Thursday, April 3, 2014

Emperor of All Maladies

Version 0.3

The Emperor of All Maladies by Siddhartha Mukherjee Considered as Annotated Genomic Analysis?

Short summary is that it's an excellent and informative book. My initial reaction was that it would not be translated into Japanese by any conventional publishing mechanism, but I was quite mistaken. One of the two suggestions or possible innovations it led me to think about was an alternative translation model driven by former patients interested in their own disease on behalf of new patients with the same condition. However, I quite misjudged the situation. Yes, it's a big book in a rapidly changing field, but the author writes so well and there are so many people who want to read about the topic that it was quickly translated into a two-volume version. Even beyond the translating process itself, it's already available in all of the libraries I checked. My primary library actually has 7 copies, of which several are currently checked out several years after its publication.

My other suggestion or possibly new idea involves leveraging those same former patients to save the time of the medical specialists by explaining the basics to the new patients. Turns out I was also behind the power curve on that one, too. However, the patients are mostly organized in the form of support groups.

Now for the body of my comments, which is essentially to nitpick at tiny details that I noticed as I read the book. However, in this case you can consider the large (571 pages) as representing the genetic information of a human being. Of course it depends on how you compress it, but the amount of DNA information in a person or a cancer could easily fill up such a book, and the things I'm noticing could be regarded as mutations or flaws that are ultimately linked to a cancer.

So here's my minor notes:

Page 37 has an interesting citation of Susan Sontag, which is not a nit, just a note.

On page 46 it says "t;yphoon" comes from "tuphon" the Greek god of the winds. He's persuasive, but I thought it was from the Japanese word (in Romanji form) taifuu. The Japanese word is used specifically for the kind of storm we now call a typhoon, and it comes from two Chinese-derived characters with the meaning of "big wind". In other words, he's arguing the ancient word made the transition, whereas I think it's a more recent borrowing.

On page 171 the work "strategy" is hyphenated incorrectly. At least I think so, and I already admitted I was looking for nits.

Page 175 says there is one space that is most infected with the idea of cancer as a transmittable disease, but the same sentence continues "and equally, the imagination of researchers", which is a second place and they can't both be the "one" space.

On page 224 there's another bad hyphenation, this time of "poignant".

On page 240 I was wondering why there was no mention of dipping snuff or chewing tobacco, but upon reflection, now I wonder if perhaps that's historically correct. Maybe dipping was a later innovation?

On pages 293 to 294 the usage of "end point" calls for "endpoint" and there's also a sentence that begins with "And". Stylistic quibbles? However they make me want to do some global searchers or other instances...

Page 416 must have caught my attention for the significance of the content. Either that, or the nit was so small I can't find it now.

After some more reflection on the topic, I reached an unanswered question and some implications for the Fermi Paradox. The question is about the genetic mechanisms for the evolution of cancer itself. It's simpler to consider it from the male perspective. In brief, if some male genes never died by cancer, then those genes could be propagated in great numbers, which seems to be a massive advantage, and yet males are also subject to cancer... In other words, I found myself trying to wrestle with the big question of "Why does cancer exist at all?" and the only analysis that seems to make sense involves the need for death as the driving force for future changes and more evolution.

As it relates to the Fermi Paradox, it also ties back to another book I read recently, Why Evolution is True. There are basically two outcomes: Changes leading to descendents and changes leading to extinction. Maybe there are some intelligent civilizations who have managed the first outcome, but just now it seems too clear that there are a whole lot of paths that lead to the second outcome... If cancer were "solved" and curable, that same knowledge could clearly be applied to nefarious and negative purposes, and some nut would probably do it, too.