Strong Medicine

  Among the mothers, several committed suicide; far more required psychiatric help. A formerly devout father cursed God. “I spit and shit upon him!” Then he corrected himself. “There is no God. How could there be?”

  And still the cause of the phocomelia outbreak remained unknown. (The word, it was explained, is from the Greek—phoke meaning “seal”; melos is “limb.”) One study suggested the cause might be radioactive fallout from atom bombs. Another, that a virus was at work.

  Many of the babies had other defects as well as missing limbs. Ears were absent or deformed; hearts, bowels and other organs were incomplete or didn’t function as they should. Some babies died—“the lucky ones,” as one observer wrote.

  Then, in November 1961, two doctors working independently and unknown to each other—a pediatrician in Germany and an obstetrician in Australia—linked phocomelia to the drug Thalidomide. Soon afterward, it was established that the drug was indeed the cause of the defective births.

  Australian authorities, acting swiftly, ordered Thalidomide off the market during the same month the connection became known. West Germany and Britain withdrew the drug a month later, in December. But in the United States it was two months more until, in February 1962, the Thalidomide-Kevadon application was withdrawn from the FDA. Canada, inexplicably, left the drug on sale until March—four months later than the Australian withdrawal and time for many more individuals, including pregnant women, to take it.

  Celia and Andrew, who followed the grim story by reading scientific publications as well as the regular press, discussed it frequently.

  One night at dinner Celia said, “Oh, Andrew, how glad I am you wouldn’t let me take any drugs during pregnancy!” A few minutes earlier she had looked with love and gratitude at their own two healthy, normal children. “I could have taken Thalidomide. I hear there are doctors’ wives who did.”

  Andrew said quietly, “I had some Kevadon myself.”

  “You did?”

  “I was given samples by a detail man.”

  Jolted, Celia said, “But you didn’t use them?”

  Andrew shook his head. “I’d like to say I had a suspicion about the drug, but it wouldn’t be true. I simply forgot they were there.”

  “Where are the samples now?”

  “Today I remembered them. I pulled them out. There were several hundred tablets. I read somewhere that more than two and a half million were distributed to American doctors. I’ve flushed mine down the toilet.”

  “Thank God.”

  “I’ll second that.”

  In the months that followed, more news about Thalidomide continued to flow in. It was estimated that twenty thousand deformed babies were born in twenty countries, though the exact number would never be known.

  In the United States the number of phocomelia births was low—an estimated eighteen or nineteen—because the drug had never been approved for general use. Had it been approved, the number of armless and legless American babies would probably have reached ten thousand.

  “I guess we all owe a debt to that woman Kelsey,” Andrew commented to Celia on a Sunday in July 1962. He was at home, relaxing, a newspaper spread out before him in the den they shared.

  “Kelsey” was Dr. Frances Kelsey, an FDA medical officer who, despite intense pressure from the drug firm which planned to market Thalidomide-Kevadon, used bureaucratic tactics to delay it. Now, declaring she’d had scientific reasons for doubting the drug’s safety all along, Dr. Kelsey was a national heroine. President Kennedy had awarded her the President’s Gold Medal for Distinguished Service, the country’s highest civilian decoration.

  “As it turned out,” Celia said, “what she did was right, and I agree about being grateful. But there are some who say she got the medal for doing nothing, just putting off making a decision, which is always the safe thing for a bureaucrat to do, and now she’s claiming to have had more foresight than she really did. Also, it’s feared that what Kennedy has done will mean that in the future, good drugs that are truly needed will be delayed by others at FDA who’d like a medal too.”

  “What you have to understand,” Andrew said, “is that all politicians are opportunists and Kennedy’s no exception, nor is Kefauver. Both of them are using the publicity about Thalidomide for their own advantage. Just the same, we need some kind of new law because whatever else Thalidomide did, it sure as hell showed that your industry, Celia, can’t regulate itself and that parts of it are rotten.”

