The Cancer Questions Project, Part 33: Özden Özer

Özden Özer, M.D. is a Hematopathologist at Marmara Leukemia Lymphoma Pathology Laboratory in Istanbul, Turkey. Dr. Özer had her medical training at Marmara University Faculty of Medicine Medical School and pathology training at Northwestern University School of Medicine, McGaw Medical Center, as well as at the University of Chicago where she trained under Drs. Janet Rowley and James Vardiman. Dr. Özer published numerous articles describing her findings in national and international medical journals.

Azra Raza, author of The First Cell: And the Human Costs of Pursuing Cancer to the Last, oncologist and professor of medicine at Columbia University, and 3QD editor, decided to speak to more than 20 leading cancer investigators and ask each of them the same five questions listed below. She videotaped the interviews and over the next months we will be posting them here one at a time each Monday. Please keep in mind that Azra and the rest of us at 3QD neither endorse nor oppose any of the answers given by the researchers as part of this project. Their views are their own. One can browse all previous interviews here.

1. We were treating acute myeloid leukemia (AML) with 7+3 (7 days of the drug cytosine arabinoside and 3 days of daunomycin) in 1977. We are still doing the same in 2019. What is the best way forward to change it by 2028?

2. There are 3.5 million papers on cancer, 135,000 in 2017 alone. There is a staggering disconnect between great scientific insights and translation to improved therapy. What are we doing wrong?

3. The fact that children respond to the same treatment better than adults seems to suggest that the cancer biology is different and also that the host is different. Since most cancers increase with age, even having good therapy may not matter as the host is decrepit. Solution?

4. You have great knowledge and experience in the field. If you were given limitless resources to plan a cure for cancer, what will you do?

5. Offering patients with advanced stage non-curable cancer, palliative but toxic treatments is a service or disservice in the current therapeutic landscape?

The Eerie Eyes Of The Lamb

by Thomas O’Dwyer

The restored Mystic Lamb of the 600-year-old Ghent Altarpiece.
The restored Mystic Lamb of the 600-year-old Ghent Altarpiece.

Across Europe, the doors of museums and art galleries, along with the gates of sports stadiums, are being slammed shut by the Covid-19 pandemic. This week, the oldest museum in Belgium, The Fine Arts Museum of Ghent, was among them. This is sad for it will prevent tens of thousands of art lovers and tourists from seeing a brilliantly restored 600-year-old masterpiece that has survived the slings and arrows of outrageous history to become a legend — and even a viral internet meme — along the way. Among its many adventures, it was stolen by Napoleon and was again looted and almost blown up by Adolf Hitler. Many art historians consider Jan van Eyck’s Ghent Altarpiece, also known as the Adoration of the Mystic Lamb, to be the most exceptional work of art ever created — sorry, Mona Lisa. The brilliantly restored altarpiece was the anchor of Jan van Eyck Year, a national celebration of the painter’s life and art. The exhibition, Van Eyck: An Optical Revolution, was the gold crown on the events.

Hubert van Eyck started to work on the painting around 1420, six years before his death, and his younger brother Jan continued and completed it in 1432. It is gratifying to note that the altarpiece, 3.5 meters wide by 4.5 meters tall,  still stands in the place for which it was commissioned 600 years ago – in the chapel of St Bavo’s Cathedral in Ghent. But it is also startling to discover that it features in the Guinness Book of Records as the most stolen piece of art in history. Indeed one of its panels is still missing since thieves stole it 86 years ago and Belgian police have a 2,000-page file on the mystery.

