The Indian Express | 1 week ago | 18-01-2023 | 05:35 am
FROM the pandemic and the “tumbling” we took right when we had thought we understood our immune system, to why science lacks rock stars, to the “new humans” that science has created, oncologist and author Siddhartha Mukherjee spoke on a range of subjects at the Express Adda in New Delhi on Monday.Author of Pulitzer Prize-winning The Emperor of All Maladies: A Biography of Cancer (2010), and The Gene: An Intimate History (2016), New York-based Mukherjee is also a noted haematologist and oncologist, whose recently published work of non-fiction, The Song of the Cell: An Exploration of Medicine and the New Human (Allen Lane), takes off from the study of the fundamental unit of life — the cell — and leads readers through the integral role it plays in medical science.Speaking on what he means by “new humans”, Mukherjee said, “I think that in many ways — including the creation of organs, organoids, and the interface between cells and devices… we are creating humans that we haven’t encountered before… In fact, there are people walking amongst us here who may have had a bone marrow transplant and are living chimeras — so their body is their own body, but their blood is being made from someone else’s body.”Giving the example of artificial pancreas in the making, people who undergo neural stimulation to alleviate symptoms of diseases such as depression, and of Louise Brown, the first child conceived in a petri dish, Mukherjee said, “We might as well be creating what in science fiction is a cyborg.”“We are creating people who, in some old technologies, will be called cyborgs. Although they are not really cyborgs, they are cellborgs. They are interfaces between cellular therapies and human beings. And, in so being, really sit at the borderlands of the limits of our current technologies… They are amongst us; they are much more real than the science-fictional new humans. And, they raise many, many questions about who we are, what we do, and what our future looks like,” said Mukherjee.In his new book, Mukherjee, who has demystified and humanised public discourse on medicine and health with his empathetic writing, also explores the pandemic, how it upended our lives and the interaction of the Sars-CoV-2 with our cells that enabled the virus to unleash the global pandemic. Even with his deep knowledge of the immune system – he has been working on immunological cures for cancers – Sars-CoV-2 took him, much like other scientists, by surprise, challenging the understanding of how the immune system tackles a bacterial or viral infection. “The tumbling that happened, I think, is very important. There was a moment of time in which we as a scientific community thought that we understood vaccination, virology, and immunology. And then, all of a sudden, here comes a virus that really challenges very fundamental things that we know and don’t know about how the immune system works.”Talking about why some people tend to get severe Covid-19 while others don’t, he said we have learnt a lot of surprising things through the pandemic. Surprise number one, he said, was that apparently healthy people, men more than women, have a pre-existing auto-immune disease that invisibly affects their capacity to respond to viruses. It’s only when Covid-19 strikes, that previously invisible incapacity to respond to the virus becomes visible. Surprise number two, he said, was that some people carry mutations in genes connected to the immune system – totally invisible for most parts, until Covid-19 hits. Citing the example of long Covid, he wondered whether other viral infections like influenza or Epstein-Barr also lead to such long duration syndromes. “It’s because Covid-19 was such a global pandemic that we have learned to understand the autoimmune consequences of Covid-19 in the long run,” said Mukherjee, who disclosed his voice had changed as a consequence of Covid-19.Replying to a question on whether the pandemic was a result of bio-warfare, Mukherjee said he didn’t think it was but he did not dismiss a lab leak theory completely. The author also spoke on the anti-vax movement in the United States and on the paradox of this being an anti-science moment in an era of medical breakthroughs. The anti-vax movement, he pointed out, was largely driven by three sets of people – the libertarians who say that my body is my body; those who have an anti-science stance; and those who are facing vaccine exhaustion. As for the disdain for medicine, he says, it is driven by medical men not being able to convey their full power and politics that scapegoats it. It is medicine and larger social changes driven by it that has led to child-birth becoming non-fatal and people living up to the ages of 80 and more.Big pharma and pricing of drugs came up for discussion, too. Mukherjee’s recent initiative in Bengaluru, Immuneel Therapeutic Ltd, in collaboration with biotech entrepreneur Kiran Mazumdar Shaw, has been rolling out a crucial clinical trial on the treatment of cancer, called the Chimeric Antigen Receptor (CAR) T-cell therapy, already in use in several countries, that will significantly bring down the cost of therapy for patients in India. He said pharma companies should not be pricing products based on what failed in the valley of death – the phase between an encouraging find and a final product. Developing medicines costs money, he acknowledged, but most large pharma companies he said were surviving by gobbling up highly successful start-ups.The author was in conversation with the Anant Goenka, Executive Director, Indian Express Group, and Devyani Onial, National Features Editor, The Indian Express.A question-answer session with the audience was followed by rapid-fire round with Goenka in which the author revealed that he did not believe in a predetermined destiny, that he believes in life on other planets and named Albert Einstein as his favourite scientist. When asked whether people should “use, reduce, or stop” the following objects, he said yes to microwaves, 5 G and cellphones, and no to hair dyes and artificial sweeteners.The Express Adda is a series of informal interactions organised by the Indian Express Group and features those at the centre of change. Previous guests at the Adda include Union Minister of External Affairs S Jaishankar, Union Minister of Health Mansukh Mandaviya, Union Minister of Housing and Urban Affairs and Petroleum and Natural Gas Hardeep Singh Puri, election strategist Prashant Kishor, Union Minister of Environment, Forests and Climate Change Bhupender Yadav and Union Road Transport and Highways Minister Nitin Gadkari.
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