Dr Bruce Chabner has had immense experience in the discipline of cancer drug discovery and development. During his career at the National Cancer Institute, he worked as a Senior Investigator in the Laboratory of Chemical Pharmacology, Chief of the Clinical Pharmacology Branch, Director of the Clinical Oncology Program, and Director of the Division of Cancer Treatment. His research significantly added to the development of high dose chemotherapy regimens and standard therapies for lymphoma. Additionally, his research led to the development of Taxol. He currently serves as a Professor of Medicine at Harvard Medical School and Director of Clinical Research at the MGH Cancer Center at Massachusetts General Hospital.

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?

Driving Lolita in the World’s Most Militarized Zone

A boy, I hid
in grandpa’s study.

An art dealer
he loved books

with gilded edges,
Aristotle to Zola

all stuck together
in the humidity.

I snuck Lo out
to his black Chevy

rifled for the dirty bits
(should ’ve looked harder, I guess),

drove her away for a spin
teen tunes swirling in my head

I Want to Hold Your Hand.
A crackdown in downtown ‑—

mothers hid their young sons.
“We fear they’ll take them away.”

A soldier rained pellets
on a nymphet’s face,

light of her mother’s eye.
“Moji,” nymphet said,

“Nothing can be seen,
as far as the eye can see.” Read more »

by Mary Hrovat

The roof of Notre-Dame de Paris, lost in the fire of April 15, 2019, was nicknamed The Forest because it used to be one. It contained the wood of around 1300 oaks, which would have covered more than 52 acres. They were felled from 1160 to 1170, when they were likely several hundred years old. It has been estimated that there is no similar stand of oak trees anywhere on the planet today.

Even in the twelfth century, sourcing the wood for cathedral construction was not always easy. When the Basilica of Saint-Denis was under construction in the mid-twelfth century, it was assumed that the nearby forests could not supply the wood needed for the project because they were depleted. Abbot Suger reportedly found a local stand of timber suitable for the job and attributed his discovery to faith and divine intervention. Causes of medieval deforestation include clearing of land for agriculture and the expansion of urban areas. Read more »

by Brooks Riley

by Jeroen Bouterse

For better or worse, Dutch 20^th-century postwar literature comes with a canon of three authors: Gerard Reve, Harry Mulisch, and W.F. Hermans. There, you learned something today. Other than this factoid, however, this post is not going to be a lecture about the landscape of Dutch literature, or even the literary qualities of these authors. I am introducing them because I am going to use two of them, and one in particular, to illustrate a point about discourse involving the landscape of science – that is, the distinction between the sciences and humanities.

The notion of a separation between the sciences and humanities usually revolves (again, for better or worse) around C.P. Snow’s famous Rede lecture. In this lecture, Snow tentatively suggests that what he calls the ‘scientific culture’ is probably more left-wing than the ‘literary culture’, as well as more progressive (scientists “have the future in their bones”). In his time, he saw his technocratic ideals represented best by the Labour party, to which he served as scientific advisor. In the 1970s, however, Snow (as chronicled by historian Guy Ortolano)[1] would drift away from the Labour party, and express himself in increasingly negative terms about all the nonsense one had to put up with as a liberal these days. Before his death in 1980, he expressed his sympathy for neo-conservative ideas.

According to Ortolano, Snow was one of multiple Anglophone intellectuals who reconsidered their political alignments in the 1970s. Nor does this necessarily imply that Snow betrayed or radically revised his own previous opinions. These, it seems, remained technocratic and meritocratic, and precisely therefore problematic in the face of a more egalitarian and anti-elitist ‘New Left’. Read more »

Ivy on a large concrete wall in Franzensfeste, South Tyrol in October, 2019.

by Marie Gaglione

I’m freaking out almost all the time, I’d say. I wouldn’t even limit my angst to my waking hours, because lately my dreamscapes have been rife with post-apocalyptic battle royale scenarios. I’m not writing this with any kind of proposed solution or discernible purpose beyond adding another frightened voice to the void, I just don’t think I can write about anything else until I work through some of this. I find that crafting my fears into essays works as a kind of filing system: I’m still afraid of the thing, but now there is a title and and my thoughts are at least ordered by paragraphs. 

