AP Meeting

Two big "takeaways" and a clarification....

First, the clarification....I've been replaying the meeting in my head and  one thing I remember is that we started talking a little bit about grading  and I was trying to quickly explain my philosophy when I said "I don't care about your grades."  I hope you all know that that didn't mean "I don't care about your grades."  I know that you care deeply about your grades and, of course, I care about what you care about. What I meant when I said that was that I care most about your mastery of the content.  And, of course, if you master the content, the grades will take care of themselves.  That's what I meant. I am sorry if for any moment today you might have thought that what is important to you is not important to me.  That is wholly untrue.

Takeaways.....

1.  Review, review, review.
2.  Let the blog and the maps be the tools that help narrow your focus for review.

New Drugs for Old Cancers

Two traditional Achilles' heels.

Three new Achilles' heels.

Of course, this Achilles' heel thing is a sweet rhetorical move.  You know, with the "long molecular 'foot'" and all.

No one had labored in vain

I think we needed this cautiously cheery little chapter.  I don't have much more to say about it.  Anyone else? (crickets:)

The hallmarks of cancer

The list of six.....

The long, slow march of cancer.....our long, slow march through this book is nearing its end as we reach Part Six.

I still want to create maps for Parts 4 and 5.  I will try to have those done by the end of the day tomorrow.

A Risky Prediction: the sequel

That was a tough section, so I am coming back to it.  I really need your help with this one.  What do you see as the major "takeaways" from having read through all of that craziness?  Everyone who contributes wins as you retain 29% more of the material with which you engage.

A Risky Prediction

So, this is the part where I do a little bragging.  Some of you may have heard me talk about my sister-in-law, Sandy.  This is the link to her lab: http://mclab.bwh.harvard.edu/index.html.  But when I met her in 2005, she worked with Robert Weinberg in his lab.  I toured it.  Confession: At the time, I had no idea about the importance of Robert Weinberg and his lab.  And, you now know who Robert Weinberg is. And so, you can see why I am kind of star struck by my own sister-in-law.

Here is another link to something else she is involved in.  http://www.dfhcc.harvard.edu/membership/profile/member/1641/0/?PHPSESSID=e2643a915c31d7a861de014cc95517b5

She is the kind of person who would be embarrassed to know that I am showing her off here.  Very humble.  So, I'm not going to tell her.  Let's keep it to ourselves.  Nah, I'm going to tell her.

ONE HUNDRED PAGES TO GO!!!!!

Piece of cake.  Finish strong, people.

The Wind in the Trees

Explain the connection between "jammed accelerators" and "missing brakes" and cancer.

The hunting of the sarc

True or False  Howard Temin's discovery of reverse transcription advanced the understanding of human carcinogenesis.

Define carcinogenesis.

Define carcinogen.

Define oncogene.

Define kinase.

I think that pages 360, 361 and 362 are probably the most difficult of the entire book.  Tons of scientific vocabulary and description of processes make it difficult to comprehend fully.  Good readers tolerate a little ambiguity in order to get the big picture.

Who are Varmus and Bishop and for what did they receive the Nobel Prize?

What famous epic poem does Varmus use to discuss the cancer cell?

And holy recursive text structure, Batman.  Hopefully, by now you know what I mean when I say that.  If you don't, just ask.

Under the Lamps of Viruses

"cancer-in-a-dish" 

I think the thing that makes this part so difficult to comprehend is that we have to understand the "prevailing schizophrenia" that Mukherjee mentions.  All of this stuff with cellular biology was going on at the same time that Farber and Frei were trying to throw cytotoxic drugs at cancer cells.  And Mukherjee has been saying over and over that what was necessary was to go back to basics to the structure of the cell.  "Frei and Farber returned to Boston with no significant change in the trajectories of their thoughts about curing cancer" ???????? After Temin's discussion???? 

So, if you understand this section, you get the retrovirus idea, Sol Spiegelman's work and how those relate to HIV, and you understand the implications of "cause on one side and cure on the other" (355).

A Unitary Cause

Isn't it an incredible relief to learn about Carla's remission?

All these pages later, we return to Virchow....science is always turning back on itself.  And it is interesting to me, as a reader, that Boveri's theory, which was so close to the truth, was actually the truth, was buried by circumstance: the convenience of Rous' virus theory.  Are we  dumping ice buckets over our heads today needlessly?  Are the answers within reach?  Buried somewhere by convenience and circumstance or something more menacing?

If you understood this section, you can describe the progression of biological discovery that begins with Mendel and ends with Monod.  You also understand why Mukherjee has to cover that to prepare us for the retrovirus discussion.  And that section and some that will follow are the ones that I warned you about at our AP Lang meeting.  Even though Mukherjee tries to explain it to the layperson, I feel he falls short here.  He seems to pushing on the accelerator when I need him to slow down.

