This Man's Pill: Reflections on the 50th Birthday of the Pill - Hardcover

Djerassi, Carl

Hardcover

ISBN 10: 0198508727 ISBN 13: 9780198508724

Publisher: Oxford University Press, 2001

Synopsis

On October 15, 1951, in a small laboratory in Mexico City, one of the key episodes in 20th century social history occurred: the first synthesis of a steroid oral contraceptive--an event that triggered the development of the Pill. Carl Djerassi has been honored worldwide for that accomplishment, which ultimately changed the life of women and the nature of human reproduction in ways that were not then foreseeable.
Now, on the 50th anniversary of this pivotal event, Djerassi weaves a compelling personal narrative full of self-reflection and humor, illuminating the impact this invention has had on the world at large and on him personally. This Man's Pill presents a forcefully revisionist account of the early history of the Pill, debunking many of the journalistic and romantic accounts of its scientific origin. Djerassi does not shrink from exploring why we have no Pill for men or why Japan only approved the Pill in 1999 (together with Viagra). Emphasizing that development of the Pill occurred during the post-War period of technological euphoria, he believes that it could not be repeated in today's climate. Would the sexual revolution of the 1960s or the impending separation of sex ("in bed") and fertilization ("under the microscope") still have happened?
Djerassi also credits the Pill with radically altering his life, allowing him to become one of the few American chemists to have a second career, that of a novelist and playwright. These talents are clearly evident in This Man's Pill, a superbly written and uniquely authoritative account of a discovery that changed the world.

About this title

About the Author

Carl Djerassi is Professor of Chemistry at Stanford University. One of the world's leading organic chemists, he is one of the few scientists to win both the National Medal of Science and the National Medal of Technology. He is a member of the National Academy of Sciences and the American Academy of Arts and Sciences, is the author of five novels and several plays, and was named by Time Magazine one of the 30 most eminent people of the millennium.

Reviews

Carl Djerassi's illuminating scientific and autobiographical memoir begins 50 years ago, when as a steroid chemist he participated in the birth of ``the Pill'' in Mexico City. Djerassi is a professor of chemistry at Stanford University, as well as an author of novels, poems, and plays -- particularly what he calls ``science-in-fiction.'' He has also written about the social-welfare aspects of the Pill.

A brief, useful history of the sex steroids, delineating their biologic activity for female and male reproductive ability, prefaces the Pill's history. The breakthrough was the discovery by Russell Marker in the late 1930s and early 1940s that progesterone could be prepared in large quantities from an inedible yam (dioscorea species) growing wild in Mexico. A small laboratory, Syntex, in Mexico City began to process progesterone from this cheap plant.

In 1945, Djerassi was a 22-year-old, newly naturalized U.S. citizen (he was born in Vienna, Austria) with a Ph.D. from the University of Wisconsin and a strong interest in steroids. In 1949, he was offered a research position at Syntex. His colleagues considered him mad to move to a backwater laboratory in Mexico City, but as Djerassi recounts, he never regretted the decision, and his fortune (literally) began with his arrival at Syntex.

He and his colleagues developed the first orally active progestational steroid at this small laboratory. He describes the steps involved in the Pill's development and the crucial role of a biologist, Elva G. Shipley, at a commercial laboratory in Madison, Wisconsin, who established the activity of orally administered norethindrone. The first clinical trials were conducted by the endocrinologist Gregory Pincus, whom Djerassi calls ``the father of the Pill,'' and John Rock. Equally important is the history of the public reactions, pro and con, to this new contraceptive for women. As Djerassi sets forth, the four decades since the Pill became a household word have witnessed a flood of books and articles on the societal effects of the Pill, ranging, as he says, from the unreservedly laudatory to the totally condemnatory, with every possible nuance in between. The book highlights the new freedom of women who use this type of contraceptive, the separation of sex from conception, and side effects of the Pill, especially in its early high-dose versions, which had 10 times the strength of later versions. This undoubtedly explained the high dropout rates from family-planning programs in many developing countries, particularly in Asia, where women weighed 10 to 15 kg less than women in the United States but no adjustment was made in the dose given.

As Djerassi describes in detail, a barrage of liability suits beginning in the 1960s led to the withdrawal of firms in the United States from contraception-related research and development; their hesitancy to engage in such research continues to this day. Only one of the eight largest pharmaceutical companies in the United States sells contraceptive drugs or devices, and only one conducts contraceptive-related research and development. These companies now focus on drugs for the diseases of aging and other types of deterioration in the health of the affluent, aging populations of developed countries, to the detriment, according to Djerassi, of the needs of the poor developing countries of Latin America, Asia, and Africa. He concludes that all we can expect in the beginning decades of this century are minor modifications of existing methods of contraception.

An important exception to this pattern of neglect was the development of the ``morning after'' pill, which contains a high dose of conventional combined oral contraceptives and can prevent implantation if it is used within 72 hours after unprotected intercourse. It took until 1995 for the World Health Organization to list the morning-after pill as an essential drug. The Food and Drug Administration approved it in 1997, but a doctor's prescription for it is necessary in the United States, except in the state of Washington. It is available in the United Kingdom without a prescription for women older than 16 years of age. As Djerassi points out, if this pill were available in this country without a prescription, it would reduce the incidence of abortions.