This essay is about technology, probably. I waffle on the theme only because I think blaming existential panic on cell phones is stale, but I’m pretty sure it’s accurate! Let me make my case. I’ve opened Mario Kart Mobile Tour on my phone three times since starting to write this and I’m not yet on my third paragraph. And I’ve already raced all the races and gotten enough stars to pass each cup. And I still keep opening the app. This week it’s Mario Kart, but before that it was Love Island The Game and before that it was Tamagotchi (and Solitaire and Candy Crush and and and). I don’t have a Twitter and I rarely open Instagram so presumably the games are just the most enticing apps I have, but it’s still gross how long I spend with my shoulders tightened, neck tensed, and thumbs exercising. I feel like a loser. And I justify all the time, pretending like I’m having such deep thoughts in the background as I throw red turtle shells. I try to map life onto the racing track; I look for metaphors as I complete a lap and am satisfied with exercising the poetic side of my brain for the day. 

We’re living in a world of infinite content. I tire of one game, there are eight hundred more with subtle variations. I finish a TV show, the streaming network has thirty more recommendations. Every movie, every show, every clip or song or soundbite – it’s all within reach if you can connect to the internet. Which now you can do even on an airplane. I’m worried about it. Read more »

by Thomas R. Wells

Fantasy politics starts from the expectation that wishes should come true, that the best outcome imaginable is not just possible but overwhelmingly likely. Brexit is classic fantasy politics, premised on the delightful optimism that if the UK were only freed of its shackles it would easily be able to negotiate the best deals imaginable.

The great appeal of fantasy politics is that you it puts you in complete control. Using the power of your imagination, you get to control not only what you will do but also how everyone else will react. Sometimes you also control laws of nature, such as economics or even physics. Unsurprisingly, this kind of politics tends to go your way. Decisiveness is the only quality needed for your actions to succeed. Everyone recognises your awesomeness and competes to serve your interests, whether motivated by admiration or fear.

Why is fantasy politics so popular these days? One reason is that it is so much easier than real politics. In real politics we try to address multiple, intersecting, complicated collective action problems – like the high cost of housing or sexism in the labour market – while at the same time grappling with the deep diversity of beliefs, values, and interests within and between societies. Real politics is a difficult and time-consuming activity that usually requires dissatisfactory compromise with reality and what other people want. It is much easier to make-believe our way to our favoured outcomes, i.e. as Boris Johnson put it after the 2016 Brexit referendum, “Our policy is having our cake and eating it.” Read more »

High and Blue Enough

plums on limb tips
across a grassy slice of space
have just begun to taste the sunny juice
that tips the scale of day —a star
that sprays its golden light across turning
leaves above our arbor vitae emeralds,
brushy backboned sentinels twenty feet tall
we planted there when they were three

sun is out of frame to right
but I visualize the mountain’s hump
of brown and ruddy trees it glides above

I visualize the red blaze I see
when time is ripe enough

I visualize the particles and waves
by which light in space behaves

space that’s wide enough
and deep and true enough

space that’s sweet and bright enough,
high and blue enough,

infused with life enough
to make all this possible

and now an aspen flicks an arbor vitae
its hellotouch of  jittering leaves
in vacuum’s breeze

Jim Culleny
10/12/19

Aliza Nisenbaum. The History Lesson, 2017.

” … depicting Carmen and José, second-generation American citizens in Queens. Framing the painting are images from a 1950s-era Mexican coloring book.”

Oil on linen.

More here, here, and here.

by Abigail Akavia

On permanent display in the MFA in Boston is a bust by Oskar Kokoschka, “Self-Portrait as a Warrior.” The sculpture is a dramatic head with bulging features: bridge of the nose, cheek bones, and creased brows. The eyeballs are painted azure blue, the parts around them bright orange. The head’s wrinkled features are highlighted by an unnatural yellow and raw red, which make it look like exposed flesh. The mouth is open. It is this last feature in particular that I found striking: the man portrayed lets out a “violent scream,” as Kokoschka himself puts it in his biography. The portrait, ridiculed when it was first shown in 1909 and later condemned by the Nazi regime as “degenerate,” is an image of torment. This artist-warrior figure of anguish, and the question whether (or how) he is giving voice to his suffering, reminded me of the ancient Greek hero Philoctetes.

