Cancer

What is it about cancer that so petrifies us? 

Cancer has been like death sentence for many people. Azra Raza, an oncologist with special interest in myelodysplastic syndrome, wrote a book to tell the stories of men and women facing death. I learned about Omar Azfar, a thirty-eight-year-old graduate of Oxford and Columbia, who fought his battle with a highly malignant osteogenic sarcoma of the left shoulder.

After many aggressive chemotherapy slash-burn-poison cycles, radiation therapy, and multiple lung surgeries, he decided to go to Greece for his honeymoon. He didn't want to tell the doctors, and never complained throughout the trip despite the cancer pain. He never lost the life of the mind. Instead of coming up with a list of the hundred books one must read before dying, he had shared with Azra Raza his list of a hundred books that one must read in order to live.

Azra Raza was devastated by Omar's death. The main theme of her book, The First Cell, is to avoid what is known as "group think", when the majority of oncologists have been striving to chase after the last cancer cell. Surgery to remove half of Omar's shoulder, arm and chest. Cisplatin, ifosfamide, and unpronounceable experimental monoclonal antibody like robatumumab. None of them were able to kill the last cancer cells of Omar.

Azra Raza thinks of the first cancer cell instead of the last cancer cell. That's a quantum leap. She reminds us that the best way to fight cancer is not to target the last cell, but to detect the first cancer cell. She pulls back the curtain on the holy grail of tackling cancer. The goal should have been to detect the first cancer cell's footprint, to find every cancer at the earliest precancerous stage. 

The last cancer cell rarely happens (or matters). The first cancer cell does. I think for the thousandth time how much we owe Azra Raza for her first and last duty to the cancer patients.

Knife

The idea of assassinating a novelist after his writing about Muhammad is brutal. 

The way Salman Rushdie was stabbed fifteen times onstage scares me. His liver was damaged. His small intestine had to be removed. He had stab wounds over the neck, the right eye, the left hand, the chest, and over all the face. One year after the miraculous recovery from the knife attack, the Booker Prize winner wrote a memoir to reflect on his journey close to death.

His message about the freedom of expression is clear. It is therefore no surprise that one day after the knife attack, Biden reminded all Americans and people around the world of our commitment to truth, courage, resilience, and the ability to share ideas without fear.

Who won't support freedom of speech? We all should value the right to speak freely. 

But what about the right not to? Sometimes silence is golden. Salman Rushdie mentioned his right eye injury. After the serious damage to the optic nerve, he lost his right eye. His doctor proposed to lower the eyelid and then stitch it shut. I didn't have to listen to his loud noises of anguish to know that procedure really hurt.

Salman Rushdie gave us two pieces of advice. First, if you can avoid having your eyelid sewn shut, avoid it. Second, if you are the surgeon, don't say to your patient "it was successful" after the awful operation. If you choose such expression, mind you, your patient could have sewn your mouth shut.

Lasker

On December 23, 1971, the United States President Richard Nixon signed the National Cancer Act into law. A number of things happened before Nixon's war on cancer. First, Mary Lasker, who remembered her family's laundress who died terribly of breast cancer with seven children around her bed, decided to lobby for expansion of cancer research when "less is spent on cancer research in America than on chewing gum." Next, Mary Lasker recruited her friend Ann Landers to write a column on Reader's Digest appealing to the public.

Nixon's effort wasn't going too well. We knew Nixon wanted to turn the kind of concentrated effort that took man to the moon toward conquering the dread disease of cancer. That's why the President infused more than 100 billion doctors into cancer research. After that, the jaw-dropping statistics showed little decline in death rates for cancer.

The breakthrough seemed to have surfaced after Dr. Luther Leonidas Terry, the ninth Surgeon General of the United States, released the report concluding that smoking causes lung cancer and chronic bronchitis. He quit smoking and encouraged millions of Americans to do the same. The efforts to cut smoking made bigger impact than that of Nixon. 

Whose responsibility is it to save the lives of the country, you might ask? The President Donald Trump, the anti-vaccine health secretary Robert Francis Kennedy, or the National Institutes of Health paralysed after the funding freeze? 