The “optical revolution” title of the now-closed Ghent Museum exhibition was admirable, as even a casual glance at reproductions of the paintings make clear. We have become so used to photography and realistic art in recent centuries that it is almost impossible to imagine the impact that Jan van Eyck had on the artistic world of his day. But we can still be astonished as we examine the exquisite fine detail in every square centimetre of his work – jewellery, decorative designs on clothes and furniture, landscapes, skies, flora and fauna, even lettering. Botanists can still identify the species of meticulously painted plants — the altarpiece features 75 different kinds of herbs, plants and trees. It seems hard to grasp how such realism was captured 400 years before the first camera. Read more »

Poems and Tales

Mother Writes to the Lion of Kashmir, Long Deceased

5 August 2019

Dear Sheikh Sahib, daring son of Kashmir’s soil.

They tell me, you’re buried on the left bank
of Naseem lake, with views of the Hazratbal
shrine, which you rebuilt, your tomb guarded
by India’s paramilitary troops.

I tell them this represents one of those
paradoxes history keeps throwing up:
the same people who banished you from
Kashmir for long years now guard your tomb,

and the same people whose “Lion” you were
are disenchanted with you for selling out
to your paymasters in New Delhi who
also bankroll your son and his —both dare

not even sigh while India’s troops, shielded
by the Armed Forces Special Powers Act,
immunize themselves even for rape
as they brutally suppress a Vale of Saints.

Gone days when the refrain
Sheikh Mohammed Abdullah
answered our sovereign plea
Azadi Ka Matlab Kyah? Read more »

Epicureanism in the 21st century

by Jeroen Bouterse

If you, like me, have read premodern philosophers not just for antiquarian interest but also as possible sources of wisdom, you will probably have felt a certain awkwardness. Looking for guidance or assistance in ordering our own beliefs, attitudes and actions, we inevitably run into the problem that the great thinkers of the past knew nothing about what our world would look like.

This is not just a matter of technology; it is primarily a matter of social and cultural change. What use is ancient philosophy to me if it presupposes a patriarchal slave-society at every turn? What use is it, if it does not know of nation-states or global markets, or almost literally any institution that I will encounter in my life?

Nor can this problem be resolved simply by ‘proving everything and keeping what is good’, accepting maxims we find useful and rejecting advice we deem problematic. If we think ancient philosophy could be relevant to our lives, it should not be just to confirm our preferences but also to criticize and change them. There must be some transferable logic to whatever school of thought we approach; it must have enough structure, enough internal coherence to challenge us. On the other hand, it must have enough generality or flexibility to be displaced to the 21st century without completely breaking down into tiny parts.

Catherine Wilson claims to have identified the sect that can do this, and it is the philosophy of tiny parts. “Epicurean materialism is, to my mind, a sound basis for humane and enlightened political action”, she writes in The Pleasure Principle (222, see below for full reference). This is a strong claim, but it is warranted: Wilson’s book, which presents Epicureanism as ‘a philosophy for modern living’, does indeed manage to connect sympathetic advice about life in our time to core principles of Epicurean or sometimes more generally materialistic philosophy. Read more »

Our very own annus mirabilis

by Charlie Huenemann

The living few, and frequent funerals then,
Proclaim’d thy wrath on this forsaken place;
And now those few who are return’d again,
Thy searching judgments to their dwellings trace.
– John Dryden, Annus Mirabilis: The Year of Wonders, 1666

This isn’t the first time universities have shut down from fear of pestilence. In 1665, “it pleased the Almighty God in his just severity to visit this towne of Cambridge with the plague of pestilence”, and Cambridge University was closed. Students were sent home, and all public gatherings were canceled. Some students arranged to meet with tutors over that time, but we can suspect that a good number of students simply went home, forgot about their studies entirely, prayed fervently, and followed whatever strategies they could to lessen the chance of death. 

One student caught up in this nightmare was Isaac Newton. At the time, he had narrowly won a scholarship at Cambridge, which meant that he could continue his attendance; he could not otherwise afford it. It is a bit of a mystery just why Newton was afforded a scholarship, has he had pretty much left behind everything that his college valued and taught, and had embarked upon his own course of self-study. His focus was on developing a new mathematics that was more adequate to understanding motion, and in doing this he had few teachers who could help him (or even keep up with him). Over 1665, he lived, ate, breathed, and dreamed mathematics, and did little else in terms of our ordinary conceptions of living, eating, and sleeping. Read more »

Stuck, Ch. 19. I’m a Horrible Person: The Talking Heads, “Burning Down the House”

by Akim Reinhardt

Stuck is a weekly serial appearing at 3QD every Monday through early April. The Prologue is here. The table of contents with links to previous chapters is here.

