Pandora's Lab Read online

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  Copyright © 2017 Paul A. Offit. All rights reserved. Reproduction of the whole or any part of the contents without written permission from the publisher is prohibited.

  NATIONAL GEOGRAPHIC and Yellow Border Design are trademarks of the National Geographic Society, used under license.

  Library of Congress Cataloging-in-Publication Data

  Names: Offit, Paul A.

  Title: Pandora’s lab : seven stories of science gone wrong / Paul A. Offit, M.D.

  Description: Washington, D.C. : National Geographic, [2016] | Includes bibliographical references.

  Identifiers: LCCN 2016030737 | ISBN 9781426217982 (hardcover : alk. paper)

  Subjects: LCSH: Errors, Scientific.

  Classification: LCC Q172.5.E77 O34 2016 | DDC 001.9/6–dc23

  LC record available at https://lccn.loc.gov/​2016030737

  Ebook ISBN 9781426217999

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  Interior design: Katie Olsen

  v4.1

  a

  To my wife, Bonnie, who listened patiently

  while I talked about rotavirus surface proteins

  during far too many dinners and vacations;

  and to our children, Will and Emily,

  who make everything worthwhile.

  “But [Pandora] took off the great lid of the jar with her hands

  and scattered all [that] caused sorrow and mischief…”

  —Hesiod, Works and Days

  CONTENTS

  Cover

  Title Page

  Copyright

  Dedication

  Epigraph

  Introduction

  Chapter 1: God’s Own Medicine

  Chapter 2: The Great Margarine Mistake

  Chapter 3: Blood From Air

  Chapter 4: America’s Master Race

  Chapter 5: Turning the Mind Inside Out

  Chapter 6: The Mosquito Liberation Front

  Chapter 7: Nobel Prize Disease

  Chapter 8: Learning From the Past

  Epilogue

  Acknowledgments

  Selected Bibliography

  About the Author

  Index

  INTRODUCTION

  “Invention does not consist of creating out of void, but out of chaos.”

  —Mary Shelley

  The Franklin Institute in Philadelphia is home to the Benjamin Franklin National Memorial. Founded in 1824, it’s one of the oldest science education centers in the United States. In 2014, the institute featured “101 Inventions That Changed the World.” When I visited this exhibition with my son, who is a science writer, we tried to guess which inventions made the list. We got a lot of them right, but some were surprising.

  The top three inventions were pasteurization, paper, and controlled fire; rounding out the list were the sail, air-conditioning, and the Global Positioning System (GPS). Among others were the telephone, cloning, the alphabet, penicillin, the spinning wheel, vaccination, transistor radios, email, and aspirin. Two inventions that my son and I would never have predicted were gunpowder (number 20) and the atomic bomb (number 30)—both of which have arguably done far more harm than good. This suggested the possibility of another list: “101 Inventions That Changed the World—For the Worse.”

  During the past few years, I’ve asked doctors, scientists, anthropologists, sociologists, psychologists, skeptics, and friends to provide a list of what they think were the world’s worst inventions. In the end, I had about 50 from which to choose. Initially, I thought I’d limit the list to discoveries that had caused the most deaths (like explosives). Then I focused only on those that had harmed the environment (like the refrigerant Freon). In the end, I settled on inventions that were not only the most surprising (at least to me) but also ones whose impact is still felt today.

  —

  HERE ARE THE SEVEN FINALISTS:

  Six thousand years ago, the Sumerians discovered a plant called hul gil, “the plant of joy,” which gave birth to a drug that now kills 20,000 Americans every year. More young adults die from this drug than from motor vehicle accidents.

  In 1901, a German scientist performed an experiment that revolutionized the food industry. A hundred years later, an editorial in the prestigious New England Journal of Medicine stated, “On a per calorie basis, [this product] appears to increase the risk of heart disease more than any other macronutrient.” The Harvard School of Public Health estimated that eliminating it from the American diet would prevent 250,000 heart-related deaths every year.

  In 1909, another German scientist invented a chemical reaction that won the Nobel Prize, allowed us to feed more than seven billion people across the globe, and unless we do something about it, will probably end life on this planet.

