The Song of the Cell: An Exploration of Medicine and the New Human

Abstract

In 1665, Robert Hooke, a British Renaissance man, looked at a piece of cork through a rudimentary microscope and observed that it comprised “a great many little boxes.” Hooke termed these “boxes” (plant walls, in fact) as “cells” from cella, Latin for “small room,” since the structures reminded him of monks’ dwellings. Some two centuries later, it was Rudolf Virchow who stated, “every pathological disturbance, every therapeutic effect”—that is, all disease and treatment—can be traced back to cells. This book is a homage to the cell: the smallest and least autonomous living unit of life. It covers the past, present, and future of this unusual unit and its structure and function—as well as similarities, dissimilarities, and relationships between them. The author states that observing the cell structure and its interactions with its environs is akin to listening to its “song.” Hence, the title of the book. The author, Siddhartha Mukherjee, is a clinical oncologist and a basic scientist. Currently on the medical faculty at Columbia, he was a Rhodes scholar and is an alumnus of Stanford, Oxford, and Harvard. This is his fourth book, the earlier ones being The Emperor of All Maladies: A Biography of Cancer (which won a Pulitzer), The Laws of Medicine: Field Notes From an Uncertain Science, and The Gene: An Intimate History. The arc of this overachiever’s oeuvre has now led to his latest book on the microscopic entity that makes up all life on this planet. The cell is as minuscule in size as it is massive in impact, and the book covers its biology (and pathology) in some detail. Other related topics covered include cell manipulation, gene editing, immunotherapies, in vitro fertilization, monoclonal antibodies, organ transplantation, stem cell research, and vaccines. In recounting the scientific endeavors relating to cell biology, Mukherjee visits the seamy side of human behavior, including contempt among contemporaries. The sheer bulk of information contained in these 450+ pages is overwhelming—and can be intimidating. Mercifully, the text is often lightened by whimsical use of metaphors (eg, a cell can be “refulgent, glimmering, alive”; an antibody is a “gunslinging sheriff”; and neutrophils “live for just a few days after entering circulation. But what dramatic days!”). The term new human in the title is a reference to those among us whose lives have already changed because of cell-based therapeutic approaches (eg, leukemias managed by cellular engineering). These new humans are still Homo sapiens but could be considered Homo sapiens plus. Ethical considerations, including those of treating embryos for cellular abnormalities leading to “genetically altered” humans, are touched upon. The Song of the Cell encourages us to reconsider some of our approaches to medicine and face the impending revolution in cellular biology. The book is simultaneously bold, challenging and dizzying, occasionally exhausting, yet invariably informative. Despite the explosion in our knowledge of the workings of the cell, it is humbling to read here that with regard to the cell, we “don’t even know what we don’t know.”

Topics & Concepts