The Emperor of All Maladies. Siddhartha Mukherjee

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СКАЧАТЬ an advertising firm based in Chicago. Albert Lasker, like Mary Woodard, was considered an intuitive genius in his profession. At Lord and Thomas, he had invented and perfected a new strategy of advertising that he called “salesmanship in print.” A successful advertisement, Lasker contended, was not merely a conglomeration of jingles and images designed to seduce consumers into buying an object; rather, it was a masterwork of copywriting that would tell a consumer why to buy a product. Advertising was merely a carrier for information and reason, and for the public to grasp its impact, information had to be distilled into its essential elemental form. Each of Lasker’s widely successful ad campaigns—for Sunkist oranges, Pepsodent toothpaste, and Lucky Strike cigarettes among many others—highlighted this strategy. In time, a variant of this idea, of advertising as a lubricant of information and of the need to distill information into elemental iconography would leave a deep and lasting impact on the cancer campaign.

      Mary and Albert had a brisk romance and a whirlwind courtship, and they were married just fifteen months after²⁶⁴ they met—Mary for the second time, Albert for the third. Mary Lasker was now forty years old. Wealthy, gracious, and enterprising, she now launched a search for her own philanthropic cause—retracing her mother’s conversion from a businesswoman into a public activist.

      For Mary Lasker, this search soon turned inward, into her personal life. Three memories from her childhood and adolescence haunted her. In one, she awakes from a terrifying illness—likely a near-fatal bout of bacterial dysentery or pneumonia—febrile and confused, and overhears a family friend say to her mother that she will likely not survive: “Sara, I don’t think that you will ever raise her.”

      In another, she has accompanied her mother to visit her family’s laundress in Watertown, Wisconsin. The woman is recovering from surgery for breast cancer—radical mastectomies performed on both breasts. Lasker enters a dark shack with a low, small cot with seven children running around and she is struck by the desolation and misery of the scene. The notion of breasts being excised to stave cancer—“Cut off ?” Lasker asks her mother searchingly—puzzles and grips her. The laundress survives; “cancer,” Lasker realizes, “can be cruel but it does not need to be fatal.”

      In the third, she is a teenager in college, and is confined to an influenza ward during the epidemic of 1918. The lethal Spanish flu rages outside, decimating towns and cities. Lasker survives—but the flu will kill six hundred thousand Americans that year, and take nearly fifty million lives worldwide, becoming the deadliest pandemic in history.

      A common thread ran through these memories: the devastation of illness—so proximal and threatening at all times—and the occasional capacity, still unrealized, of medicine to transform lives. Lasker imagined unleashing the power of medical research to combat diseases—a power that, she felt, was still largely untapped. In 1939, the year that she met Albert, her life collided with illness again: in Wisconsin, her mother suffered a heart attack and then a stroke, leaving her paralyzed and incapacitated. Lasker wrote to the head of the American Medical Association to inquire about treatment. She was amazed—and infuriated, again—at the lack of knowledge and the unrealized potential of medicine: “I thought that was ridiculous. Other diseases could be treated . . . the sulfa drugs had come into existence. Vitamin deficiencies could be corrected, such as scurvy and pellagra. And I thought there was no good reason why you couldn’t do something about stroke, because people didn’t universally die of stroke . . . there must be some element that was influential.”

      In 1940, after a prolonged and unsuccessful convalescence, Lasker’s mother died in Watertown. For Lasker, her mother’s death brought to a boil the fury and indignation that had been building within her for decades. She had found her mission. “I am opposed to heart attacks and cancer,”²⁶⁵ she would later tell a reporter, “the way one is opposed to sin.” Mary Lasker chose to eradicate diseases as some might eradicate sin—through evangelism. If people did not believe in the importance of a national strategy against diseases, she would convert them, using every means at her disposal.

      Her first convert was her husband. Grasping Mary’s commitment to the idea, Albert Lasker became her partner, her adviser, her strategist, her coconspirator. “There are unlimited funds,” he told her. “I will show you how to get them.” This idea—of transforming the landscape of American medical research using political lobbying and fund-raising at an unprecedented scale—electrified her. The Laskers were professional socialites, in the same way that one can be a professional scientist or a professional athlete; they were extraordinary networkers, lobbyists, minglers, conversers, persuaders, letter writers, cocktail party–throwers, negotiators, name-droppers, deal makers. Fund-raising—and, more important, friend-raising—was instilled in their blood, and the depth and breadth of their social connections allowed them to reach deeply into the minds—and pockets—of private donors and of the government.

      “If a toothpaste . . .²⁶⁶ deserved advertising at the rate of two or three or four million dollars a year,” Mary Lasker reasoned, “then research against diseases maiming and crippling people in the United States and in the rest of the world deserved hundreds of millions of dollars.” Within just a few years, she transformed, as BusinessWeek magazine once put it, into “the fairy godmother of medical research.”²⁶⁷

      The “fairy godmother” blew into the world of cancer research one morning with the force of an unexpected typhoon. In April 1943, Mary Lasker visited²⁶⁸ the office of Dr. Clarence Cook Little, the director of the American Society for the Control of Cancer in New York. Lasker was interested in finding out what exactly his society was doing to advance cancer research, and how her foundation could help.

      The visit left her cold²⁶⁹. The society, a professional organization of doctors and a few scientists, was self-contained and moribund, an ossifying Manhattan social club. Of its small annual budget of²⁷⁰ about $250,000, it spent an even smaller smattering on research programs. Fund-raising was outsourced to an organization called the Women’s Field Army, whose volunteers were not represented on the ASCC board. To the Laskers, who were accustomed to massive advertising blitzes and saturated media attention—to “salesmanship in print”²⁶³—the whole effort seemed haphazard, ineffectual, stodgy, and unprofessional. Lasker was bitingly critical: “Doctors,” she wrote, “are not administrators²⁷¹ of large amounts of money. They’re usually really small businessmen . . . small professional men”—men who clearly lacked a systematic vision for cancer. She made a $5,000 donation to the ASCC and promised to be back.

      Lasker quickly got to work on her own. Her first priority was to make a vast public issue out of cancer. Sidestepping major newspapers and prominent magazines, she began with the one outlet of the media that she knew would reach furthest into the trenches of the American psyche: Reader’s Digest. In October 1943, Lasker persuaded a friend²⁷² at the Digest to run a series of articles on the screening and detection of cancer. Within weeks, the articles set off a deluge of postcards, telegrams, and handwritten notes to the magazine’s office, often accompanied by small amounts of pocket money, personal stories, and photographs. A soldier grieving the death of his mother sent in a small contribution: “My mother died from cancer²⁷³ a few years ago. . . . We are living in foxholes in the Pacific theater of war, but would like to help out.” A schoolgirl whose grandfather had died of cancer enclosed a dollar bill. Over СКАЧАТЬ