Siddhartha Mukherjee, an oncologist and prof of medicine astatine Columbia University, won the Pulitzer Prize for his archetypal book, “The Emperor of All Maladies: A Biography of Cancer” (2010), and has had a ample fashionable pursuing ever since. In “The Song of the Cell: An Exploration of Medicine and the New Human,” helium repeats an engaging formula. He tells a vivid communicative — the fatal melanoma of a beloved friend, a peculiar patient’s unwellness and palmy treatment, his ain acquisition of depression, the valiant struggles of a researcher successful the past and contiguous — and relates it to the broader science. Mukherjee writes lucid sentences dense with metaphors arsenic pedagogical tools: the compartment arsenic “spacecraft”; the cell’s nucleus arsenic “command center”; the genome arsenic “library”; neutrophils, achromatic humor cells important to immune response, arsenic “teenage soldiers deployed to battle”; and MHC people 1 molecules connected a cell’s aboveground arsenic “two unfastened halves of a hotdog bun.”
The book’s refrain is that the compartment is “an autarkic surviving being — a portion — that forms a portion of the whole.” Organisms, including quality beings, are nary much oregon little than the sum of those parts. The author’s sweeping ambition is to amusement “how the conception of the compartment and our comprehension of cellular physiology, altered medicine, science, biology, societal structure, and culture” and what helium believes the aboriginal of cellular manipulation volition bring — replacement parts for “the caller human” of his subtitle.
Although Mukherjee’s compartment saga is not strictly chronological, helium summarizes its aboriginal past successful the archetypal portion of the book, including the invention of the microscope successful the precocious 16th period and its astir celebrated users: Robert Hooke, the writer of “Micrographia” (1665), who gave the compartment its name, and Antonie van Leeuwenhoek, who spotted surviving creatures, “animalcules,” nether the magnifying lenses helium had made. The writer covers the debates that raged successful the 18th and 19th centuries betwixt mechanists, who understood quality arsenic a instrumentality reducible to its discrete parts (reductionism), and vitalists who argued that this sum did not suffice to explicate life. Mukherjee advances the accepted presumption that vitalists projected a divine constituent arsenic the root of animation. Some did. Members of the French Montpellier school, however, projected nary supernatural constituent but alternatively a functional, relational, dynamic biology that could not beryllium reduced to its elements. In this “holistic” model, the sum is much than its parts.
Although the reductionists won this statement and “vitalism” is simply a connection utilized successful subject lone with caution, a conflict betwixt reductionism and holism has been revived successful the 21st-century doctrine of subject and successful systems biology. The authors of “Complex Systems are More Than the Sum of their Parts,” a 2015 insubstantial successful Integrative and Comparative Biology, are not unsocial successful arguing that arsenic organisms get much complex, caller properties look from their dynamic networks. From this perspective, breaking a carnal down into its discrete parts and putting them backmost unneurotic again volition not springiness a afloat knowing of the full organism. This contested contented is ne'er mentioned successful the book.
Mukherjee recounts the beginnings of compartment mentation among 19th-century European scientists and the increasing statement that the compartment is the cardinal portion of beingness successful plants and animals. He follows this past with much cellular tales related to aesculapian interventions and retreats to humanities technological progenitors arsenic needed — antibiotics, successful vitro fertilization, cistron editing, monoclonal antibodies, vaccines, heavy encephalon stimulation (an implanted instrumentality that has shown immoderate occurrence with Parkinson’s and slump patients), immunotherapies for cancer, bony marrow transplants and stem compartment research.
Mukherjee is candid astir aesculapian failures, the heartbreak of treating patients who endure and die, and the motivation risks that travel with innovation, and helium admits that overmuch remains chartless successful compartment science. Borrowing from his pathologist hero, Rudolf Virchow (1821-1902), who viewed the compartment arsenic a national successful a larger society, Mukherjee stresses the limits of “atomism” and the value of “interconnectedness.” He “expands” Virchow’s compartment biology: “Beyond knowing cells successful isolation, deciphering the interior laws of cellular citizenship — tolerance, communication, specialization, diversity, bound formation, cooperation, niches, ecological relationships — volition effect in the commencement of a caller benignant of cellular medicine.”
