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humorism, finishingwhat Paracelsus had started in Basel more than three hundred years earlier.
    Cancer fit neatly into Virchow’s ideas about the cellular nature of disease, and his close observations of malignant cells helped him form his theories. In 1845, two years out of medical school, he was the first to observe that some sick patients had far too many white cells in their blood and too few platelets and red blood cells. He coined the word
leukemia
to describe their condition because it meant “white blood” in Greek. Later, he noticed that a swollen lymph node above the left collarbone—now known as Virchow’s node—was often an early sign of cancer, an indicator still used by physicians today. Virchow poured all of his ideas and observations about cancer into an eighteen-hundred-page, three-volume work entitled
Die Krankhaften Geschwülste
(The Malignant Neoplasms), published in 1863. Many of his core beliefs have been vindicated, including the cellular nature of cancer, the central role of rapid cell division in its development, and the importance of an initiating event, an “irritation,” to begin the process by disrupting a previously healthy cell. As Virchow aged, his irritation theory fell out of favor and researchers drifted toward competing theories of carcinogenesis. He died in 1902, at age eighty—too soon to see his ideas return to vogue, and in variations that even someone with Virchow’s remarkable foresight could not have anticipated.
    One of the many reasons the discovery of a malignant tumor in a child is so emotionally wrenching is that it is so surprising. Cancer is, in the main, an affliction of the elderly. In any given year, a person over age sixty-five in the United States is almost ten times more likely to be diagnosed with cancer than someone younger. 8 In fact, between ages five and sixty-nine, the likelihood of getting cancer in any particular year rises with each year of life, and it does so in increasingly large intervals: from about one in nine thousand in the fifth year of life to about one in fifty-seven in the sixty-ninth year. There seem to be many reasons for this: complex molecular changes that occur in the cells of older organisms, immune deficiencies associated with aging, and the many years and intricate biochemical steps required before some types of tumors (prostate lesions, for example) can begin growing. 9
    And yet, about thirty-eight times a day in the United States, and perhaps eight hundred times elsewhere on Earth, a child is diagnosed with cancer. That is still a rare occurrence, with fewer than one in six thousand American children diagnosed per year, but not as rare as it used to be. Childhood cancer incidence jumped by more than one-third between 1975 and 2005—more than twice as much as overall cancer incidence. 10 Improved case reporting and earlier diagnosis explain some portion of the overall increase but do not explain why cancer cases among children are rising at a much faster pace than cancers in adults. Nor has science credibly explained why a child would get an old person’s disease in the first place.
    For Michael Gillick’s parents, the diagnosis of neuroblastoma, a cancer of the nervous system, was a thunderbolt from a cloudless sky, a sucker punch from the blind side. They were on the floor before they even knew what hit them. A week after his father discovered the first lump, three-month-old Michael was strapped down on an operating table at New York Hospital in Manhattan. A surgeon made an incision from his neck to his groin and tried to remove a softball-sized tumor that had enveloped Michael’s left kidney and adrenal gland and the blood vessels near his heart. When the discouraged surgeon realized that the tumor was far too large to be safely cut out, especially in light of Michael’s sky-high blood pressure (170 over 100, instead of the normal 70 over 50 for an infant), the doctor sewed him back up, noting on his way out that the cancer