A famed archer, Philoctetes was one of the warriors that embarked on the initial expedition against Troy. On the way, he was bit on the foot by a snake. The wound festered and became putrid; Philoctetes screamed in pain so badly that the fleet could not carry out the required sacrifices to the gods. Philoctetes’ suffering presence, in short, was so repulsive and disruptive that the Greeks had to get rid of him. They abandoned him on the island Lemnos, where he remained for ten years, periodically visited by bouts of pain. In the version of his story that has come down to us, a tragedy by Sophocles first performed in 409 BCE, Lemnos is uninhabited. The only thing keeping Philoctetes alive on this desolate place is a magical bow he inherited from his friend Heracles (i.e. the legendary Hercules), with which he preys on wild beasts and birds. Ten years after first leaving him there to fend for himself, the Greeks learn by prophecy that Philoctetes and his bow are necessary to take Troy down. Odysseus sets out to Lemnos to bring him back, with the help of the young Neoptolemus, son of Achilles. Odysseus, forever conniving, deduces rightly that Philoctetes would sooner die than help the Greeks, and concocts a scheme in which it is Neoptolemus’ job to trick Philoctetes into joining him.

To make a long story short, things do not quite go as planned, especially from the moment Neoptolemus witnesses Philoctetes’ excruciating pain. Sophocles’ play is a plot-twisting, complex exploration of the power of language in its various manifestations—sophistry, lies, pleas, inarticulate cries, and poetic invocations, to name some of the drama’s expressive linguistic media. What becomes of humanity when language is used to defy its proclaimed ends? Can language help restore trust and reintegrate into human community a man that has been so traumatized, physically and emotionally, that he can no longer envision camaraderie—no longer imagine any existence other than his beastly exile? Can this trauma be voiced, and responded to, in language? Read more »

Dr. Siddhartha Mukherjee is a physician-scientist with a persistent scientific and clinical interest in acute myeloid leukemia, hematopoiesis, novel therapeutic drug development and cancer biology. He is a Pulitzer Prize-winning author of The Emperor of All Maladies: A Biography of Cancer. He has published articles in Nature, The New England Journal of Medicine, The New York Times, and Cell. Dr. Mukherjee’s research lab at Herbert Irving Comprehensive Cancer Center studies the biology of blood development malignant and premalignant diseases such as myelodysplasia and acute myelogenous leukemia (AML). His goal is to develop new drugs against diseases. He currently serves as an Associate Professor of medicine at Columbia University Medical Center.

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?

by Samia Altaf

I could not believe my luck when I woke up this morning. It had rained last night, but this morning the sky was blue the breeze gentle,and the wild grass along the smelly sluggish, open sewer that meanders through the swanky Defense Housing Authority—home to lush golf courses and palatial villas—past the gates of the elite Lahore University of Management Sciences, was audaciously green. The mango tree in the front yard of my mother’s  house—quiet after a fertile summer of exuberant fruiting—balances the crow’s nest full of chattering chicks in its gently swaying branches. All God’s creations bask in the mellow sunshine. No more the snow and ice and cold of Eastern US. For these weeks, it’s going to be this bliss in Lahore. I was glad to be me, and to be alive. I say to myself “Thank God I am on this side of the earth, rather than under it.” What a beautiful world. So much to see and so much to do. I could live like this for a hundred years like William Hazlitt, who claimed to have spent his life “reading books, looking at pictures, going to plays, hearing, thinking, writing on what pleased me best.” I’ll add eating to that list, at the top of it, fried eggs and buttered toast.

