Kenneth L Abbott, MD, FACP  |  10/28/2021

The Symphony of the Human Body

One fine, long-anticipated evening, you and your equally well-dressed partner settle into your plush red-velvet front row balcony seats. A hum of excited expectation fills the theater. The eye gorges on rich brocades and exquisite carvings illuminated by brilliant chandeliers. Programs rattle as concert-goers rifle through the pages, devouring the biographies of the famous conductor and the notable musicians. Some of your favorite compositions lay in store. You listen to the musicians tuning up, catching recognizable snippets of those pieces that serve as appetizers. As the house lights dim and the conductor crosses from the wing to his podium with tumultuous welcoming applause, a wide and satisfied smile plays across your lips. You exchange happy glances with your partner. Expensive tickets, but certain to be worth it. A hush settles over the audience as the conductor raises his baton. You catch your breath.

To your horror, what next assaults your ears and eyes beggars description. Each musician produces blasts and squeaks and nerve-chilling scrapes and ponderous thuds. Pages of the score fly everywhere. The conductor flails the air with wild, uncoordinated swings of his arms. No one pays any attention to him or what anyone else is doing. Soon several of the violinists stand up and walk aimlessly around the stage, in time insinuating themselves into the brass section, while trumpet players sprawl on the floor and writhe around. A clarinetist uses her instrument as a cudgel, knocking a cellist senseless. The triangle player rushes the podium and wrestles with the conductor for control of the baton. Eventually the curtain comes crashing down, leaving the audience in stunned silence. Your ticket stubs flutter unheeded to the ground. What could possibly have gone wrong?

Consider what should have gone right. A modern symphony orchestra employs about a hundred skilled and highly-trained musicians, led by a conductor according to a predetermined musical plan which all the members share. Their complicated interaction and cooperation produces a grand and glorious auditory experience. Everything depends on all the disparate parts functioning as a whole while performing their individual tasks effectively. Without control, without a coordinated and coherent plan, if things collapse, chaos and cacophony ensue. Expand the orchestra by a factor of ten, a hundred, a thousand, and complexity quickly escalates. The opportunities for mishap multiply.

Imagine, then, the difficulties if the orchestra contained 37 trillion musicians! That’s 37 followed by 12 zeros, or roughly 4700 times the current population of the world. This gargantuan number represents the best current scientific estimate of the average number of cells in a human body. How do that many individuals function as a harmonious whole for years on end? How do they communicate? How do the gracefully aged know when it is time to depart the stage to make room for new members? And how to keep the inevitable renegades and wrecks under wraps? The answers to these and many related questions have expanded and deepened our understanding of the nature of cancer, and given us new tools to treat and, in many instances, cure the disease. In future posts, I will explain some of the basic insights into cancer we possess in the early 21st century. First, however, I’ll examine some of the various mistaken attempts at explaining the origins of this mysterious and daunting disease.

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