The Emperor of All Maladies. Siddhartha Mukherjee

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СКАЧАТЬ evangelistic tambourine, Lasker added her own drumbeats of enthusiasm. She spoke and wrote passionately and confidently about her cause, emphasizing her points with quotes and questions. Back in New York, she employed a retinue of assistants to scour newspapers and magazines and clip out articles containing even a passing reference to cancer—all of which she read, annotated on the margins with questions in small, precise script, and distributed to the other Laskerites every week.

      “I have written to you so many times²⁹⁰ in what is becoming a favorite technique—mental telepathy,” Farber wrote affectionately to Lasker, “but such letters are never mailed.” As acquaintance bloomed into familiarity, and familiarity into friendship, Farber and Lasker struck up a synergistic partnership that would stretch over decades. In a letter written in 1954, Farber used the word crusade to describe their campaign against cancer. The word was deeply symbolic. For Sidney Farber, as for Mary Lasker, the cancer campaign was indeed turning into a “crusade,” a scientific battle imbued with such fanatical intensity that only a religious metaphor could capture its essence. It was as if they had stumbled upon an unshakable, fixed vision of a cure—and they would stop at nothing to drag even a reluctant nation toward it.

       “These new friends of chemotherapy”

      The death of a man²⁹¹ is like the fall of a mighty nation

      That had valiant armies, captains, and prophets,

      And wealthy ports and ships all over the seas

      But now it will not relieve any besieged city

      It will not enter into an alliance

      —Czeslaw Milosz, “The Fall”

      I had recently begun to notice²⁹² that events outside science, such as Mary Lasker’s cocktail parties or Sidney Farber’s Jimmy Fund, had something to do with the setting of science policy.

      —Robert Morison

      In 1951, as Farber and Lasker were communicating with “telepathic” intensity about a campaign against cancer, a seminal event drastically altered the tone and urgency of their efforts. Albert Lasker was diagnosed with colon cancer. Surgeons in New York heroically tried to remove the tumor, but the lymph nodes around the intestines were widely involved, and there was little that could be done surgically. By February 1952, Albert was confined²⁹³ to the hospital, numb with the shock of diagnosis and awaiting death.

      The sardonic twist of this event could not have escaped the Laskerites. In their advertisements in the late 1940s to raise awareness of cancer, the Laskerites had often pointed out that one in four Americans would succumb to cancer. Albert was now the “one in four”—struck by the very disease that he had once sought to conquer. “It seems a little unfair,”²⁹⁴ one of his close friends from Chicago wrote (with vast understatement), “for someone who has done as much as you have to forward the work in this field to have to suffer personally.”

      In her voluminous collection of papers—in nearly eight hundred boxes filled with memoirs, letters, notes, and interviews—Mary Lasker left few signs of her response to this terrifying tragedy. Although obsessed with illness, she was peculiarly silent about its corporality, about the vulgarity of dying. There are occasional glimpses of interiority and grief: her visits to the Harkness Pavilion in New York to watch Albert deteriorate into a coma, or letters to various oncologists—including Farber—inquiring about yet another last-ditch drug. In the months before Albert’s death, these letters acquired a manic, insistent tone. He had seeded metastasis into the liver, and she searched discreetly, but insistently, for any possible therapy, however far-fetched, that might stay his illness. But for the vast part, there was silence—impenetrable, dense, and impossibly lonely. Mary Lasker chose to descend into melancholy alone.

      Albert Lasker died at eight o’clock²⁹⁵ on the morning of May 30, 1952. A small private funeral was held in the Lasker residence in New York. In his obituary, the Times noted, “He was more than a philanthropist, for he gave not only of his substance, but of his experience, ability and strength.”

      Mary Lasker gradually forged her way back to public life after her husband’s death. She returned to her routine of fund-raisers, balls, and benefits. Her social calendar filled up: dances for various medical foundations, a farewell party for Harry Truman, a fund-raiser for arthritis. She seemed self-composed, fiery, and energetic—blazing meteorically into the rarefied atmosphere of New York.

      But the person who charged her way back into New York’s society in 1953 was fundamentally different from the woman who had left it a year before. Something had broken and annealed within her. In the shadow of Albert’s death, Mary Lasker’s cancer campaign took on a more urgent and insistent tone. She no longer sought a strategy to publicize a crusade against cancer; she sought a strategy to run it. “We are at war with an insidious,²⁹⁶ relentless foe,” as her friend Senator Lister Hill would later put it—and a war of this magnitude demanded a relentless, total, unflinching commitment. Expediency must not merely inspire science; it must invade science. To fight cancer, the Laskerites wanted a radically restructured cancer agency, an NCI rebuilt from the ground up, stripped of its bureaucratic excesses, intensely funded, closely supervised—a goal-driven institute that would decisively move toward finding a cancer cure. The national effort against cancer, Mary Lasker believed, had become ad hoc, diffuse, and abstract. To rejuvenate it, it needed the disembodied legacy of Albert Lasker: a targeted, directed strategy borrowed from the world of business and advertising.

      Farber’s life also collided with cancer—a collision that he had perhaps presaged for a decade. In the late 1940s, he had developed a mysterious and chronic inflammatory disease of the intestines—likely ulcerative colitis, a debilitating precancerous illness that predisposes the colon and bile duct to cancer. In the mid-1950s (we do not know the precise date), Farber underwent surgery to remove his inflamed colon at Mount Auburn Hospital in Boston, likely choosing the small and private Cambridge hospital across the Charles River to keep his diagnosis and surgery hidden from his colleagues and friends on the Longwood campus. It is also likely that more than just “precancer” was discovered upon surgery—for in later years, Mary Lasker would refer to Farber as a “cancer survivor,” without ever divulging the nature of his cancer. Proud, guarded, and secretive—reluctant to conflate his battle against cancer with the battle—Farber also pointedly refused to discuss his personal case publicly. (Thomas Farber, his son, would also not discuss it. “I will neither confirm nor deny it,” he said, although he admitted that his father lived “in the shadow of illness in his last years”—an ambiguity that I choose to respect.) The only remnant of the colon surgery was a colostomy bag; Farber hid it expertly under his white cuffed shirt and his four-button suit during his hospital rounds.

      Although cloaked in secrecy and discretion, Farber’s personal confrontation with cancer also fundamentally altered the tone and urgency of his campaign. As with Lasker, cancer was no longer an abstraction for him; he had sensed its shadow flitting darkly over himself. “[It is not] necessary,” he wrote, “in order to make great progress in the cure of cancer, for us to have the full solution of all the problems of basic research . . . the history of Medicine is replete with examples of cures obtained years, decades, and even centuries before the mechanism of action was understood for these cures.”

      “Patients with cancer who are going to die this year cannot wait,” Farber СКАЧАТЬ