Profile £15 pp312

In the final stages of his father’s cancer, Adam Wishart describes how he visited the workshop at his parents’ home where stood a Victorian printing machine with lines of lead type set for inking. Wishart’s father was a distinguished statistician and polymath with an amateur interest in hand presses. “The orderly lines of letters had fallen sideways,” writes Wishart, “and the words were in a jumble . . . there were still some lines of poetry and aphorisms, and even some pages of sentences, but there was also much nonsense. It made me think of the errors in the patterns of nucleic acids that now formed some of his genes.”

An imaginative fusion of anecdotal detail, medical science and poignant, elegiac narrative marks every chapter of this unusual book, which recounts the development of Wishart’s father’s illness. The author punctuates the progression of his father’s decline with episodes from the long and chequered history of attempts to understand cancer and find a cure. He writes with admirable clarity on the early days of cell biology, the discovery of chemotherapy and the technology of radiotherapy, and on the heady early days of DNA and genetic science, the significance of epidemiology and the authenticity of alternative strategies such diet and meditation. At the same time, he builds a portrait of his father under the duress of a roller-coaster illness (the joyous remissions, the false hopes, the inevitable lapses) as a man who becomes all the more noble, human and understood in the course of his affliction.

This dual focus is ambitious. There are times when the relentless contrasts between the personal and the factual are almost too queasily contrived for comfort. And yet, ultimately, the strategy works; for without the constant relief of the detached scientific set-pieces, the intimate reportage of the sickroom might have proved unbearable. What emerges is a unique profile of a father-son relationship, poignantly affectionate yet utterly devoid of sentimentality.

Writers of medical case-histories, from Alexander Luria to Oliver Sacks, have demonstrated the power of illness to reveal character and essential humanity. Wishart has also exploited this potential in an intimate personal history with skilful literary acumen. He tells us, for example, of his life-long fear for his father’s health, which sprang in part “from his inability to see his body as anything other than a rather pointless and badly engineered vessel to transport his brain”. The father’s passionate, obsessive, restlessly inquiring mind is thus inextricable from the neglect of his body. “Blind to his own physicality,” writes Wishart, “he hardly ate for reasons other than taste, nor did he exercise, and he smoked the odd cigar in the face of my mother’s protests and drank copious amounts of red wine.”

Every year a great many books are published about cancer. Scientific studies in oncology proliferate as medical science expands. There is a virtual publishing industry, moreover, in objective, information, advice, and self-help for a general readership. There are also books that tell the stories of individual sufferers; they do not make comfortable reading. Yet some accounts succeed in giving both sufferers and those close to them hope and strength. It is this cathartic effect that raises CS Lewis’s A Grief Observed (later made into the film Shadowlands), into a work of literature. And now there is Wishart’s book, which inhabits a remarkable genre of its own.

A fitting finale is his description of a new class of drugs such as Glivec, which work by blocking signals within cancer cells and preventing a series of chemical reactions that cause the cells to grow and divide. Another striking recent example, not mentioned in his book, is Herceptin, designed to treat breast-cancer patients. The remarkable results of the global Herceptin trials, known as Hera, were announced in Orlando in May 2005, but a shortcoming of the closing chapter is Wishart’s neglect of the political battle in Britain over Herceptin’s availability on the National Health Service. He rightly points out that the new class of blocker drugs, widely prescribed in Europe and North America, indicate that cancer is on the way to becoming a chronic illness: a disease that many will die with rather than from. That can only happen for British patients, of course, if the new classes of drugs are available for all appropriate patients, and in good time.

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