  The remark was prompted by revelations, following investigations into the drug firms responsible for Thalidomide, of duplicity, callousness, greed, cover-up and incompetence, revelations that seemed to surface almost daily.

  Celia acknowledged sadly, “I wish I could argue with you. But no one in their right mind could.”

  Surprisingly, and despite the political maneuvering that preceded it, some good legislation did emerge and was signed into law by President Kennedy in October 1962. While far from perfect, and with provisions which later would deny valuable new drugs to those in desperate need of them, the new law provided consumer safeguards that had not existed “B.T.”—which was how many in the drug industry would in future identify the era of “before Thalidomide.”

  Also in October the news reached Celia that Eli Camperdown, president and CEO of Felding-Roth, who had been ill for several months, was dying. The cause was cancer.

  A few days after she heard, Sam Hawthorne summoned Celia to his office. “Eli has sent a message. He would like to see you. He’s been taken home from the hospital and I’ve arranged for you to be driven there tomorrow.”

  The house was five miles southwest of Morristown at Mount Kemble Lake. Located at the end of a long driveway and shielded from outside view by trees and heavy shrubbery, it was large and old, with a frontage of fieldstone which had weathered and taken on a green patina. From the outside the interior looked dark. Inside, it was.

  A stooped, elderly butler let Celia in. He led her to an ornate drawing room furnished with heavy period pieces and asked her to wait. The house was quiet, with no sounds of activity. Perhaps, Celia thought, it was because Eli Camperdown lived alone; she knew he had been a widower for many years.

  In a few minutes a uniformed nurse appeared. In contrast to the surroundings, she was young, pretty and brisk. “Will you please come with me, Mrs. Jordan, Mr. Camperdown is expecting you.”

  As they climbed a wide, curving staircase with deep carpeting Celia asked, “How is he?”

  The nurse said matter-of-factly, “Very weak and in a good deal of pain, though we use sedation to help him with that. Not today, though. He said he wished to be alert.” She looked at Celia curiously. “He’s been looking forward to your coming.” Near the head of the staircase the nurse opened a door and motioned Celia in.

  At first Celia had difficulty in recognizing the gaunt figure propped up by pillows in the large four-poster bed. Eli Camperdown, who not long since had seemed the embodiment of strength and power, was now emaciated, wan and fragile—a caricature of his former self. His eyes, sunk in their sockets, regarded Celia as his face twisted in an attempt to smile. When he spoke his voice was low and reedy. “I’m afraid advanced cancer isn’t pretty, Mrs. Jordan. I hesitated about letting you see me like this, but there are things I wanted to say to you directly. I thank you for coming.”

  The nurse had brought a chair before leaving them alone and Celia sat in it beside the bed. “I was glad to come, Mr. Camperdown. I’m just sorry you are ill.”

  “Most of my senior people call me Eli. I’d be glad if you would do that.”

  She smiled. “And I’m Celia.”

  “Oh yes, I know. I also know you’ve been important to me, Celia.” He raised a frail hand and motioned to a table across the room. “There’s a Life magazine over there, some papers with it. Would you pass them to me?”

  She found the magazine and papers and brought them. With effort, Eli Camperdown began leafing through the issue of Life until he found what he wa
s seeking.

  “Perhaps you’ve seen this.”

  “The article about Thalidomide, with the photos of deformed babies? Yes, I have.”

  He touched the other papers. “These are more reports and photographs; some haven’t reached the public yet. I’ve been following the case closely. It’s awful, isn’t it?”

  “Yes, it is.”

  They were silent, then he said, “Celia, you know I’m dying?”

  She answered gently, “Yes, I know.”

  “I made the damn doctors tell me. I’ve a week or two, at best; perhaps only days. It’s why I had them bring me home. To finish here.” As she started to speak, he stopped her with a gesture. “No, hear me out.”

  He paused, resting. Clearly the effort made so far had tired him. Then he went on.

