Rethinking Cancer

I was blown away by the scope, clarity, interdisciplinary artistry, and intelligence of Siddhartha Mukerjee’s 2010 book, “The Emperor of All Maladies: A Biography of Cancer“. Like Atul Gawande, Mukerjee somehow practices medicine, runs a world class research lab, while being married with two school-aged children. I like this quote from his wife, Sarah Sze, a MacArthur Genius grant recipient and tenured art professor/sculptor at Columbia.

“‘You can’t get lost in the everyday details. Sid and I are both totally like that, which can be not good with things like parking tickets. Sure, things are falling through the cracks all the time, but that doesn’t matter. The big things matter.'”

I haven’t read Mukerjee’s 2016 book, “The Gene: An Intimate History,” but did just finish his recent New Yorker essay, “The Invasion Equation,” about how cancer biologists are rethinking cancer. And he’s done it again, written so clearly even I can make sense of the science. His writing is deeply engaging on top and will not disappoint anyone interested in the current state of oncology.

A one-sentence caption on the second page of the essay summarizes the shift in thinking:

“We’ve tended to focus on the cancer, but its host tissue—”soil,” rather than “seed”—could help us predict the danger it poses.”

Later, he elaborates:

“It was only natural that many cancer biologists, confronting the sheer complexity of the whole organism, trained their attention exclusively on our “pathogen”: the cancer cell. Investigating metastasis seems more straightforward than investigating non-metastasis; clinically speaking, it’s tough to study those who haven’t fallen ill. And we physicians have been drawn to the toggle-switch model of disease and health: the biopsy was positive; the blood test was negative; the scans find “no evidence of disease.” Good germs, bad germs. Ecologists, meanwhile, talk about webs of nutrition, predation, climate, topography, all subject to complex feedback loops, all context-dependent. To them, invasion is an equation, even a set of simultaneous equations.”

My take-away from Mukherjee—whether you or I are likely to die from cancer depends largely on whether oncologists learn to think like ecologists.

Friday Assorted Links

1. The British Open has always been my favorite golf tournament because of the history, creative shot making, hellish bunkers, cold wind and rain, and the gorse of course. I’m going to miss it.

Englishman Nick Faldo, a three-time Open champion, said it is no longer correct to call it the Open Championship. “Now it’s ‘The Open. In another five years, it will just be called ‘The.’ ”

2. Tyler Cowen on his writing process.

“I try to write a few pages every day. I don’t obsess over the counting, I just do as much as I can and stop before I feel I am done, so I am eager to start up again the next day, or after lunch. That to me is very important, not to write too much in a single day, but to get something written every single day.”

3. Principals are loath to give teachers bad ratings.

“When principals are asked their opinions of teachers in confidence and with no stakes attached, they’re much more likely to give harsh ratings, researchers found.”

4. So this is why eldest daughter chooses to live in Chicago.

“Another interesting trend is that all cities in Southwest, from Texas, New Mexico, and Arizona, are taco cities. Burrito cities are mostly from the Midwest and West. California has cities in both categories. It appears that SoCal prefers tacos (LA and San Diego), while NorCal prefers burritos (San Francisco, Sacramento, San Jose).”

Clearly, burritos > tacos, so I need to visit Indianapolis and San Fransisco.

5A. Trumpcare collapsed because the Republican Party cannot govern.

“In truth, it was never possible to reconcile public standards for a humane health-care system with conservative ideology. In a pure market system, access to medical care will be unaffordable for a huge share of the public. Giving them access to quality care means mobilizing government power to redistribute resources, either through direct tax and transfers or through regulations that raise costs for the healthy and lower them for the sick. Obamacare uses both methods, and both are utterly repugnant and unacceptable to movement conservatives. That commitment to abstract anti-government dogma, without any concern for the practical impact, is the quality that makes the Republican Party unlike right-of-center governing parties in any other democracy. In no other country would a conservative party develop a plan for health care that every major industry stakeholder calls completely unworkable.”

5B. The Republican healthcare meltdown.

