Chapter 6
THE OCTOPUS
as dr. henry welch took the stage, a hush fell over the crowd. Hundreds of doctors, chemists, pharmaceutical executives, and admen had convened in Washington, D.C., for the Fourth Annual Symposium on Antibiotics. They had gathered at the Willard, an opulent hotel overlooking the National Mall, just a few blocks from the White House, for a series of presentations about the latest developments in antibiotics, with guest speakers from across the country and around the world. It was the first day of the conference, a mid-autumn morning in 1956, and Welch, who was one of the impresarios behind the event, extended a warm welcome to the participants.
This would not be one of those perfunctory early morning speeches that the crowd, more focused on settling in and finding coffee, half ignores. Welch was an important figure in pharmaceutical circles: the chief of antibiotics at the Food and Drug Administration, a man with the power to make or break a drug. People in the room wanted to hear what he had to say. He was not actually an MD, but he had a PhD in medical bacteriology, and he was regarded as an authority in the field. Square-faced and jowly, with horn-rimmed glasses and the meaty physique of an ex-athlete, Welch was also the drug-industry equivalent of a war hero: during the war, he had developed a system for testing and approving all of the lifesaving penicillin that was distributed to U.S. forces abroad, a contribution for which he had been awarded a Distinguished Service Gold Medal from the federal government.
The people assembled in the room that day had a sense that they were engaged in an important mission that was inextricable from the American national interest. Before the conference, Welch had received a telegram from the White House in which President Eisenhower welcomed the attendees, noting that the nascent antibiotics industry, "developed through the cooperative efforts of scientists and business executives," had "been instrumental in saving the lives of thousands of citizens."
Launching into his upbeat welcome, Welch invoked the "worldwide interest" in the research that they were all doing and "the tremendous dollar expansion of this young industry." Together, they were fighting an epic battle against germs, he said. They had made great progress, but the war was not yet won, because the widespread use of antibiotics had given rise to new, battle-hardened bacteria that were resistant to these drugs.
As Welch spoke, a thin man with an olive complexion and a pencil mustache looked on with muted excitement. His name was Félix Martí-Ibáñez, and he was a charming, if slightly unctuous, physician and Welch's partner in organizing the event. Martí-Ibáñez was a psychiatrist by training who had practiced in Barcelona and been wounded in the Spanish Civil War before immigrating to the United States. In New York, he had held positions at a number of pharmaceutical companies, including Roche, and done research in the asylum at Creedmoor, where he worked closely with the Sackler brothers. In a letter he wrote in 1956, Arthur Sackler described Martí-Ibáñez as his "dearest friend," remarking, "There is no man in medicine, in fact, no man I know, for whom I have greater affection than Félix."
Like Arthur, Martí-Ibáñez fashioned himself as a Renaissance man. He discoursed on a wide range of subjects in his mellifluous Spanish accent and liked to claim that his father, who had been a professor in Spain, was the author of "some five hundred books." In addition to publishing medical papers with the Sacklers, Martí-Ibáñez wrote novels and short stories and volumes of medical history and columns in popular magazines (Cosmopolitan, 1963: "It is no longer 'fashionable' to be ill").
In recent years, Martí-Ibáñez had been working for Arthur at his advertising agency, William Douglas McAdams. But he had also been focusing on a publishing company that he'd established a few years earlier, called MD Publications. MD put out a glossy magazine about medicine, featuring lots of sumptuous advertising from pharmaceutical companies. It also published a pair of technical journals, Antibiotics and Chemotherapy and Antibiotic Medicine and Clinical Therapy, which Henry Welch co-edited with Martí-Ibáñez. The journals were sponsors of this conference. It was Martí-Ibáñez who had proposed to Welch that they work together. The two men were very different: whereas Martí-Ibáñez was a flamboyantly cultured European, with a habit of speaking in flowering mixed metaphors, Welch was a plainspoken, meat-and-potatoes mid-century American man. But they forged a close friendship, with Martí-Ibáñez tending to business in New York while Welch continued to run his division at the FDA in Washington. Martí-Ibáñez liked to send Welch letters with comical doodles in the margins, like a tiny cartoon man reaching for a big bottle of the tranquilizer Miltown.
If the notion of an FDA regulator serving as editor of a private sector journal that covered the very industry that he happened to be regulating seemed a bit strange, neither Welch nor Martí-Ibáñez dwelled on it. And if anyone at the FDA had issues, they knew better than to raise them. "Welch had strong opinions and did not brook contradiction," one former associate recalled. Welch had created the antibiotics division at the FDA, and he was not averse to throwing his weight around in the bureaucracy or exercising his available prerogatives. When he wanted to build a swimming pool at his home in suburban Maryland, he ordered a bunch of his FDA underlings to leave the agency for an afternoon and come dig it themselves. (They "felt obliged," another former FDA colleague recalled. "In order to keep their job.")
