Remembering Thalidomide

What do these names have in common: Distaval, Contergan, Kevadon, Tensival, Softenil, Asmaval, Valgraine? Something meretriciously soothing about them suggests the medical ad-man, and in fact they’re some of the 35 or so trade names once used round the world for the drug thalidomide. Looking at that drug’s tragic history from the sales end like this (and it did start out as a freely purchasable medicine) is a helpful reminder that the delinquency behind it was much more commercial than scientific. Thalidomide was aggressively and mendaciously marketed at every stage, in defiance of the gathering evidence against its safety. Really its trade name should have been Moneymaker (like the commercial tomato variety, but with a good deal more justice). One small but characteristic instance of this: when Distillers Company (Biochemicals) Limited, which had bought the British rights to thalidomide from Chemie Grünenthal, was told by its own pharmacologist, George Somers, that a new liquid formulation of the drug had proved dangerously toxic, the Managing Director muffled the information in a notable euphemism – “I understand that it has not yet been possible to develop a formulation which compares favourably in terms of toxicity with our tablets” – and the liquid version was put on sale just the same (in July 1961).

That the testing on animals had been unhelpful is true enough, but only in so far as such tests are inherently unhelpful. True, the Chemie Grünenthal laboratory had tested the drug only for efficacy and toxicity in mature animals, and not for effects on their offspring. But almost certainly that omission made no difference. Notoriously, it proved difficult both during and after the scandal to confirm thalidomide’s teratogenic effect in animals. Thus the physician who first suspected and made known the harm being done by the drug, William McBride, tested it for that specific harm on mice and guinea pigs, and got no results. It made him doubt for a time the soundness of his own suspicions. The actor Mat Fraser, survivor and brilliant scourge of thalidomide, is surely right in saying that animal tests actually delayed the withdrawal of the drug. The human evidence, by contrast, was prompt and conclusive, but it was not acted upon.

Anyway, the animal kingdom was indeed scoured for results, often with enormous doses of the drug (“we just stuffed it into them”, McBride said), before the ‘right’ species were eventually found: New Zealand rabbits and certain non-human primates. By 1966, a hundred or more papers had been published on such hit and miss animal tests. A review of this unsavoury literature concluded that, since the different species varied so much in their responses to the same drug, “it is rather difficult now, as ever, to apply in humans the experimental findings.” The writer in this case was a scientist on the staff of Chemie Grünenthal, so he was not exactly impartial; still, his article appeared in the very respectable peer-reviewed journal Arzneimittelforschung, and its conclusion seems very well justified. The Sunday Times book about thalidomide, Suffer the Children (1979), quotes it with ironic reservation, but admits readily enough the complementary fact about animal tests, that negative results provide no reliable guidance either:

the biochemical variations between human and animal species are so great that even if a drug shows no ill effect in animals, it may still do so once human use begins… When we describe a drug as “safe”, therefore, what we should really say is that it is a drug that has not yet been found unsafe.

The animals, in short, can tell us nothing that we really need to know.

These unhappy recollections of thalidomide are prompted by yet more medical ‘disasters’ in the news. In January, one participant died during tests in France for the company Bial of a painkiller/tranquilliser; a few weeks later, the drug Pacritinib, developed for the treatment of blood cancer, similarly proved to have, as the FDA put it, “a detrimental effect on survival” (I collect these weird euphemisms). This last misfortune was felt to be especially shocking because it happened in a ‘phase 3’ trial: i.e. after two earlier stages of clinical tests in humans. Evidently it is agreed that human tests at least can be expected to provide reliable guidance – and correspondingly that nobody should be much surprised at being misled by the results from animals. This is no doubt right, although unfortunately, as Suffer the Children says, and as records of adverse reactions in patients continually show, no drug can ever be called absolutely safe.

Bial’s representatives have insisted, truthfully I’m sure, that they followed all the right procedures. They have even cited the Declaration of Helsinki, that honourable legacy of the Nuremberg Medical Trials which laboriously, revision after revision, protects the interests of research ‘subjects’ from abuse, provided they’re human. And it’s worth saying a bit more about that remarkable document. Here are some of its principles: that subjects should not be asked to take risks for research they don’t stand to benefit from, that the interests of research should “never take precedence over the rights and interests of individual research subjects”, that the subject’s consent or dissent should be respected even where it cannot be classified as “informed”, that “vulnerable” (= easily exploited) groups need particular protection. Note how all these principles exactly fit the situation of non-human animals. In fact the Declaration is a great monument to speciesism, haunted by the animals that it doesn’t (dare?) mention, except the perfunctory once: “The welfare of animals used for research must be respected.” Since the drug which Bial had been testing on its animals was a pain-killer, with all that implies as to the nature of the tests, even that one crumb of compassion from Helsinki’s table probably didn’t do them any appreciable good.

