The Song of the Cell, Siddhartha Mukherjee. New York: Scribner, 2022.

Summary: A history of the advances of cell biology including the cutting-edge innovations that allow for the modification or implantation of cells, creating in essence, a new human.

There was a time when those who studied organic life did not understand that a fundamental component of all living things was the cell. And then Hooke in England and van Leeuwenhoek in Amsterdam used their primitive microscopes to look at water droplets and tissue and saw–cells. Not only that, these early cell biologists realized all living organisms were constituted of one or more cells that are the basic structure on which all of life is organized.

Siddhartha Mukherjee, a cancer researcher, takes his readers on a step by step narrative unpacking the basics of cell biology (and pathology) for a lay audience. He takes us through the different structures within the cell and the incredible phenomenon of cell division. He traces how cells develop into living organisms from a tiny clump to a blastocyst to a living human being or other creature.

Perhaps the most fascinating section of the book is that on the nature of blood. He describes the different components of blood–red cells, how blood clots, and the intricacies of the immune cell and how self recognizes non-self, and what happens when self fails to recognize non-self and when self thinks self is non-self. Later, we learn that all the different components of our blood arise from a single type of stem cell.

Amid the story (and the writing) came the pandemic. Mukherjee remarks that it came at a time when cell biologists were celebrating breakthroughs in understanding immunology. And COVID-19 unraveled so much of what we thought we knew, once again showing us how much we’ve yet to learn. Here as in the rest of the story, Mukherjee intermixes personal narratives, sometimes tragic, with the science.

He takes up how cells work together. There are the “citizen cells” of the heart muscle, pulsating in rhythm for decades. There are the “contemplating cells,” the neurons, and the fascinating role of microglia in pruning away unused connections, creating the particular ways we are “wired.” Then there are cells within key organs that maintain homeostasis, those in our pancreas our metabolism, in our kidneys, our salt levels, and our liver, metabolizing harmful chemicals like alcohol.

An underlying theme that Mukherjee draws to a focus at the end are the ways we intervene to modify cells. It may be the interventions to halt and destroy cancer cells, runaway cells that cannot turn off their multiplication and trick the body to not recognize the foreign, yet non-foreign, invader destroying it. We’ve pioneered IVF techniques and, in the case of one researcher at least, genetically edited and embryo (and went to prison for it), resulting in the first gene-edited baby. The use of edited stem cells to reverse sickle cell anemia, to reverse osteoarthritis and a host of other therapies suggest the possibility of “new humans,” or at least renewed ones.

There are always the questions of how far to go with such things, questions that often arise only after we realize something is possible. Mukherjee explores the boundaries between maintaining and restoring health and the enhancements that somehow change who we are. What is most troubling about the latter augmentations is that they reflect a certain privilege not open to all, creating the potential for two races, those of super-humans and then ordinary humans. How long will it be before they are viewed as sub-human?

Aside from these sometimes fascinating and sometimes vexing questions is the sheer wonder Mukherjee describes, aptly called the “song” of the cell. Often, his writing sings and soars, and one finds oneself saying, “how wondrous.” Sometimes the song descends as well, as we learn of the microbes that invade us or the cancer that consumes and wastes us. Sometimes the song is beautifully complex, like a baroque fugue, and other times chaotic, difficult to make sense of, as are many of the intricacies of various cancers. This was a stunning work, leaving me in a state of wonder, even with all the mysteries of the cell yet to be unraveled.