The conference at the Willard was co-sponsored by the FDA, but all the expenses were paid for by the journals that Martí-Ibáñez and Welch published. In a letter to Welch, Martí-Ibáñez described the "unique opportunity" the two men had to "slant" the symposium in a direction that would "be most useful to the audience of our publications." From the beginning of their relationship, Welch had known, or at least suspected, that there was some other silent partner who had a stake in the journals: some unnamed backer who helped bankroll the whole enterprise. But when he pressed Martí-Ibáñez about who this person might be, the Spaniard was evasive, saying that the "private and confidential aspects of our work" should not be "open to anyone." Not even Welch.
"We are now in the third era of antibiotic therapy," Welch announced, triumphantly, at the Willard. The first era had involved "narrow spectrum" antibiotics, like penicillin. The second era came with the introduction of broad-spectrum therapies, like the Pfizer drug Terramycin, which were effective against a range of disease-causing bacteria. The third era, Welch explained, would be characterized by "synergistic" combinations of different therapies, which could attack even illnesses that resisted traditional antibiotics.
A few of the foreign visitors in the ballroom that morning expressed unease at the spectacle of America's antibiotics czar sounding so much like an industry booster. But such skeptics were in the minority. "Deadliest Ills Defeated by Antibiotics," The Washington Post declared, describing the conference in excited tones and extolling the "conquest" of stubborn infections and the power of "the so-called wonder drugs." Scarcely an hour had passed after Welch's remarks before Pfizer put out a press release hailing "the third era in antibiotic treatment" and introducing a new drug of its own, Sigmamycin, which the company billed as the first "synergistic combination," which could attack "germs that have learned to live with older antibiotics." The release pointed out that no less an authority than Henry Welch of the FDA had cited synergistic combinations as "comprising a new and powerful trend."
For Welch and Martí-Ibáñez, the conference was a resounding success. But the symposium—and in particular Welch's opening speech about the "third era" in antibiotics—would soon embroil both men in a scandal and a federal investigation that would end one of their careers and ensnare Arthur Sackler and his brothers.
***
One day in 1960, Arthur Sackler bought a house in Manhattan. It was an impulse buy. He didn't even consult Marietta. It was a small town house, four stories and a basement, on East Fifty-Seventh Street. After he surprised Marietta with the news that he had purchased a new home, she joked that it was "too small for all of us but just right for him!" The building would be helpful for Arthur's business, she acknowledged, and, anyway, she had been feeling cooped up in the house on Long Island. After Denise was born, Marietta had briefly gone back to work, passing her medical exams. But Arthur did not see why she insisted on working, and she felt guilty being away from the children, so she ended up abandoning her career after a year. If the family moved into the city, perhaps it would be an opportunity for them to spend more time with Arthur. So, while Arthur supervised the decorating of the new home, Marietta oversaw the relocation of herself, her kids, the dog, the hamster, and a litter of white mice. They would hold on to the Long Island house, as a weekend retreat. And, not long after moving in, Marietta began negotiating with the woman who owned an identical town house next door, with an eye to buying it and combining the two, which the Sacklers ultimately did.
Marietta liked the idea of her children living in the city, where they might encounter a diversity of experience and stimulation beyond the narrow idyll of their suburban life on Long Island. In the city, she mused, they might cross paths with "a poor man, a blind person, a beggar." She treated the whole experience as if it were an urban safari, rife with danger, but also with wonder and beauty. When little Arthur was ready to go off to his new school in the big city, she gave him a compass, in case he got lost.
The town house on Fifty-Seventh Street was just a short walk from the building at 15 East Sixty-Second Street where the Sackler brothers had recently set up shop. The warren of offices, in a narrow limestone building just a few steps off Central Park, had become home to the brothers' psychiatric research activities, to the new foundations that they established to administer their charitable giving, to their publishing interests, and to a range of other, smaller concerns. From here, the brothers could shuttle to the McAdams agency on Fifty-Ninth Street or down to their pharmaceutical company, Purdue Frederick, in Greenwich Village.
As the youngest son, Raymond Sackler was spending a lot of time tending to their mother, Sophie. After several years of the silent treatment, Sophie had finally started talking to Marietta, and eventually the two women developed a warm relationship. But Arthur had conflicted feelings about his mother and spent as little time as possible with her. He felt great respect for her and gratitude for all that she had invested in him. But Sophie was overbearing and always had been. She made sure that her secular sons celebrated Passover and other high holidays, but otherwise Arthur kept his distance. Eventually, Sophie was diagnosed with lung cancer. Mortimer kept her in his home and arranged her medical care. When the younger Arthur Sackler turned thirteen, the family decided to throw him a Bar Mitzvah, on the grounds that it would bring Sophie comfort to see the firstborn son of her firstborn son initiated into the faith. There was no service at the synagogue, just a party at the Waldorf Astoria, but the whole family came. The older Arthur wore a bow tie. Sophie beamed with pride, a rope of pearls around her neck.
Purdue Frederick had enjoyed success, earlier in the century, with Gray's Glycerine Tonic, a sherry-based "elixir" that, the company suggested, stimulated the appetite, promoted nutrition, and should be taken "whenever a general tonic is needed or desired."