Image result for raccoon garbageBeing a horrible person is all the rage these days. This is, after all, the Age of Trump. But blaming him for it is kinda like blaming raccoons for getting into your garbage after you left the lid off your can. You had to spend a week accumulating all that waste, put it into one huge pile, and then leave it outside over night, unguarded and vulnerable. A lot of time and energy went into creating these delectable circumstances, and now raccoons just bein’ raccoons.

Likewise, we Americans have spent decades challenging the social norms that used to shame us into proper behavior, or at least discouraged us from publicly engaging in bad behavior. That, in turn, has led to our very own raccoon frenzy, so to speak. Our society now actually rewards certain types of nastiness. We live in a world that abounds with what can only be described as Professional Assholes such as Ann Coulter, Milo Yiannopoulos, Alex Jones, and Simon Cowell.

Yes, dispensing with some of those old social norms was actually the right thing to do. Some of them were restrictive and oppressive. Some of them were used to keep LGBT people in the closet, minorities “in line,” and women “in their place.” Reform was needed.

But we were sloppy. We needed to separate the good social norms, the helpful ones that promote stability, maintain reasonable standards, and discourage people from being assholes, from the old junk norms that repress women and minorities of all stripes. We needed to sort the garbage from the recyclables. But we tossed them all out at once. Read more »

On Pandemic and Literature

Ed Simon in The Millions:

Less than a century after the Black Death descended into Europe and killed 75 million people—as much as 60 percent of the population (90% in some places) dead in the five years after 1347—an anonymous Alsatian engraver with the fantastic appellation of “Master of the Playing Cards” saw fit to depict St. Sebastian: the patron saint of plague victims. Making his name, literally, from the series of playing cards he produced at the moment when the pastime first became popular in Germany, the engraver decorated his suits with bears and wolves, lions and birds, flowers and woodwoses. The Master of Playing Cards’s largest engraving, however, was the aforementioned depiction of the unfortunate third-century martyr who suffered by order of the Emperor Diocletian. A violent image, but even several generations after the worst of the Black Death, and Sebastian still resonated with the populace, who remembered that “To many Europeans, the pestilence seemed to be the punishment of a wrathful Creator,” as John Kelly notes in The Great Mortality: An Intimate History of the Black Death, the Most Devastating Plague of all Time.

The cult of Sebastian had grown in the years between the Black Death and the engraving, and during that interim the ancient martyr had become associated with plague victims.

More here.

Microbiological Class War in China

From Chuang:

Wuhan is known colloquially as one of the “four furnaces” (四大火炉) of China for its oppressively hot humid summer, shared with Chongqing, Nanjing and alternately Nanchang or Changsha, all bustling cities with long histories along or near the Yangtze river valley. Of the four, Wuhan, however, is also sprinkled with literal furnaces: the massive urban complex acts as a sort of nucleus for the steel, concrete and other construction-related industries of China, its landscape dotted with the slowly-cooling blast furnaces of the remnant state-owned iron and steel foundries, now plagued by overproduction and forced into a contentious new round of downsizing, privatization and general restructuring—itself resulting in several large strikes and protests in the last five years. The city is essentially the construction capital of China, which means it has played a particularly important role in the period after the global economic crisis, since these were the years in which Chinese growth was buoyed by the funneling of investment funds into infrastructure and real estate projects. Wuhan not only fed this bubble with its oversupply of building materials and civil engineers but also, in so doing, became a real estate boomtown of its own. According to our own calculations, in 2018-2019 the total area dedicated to construction sites in Wuhan was equivalent to the size of Hong Kong island as a whole.

