From Empire of Pain (Patrick Radden Keene, 2021) 82-4
The trouble started when Arthur Sackler attracted the scrutiny of a nettlesome investigative reporter, a man named John Lear. A science editor at the Saturday Review, Lear had come from Collier’s magazine, where he had acquired a reputation as a dogged muckraker with a theatrical flair. In August 1950, five years to the week after the U.S. nuclear attack on Japan, Lear had published a cover story in Collier’s called “Hiroshima, U.S.A.,” which explored in gruesome, if conjectural, detail what a Soviet nuclear attack on New York City might look like. The cover featured an apocalyptic full-color illustration of lower Manhattan engulfed in flame, with bridges collapsing into rivers and a mush. room cloud darkening the sky. Like Arthur Sackler, Lear knew how to get people’s attention.
One night in the late 1950s, Lear had dinner with a research physician he knew. When they had finished their meal, the man invited Lear to visit the hospital laboratory where he worked. There was something the doctor had grown concerned about, which he wanted to discuss with Lear. “Take a look at this stuff,” he said, opening a drawer filled with pharmaceutical advertisements and free samples of new drugs, The ads were often fraudulent, the doctor said, with indignation. They made unsupportable claims about what the drugs could do. This was a big story, he insisted, as he showed Lear a series of ads for Sigmamycin, the “third era” combination antibiotic that Pfizer had unveiled at the conference at the Willard back in 1956.
One of the ads, a brochure that had been sent to doctors in the mail, said,
More and More Physicians Find Sigmamycin
the Antibiotic Therapy of Choice
It featured an array of business cards with the names, addresses, and office hours of eight doctors, who appeared to be endorsing the product. There was a doctor in Miami, another in Tucson, a third in Lowell, Massachusetts. Sigmamycin was not just “highly effective,” the ad suggested, but “clinically proved.” As Lear inspected the brochure, the doctor explained that he had written to each of the named physicians, to inquire about the results of the clinical tests that they had presumably conducted. He handed Lear a stack of envelopes. It was the letters he had written. They were all stamped RETURN TO WRITER UNCLAIMED.
Intrigued, Lear wrote to the doctors himself His letters came back unopened. He sent telegrams, only to be informed that no such addresses existed. Finally, he tried calling the telephone numbers on the business cards in the ad, but without success: the numbers were made up, too. Pfizer had blasted this advertisement, with its fake endorsements, to physicians across the country. And it looked so plausible, so real, with the special patina of authority conferred by eight MDs. The ad was polished, impressive, and fundamentally deceptive. It had been produced by Arthur Sackler’s agency.
In January 1959, Lear published the initial results of his investigation in a Saturday Review article called “Taking the Miracle Out of the Miracle Drugs.” In stark contrast to the euphoria that generally accompanied public discussion of antibiotics, Lear suggested that these drugs were being wildly overprescribed, often without any firm medical basis for doing so, and that the ubiquity and sophistication of pharmaceutical advertising shared some of the blame.
After the article was published, Lear was deluged with mail. A number of the medical professionals who got in touch suggested that if Lear was pursuing this particular theme of the corruption of medicine by business interests, he might want to look into the fellow who ran the Division of Antibiotics at the FDA, a guy named Henry Welch. So Lear put in a call to Welch, to request an interview.
What a coincidence, Welch said, when Lear got him on the phone. He had just been sitting down at that very moment to write Lear a letter about all the “mistakes you made in your article.”
Lear traveled to Washington to see Welch, and they spoke for two hours, Welch seemed at ease. He assured Lear that any fears about the marketing of new drugs were misplaced. Surely, he scoffed, America’s doctors “are not naive enough to be fooled by ads.” The dangers of antibiotics had likewise been exaggerated, Welch continued, and to the extent that Lear had sources in the medical community who were telling him otherwise, they were people who “spoke from ignorance.” In a textbook Washington power move, Welch had invited an aide from the FDA to join him for the interview, and the function of this apparatchik, it seemed to Lear, was mostly to express profound agreement with everything that Welch was saying. But now Lear turned the tables, saying he would like to speak with Welch in private and asking, politely, if the subordinate could leave. When they were alone, Lear said that he had spoken to sources who suggested that Welch derived significant income from the two journals that he ran with Félix Marti-Ibanez.
“Where my income comes from is my own business,” Welch snapped, dropping the pretense of affability.
This struck Lear as a peculiar position for a public official to stake out, Welch explained that the two journals were run by an outfit called MD Publications and that he had no financial stake in that company. “My only connection is as an editor, for which I receive an honorarium,” he said, adding that he enjoyed editing the journals, “and I don’t intend to give them up.” Lear had hoped to ask a few more questions. There was that business about the “third era” of antibiotics, for instance. But Welch had turned brittle, and the interview was over.
Welch might have thought, when he got Lear out of his office, that he had seen the end of this matter. But if he did, then he badly underestimated John Lear, because Welch was not the only official in Washington whom Lear was talking to. In fact, Lear had recently met with a couple of staffers of a U.S. senator—a senator who happened to share Lear’s penchant for investigation.
—
Senator Estes Kefauver was a ruddy, rawboned public servant who stood six feet three and had grown up in the mountains of Tennessee. A Yale-trained lawyer, he was a southern liberal and the sort of earnest do-gooder who can occasionally strike even his supporters as being a bit in love with his own virtue. Kefauver was a trustbuster, chairman of the powerful antitrust and monopoly subcommittee. This was a time when congressional committees enjoyed enormous power and resources. When Kefauver started looking into the pharmaceutical industry in the late 1950s, his subcommittee had a full-time staff of thirty-eight.
Kefauver liked to investigate things. A decade earlier, he had leaped to national prominence when he launched a groundbreaking investigation of the Mafia.
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