That point in the reading...

where you put a sticky note in front of the Acknowledgements so you can feel how many pages you have left.  #Hollaback

Cool Atwood Quote

"Who says there are no such things as monsters?  I say they are everywhere. But we are not powerless.  We have an incredibly powerful weapon with which to fight each and every one.  That weapon is language.  "A word after a word after a word is power."- Margaret Atwood.

The Map and the Parachute

To model my reading of this section, and mix it up a bit, I am simply going to list a couple of the sentences of note.  By that I mean, sentences that seem central to comprehension of this section and sentences that  exhibit syntactical craftsmanship. It's interesting to pay attention to the sentences you notice and then try to figure out--and even more importantly, talk about-- why you notice them.  So, I'll go, and then maybe you'll go?  Share your sentence of note and tell us why you noticed it.

"An investigational agent, AIDS activists insisted, was no longer a hot-house flower meant to be cultivated only in the rarefied greenhouses of academic medicine, but rather a public resource merely waiting in the warming antechamber of science while doctors finished clinical trials that would, in the end, prove the efficacy of said drugs or procedures anyway" (322).

I noticed this one because it creates a link between the last section with all of the AIDS information and the significance of the patient activism for the world of chemotherapy.  I also think the comparison to the hot-house flower followed my the "warming antechamber of science" is an apt image of the trials, the length of the trials, as a process that is far removed from the urgency of saving lives.  It just takes too long.The choice of those sensory words "hot-house" and "warming antechamber" are essentially the same thing, but they work together to increase the temperature of the sentence and the issue towards which the reader is propelled with increasing speed at the end.  The reader is left with the most important idea roasting in the recesses (Sorry! Sometimes I can't help myself) of his mind....the drugs would have proven effective anyway.

"Patients, in short, had lost patience" (322).

Well....I mean, what do I have to say? You get it, right?

Okay.  Your turn.  I am going to create a map of section 4, which is all about prevention.

STAMP

I should tell you...as a reader, I had to go back and look up Huggins and Walpole at the end of the last section.  Huggins was the "chemical castration" guy and Walpole and Cole were the "estrogen antagonist", tamoxifen, breast cancer scientists.  I'm glad I went back because it seems in this section that we are back to chemotherapy and judging from the last line of the last section, it isn't going to be a cheery read.



The reason that I chose this book for our summer is represented in the narrative about Thomas Lynch.  No matter what you do: surgeon, insurance claims adjuster, lawyer, administrative assistant, advertising executive, graphic artist, heating and cooling technician, construction worker, stay at home dad; a facility with language is imperative.  If you are going to be good at what you choose to do, you need to be able to talk and write to people about what you do, what you want, what you need them to know, what you want them to think, what you want them to do.

A sentence I want you to notice: "Politically, too, AIDS activists borrowed language and tactics from cancer lobbyists, and then imbued this language with their own urgency and potency" (318).  Why might I want you to notice that sentence?

If you understand this section, you can discuss the impact that the AIDS epidemic is about to have on chemotherapy. 

Reading and Writing

http://www.npr.org/blogs/health/2014/08/14/340351393/when-patients-read-what-their-doctors-write?utm_source=facebook.com&utm_medium=social&utm_campaign=npr&utm_term=nprnews&utm_content=20140817

Sweet Resource

http://wordsense.me/

"A Spider's Web"

This section is particularly exciting for a teacher of AP Lang.  This is the "slouch" section that I wrote about in an entry towards the beginning of summer.   This chapter also marks the beginning of Mukherjee's  Lewis Carroll's, Through the Looking Glass allusions.  He'll lay them on pretty heavy towards the end.  I think I also included some of Lewis Carroll's work about learning in an earlier entry.

Big ideas in this section:
screening trials
Detecting precancerous states as a means of prevention,
mammography and
the pap smear,
false positives,
false negatives,
underdiagnosis and
overdiagnosis.
the irony of small tumors and metastasis


And if you understood some of these big ideas, you understand the outcome of mammography, what it means for women over 50, what it means for those who are younger, and how that relates to bicycle helmets.  I have to tell you that none of it sits comfortably in this chair with me and my 46 year old self.

Curiouser and Curiouser

Curiously enough, I have tried to read this section countless times and I can't seem to focus on it.  I think it might be that it is August 15 and I am starting to FREAK out about school being just over two weeks away.  Every year, no matter how long I have been teaching-18 years, I freak out in this way.  I get scared that I won't be able to do the job.  Silly, I know.  I start to have nightmares in which my classroom is out of control and I have no lesson plans.  Craziness.

