If you hate people but dont hate communism, you dont hate people. Where can you listen to your radio show . You can go you can get everyone of my shows without commercial anytime you want and there is craig or there isgoo much for being here. Despite what is an unusually rainy miami november evening, we at the university of miami are extraordinarily privileged to sponsor tonights event. We are fans of the author and also of the interviewer, and it is my privilege to introduce them both to you. So mikhail securus, who i consider one of my besties, is a professor of medicine and, the chief of division of hematology at the Sylvester Comprehensive Cancer Center at the university of Miami Miller School medicine. He has a medical degree and a masters degree in clinical epidemiol from the university of Pennsylvania School of medicine and completed postgraduate training at harvard university. Mikhail is also the coauthor or author of more than 400 scientific manuscripts cancer. He is on the Editorial Board of several journals, has 60 essays for the New York Times and authored eight books, including when blood down life lessons from leukemia. The food and Drug Administration has been frequently in the headlines recently, but few of us know much about how the agency works. Drugs, the fda safety, efficacy and the Publics Trust tells story of how the fda became the most trusted Regulatory Agency the world before it existed. Drug makers could hawk any potion claim treatment for any ailment and make any promise on a label. But a series of tragedies, Health Crises and Patient Advocacy forced the government to take responsible for the efficacy and safety, drugs and medical devices. In 2011, the avastin hearings, a century of the fdas evolution demonstrating how its of checks and balances works or doesnt. Now on to Siddhartha Mukherjee who is the author of the New York Times best seller gene an intimate history the emperor of all maladies, a biography of cancer, which the 2011 Pulitzer Prize in general nonfiction and the laws of medicine. He also happens to be an associate professor of medicine at Columbia University and a cancer and researcher. The song of the cell an exploration medicine in the new human begins in the late 1600s, when english polymath robert hooke and an eccentric dutch cloth merchant, anthony van lavan, hooke looked through their handmade microscopes. What they saw introduced a radical concept that swept through biology and medicine, complex living organism are assemblages tiny, selfcontained, selfregulating units. Our organs are physiology. Ourselves are built from these which hooke named cells reframing human body as a cellular ecosystem marked the birth of a new kind of medicine based on manipulating cells. And here, mukherjee tells the story of how scientists discovered began understanding them and now are using that knowledge to create new humans. It is my great pleasure to introduce dr. Saka, harris and mukherjee the stage. Thank you. For. Said. Its so nice to see you. Same here. Mikhail said, and i have a bit of a history now. Not bad history in the way people sometimes say we have a history, but the two of us first met when sid was a medical student at harvard and i was a resident at mass general. And so i think were separated training by about three to 2 to 4 years, Something LikeSomething Like that. And then you followed through mass general and then at the danafarber cancer institute. And here we are today. Im going where you are. Well, i hope our rain didnt deter you today. Its delightful to have you here. My pleasure for making the trip. I wonder if i could start off. I wanted to read a little bit, just a brief section from your book, because loved this part and its what draws a lot of us into science. In the introduction, sid writes i have spent a lifetime cells. Every time i see a cell under a microscope with fulgent glimmering. I relive thrill of seeing my first cell on a friday afternoon in the fall of 1993, about a week after i had arrived as a graduate student in allentown science lab at the university of oxford to study immunology. I had ground up a mouse spleen. Yes, we actually do things like that and plated the blood tinged soup in a petri dish with facteur to stimulate t cells. The weekend passed and on monday morning i switched on the microscope. The room was so dimly lit that it was not even necessary to pull the curtains. The city of oxford, always dimly lit, if cloudless. Italy was a land made for telescopes. Then foggy, dark. England seemed custom made for microscopes. And i put the plate under scope, waiting beneath a tissue culture medium where masses of translucent, kidney shaped t cells that possess what i can describe only as an inner glow and a luminous fullness. The science of healthy active cells like eyes looking back at me, i whispered to myself and then to astonishment, the tcell moved deliberately, purposefully seeking out an infected cell that it might purge and kill. It was alive. Its a beautiful segment. And i think that. Thank you. One of the reasons youre so popular here with your writing said you make science approachable and you make science come alive. I understand. Rumor has it we may have some liberal arts majors in the audience. Can i ask you for a brief biology refresher . What is a cell . How does it divide and form organs . So thank you. Mcgill, first of all, and thank you for coming wading through the rain. A cell is the smallest autonomous unit of life. Its its very important to recognize the idea that it in fact the smallest autonomous unit of life, were built out of them. But write down to any living creature, single celled living are still cells. One of the things that a years ago i was working i had a book opening in brazil and i was walking outside botox clinic there everywhere. By the way, in brazil, i was not getting botox. What happens in brazil stays in. Yeah, exactly. But anyway, it was called a life clinic and was this picture of dna outside . It and dna, of course, is the molecule that carries Genetic Information and it has become. Its an