Hive Health

From this January onward, the Hive writing team produces a monthly review on a key text. First in the series is the 2011 Pulitzer non-fiction winner – a vivid biography of humanity’s  greatest mortal dread.

At the conclusion to his extraordinary history of cancer, Siddhartha Mukherjee, an Indian-born, US-based cancer specialist, posits that ‘as the fraction of those affected by cancer creeps inexorably in some nations from one in four to one in three to one in two, cancer will, indeed, be the new normal – an inevitability. The question will not be if we will encounter this immortal illness, but when.’

That Mukherjee’s book is so compelling isn’t due solely to the drama of the story he tells, but because he is alive to the efficacy of art as well as science. ‘Normal cells are identically normal,’ he writes, ‘malignant cells become unhappily malignant in unique ways.’ His repurposing of Anna Karenina’s opening line is more than a rhetorical flourish: it’s indicative of the intelligent and illustrative way he approaches his material. Like all well-executed ideas, the question it raises is “Why hasn’t anyone done this before?”

The Emperor of All Maladies follows cancer from the palaces of ancient Persia to the R&D campuses of modern pharmaceutical companies. The majority of the story, however, takes place in the mid-to-late 20^th century, when increased life expectancy in the western world saw the prevalence of cancer skyrocket (in third world countries cancer doesn’t even make the top 10 causes of death).

Mukherjee’s story centres on two figures who defined the post-war struggle against cancer. Sidney Farber was a paediatric pathologist who became the father of chemotherapy. Mary Lasker was a wealthy socialite and fearsome lobbyist who believed that if enough money was aimed at it, cancer could be vanquished. In 1971, after nearly 20 years of their campaigning, President Nixon declared the ‘War on Cancer’: legislation that devoted millions of dollars in federal funds to finding a cure.

Farber and Lasker’s achievement was of mixed worth. ‘Cancer,’ Mukherjee writes, ‘a shape-shifting disease of colossal diversity, was recast as a single, monolithic entity’. Scientists competed to find cures, theories of prevention were all but non-existent, and misguided treatments such as megadose chemotherapy did more harm than good.

Mukherjee’s recreation of the ambitions, disappointments and, occasionally, triumphs at each stage of the fight against cancer is one of his book’s greatest achievements. He successfully places the reader in whichever era, lab or ward he describes. He also renders cancer itself in a way that’s both horrifying and gripping. Of leukaemia he writes, ‘Its pace, its acuity, its breathtaking, inexorable arc of growth forces rapid, often drastic decisions; it is terrifying to experience, terrifying to observe, and terrifying to treat.’

The book’s final section is its most optimistic and most complex. Harold Varmus and J. Michael Bishop won the Nobel Prize in 1989 for proving the link between cancer and genes, which led to the subsequent identification of many oncogenes (genes with cancer-causing potential). ‘Having wandered in the darkness for decades,’ writes Mukherjee, ‘scientists had finally reached a clearing in their understanding of cancer. Medicine’s task was to continue that journey toward a new therapeutic attack.’ This came with development of drugs such as Herceptin, which targets an oncogene in a particular type of breast cancer.

But Mukherjee is too knowledgeable about cancer to be swept up in an optimism that has, time and again, proved false. Other gene-targeted therapies like Herceptin and Glivec may emerge over time, but that’s a forecast quite different to the ‘cure for cancer’ that has been dreamed of for so long. ‘This War on Cancer,’ he cautions, ‘may best be “won” by redefining victory.’

Mukherjee says the idea for his book was hatched when a patient asked him the simple question, ‘“What is it, exactly, that I am battling?”’ His answer, all 500 pages of it, is fascinating, depressing and exhilarating, and his writing on lung cancer is so affecting that, after 24 years of smoking, I haven’t had a cigarette since finishing the book six weeks ago.

Have you read this book? We’d love to have your comments.

Charlie Brooker wrote about his triumph over cigarette addiction in May 2007 and, because it is January, and it is CB, his article is still surfacing on the Facebook Guardian app.

I used to think New Years’ resolutions were cynical and flimsy. Now I act upon the clarity that comes with early January. You know it: after the cleansing rituals of giving and eating, taking stock of our human treasures, contemplating the mouthfeel of true happiness. Time slows. A light snowdrift may pass.

At some point, heart and mind airpunch their way off the sofa. This is so good it must never ever end! We delve for the will to be less apathetic, to punch up the system.

This year I’ve got the big one. I’ve stopped smoking. For a long time my habit has housed me like a condemned building. I was smoking because I didn’t know what to fix first. Trigger:  a natural spasm in concentration – you think you need a change of scene. Trigger: all kinds of hunger. Trigger: tired. Feeling awkward in company.

I’m 8 days in. I feel good. The lust has needled only once: when I got off the phone from Haringey Council. Trigger: despair.

