The Song of the Cell: An Exploration of Medicine and the New Human

Between the 16th and 18th centuries, scientists believed that miasmas—unpleasant smells or vapors—caused disease. In particular, they thought that “miasmas carried particles of decaying matter called miasmata that somehow entered the body and forced it to decay” (22). Diseases like cholera and typhus ran rampant through densely populated areas in the poorer parts of cities. In contrast, wealthier neighborhoods, with cleaner air and water, had healthier populations. Scientists used this as evidence to support their miasma theory of disease. Mukherjee notes that “while the notion of vaporous contamination and miasmata seemed to carry a vague ring of truth—and provided perfect justification to further segregate rich and poor neighborhoods in cities—the understanding of pathology was riddled with peculiar puzzles” (23). One such puzzle of the time was why a clinic in Vienna, Austria had substantially higher maternal death rates than an adjacent clinic. Doctors and scientists couldn’t yet explain human diseases systemically.

The invention of the microscope in the early 17th century is the first major breakthrough that Mukherjee discusses. The microscope revolutionized cell biology and medicine. For the first time, scientists could see organisms (i.e., cells). They soon found cells in all living organisms. Matthias Schleiden and Theodore Schwann collated the work of these early microscopists to argue that cells were the building blocks of all living creatures, launching cell theory. In addition, microscopic observations enabled researchers to begin explaining the cause of human diseases.

Mukherjee discusses how the evolving understanding of cells led to breakthroughs. One example is the centrifuge, which enabled cell biologists Keith Porter, Albert Claude, and George Palade to look inside a cell. The centrifuge pulled apart the different components of a cell, allowing the researchers to study them separately using an electron microscope. Mukherjee notes that this method helped the researchers enter the “luminous heart of the cell” (84). Understanding the cell’s anatomy led to numerous breakthroughs in medicine and treatments for disease (including at the cellular and organelle levels). Insulin is another example. By understanding human stem cells, scientists refined how patients received insulin. In particular, Mukherjee notes that science is close to creating a bioartificial pancreas, which could eradicate diabetes, improving many lives.

The desire to study cells between the late 1600s and the present has attracted people from many different backgrounds. Some were self-taught, like Antonie van Leeuwenhoek, whereas others came from the scientific establishment, like John Snow and Louis Pasteur. Fierce rivalries between scientists (some of which ended in murder) helped lead to some of the most transformational discoveries, including vaccines, in vitro fertilization (IVF), and an understanding of the pancreas.

Mukherjee underscores how science doesn’t operate in a bubble. Scientists continuously build on, refine, and reject ideas that had come before them or were contemporaneous. One poignant example of this was the discovery of the first five tenets of cell theory. Schwann and Schleiden created cell theory from the work of earlier scientists who had discovered that cells were found in all living organisms (which represents the first tenet of cell theory). Their argument was unique because they asserted that cells were the building blocks of all organisms (the second tenet of cell theory). Building on these two ideas, Rudolf Virchow added another three: that cells derive from other cells (Omnis cellula e cellula), that cells are responsible for normal physiology, and that the disruption in the physiology of cells causes disease. Virchow wouldn’t have been able to identify these tenets without Schwann and Schleiden’s two founding tenets. Likewise, Schwann and Schleiden’s tenets relied on the work of other scientists. These five tenets “revolutionized our understanding of the human body as assemblages of these units [cells]” (50), but this revolution happened only because of the collaborative and iterative nature of the scientific process.

While breakthroughs are critical to advance the understanding of cells, disease, and life, Mukherjee emphasizes throughout the book that these breakthroughs shouldn’t violate the fundamental ethics of research (e.g., informed consent and the proper use of human and animal subjects). A particularly egregious example of this is the story of He Jiankui. While he may have been the first to successfully edit a human genome, he “made terrible choices at every level” (130)—choices that hurt the scientific community because they increased the public’s concern about gene editing and IVF. Additionally, his actions adversely impacted individuals who might eventually benefit from these two cellular therapies.