My grandfather received a diagnosis of brain cancer a week before I had to hand in my master’s thesis. The very first chapter discussed a scientific paper about his type of brain tumor. I found comfort in losing myself in the work: I sat by his hospital bed as he slept, and analyzed cancer data, typing out equations filled with Greek symbols that he had joked were some kind of sorcery.
When he woke, I presented him with a copy of the thesis; the dedication began, “To my grandfather, who says the math in this thesis is black magic.” My grandmother, a former scientific editor, alternated between feeding my grandfather matzo ball soup and critiquing the language in the thesis; “data,” she said, should be plural.
“I agree with your grandmother,” my grandfather said from his bed.
“Plural sounds pretentious,” I told them.
At least, I thought, I was working on something that would help him. But the night after I visited him in the hospital, I reread the brain cancer paper referred to in my thesis and felt despair. It was far more impressive than my thesis — the sort of work I hoped one day to produce, published in a top-tier journal by more than a dozen scientists. But it offered nothing that could help treat my grandfather; rather, it pointed out how far from understanding brain cancer we are. Brain cancers classified as a single subtype, in fact, contain cells from multiple subtypes of cancer, and this heterogeneity means that treatments are more likely to fail.
I started studying cancer because I had hoped to help myself and those I loved. I learned at 20 that I had inherited the BRCA1 mutation from my mother, who had gotten it from my grandfather. A study in the journal Science found that carriers like me, from families with a history of breast cancer, have an 81 percent lifetime risk of breast cancer and a 54 percent lifetime risk of ovarian cancer.
“Like the protagonist in ‘Flowers for Algernon,’ I will be both scientist and patient,” I wrote, conveniently forgetting that the protagonist was fictional.
We love it when scientists study themselves. We idolize (justly) the researchers who lost their lives during the Ebola outbreak even as they worked to sequence the virusthat was killing them.
But in the four years since I learned I carried a BRCA mutation, I have watched my attempts to do something about it repeatedly miss the mark. I joined a laboratory to do cancer research, but the paper we wrote had little to do with cancer; I joined a company that offered the cheapest BRCA tests on the market, and its service was shut down a month after I arrived. I am 24 years old; at 25, I will have to choose between aggressive screening and prophylactic mastectomy. I had hoped to use my brain to protect my body, but I am running out of time.
If life’s complexities confound a 20-year-old’s desperate idealism, cancer’s do as well. The more I learn, the more I worry that we may never find a singular cure for cancer: that each cancer’s unique biological filigree necessitates a brutal and byzantine combination of treatments.
I also worry that the end goal is so far away that we sometimes lose sight of its importance, and view biological research as a competitive game rather than a means of saving lives. I feared being the worst student in my first cancer class, even though a roomful of researchers better than I am is exactly what I should want. Since then, I’ve seen many indications of the competitiveness in cancer research — a teacher who made us promise not to steal other students’ final projects, scientists who snipe at one another or falsify work — that make me think I am not the only one who sometimes forgets what is at stake.
It is easy to stagger back from the vastness of the problem. “We don’t even understand the rules of the game,” a scientist at the Broad Institute told me. “We are playing checkers, and cancer is playing chess.”
But here at last is a metaphor that gives me hope — because, as it happens, my grandfather taught me to love chess. From the time I was 7, we played every Sunday at a local French cafe, battling for hours over crepes with strawberries and whipped cream. My grandfather was not a scientist, but he loved chess because he had a scientist’s love of a problem complex beyond comprehension. (We also spent a lot of time trying to prove Goldbach’s Conjecture, a statement about prime numbers that has stood for 250 years.) To cancer’s complexities, I think my grandfather would say, as I do, “Bring ’em on.”
Which is not to say this problem will be solved in my lifetime. But this is perhaps the most important lesson I learned from my grandfather: the value of fighting for a future you will never see. Raised by a single mother at the height of the Great Depression, he became a lawyer who devoted much of his earnings to ensuring that all eight of his grandchildren could go to college, even though he knew he would never see us all graduate. As he lay in the hospital, he kept asking how many graduate degrees I would earn.
I am not going to cure cancer, not even the BRCA cancers. And I am going to watch the people I love die from diseases I cannot understand or prevent. I would be lying if I told you I have made my peace with that. It gives me hope only to fight, as my grandfather did, for futures unseen: to strive, to seek, to find and not to yield.
Emma Pierson (Virginia & St Anne's 2014) is studying for a Ph.D. in computer science at Stanford and she writes about statistics on her blog Obsession With Regression. This blog post first appeared in the New York Times.