  In 1916, a New York City conservationist wrote a scientific treatise that caused Congress to pass a series of draconian immigration laws, enabled the forced sterilization of tens of thousands of American citizens, and provided a scientific rationale for Adolf Hitler to murder six million Jews. Echoes of this treatise can be heard today when politicians like Donald Trump denounce Mexican immigrants, calling them “rapists” and “murderers.”

  —

  In 1935, a Portuguese neurologist invented a surgical cure for psychiatric disorders that won a Nobel Prize, took only five minutes to perform, caused President John F. Kennedy’s sister to be permanently disabled, and is now a subject of horror films. Remnants of this dangerous quick-fix procedure can be found today in promised cures for one of the most common psychiatric disorders of childhood: autism.

  In 1962, a popular naturalist—the mother of the modern environmental movement—wrote a book that led to the ban of one particular pesticide. The prohibition was hailed by environmental activists but feared by public health officials. Their fears were well founded; as a consequence of the ban, tens of millions of children died needlessly.

  In 1966, with the power of two Nobel Prizes behind him, an American chemist elevated the word “antioxidant” into the pantheon of can’t-miss marketing terms. Unfortunately, those who have followed his advice have only increased their risks of cancer and heart disease. Worse, he gave birth to an industry whose harm can be found today in the sudden need for liver transplants in Hawaii or in the strange onset of masculinizing symptoms in women in the Northeast.

  —

  ALL OF THESE STORIES ARE UNITED by a myth that dates back to 700 B.C.—the myth of unintended consequences. Zeus, angry that Prometheus had stolen fire from the gods, was intent on punishing mankind. So he gave a marvelous jeweled box to Pandora—its contents, a secret. When Pandora opened the box, which she had been warned not to do, a stream of ghostly creatures representing disease, poverty, misery, sadness, death, and all manner of evil escaped. Pandora closed the box, but too late. Only hope remained.

  Science can be Pandora’s beautiful box. And our curiosity about what science can offer has allowed us, in some cases, to unleash evils that have caused much suffering and death. In one case, it probably
sowed the seeds of our eventual destruction. Because these stories start at the beginning of recorded history and extend to the present day, the lesson of Pandora’s box remains unlearned.

  As a scientist who has worked on vaccines for the past 35 years, I have witnessed both the joy of science as a panacea and the sadness of unintended consequences. For example, the oral polio vaccine, which eliminated polio from the Western hemisphere and is still used throughout the world, can itself cause polio. Although this side effect is rare, it’s real. A rotavirus vaccine given to infants in the United States for ten months between 1998 and 1999 before it was withdrawn was a rare cause of intestinal blockage: One child died as a consequence. A swine flu vaccine given in Europe and Scandinavian countries in 2009 was found to cause a rare but permanent disorder of wakefulness called narcolepsy. All of these inventions were well intentioned, all protected against potentially fatal infections, and all resulted in some level of tragedy.

  —

  FOR EACH OF THE SEVEN INVENTIONS that follow, we’ll analyze how their deadly outcomes might have been avoided. Then, in the final chapter, we’ll apply what we’ve learned to modern-day discoveries such as e-cigarettes, chemical resins, autism cures, cancer-screening programs, and genetically modified organisms (GMOs) to see if we can distinguish a scientific advance from a scientific tragedy in the making, to see whether we have learned from our past or have once again opened Pandora’s box. The conclusions, no doubt, will surprise you.

  CHAPTER 1

  GOD’S OWN MEDICINE

  “Of pain you could wish only one thing: that it should stop. Nothing in the world was so bad as physical pain. In the face of pain there are no heroes.”

  —George Orwell, 1984

  The first civilization produced the first medicine.

  About 6,000 years ago, around the time of Abraham, the Sumerians migrated from Persia (now Iran) and settled between the Tigris and Euphrates Rivers. They invented cuneiform writing, producing more than 400,000 clay tablets. They invented farming, growing barley, wheat, dates, apples, plums, and grapes. And they discovered a plant that would eventually cause more pleasure and more suffering than any other plant in history. They called it hul gil, “the plant of joy.” Carl Linnaeus, an 18th-century Swedish botanist, called it Papaver somniferum. Today, we call it the opium poppy.

