Shortly after I began the multifarious medical appointments related to my own cancerous condition, I reserved a book from the library called The Emperor of All Maladies: A Biography of Cancer by Siddhartha Mukherjee. It had been on my radar since it won the Pulitzer Prize over a decade ago, but until I became personally involved, I could never summon the inspiration to read a book about the history of cancer. Now, though, it seemed appropriate to conduct some research to discover what exactly I was dealing with. It is very well-written and well-researched and full of fascinating insight. For instance, there is a description of cancer in a papyrus record from 2500 BC, but for the most part the disease is absent from ancient medical literature. One of the main reasons, as Mukherjee tells it, is that “cancer is an age-related disease – sometimes exponentially so” and “in most ancient societies, people didn’t live long enough to get cancer.” He goes on to point out that “nineteenth-century doctors often linked cancer to civilization,” but “civilization did not cause cancer, but by extending human life spans – civilization unveiled it.”

Of course not all cancer is age-related; the author documents the traumatic struggle of attempting to find a cure for childhood leukemia. He moves from one iteration of cancer to the next, sharing how researchers devoted their lives to discover surgical, radiological, or chemical solutions to this deadly malady. Often it appeared that early pioneers of cancer took one step forward and two steps backward, but they persevered despite innumerable setbacks.

In the midst of reading this tragic epic, I wondered what the hell I was doing. Was it wrong to immerse myself in cancer stories? It was a brilliant book but it was dragging me down. Maybe instead I should be reading something that could get my mind off all of this: perhaps some science fiction or fantasy. Except that I shouldn’t run when I confronted the monster, when I realized it was much more horrible than I had imagined. Instead, I should face it head on. I had been flippant about it all: my diagnosis, the biopsies, and even the initial surgery. As I read on in this book, though, I realized I faced a profound and lengthy and all-absorbing battle – a battle that very possibly might be to the death. Wasn’t it better to know the monster that already had me in its claws? And rather than cower to spit in its face? Why back down? To hell with fear. And to hell with cancer. Getting to know your enemy – that’s the key.

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Mukherjee devotes a lengthy section in the middle of the book to the link between cigarette smoking and lung cancer. Long before mandatory warnings appeared on cigarette packages, scientists were aware that tobacco was a carcinogenic agent and was directly responsible for the explosive rates of lung cancer among smokers. However, the tobacco companies were extremely powerful and replete with well-paid politicians, lawyers, and lobbyists eager to do their bidding. In the years following the Second World War, cigarette smoking was well-nigh ubiquitous among men, and sales campaigns specifically targeted women so as to bring them into the deadly fold as well. It wasn’t until the mid-sixties that the government began to sit up and take notice: Americans were dying of lung cancer at ever-increasing rates, and the tobacco industry was clearly at fault. At first, the warnings on packages were watered down: Cigarette smoking may be hazardous to your health. Later, they became more direct.

Reading about the battle to publicize the toxic effect of cigarettes reminded me of how different things were in my youth. You could smoke anywhere: in restaurants, coffee shops, supermarkets, department stores, buses, trains, and even airplanes. Commercials saturated airtime on radios, television, and movie theaters; men were reminded of how macho and attractive to women they would be if they smoked, and women received messages of empowerment, freedom, and joy. And by the time I personally witnessed these commercials in the late fifties and sixties, the manufacturers knew that their products were deadly and they were killing their customers. They just didn’t care. The money was too good.

I first became hooked on smoking as a young teenager during an excursion for Seattle Times newspaper deliverers. The company booked a passenger liner and took us all on a cruise from Seattle to Victoria B.C. in Canada. On the voyage, the hallways and common areas were thick with smoke. Almost everyone was sitting around smoking and playing poker. The second-hand smoke was murderous enough, but I couldn’t risk ostracism and so I tried a cigarette. And then another. And another. It took just that one boat trip to get me hooked. In the days following, after I got home, I would daydream about living in a mansion with nearby warehouses stuffed with cartons of cigarettes. I soon discovered that the regular smokers, during breaks from high school, would walk up a nearby hill and light up, so I joined them as often as I could.

As a young man I tried to quit smoking at least four times, but always went back to it. At the start of my epic hitchhiking journey from Seattle to Goa, India, in the middle of winter in the 1970s, I hadn’t been smoking for months, but I made a conscious decision to start again because I thought that it might help me get through the hardships I knew were ahead. When I reached Goa, though, and I was about to join a commune of fellow travelers, I knew that they didn’t allow smoking. I made the decision to stop cold turkey as I was walking along the path towards the house and since then, almost five decades ago, I’ve never touched another cigarette. I dodged a bullet there. Mukherjee clarifies that there is no safe way to smoke; a cigarette habit is basically slow suicide. The filters that tobacco companies attached to their products, beginning in the fifties, are ineffective in reducing risk; their advantage, for the tobacco companies, is in the misconception of safety, in the illusion that because of them the toxic product is somehow safer. But it’s not true.

This tale of humans deliberately poisoning their fellow humans, their only motivation being the avaricious accumulation of wealth, is a true-life horror story. I can’t even imagine the mindset. Who would deliberately hurtle a fellow human into the ravenous maw of the cancer beast?

(To be continued)