With the fascinating scholarship of The Emperor of All Maladies and the deeply personal experience of When Breath Becomes Air, a world-class oncologist examines the current state of cancer and its devastating impact on the individuals it affects -- including herself.
In The First Cell, Azra Raza offers a searing account of how both medicine and our society (mis)treats cancer, how we can do better, and why we must. A lyrical journey from hope to despair and back again, The First Cell explores cancer from every angle: medical, scientific, cultural, and personal. Indeed, Raza describes how she bore the terrible burden of being her own husband's oncologist as he succumbed to leukemia. Like When Breath Becomes Air, The First Cell is no ordinary book of medicine, but a book of wisdom and grace by an author who has devoted her life to making the unbearable easier to bear.
Raza, a Columbia University professor of medicine and practicing oncologist, offers a passionate account of how humans grapple with the scourge of cancer. She masterfully explains how her research science work intersects with her job treating dying patients on a daily basis: "Nowhere is the science of medicine replaced by the art of caring as in the final days of a terminal illness." She also explains why using animal models to search for new cancer treatments is unlikely to work, as cancer is so variable and dependent on the specific environment in which it grows. Meanwhile, most new cancer drugs, if they work at all, add months to life and are accompanied by severe costs, both financial and physiological. Her message is as simple as it is paradigm-shifting: rather than trying to kill every last cancer cell, medicine needs to focus on finding the first occurring cancer cells. Progress is being made on this front, she shows, but only a small percentage of available research dollars are being spent on it. Showing that compassion is just as important for cancer patients as the drugs administered to them, Raza's deeply personal work brings understanding and empathy to the fore in a way that a purely scientific explication never could.
Compelling message marred by a pretentious writing style
There were times when I was reading this book when I wished I could have thanked the author personally, shaken her hand, and maybe even given her a hug. And there were other times when I seriously considered putting the book aside and having nothing more to do with it. The reason is the message versus the overall book. If I had been the author or the editor, once this work was completed, I would have asked: How much of this is about the message, and how much is about Azra Raza? And I would have seriously considered filtering out a significant part of the latter. The book’s message is undeniably valuable and compelling, and the author’s argument is well-presented, clear, and well-documented. Really, everyone should be aware of this message, considering how many of us will be impacted by cancer in our lifetimes. But then there’s the book itself, which often comes across as an extended, pretentious tirade. Added to that, it seems she decided early on to use this book as a chance to give 15 minutes of fame to people she likes, however cheap and cliché her literary devices might be (“Michele floated in lightly, looking beautiful in a summer dress … and gently inquired if we were ready for lunch”), and also to take petty stabs at those she doesn’t like, like the “young male researcher whose ego was so dense, light would bend around him." The endless self-aggrandizement, fist-pounding, and needlessly pretentious language —such as her description of cells “seeking comfort in uninhabited beds, forging alliances with cooperative bedfellows in marrow niches and safe havens of supportive organs” — make the book laughable at times and nauseating at others, so much so that it ultimately comes across as the voice of an eccentric ranting and raving in the wilderness. For me, it’s 5 stars for the message but only 3 for the overall book.