The Emperor of All Maladies: A Biography of Cancer (19 page)

It was not a promising quest. Farber was treating several children with aminopterin, and the beds in the wards upstairs were filled with miserable patients—dehydrated and nauseated from chemotherapy, children barely able to hold their heads and bodies upright, let alone be paraded publicly as optimistic mascots for cancer treatment. Looking frantically through the patient lists, Farber and Koster found a single child healthy enough to carry the message—a lanky, cherubic, blue-eyed, blond child named Einar Gustafson, who did not have leukemia but was being treated for a rare kind of lymphoma in his intestines.

Gustafson was quiet
and serious, a precociously self-assured boy from New Sweden, Maine. His grandparents were Swedish immigrants, and he lived on a potato farm and attended a single-room schoolhouse. In the late summer of 1947, just after blueberry season, he had complained of a gnawing, wrenching pain in his stomach. Doctors in Lewiston, suspecting appendicitis, had operated on his appendix, but found the lymphoma instead. Survival rates for the disease were low at 10 percent. Thinking that chemotherapy had a slight chance to save him, his doctors sent Gustafson to Farber’s care in Boston.

Einar Gustafson, though, was a mouthful of a name. Farber and Koster, in a flash of inspiration, rechristened him Jimmy.

Koster now moved quickly to market Jimmy.
On May 22, 1948, on a warm Saturday night in the Northeast
, Ralph Edwards, the host of the radio show
Truth or Consequences
, interrupted his usual broadcast from California and linked to a radio station in Boston. “Part of the function of
Truth or Consequences
,” Edwards began, “is to bring this old parlor game to people who are unable to come to the show. . . . Tonight we take you to a little fellow named Jimmy.

“We are not going to give you his last name because he’s just like thousands of other young fellows and girls in private homes and hospitals all over the country. Jimmy is suffering from cancer. He’s a swell little guy, and although he cannot figure out why he isn’t out with the other kids, he does love his baseball and follows every move of his favorite team, the Boston Braves. Now, by the magic of radio, we’re going to span the breadth of the United States and take you right up to the bedside of Jimmy, in one of America’s great cities, Boston, Massachusetts, and into one of America’s great hospitals, the Children’s Hospital in Boston, whose staff is doing such an outstanding job of cancer research. Up to now, Jimmy has not heard us. . . . Give us Jimmy please.”

Then, over a crackle of static, Jimmy could be heard.

Jimmy: Hi.

Edwards: Hi, Jimmy! This is Ralph Edwards of the
Truth or Consequences
radio program. I’ve heard you like baseball. Is that right?

Jimmy: Yeah, it’s my favorite sport.

Edwards: It’s your favorite sport! Who do you think is going to win the pennant this year?

Jimmy: The Boston Braves, I hope.

After more banter, Edwards sprung the “parlor trick” that he had promised.

Edwards: Have you ever met Phil Masi?

Jimmy: No.

Phil Masi (walking in): Hi, Jimmy. My name is Phil Masi.

Edwards: What? Who’s that, Jimmy?

Jimmy (gasping):
Phil Masi!

Edwards: And where is he?

Jimmy: In my room!

Edwards: Well, what do you know? Right here in your hospital room—Phil Masi from Berlin, Illinois! Who’s the best home-run hitter on the team, Jimmy?

Jimmy: Jeff Heath.

(Heath entered the room.)

Edwards: Who’s that, Jimmy?

Jimmy: Jeff . . . Heath.

As Jimmy gasped, player after player filed into his room bearing T-shirts, signed baseballs, game tickets, and caps: Eddie Stanky, Bob Elliott, Earl Torgeson, Johnny Sain, Alvin Dark, Jim Russell, Tommy Holmes. A piano was wheeled in. The Braves struck up the song, accompanied by Jimmy, who sang loudly and enthusiastically off-key:

Take me out to the ball game,

Take me out with the crowd.

Buy me some peanuts and Cracker Jack,

I don’t care if I never get back

The crowd in Edwards’s studio cheered, some noting the poignancy of the last line, many nearly moved to tears. At the end of the broadcast, the remote link from Boston was disconnected. Edwards paused and lowered his voice.

