Customer Reviews

The Language of Cells: Life as Seen Under the Microscope

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Spencer Nadler is a pathologist who would be a clinical physician. He is a doctor of medicine who would be a literary artist. He demonstrates in these exquisitely wrought pages a deep sense of identification and empathy with the very real human beings whose cells he sees in his microscope. He writes about intersecting with their lives in a style both concrete and moving so that we cannot help but also identify with the heart-wrenching experience of disease.

So there's an irony in the title and a kind of strange misdirection: Dr. Nadler's concentration is NOT on cellular life, but instead on the psychological, existential and spiritual aspects of people whose cells have gone bad.

He begins with the story of a 35-year-old woman who has breast cancer. She wants to see the cancerous cells in the microscope. Nadler, whose daily work is performing biopsies, especially surgical biopsies made on the fly as the patient is etherized upon a table, obliges, and thereby begins a relationship with her and her illness that goes well beyond what can be experienced through the lenses of his "research-quality German microscope made by Zeiss." She sees landscapes and metaphors in the dead and dying cells, and Nadler is once again reminded of the human experience of disease.

Next is the chapter entitled simply "Fat" about a woman suffering from morbid obesity. She undergoes the Rouxen-Y gastric bypass, a gastrointestinal reconstruction surgery that miniaturizing her stomach from a capacity of 1,700 milliliters to 35 milliliters. (I have a question not answered in the text: why did her stomach have to be SO small? Couldn't they have left her with say, two or three hundred milliliters?) The procedure works and she goes from over 360 pounds to 180, but she cannot eat more than a few ounces of food at any one setting and she must--as Nadler so beautifully phrases it on page 39-swallow only "bonsaied boluses" and take "great care to chew them to a flow."

"Fat" is quite frankly one of the best medical essays I have ever read. But I am not alone in admiring the artistry of Nadler's carefully constructed prose. Two of the essays in this book, "Brain Cell Memories" and "An Old Soldier," the first about brain tumors, and the second about a 75-year-old man who has been a paraplegic for 55 years, are included in, respectively, The Best American Essays, 2001 and The Best American Essays, 1999. I was particularly impressed with "An Old Soldier," in which Nadler's clear, stark prose reveals the courage, strength and sheer cussed determination it takes for WWII vet Sam Patterson to live when "His lower trunk and limbs, his bowels, bladder, and genitals, are permanently incommunicado, shutting him off from the rest of his body like a demented mind." (p. 150)

The other chapters are "Heart Rhythms," which is essentially a heroic portrait of conductor Mehli Mehta; "Early Alzheimer's: A View from Within" which features AD-sufferer Morris Friedell who "can crystalize the life that remains and devise ways to enhance it" (for example, he takes notes and crosses off the tasks and experiences as they are lived); and "The Burden of Sickle Cells" about a boy that Nadler befriends who has the sickle cell disease.

The last chapter in the book is an appreciation of hospice work and grief counseling with a focus on Nadler's friend, Brad Deford, a chaplain to the dying. Nadler follows him on his rounds and experiences first hand how comforting it can be to have someone help with the emotional and spiritual preparations. Nadler refers to one old couple, each facing eminent death, as having become, "in their married years together...two nuclei in a single cell." His final words before the Epilogue are: "How awesome is this cellular ride, so steeped in mysterious efficiency. But it is the human dying, so urgent and inevitable, that is graven unto me."

As can be seen, Nadler is a very fine prose stylist, and his book is to be compared favorably with the best works written by practicing doctors from what I might call "the medical tale genre." Some recent examples include Jerome Groopman's Second Opinions: Stories of Intuition and Choice in the Changing World of Medicine (2000) and of course the works of Oliver Sacks, e.g., An Anthropologist on Mars: Seven Paradoxical Tales (1995) and The Man Who Mistook His Wife for a Hat and other clinical tales (1987).

7/25/08

I have just finishd reading The Language of Cells, and am putting the book aside with sadness that this glimpse in the thoughts of a compassionate pathologist has come to an end. I lived with this doctor for the last few days and with his patients. Spencer Nadler uses the language of a poet and through the pages flows his compassion and human understanding of the interrelatedness of the smallest of cells to the complex body of man. There is much the layman can learn from reading this book, how these cell structures support life or herald death. The book begins with a patient viewing her cancer cells on a screen, and she describes them as a painter would a most mysterious landscape. A while later we meet Mehli Mehta, and Dr. Nadler describes the concert this ninety-two year old suffering from heart disease conducts, a micro chip implanted in his chest jolts his heart elctronically when his pulse rate races away from him. In these paragraphs I learned how the stress on the heart of conducting a strenuous symphonic piece, or running a mile, varies physically from the stress created by anguish or sorrow. Though in both scenarios the heart rate may go up to the same unhealthy level, the physical footprint on the heart would look different. There is a remedy for stress. Let me quote Nadler: "If my mind's stress has my heart racing and pulse waves pound my body's shores, I close my eyes and deepen my breath. Transferring the rhythm of my heartbeat into a drumbeat, I let the rhythm of my music begin..." In these words speaks a poet, not a doctor-writer.
Nadler is equally eloquent when discussing Sickle Cell Anemia, Alzheimers, Leukemia, Paraplegia and in the last chapter he discusses dying and the acceptance of death by the patient.
This book should be read by all who have an ill spouse, child or are ill themselves. It should be read by doctors and caregivers to show over again the great positive influence a kind and understanding doctor will have, so important in our increasingly robotic world.

