Hindustan Times ST (Mumbai) - Live
The cosmic dance of the cell
In his latest book, The Song of the Cell, Siddhartha Mukherjee argues that we need to look at the interconnectedness between the trillions of cells in the body as well as between cells and the environment
Growing up in a family of doctors, I was fascinated by how they could hold forth about organs and diseases as if they were entities independent of the individual in which they resided. This conception of the human body as an amalgamation has a flip side, which Rajeev Kurapati talks about in his book Physician: “Physicians and biologists use the term ‘mechanism’ liberally in describing a disease process or an organic function. We describe our bodies as being made up of ‘parts’ instead of referring to them as ‘features’... Treating patients solely like machines, who need to be fixed, forces them to feel just that: like objects to be passed down the conveyor belt.”
Siddhartha Mukherjee rejects this atomistic view of the human body and proposes an alternative conception in his latest book, The Song of the Cell. He argues that we need to look at the interconnectedness between the trillions of cells in the body as well as between cells and the environment. In these connections could lie answers to medical mysteries. Mukherjee catalogues some of these enigmas in the book: Why do patients who describe their depression as an “existential ennui” typically not respond to deep brain stimulation, while those that describe themselves as “falling into vertical holes” often do? Why do patients with certain neurodegenerative diseases have a lower risk of cancer?
When Mukherjee discusses biological concepts through songs and metaphors, there is no woolliness. He arrives at his conclusions through an examination of the cell — the simplest unit of life. His enquiry is not restricted to what we know today about cells, but also how that knowledge came to be. Take the microscope. Invented in the late 16th century, it enabled the cell’s discovery in subsequent decades. Dutch trader Antonie van Leeuwenhoek characterised his microscopic observations thus: “No greater pleasure has yet come to my eye than these spectacle of the thousands of living creatures in a drop of water”. Microscopist Nicolaas Hartsoeker inspected spermatozoa and imagined they contained homunculi — miniature humans “all tucked origami-like into the sperm’s head”.
There is a popular perception of science as an eternal truth, which scientists gradually uncover. In the initial days of the Covid-19 pandemic, many people were befuddled by the constantly changing scientific advisories, resulting in them believing that scientists didn’t know what they were talking about, and opting for unproven, even dangerous, remedies that charlatans confidently proffered.
In a 2020 article in The Guardian, physicist Jim Al-Khalili wrote: “People are searching for certainty about coronavirus, and that’s the opposite of what leads to scientific breakthroughs… It has never been more important to communicate the way science works. In politics, admitting a mistake is seen as a form of weakness. It’s quite the opposite in science, where making mistakes is a cornerstone of knowledge. Replacing old theories and hypotheses with newer, more accurate ones allows us to gain a deeper understanding of a subject.”
In a similar vein, by highlighting the evolution of medicine — the missteps along with the steps — Mukherjee punctures the notion of a singular trajectory towards scientific progress. These different trajectories are most prominent when he discusses vaccination. According to him, “the story of vaccination is not the story of progressive scientific rationalism… Rather, its history is one of veiled hearsay, gossip, and myth. Its heroes are nameless: the Chinese doctors who airdried the first pox pustules; the mysterious sect of worshippers of Shitala who ground viral matter with boiled rice and inoculated it into children; the Sudanese healers who came to discern the ripest lesions.” An example he cites from the 20th century is of the American chemist Linus Pauling, who proposed an “answer so wrong that it would eventually point to the truth”.
Mukherjee’s delineation of hilarious misconceptions; missed opportunities; social prejudices impinging on scientific knowledge; and researchers who were initially ignored or ridiculed and later feted reinforces why we might need to revisit current medical approaches. This is not to say that these approaches are wrong — they might be useful for certain kinds of treatments, but not as much for others. An analogy would be Newtonian physics vis-a-vis quantum physics. The former applies to macroscopic objects and explains everyday phenomena — most famously, why an apple falls down from a tree. The latter has better explanatory power when it comes to minuscule particles or movement at the speed of light.
Like Mukherjee’s other books, The Song of the Cell is profoundly personal. He delves into friends, colleagues and patients’ lives, and also his own — ageing, his father’s death, his subsequent struggle with depression. There are anecdotes seemingly beyond the pale of medicine, such as an internist advising him, “Don’t forget to smell the patient” or a Tibetan doctor checking his friend’s pulse and diagnosing heartbreak.
Mukherjee writes about complex bodily systems and novel technologies with remarkable lucidity, though comprehension eluded me in a couple of sections, such as when he delves into the immune system’s intricacies. For the most part, his intimate, forthright writing makes the book as breezy a read as it is illuminating. Would the paradigm shift Mukherjee proposes solve niggling medical conundrums? To paraphrase him, we don’t even know what things we don’t know.
Investigating his hypotheses could be a step towards formulating ones that could yield medical breakthroughs. And therein lies the beauty of science.
The Song of the Cell: An Exploration of Medicine and the New Human
Siddhartha Mukherjee 576pp, ~799, Penguin
WHEN MUKHERJEE DISCUSSES BIOLOGICAL CONCEPTS THROUGH SONGS AND METAPHORS, THERE IS NO WOOLLINESS. HE ARRIVES AT HIS CONCLUSIONS THROUGH AN EXAMINATION OF THE CELL — THE SIMPLEST UNIT OF LIFE
and diverse cast of characters — Hindu and Muslim zamindars, traders, slaves, Portuguese pirates, lake-diggers from the tribal Mog community… all rooted in historical events.
Deftly, new characters are woven into the narrative with all their complexity, often only to be killed off. Akhtar is an accomplished writer. She has written six novels and six short-story collections in Bengali and many of them have been translated in other languages. The Korean translation of her 2004 novel Talaash (The Search, translated into the English by Ella Dutta and subsequently translated into Korean by Seung Hee Jeon) won the third Asian Literary Award in 2020. Nadiya is a Bangladeshi writer based in California, who has translated Akhtar’s short stories before. In an interview about Beloved Rongomala with the Dhaka Tribune, she said, “How could I not fall for a lowcaste royal mistress who writes love letters with lines like, ‘I sought and found that I had none / You, my moon, the only one’...?”
This is a dazzling translation. Somehow Nadiya is able to maintain, at the sentence level, a kind of juiciness: “The weavers and traders banded together like rice and lentils mixed in a hodgepodge.” Or: “In tent after tent, the men sat gambling… Five among them suffered a terrible habit. They rubbed salt on the dead skin of almost-healed scabs and found pleasure in the lingering itchiness.”
While reading Beloved Rongomala, I thought of both Sanjay Leela Bhansali (zamindars, beautiful women) and George RR Martin (squabbling royals, death, etc). I can’t remember the last time I read historical fiction this good — so good that I feel like I binge watched it.