Friday, January 28, 2022

Empire of Pain: The Secret History of the Sackler Family, by Patrick Radden Keefe


Doubleday, 2021
535 pp


In the afterword of this book, the author notes that he'd started working on this project in 2016, having come to it "indirectly."  While researching the Mexican drug cartels ("not just as criminal organizations but as businesses"),  his research had led him to the "new emphasis, among the cartels, on heroin."  From there, Keefe was led to OxyContin, and to reading Barry Meier's Pain Killer and Dreamland (an excellent book, by the way) by Sam Quinones as well as articles published in the Los Angeles Times.  He notes that he 
"was astonished to discover that the family that presided over the company that made OxyContin was a prominent philanthropic dynasty with what appeared to be an unimpeachable reputation."   
In an interview at Esquire in October of last year, the author explains what was behind the writing of this book, saying that he didn't want to write a book "in which the Sacklers felt like cyphers, in which they felt very remote."   Since they would neither speak to or communicate with him,  writing a book would feel "ineffective -- as though you were seeing them through a telescope, very, very distantly." But then litigation against the company and later the family resulted in  a "huge body of documentation ... getting released in these lawsuits, including lots and lots of private emails" that offered Keefe a way to tell a "vivid and engaging" story, one in which "you feel like you really come to understand these people."   An engaging revelation of the lengths this uber-wealthy family would go to to avoid any accountability, Empire of Pain  is also a story of a family that somehow failed to pass on any sort of empathy through the generations, valuing their "good name" and their ongoing wealth above all other considerations.   

And what a story it is indeed.  In 1904 Isaac Sackler arrived in America from Galicia, and along with his three brothers, opened up a small grocery store in Williamsburg, New York.  He did well enough to invest in real estate, but during the Depression when his fortunes started to wane,  he reminded his three sons that he had "bestowed upon them something more valuable than money... a good name."  As the sons' wealth began to grow, they delighted in seeing that "good name" adorn many a philanthropic enterprise, all the while keeping silent about where their money originated. In Empire of Pain, the author examines the Sackler dynasty, revealing a 
"story about ambition, philanthropy, crime and impunity, the corruption of institutions, power, and greed."

Isaac Sackler always hoped that his sons would "leave their mark on the world,"  which  they did, but my guess would be probably not in the way Isaac had intended.  

The three Sackler sons (Arthur, Raymond and Mortimer) went on to become doctors, the latter two joining Arthur  working in a state psychiatric facility in New Jersey, Creedmoor Hospital.  In 1942, while still working at Creedmoor, Arthur accepted a position with the William Douglas McAdams agency which specialized in pharmaceutical advertising, where the focus became one of "how do you sell a pill?"  Sackler was savvy enough to know that the real money would come from advertising directly to physicians rather than consumers, and beginning with a Pfizer product called Terramycin, he laid the foundations for future pharmaceutical marketing.  Without going into detail, Sackler's strategies included marketing to "the prescribers" in medical journals,  hiring a force of energetic sales reps, convincing prominent doctors to get on board with endorsements, having drug companies cite certain scientific studies (often underwritten by the companies themselves) that claimed that the new drug worked well and that it was safe.   What Sackler had created was a "synergy between medicine and commerce,"  and the strategies worked:  while the product itself wasn't particularly "groundbreaking," it was highly successful since "it had been marketed in a way that no drug had ever been."  Not only had "Arthur invented the wheel," but he'd also laid the foundation for the future of pharmaceutical sales, including Valium, which more than cemented the Sackler family fortune.  He also bought a "small pharmaceutical company" in 1952, by the name of Purdue Frederick, the running of which would be left in the hands of his brothers.  

Flash forward in time: Richard Sackler, son of Raymond, got his medical degree  and in 1971 joined Purdue Frederick as assistant to the president (his dad).   When MSContin came along, Purdue started manufacturing and selling it in 1984, generating hundreds of millions in sales, "dwarfing anything that the company had sold in the past."  By 1990 though, Purdue was set to "lose the monopoly on its flagship painkiller" due to patent issues, so they needed a "successor." Enter OxyContin, in 1996.   The word at Purdue Pharma (formed in 1991)  was that this drug was so good that it would "sell itself" but Purdue was taking no chances.  The Sacklers followed Arthur's template in influencing government agencies like the FDA, co-opting physicians, completely downplaying the addictive qualities of the drug, faking reports, offering "capless" incentives to the sales reps, financing organizations advocating freedom from pain as well as pain research, and the list goes on.   OxyContin became "the one to start with and the one to stay with."  That turned out to be true: Purdue created a huge market for OxyContin, which in turn led doctors to prescribe it and to people becoming dependent on it.    It also launched a major public health crisis -- by 2010, "millions of people had become addicted to OxyContin and other opioids," and America was "in the grip of a full-blown opioid epidemic."   Purdue's answer:  it's not the drug, it's the people abusing the drug. 

 In the long run, as Keefe so skillfully reveals, the Sacklers did anything and everything necessary not only to deny and refute the claims of addiction, but also to preserve their "good name."  

There is much more to this book than I can describe here, but as the dustjacket blurb notes,  Empire of Pain is "a portrait of excesses,"  as well as a 
"study of impunity among the super elite and a relentless investigation of the naked greed and indifference to human suffering that built one of the world's great fortunes." 
I don't know how anyone can read Empire of Pain and walk away unaffected.  What struck me the most was the family's sheer lack of empathy, the lack of any sort of accountability, and the ease with which they managed to co-opt the institutions that are supposed to protect the public, including the FDA and the Department of Justice.   The icing on the cake comes in watching the HBO documentary "Crime of the Century," which not only shows certain members of our government allowing all of this to happen, but also reveals how much Sackler money they'd received in campaign contributions.  But read this book first. 