Thank goodness for Barry Marshall's decision to imbibe the "cloudy brown liquid."  Finally, a little excitement, right?

This importance of this section seems to be in the discussion of carcinogens and the quest for a cause.  Ultimately, it ends with the idea of going back further yet to "carcinogenesis."

Facebook Group

There is one now.  Thank you to Jessie Singh and Owen Purdue for taking the initiative to create this.  I think it will be a very useful tool.  If you aren't "friends" on Facebook with either one of these guys, send one of them a request so they can invite you to this closed group.

If you get a chance....

and if you, like so many others, are mourning--on any level-- the loss of Robin Williams...even if you aren't, you should read this.  It's Russell Brand's response to loss.  When I first saw Russell Brand, I thought he was mostly unfunny.  I haven't paid much attention to him since.  This article reveals him to be an intelligent and articulate person and an incredible writer.  This article is a piece to emulate.

http://www.theguardian.com/commentisfree/2014/aug/12/russell-brand-robin-williams-divine-madness-broken-world

FYI: The novels we will read this year

They include:

Macbeth
The Poisonwood Bible
1984
Brave New World
Jekyll and Hyde
Siddhartha

Some wanted to know.

A Statement of Warning

This is a big section. I'm wondering if anyone would  agree with my argument that this section seems to have an intensity and a momentum that is unlike other sections?  Especially at the end.


I couldn't help but notice/wonder about advertisements.  Once upon picking up some old magazines, I noticed that advertisements used to contain many more words.  As in the Camel ad, ""[It's] a game only for steady nerves.  But, then, what isn't in these days-- with all of us fighting, working, living at the highest tempo in years" (268).  I don't spend a lot of time reading magazines other than The New Yorker.  But I'm pretty sure that sentences like that are scarce.  It seems to me to be less about language and more about imagery and a couple of words.  Visual literacy.  We'll spend some time there. But what does that shift say about language in our society today?

Forest Hills' very own Dr. Farber, I mean Fahner

http://www.mlive.com/news/grand-rapids/index.ssf/2014/08/devos_childrens_hospital_cance.html#incart_river

A Thief in the Night

Someone explain the connection between the content in this section and the following quotation:

"The price of freedom is eternal vigilance." -Aldous Huxley


If you understood this section, then you can explain the purpose of Bradford Hill's list of nine criteria and what that meant in relation to lung cancer.



Favorite line:  "Persuading mice to chain-smoke was obviously unlikely to succeed" (254).


RIP Evarts Graham.  His Bilateral bronchogenic carcinoma snuck up on him "like a thief in the night."

And here is a line that is particularly striking in its relevance to what you will practice with essay writing in AP Lang this year:  " At the end of the essay, Graham wondered about...." Would anyone care to comment about how that line, that piece of a line, goes against much of what you have been taught about essay writing?

The Emperor's Nylon Stockings

So, what starts out as a big joke ends up to be pretty serious.  It makes me wonder if there is anything that the medical community is laughing off today that will be tomorrow's cause of cancer.

I can't help but think about how difficult it must have been to catch all of those moths in the Ford study.  How difficult would that be?  And are they such a controlled and localized creature containing themselves into one set of marshes that one can easily study them and their offspring?    Imagine being one of Ford's students with your galoshes and your net.

So, inspired by the Ford study, Doll and Hill conduct theirs on doctors of all people.  Pretty clever and resourceful to use the registry in that way.  The ability that those two had to make connections, first to the Ford study and then to the registry as a resource.......powerful inquiry.

"Coffins of Black"

Noticings and Notes:
(After I wrote the word "noticings" above, I googled it to see if it was really a word recognized by an online dictionary.  I found this: http://noticin.gs/about which sounds really cool and I am sorry I missed.  I want to spend some time checking out the tag on Flickr, but not now.  There is work to do.)
Starting with a narrative is often a good idea.  Percivall Pott (2 l's, 2 t's) seems quite Dickensian to me as he is portrayed "sifting" through his observations.  (Oh, clever, clever Mukherjee.)

Potts-----carcinogens-----cancer is preventable

Hill----know your audience---choose the appropriate language to convey your message (ethos) so that your audience will be willing to listen

"When these soldiers returned from the war, they brought their habits, like viruses again, (or like metastases, Mr. Mukherjee? Probably not the apposite that virus is....) to their respective homelands with them" (240).




If you understood this section, then you can explain the reasons for the initial difficulty correlating the occurrence of cancer with tobacco.  You also understand the difference between establishing that correlation and the correlation of the chimney sweeps and scrotal cancer.

