Views & Reviews Medical Classics

The Lives of a Cell

BMJ 2008; 337 doi: (Published 08 July 2008) Cite this as: BMJ 2008;337:a720
  1. Douglas Kamerow, chief scientist, RTI International, and associate editor, BMJ
  1. dkamerow{at}

    I decided to go to medical school towards the end of my college years in the United States and thus took only the absolute minimum number of premedical science courses. I worried about my lack of scientific preparation. In an attempt to remedy my deficiencies I took out a subscription to the New England Journal of Medicine (NEJM) when I began medical school in 1974. What a disappointment. I understood virtually nothing in the august journal, and what I did understand I found uninteresting. Lewis Thomas’s Notes of a Biology Watcher column was the lone, wonderful, exception.

    Thomas had begun writing his NEJM columns in 1971. A graduate of Princeton University and Harvard Medical School, he was a physician, immunology researcher, dean, poet, etymologist, and essayist. It is said that the journal’s legendary editor, Franz Ingelfinger, offered him a monthly column for no pay but with the promise that he wouldn’t be edited. Thomas accepted and wrote his monthly essays for 10 years.

    I remember being enthralled by the columns. He seemed a wise tour guide with an encyclopaedic knowledge, who wrote clearly and beautifully about biology and society. I could understand everything he said, and he opened my eyes to subjects I never knew or cared about: obscure micro-organisms, organelles within cells, ants, termites. He connected microscopic particles and tiny animals to human biology and psychology. He was curious and speculative and seductively modest.

    I looked forward to reading the NEJM issues that contained his columns. He gave me confidence that “basic” science was interesting and that medicine and basic science were actually connected—indeed, that society and medicine were linked and that it was important to understand both. Furthermore, it was great to realise that at least some doctors could write engagingly.

    So it was with some trepidation that I began to reread The Lives of a Cell, the first book length compilation of Thomas’s columns, after a gap of 30 years. I needn’t have worried. The writing is still graceful, the perspective is intelligent, and the themes are, if anything, more relevant now than when they were written: the interdependence of different forms of life, the importance and universality of language, the process of scientific discovery. I was surprised at the modernity of some of his musings, about technology assessment, the difference between health care and medicine, and the important role of behaviour in health.

    Thomas is endlessly quotable: “We might as well face up to it: there is a highly visible difference between the pace of basic science and the application of new knowledge to human problems.” Or: “The great thing about human language is that it prevents us from sticking to the matter at hand.” Thomas didn’t invent the idea that the earth or human society can be seen as one huge cell, but he wrote with fascination and erudition about the interdependence of all living creatures. Talking both about the earth as viewed from the distance of space and of a single cell, he said, “It takes a membrane to make sense out of disorder in biology.”

    What a pleasure to be along for the ride as Lewis Thomas makes sense out of the disorder of everyday life.


    Cite this as: BMJ 2008;337:a720


    • The Lives of a Cell

    • By Lewis Thomas

    • First published 1974

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