iconic molecule, a double helix. Everyone knows it. You walk outside if theres a life clinic here, itll have a picture of dna on it. Whats amazing, that dna itself, the genes is are lifeless. The molecule is lifeless. It has no life. You could swallow it and eat it and would just go right through you. Its the cell that brings dna to life and it i often make the analogy that you can imagine your Genetic Information, your genome as a musical score, but a musical score is a piece of writing. It has no music. Its the cell that that music to life. Hence the word. Hence the song of the cell in the title. But but its very important to realize that that that its if you want to think about life and you want to think about medicine, you have to of course, genes are incredibly important, but you have to think about the cell. And as i said, going back, you know, what is a cell . The cell is the the smallest autonomous unit of life that we know. And everything goes back to the cell. Im going to finish by saying, you know this goes takes us back history to the book in the late 1800s Rudolf Rudolf virchow who will come to was a young pathologist who made two very, very radical statements. His first statement was that all normal physiology is the consequence of cellular physiology. So essentially he was saying, is that everything that we do, every activity, every function, every this conversation, the fact that, you know, the temperature has fallen 20 degrees, what bodies have managed to regulate it and our temperatures havent 20 degrees. Everything is about life is a consequence of cellular function. So that was statement one. And then he made the the obverse of that statement, which actually extraordinarily important in medicine. And he he posited. And now we know its increasing be true. He posited that all disease is cellular dysfunction. So if you want to track down any disease, any source of any disease, it might originate in the environment it might originate in some behavior. It might originate in a situation occupational hazard, a diet, whatever it might be. But ultimately, it has to impinge on ourselves and all illness is cellular dysfunction. And so thats just too highlight the importance of of why we need to understand cells and why why even wrote this book. I love how you positioned that of the cell and the cell and the functions of the cell as, basically carrying out the instructions of the genetics. We but i dont know if anyone knows this. Sid and i both specialize in cancers at the bone marrow, particularly leukemia and leukemia like conditions. And when we talk to patients, we go we talk about the cell. I mean we jump right to it. There arent i dont think there are a lot of diagnoses where understanding the cell those genetics are so critical to understanding the treatments that were offering why why those treatments work and ultimately what we follow over time in people to hopefully show that their leukemia is in remission or even cured or unfortunately, sometimes when it comes back, you harkens back to a past age. Prior to the 20th century. Could you talk a little bit about what people really understood about the cell from the time of robert hooke to Rudolf Virchow, Louis Pasteur and and Walter Fleming . Yeah. So robert hooke was the first person to look at cells and theres a theres a picture of, of, of his first, his own first picture of cells. Actually, he saw he didnt see cells. He the outlines of cells in plants. Hooke was an amazing, amazing. He was an incredible. He was an indigent young student at Oxford Wadham college and sort of a strange world. When i first went to oxford, my my rooms were across from hookes rooms in a bizarre way. Now, are those those have become a national monument. And theyre preserved. But anyway, there was hooke and he i describe him as someone who had a his theres intelligence was phosphorescent and elastic like a rubber band that stretches as it glows or glows as it stretches. Theres a pun in there because. He he all he discovered the laws of elasticity. So hookes one of his major contributions is that he actually figured out how rubber bands work and the physics of how bands work. But nonetheless he was an incredible polymath he was an architect. He was a scientist he was a microscopist he was a telescope. He did telescopes. And at one point in time, he into a nasty argument with newton and said that hed even invented or discovered the laws of gravitation which he hadnt. And and the great irony of this was and this an apocryphal story that apparently that president of the of the Royal Society and the the great story runs that when the royal moved its offices newton was so about about hooke that he refused or or neglected to take the single portrait of robert hooke that exists in in the in the history of the world. And he apparently left it behind in the old the Royal Society. And so there is the man who really the basis optics theres no picture of him. We dont know he looked like anyway so back to hooke so hooke finds these but hooke has no idea why important and he doesnt even know whether theyre general whether he discovered something some universal principle or whether hes just found, you know, something unusual or interesting in his under his microscope. About ten years after him. Theres character who plays a big role in this book named anthony van leeuwenhoek. Hes a dutch clothes salesman, so hes a cloth salesman. And he also invents a microscope, a very different kind of microscope. And his original idea that he wants to look at that, the quality thread, because he lives in delft, theres a big booming trade of of cloth. And so he to look but then he becomes obsessed with his microscope. Now this louis hooke is completely the opposite of hooke. He is. Hes never been trained in science. He has no scientific background. But then he begins to discover in droplets of water and everywhere he looks, he begins to discover what he calls animal quills. But those are, of course, cells. And if youve ever seen that beautiful microscopes, you ever have a chance to go there. Theres