  “This is selfish, Celia. None of it will do those poor, innocent children any good.” His fingers touched the photos in the magazine. “But I’m glad I’m dying without that on my conscience, and the reason I don’t have it there is you.”

  She protested, “Eli, I believe I know what you’re thinking, but when I suggested …”

  He continued as if not hearing her. “When we at Felding-Roth had that drug, we planned to push it hard. We believed it would be big. We were going to test it widely, then pressure the FDA to pass it. Maybe it would have passed. Our timing would have been different; there could have been another examiner. There’s not always logic to these things.”

  He paused again, mustering his strength and thoughts. “You persuaded us to do the tests on old people; because of that, no one under sixty took it. It didn’t work. We dropped it. Afterward I know there was criticism of you … But if it had happened … the way we intended in the beginning … then I’d have been responsible …” Again his fingers found the photos in the magazine. “I’d have died with that terrible thing upon me. As it is …”

  Celia’s eyes were misty. She took his hand and told him, “Eli, be at peace.”

  He nodded and his lips moved. She leaned closer to hear what he was saying. “Celia, I believe there is something you have: a gift, an instinct, for judging what is right … Big changes are coming in our business, changes I won’t see … Some in our company believe you are going far. That’s good … So I’ll give you some advice, my last advice … Use your gift, Celia. Trust your good instincts. When you have power, be strong to do what you believe … Don’t let lesser people dissuade you …”

  His voice drifted off. A spasm of pain contorted his face.

  Celia turned, aware of movement behind her. The young nurse had come into the room quietly. She had a syringe on a tray which she put down beside the bed. Her movements were efficient and quick. Leaning over her patient she asked, “Is it pain again, Mr. Camperdown?” As he nodded feebly, she rolled back the sleeve of his pajamas and injected the syringe’s contents into his arm. Almost at once his facial tension eased, his eyes closed.

  “He’ll drift now, Mrs. Jordan,” the nurse said. “I’m afraid there isn’t much point in your staying.” Again she regarded Celia curiously. “Did you finish your talk? It seemed important to him.”

  Celia closed the Life magazine and put it, with the papers, back where she had found it.

  “Yes,” she said. “Yes, I think so.”

  Somehow—though not from Celia, who kept her own counsel—a report of her encounter with Eli Camperdown filtered through the company. As a result she found herself regarded with a mixture of curiosity, respect, and occasionally awe. No one, including Celia, had any illusion that some exceptional insight had prompted her suggestion five years earlier about Felding-Roth’s testing of Thalidomide, testing that turned out to be unsuccessful. But the fact was, the route the company took had saved it from what could have been disaster, and Celia’s contribution to that route was cause enough for gratitude.

  Only one person in the company’s top echelon failed to acknowledge Celia’s role. The director of research, although he was one of those who had originally urged wide testing of Thalidomide—including giving it to obstetricians, which Celia specifically opposed—chose to keep quiet about that portion of his involvement with the drug. Instead he reminded others that his had been the decision to turn it down when it failed during testing on old people. His statement was true, though incomplete.

  There was, however, little time for prolonged discussion. The death of Eli Camperdown occurred two weeks after Celia visited him. In newspapers the following day, November 8, 1962, the Camperdown obituaries were respectfully long, though even longer were those for Mrs. Eleanor Roosevelt, who also had died the day before. As Celia said to Andrew, “It seems as if two pieces of history ended together—one that was big history, the other smaller, but which I was part of.”

  The death of the Felding-Roth president resulted in changes within the company, as a new president was named by the board of directors, and others moved up the promotion ladder. Among those affected were Sam Hawthorne, who became a vice president and national sales manager, while Teddy Upshaw, to his great joy, was appointed sales manager of over-the-counter products, marketed by the company’s Bray & Commonwealth division. “A smashing chance with O-T-C to do some really drag-’em-in, knock-’em-down selling” was how Teddy described his impending move excitedly to Celia and told her, “I’ve recommended that you get my job, though I have to tell you there are still some around here who don’t like the idea of a woman being director of anything.” He added, “To be honest, I used to feel that way myself, but you changed my mind.”

