The Emperor of All Maladies. Siddhartha Mukherjee
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rel="nofollow" href="#ulink_d88eefa4-cd51-54ee-af9c-afb7ce02212f">Part Two An Impatient War
Perhaps there is only one cardinal sin256: impatience. Because of impatience we were driven out of Paradise, because of impatience we cannot return.
—Franz Kafka
The 325,000 patients with cancer257 who are going to die this year cannot wait; nor is it necessary, in order to make great progress in the cure of cancer, for us to have the full solution of all the problems of basic research . . . the history of Medicine is replete with examples of cures obtained years, decades, and even centuries before the mechanism of action was understood for these cures.
—Sidney Farber
Why don’t we try to conquer cancer by America’s 200th birthday? What a holiday that would be!
—Advertisement published in the New York Times by the Laskerites, December 1969
All of this demonstrates why258 few research scientists are in policy-making positions of public trust. Their training for detail produces tunnel vision, and men of broader perspective are required for useful application of scientific progress.
—Michael Shimkin
I am aware of some alarm259 in the scientific community that singling out cancer for . . . a direct presidential initiative will somehow lead to the eventual dismantling of the National Institutes of Health. I do not share these feelings. . . . We are at war with an insidious, relentless foe. [We] rightly demand clear decisive action—not endless committee meetings, interminable reviews and tired justifications of the status quo.
—Lister Hill
In 1831, Alexis de Tocqueville, the French aristocrat, toured the United States and was astonished by the obsessive organizational energy of its citizens. “Americans of all ages,260 all conditions, and all dispositions constantly form associations . . . of a thousand other kinds—religious, moral, serious, futile, general or restricted, enormous or diminutive,” Tocqueville wrote. “Americans make associations to give entertainments, to found seminaries, to build inns, to construct churches, to diffuse books, to send missionaries to the antipodes. . . . If it is proposed to inculcate some truth or to foster some feeling by the encouragement of a great example, they form a society.”
More than a century after Tocqueville toured the States, as Farber sought to transform the landscape of cancer, he instinctively grasped the truth behind Tocqueville’s observation. If visionary changes were best forged by groups of private citizens forming societies, then Farber needed such a coalition to launch a national attack on cancer. This was a journey that he could not begin or finish alone. He needed a colossal force behind him—a force that would far exceed the Jimmy Fund in influence, organization, and money. Real money, and the real power to transform, still lay under congressional control. But prying open vast federal coffers meant deploying the enormous force of a society of private citizens. And Farber knew that this scale of lobbying was beyond him.
There was, he knew, one person who possessed the energy, resources, and passion for this project: a pugnacious New Yorker who had declared it her personal mission to transform the geography of American health through group-building, lobbying, and political action. Wealthy, politically savvy, and well connected, she lunched with the Rockefellers, danced with the Trumans, dined with the Kennedys, and called Lady Bird Johnson by her first name. Farber had heard of her from his friends and donors in Boston. He had run into her during his early political forays in Washington. Her disarming smile and frozen bouffant were as recognizable in the political circles in Washington as in the salons of New York. Just as recognizable was her name: Mary Woodard Lasker.
Mary Woodard was born in Watertown, Wisconsin, in 1900. Her father, Frank Woodard, was a successful small-town banker. Her mother, Sara Johnson, had emigrated from Ireland in the 1880s, worked as a saleswoman at the Carson’s department store in Chicago, and ascended briskly through professional ranks to become one of the highest-paid saleswomen at the store. Salesmanship, as Lasker would later write, was “a natural talent” for Johnson. Johnson had later turned from her work at the department store to lobbying for philanthropic ventures and public projects—selling ideas instead of clothes. She was, as Lasker once put it, a woman who “could sell261 . . . anything that she wanted to.”
Mary Lasker’s own instruction in sales began in the early 1920s, when, having graduated from Radcliffe College, she found her first job selling European paintings on commission for a gallery in New York—a cutthroat profession that involved as much social maneuvering as canny business sense. In the mid-1930s, Lasker left the gallery to start an entrepreneurial venture called Hollywood Patterns, which sold simple prefab dress designs to chain stores. Once again, good instincts crisscrossed with good timing. As women joined the workforce in increasing numbers in the 1940s, Lasker’s mass-produced professional clothes found a wide market. Lasker emerged from the Depression and the war financially rejuvenated. By the late 1940s, she had grown into an extraordinarily powerful businesswoman, a permanent fixture in the firmament of New York society, a rising social star.
In 1939, Mary Woodard met Albert Lasker262, the sixty-year-old president of Lord and Thomas, an advertising firm based in Chicago. Albert Lasker, like Mary Woodard, was considered an intuitive genius in his profession. At Lord and Thomas, he had invented and perfected a new strategy of advertising that he called “salesmanship in print.” A successful advertisement, Lasker contended, was not merely a conglomeration of jingles and images designed to seduce consumers into buying an object; rather, it was a masterwork of copywriting that would tell a consumer why to buy a product. Advertising was merely a carrier for information and reason, and for the public to grasp its impact, information had to be distilled into its essential elemental form. Each of Lasker’s widely successful ad campaigns—for Sunkist oranges, Pepsodent toothpaste, and Lucky Strike cigarettes among many others—highlighted this strategy. In time, a variant of this idea, of advertising as a lubricant of information and of the need to distill information into elemental iconography would leave a deep and lasting impact on the cancer campaign.
Mary and Albert had a brisk romance and a whirlwind courtship, and they were married just fifteen months after264 they met—Mary for the second time, Albert for the third. Mary Lasker was now forty years old. Wealthy, gracious, and enterprising, she now launched a search for her own philanthropic cause—retracing her mother’s conversion from a businesswoman into a public activist.
For Mary Lasker, this search soon turned inward, into her personal life. Three memories from her childhood and adolescence haunted her. In one, she awakes from a terrifying illness—likely a near-fatal bout of bacterial dysentery or pneumonia—febrile and confused, and overhears a family friend say to her mother that she will likely not survive: “Sara, I don’t think that you will ever raise her.”
In another, she has accompanied her mother to visit her family’s laundress in Watertown, Wisconsin. The woman is recovering from surgery for breast cancer—radical mastectomies performed on both breasts. Lasker enters a dark shack with a low, small cot with seven children running around and she is struck by the desolation and misery of the scene. The notion of breasts being excised to stave cancer—“Cut off ?” Lasker asks her mother searchingly—puzzles and grips her. The laundress survives; “cancer,” Lasker realizes, “can be cruel but it does not need to be fatal.”
In the third, she is a teenager in college, and is confined to an influenza ward during the epidemic of 1918. The lethal