Reflections on The Emperor of All Maladies

I’ve been listening to Siddhartha Mukherjee’s The Emperor of All Maladies [public library] on audiobook for the past few days.  The book is a history of cancer and the medical community’s various efforts to fight the disease.

What I have learned thus far:

#1.  If I were dropped back in the 1800s or prior without access to modern medicine, practicing proper sanitation/hygiene, using carbolic acid on cuts to prevent infection, and staying the fuck away from “doctors” will expand my lifespan considerably.  In fact, seeing a “doctor” (aka butcher/quack) is most likely to result in a very painful death (e.g. by infection, blood loss, traumatic surgery, poisoning, etc.)

#2.  Preventative care for the win, because it sounds like cancer is mostly incurable and all the treatments sound extremely painful.  Basically, cut sugar, do keto, and start intermittent fasting to clean out the useless cellular detritus in your body and signal to your body that now is NOT the time to go on an uncontrolled growth binge because resources are tight.

#3.  Just because someone is a doctor doesn’t mean they automatically know the right answers.  You need to do your own research and come to your own conclusions.  Some doctors don’t know jack shit.  And/or their egos are so inflated that they can’t even see that they don’t know jack shit.  Which results in poor patient care and outcomes.  Basically, no one cares about your life more than you.  So take what they tell you with a grain of salt.

#4.  Sometimes you gotta make a decision about whether you want to die a dignified controlled low-pain death, or eke out a few more extra days/months in extreme pain in the hospital.  Is it worth it to try those experimental trials?  Is it worth it to go through radical untested surgeries?  Sometimes irrational hope leads to a painful and ignoble way to die.  To the extent that you have the choice in how you die, you should make a reasoned choice.  Personally, if I catch an incurable disease, I’d rather not put myself through that extra misery, and I’d rather spare my family the hardship/burden (emotionally, financially, temporally) of going through a long expensive complicated and painful treatment process.  (But then, maybe I have an obligation to the rest of society/future patients to be a good little data point in that experimental trial so that my death can contribute to the medical corpus and maybe help with the search for a cure.)

#5.  Whenever I read history, I am reminded of how lucky I am to have been born in the 20th century.  To be able to live in a first world country (in what some might argue, is the best country in the world).  To have access to public sanitation, clean water, relatively unpolluted living environs, healthy(ish) food, civil rights, and of course, medical care that is usually more likely to make you feel better rather than worse.  I have been hospitalized twice in my life, and I am grateful that I had good experiences and came out fully recovered.  I had a life-threatening disease that would have killed me in any other prior era, but instead I was cured and got to live.  So thank you, all the people who have gone before me, who have died to make the world what it is today.  All of you heroes, experimenters, mad scientists, human guinea pigs, activists, politicians, donors, biochemists, and everyone else who quietly worked to make the world a better place.  I will do my best to pay it forward so that the next generation is also able to feel this sense of awe and gratitude.

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