  Another eight weeks passed during which Celia functioned as head of sales training in everything except title. Day by day her frustration at the unfairness increased. Then, on a morning in early January, Sam Hawthorne walked into her office unannounced and beaming. “By God, we did it!” he declared. “I had to plunge my sword into the entrails of a few male diehards, and blood has flowed, but word has now come down. You are director of this bailiwick and, what is more important, Celia, you are officially on the company’s fast track.”

  TWO

  1963–1975

  1

  Being on the fast track at Felding-Roth meant much the same as it did at other companies. You had been selected as a candidate for senior management and would be given better than normal opportunities to learn the business and to prove yourself. Of course, not everyone on the fast track made it to the finish line. There were others on the track. Competition was keen. Also, a name could be removed at any time.

  Celia realized all this. She also knew that, as a woman, she had overcome an extra hurdle of prejudice which men didn’t have to. The need for double achievement made her keener still.

  Which is why it seemed unfortunate that the 1960s were already proving a dry, non-innovative period for the prescription drug business.

  “It’s happened before,” Sam Hawthorne said when Celia raised the subject. “Look, we’ve just gone through twenty years of miracle drugs—antibiotics, new heart medicines, the Pill, tranquilizers, all the rest. Now we’re in a flat spell before the next big scientific breakthrough.”

  “How long a flat spell?”

  Sam rubbed his bald head thoughtfully. “Who knows? Could be two years, could be ten. Meanwhile, our Lotromycin is selling well and we’re developing improved versions of existing drugs.”

  Celia said pointedly, “Don’t you mean developing ‘me-toos’? Copying the successful drugs of our competitors? Playing molecular roulette by changing them just enough so we can’t be sued for infringing someone’s patent?”

  Sam shrugged. “If you choose to use our critics’ language, maybe so.”

  “Speaking of critics, isn’t it true they accuse us of wasting research effort on ‘me-too’ drugs, effort we ought to use in more productive, beneficial ways?”

  “And isn’t it time you realized this industry is criticized for everything?” An edge of sharpness crept into Sam’s voice. “Especially by people who don’t know or care that ‘me-too’ drugs keep companies
like ours afloat when nothing much is happening in science. There have always been gaps. Do you know that after vaccination for smallpox began to be used successfully, scientists took another hundred years to find out why it worked?”

  Though the conversation depressed Celia, she discovered afterward that other pharmaceutical companies were experiencing the same dry period, with little that was new or exciting being developed. It was an industry-wide phenomenon which—though no one knew it then—would last until the 1970s, eventually proving Sam an accurate prophet.

  Meanwhile, through most of 1962, Celia continued to work successfully as director of sales training. Until November.

  “I sent for you,” Sam told Celia on an afternoon in late November, with the two of them seated in his oak-paneled office, “to tell you you’re getting a new assignment. And, oh yes, it’s also a promotion.”

  Celia waited. When Sam said nothing more, she sighed and smiled. “You know perfectly well I’m dying of curiosity, but you’re going to make me ask the question, so I will. Okay, Sam: what’s my new job?”

  “General manager of over-the-counter products. You’re to be in overall charge of Bray & Commonwealth. Teddy Upshaw, who used to be your boss, will now report to you.” Sam smiled. “Celia, I hope you’re suitably happy and impressed.”

  “Oh, I am! I really am, Sam. Thank you!”

  He looked at her shrewdly. “Amid that enthusiasm, do I detect a reservation?”

  “No reservation.” Celia shook her head decisively. “It’s just that … Well, the fact is, I know nothing about our over-the-counter business.”

  “You’re not unique,” Sam said. “I used to have the same gap in knowledge until I served a couple of years in O-T-C territory. In some ways it’s like going to a foreign country.” He hesitated. “Or crossing the tracks to another side of town.”