Stoppard and chemotherapy
A letter to the Times
Sir, In 1993 my wife and I went to see the first production of Arcadia by Tom Stoppard (obituary, Dec 1), and in the interval I experienced a Damascene conversion. As a clinical scientist I was trying to understand the enigma of the behaviour of breast cancer, the assumption being that it grew in a linear trajectory spitting off metastases on its way. In the first act of Arcadia, Thomasina asks her tutor, Septimus: “If there is an equation for a curve like a bell, there must be an equation for one like a bluebell, and if a bluebell, why not a rose?” With that Stoppard explains chaos theory, which better explains the behaviour of breast cancer. At the point of diagnosis, the cancer must have already scattered cancer cells into the circulation that nest latent in distant organs. The consequence of that hypothesis was the birth of “adjuvant systemic chemotherapy”, and rapidly we saw a striking fall of the curve that illustrated patients’ survival.
Stoppard never learnt how many lives he saved by writing Arcadia.
Michael Baum
Professor emeritus of surgery; visiting professor of medical humanities, UCL
That was a letter in the Times this morning that Sebastian Payne shared on Twitter.
UPDATE: Baum shared this on Twitter
This morning I published a letter in the Times to illustrate paradigm shifts in science. After editing to fit the page it reads like I was the first to introduce adjuvant systemic chemotherapy. That honour goes to B.Fisher in Pittsburgh and G.Bonadonna in Milan
If you haven’t seen this update: https://x.com/MichaelBaum11/status/1995804481804452276?s=20
I think this Physician's letter is a good example in how he noticed how Stoppard somehow became able to understand bits and pieces of how physical reality functions which is how the deep thinkers in literature or the theater, uncover the secrets of the universe. I'm in no way any sort of expert and this may be a little too simplistic. But the physical reality universe is linked up into a vast parallel mental universe of which Stoppard was able to very fully inhabit. It seems Stoppard was able to observe randomity in the mental universe with previously unobserved odd linkages between very diverse elements which continually show up in his best plays. The metastatic quality of cancer is an excellent example of how randomity occurs in how cancer cells spread throughout the body like guerrilla soldiers spreading terror and destruction in order to bring the body down. I know of a lady with 4th stage breast cancer where the scans showed malignant cancer cells all over and inside the bones and internal organs. So her doctors put her on an immuno therapy treatment schedule. Then they would do followup scans to see how it was working. The immune cells or the active agents were like antiguerrilla fighters hunting only the malignant cells wherever they were. Then in her last scan, it didn't spot any cancer at all but she said the doctors wasn't actually in remission. This immuno therapy probably never would have been figured out if not approached through the lens of randomity. And Stoppard always put our attention on this aspect within the parallel mental and physical universe. And he illustrated that the theater is not detached from harsh reality or brimming life experience, but in the best plays is overwhelming filled with it.