A Fatal Inheritance

How a Family Misfortune Revealed a Deadly Medical Mystery

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Pub Date 14 May 2024 | Archive Date 14 Jun 2024
Henry Holt & Company, Henry Holt and Co.


Weaving his own moving family story with a sweeping history of cancer research, Lawrence Ingrassia delivers an intimate, gripping tale that sits at the intersection of memoir and medical thriller

Ingrassia lost his mother, two sisters, brother, and nephew to cancer—different cancers developing at different points throughout their lives. And while highly unusual, his family is not the only one to wonder whether their heartbreak is the result of unbelievable bad luck, or if there might be another explanation.

Through meticulous research and riveting storytelling, Ingrassia takes us from the 1960s—when Dr. Frederick Pei Li and Dr. Joseph Fraumeni Jr. first met, not yet knowing that they would help make a groundbreaking discovery that would affect cancer patients for decades to come—to present day, as Ingrassia and countless others continue to unpack and build upon Li and Fraumeni’s initial discoveries, and to understand what this means for their families.

In the face of seemingly unbearable loss, Ingrassia holds onto hope. He urges us to “fight like Charlie,” his nephew who battled cancer his entire life starting with a rare tumor in his cheek at the age of two—and to look toward the future, as gene sequencing, screening protocols, CRISPR gene editing, and other developing technologies may continue to extend lifespans and perhaps, one day, even offer cures.

Weaving his own moving family story with a sweeping history of cancer research, Lawrence Ingrassia delivers an intimate, gripping tale that sits at the intersection of memoir and medical thriller

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Featured Reviews

In 1968, at the age of 42, Ingrassia's mother died of cancer—a tragic event for any family, but unusual mostly for her young age. Cancer is common enough that all of us will be touched by it in some way or another—oneself, a loved one, etc.—and treatment options had (still have) a long way to go. But then Ingrassia's youngest sister was diagnosed with cancer and died at 24, and his other sister was diagnosed with cancer and died at 32, and his nephew got cancer when he was just 2. It didn't end there. "In the United States," writes Ingrassia, "life expectancy is nearly eighty years. In my family, not including me, the average life span was forty-five" (loc. 3997*). The odds were staggering, but at the time doctors shrugged it off as terrible luck.

But the brilliance of this book is that it is not only memoir—and I say this as someone who loves memoir—but a meticulously researched, compassionately reported dive into the history of cancer research: more specifically, how scientists came to identify what caused this rare and horrible quirk in some families' histories, and what all that research means for individuals, and families, affected by cancer.

Although Ingrassia opens with his family's story in the first chapter, it's another dozen chapters before he returns to the subject—instead he introduces other families facing staggering counts of cancer diagnoses (and deaths), sets the scene for the scientists who are some of the heroes of the story, and begins to carefully and precisely walk lay readers through the complicated science behind cancer and gene mutations. I thought this might be a book to read in small pieces, but instead I tore through it in two days. Reminiscent of "Hidden Valley Road", which explored research into schizophrenia via the lens of one family disproportionately affected by it, "A Fatal Inheritance" brings to life the drier work of lab science by putting it within the context of families—including his own—for whom cancer after cancer made the future uncertain.

It is at times hard to keep all of the names and dates straight, but Ingrassia is an award-winning journalist, and the skill and care he has put into this work shows. I'd be remiss not to note that although I found tremendous value in the research and science Ingrassia makes accessible to the lay reader, he observes toward the end that "while this is a book about scientific discovery begun by two tireless doctors, it is even more a love letter to my family, written to preserve memories for my children, and their children, and the children after them. Because I will be gone someday as well, and I don't want these memories to be gone with me" (loc. 3991).

4.5 stars; this will be a must-read for those seeking to better understand cancer and cancer research.

Thanks to the author and publisher for providing a review copy through NetGalley.

*I read an ARC, and quotes may not be final.

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