 118–20.
129 “I have never seen Freireich in a moderate mood”: Emil Frei III, “Confrontation, Passion, and Personalization,” Clinical Cancer Research 3 (1999): 2558.
129 Gordon Zubrod, the new director: Emil Frei III, “Gordon Zubrod, MD,” Journal of Clinical Oncology 17 (1999): 1331. Also see Taylor, Pioneers in Pediatric Oncology, 117.
130 Freireich came just a few weeks later: Grant Taylor, Pioneers in Pediatric Oncology (Houston: University of Texas M. D. Anderson Cancer Center, 1990), 117.
130 “Frei’s job,” one researcher recalled: Edward Shorter, The Health Century (New York: Doubleday, 1987), 192.
130 To avert conflicts: Andrew M. Kelahan, Robert Catalano, and Donna Marinucci, “The History, Structure, and Achievements of the Cancer Cooperative Groups,” (May/June 2000): 28–33.
131 “For the first time”: Robert Mayer, interview with author, July 2008. Also see Frei, “Gordon Zubrod,” 1331; and Taylor, Pioneers in Pediatric Oncology, 117.
131 Hill and randomized trials: Austin Bradford Hill, Principles of Medical Statistics (Oxford: Oxford University Press, 1966); A. Bradford Hill, “The Clinical Trial,” British Medical Bulletin 7, no. 4 (1951): 278–82.
132 “The analogy of drug resistance”: Emil Freireich, interview with author, September 2009.
132 The first protocol was launched: Emil Frei III et al., “A Comparative Study of Two Regimens of Combination Chemotherapy in Acute Leukemia,” Blood 13, no. 12 (1958): 1126–48; Richard Schilsky et al., “A Concise History of the Cancer and Leukemia Group B,” Clinical Cancer Research 12, no. 11, pt. 2 (2006): 3553s–55s.
133 “This work is one of the first comparative studies”: Frei et al., “Comparative Study of Two Regimens.”
134 “The resistance would be fierce”: Emil Freireich, personal interview.
134 a “butcher shop”: Vincent T DeVita, Jr. and Edward Chu, “A History of Cancer Chemotherapy,” Cancer Research 68, no. 21 (2008): 8643.
An Early Victory
135 But I do subscribe to the view: Brian Vastag, “Samuel Broder, MD, Reflects on the 30th Anniversary of the National Cancer Act,” Journal of the American Medical Association 286 (2001): 2929–31.
135 Min Chiu Li: Emil J. Freireich, “Min Chiu Li: A Perspective in Cancer Therapy,” Clinical Cancer Research 8 (2002): 2764–65.
136 Li and Ethel Longoria: Mickey Goulian, interview with author, September 2007.
136 “She was bleeding so rapidly”: Ibid.
137 Li and Hertz rushed to publish: M. C. Li, R. Hertz, and D. M. Bergenstal, “Therapy of Choriocarcinoma and Related Trophoblastic Tumors with Folic Acid and Purine Antagonists,” New England Journal of Medicine 259, no. 2 (1958): 66–74.
137 Li’s use of hcg level in chemotherapy: John Laszlo, The Cure of Childhood Leukemia: Into the Age of Miracles (New Brunswick, NJ: Rutgers University Press, 1995), 145–47.
137 In mid-July, the board summoned: Ibid.
137 “Li was accused of experimenting on people”: Emil Freireich, interview with author, September 2009.
138 When Freireich heard about Li’s dismissal: Laszlo, Cure of Childhood Leukemia, 145.
Mice and Men
139 A model is a lie that helps: Margie Patlak, “Targeting Leukemia: From Bench to Bedside,” FASEB Journal 16 (2002): 273E.
139 “Clinical research is a matter of urgency”: John Laszlo, The Cure of Childhood Leukemia: Into the Age of Miracles (New Brunswick, NJ: Rutgers University Press, 1995.
139 To test three drugs, the group insisted: Ibid., 142.
139 “The wards were filling up with these terribly sick children”: Emil Freireich, interview, September 2009.
139 Vincristine had been discovered in 1958: Norman R. Farnsworth, “Screening Plants for New Medicines,” in Biodiversity, ed. E. O. Wilson (Washington, DC: National Academy Press, 1988), 94; Normal R. Farnsworth, “Rational Approaches Applicable to the Search for and Discovery of New Drugs From Plants,” in Memorias del 1er Symposium Latinoamericano y del Caribe de Farmacos Naturales, La Habana, Cuba, 21 al 28 de Junio, 1980, 27–59 (Montevideo, Uruguay: UNESCO Regional Office Academia de Ciencias de Cuba y Comisión Nacional de Cuba ante la UNESCO).