RNA

It strikes me that discovery of RNA can be more groundbreaking than that of the famous double-helix DNA. RNA turns out to be more than a humble servant of DNA. And an important molecule it is. A game changer.

As far as scientific recognition is concerned, RNA-related breakthroughs have led to 11 Nobel Prizes since 2000. Do I have to remind you the 2023 Nobel Laureates have been working on the mRNA vaccines that save millions of lives?

But the structure and functions of RNA have proved to be a lot trickier than DNA's. To learn more about RNA, I borrowed The Catalyst written by the Nobel Prize-winning scientist Thomas Cech. 

To be frank, it is a book I wish I had read before my biology class. It is extraordinary to see how Thomas Cech explains the complicated subject in an easy-to-understand way. One trick of his is to use figurative language or analogy. To explain the concept of splicing noncoding DNA or introns, Thomas Cech reminds us the repair of a badly frayed rope segment by a sailor. That's how a sailor would cut the rope above and below the frayed segment, throw away the damaged piece, and attach (or splice) the ends of the two good pieces back together.

To give us a better idea of splicing, Thomas Cech invites us to think of an intron as a few meaningless words, a string of "blahs," interrupting an otherwise intelligible sentence: You really smell nice blah-blah-blah-blah-blah-blah-blah today. Splicing is explained like a word-processing system which can highlight the offending interruption. Press "Delete", and the blahs are spliced out. You really smell nice today.  

What if there is something called alternative splicing? That happens when there are two introns instead of one: You really smell blah-blah nice blah-blah-blah-blah-blah-blah-blah today. As usual, both introns are spliced out, and then the final version reads: You really smell nice today. But wait, hang on a minute. An unexpected mistake, or so-called alternative splicing, could have come with a hefty price tag. The alternative step could have skipped over nice, resulting in smell being joined to today. That way of splicing would then change the sentence.

You really smell today.

Burial

It's no accident that crime gets lots of attention. This speaks for the journalism cliché: If it bleeds, it leads.

When I read the story of the Lockdown Ladies' Burial Club recently, I was technically sympathising with five women who had killed their husbands. The novel The Best Way to Bury Your Husband looks like a black comedy – and it is.

After the five women had been caught on the dilemma of disposing the dead bodies, they put their heads together to make plans and brainstorm for disposal-site ideas. By pure, horrific change, two of them came up with the ingenious idea of pouring cat litter to dry the body out and stop it stinking.

Slushy nonsense? Not a bit of it. All the women had good reason and deserved the option to get rid of the abusive relationship. Their choice seems to be the only one to stop men being violent. Instead of hiding blue-green bruises by ivory makeup, shutting up to avoid burns because of wrong words, wrong tone, or even wrong place to set the cup down, the women killed in self-defense.

The way this novel was set in the lockdown period speaks for the spiking of domestic abuse since 2020. The abuser says, "You can't go out; you're not going anywhere." As the pandemic dragged on, one of the women in the novel paused at the newspaper front page showing volunteer gravediggers hard at work, with the headline "funeral and burial services unable to keep up with demand." Surely, nobody would notice if one more dead husband was filled in.  

The sad truth is that far more women were killed by the partners than vice versa. Can anyone notice?

Blossom

Every spring, Hong Kong Instagrammers love to post the deciduous golden trumpet trees in full blossom. Also known as yellow poui trees, these bright yellow trumpet-shaped flowers are the prime photographer draw. 

I arrived at the alma mater early two weeks ago so I could pick a serene spot, and an unmistakably beautiful one, to have a stroll before attending an organ donation ceremony. As soon as I arrived, I saw the vibrant golden flowers, resembling wind chimes or bells. Their blossoming period lasts for less than a month. By the time I returned today, the flowers have gone. 

After the golden blooms, long furry brown seed pods hang from the branches. It's one thing to capture the yellow flowers by camera, quite another to capture the seeds. Nowhere else do you see such a dramatic change in appearance. That’s almost a fairy tale of The Ugly Duckling in reverse order.