Tuesday, 24 April 2012

Book: The Emperor of all Maladies by Siddhartha Mukherjee

(Image courtesy of Indigo.ca)

Score: 4.5 / 5

I first got interested in cancer when in elementary school my parents brought me to visit a dear family friend with leukemia in the hospital.  She looked thin, pale, and our conversations were interrupted by sudden onsets of vomiting.  Mom said she has cancer, and the chemotherapy made it hard to keep food down.  This first encounter with the disease left a big impression on me.

Intrigued by cancer, in grade 7 while browsing in the library I picked up a book about cancer and went through it.  Though it explained that cancer is characterised by uncontrolled cell division, I still had many questions.  Why are there different kinds of cancer?  Why are they so difficult to treat?  What is chemotherapy?

Fortunately, Dr. Mukherjee found it worthwhile to write this book to help answer those questions for a layman like me.  This book is one of the best books I have read.  It tells the history of cancer discovery, treatment, and care through the stories of doctors, scientists, politicians, activists, and patients.

Cancer is a family of diseases, characterized by the frenetic and uncontrolled division of cells.  Unlike other diseases that originated with foreign bacteria, cancer cells are normal cells with normal functionalities gone haywire.  Conventional medicine targeted cells or organisms by recognizing their differing enzymes.  Cancer and normal cells have very similar enzymes, thus making it notoriously difficult to target.

Cancer has been around for a long time.  The first possible case was documented in Egypt around 2500 BC.  The examiner carefully documented the observations of the tumour but could offer no treatment.  Since that time, a lot has changed.  Thanks to the efforts of many before us, a series of notable innovations occurred to give us what we have today –

  • How Chemicals in mustard gas used in wars were discovered to have dried up the bone marrow cells in those exposed and would later become a drug for chemotherapy
  • How multi drug chemotherapy (a norm now) was heavily resisted but eventually proven correct
  • How radical mastectomy, a procedure excavated huge amounts of a woman’s body in hopes of curing breast cancer, took nearly a century, the quality of life of five hundred thousand women, and many brave surgeons willing to challenge the status quo to prove wrong
  • How the public became aware of cancer and public movement on the war on cancer was formed
  • How, slowly, the medical field learned that caring for patients’ quality of life (for example, by developing antinausea drug and dispensing opiates as a measure for pain management) is as important as curing the patient
  • How cancer biology finally turned the descriptive symptoms of the disease into functional actions and gave birth to targeted therapy (though still in its infancy) that is turning a deadly disease into a chronic condition with minimal side effects for certain cancers
  • How scientists achieved the difficult task of proving cigarette as a carcinogen when smoking was so pervasive (it’s like proving sitting down causes cancer – everyone sits, so how can you prove that “non-sitting” helps in the long run?)
  • How scientists, surgeons, and chemotherapy doctors stayed in their silos and tried each to understand and attack the disease alone, but finally came to find a jointed effort was more effective
  • How there are hype and disappointments with each types of therapy at various points in history

Ultimately, Mukherjee had written a book rich with historical context, filled with the zeitgeist and hopes of the public and medical community at various points in time, and full of the interplay between different industries and medical disciplines.  The book is beautifully written and is a balanced account of humility and optimism.  To me, it is also a history of innovation in the medical field, and shows the totality of human effort in the face of this ancient disease.  I highly recommend this book.

I will end with an excerpt from the book about Germaine, a patient in Mukherjee’s care:

Germaine seemed, that evening, to have captured something essential about our struggle against cancer: that, to keep pace with this malady, you needed to keep inventing and reinventing, learning and unlearning strategies.  Germaine fought cancer obsessively, cannily, desperately,fiercely, madly, brilliantly, and zealously – as if channeling all the fierce, inventive energy of generations of men and women who had fought cancer in the past and would fight it in the future.  Her quest for a cure had taken her on a strange and limitless journey, through Internet blogs and teaching hospitals, chemotherapy and clinical trials halfway across the country, through a landscape more desolate, desperate, and disquieting than she had ever imagined.  She had deployed every morsel of energy to the quest, mobilizing and remobilizing the last dregs of her courage, summoning her will and wit and imagination, until, that final evening, she had stared into the vault of her resourcefulness and resilience and found it empty.  In that haunted last night, hanging on to her life by no more than a tenuous thread, summoning all her strength and dignity as she wheeled herself to the privacy of her bathroom, it was as if she had encapsulated the essence of a four-thousand-year-old war.

Friday, 13 April 2012

Book: 大江大海(作者: 龍應台) Da Jiang Da Hai 1949 by Yingtai Long

Score: 4/5
(Cover picture from the web site of 博客來)

Embarrassingly, I have been quite ignorant of recent Chinese and Taiwanese history, especially pertaining to the 1900’s.  Luckily, someone like Dr. Long had written this book to educate me on the subject.

This book is about the Chinese civil war in the year of 1949 between the Communist Party and the Nationalist Party, with the historical background on the Japanese invasion and WWII.  Long wrote vividly and objectively on the past, telling stories of first hand accounts in the book from veterans and civilians.  I am happy for this book placed more emphasis on the multifaceted perspective of the historical events, rather than focusing on one character and have the narrative revolve around one person.

