The book begins with the story of Carla Reed, a 31-year-old kindergarten teacher and mother of three who experiences headaches, strange bruising, white gums, and exhaustion. The author hears about Carla as he is heading to work at Massachusetts General Hospital in Boston and his beeper goes off to tell him to see a patient with leukemia when he arrives. Leukemia, a cancer of the white blood cells, is “breathtaking” (3) with regard to its pace and acuity. Ten months into his two-year fellowship in oncology, the author already feels drained and inured to the death around him.

Nothing in Mukherjee’s training could have prepared him for this work. He thinks about Aleksandr Solzhenitsyn’s novel Cancer Ward, in which the protagonist, diagnosed with cancer, experiences the erasure of his identity. The author feels stunned, almost to the point of incoherence, about the decisions he must make about his patients each day.

Following his experience, the author is motivated to learn more about the history and ongoing war against cancer. He knows the biology of the disease, which he describes as “the uncontrolled growth of a single cell,” and he notes that cancer cells, which grow better than other cells, “are more perfect versions of ourselves” (6).