  Opium was so powerful that ancient cultures reasoned it could only have come from the gods. The Sumerians believed it was a gift from Isis, who gave it to the sun god, Ra, to treat his headache. In India, enthusiasts believed it had come from Buddha, who had cut off his eyelids to prevent sleep. When the eyelids touched the ground, they became the beautiful flower that would provide sleep and dreams for all eternity. Thomas Sydenham, a 17th-century English physician said, “Among the remedies which it has pleased the Almighty God to give man to relieve his sufferings, none is so universal and efficacious as opium.” The characterization of opium as divine persisted into the 20th century. In the early 1900s, William Osler, arguably the most distinguished physician of his day and a founder of Johns Hopkins Hospital, called opium “God’s own medicine.”

  —

  THROUGHOUT HISTORY, the opium poppy has been accommodating, growing in many different types of soils and locations. It’s also naturally resistant to insects and fungi. For these reasons, even countries with limited resources can grow and harvest the plant. (Today, the opium poppy is the leading cash crop of Afghanistan.) The money is in the seedpod, which contains a milky white liquid that hardens into a dark gum. The gum (opium) contains five biologically active ingredients: morphine, the most powerful pain-relieving (analgesic) medicine known to man; codeine (methylmorphine), a mild analgesic and cough suppressant; alpha-narcotine and papaverine, which are muscle relaxants; and thebaine, which, starting in the late 1990s, formed the basis of a drug that is now killing about 20,000 Americans a year.

  —

  SINCE THE DAYS OF ANCIENT GREECE, doctors have used opium to treat pain as well as a vast array of other illnesses.

  Hippocrates, the father of modern medicine, used it to treat insomnia. Galen, the last of the great Greek physicians, used it to treat headaches, vertigo, deafness, epilepsy, apoplexy (stroke), poor sight, bronchitis, asthma, coughs, hemoptysis (coughing up blood), colic, jaundice, hardness of the spleen, kidney stones, urinary complaints, fever, dropsy (swelling of the limbs, caused by heart failure), leprosy, menstrual problems, and melancholy. Neither Hippocrates nor Galen was aware of opium’s snare. Rather, it was a relatively unknown physician named Diagoras of Melos who was the first to realize that many of his fellow Greeks had become hopelessly addicted to the drug. As a consequence, he became the first person in history to argue against its use, declaring that it was better to suffer pain than to become addicted to opium. His warnings have been ignored for the last 2,500 years.

  The Romans were also smitten with the opium poppy, which was emblazoned on their coins and honored by Somnos, their god of sleep. But the Romans also understood that opium could be a powerful poison. In 183 B.C., the Carthaginian general Hannibal used it to kill himself. And the emperor Claudius’s wife, Agrippina, used it to poison her 14-year-old stepson, Britannicus, so that her son, Nero, could become emperor.

  A reference to opium can even be found in the New Testament. As described in Matthew 27:34, when Jesus was hanging on the cross, his followers offered him something to dull the pain: “They gave him vinegar to drink mingled with gall; and when he had tasted thereof, he would not drink.” Because it was bitter, opium was often mixed with wine or beer to make it more palatable. Biblical scholars have theorized that gall, which means “something bitter,” was probably opium.

  Neither the Greeks nor the Romans traded in opium. Rather, opium commerce was the province of Arab merchants, who brought the drug to China—where it enslaved a nation.

  —

  OPIUM FIRST MADE ITS WAY TO China in the seventh century A.D., where it was used primarily for medicinal purposes, although sometimes it was added to sweets and cakes. At first, opium was a pleasant distraction. But when the Portuguese brought the smoking pipe to China, everything changed. Chinese citizens couldn’t get enough of the drug.

  In 1660, British-owned companies shipped 1,350 pounds of opium from India to China; by 1720, 33,000 pounds; and by 1773, 165,000 pounds. About three million Chinese citizens were addicted. In response, the Chinese government banned opium smoking. It didn’t work. By 1839, the British were exporting a startling 5,600,000 pounds. At least 25 percent of the Chinese population was addicted to opium; in some regions, the addiction rate was as high as 90 percent. Chinese society was on the verge of collapse. In response, the Chinese government pleaded with British officials to stop exporting opium from India. When they refused, Chinese officials, desperate to end the massive epidemic of addiction and crime that had overtaken their country, took the next step.