Due to my lack of knowledge in Chinese history and geography, the book with its eyewitness accounts jumping from one person/location to another can at times be hard to follow.  However, it did give a good sense of the zeitgeist of the era.  It helped me to realize the horrors of war: teenagers were made to escape with their teachers from the war and separate from their parents, never to see them again.  Some of them would climb onto such overcrowded trains that they had to sit on the rooftop, and a train tends to exit a tunnel with less people than when it went in.  In one group, 5000 students who tried to escape the war had reached the Vietnam border with less than 300 students left.  In prisoners of war camps, any small cut to the body meant certain and painful death, as infection ran rampant in the camp due to malnutrition and lack of medical care.  Siblings saw their sisters raped dozens of times and hang themselves in desperation.  Parents collapse in despair in a field of corpses upon finding their son/daughter’s mutilated body.  In Leningrad, the city was encircled by the Germans for so long that cannibalism occurred and 500,000 civilians starved to death.  It saddened me tremendously yet also made me cherish the peace I enjoy all the more.

As the book unfolds gradually with characters of vastly different backgrounds sharing their points of view and stories, a cultural identity and understanding slowly and vaguely emerged.  I felt the book gave enough historical background to help me start understand the various sentiments between the different sides of the this civil war.

The civil war was fought in 1949, yet its consequences are ever more present today.  This is an important book and I’d recommend it to anyone wanting to get a glimpse of living as a Chinese around the year 1949.

Friday, 6 April 2012

Book: Steve Jobs by Walter Isaacson

(Image from Amazon.ca)
Score: 4.5/5

I first got interested in Steve Jobs when playing with my friend’s iPod touch a few years ago.  It was my first serious encounter with an Apple product.  Though my initial reaction was “it’s just a fancified Walkman”, I was soon eager to try out all the function on the device and declared to my friend that I wanted one for myself.

I was intrigued and attracted to the device not only because it had a beautiful hardware and software interface, but also the entire user experience “flowed” graciously.  The hassle of trying to figure out how to use the device is replaced with the joy of seeing yourself performing the functions without prior instructions, and the entire experience has consistency and elegance to it.  It’s like being checked into a 5 star hotel by an fashionable, courteous, and experienced receptionist.  So I wondered – what type of person does it take to create such a device and how did he do it?

Isaacson is a masterful writer who provided a balanced account of Jobs that is easy and delightful to read.  At 571 pages it can feel long at times, but it’s a small price to pay for completeness.  I highly recommend the book.

It would be naive to think this book is the definitive guide to being Steve Jobs, but there are many thought provokers in the book.  This is what I derived from after reading the book:

  • Much of Steve’s genius is in his ability as an editor.  He may not know how to use a computer to draw out the specifications that engineers can understand, but he knew intuitively and logically what the customers wanted, how much they wanted them, who he can entrust to come up with solutions, and recognize a good solution when it is presented and present it to customers in an attractive and relatable way.  Malcolm Gladwell says it very well here.
  • Steve’s idea of design isn’t just aesthetic, it’s also philosophical.  The goal of design is to create a beautiful and useful user experience, using both form and function to achieve that goal.  I think he understands that though aesthetics can generate hype, tools that people find useful and easily accessible is what gives sustainable attachment.  He often thought deeply and philosophically about what is the “essence” of the things he creates.
  • One of Steve’s greatest contributions is design education – how technology can be “sexy”, and what beauty can mean in retail, movies, computer hardware, and software.  Design has gotten more legitimacy and taken on more concrete form in the many industries, I think thanks to Steve.  He also showed that art and technology can be a powerful combination, that the creative talents at Pixar are very disciplined, and that the software engineers at Apple can be really imaginative. 

Ultimately, I wondered if Steve felt truly happy or fulfilled.  He was certainly driven and cared deeply about his company, yet whether that gave him the satisfaction in return isn’t as clear to me.  Steve is probably the only one with the answer.

I will let Steve end this post.  Below is a quote of him about what motivates him to do his work:

What drove me?  I think most creative people want to express appreciation for being able to take advantage of the work that’s been done by others before us.  I didn’t invent the language or mathematics I use.  I make little of my own food, none of my own clothes.  Everything I do depends on other members of our species and the shoulders that we stand on.  And a lot of us want to contribute something back to our species and to add something to the flow.  It’s about trying to express something in the only way that most of us know how – because we can’t write Bob Dylan songs or Tom Stoppard plays.  We try to use the talents we do have to express our deep feelings, to show our appreciation of all the contributions that came before us, and to add something to that flow.  That’s what has driven me.

Wednesday, 4 April 2012

Video: “China Rediscovers its Own History” by Dr. Ying-Shih Yu

A fascinating talk from Dr. Yu, a renowned Chinese historian, at a Library of Congress event on the recent Chinese phenomenon to rediscover its roots.  It covers many aspects of Chinese culture, commenting on the Taiwanese political situation regarding China, and on the Chinese legal system as well.

The video requires a RealPlayer plug in but that didn’t work for me.  If you’re having the same issue, you can download it from my dropbox account here and watch it on RealPlayer.


Tuesday, 3 April 2012

Video: 余英時----傑出華人系列part1 (with Chinese subtitle)

Dr. Yu is a renowned Chinese historian who taught at Harvard, Princeton, and Yale.  He won the John W. Kluge Prize for the Study of Humanity.  This is a short documentary film on him.