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When oncologist and Columbia University Medical School professor Siddhartha Mukherjee completed his Pulitzer Prize-winning epic "biography" of cancer, The Emperor of All Maladies, in 2010, he expected it to be his one and only book. He was wrong.
As is often the case for a gifted writer, another book found him. The Gene, he writes, is "the prequel to Emperor's sequel." It is the story "of normalcy before it tips into malignancy.... of the search for normalcy, identity, variation, and heredity."
The book is as compelling and revealing as the earlier work. It begins with a very personal Prologue about nature and nurture. Schizophrenia and bipolar disorder run through Mukherjee's father's Bengali family. For two of his father's brothers, the illness manifested itself against the turbulent background of the partition of the Indian subcontinent in 1947. Theirs is a classic story of the interplay of genetic inheritance and external triggers, and it provides a touchstone to which Mukherjee returns at various points in the narrative.
On one level, The Gene is a comprehensive chronological compendium of well-told stories with a human touch. But at a deeper level, the book is far more than a simple science history. It includes another narrative thread that is, by design, discomfiting.
That thread catches readers by surprise. For its first few chapters, the book seems to be a more or less standard historical narrative as it tells the stories of Gregor Mendel in the garden breeding peas and Charles Darwin mining his trove of samples from his epic voyage on the Beagle which led him to The Origin of Species. Then readers encounter Francis Galton, who took his cousin Darwin's ideas in an unexpected direction.
In 1883, the year after Darwin's death, Galton published a provocative book with a plan for improving the human race by selective breeding, which Mukherjee calls "unnatural selection." Galton thought "he could achieve over just a few decades what nature had been attempting for eons." He called it eugenics, combining a Greek prefix meaning good with the root of genesis.
By 1912, eugenics had become a topic worthy of a prestigious international conference, with the United States taking the lead. Mukherjee's almost matter-of-fact prose leaves readers squirming:
Bleecker Van Wagenen, the young president of the American Breeders' Association, gave a rousing presentation. Unlike the Europeans, still mired in theory and speculation, Van Wagenen's talk was all Yankee practicality. He spoke glowingly about the operational efforts to eliminate "defective strains" in America. Confinement centers--"colonies"--for the genetically unfit were already planned. Committees had already been formed to consider the sterilization of unfit men and women epileptics, criminals, deaf-mutes, the feebleminded, those with eye defects, bone deformities, dwarfism, schizophrenia, manic depression, or insanity."
Even more chilling is the title of the next chapter, "Three Generations of Imbeciles is Enough." It comes not from a Nazi court but from a notorious 1927 U.S. Supreme Court opinion by Oliver Wendell Holmes, Jr., authorizing the sterilization of twenty-year-old Carrie Buck (who shares the book's dedication with Mukherjee's father).
From that chapter forward, readers view the narrative through a different lens. Mukherjee celebrates the acquisition of scientific knowledge of DNA and how it guides the development and functioning of an organism. He makes clear that the technological application of that knowledge offers major benefits to human health. But readers now engage with his discussion of each advance by asking their own ethical questions. That engagement is what makes the history, as the subtitle notes, intimate.
Genetics has now brought us to a pivotal moment. A new technology known as CRISPR/Cas9 enables us to edit DNA with precision. Mukherjee compares the current state of affairs in genetic technology with another ethics-laden technological choice.
In the spring of 1939, Albert Einstein, mulling over recent advances in nuclear physics in his study at Princeton University, realized that every step required for the creation of an unfathomably powerful weapon had been individually completed.... All that was required was sequence: If you strung these reactions together in order, you obtained an atomic bomb....
We are at a similar moment--a quickening--for human genome engineering. Consider the following steps in sequence.... and you arrive, rather effortlessly, at genetically modified humans.
That brings him to this culmination. "We need a manifesto--or at least a hitchhiker's guide--for the post genomic world.... The task of writing that manifesto belongs to another generation, but perhaps we can scribe its opening salvos by recalling the scientific, philosophical, and moral lessons of this history."
There the narrative ends, and a list of thirteen points follows, including many loose ends. It is left as an exercise to the reader, and to future generations, to try to tie them together.