Saved by Stoppard

Headline: Saved by Stoppard

Sir, In 1993 my wife and I went to see the first production of Arcadia by Tom Stoppard (obituary, Dec 1), and in the interval I experienced a Damascene conversion. As a clinical scientist I was trying to understand the enigma of the behaviour of breast cancer, the assumption being that it grew in a linear trajectory spitting off metastases on its way. In the first act of Arcadia, Thomasina asks her tutor, Septimus: “If there is an equation for a curve like a bell, there must be an equation for one like a bluebell, and if a bluebell, why not a rose?” With that Stoppard explains chaos theory, which better explains the behaviour of breast cancer. At the point of diagnosis, the cancer must have already scattered cancer cells into the circulation that nest latent in distant organs. The consequence of that hypothesis was the birth of “adjuvant systemic chemotherapy”, and rapidly we saw a striking fall of the curve that illustrated patients’ survival.

Stoppard never learnt how many lives he saved by writing Arcadia.

Michael Baum Professor emeritus of surgery; visiting professor of medical humanities, UCL