“The larger lesson of this sorry episode is that nobody—not McConnell, or Trump, or House Speaker Paul Ryan—can resolve the contradictions of today’s Republican Party. Once the political arm of the Rotary Club and the affluent suburbs, the Party is increasingly one of middle-class and working-class voters, many of whom are big beneficiaries of federal programs, such as Medicaid and the Obamacare subsidies for the purchase of private insurance. But the G.O.P. remains beholden to its richest, most conservative donors, many of whom espouse a doctrine of rolling back the government and cutting taxes, especially taxes applicable to themselves and other very rich people. It was the donors and ideologues, with Ryan as their front man, who led the assault on the Affordable Care Act.”

5C. Trump’s clueless abdication of presidential responsibility.

“Predictable and despicable” are more apt than “clueless”.

“The first duty of any President is to protect the welfare of the citizenry. In blithely threatening to allow the collapse of the Obamacare exchanges, through which some twelve million Americans have purchased health insurance, Trump was ignoring this duty. Arguably, he was violating his oath of office, in which he promised to ‘faithfully execute the office of the President of the United States.'”

On Travel 2

Today, the Good Wife and I have been married for 29 years, 11 months, and 18 days. Fairly confident we’ll make it to three zero, we’re planning a celebration of marital endurance bliss for a week and a half from now. Given assorted responsibilities we can’t shake, we’re temporarily tabling a trip to a Spanish speaking country in favor of a nearby quick hit.

Meaning Portland, Oregon.

Read and/or watch the New York Times depiction of the Rose City and then dig this person’s comment which I’m assigning an “A+”:

“It’s a very pretty video. Please forgive my peeve. Some of us aren’t cheering.

It’s the weirdest feeling to have lived somewhere your whole life and suddenly feel like a stranger. The aggressively smug city in the video is not Portland as many of us know it (or knew–past tense–and loved it). Portland is unrecognizable to me, anymore. Portland was a decided introvert until fairly recently; a dark, foggy haven for privacy-loving people, many of them genuine eccentrics–not the braying and proud ‘Portland Weird’ of now.

The self-satisfied extrovert it has become is due mainly to hype and an internet-fed culture of rootlessness and restlessness (“I can do better!”), spawning quality-o’-life-seeking newcomers looking to reinvent themselves and put their stamp on what too many have regarded as a tabula rasa, ignoring what existed before they arrived to ‘improve’ it.

The noisy eagerness with which new lookalike (mostly white, mostly moneyed) arrivals and discoverers advertise and idealize the city feels like an extension of FB-fed narcissism and now-epidemic attention seeking. “I found it! I discovered it! Look what I did!” Portland makes a great FB post, a great tweet, a great NY Times feature. It reflects well on mememe. Aren’t we all clever for discovering this place? We are curators!

“Authentic” is not a word I’d use to describe Portland now. And I always thought relentless self congratulation was the antithesis of ‘cool.'”

How does one add to that? It’s not just a very thoughtful take-down of the NYT, it’s a trenchant critique of our penchant for superficial travel.

The Scourge of Vagueness

The Columbia Basin Herald:

“The Moses Lake School District is looking for a new high school principal following the resignation of Mark Harris Wednesday.

“We came to a mutually agreeable decision that his skill set is not the best fit for Moses Lake,” said outgoing superintendent Michelle Price.”

I’d be very disappointed if one of my first year writing students explained someone’s firing by writing, “his skill set was not the best fit”, because that requires readers to work way too hard.

Then a slight elaboration:

“We had a conversation about where we are and the future of two high schools,” Harris said. “And we decided they need someone who knows the community and is steeped in its traditions and culture.”

More vagueness, “where we are”, “the future”, “knows the community”, “its traditions and cultures”. Those references are far from self-explanatory. This reader is going to guess Harris didn’t ask enough questions, implemented changes with little input from teacher-leaders, and probably lacked the needed interpersonal skills to effectively lead a high school more generally.

There’s this pseudo-elaboration too:

“Explaining the phrase ‘skill set,’ Price elaborated that with the addition of the second high school as well as planned upgrades to the existing high school, Harris didn’t really have the skills to lead through that kind of change.”