Although I've read most of Spencer Nadler's personal essays in various literary journals along the way, reading The Language of Cells in its entirety has been a wonderful experience. Dr. Nadler gives cells an emotional life,a human side in the world of the layman and fuses emotions with the stark reality of the world of medicine. Bravo!!

this book is a collection of beautifully written essays that explore the doctor/author's experience with a variety of patients dealing with serious illnesses. what I like so much about the book is how caring the doctor is towards his patients. I think that anyone facing a serious illness would be comforted by reading this book, even if they don't have the particular illnesses in the book. It is great to know that there are doctors are out there who care. I would give this book to anyone who has to deal with the medical profession and who is afraid that all doctors are concerned more about themselves than their patients.

This is not a biology or a medical science book as many probably would assume since it is found in the biology/medical section in the bookstore.
This book should be found at the front of the store and be in what I would say should be human interest. People with a medical problem or those with a loved one with a medical problem that need to understand what is going on inside the body, inside the cell, what the cell is saying.

Sure, Dr. Nadler is a surgical pathologist but he leaves the complex medical jargon out and takes a slice of the life of those whose cells he has diagnosed. His book is the glass slide for us to peer into to see the human aspects, struggles and victories of those whose cells he studied. Circumstances we have never thought of, you will look at people with a better understanding. Those who have come to better understand their disease by knowing what those diseased cells are doing, not doing or how they are changing. How and why that changing cell is disrupting their lives
I have a friend whose dad has Alzheimer's, a friend whose husband is terminal with throat cancer, even a buddy who spends to much time in the sun and now has small face skin cancers, thankfully removed.
I am sure we all know someone with cancer. This book has helped me relate and understand and encourage.
There is the average mom with breast cancer to a world renown conductor with a failing heart in this book. We realize we are all suseptible.

Spencer Nadler is a rare breed--a doctor who can transform the intricacies of surgical pathology into lyrical narratives that are as inspiring as they are informative. Reading these moving essays gave me access to a world that I normally consider way over my head. I only wish all doctors had Nadler's sensitivity to his patients and insight into the innermost workings of the body. This is a very unique, uplifting book.

I had to get this for my A&P class.
It was a good book, I think.
If you are thinking about going for a medical field, this is a good book,
but for people who don't have knowledge for that field,
this book may be difficult to understand.

Every once in a while I pick up a book or choose to purchase a book on the basis of a slim review, or because the book itself looked interesting. I tend to buy books in bulk, often more than one at a time. This was one such instance where four books were bought about two months ago. This one was put aside, as I had to finish two classes and do work for the two computer web sites I work for. The other books were read and discarded, appreciated for what they were...then given to the library so others may enjoy them to. This particular book, from which I expected little, will remain in my own personal library to be lent to the few who I know can appreciate both the medicine and the literacy of this particular doctor-author.

Other reviewers have outlined the stories of this book. It is immediate recognized that it is a different book...it's table of content is not a one-page outline of the chapter titles. Rather each chapter is outline by a large photograph of the cell types dealt with in that chapter. The 'name' of the chapter is in small typeface below or adjacent to the electron photograph. This warns the reader that whatever they had expected from this book, is liable to be different from what they get. Thankfully, this is so...

Nadler is a pathologist, a man who devotes his life to diagnosing the secrets of the individual units of our bodies. Pathologists are decoders basically. They read and tell other surgeons and doctors what they have biopsied or what they have seen. Pathologists rarely have intimate contact with the people whose cells they have examined. I worked in two neuropathology labs for almost six years. It is fascinating work, but other than your fellow lab workers, there is no human contact.

Somehow, from reading Dr. Nadler's book, I will guarantee that this physician has made it a point throughout his life and career to purposely remain involve with individuals. Unlike some doctors who I know have much more contact with patients, this doctor refuses to consider the cells alone, without considering the person. Perhaps because he is not involved in the conveyor belt of modern medicine, he has not lost that compassion or steeled himself against 'feeling' too much. For that alone, he deserves accolades.

His language, his metaphors, the observations he makes are far beyond the abilities of most doctors, indeed beyond the abilities of most people period. Like Oliver Sacks, he brings attention to a disease through the person who is affected by that disease. In doing so, readers become aware of the courage these individuals choose to face their illness with. So many times in labs and hospitals, we forget that what we see under the microscope was once deeply embedded in an individual. Nadler reminds us exquisitely of that, and in his writing, he brings an understanding of not just the disease, but of those who must deal with these particular disease. The story told, the picture drawn...may start with the cell that he originally focused on, but Nadler quickly changes the focus to the person.

An outstanding book by an outstanding person...

Karen Sadler,
Science Education,
University of Pittsburgh

Being a suspense-thriller freak, this is not the kind of book I would read but, given to me as a gift, I dutifully picked it up, thinking I'd read the first story and put it down. Wrong!
The stories are about any one of us or someone we may know, written in a very readable way that any non-medical person can easily understand. It is as intriguing as any thriller. I lent it to a friend, an oncology nurse, who lent it to her boss, who lent it to another doctor and so it's been making the rounds. I don't think I'll ever see it again and have ordered another copy that I won't lend: this is a book you want in your home library to pick up every now and then for it's inspiration and plain beauty.
Spencer Nadler is the kind of doctor we want and need to take care of us...his insight, his feelings, his empathy, knowledge, care and concern for his patients is there from page one. The stories are heart-wrenching and heart-warming, moving and inspiring and even though the book is not yet available here in Israel, I found it worth the expense to order several from abroad to give as gifts here.

In beautiful and clear prose, this book depicts the drama in interpreting a sick patient's cells. But it is also the story of one surgical pathologist's journey to find out what is human about his patients and himself. It is a touching read and a fascinating look behind the curtain into a highly specialized hospital laboratory.