There’s an ugly sense in the Sunday Times book (and more generally) that the painful glare of human suffering properly puts the suffering of other animals into complete darkness, and even that willingness to plough through laboratory animals is to be taken as an index of proper medical humanitarianism – though that’s never made explicit, of course. (It fits George Bernard Shaw’s shrewd suggestion that vivisection shows the ancient superstition of propitiatory sacrifice living on into modern times.) Thus, speaking about another of Grünenthal’s products, an antibiotic called Supracillin, the Sunday Times says,

Somers of DCBL spent a great deal of time trying to verify Grunenthal’s claim that Supracillin would not destroy the hearing of cats. To Mueckter’s displeasure [Muekter was head of Grunenthal’s research laboratory], he managed at last to show that the claim was entirely baseless. [italics in the original]

All the emphases here are designed to contrast the scientific diligence of Somers with Muekter’s hustle (“great deal of time”, “managed at last” “entirely baseless”); what all this thoroughness meant for the cats is unmentioned, probably unthought of. That word “entirely” is especially chilling.

A more recent account of the thalidomide affair (Stephens and Brynner, Dark Remedy, Cambridge, Mass., 2009) is able to take a longer view, and does indeed attempt a general “moral”, as follows: “Wherever there is an absence of compassion, individual or collective, a lesser human attribute will fill the vacuum.” There’s a slightly bogus suggestion here that a real law (in psychopathology? cybernetics?) has been uncovered, matching the one in physics, but there’s also some useful if obvious truth. Better to say, probably, that the more immediate and urgent motives – notably the commercial motive and careerism – will always tend to drive out more removed ones like compassion and even ordinary caution. (And that seems to be the lesson the U.K. government was taking when it passed the 1968 Medicines Act, with its new array of regulations.) But like their predecessors (and like the Medicines Act itself) these authors don’t include animals in the scope of their “compassion”. Unhappily illustrating their own ‘law’, they allow horror, fear, indignation, to drive out disinterested pity.

If it had been impossible for some reason (decency, perhaps) to use animals in medical research, we would certainly by now have made far greater progress in human models of one sort or another than we actually have, and accordingly in medical safety. William McBride himself subsequently wrote, “we will have more thalidomide-type tragedies in the future, perhaps not on such a large scale, but as man is different from other animal species it is likely that, no matter how thoroughly new drugs are tested on animals, species differences or synergistic actions [i.e. unpredicted whole-body responses] will occasionally betray us.” Thalidomide remains uniquely dreadful among medical disasters, but we have not changed the situation or the attitudes which made it possible.

 

Notes and references:

The picture at the top, Thalidomide Baby (oil on acetate), is used by kind permission of the artist, Josephine Storer of Oxford Brookes University’s School of Art and Design: this strong and most poignant image has saved me having to attempt in words the sorrow and sympathy which ought to preface any discussion of this subject.

Suffer the Children: the Story of Thalidomide, was written by Phillip Knightley, Harold Evans, Elaine Potter, and Marjorie Wallace, and published by Andre Deutsch. Quotations are from pp. 22, 23, 61, 88, 274. The Sunday Times newspaper, I should recall here, played a crucial and even heroic part in exposing the scandal and getting justice for the people affected by the drug. The quotation from Dark Remedy: the Impact of Thalidomide and its Revival as a Vital Medicine is from p.201. Both these books are well worth reading, and the second (as its title shows) talks about thalidomide’s controversial reappearance as a treatment for leprosy and some cancers.

The final quotation is from a letter which McBride wrote to the Daily Telegraph in 1973, as re-printed in Richard Ryder’s Victims of Science, NAVS, 1983, pp.174-5.

Revenge on the Farm

The previous post featured a Teach Yourself title of 1965, Modern Poultry Keeping, championing the new factory model for British chicken-farming – nearly new, anyway, for already the toll of chickens eaten in the U.K. had increased from 1 million in 1950 to about 150 million in the year of that book’s publication. Today, it’s approaching 1 billion. And of course biotechnology has been backing or pushing the progress all the way.

Accordingly, most of the 139,000 birds which appear in the Home Office’s statistics for animal research in 2014 were so-called ‘domestic fowl (Gallus domesticus)’. These were chosen to pioneer, test, or otherwise provide information about farm-animal disease (6,512 birds), drugs and poisons (11,045) feed safety (8,553), GM possibilities (798), etc. etc.  Really the word ‘domestic’ is now a sad misnomer for this animal which research and development have done so much to evict from its own or anyone else’s home-life. As the novelist Patricia Highsmith notes, when she sets the scene for her chicken-farm story ‘The Day of Reckoning’, “not a chicken in sight!” This is a fine come-uppance story which I shall, in a moment, add to the category discussed last month under the heading ‘Animal Revenges’ (15 February). But first a little more about science on the farm.