And what does that have to do with nylon stockings?

A one page map. Part #3

Fellow office supply nerds: fine point Sharpies are on sale at Office Depot for $5.00!!!!!!

Counting Cancer

Bleak accounting.

Best line:  "To understand the Bailar-Smith analysis, we need to begin by understanding what it was not."  The reason that I like that one so much has nothing to do with the Bailar-Smith analysis, of course.  I like it because it illustrates an important truth about critical reading; most of the time, we spend all of our time talking about what a text says, but what about what it doesn't say?  Where does it leave matters unclear?  By examining those questions, we can begin to understand the arguments of text at their deepest level.

Here is what this section makes me think:  One CAN argue with data.  What the data tells us can sometimes depend on what the provider of the data wants us to think. And sometimes, we can tell what they want us to think by what they don't say as much as what they do say.

On Mlive today

Acute Lymphoblastic Leukemia....what would Farber say?

http://www.mlive.com/news/flint/index.ssf/2014/08/im_a_survivor_teen_cancer_surv.html

Halstedt's Ashes

Here's a fun game:  What do you think is the most important word in this section?  Why?

I'll go first.

The word I really want to choose is pride, but scour as I might, I cannot find it in this section.
So, I'll choose "Conceit" (223) although that feels overdone.  Conceit is "Excessive pride."  Like Halstedt's "well-intentioned" radical mastectomy.  Like the lack of collaboration and communication between surgeons and chemotherapists in the 70's which caused the stagnation of cancer research.  Like the daughter in the narrative, although I think we could probably characterize her attitude and behavior as something other than prideful or conceited because she seems to be desperately seeking longevity for her mother.  Who can blame her?  Like the reaction of some to "palliative medicine."  Like Bonadonna in his suits.

Sidenote:  Bonadonna.  I guess clothes do matter.

Does anyone get the sense that Mukherjee is trying to soften the unintentional mistakes  of Halstedt?

And why do you think Mukherjee chose to put the "Know thine enemy" stuff in this section as opposed to the "Knowing the enemy" section?

Okay.  Now, you go.

Knowing the Enemy

If you understood this section, then you can explain the following:

• "Chemical castration" and the significance of its discovery for chemotherapeutic research.

• Why the removal of the ovaries can affect breast cancer and how that might remind a reader of Galen.

• The shift in thinking about cytotoxic drugs and cell biology and how research with breast and prostate cancer led to this shift.

The Smiling Oncologist

Okay, everyone comment with the line from this section that most resonates with you and explain why.  I'll go first.

"Like lunatic cartographers, chemotherapists frantically drew and redrew their strategies to annihilate cancer" (208).  Who doesn't like a good simile?

But the one that really resonates with me is the following, "But the basic purpose is not to save that patient's particular life but to find means of saving the lives of others" (203).  This sentence paired with the description of the chemo wards of the 70's makes me hopeful about how far cancer researchers have come.  I've been on the chemo ward with my mom and I witnessed Ms. Engelhardt's chemo, and it is nothing like what it being described here.  In the chemo ward at Lemmen Holton, the most disturbing signs of cancer are the numerous head scarves and the pallor of the patients.  But, the anti-nausea drugs that we have now take care of the effects of cisplatin.  I mean, it isn't like anyone feels 100% heatlthy during chemo of any kind, but when you compare what it looks like now with the way it looked before...it's much more manageable.  It still almost completely decimates the patient, especially by the end.  They still have to destroy the cells and then build it all back up.  But,f rom what i've seen, having chemotherapy in 2014 is quite different than during the 70's.  And the truth is that now, particular lives are saved.  Although the "magic bullet"  idea still seems present, there is much more research to draw upon when doctor's choose chemotherapy drugs.  The bullets are more likely to hit the target.

Okay, now you go.

"In God we trust. All others [must] have data."

So, the kingdom of the "patron saint of cancer surgery" has finally fallen.

For me, the most interesting part of this section is the emergence of the "patient voice."  Finally, someone is questioning methods.  You will hear this a lot from me this year:  Aldous Huxley said, "The price of freedom is eternal vigilance."  That means vigilance over everything.  Questioning.  Critical thinking. 

There are some pretty incredible rhetorical moves in this section.  Anyone care to comment on what they noticed?  :)

Please excuse my absence

In addition to taking on this summer book study, I also took on two graduate courses.  I am happy to announce that I just put the finishing touches on the last one this evening and will be returning to daily blog entries tomorrow.  I apologize for any anxiety.  I hope to see all of you at the next AP Lang summer meeting (voluntary) on August 13 at 1:45.

A definition of reading