But now this furnace driving the post-crisis Chinese economy seems, much like those found in its iron and steel foundries, to be cooling. Though this process was already well underway, the metaphor is now no longer simply economic, either, as the once-bustling city has been sealed off for over a month, its streets emptied by government mandate: “The greatest contribution you can make is: don’t gather together, don’t cause chaos,” read a headline in the Guangming Daily, run by the Chinese Communist Party’s propaganda department. Today the Wuhan’s broad new avenues and the glittering steel and glass buildings that crown them are all cold and hollow, as winter dwindles through the Lunar New Year and the city stagnates under the constriction of the wide-ranging quarantine.

More here.

The Logic of the Rebel: On Simone Weil and Albert Camus

Robert Zaretsky in LA Review of Books:

IN THE SUMMER or fall of 1943, La France libre, the London-based provisional government led by General Charles de Gaulle, received a letter from across the Channel. In three closely typed pages, the writer, identifying himself as “un résistant intellectuel,” described the “anguish” he felt as he surveyed the political and moral landscape of Nazi-occupied France. We are teetering, he declared, between renaissance and ruin. Moreover, those struggling on behalf of the former were driven by two often competing ideals: “The clear desire for justice and profound demand for liberty.” Yet, he warned, if we can one day create a doctrine based on these two imperatives, they would lead to the “complete overhaul” of the nation’s constitutional and financial institutions. One way or another, in short, France would never again be the same.

De Gaulle most probably never read this letter. He was, for the most part, too busy making life wretched for Franklin Roosevelt and Winston Churchill to find the time to read or reflect on the clandestine missives sent by the internal resistance movements. Besides, while de Gaulle cast himself as the embodiment of a free France, he had a cast of hundreds to attend to the details of achieving this freedom. This cast included analysts who read these letters from France, recapped the contents, and reported them to their immediate superiors.

This particular letter, I think, would have caught the attention of one of the analysts. Like the writer, the analyst was thinking hard how to balance the often-competing imperatives of liberty and justice. Equally important, she wanted to be sent to France in order to fight, like the writer, in the Resistance. As she told a friend, the suffering of those in France “obsesses and overwhelms me to the point of annihilating my faculties and the only way I can revive them and release myself from the obsession is by getting for myself a large share of danger and hardship.” Her efforts to persuade her superiors, however, were repeatedly rebuffed. Indeed, when de Gaulle himself read one of the analyst’s proposals — namely, to lead a group of nurses as poorly trained as herself to be parachuted onto a battlefield — he dismissed her as “crazy.”

More here.

Between the spreadsheets

Alice Hines in More intelligent Life:

Once upon a time, there was a man who thought love was a maths problem.

“Love is a capricious spark, a miraculous whirlwind,” one of his blog posts began, sarcastically. “It is found by following ancient prophecies, embarking on dangerous quests…Something like that, who knows. Anyway, it sounds like finding a girlfriend was crazy hard before computers!” The man’s name was Jacob. He is currently 32 and works in finance, creating software that helps banks comply with regulations. He has dark curly hair and a beard, a left eyebrow that’s often raised and, in his own words, a “dad bod”. His self-deprecating streak is tempered by optimism. “Growth mindset” is one of his favourite phrases. As in “I’m still not bisexual, but, you know, growth mindset.” For most of his life Jacob dated only when he’d received clear signs of encouragement from one of the many women he found beautiful or fascinating. In 2013 he moved to New York from North Carolina. Thanks to the volume of people using dating apps, it was suddenly possible to spend each night of the week with a different woman who was already intrigued by his online persona. There was the cheesemaker. The fashion designer. Three different med-school students. Jacob liked them all. On each date, he holidayed in another person’s world and learned something new.