Metaphors are important to thought successful science. As 1 philosopher of science, Evelyn Fox Keller, has argued, metaphors whitethorn some unfastened avenues of find and unopen them down. The figurative is easy confused with the literal. The thought of the genome arsenic maestro molecule, commander, codification and blueprint has often been mistaken for factual reality, adjacent though, arsenic Mukherjee points out, quoting the large geneticist Barbara McClintock, the genome is “a delicate organ of the cell.” It is inert without its cellular environment.
Throughout the book, Mukherjee uses a communal metaphor for the immune strategy arsenic a battleground betwixt “us” and “them” — the cells that beryllium to a idiosyncratic (a self) and invading microbial oregon different “foreigners” (a non-self). Mukherjee explains that Frank Macfarlane Burnet codified the self/non-self model for the immune strategy successful the mediate of the 20th period and provides galore examples of cells that “recognize” and destruct antigens — substances that trigger immune response. Although Mukherjee takes the self/other favoritism literally, it excessively is simply a metaphor, a riddled conception borrowed from science and philosophy, which is being challenged successful immunology. “Human beings,” helium writes, “don’t person to interest astir cells from different quality bodies invading and colonizing our bodies and trying to walk themselves arsenic selves.” He describes the menace of mingling arsenic “chimerism” and tells america that this “fusion of carnal selves — is not a caller property phantasy but an property aged threat.”
Mukherjee does not notation that quality reproduction is simply a cooperative fusion of cellular selves — the fertilized compartment oregon zygote is made from 2 radical — and the embryo-fetus is partially a familial foreigner to the large person. But the maternal immune strategy does not cull the embryo, thing scientists person puzzled implicit for years. I person ever wondered wherefore pregnancy, during which the self/non-self paradigm is rendered moot, is seldom brought up successful the discussion. Further, compartment transportation via the placenta from fetus to parent and parent to fetus, different fusion of carnal selves known arsenic microchimerism, has precocious been acknowledged arsenic portion of mean pregnancy. Fetal cells tin endure for decades successful the mother, and researchers are moving to recognize the relation these migrated cells play successful immune rescue and disease. Mukherjee besides leaves retired the information that humans are hosts to immense numbers of “alien” microbes and viruses (the non-selves of the quality microbiome and virome), which are not lone tolerated but indispensable for our survival. Philosophers of biology, including John Dupré, Polly Matzinger, Thomas Pradeu and Alfred Tauber, person challenged the self-other presumption Mukherjee takes for granted.
There is thing unusual astir uncovering entrenched orthodoxies repeated successful fashionable subject books. What is unusual is that Mukherjee, with his accent connected “interconnectedness,” “cooperation” and “ecological relationships” successful biologic processes, hovers connected the brink of countering his ain reductionist statement that the full is the sum of its parts. He flirts with a signifier of holism, an thought helium calls “scientifically defiled,” though the connection is ubiquitous successful systems biology, a tract dedicated, according to Christopher Wanjek, writing for the National Institutes of Health, “to knowing the larger representation — beryllium it astatine the level of the organism, tissue, oregon compartment — by putting its pieces together. It’s successful stark opposition to decades of reductionist biology, which involves taking the pieces apart.”
Despite its omission of important existent disputes successful biology, which person roots successful earlier centuries, “The Song of the Cell” is simply a lively, personal, detailed, often moving relationship of the compartment successful aesculapian past and its committedness successful the present. Time volition determine if Mukherjee’s caller human, “a caller sum of caller parts,” belongs to our future.
Siri Hustvedt is the writer of 13 books, astir precocious “Mothers, Fathers, and Others.” She is simply a lecturer successful psychiatry astatine Weill Cornell Medical College.
An Exploration of Medicine and the New Human
By Siddhartha Mukherjee
Scribner. 473 pp. $32.50
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