It is fair to ask whether or not North American needs several hundred thousand new books every year. What we unquestionably do need, however, is more challenging books, more contrarian books, more brave books. And so this week we celebrate three excellent releases from 2019 that are in different yet important ways challenging, contrarian, and brave.
Azra Raza (above) is a world-class oncologist and the author of one of the most important books of the year. The First Cell: And the Human Costs of Pursuing Cancer to the Last is the author’s account of losing her husband (also an oncologist) to leukemia, a dissertation on the horrors wreaked by various kinds of cancers on human lives (based on her treatment of thousands of patients), and a passionate argument that the medical community needs to drastically shift its efforts and resources from treating cancer victims in the last stages of the disease to early detection.
Raza calls out the medical community for its “embarrassing” lack of progress in cancer treatment protocols over the last half-century. Despite regular predictions that magical treatments are just around the corner, the science remains primitive. Almost all of the drugs brought to clinical trial fail, and those that do not are so ineffective that they might as well have failed. The slim gains made in treatments are measured in weeks, and the small improvements in the overall cancer rate are largely due to early detection of some cancers and the decline in smoking.
“No one,” she declares, “is winning the war on cancer.” Instead of admitting this fact, the medical community insists on telling patients to stay positive in the face of intense pain and inevitable suffering that almost always results in an ugly and expensive death. “Treating the public like fragile, vulnerable, over-sensitive, easily hurt, anxious adolescents needing protection from stressful details is unfair, short-sighted and, in the long run, counterproductive for everyone involved.”
Raza argues that it’s time to abandon the strategy of curing cancer and adopt a new strategy of prevention, something that is always cited as preferable to treatment yet, as a matter of practice, lags obscenely behind:
The new strategy must go beyond early detection as practiced currently through mammograms and other routine screening tests. The prevention I am talking about is through identification and eradication of transformed cancerous cells at their inception, before they have had a chance to organize into a bona fide malignant, incurable disease. This may seem an unattainable, utopian dream, but it is achievable in a reasonable time. We are already using sophisticated technology to detect the residues of disease that linger after treatment, the last cancer cell. Can we not reverse the order of things and use the tests to detect the first?”
We first came across the Finnish historian Pekka Hamalainen (above) in the late aughts when his book The Comanche Empire was a finalist for the Cundill Prize (it had already won the more prestigious Bancroft). That book told the story of a Native American empire that dominated the American Southwest and northern Mexico in pre-settlement times. The Comanche had European and Indigenous rivals at their borders but by every measure of power—political, economic, cultural—they reigned supreme until finally meeting their match, colonizer against colonizer (in this case, the U.S. military) in 1875. It is a bracing and hugely informative retelling of a crucial chapter of western American history.
Hamalainen—who, it can’t be repeated often enough, is not an American but a Finn—continues his stunning assault on what we thought we knew about the history of the American west with Lakota America: A New History of Indigenous Power, the latest in the brilliant Lamar Series in Western History out of Yale University. It is similar to the Comanche story in that Hamalainen is concerned with imperial power. Here, however, he takes as his starting point the birth of two empires in 1776, one based in Philadelphia, the other in the Black Hills of South Dakota. A hundred years later they would clash at arms along the Little Bighorn in what is now Montana.
American history best remembers the Lakota for that violent end to their history: Sitting Bull, Crazy Horse, the Battle of Little Bighorn, Custer’s Last Stand, and the subsequent breaking of the tribe’s power by U.S. troops. Hamalainen instead tells the story of how the Lakota, obscure hunter-gatherers from the Eastern Woodlands, possessing no guns or metal weapons, abjured their ancestral lands and migrated in the mid-seventeenth century to the sprawling grasslands on the far side of the Mississippi where they improbably reinvented themselves as horse people:
This is what I call Lakota America, an expansive, constantly transmuting Indigenous regime that pulled numerous groups into its orbit, marginalized and dispossessed its rivals—both native and colonial—and commanded the political, social, and economic life in the North American interior for generations. Just as there was Spanish, French, British, and the United States of America, there was Lakota America, the sovereign domain of the Lakota people and their kin and allies, a domain they would protect and, if necessary expand. A century later, the Lakotas had shifted the center of their world three hundred miles west into the Missouri Valley, where they began to transform into a dominant power. Another century later they were the most powerful Indigenous nation in the Americas, controlling a massive domain stretching across the northern Great Plains into the Rocky Mountains and Canada. It was an expansion that, in many ways, should not have been possible.
How the Lakota pulled it off, using creative diplomacy and brilliant strategy, is the substance of this fascinating book.