This January the general kick-butt movement hears from the Harvard School of Public Health that, in the long term,  nicotine replacement is no more effective than cold turkey.

This was by no means a massive study, with only 787 smokers followed over three non-consecutive time periods. While many studies have shown that NRT significantly aids quitting, the study does remind us of the importance of a sustained outlook (read Brooker’s article for an insider’s take on that). We all know behaviour change doesn’t stop being hard.

I’ll be looking to find out whether patients who received professional or self-directed support had better luck with their quits – in the UK at least, NRT is bundled with patient support programmes and efficacy is rarely attributed to the product alone.

To my mind, understanding your smoking habit is key to cutting it loose. Charlie Brooker had plenty of relapses, mostly on pub doorsteps. If we know our weak points, let’s never leave them undefended, and not just for January. I’ve boarded up the condemned house and I’m out of there, but not in the pub just yet.

Monday kicked off my winter night class on Experience Design at Central St. Martins. Asymetric haircuts, country headwear, the diverse and arty greeted me for a 10 stretch of academia. I even took a pencil to sketch  with whilst looking into the mid distance.

Experience design is just that and far from just that. Dozens of man-years have been spent crafting a definition that still struggles with the difference between art and design, let alone the requirement we have to trap, cagoule and force down the edges of what it is to be experiential or to provide experience. The wooliness of the subject is refreshing and helping get my head out of the structured, problem/solution world that billable work often requires (especially on a Monday!).

From 5 senses, to 360 degree immersive sessions it’s clearly going to be an awesome 10 weeks.

My reading list is whizzing past Hegel, Marx, through terms as diverse as relational aesthetics and dystopian community. It’s been a while since I read something (Harvard biz review tends to pride itself on accessibility!) that had me rubbernecking to google this regularly. Blindingly good stuff, even this early session got me thinking like mad on a stack of plans/briefs/trickies I have in front of me.

In a world where ‘Brand is…’ is cumbersome and ‘brand does’ becomes more central to our planning model - experiential planning is pretty sexy for me. It channel planning with lipstick on, spinning on a table, air thick with perfume.

With HBR continuing to kick sand in the face of goods providers with yet another article on the worth of the experience economy. Joining the greying of the boundaries between sponsorship, co-branding, commissioned design, corporate installation etc. And Josephs Pine conforming that customer value has run away from all the  commodities and goods, towards tailored services or authentic experiences. It it  the time to try and consider how we offer these experiences, planned, proactive and of course with an audience insight bang in the centre.

With crossed fingers, in a dark, endless cold room . I am hoping that experience design and the time spent with the talent at CSM contributes a component  to me working on a structured approach to behavioural change achieved along a considered, multichannel, richer journey.

In the meantime – a rather nice Nokia experience, corporate installation, co-branded event, light show or Son et lumière (your choice).

Right the first blog of the year for me. Time for a warming up of WordPress and the usual NY thoughts.

I have promised myself that I will find something academic to write about, but it’s sunny outside, and I have diary chunks all over the day. I feel I need some inspiration.

Those resolutions to date are;

1. Continue to fuel the agencies future growth. Slot an entire vertical into Account services. Thus far the implementations pretty much perfect. This quarter finds us slot individual talent into the team a few weeks apart allowing us to transform these newbies into New-bees with thoroughness and get this capacity up and buzzing. For us at Hive, it’s a growth focused way to start the year; people in place prior to the sales curve – a great way to stably grow the biz into 2012 and beyond whilst maintaining our focus on the awesome set of clients we are delivering with already.
2. Get on those Q1 pitches! Ian’s juggling Prezi, Powerpoint and MS Word today alone, and the new biz leaderboard is brimming with invites, chemistry meetings and requests for proposals across the management team. those deals need closing!
3. Finalise the 2012 development plans. Seriously long writing tasks for me this week. Bullets points, individual tasks, a training programme and people stuff all cover my desk currently. I need a list.
4. Diversify hivehealth.com’s blog contributors list. Encourage the great, good and bold to deliver views on us, healthcare, communications and the agency. It’s a plan; in a mice and men way!
5. Find bigger offices. Staying in Soho we kick off the task of hunting down big spaces for us all to beapart in.
6. Buy Werthers Original to share with all those wearing progressive knitwear today. Paul Smith is topping the list today and the Granddad look dominating the offices. Cardigans and cable-knit hand in hand with innovation and cool? Really?
7. Formulate a service design toolkit. It’s an area I have written about lots, done a few workshops and now its time to consolidate the learnings and structure this offer. Its out of lab stuff and into the marketplace time.
8. Get to grips with the current W1 bubble tea craze. I means what’s it all about, it’s beyond odd on a cold January afternoon.

I think that’s it for this week. I shall now hit my iCloud To Do List of blogs/ideas/rants then come back with some higher end content. To make our first week back more Open University than Fresher’s week.