Djerassi turned to writing fiction in order to illustrate the human side of scientists, their personal conflicts, and the implications of science for society. He has published six novels, two plays, and three nonfiction works, including The Politics of Contraception. His scientific publications include 1200 papers and 7 monographs.

The literary works were an outgrowth of his decision in 1969 to leave the scientific research that had occupied him for ``26 hours in a 24 hour day'' as well as the chairmanships of three corporations in order to concentrate on public-policy publications espousing a global view of contraception for the rapidly growing populations of developing countries. Djerassi is convinced that politics rather than science will have the dominant role in the future of birth control. Samples of some of his pertinent provocative writings on the subject are reprinted in This Man's Pill.

In 1972, Djerassi began lecturing in the human-biology program at Stanford University on the ``biosocial aspects of birth control.'' His aim was to encourage undergraduate students to think seriously about public policy and about bridging academia and industry.

The final chapter of the book is a sober review of the present status of the Pill worldwide and its remaining side effects. The major established health risks include circulatory diseases. Over the years, reduction of the doses of estrogen in the Pill has diminished the incidence of these side effects, but risks remain, including the long-term risk of breast cancer if the Pill has been used during the previous 10 years.

On the other hand, the Pill is protective against ovarian and endometrial cancers and loss of bone mineral density, and as Djerassi points out, its most important effect is the prevention of unplanned and unwanted pregnancy and therefore the reduction in the incidence of abortions. It thus permits planning and provision for desired children.

Djerassi's wide-ranging interests include art -- specifically, the paintings of Paul Klee, which he collected for many years. In 1982, he founded the Djerassi Resident Artists Program, which provides residences and studios for artists in the visual arts, literature, choreography, the performing arts, and music. The breadth of Djerassi's interests and the energy he has devoted to them are imparted through this important memoir of the birth of the Pill.

Rose E. Frisch, Ph.D.
Copyright © 2001 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.

"Until 1969, I would have described myself as a `hard' scientist, the proudly macho adjective employed by chemists and other physical scientists to distinguish their work from the `soft,' fuzzy fields such as sociology or even psychology," writes Djerassi, whose historic synthesis of a steroid contraceptive in 1951 revolutionized human reproduction. In this learned memoir, he describes the turning point as the publication of his first public policy article in Science magazine, an event that he says marked the beginning of a life change attributable ultimately to the pill. The first part of this memoir is a well-reasoned apologetic on the pill's origins and its benefits to women, where Djerassi follows familiar debunkings: of fundamentalists, on the one hand, who regarded the pill as "a symbol, if not an agent, of what they perceived as a pervasive moral decline," and of feminists, on the other, who he says viewed the manmade contraceptive as the supreme gesture of patriarchy. The balance of this book, however, explores how the pill altered the rules of the author's own life, raising his awareness of "the social consequences arising from scientific and technological developments" and leading him down unexpected creative avenues; Djerassi, now in his late 70s and an emeritus professor of chemistry at Stanford, has since become a prolific playwright and author of five novels and a book of poetry. His meditations on "science-in-theater" and other aspects of the writing life (along with frequent quotations from Djerassi's favorite authors) are sprinkled through the book, giving this winning, disorganized set of reflections depth and heart. (Oct. 15)Forecast: While few readers are likely to share Djerassi's precise combination of interests, this book should draw the attention of the parents of boomers, and the countercultural boomers themselves and it could break out on reproductive interest alone. Djerassi's play, An Immaculate Misconception, dealing with current fertility issues, opens in New York this fall.

Copyright 2001 Cahners Business Information, Inc.

As a genre, the superstar scientist's memoir tends to be either very bad or very good. At best, it humanizes the person and offers perspective on the work. At worst, it smothers the reader with arcane details and reeks of arrogance. Djerassi, a true polymath best known as the inventor of the birth control pill, is too skilled a writer and broad a thinker to fall victim to the latter tendency. His new book is artful, thoughtful, and entertainingly iconoclastic. Still, for those familiar with his work, it covers much old territory. For example, in 1992 he published an autobiography (The Pill, Pygmy Chimps, and Degas' Horse), and 1994's From the Lab into the World addressed many of his thoughts on the social impacts of the Pill. The first five essays of this new book deal with the development and distribution of the Pill, most of which Djerassi has discussed in prior titles. The most interesting essays here are those in which he expounds upon his forays into literature and the arts a later life passion that he credits to perspective gained as a result of what he had experienced because of the Pill. In all, a worthy if not entirely fresh memoir. Gregg Sapp, Science Lib., SUNY at Albany
Copyright 2001 Reed Business Information, Inc.

Edition details

• Publisher: Oxford University Press
• Publication date: 2001
• Language: English
• ISBN 10: 0198508727
• ISBN 13: 9780198508724
• Binding: Hardcover
• Edition number: 1
• Number of pages: 320