I also mentioned in the previous post Ruth Harrison’s book Animal Machines, which at that same mid-60s time made public the immorality of the new farming. There was a very welcome re-issue of this book in 2013, and in the new introductory pages we are told that although ‘improving animal welfare’ has now become “one of the key ways a scientist can demonstrate the importance and impact of their work”, still “Ruth’s work is not yet done”.

Not indeed, and surely not even as well on the way as those words seem rather complacently to imply. As to ‘improving animal welfare’: that it has become a respectable scientific discipline is certainly a good thing (although 1,509 domestic fowl apparently had to be sacrificed for it in 2014); that it took so long to do so is something which the Royal Veterinary College might reasonably be asked to explain, if it wasn’t for the fact that, being itself a vivisector, that organisation is also itself part of the explanation. For to relegate ‘animal welfare’ (as opposed to mere animal health) for as long as possible to the realm of the ‘sentimental’ amateur has been very helpful to all such institutions. But anyway, even this celebrated advance is partly, perhaps largely, humbug. Most technical or biomedical innovations in the process of turning animals into food can also, with a little thought and PR, be presented as good for the animals, if that’s also good for their own “importance and impact”. Even the recent grotesque experiment in featherlessness turned out to be altruistic: with their feathers on, it was said, chickens “suffer tremendously” from over-heating in broiler sheds, at any rate in hot countries.

As to Ruth Harrison’s work being “not yet done”, it’s rather the point of that story of Patricia Highsmith’s to show that there’s only one way to get that work done, if we really do want it done, so I shall now turn to ‘The Day of Reckoning’.

The story is set in North America in the early 1970s, but like all good cautionary tales it will do for anywhere, any time – a point which I shall illustrate in square brackets here and there. John Hanshaw, a young politics student, is paying a visit to his uncle Ernie’s farm – or rather to Hanshaw Chickens, Inc., as it’s proudly called now that Ernie has made the change of farming method urged by our Teach Yourself title. So now there’s a “long grey barn … huge, covering the whole area where the cow barn and pigpens had been”. Ernie Hanshaw himself has turned from husbandman into the sort of engineer that Teach Yourself prefers: “Machine farming”, he exclaims to his nephew; “just imagine, one man – me – can run the whole show!” At meals, his talk is “of vitamins and antibiotics in his chicken feed, and his produce of one and a quarter eggs per day per hen.” [Title of paper to be read at the forthcoming World’s Poultry Science Association meeting at Chester University: ‘The effect of high levels of whole barley with enzyme supplementation on laying hen performance’]

What this change means for the animals, Patrician Highsmith makes plain enough. A modern reader will not be taken by surprise, except perhaps by the so-far modest scale of Hanshaw’s one shed, holding perhaps a few thousand birds. [Application at present before York City Council: plan for a broiler ‘farm’ at Rufforth accommodating 288,000 birds at any one time, with six ‘crops’ a year] The lighting system deludes these young birds into behaving as if it’s Spring, and therefore into wearing themselves out laying eggs steadily for ten months. This and their close confinement (they “couldn’t turn around in their coops”) has so disturbed them that, as Hanshaw’s wife Helen unhappily says, “Our chickens are insane”. But Patricia Highsmith also makes it clear that they have not lost the urge to live according to their nature. They are either trying to do so (“Much of the flurry in the barn was caused by chickens trying to fly upward”), or expressing their frustration at the impossibility, through neurotic behaviour which is in its turn frustrated: “They’re de-beaked. They’d peck each other through the wire, if they weren’t … ever hear of cannibalism among chickens, John?” [Advice from the Virginia Tech Agriculture and Life Sciences faculty: “Don’t take chances! Make cannibalism control part of your management program and you will save a great deal of time and money.”]

By contrast there is, not far away from Hanshaw Chickens Inc., one of those unreconstructed farms of the mixed and under-automated variety so much deplored by Teach Yourself (although, as that book’s author says, “thankfully the numbers become fewer each year”). On this farm, the hens live a more or less natural life: “They can see the sun! They can fly! … And scratch for worms – and eat watermelon!” Those cries of sympathetic pleasure are human, but not therefore necessarily more complex than the pleasures which they respond to. Still, implicit in them there is this much more, an idea of freedom which may turn into something more thought-out and purposeful. So Helen adds, “Sometimes I want to open all the coops in the barn and open the doors and let ours loose, just to see them walking on the grass for a few minutes.” And the same idea is more powerfully represented in a dream which John has that night:

He was flying like Superman in Ernie’s chicken barn, and the lights were all blazing brightly. Many of the imprisoned chickens looked up at him, their eyes flashed silver, and they were struck blind. The noise they made was fantastic. They wanted to escape, but could no longer see, and the whole barn heaved with their efforts to fly upward. John flew about frantically, trying to find the lever to open the coops, the doors, anything, but he couldn’t.

