Medicine, Science and Merck (The First Three Careers of Roy Vagelos)

P. Roy Vagelos grew up during the Depression as a wise-cracking son of Greek immigrants. He left his family's small restaurant to become a doctor and went on to master three professions and become the Chief Executive Officer of the multinational pharmaceutical giant, Merck & Co. Medicine, Science, and Merck follows Vangelos' life from childhood to retirement, from his academic years at the University of Pennsylvania, Columbia University's Medical School, and Massachusetts General Hospital through his professional career at the National Institute of Health, Washington University, and Merck. Throughout, Vagelos never lost touch with his family values, his intense desire to help others, and his faith in the partnership principle and the competition that makes it work. P. Roy Vagelos and Louis Galambos offer an unusual perspective on working in three leading professions: medicine, science, and business. They take readers inside the laboratory and boardroom of one of America's large corporations, analyzing the mistakes and the innovations of Merck. P. Roy Vagelos, M.D. served as CEO of Merck & Co., Inc. from 1985 to 1994. Before assuming responsibilities in business leadership, he had won scientific recognition as an authority on lipids and enzymes and as a research manager. The author of more than 100 scientific papers, Vagelos has been elected to the American Academy of Arts and Sciences, the National Academy of Sciences and the American Philosophical Society. Louis Galambos has written extensively on U.S. business-government relations, on economic aspects of modern institutional developments and on the rise of the bureaucratic state. A professor at Johns Hopkins University, Professor Galambos is the author of several books, including Anytime, Anywhere (Cambridge, 2002).

Writing one's life is a risky venture of memory, invention, and desire. With intellectual depth and formal rigor, Roy Vagelos and the historian Louis Galambos have written a serious and nourishing report of Vagelos's life in medicine, science, and the corporate world. Vagelos became chief executive officer of Merck by way of an authoritative career as a cardiologist and biochemist, as a National Institutes of Health scientist at the forward edge of research on the biosynthesis and control of cholesterol, as chair of the Department of Biological Chemistry at Washington University, and as a research scientist at Merck. His scientific life is animated by a set of enduring questions about lipids and heart disease. Spanning enzyme research, molecular genetics, human trials, and the marketing of statins, his career helped to usher in our current powers in preventive cardiology. His interior life has been informed by a set of enduring values, which were derived from the Greek immigrant experience of the Great Depression. By making ice cream and working the sandwich counter in his father's delicatessen in Westfield, New Jersey, Vagelos infused duty and familial loyalty into his bones. Medicine, Science, and Merck achieves the goals of autobiography by making the present transparent with the past, showing the subject -- as both narrator and protagonist -- reflecting on his past actions and making sense of them in the light of present knowledge. The book is a seamless weave of many stories -- of the familial and cultural, of the complex fellowship among colleagues, and of the science itself, all the way down to the tales of molecules. The reader not only absorbs each strand of the narrative but also recognizes that these strands are irrevocably linked, that there is no science without them. There is no need to "humanize" science or medicine; it comes to the reader, because the science or medicine itself is humanizing as long as one is equipped with the imagination to heed its generative purpose. (Vagelos's full given name is Pindaros Roy; he lives up to his namesake, the classical Greek poet Pindar.) This is also a moral book. Like an active pump on a membrane, Vagelos injects his idealism into Merck's corporate setting, enacting values of accountability, altruism, and devotion even while toeing the bottom line. Merck's decision to make ivermectin available free to cure river blindness in sub-Saharan Africa presages efforts of the industry, one hopes, to make other pharmaceutical agents affordable. This journey shines with optimism for all of us who have become demoralized by the failure of the ideals of science, medicine, and the corporate world and by the threat of defeat of our shared ethical vision. The book also gives heart to the reader to take a similar look at his or her journey, assessing its enduring values, measuring its missed opportunities, admiring its texture. Medicine, Science, and Merck brings into focus hard questions about the social costs of corporate profit structures, scientific pride, and the hunger for political power. No doubt this is but a partial report; no doubt others can tell competing versions of these events. Nonetheless, the moral freshness of the effort poses a challenge to us all to live within our cosmos as searchers, risk takers, beholders of the complexity of our world, and servants to its needs. Rita Charon, M.D., Ph.D.
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