But cumulatively, the experience was overwhelming. Jacob knew he wanted to get serious with someone, but he found it hard to weigh the merits of each of these potential partners against each other. So he did what he knew best: he made a spreadsheet. He called it “How to Choose a Goddess”. When he described this to me, some of the calculations lay beyond my comprehension. But my more quantitatively minded friends seemed impressed when I rattled them off.

More here.

Sunday Poem

We’re Together Now

I longed for five years, and then
I got her, my tailfeathers more resplendent
then the other guy’s. Or I have bigger antlers.
So she’s mine. I can circle her
for hours, and she won’t chase me away.
We’ll make a home somewhere
with detritus from both our lairs, I love
the intimacy we share, the body sounds,
though sometimes sort of miss the longing,
which was always there, a scar.

It was like the Red Sox fans
felt the eighty-six years their team
didn’t win the World Series. Then they did,
and what kept those fans on edge
for decades was gone. Sure, winning
was great. But so was all that hope,
so close you could almost touch
the skittish thing, if only, if only.
When if only came true, they had
to learn to live without it.
………………………..It was not the same
after winning. I was better;
it was just not the same.

Michael Chrisman
from
Little Stories
Dyslexia Books, NY, NY;
Antigua Guatemala, 2013

The Party Cannot Hold

Michael Tomasky in the NYRB:

At the moment, as the Democrats struggle over their future, one can legitimately wonder whether the poles of the Democratic tent are strong enough to hold. The divisions are stark. This historical moment is often compared to 1972, when a youth movement similar to the one Sanders leads today took over the party and nominated George McGovern. But if anything, today’s divisions run far deeper. Then, the party was split chiefly over the Vietnam War. There were other issues, to be sure, and the New Left—the 1960s movement of student radicals that spread from Madison to Berkeley to everywhere—pressed a broader critique of American society; but McGovern’s was fundamentally an antiwar candidacy. And while the Vietnam debate was shattering to the party for a few years, wars eventually end, as indeed that one did, not long after the 1972 election.

Once it ended, and once the Watergate scandal mushroomed, the party was able to stitch itself back together with surprising ease. In the 1974 midterms, both liberals and moderates were able to run aggressively against Richard Nixon, and the Democrats made historic gains that year. Then, with the country still agitated over Nixon and Gerald Ford’s pardon of him, and with a sunny southern moderate vaulting over several better-known and more liberal senators, they recaptured the White House in 1976.

The current divide is not about one war. It is about capitalism—whether it can be reformed and remade to create the kind of broad prosperity the country once knew, but without the sexism and racism of the postwar period, as liberals hope; or whether corporate power is now so great that we are simply beyond that, as the younger socialists would argue, and more radical surgery is called for.

More here.

Trump’s Culture Wars Come to Architecture

Anthony Paletta in The Boston Review:

Nearly everything is exasperating about the debate surrounding the Trump administration’s draft executive order, “Making Federal Buildings Beautiful Again.”

The foremost problem is the order itself. An intemperate jeremiad against modernist architecture, it proposes that “the classical architectural style shall be the preferred and default style” for government buildings in Washington and for federal courthouses; the subsequent fine print is designed to ensure that exceptions would be difficult and unlikely. The order first nails its list of grievances to the door of Marcel Breuer’s Brutalist Hubert Humphrey building. It then proceeds to derogate federal architecture over the last fifty-eight years in support of its argument that the government has “stopped building beautiful buildings that the American people want to look at or work in.”

The draft has provoked well-warranted opposition from a chorus of critics: every conceivable architectural professional organization, historic preservationists, architectural historians, and a wide range of others. Most of this response has been sound and reasonable; some has been intemperate and outlandish. The order’s exaggerated contempt for modernism as a willful and deliberate assault on beauty has provoked similarly overheated charges identifying neoclassicism as a vessel for fascismwhite supremacy, and genocide. In this, the Trump administration has displayed its typical incendiary skill at pouring accelerants onto any squabble, inflaming ground that has largely managed, until now, to escape the pitched battles of the ever-widening culture wars.

More here.