In this brilliantly imagined episode, John Hanshaw, airborne but struggling ineffectually with the man-made machinery, becomes physiologically identified with the chickens and their urge to freedom. At the same time, as a super-man, he is the one active and practical possibility to which they look for its realisation.

And at this point I go back to the comment which Stephen Eisenman added to that post ‘Revenges of the Animals’, mentioning his recent article entitled ‘The Real “Swinish Multitude”’. In that article, he has proposed a way of understanding and acknowledging, as political history, the liberation efforts of animals: a “history from below” of the kind which E. P. Thompson so notably pioneered in his Making of the English Working Class (1963). Without such a history, a resistance or liberation movement lacks the self-awareness and coherent vision which it needs if it is to be cumulative in what it achieves, and if it is to be finally respected and given the place it claims: in short, if it’s to win. As Jason Hribal’s African saying goes, “Until the lion has his historian, the hunter will always be a hero” (see again ‘Revenges of the Animals’). And this is where even the lion must look upward, like Hanshaw’s hens, to higher (or let’s say, different) faculties than he or they possess. But not just in the writing: “All political resistance requires collaboration, mutual aid, and action in common”, says Stephen Eisenman: “… This is how animal protest occurs – sympathy and collaboration between humans and animals striving for liberty.”

Even purely human revolt is driven by a full spectrum of motive, from the most deeply buried collective instinct to flourish (“the whole barn heaved with their efforts”), through to the intellectually formulated insistence on the right to do so. Anyone who has ever been part of an impassioned demonstration will have felt this. All of the less verbalised region of motive we can share with the animals: but it is up to us, as specialised thinkers, to supply what Eisenman calls “higher level executive function”, our capacity to deal with the man-made world and its machinery, political and material. It’s what John Hanshaw tries to supply in his dream, sharing but also rising out of the common urgency of the barn to do so.

Stephen Eisenman summarises thus: “animals live in a political and not simply a biological arena; … they communicate to each other and to us their desires for safety, companionship, and love; and … their aspirations for freedom cannot be easily separated from the project of human emancipation.” It’s the meaning of Patricia Highsmith’s story too. The hens are a pathetic few months old, hardly more than children, but they have an insistent collective interest, clearly communicated, and as clearly refused by force. It’s a political situation. And bound into it is a human bafflement only slightly less poignant. For the farm is an inhuman place for the people as well as for the animals:  bleak and dangerous. [See label, right, from a sack of dressed seed.] The sort of thing that happens to the Hanshaws’ kitten, run over by one of the huge service-vehicles (its flattened corpse is the first and emblematic sign of ‘life’ that John sees when he first arrives on his visit), might equally happen to one of the family – and indeed does. The young daughter is caught and killed under a descending grain-container. And it’s this shock that precipitates the “reckoning” of the title. What John only attempted in a dream, Helen, the bereaved mother, gets done. The hens, themselves bereaved mothers though they haven’t ‘known’ it, come pouring out of the sabotaged barn and, though scarcely able to walk (“staggering, falling on their sides … falling backwards”), begin to reclaim their species-life, their birthright: “Look! … They don’t know what grass is! But they like it!” And John and Helen share in this liberation: they and the chickens are equally described as “mad”, a revolutionary madness perhaps.

As for poor Ernie, obsessed and (not unlike his hens) wretchedly depreciated by the mechanisation he thinks so highly of … well, the “reckoning” itself is between him and the hens, and readers of Patricia Highsmith will guess that it’s surprisingly unpleasant.

‘The Day of Reckoning’ was published in 1975, part of a collection of stories called The Animal-Lover’s Book of Beastly Murder. All but one are come-uppance stories, mostly told from within the mind of the animals (“history from below”, in fact): elephant, camel, truffle-pig, rat, goat, and others. The exception is a fine study, likewise from within, of a fastidious cockroach, though even he (it is a he), by making his way in a hostile man-made world, triumphs. That punning title, Beastly Murder, may initially seem to mean ‘horrible murders by animals’. But as you read the stories, the libellously pejorative sense of ‘beastly’ is worn away, and the title comes rather to mean the murders which animals might be driven to commit  in pursuit of, and within the means of, their proper nature: beast-like bids to live beast-like lives.

“Agriculture”, says the University of Wisconsin-Madison, “is applied biology, and it’s where a lot of today’s cutting edge science is getting done.” No; freedom is applied biology, and it’s in accordance with that principle that we must re-write animal history, in words and in their lives and our own.

 

[References: the 2013 edition of Animal Machines is published by CABI, and Beastly Murder (1975) by Heinemann; Stephen Eisenman’s article appears in Critical Inquiry, vol.42, no.2 (Winter 2016), pp.339-373; the quotations from research institutions and the Home Office animal research analysis can be found on the relevant web-sites; featherless chicken report from BBC Online News, 21 May 2002.]