“Now listen, folks. Jimmy can’t hear this, can he? . . . We’re not using any photographs of him, or using his full name, or he will know about this. Let’s make Jimmy and thousands of boys and girls who are suffering from cancer happy by aiding the research to help find a cure for cancer in children. Because by researching children’s cancer, we automatically help the adults and stop it at the outset.

“Now we know that one thing little Jimmy wants most is a television set to watch the baseball games as well as hear them. If you and your friends send in your quarters, dollars, and tens of dollars tonight to Jimmy for the Children’s Cancer Research Fund, and over two hundred thousand dollars is contributed to this worthy cause, we’ll see to it that Jimmy gets his
television set.”

The Edwards broadcast lasted eight minutes. Jimmy spoke twelve sentences and sang one song. The word
swell
was used five times. Little was said of Jimmy’s cancer: it lurked unmentionably in the background, the ghost in the hospital room. The public response was staggering. Even before the Braves had left Jimmy’s room that evening, donors had begun to line up outside the lobby of the Children’s Hospital.
Jimmy’s mailbox was inundated
with postcards and letters, some of them addressed simply to “Jimmy, Boston, Massachusetts.” Some sent dollar bills with their letters or wrote checks; children mailed in pocket money, in quarters and dimes. The Braves pitched in with their own contributions. By May 1948, the $20,000 mark set by Koster had long been surpassed; more than $231,000 had rolled in. Hundreds of red-and-white tin cans for donations for the Jimmy Fund were posted outside baseball games. Cans were passed around in film theaters to collect dimes and quarters. Little League players in baseball uniforms went door-to-door with collection cans on sweltering summer nights. Jimmy Days were held in the small towns throughout New England. Jimmy’s promised television—a black-and-white set with a twelve-inch screen set into a wooden box—arrived and was set up on a white bench between hospital beds.

In the fast-growing, fast-consuming world of medical research in 1948, the $231,000 raised by the Jimmy Fund was an impressive, but still modest sum—enough to build a few floors of a new building in Boston, but far from enough to build a national scientific edifice against cancer. In comparison, in 1944,
the Manhattan Project spent
$100 million every month at the Oak Ridge site.
In 1948, Americans spent more than
$126 million on Coca-Cola alone.

But to measure the genius of the Jimmy campaign in dollars and cents is to miss its point. For Farber, the Jimmy Fund campaign was an early experiment—the building of another model. The campaign against cancer, Farber learned, was much like a political campaign: it needed icons, mascots, images, slogans—the strategies of advertising as much as the tools of science. For any illness to rise to political prominence, it needed to be marketed, just as a political campaign needed marketing. A disease needed to be transformed politically before it could be transformed scientifically.

If Farber’s antifolates were his first discovery in oncology, then this critical truth was his second. It set off a seismic transformation in his career that would far outstrip his transformation from a pathologist to a leukemia doctor. This second transformation—from a clinician into an advocate for cancer research—reflected the transformation of cancer itself. The emergence of cancer from
its
basement into the glaring light of publicity would change the trajectory of this story. It is a metamorphosis that lies at the heart of this book.

Etymologically, patient means sufferer
. It is not suffering as such that is most deeply feared but suffering that degrades.

—Susan Sontag,
Illness as Metaphor

Sidney Farber’s entire purpose
consists only of “hopeless cases.”

—
Medical World News,
November 25, 1966

There was a time when Sidney Farber had joked about the smallness of his laboratory. “
One assistant and ten thousand mice
,” he had called it. In fact, his entire medical life could have been measured in single digits. One room, the size of a chemist’s closet, stuffed into the basement of a hospital. One drug, aminopterin, which sometimes briefly extended the life of a child with leukemia. One remission in five, the longest lasting no longer than one year.

