The Song of The Cell: An Exploration of Medicine and New Man. Siddhartha Mukherjee. Penguin Random House India. Pages 473. Rs 799.
Futurologist and author Alvin Toffler wrote 52 years ago about a new class of humans emerging among us. He used a term which was at that time very novel but is now almost a household term, thanks to Hollywood – ‘cyborg’.
Toffler started his provocatively termed sub-section titled the ‘Cyborgs among us’ with a flourish of sci-fi mysticism:
Today the man with a pacemaker or a plastic aorta is still recognizably a man. The inanimate part of his body is still relatively unimportant in terms of his personality and consciousness. But as the proportion of machine components rises, what happens to his awareness of self, his inner experience?
Fifty-two years later from the cutting edge of another scientific domain comes another book and it talks about new humans too. These humans are no speculations. They are not ‘AI-augmented, robotically enhanced, infrared-equipped’ etc. But they are real.
The new human is ‘a human rebuilt anew with modified cells who looks and feels (mostly) like you and me’, says Siddhartha Mukherjee – a cancer physician and one of the best science-writers of our generation.
His latest book, The Song of The Cell: An Exploration of Medicine and the New Human, with 377 pages combines seamlessly the history of cell-science, that of medicine from the mid-nineteenth century to the latest cutting-edge explorations and also explores how medical science gives hope to patients who are fighting for their lives and physicians who are fighting for their patients.
The book is a treat at every level for a wide variety of readers.
From Antonie van Leeuwenhoek to Robert Hooke to Schwann and Schleiden, the reader gets an interesting taste of the history of cell-biology.
Things become quite colourful when we arrive at the time of Rudolf Virchow. But special mention should be made about an almost forgotten but an important contributor to microbiology- François-Vincent Raspail (1794-1878). Quite a colourful personality he was!
A rebel, a self-taught microscopist, botanist and chemist, he was also a free-thinker. It is quite amazing how this little-celebrated, self-made scientist had pre-envisaged quite remarkably the inner dynamics of cell. Mukherjee writes:
More than any microscopist, though, it was François-Vincent Raspail who tried to build a theory of cellular physiology out of these early observations. … What were cells made of? “Each cell selects from its surrounding milieu, taking only what it needs,” he wrote in the late 1830s, presaging a century of cellular biochemistry. … What did cells do? “A cell is […] a kind of laboratory,” he posited. Pause for a moment to contemplate the scope of that thought. Using no more than basic assumptions about chemistry and cells, Raspail deduced that a cell performs chemical processes to make tissues and organs function. In other words, it enables physiology. He imagined the cell as the site for the reactions that sustain life. But biochemistry was in its infancy, and so the chemistry and reactions that occurred within this cellular “laboratory” were invisible to Raspail.Mukherjee, p.40
Mukherjee calls him ‘cell biology’s reluctant, defiant pioneer’.
It was Raspail who came with that important Latin aphorism, Omnis cellula e cellula: “From cells come cells”.
This aphorism was made famous by Rudolph Virchow who too was a very interesting personality.
It is quite interesting to note that even before Nazis, the German State had started a malignant quest for a pure race with ‘Aryan’ qualities. We find this interesting titbit about Virchow in this context:
Virchow’s response, characteristically, was to reject accepted wisdom and to try to restrain the surging myth of racial division: in 1876, he began to coordinate a study of 6.76 million Germans to determine their hair color and skin tone. The results belied the mythology of the state. Only one in three Germans bore the hallmarks of Aryan superiority, while more than half was a mixture: some permutation of brown or white skinned, or blond or brown haired and blue eyed or brown eyed. Notably, 47 percent of Jewish children possessed a similar permutation of features, and a full 11 percent of Jewish children were blond and blue eyed—indistinguishable from the Aryan ideal.Mukherjee, pp.51-2
Seamless we move into twentieth and twenty-first century discoveries and advancements made in cellular biology and how these discoveries help us understand our health and vastly reduce human suffering.
Mukherjee combines the actual treatments made to the patients with the narrative of the discoveries that led to the treatments. So, even detailed discussions of the cellular processes (mostly made non-technical and easy reading for the rest of us) make striking sense in a very human and humane context.
This is a book where you will be richly rewarded even in the footnotes.