a couple of them in the United States where many and in in in the netherlands, the one in the university of cambridge. Theyre theyre beautiful there. But this big. And you hold them up to the sun, you almost think it wouldnt work. But anyway, so hook and lou and hawks sort of discover that there are cells, but none. And neither of them realizes how important they are. This is a time when people are still unclear about how were made, how bodies are made, and theyre to in mass questions that are sweeping through biology. One question is how our bodies made, what are we made of . And for the longest time, people believed that were slabs of meat. And how do those slabs of meat around or you know what . Theres a theory that theres some vital satirical vitalism. Theres some vital fluid. And thats how cells are born. Theyre born out of a process analogous to crystallization. So when you put salt in water in a bath and evaporate some of the water out, it spontaneously forms crystals. And so lots of people believe that thats how cells rise. They you know come into life like crystals come into. So so theres this theory thats sweeping through biology and then theres the other theory which is goes back the same kind of question. Well, if we how do we go from a tiny embryo to being a large, you know, animal . And again, theres no theres no understanding of cells and people that theres a very popular theory called formation in which people think that were sort of we we are fully formed when were born like a little mikhails and and we get sort of blown up like like those macys thanksgiving balloons and we become and bigger and bigger. And ultimately we become fully sized. And thats that those are the reigning theories. Cells come out of spontaneous generation and we as creatures also arise out of spontaneous generation. And the book begins at a moment when these two scientists in germany begin to realize that both those theories are unlikely to be true. Sladen and schwann. The book begins with an evening with them, and all of a sudden realize that that when theyre looking down their microscopes, they begin to in animals and in plants. One is a botanist, ones a zoologist. They realize that, in fact, were made of cells and, thats the beginning of cell theory. So now this brings us up to the 1800s. Then theres theres a long what i call a valley in which people begin to explore. Well, if youre made out of cells, how do cells arise . How do they come, come, come around . How do you how are they born . And how do we develop as humans. And that leads us into the early or late 18, 19th century, early century, when scientists like Rudolf Virchow make the argument that, first of all, that all cells come from cells, and he actually picks up that line from an earlier investigator. But its a its a very audacious line because. Theres no spontaneous, not like crystals you dont form it. You know, you dont form out of water. All cells come from other. And and then i told you the other two that normal function is cellular function and all illness is cellular dysfunction. Incredibly ideas for their time of course later, all proven to be true. Now if you follow that line of thought, lots of things begin to fall out of it. First of all, if you say all cells come from cells, it might seem like a very bland statement, but incredibly important things fall out of that. One thing that falls out of that is if all cells come from cells, then the way you can explain, the development of a of a human being with several trillion. Right, is that they must have come from the division of the first cell, which is the union of the and the egg by the way, the smaller in the body and the largest cell in the body. So thats one thing that comes out of it. And then the other thing that comes around much, much later in the 1950s is a theory of cancer. So if all cells come from cells, then a cancer cell must have come from a normal cell. Theres thats the only way that it could have come. And if thats true, then something must have happened to a cancer cell to make it a cancer cell from a normal cell. And thats the genetic basis of cancer. So you begin to see the roots of these ideas becoming enormous, full of disciplines, the whole discipline of pathology, the whole discipline, embryology, the whole discipline, you know, the study of humans, the study of bacteria, everything comes back to. This this moment of time when cellular theory is established in the late 19th century and, you know, you make it so clear how it was that one critical theory that led to this explosion and probably reason we have such an incredible understanding of the science in the past 100 years as opposed to what had occurred hundreds of years prior to that. Yeah. And again, you know, we had to wait. I mean cell biology had to wait for its its moment and its moment was to some extent it was microscopy. Subsequently, of course, it became much more complex and more developed. It had to wait for that for, that moment and microscopy was that was that moment. Yeah. So lets move on to the 20th and 21st centuries. If okay. One important medical innovation that occurred, the transfer of cells from one human being to another. I never thought about it that way until i read it in your book. But thats whats happening. A straightforward example, of course, are blood transfusions, right . Were bringing cells from one body into another body early, experiments for which range from the macabre to the mad. Those are your words actually love that phrase. So how has the transfer of been used to treat disease as has been the case with bone marrow and even create new life, as was the case for louise brown in england. So cell transplantation has had has a very strange birth. So again going back to the 19th century, you have the first blood transfusions. And initially people thought, well, blood is blood. Why dont we put sheeps blood into a human . And that didnt go very well, not only for the sheep, but for the human being. And so so but the interesting thing that which actually goes back to the subtitle of this book i