But again the phrase, “the skills to lead through that kind of change” is the same vague reflex. What does that mean? What specific skills was Harris lacking? The reader has to speculate. After a couple of readings, I still don’t know what “the skills to lead through that kind of change” is code for?

The district spokesperson concludes by proving it is possible to speak entirely in cliches:

“It will take someone special to lead people through the coming changes,” she added. “Leadership is about fit.”

What does “someone special” mean? And “changes”? And “Leadership is about fit.”? Dear CBH, please resubmit.

Even though all of Moses Lakes probably knows, I can’t help but conclude that Harris flamed out as a principal in ways the district really doesn’t want made more public.

Here’s an idea. When no one is willing to tell ANY of the story behind the story, just go to Twitter, and spare readers the public relations chess game.

Sentence of the Day

It’s still early on the Best West Coast, but it’s going to be very difficult to top this, from Katy Waldman of Slate:

“It is such an odd, ubiquitous detail—that Trump is ‘enraged.’ He is apoplectic, incensed, irate, vexed, sore, peeved, tantrum-y, mad online, mad offline, mad in a boat, mad with a goat, mad in the rain, mad on a train.”

 

Sentence of the Sentury

In my early twenties, while attending a workshop on “Teaching About Africa”, I was introduced to African literature which has enriched my life unmeasurably. My current exercise in seeing the world through African lenses is We Need New Names by NoViolet Bulawayo. Highly recommended. Before digging in though, read a bit about recent Zimbabwean history. For example, this backgrounder compliments of the Daily Mail.

There are so many passages I’d like to highlight, but I’ll limit myself to one which requires a brief intro. Here the central character, Darling, is describing her Kalamazoo, Michigan, adolescent self:

The last book I read was that Jane Eyre one, where the long meandering sentences and everything just bored me and that Jane just kept irritating me with her stupid decisions and the whole lame story made me want to throw the book away. I had to force myself to keep reading because I had to write a report for English class.

Then Bulawayo goes all Jane Eyre on her readers. Dig this sentence of the sentury:

It’s early in the morning so the mall is a little dead. If this was at home, the place would be throbbing with life already: little kids riding that escalator over there like it would take them to heaven, their screams rising like skyscrapers—you would hear them all the way at Victoria’s Secret on the third floor; the mothers gossiping and laughing on the first floor, taking turns to look up and shouting warnings at their children, bodies constantly shuffling about because women never stand still since there is always something to do, always something; the men doing their thing maybe around those benches outside Payless, maybe passing around a Kingsgate cigarette or huddled around a newspaper and maybe talking about football scores in the European League, or the war in Iraq; their voices deep but never rising about those of the women and children because a man’s voice needs to stay low always; and then, in the open space where that Indian girl does threading, the older kids would be dancing to house musice, to DJ Sbu, and DJ Zinhle and Bojo Mujo, being reckless with their contorting bodies like they know they don’t own them and therefore they don’t care if they break; and in the massage chairs near the elevator, toothless old people sprawled out like lizards basking in the sun, making groaning noises as the massage thingies worked their wilted bodies; and at the telephone near the candle shop, an impatient line queuing to make calls to relatives in places like Chicago and Cape Town and Paris and Amsterdam and Lilongwe and Jamaica and Tunis; in the air, the dizzying aromas of morning foods cutting those perfumed smells from Macy’s to shreds; and maybe on that little square outside Foot Locker, under the fake tree, someone preaching from a Bible, a small crowd gathered around him, maybe wondering whether to believe or not, litter at their feet and around the mall to show there are people living there.

Most Read Posts This Year

  1. The Problem With The Simple Living Movement
  2. Two Types of Self Esteem
  3. School Mission Statements
  4. When Parents Are Too Child-Centered
  5. What Engineers Get Wrong

Each was written prior to 2015. Meaning it’s time to step up my game this year. Thank you as always for stopping by. Most readers were from the United States, with Canada and the United Kingdom close behind. Most groovy of all, readers were from 139 different countries.

My two favorite Christmas gifts this year.

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