In 1970s, Ralph Steinman discovered what are called 'dendritic cells'. These are cells which are mainly in the spleen and send out 'dozens of branches—almost beckoning the T cell to come and look', once they detect a pathogen.
They are 'among the most potent mechanisms to secrete molecular alarm bells that activate both the adaptive and innate immune responses.' Steinman discovered these cells and studied them through microscope and worked on them for nearly four decades. He passed away on 30 September 2017. Naturally, obituaries poured in. Mukherjee packs all these in his footnote in the chapter:
But the one tribute that I find the most evocative, written by the Seattle immunologist Phil Greenberg, carries a title that brings us back to the very roots of cell biology—to Van Leeuwenhoek, Hooke, and Virchow, looking down their scopes and unveiling a new cosmos of biology. The article is called “Ralph M. Steinman: A Man, a Microscope, a Cell, and So Much More.” It is the story of virtually every researcher who inhabits this book captured in three words: A scientist. A scope. A cell.Mukherjee, pp.215-6
The book is also a repository of wisdom in doing science. Citing Mendel, Vavilov and Darwin, Mukherjee writes: ‘Highbrow science was born from lowbrow tinkering.’ An apt inspiring guideline for Atal Tinkering Labs now getting implemented in Indian schools.
In 1996, particle-physicist-turned-systems-scientist Fritjof Capra published The Web of Life. Though a good 26 years separate the two books, The Web of Life serves as a good theoretical complementary work to The Song of the Cell. According to Capra, the cell theory of Virchow signals the start of a strong reductionist journey of biology:
When Rudolf Virchow formulated cell theory in its modern form, the focus of biologists shifted from organisms to cells. Biological functions, rather than reflecting the organization of the organism as a whole, were now seen as the results of interactions among the cellular building blocks.Capra, 1996, p.23
The traditional notion of an immune system was based on mostly a reductionist approach, contends Capra. However, the research was revealing something different.
Based mainly on the work of Chilean neurobiologist Francisco Varela, Capra wrote:
The entire system looks much more like a network, more like people talking to each other, than soldiers out looking for an enemy. Gradually immunologists have been forced to shift their perception from an immune system to an immune network. ... The immune system seems to be able to distinguish between its own body's cells and foreign agents, between self and nonself. ... Varela and his colleagues argue that the immune system needs to be understood as an autonomous, cognitive network, which is responsible for the body's "molecular identity." ... As Francisco Varela and immunologist Antonio Coutinho explain, "The mutual dance between immune system and body ... allows the body to have a changing and plastic identity throughout its life and its multiple encounters."Capra, 1996, p.280
Capra wrote of the immune system as a cognitive network and even wrote of a new emerging discipline: ‘cognitive immunology’.
While Mukherjee's book does not mention the brilliant Chilean biologist Francisco Varela, it does bring out vividly the self-non-self-problem.
This is not only a problem of philosophy and theoretical biology but also plays a crucial role in the problems faced by medicine.
From the axiom-like statement that ‘to be a cell, to exist as cell, it must distinguish itself from its nonself’ to the detailed discussion of the role of T-cell in the recognition of the self and non-self for immune response, the problem has a pervasive presence throughout the book.
Nevertheless, here is a very interesting definition of the self from the book:
The self is defined, in part, by what is forbidden to attack it. Biologically speaking, the self is demarcated not by what is asserted but by what is invisible: it is what the immune system cannot see. “Tat Twam Asi.” “That [is] what you are.”Mukherjee, 2022, p.233
That is 'self' defined at a fundamental biological level. But does not that definition remind you of another similar definition? That is what is natural and that is life for you.
In his 1996 book, Capra wrote about cognition at the cellular level. Here is a title of a chapter in the book- 'The Discerning Cell : The Subtle Intelligence of the T-Cell.'
And Siddharth Mukherjhee also captures the complex interactions and processes that Capra talks about:
What about the mechanisms that drive embryogenesis? How do these cells and organs know what to become? It is impossible, in a few paragraphs, to capture the immense complexity of the cell-cell and the cell-gene interactions that allow the developing embryo to create each of its parts—organs, tissues, and organ systems—at the right time and in the right place in the body. Each of these interactions is a virtuoso act, an elaborate, multipart symphony perfected by millions of years of evolution.Mukherjee, 2022, p.140
This is a book that weaves Cultural elements and experiences along with the science in its pages too.