By the early months of 1951, however, Farber’s work was growing exponentially, moving far beyond the reaches of his old laboratory. His outpatient clinic, thronged by parents and their children, had to be moved outside the hospital to larger quarters in a residential apartment building on the corner of Binney Street and Longwood Avenue. But even the new clinic was soon overloaded. The inpatient wards at Children’s had also filled up quickly. Since Farber was considered an intruder by many of the pediatricians at Children’s, increasing ward space within the hospital was out of the question. “
Most of the doctors
thought him conceited and inflexible,” a hospital volunteer recalled. At Children’s, even if there was space for a few of his bodies, there was no more space for his ego.

Isolated and angry, Farber now threw himself into fund-raising. He needed an entire building to house all his patients. Frustrated in his efforts
to galvanize the medical school into building a new cancer center for children, he launched his own effort. He would build a hospital in the face of a hospital.

Emboldened by his early fund-raising success, Farber devised ever-larger drives for research money, relying on his glitzy retinue of Hollywood stars, political barons, sports celebrities, and moneymakers.
In 1953, when the Braves franchise left
Boston for Milwaukee, Farber and Koster successfully approached the Boston Red Sox to make the Jimmy Fund their official charity.

Farber soon found yet another famous recruit: Ted Williams—a young ballplayer of celluloid glamour—who had just returned after serving in the Korean War. In August 1953,
the Jimmy Fund planned a “Welcome Home, Ted” party
for Williams, a massive fund-raising bash with a dinner billed at $100 per plate that raised $150,000. By the end of that year, Williams was a regular visitor at Farber’s clinic, often trailing a retinue of tabloid photographers seeking pictures of the great ballplayer with a young cancer patient.

The Jimmy Fund became a household name and a household cause. A large, white “piggy bank” for donations (shaped like an enormous baseball) was placed outside the Statler Hotel. Advertisements for the Children’s Cancer Research Fund were plastered across billboards throughout Boston. Countless red-and-white collection canisters—called “Jimmy’s cans”—sprouted up outside movie theaters.
Funds poured in from
sources large and small: $100,000 from the NCI, $5,000 from a bean supper in Boston, $111 from a lemonade stand, a few dollars from a children’s circus in New Hampshire.

By the early summer of 1952, Farber’s new building, a large, solid cube perched on the edge of Binney Street, just off Longwood Avenue, was almost ready. It was lean, functional, and modern—self-consciously distinct from the marbled columns and gargoyles of the hospitals around it. One could see the obsessive hand of Farber in the details. A product of the 1930s, Farber was instinctively frugal (“
You can take the child out of the Depression
, but you can’t take the Depression out of the child,” Leonard Lauder liked to say about his generation), but with Jimmy’s Clinic, Farber pulled out all the stops. The wide cement steps leading up to the front foyer—graded by only an inch, so that children could easily climb them—were steam-heated against the brutal Boston blizzards that had nearly stopped Farber’s work five winters before.

Upstairs, the clean, well-lit waiting room had whirring carousels and boxes full of toys. A toy electric train, set into a stone “mountain,” chugged on its tracks. A television set was embedded on the face of the model mountain. “
If a little girl got attached to a doll
,”
Time
reported in 1952, “she could keep it; there were more where it came from.” A library was filled with hundreds of books, three rocking horses, and two bicycles. Instead of the usual portraits of dead professors that haunted the corridors of the neighboring hospitals, Farber commissioned an artist to paint full-size pictures of fairy-book characters—Snow White, Pinocchio, and Jiminy Cricket. It was Disney World fused with Cancerland.

The fanfare and pomp might have led a casual viewer to assume that Farber had almost found his cure for leukemia, and the brand-new clinic was his victory lap. But in truth his goal—a cure for leukemia—still eluded him. His Boston group had now added another drug, a steroid, to their antileukemia regimen, and by assiduously combining steroids and antifolates, the remissions had been stretched out by several months. But despite the most aggressive therapy, the leukemia cells eventually grew resistant and recurred, often furiously. The children who played with the dolls and toy trains in the bright rooms downstairs were inevitably brought back to the glum wards in the hospital, delirious or comatose and in terminal agony.