In addition to the sunshine and the crows, and trees waving gently in the breeze, there are books to read, newspapers to follow, old trunks to sort through and the joy of restoring broken things. And now, thanks to the miracle of YouTube, music to listen to, movies to watch, many enlightening videos to engage with. This is no time to die! Although it seems unlikely, I have been hooked onto Gayatri Spivak since I heard her speak here in Lahore some years ago. That formidable woman and her harangue about the subalterns, a word I associated with the military, which I was quite intrigued to learn that evening applies to me as well. Not a word of what she says about subalterns makes sense to me but I love to hear her speak. She really is something. She said things that evening, to a crowded hall of Pakistani college students, activists and others, about Derrida and Gramsci —names I  heard for the first time. Read more »

by Mindy Clegg

In 1994, Miramax Pictures released a small, independently made film by an unknown director from New Jersey named Kevin Smith. Made for a mere $27,000 (maxing out credit cards and the proceeds from selling his comic collection), the black and white film—replete with deeply offensive language, references to drug dealing and usage, and philosophical debates on Star Wars—grossed over $3 million and netted the young director not only a career, but accolades from the Cannes and Sundance film Festivals and nominations in three categories at the Independent Spirit Awards that year.¹ It’s since been acknowledged as one of the best indie films of the 1990s.

Clerks, it can be argued, functions as a brilliant example of Gen X slacker culture that prized authenticity over slick production techniques and funny but insightful discourse over spectacle. Smith’s career has been built on that authenticity in community and self-expression, even in films that fall outside of his “View Askewniverse.” Generally speaking, Smith makes films that he wishes to see, not what he thinks will sell, and that was very generationally grounded. He infused his love of endlessly examining comic books and sci-fi/fantasy films/shows with the structure of the rom-com and buddy film genres to carve out a career catering not to all mainstream audiences, but to a like-minded audience of fans who love seeing themselves reflected on the screen.

Part of the enduring popularity of Smith’s work represents various shifts within film and TV making that centers on at least some Gen X sensibilities. His work also signaled a shift in Hollywood finally beginning to take speculative fiction seriously, in part to cater to Gen X (and later millennial and Gen Z tastes). The goal was never superstar status as a filmmaker, but a career that allowed Smith to make the kind of work he himself sought out and enjoyed, which mirrors the Gen X relationship to other cultural forms, too—the rise of the current subcultural society that we live in now. Read more »

For the Artists

I know you just want to be a flute
the wind sings through
to make a melody
or an intricate mistake
like the existence of crystals
in nature, drifting as flakes
to cover a field
in a clean white blanket
or inside a rock,
the tiny, glittering caves.

In other words, you just want to be
a structure
with the beauty
already
built into it.

But I’d guess, like me
you’ve walked through a few
gardens in heavy shoes
accused friends & lovers of things they did
& sins they didn’t do
panicked awake at 3am
to sit alone in the kitchen
trying to sip breaths in
past your choked throat.

Still, I hear a song
alive in you
when the joy sets in along
your spine and through
the fields and caves of your body.
Somewhere within
a tree, a willow
rustles as a cool wind
from some other world begins to blow.

by Amanda Beth Peery

by Cathy Chua

Shortly before my first trip to Austria in September, a story did the rounds of  a tourist sued for leaving a review on Tripadvisor complaining of a photographic display of Nazis at a hotel in a little town called Gerlos in the Tyrolean Alps. The case has not yet ended, but for now the Austrian court has granted a temporary injunction against the tourist, in favour of the hotel.

Seeing a Nazi publicly honoured at the hotel had made K and his wife feel indignation and disgust, the post said. “This made us wonder what the hotel owners are trying to tell us with this image. This incident speaks volumes about the current state of affairs in this region of Austria. Sadly, our desire to visit this mountain region has disappeared completely.

For me this raised an issue I often find  myself discussing: is the Far Right in Europe, as it presents itself at the moment, ‘new’? Being a historian, I take the long view and see the continuum. For me,  what is happening isn’t new, it’s connected to the past. Far Right sympathies haven’t stopped, they have from time to time gone into hiding, or disguised themselves, but they have always been there, if not necessarily in plain sight. I hope that is full disclosure of my relevant bias. Read more »