Consider the way the author looks at the shrine of Shitala, the Goddess presiding over the healing of smallpox, which She shares with Manasa, the Goddess for healing snake-bites.
Instead of the narrative of triumphalism of science over a pagan pre-modern goddess worship, the author locates the shrine in the context of both medical history and religious culture.
In the inner sanctum, moistened with sprays of water, there was a figurine of the goddess sitting on a donkey and carrying a jar of cooling liquid—the way she has been depicted since Vedic times. The temple was 250 years old, the attendant informed me. That would place it, not by coincidence, perhaps, from around the time when a mysterious sect of Brahmans began to wander up and down the Gangetic Plain to popularize the practice of tika: taking a live pustule from a smallpox patient, mixing it with a paste of boiled rice and herbs, and inoculating a child by rubbing the mixture on a sharp nick on the skin.Mukherjee, p.178
The author writes about the work on creating ‘a type of cell that has never existed in biology’ which is actually ‘an intermediate cell that lived somewhere between a monocyte, with its indiscriminate cell-eating propensities, and a T cell, with its ability to go after a particular target’ so that it can be used to furiously target the cancer cells. That work was in 2020 at his New York lab. And his thoughts move to Shitala temple:
Shitala, the cool goddess, is also known to have a tetchy side: anger her, and she might wreak havoc on the body with inflammation from poxes, fevers, plagues. Sometime in the near future, we will learn to pitch the innate immune system’s wrath against cancer cells; to calm it in the case of autoimmune diseases; to augment it to create a new generation of vaccines against pathogens.Mukherjee, pp.184-5
The Goddess here becomes the metaphor for the use of immunity networks and processes in ingenious ways to fight cancer – ‘the emperor of all maladies.’
One has to mention a remarkable passage this book has on an Upanishadic Mahavakya – Tat Tvam Asi.
The non-dualism that Indian tradition talks about is not a mechanistic unity into a larger homogeneity. It is subtler. Mukherjee rightly points this out. It resonates more with the ecological boundlessness that connects all rather than all becoming just one larger entity.
There was a cosmic ecology that bound the individual and the spiritual collective into one Being. The phrase “Tat Twam Asi”—“That you are”—permeates the Upanishads and is an expression of the boundless self that permeates not just a single physical body but also the cosmos. … In science, this boundlessness of the individual body and the cosmic body has more recently found its echo in ecology. The whole ecosystem of living beings, we might say, is connected through a network of relationships and, to some extent, the erasure of the boundaried self. A human body and a tree, and the bird that dwells in that tree, say, are linked through such networks—networks that ecologists are just beginning to decipher.Mukherjee, p.228
Mukherjee contrasts a very physical literal monistic unity against this ecological non-dualistic interconnectedness:
Cellular selves don’t particularly like to mix with other cellular selves. Why else would a sponge go to such lengths to limit its fusion with another sponge to form a blissfully boundless cosmic Brahman sponge?p.228
Here then is a poetic example of how understanding of science can elaborate and deepen our own spiritual concepts and vice-versa.
There is also a lesson here for students of Indian culture and society. Here is a scientist, definitely not someone deeply interested in Indian culture or spirituality, just in science – but who grew up in Indian culture. Notice that he is at peace and is comfortable deriving insights and creating metaphors out of both a ‘village’ Goddess and Upanishad Mahavakya.
This is the essence of Indian culture – a deeper unity of healing and auspiciousness, crisply brought out by the term -Subham and not the dialectics of racial-ethnic conflict and artificial binaries.
If you are an artist then you should study this book to get an experience of science that will enhance your art. If you are a student of science then you should read this book to get inspiration to do good science – both as your Sadhana—quest for truth—and Seva—service towards all humanity.
If you are simply interested in reading good books then make sure you read this – you will never again see any living organism as just another living organism.
Once Richard Dawkins wrote that there should be a Nobel Prize for good science writing. Taking science to the society is important. It enrichens all walks of life – from art to politics to religion. If such a category in Nobel Prize is created then Siddhartha Mukherjee emerges as a strong contender for that Nobel Prize.
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