Highly, highly, highly recommended.  

Saturday, January 8, 2022

The Disappearance of Lydia Harvey: A True Story of Sex, Crime, and the Meaning of Justice, by Julia Laite


Profile Books, 2021
410 pp


Before I launch into my thoughts here, I absolutely have to offer my grateful thanks to the unknown but very much appreciated person who sent me this book, whoever that person may be.  

 The Disappearance of Lydia Harvey is a well-constructed and thoroughly engaging work of history which might best be described as narrative nonfiction, meaning that there is not only a story to be told here, but a central plot, if you will, with a young woman by the name of Lydia Harvey at its center. We learn in the first sentence of this book that in January, 1910, "just a few months shy of her seventeenth birthday, Lydia Harvey disappeared."   That was her physical disappearance, but she also "disappeared again and again" in the stories told about her by others:
"She was no one. Who she was, what she wanted, what happened afterwards; none of this mattered.  She joined a legion of missing girls, whose brief appearances in newspapers and books remained uncomplicated by their past experiences of poverty, abuse or their exploitation in other kinds of work."
While many of these women had stories told about them which ended, 
"condemned to a short life of misery, disease and degradation; they 'vanished forever beneath the slime of the underworld' and remained 'literally nameless and unknown,' "
Lydia, as we are told, "refused this story;"  and did not, as the dustjacket blurb reveals, "vanish forever into the slime of the underworld" despite others' expectations.   

Lydia Harvey was sixteen years old in 1910 when she boarded a ship for Buenos Aires, leaving her family, her friends  and her job behind.  She had earlier been taken into a "respectable" home in the city as a domestic, but she worked long hours for very little money so when the opportunity arose to work in a photography studio, she took it.   It wasn't long until she met "a beautiful woman and a handsome man" who offered her "nice dresses" and would "help her to travel;" her job would be "seeing gentlemen."   Whether or not Lydia realized what she was in for is unknown, but as the author states, this girl, alone, sixteen, "work-weary and starry eyed" decided to take a risk, explaining her absence via letter to her mother saying that she'd gone on to become a "nursemaid for a respectable couple" in London.   In Buenos Aires she found herself working as a prostitute, constantly reminded of how indebted she was to  the couple who had brought her there, but things didn't go as planned, so  they all  traveled to London where eventually Lydia was arrested.  Her story might have ended there, but  in a Soho police station she "gave a witness statement that would form the key piece of testimony that saw her traffickers brought to some semblance of justice," and then, unlike so many young women in her situation, actually testified in court.

Author Julia Laite had first encountered Lydia and her statement while  researching her first book Common Prostitutes and Ordinary Citizens, published in 2011, and according to this interview in the New Zealand Herald ,  she couldn't get Lydia out of her head, "wondering what had happened before and what happened after."  In writing this book, not only does the author answer this question, but she focuses a lens on several people whose lives became interwoven with Lydia's, offering Lydia's story to emerge through their eyes as well.  She begins with Lydia's early life, moving her forward in time to being trafficked and to her encounter with the police in London; she then takes up the story from the perspective of the police, followed by that of the media, a rescue worker to whom Lydia was sent after being arrested,  and then finally on to the couple who trafficked her.  Yet this is neither a simple  biography or history by any means; there is a wider story at work here involving, among other things, rapidly-changing women's roles, a world becoming much more interconnected,  an increase in mobility among women, especially among the lower-middle and working classes, all of which sparked societal anxieties encapsulated by the "white-slavery panic" 
"fashioned by crusading journalists and anti-vice campaigners and taken up by a society that longed for young women to remain in their traditional place, while exploiting them for their cheap and flexible labor." 

 Unfortunately, "the language of white slavery" didn't cover the exploitation of  "black, Asian and indigenous" victims;  the actual "white slavers" were also "profoundly racialised."   Often women such as Lydia were somewhat idealized, while at the same time there seemed to be far less attention paid to who was responsible.  There is also another, more complex matter that muddies the water: often, as in the case of one of Lydia's traffickers, Veronique Caravelli, sometimes women were both sex workers and traffickers, which seems to upset the typical understanding of victim and victimizer -- women who didn't quite fit the accepted mold of victims were most often characterized as criminals.   Lydia's story played out at a time of a growing  globalization of sex work,  the trafficking existing on an international scale that  ultimately required police forces around the world not only to be in communication with each other, but also to "establish a central authority in each country" to coordinate both national and international anti-trafficking efforts, which continued to victimize women. Obviously this is just a sort of nutshell description, and there is much, much more that I haven't even touched upon -- the role of the press, the role of social work, and so on, leaving it for the reader to discover.  

At  the outset the author reveals that there are "thousands of missing pieces to this puzzle," either lost, destroyed, or never made part of any historical record.  Acknowledging that she had to weave "threads of imagination"  into the information she discovered, she also notes that she has "followed careful rules" in doing so -- historical evidence exists for every detail offered in this story.    Considering what she didn't have, she's done an excellent job here; not only is this book well researched, but the different perspectives that come to interconnect offer a more in-depth understanding of the individuals who made up part of Lydia's story  as well as (quoting the dustjacket blurb) "the forces that shaped the twentieth century."    I absolutely love reading history when it's written like it is here, in which an obscure figure from the past is given a voice and a life while all the while a clear picture of the world surrounding her takes shape.  It is also amazing how much of this story continues to resonate in our own time, which I picked up on very early in the reading, but it is an idea runs throughout the book.   

Very nicely done and very, very highly recommended.