The Song of the Cell: An Exploration of Medicine and the New Human by Siddhartha Mukherjee 2022

In this his third book about medicine and science, Mukherjee an oncologist and cell biology scientist, has taken on a herculean task and brilliantly succeeded.  After delving into the history, biology, and current status of cancer and then the gene in his previous books, he’s turned his inquiring mind and engaging style to explore the basic building block of living matter, the cell.

Beginning with the earliest theories of biology (think Aristotle, Galen, Avicenna) through the microscopic observations of Von Leeuwenhoek and Robert Hooke in the 17th C, to Virchow in the 1800’s and right up to today’s gene manipulation of the hemoglobin molecule in sickle cell disease by researchers at Boston Children’s Hospital, Mukherjee provides detailed facts and diagrams to elucidate this rather incredible structure.  He makes this complex information accessible by using wonderfully creative metaphors, e.g. the passage of proteins and lipid-soluble vesicles through ion channels and pores in the cell membrane are likened to an astronaut exploring a mysterious spacecraft and comparing the out-of-control growth of cancer cells to a car’s accelerator being fixed in the floored position while the brakes have been disabled.

Make no mistake, this is not simple stuff.  Having gone to medical school 50 years ago, I found most of the material in the early chapters to be familiar, and I loved revisiting the Golgi apparatus, the endoplasmic reticulum, and the lipid bilayer membrane that form the basic machinery of every cell.  On the other hand, as the stack of pages in my left hand gradually grew, so did the challenge to my rapidly aging brain.  B cells, killer T-cells and helper T-cells, cyclins, the modifiers of gene expression, and a hundred other ‘new’ scientific observations at times left my head spinning as Mukherjee related the basic biology of the cell to clinical conditions—AIDS, immunologic therapy for cancer, gene modification to treat diseases as common as diabetes and as rare as blindness caused by a single gene deletion.

In the book’s epilogue, Mukherjee addresses the ethical and moral dilemmas that are raised by these innovations that enable the engineering of the human genome.  When does repair and regeneration to treat or prevent a serious disease morph into using the same techniques to choose our children’s gender or their height or even their IQ?  While marveling at the brilliant science and indefatigable work ethic of a host of scientists and physicians, the question of what this “New Human” will look like in the coming decades hovers over the book.

Is this a book that everyone should read and will enjoy?  I’m not sure.  I think without some scientific background, it will be tough sledding for many, but perhaps not. There are what seemed like a thousand names of investigators, their universities or hospitals, and their collaborators many of which were interesting for me, but will probably feel like reading the phone book to those who haven’t been a part of this scientific community.  Likewise, does one really need to know about the Myc gene to understand that all cancer is likely due to an accumulation of mutations in otherwise normal cells?

Reading ‘The Song of the Cell’ for me was a reminder of my fascination with biology and its ever growing understanding of how we humans begin as two germ cells and develop specialized organs that pump our blood, exchange oxygen and carbon dioxide with the outside world, synthesize a protein called insulin that regulates glucose levels in the blood, and on and on—-all from a single cell, the zygote.  How absolutely incredible is that!!!  And how wonderful that I was transported back in time to my younger years when this fascination led me to a life of learning and then applying that knowledge to caring for some of the most vulnerable humans, critically ill premature infants.  What a ride!

The NYT Sunday Book Review this week has Mukherjee’s book on the cover.  I’m eager to read someone else’s take on the book. Similarly, I’ll be eager to hear from non-scientist friends who read the book.  My guess is that the 377 page endeavor (473 if you read the endnotes and index!) will prove to thwart the good intentions of most readers.  If you’re game, give it a try.