  In 1839, Commissioner Lin Tse-hsu seized and destroyed 2,600,000 pounds of British opium. War ensued. Between 1839 and 1860, China and Britain fought two Opium Wars. China lost both times. As a consequence, China had to open more ports for opium importation, pay Britain $21 million in reparations, and cede Hong Kong to British rule (which, by treaty, wasn’t returned to China until 1997). Eventually, China legalized the drug. By 1900, China was importing 8,600,000 pounds of opium and had more than 13 million opium addicts.

  While the Chinese were smoking opium, Americans—thanks to a European inventor—were drinking it.

  —

  IN THE EARLY 16TH CENTURY a Swiss alchemist, physician, astrologer, and philosopher named Paracelsus mixed opium with brandy, calling his concoction laudanum, from the Latin verb laudare, meaning, “to be praised.” “I possess a secret remedy which I call laudanum and which is superior to all other heroic remedies,” he said. Liquid opium swept through Europe. Victorian women, who found it unacceptable to frequent bars and saloons, turned to laudanum; they also gave it to their babies to help them sleep. British physicians used laudanum to tr
eat coughs, diarrhea, dysentery, and gout.

  Americans also embraced liquid opium. Louisa May Alcott and George Washington used laudanum; Mary Todd Lincoln was addicted to it. By the late 1800s, about 200,000 opium addicts lived in the United States; three-quarters were women. Unlike opium smokers in China, women in Europe and the United States who drank laudanum were considered to have a gentle, harmless addiction. In Harper Lee’s To Kill a Mockingbird, set in a small Alabama town, Mrs. Henry Lafayette Dubose is addicted to laudanum, the picture of decay. But Atticus Finch—the lawyer who takes the town to task for its racist beliefs—praises Dubose for her courageous attempt to fight her addiction and die with dignity. Finch sees Dubose as a sympathetic, not pathetic, character.

  Opium was also a staple of the patent medicine craze. Medicines like Stott’s Unique Fruit Cordial, which contained 3 percent opium, and Chlorodyne, which contained opium, cannabis, and chloroform, were easily purchased over the counter. And Mrs. Winslow’s Soothing Syrup, Mother Bailey’s Quieting Syrup, and Hooper’s Anodyne were all spoon-fed to “quiet the cranky child.” The American Medical Association later called opium-containing preparations “baby killers.”

  The opium poppy also made a cameo appearance in L. Frank Baum’s best-selling book, The Wizard of Oz.

  [Dorothy’s] eyes closed in spite of herself and she forgot where she was and fell among the poppies, fast asleep.

  “What shall we do?” asked the Tin Woodsman.

  “If we leave her here she will die,” said the Lion. “The smell of the flowers is killing us all. I myself can scarcely keep my eyes open and the dog is asleep already.”

  —

  UNLIKE THE EUROPEANS, Americans eventually banned opium use. They did it because of a series of events triggered by the California gold rush.

  Between 1850 and 1870, about 70,000 Chinese citizens entered the United States to mine gold and work on the railroads, bringing their opium pipes with them. They came through the port of San Francisco. Initially, opium smoking was limited to Chinese immigrants. But, starting in the 1870s, opium dens became a popular haunt for actors, gamblers, prostitutes, and criminals, spreading to almost every major American city, including Los Angeles, New York, Chicago, and Miami. Opium addiction became so widespread and so perverse that in 1875 San Francisco city officials passed the Opium Den Ordinance, prohibiting public smoking of opium. Other cities followed. Then, the United States government stepped in. In 1909, Congress passed the Opium Exclusion Act, banning importation. But it was too late. Many Americans were already addicted to the drug. And, as reflected by a new American lexicon, people addicted to opium were no longer sympathetic figures. They were called junkies, because they often sifted through junkyards to find salable items. Or hop heads, from the Cantonese phrase ha peen, meaning “bird or cow manure.”