Siddhartha Mukherjee in conversation with Rohini Mohan at THIiNK 2011
THE WONDERFUL thing about medicine is that there is an urgency about it. The consequences are so deep. The question I keep asking is: How do we communicate this urgency to a 25-year-old? How do we fire the scientific curiosity of young Indians? The capacity of inspiration can be transformative. How does one create the hunger for new medical ideas?
The misconception of science being the same as technology belongs to postwar America, but it also afflicts India today. There is a lot of technological fire here, but science is not technology. Science generates technology; it is one engine driving the other. There’s substantial curiosity in India about non-technological science, but more than ever today, it needs an ecosystem to thrive.
In science, you don’t say — you do. I didn’t write a proposal for my book because saying that I would write an epic history of cancer would have the idiotic quality of hubris. In the same sense, people in India want to do, but they should DO. Curiosity needs infrastructural resour – ces to turn into research. India needs an atmosphere that allows doctors and researchers to ask the right questions. Post-war USA created a model through the National Cancer Institute; it was the best post-war plan that the US had because its offshoots went so deeply into helping nations around the world. Post-1980s China too had such a self-conscious model. A similarly path-breaking one could be created by post-2011 India.
The longitudinal term of such an innovation project means there can be philanthropists and corporates in medicine, but the State must give the vision.Innovation has to be about nationhood itself. Nations need to be curious about their scientific future. Illness or disease don’t live in a person, they live in networks, in society. It’s not your problem or my problem. It’s our collective problem.
Innovation has to be both social and technological. It sets out to undo mythologies and fixed beliefs. Sometimes it becomes a political question. For instance, you cannot have thriving medicine in a society that disbelieves in evolution. The bigger question, then, is one of freedom. To create the freedoms that are fundamental to scientific enquiry, we need accompanying social freedoms. You can imagine a rather orthodox State saying that we’ll invent new technologies but will still have a system of censorship and surveillance, or live in the darkness of myths. No. The battle is of acquiring the beautiful and complete freedom of thought, of knowledge.
So is this ‘airy fairy understanding’ of medicine relevant to the realities of our world? It’s extremely relevant. Cervical cancer can be largely eliminated by educating women about correct vaccination. There’s no such education today, and tens of thousands of young women are going to die of cervical cancer in India every year. Dollar for dollar, if you eliminated tobacco without being draconian, you wouldn’t even need hospitals with massive chemotherapy units for this. Healthcare is, after all, a multidisciplinary phenomenon that exists in all honesty to help the profound realities of patients and doctors.