Review: "A Fatal Inheritance" by Lawrence Ingrassia

A Fatal Inheritance by Lawrence Ingrassia
Published May 2024 via Henry Holt & Company
★★★★★

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.