I had gleefully agreed to review this book, but when I got the copy I scowled. My aging elbows protested that after six medical college years of coping with Gray’s Anatomy and its muscular cousins, they were in no mood for weight-lifting. But it was so well worth the effort. Sure of my knowledge of some sections of medical history, I thought of skipping chunks of the book to read later. Better sense prevailed—and it was as if the dull pages of botany and zoology had been rewritten by magic fingers. Writerly sophistication comes naturally to this doctor-writer, winner of the Pulitzer for The Emperor of All Maladies. The history of the gene is skilfully interlaced with evolution, heredity and eugenics, its future possibilities are made clear, with never a paragraph that could divert or dull the engrossed mind.
In The Double Helix’s Tight Embrace
Genes define the individual. Siddhartha Mukherjee’s poetic exegesis charts its thrilling discovery and its current significance in ethical medicine.
The gene’s history begINS with Mendel (that endearing monk of posthumous fame), who repeatedly failed the school teachers’ examination and then immersed himself in his passion for gardening, grew 28,000 pea plants and from their breeding habits gained the basic body of knowledge that was to become the foundation of genetics. Mendel lived around the same time as Charles Darwin and his cousin Galton, who pioneered eugenics. The book reveals absorbing stories of scientists wrestling with their ambitions, egos, and often obstinate zeal for discovery, with the tantalising secrets of nature waiting to be revealed. Mukherjee, who is so obviously in love with his subject, writes with restrained passion. About Darwin’s theory of natural selection and survival of the fittest, he has one limpid sentence: “The crucial driver of evolution, Darwin realised, was not nature’s sense of purpose but its sense of humour.” It would have pleased Darwin to see it put so eloquently.
Several physical, mental and emotional traits of an individual can be traced to a specific gene—the basic unit of hereditary information—but, more often, to a number of genes. The entire set of genetic instructions in a person is termed the genome, an encyclopaedia of hereditary knowledge. Mukherjee’s narration embraces the human and scientific parts of the story with lucid empathy and opens it to a wide readership. Explaining the far-reaching possibilities of genetics (both magnificent and reprehensible) with a clear eye and controlled hand requires a certain audacity that comes from insight.
Why is the gene’s story important? We know that developmental defects can be diagnosed in utero, in an embryo. Parents can choose to have specific tests done to find these, and if desired, terminate the pregnancy on ‘medical grounds’. Look into the future of an unborn foetus and decide its fate—to live a life of suffering that the disease may cause, and cost a great deal of expenditure, or not be born at all. Who decides? Parents and medical experts. In countries like India and China, where millions of girls are ‘terminated’ before birth, the implications of such choices are chilling. In the US and later in Europe, the pursuit of eugenics to create a perfect race fascinated scientists. It resulted in their collaboration with lawyers and bureaucrats in deciding to confine mentally disabled persons (including epileptics, the feeble-minded, ‘the idiots, morons and imbeciles’) and sterilise those within the reproductive age. This dystopian fantasy culminated in mass murder in Hitler’s Germany.
Mukherjee describes the competition between scientists to discover the structure of the DNA (which is responsible for genetic coding) right up to its breathtaking finish, and humanises it: “The two of them—Watson and Crick—talked so volubly, like children let loose in a playroom, that they were assigned a room to themselves...to their own devices and dreams, their mad pursuits. They were complementary strands, interlocked by irreverence, zaniness and fiery brilliance. They despised authority but craved its affirmation. They found the scientific establishment ridiculous and plodding, yet they knew how to insinuate themselves into it.... They were self-appointed jesters in a court of fools.”
In 1953, in a lab in Cambridge, Watson and Crick worked out the structure of the DNA, having wrestled their way through a minefield of hopefuls, and all but being tripped by Rosalyn Franklin at King’s College, London, whose near-flawless photograph of the DNA gave them the vital clue to the double helix configuration.
Having solved the initial mystery, scientists set to work on the coding of genes, leading to the identification of abnormal or ‘mutant’ gene formation, which causes disease. Mukherjee’s detailing of the mental illness that afflicted his family complements the questions that arise regarding genetic mutations. But I wish his personal tales weren’t so fragmented. He probes, without saying so, the in-built cruelties of society, which detests any deviation from the normal. We love each other when everything is smooth but heaven help the ‘different’!
The big question is: What happens when coding of genes with pre-natal testing offers the choice of having ‘near-perfect’ children to those who can afford them and not to the others? How exactly are we to cope when ‘humanity’ is pitted against ‘humanity’?
Genetic mutations are a part of evolution. We are now clearly able to identify the ‘mutants’ as different from the ‘normal’ and decide what to do with them. The outcome of genome study will depend on the scope of human imagination, Mukherjee says. The genome is ‘Narcissus reflected’. Is it possible to responsibly modify the genome, he asks, towards the end of the book. In China, it is being tried in four different labs. The first post-genomic human might be on its way. However, while the modification of a gene is relatively simple and involves a single cell, modifying the entire genome (containing some 21,000 genes) is more complex. But it’s not science fiction any more. Is there a gene for humanism? If so, will it triumph over the horrors we are capable of?
For me, reading this book was like being back in college with an eager, 16-year-old mind, savouring the inimitable prose of some of the great writers of physiology, anatomy and pathology. To them I owe whatever ability I have for finding knowledge invigorating, and thirsting for more. I have a few favourites from the writerly world of medicine. This is clearly among the best.
(Nambisan is a surgeon and a novelist)
The Word
Siddhartha Mukherjee says he found writing about the madness in his family the most difficult part of The Gene: An Intimate History. He took the entire family into confidence before going to print and one of the first family members he showed the manuscript to came back with the comment: “It’s a very brutal book.”