Charles Graeber: The Breakthrough

April 03, 2019

For this column, NASW book editor Lynne Lamberg asks NASW authors to tell how they came up with the idea for their book, developed a proposal, found an agent and publisher, funded and conducted research, and put the book together. She also asks what they wish they had known before they began working on their book, what they might do differently the next time, and what tips they can offer aspiring authors. She then edits the A part of that Q&A to produce the author reports you see here.

Publication of NASW members’ reports in Advance Copy does not constitute NASW’s endorsement of their books. NASW welcomes your comments, and hopes this column stimulates productive discussions.

Cover: The Breakthrough

Cover: The Breakthrough

Charles Graeber
Hachette Book Group/Twelve Books, November 13, 2018
U.S. $28.00, CAN $34.00
ISBN-10: 1455568503; ISBN-13: 978-1455568505
Ebook 978-1-4555-6849-9

Graeber reports:

The Breakthrough started as a surprising fact: cancer had evolved “secret handshakes” that tricked our killer immune cells, and we’d recently discovered some of those tricks and could block them, unleashing the immune system to fight cancer the way it did other diseases.

My reaction was: What, really? At the time (nearly five years ago), I’d heard nothing about it. Or, rather, I’d failed to recognize it as a penicillin moment in our war against cancer. This was new and complex news from a field (cancer immunotherapy) that had spent decades in scientific disgrace; an old idea that hadn’t worked in practice until, suddenly and recently, it did. Most doctors had been trained not to trust it. Siddhartha Mukherjee doesn’t even mention cancer immunotherapy in The Emperor of All Maladies.

Charles Graeber, photo by Robert Krivicich

Charles Graeber, photo by Robert Krivicich

When I approached my agent Susan Golomb about doing a book on the subject and its researchers (“They will win the Nobel someday”, I told her, which they did), she consulted her father, a retired oncologist. “He said not to bother,” she told me. “It doesn’t work.” Susan trusted me and sold the book anyway, inflamed by my need to correct the record.

The Breakthrough was incredibly difficult to report and write. I felt at times like I was trying to sketch a speeding bullet train. Before I could explain the science, I had to understand it- which only a handful of MD/PhDs truly did. The advance didn’t cover the years of research as I struggled to find compelling personal stories that also captured the big picture, and cobble science into a flowing human narrative with a “so what.” But of course, if it was easy or obvious, the book wouldn’t even be necessary.

Nearly every story in The Breakthrough is of a character who could have given up. They didn’t, and that made the difference. That’s the message of The Breakthrough for patients and researchers alike. Hope is warranted; don’t give up. It’s a lesson I’d like to pass on to my fellow authors as well.

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Tell your fellow NASW members how you came up with the idea for your book, developed a proposal, found an agent and publisher, funded and conducted research, and put the book together. Include what you wish you had known before you began working on your book, or had done differently.


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Advance Copy

The path from idea to book may take myriad routes. The Advance Copy column, started in 2000 by NASW volunteer book editor Lynne Lamberg, features NASW authors telling the stories behind their books. Authors are asked to report how they got their idea, honed it into a proposal, found an agent and a publisher, funded and conducted their research, and organized their writing process. They also are asked to share what they wish they’d known when they started or would do differently next time, and what advice they can offer aspiring authors. Lamberg edits the authors’ answers to produce the Advance Copy reports.

NASW members: Will your book be published soon? Visit for information on submitting your report.

Publication of NASW author reports in Advance Copy does not constitute NASW's endorsement of any publication or the ideas, values, or material contained within or espoused by authors or their books. We hope this column stimulates productive discussions on important topics now and in the future as both science and societies progress. We welcome your discussion in the comments section below.