140 “Frei and Freireich were simply taking drugs”: David Nathan, The Cancer Treatment Revolution (Hoboken, NJ: Wiley, 2007), 59.
140 A scientist from Alabama, Howard Skipper: Laszlo, Cure of Childhood Leukemia, 199–209.
141 Skipper emerged with two pivotal findings: See, for example, Howard E. Skipper, “Cellular Kinetics Associated with ‘Curability’ of Experimental Leukemias,” in William Dameshek and Ray M. Dutcher, eds., Perspectives in Leukemia (New York: Grune & Stratton, 1968), 187–94.
141 “Maximal, intermittent, intensive, up-front”: Emil Frei, “Curative Cancer Chemotherapy,” Cancer Research 45 (1985): 6523–37.
VAMP
143 If we didn’t kill the tumor: William C. Moloney and Sharon Johnson, Pioneering Hematology: The Research and Treatment of Malignant Blood Disorders—Reflections on a Life’s Work (Boston: Francis A. Countway Library of Medicine, 1997).
143 “I wanted to treat them with full doses of vincristine”: John Laszlo, The Cure of Childhood Leukemia: Into the Age of Miracles (New Brunswick, NJ: Rutgers University Press, 1995), 141.
143 “poison of the month”: Edward Shorter, The Health Century (New York: Doubleday, 1987), 189.
144 Farber, for one, favored giving one drug at a time: See David Nathan, The Cancer Treatment Revolution (Hoboken, NJ: Wiley, 2007), 63.
144 “Oh, boy,” Freireich recalled: Emil Freireich, interview with author, September 2009.
145 “You can imagine the tension”: Laszlo, Cure of Childhood Leukemia, 143.
145 First VAMP trial: E. J. Freireich, M. Karon, and E. Frei III, “Quadruple Combination Therapy (VAMP) for Acute Lymphocytic Leukemia of Childhood,” Proceedings of the American Association for Cancer Research 5 (1963): 20; E. Frei III, “Potential for Eliminating Leukemic Cells in Childhood Acute Leukemia,” Proceedings of the America
n Association for Cancer Research 5 (1963): 20.
145 “I did little things”: Laszlo, Cure of Childhood Leukemia, 143–44.
145 “like a drop from a cliff with a thread tied”: Mickey Goulian, interview with author, September 2007.
145 The patient “is amazingly recovered”: Letter from a Boston physician to patient K.L. (name withheld). K.L., interview with author, September 2009.
146 “The mood among pediatric oncologists changed”: Jonathan B. Tucker, Ellie: A Child’s Fight against Leukemia (New York: Holt, Rinehart, and Winston, 1982).
146 In September 1963, not long after Frei and Freireich: Freireich, interview with author.
146 “Some of us didn’t make much of it at first”: Goulian, interview with author.
146 By October, there were more children back at the clinic: Freireich, interview with author.
147 “I know the patients, I know their brothers and sisters”: “Kids with Cancer,” Newsweek, August 15, 1977.
147 morale at the institute to the breaking point: Freireich, interview with author.
148 A few, a small handful: Emil Frei, “Curative Cancer Chemotherapy,” Cancer Research 45 (1985): 6523–37.
150 he triumphantly brought photographs of a few: Harold P. Rusch, “The Beginnings of Cancer Research Centers in the United States,” 74 (1985): 391–403.
150 further proof was “anticlimactic and unnecessary”: Ibid.
150 “We are attempting”: Sidney Farber, letter to Etta Rosensohn, Mary Lasker Papers, Columbia University.
An Anatomist’s Tumor
151 It took plain old courage to be a chemotherapist: Vincent T. DeVita Jr. and Edward Chu, “A History of Cancer Chemotherapy,” Cancer Research 68, no. 21 (2008): 8643–53.
156 Hodgkin was born in 1798 to a Quaker family: Louis Rosenfeld, Thomas Hodgkin: Morbid Anatomist & Social Activist (Lanham, MD: Madison Books, 1993), 1. Also see Amalie M. Kass and Edward H. Kass, Perfecting the World: The Life and Times of Dr. Thomas Hodgkin, 1798–1866 (Boston: Harcourt Brace Jovanovich, 1988).
157 a series of cadavers, mostly of young men: T. Hodgkin, “On Some Morbid Appearances of the Absorbent Glands and Spleen,” Medico-Chirurgical Transactions 17 (1832): 68–114. The paper was read to the society by Robert Lee because Hodgkin was not a member of the society himself.