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“癌”的正传
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两天前，哥伦比亚大学宣布了2011年Pulitzer奖名单（http://www.pulitzer.org/files/2011longlist.pdf），偶然看到华人周龙的歌剧《白蛇传》获得了音乐奖；不过我只对图书感兴趣，可看看题目，却都不是我能感兴趣的：
FICTION - "A Visit from the Goon Squad" by Jennifer Egan (Alfred A. Knopf)
DRAMA - "Clybourne Park" by Bruce Norris
HISTORY - "The Fiery Trial: Abraham Lincoln and American Slavery" by Eric Foner (W. W. Norton & Company)
BIOGRAPHY - "Washington: A Life" by Ron Chernow (The Penguin Press)
POETRY - "The Best of It: New and Selected Poems" by Kay Ryan (Grove Press)
GENERAL NONFICTION - "The Emperor of All Maladies: A Biography of Cancer" by Siddhartha Mukherjee (Scribner)
最后那本非虚构类的书，名字起的好，把癌症封为“病帝”，为病帝立传，该是别开生面的医学史吧？《纽约时报》书评http://www.nytimes.com/2010/11/14/books/review/Weiner-t.html （2010年11月12日）的题目也有意思：The Mind of a Disease——既然将癌症拟人了，为他立传自然要走进他的内心，enter the mind of this immortal illness, understand its personality, to demystify its behavior。作者开头就说，所有的病人都是讲故事的高手，他们历经病痛，就像行者游历“kingdom of ill”。
凭我的一点直观认识，癌与其他疾病的区别大概在于它是“内秉的”，是天生的。肿瘤学（oncology）一词源自希腊语的onkos，意思是“重负”（mass和burden），所以作者说，“Cancer is indeed the load built into our genome, the leaden counterweight to our aspirations for immortality.”
这样看来，癌变也许像非线性系统里的avalanche，在一定临界条件下就会发生，怎么也挡不住（如核辐射激发的癌变）。作者也抱谨慎乐观的态度（only guardedly optimistic），说肿瘤学总在“绝望与希望之间打转”（“the queasy pivoting between defeatism and hope.”）虽然James Watson说了，“Beating cancer now is a realistic ambition because, at long last, we largely know its true genetic and chemical characteristics.” 但即使明白了一种机制，我们也未必能预言或控制事件的发生——除非把整个系统都破坏了。
因发现逆转录病毒致癌基因（retroviral oncogenes）的细胞起源而获诺贝尔奖（1989）的Harold Varmus把癌细胞比作Beowulf里的怪物Grendel，是人类自己的扭曲的变体："We have only seen our monster more clearly and described his scales and fangs in new ways – ways that reveal a cancer cell to be, like Grendel, a distorted version of our normal selves." Mukherjee认为这不仅是一个metophor，它还意味着我们不能完全摆脱癌，因为我们不可能完全摆脱自我的“扭曲”——“We can rid ourselves of cancer, only as much as we can rid ourselves of the processes in our physiology that depend on growth -- ageing, regeneration, healing, reproduction.”摆脱癌变，相当于摆脱我们的那些生理过程……
在获Pulitzer奖之前，这本“传记”已经很火爆了：
Amazon.com 100 best books of 2010
New York Times 10 best books of 2010
Daily Beast 20 “Must Reads”
Entertainment Weekly 20 “Must Reads”, Fall 2010
Books for a Better Life nominee
Book Expo America Editor’s Buzz Panel pick (8 books)
Barnes and Noble “Discover” series
本书的广告词儿很多，大多是不费本钱和感情的空头表扬。我选两条稍微具体点儿的，一个夸它的内容，一个夸它的写作：
An elegant … tour de force. The Emperor of All Maladies reads like a novel … but it deals with real people and real successes, as well as with the many false notions and false leads. Not only will the book bring cancer research and cancer biology to the lay public, it will help attract young researchers to a field that is at once exciting and heart wrenching … and important.
—Donald Berry, Ph.D., Anderson Cancer Center, University of Texas
Rarely have the science and poetry of illness been so elegantly braided together as they are in this erudite, engrossing, kind book. Mukherjee’s clinical wisdom never erases the personal tragedies which are its occasion; indeed, he locates with meticulous clarity and profound compassion the beautiful hope buried in cancer’s ravages.
—Andrew Solomon, National Book Award-winning author of The Noonday Demon
读书荐书
https://blog.sciencenet.cn/blog-279992-435168.html
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