The NIH Big Read

A Review of Inaugural Event with Writer Siddhartha Mukherjee

BY HAYLEY RAQUER, NIAID

Excitement built throughout NIH this spring when NIH’s inaugural Big Read program had dozens of people reading and discussing Siddhartha Mukherjee’s new book, The Gene: An Intimate History. Then, on April 17, the Big Read culminated with an appearance by the Pulitzer-Prize-winning author himself to discuss his book and meet his fans. It was his second book visit to NIH, the first being in 2011 to talk about The Emperor of All Maladies: A Biography of Cancer, the bestseller that won him the Pulitzer Prize and was the basis of a PBS film on cancer.

Although he carries obvious credentials within literary circles, Mukherjee’s background is rooted firmly in the biomedical sciences. In 1992, he graduated from Stanford University (Stanford, California) with a B.S. in biology. He had undergraduate research experience in the lab of Nobel Prize winner Paul Berg. After completing his Ph.D. at Oxford University (Oxford, England) as a Rhodes scholar, Mukherjee matriculated to Harvard Medical School (Boston), where he received his M.D. in 2000. Now an assistant professor of medicine at Columbia University in New York, he splits his time among being an oncologist, a researcher, and a science writer.

Given his extensive curriculum vitae and contributions to science, medicine, and scientific communication, it is not surprising that Mukherjee returned to the NIH to a packed auditorium. This visit and the successful turnout were thanks to the tireless efforts of the NIH Library, who partnered with the Foundation for Advanced Education in the Sciences, and its drive to bring literature and discussion to the NIH through this Big Read program.

One of the core pillars of the Library is to “foster collaboration and community across NIH,” said Kathleen McGlaughlin, the librarian who oversaw the planning and preparation for the entire Big Read event. The biggest hope of the project was to create a forum in which diverse members of the NIH community could weigh in on The Gene and its discussion of the latest technologies in human genetics and their inevitable social, ethical, and moral implications.

Anyone who follows the latest in biomedical research knows that the past few years have seen an explosion of potential in genome editing—led by the speeding bullet that is the Crispr/Cas9 gene-editing technique. Mukherjee, as a physician–scientist, has seen these breakthroughs and recognizes their great and terrible potential. And members of NIH’s workforce—whether technicians, administrators, trainees, professors, physicians, counselors, nurses, or people holding other positions—recognize that potential, too, and were eager to discuss the ideas and concerns reflected in Mukherjee’s book.

For two months, more than 70 individuals came together for hour-long book-discussion sessions hosted by the Library. Interest was so strong that a fourth discussion group had to be opened to accommodate the lengthy waitlist. Unlike participants in some proctored events who require prodding and pointed questions, the book-club participants needed little incentive to share their thoughts on the book, its historical context, and the ethical implications of the past few years of research. What was particularly remarkable was the obvious time and depth of thought both scientist and nonscientists had given to many of the ethical issues raised in the final chapters of The Gene. As one participant pointed out, “We can’t afford to stick our heads in the sand and not think about these issues.”

Although the Big Read sought to include the entire NIH in discussion of genetics history, medicine, and biomedical ethics, Mukherjee had a larger goal for his book. He stated that the book, and the coming documentary by Ken Burns, was meant to reach an audience wider than “laboratories and scientific institutions” and to explore “the extent [to which] these technologies [such as gene editing] will transform human beings and human culture.”

His motivation for writing The Gene stemmed from three sources. The first was his desire to write a prequel to his previous book, The Emperor; the second, to explore the latest advances in genetics and medicine; and the third, to chronicle his own personal familial relationship with genetic diseases. During the question-and-answer session that followed Mukherjee’s talk, NIH Director Francis Collins asked him how he set about writing a book of the depth and scale of The Gene.

The most “complicated thing is not what you put in, but what you leave out,” Mukherjee said. He was wary of overwhelming his audience with too much scientific information because he did not want to lose the “most important readers,” the nonscientists, with whom he hoped to spark a discussion and invite into the conversations surrounding the history and future of genetics.

The question is no longer “Can we?” said Mukherjee. We must now ask, “Should we?” and determine “the limits and constraints, both scientific and social…ethical that [these technologies] have to be tempered with.” Later, he elaborated on this perspective when asked what role bench scientists who are developing the technologies should play in these often highly charged conversations. “They absolutely should” play a role, he said. “And they definitely are.”

From the size of the audience and the successful book clubs, it appears that the NIH has heard The Gene’s rallying cry and is prepared to listen to and reflect on the implications that have arisen with our entrance into this new age in genetics. As our community has learned over the last few hundred years, the ethical implications are just as important as the scientific questions. The NIH Library has done an excellent job of creating a space for discussion and community; Mukherjee provided a strong framework and context; and it is now up to us to continue the conversation.

The NIH Big Read was inspired by the National Endowment for the Arts’ Big Read program and sponsored by the NIH Library and the Foundation for Advanced Education in the Sciences. To watch a videocast of Mukherjee’s April 17, 2017, presentation (NIH-only), go to https://videocast.nih.gov/launch.asp?23226.