The Birth of the Pill: How Four Crusaders Reinvented Sex and Launched a Revolution (27 page)

Pincus and Rock were too old to be on the front lines of the revolution in sex that was shaping up, but that didn’t mean they avoided it entirely. Goody Pincus never cheated on his wife, as far as his friends and relatives could tell. Rock was a great romantic, and as he grew older he became increasingly comfortable discussing sex in public. He liked to dance and drink and interview strangers about their sexual habits. One person who spent time with him in Puerto Rico remembered a handsome young man with a guitar serenading Rock from beneath the doctor’s hotel window.

Pincus and Rock were old enough to recognize that a birth-control pill would not likely have much effect on their own lives, but they knew it had the power to unlock desire in others.

Even so, Pincus was focused on the science more than the possible consequences. He was more than three years into the project and still lacked a reliable compound. Sanger and McCormick were pushing him hard for results, and he assured them again and again that progesterone was the answer, even though it had only worked in about 85 percent of the women tested so far. He was like Orville and Wilbur Wright after their initial flight: confident he had the right idea even though the first try had crashed. As he explained in a letter to Sanger, “[I]f ovulation may be inhibited in a good proportion it should be possible to
develop a method for inhibition
in 100%.”

He didn’t offer any details, however, as to why that should be true. All he said was that he intended to find out.

TWENTY

As Easy as Aspirin

O
N FEBRUARY 1, 1955,
a cold and cloudy Tuesday, Gregory Pincus set out from Shrewsbury to visit Katharine McCormick in Boston. As he drove, snow began to fall, lightly at first and then more heavily.

Pincus had recently returned from Puerto Rico, and he was eager to tell McCormick about his trip. He was also eager, once again, to ask her for money. The snow began to dust the hillsides and coat the blacktop as he rumbled east along Route 9. A car slid in front of Pincus’s, and as he tried to avoid a collision he lost control of his vehicle and skated off the road. He climbed out from behind the wheel,
shaken but not hurt
. He managed to get the car to a mechanic’s shop, and from there he
hitched a ride to Boston
.

McCormick’s four-story Back Bay home was like her wardrobe: elegant yet frozen in time circa 1920. A butler greeted Pincus and a
maid stood by to fetch drinks
. McCormick wanted to hear everything, beginning with the story of his automobile accident. No detail was too small for her attention. She wanted to know if Pincus still believed in progesterone and the assorted progestins he’d been trying. If he were to lose faith, she didn’t know what she would do. Pincus said much remained to be done. He still didn’t understand exactly how the progestins worked, and he was concerned that about 15 percent of patients still ovulated, even when taking high doses, but he was confident that all the answers would come to him with more time and work.

Late in 1954, Pincus had begun experimenting on animals with a new group of progestins that were many times more powerful than natural progesterone. Two of the compounds seemed especially promising. One, called norethindrone, had been developed by Carl Djerassi of Syntex, the Mexican-based drug company. The other, named norethynodrel, had been developed by Frank Colton of Searle. Pincus had considered a third compound made by the Pfizer company, but Pfizer’s owners were Catholic and they
refused to supply the chemical
when they learned why Pincus wanted it. That left two choices, norethindrone and norethynodrel—two chemical compounds that appeared almost identical in structure. But in testing them on lab animals, Pincus and Chang observed one small difference: Djerassi’s compound, norethindrone, caused some of the female animals to develop slightly masculine characteristics. For reasons no one could explain, Colton’s formula did not have the same effect.

Pincus informed Searle that he liked norethynodrel, which Searle referred to in its catalogues as SC-4642, and intended to try it as an oral contraceptive for women, possibly on a large scale. He encouraged the drug company to provide the drug to other researchers so they might begin to experiment with it as well. But Searle officials were leery, saying they
did not yet understand how or why
it worked. Was the pill preventing ovulation, stopping fertilization, or impeding implantation? Was it doing all three? No one knew.

Then there had been another problem, one that Pincus declined to tell McCormick about. Sometime late in 1954, one of John Rock’s patients developed a sterile abscess formed by the body’s failure to absorb an injected drug, and Al Raymond of Searle wrote Pincus to say the news “
throws grave doubt
on any interest we might have in this product.” If such a side effect were to occur even one time in one hundred thousand, Raymond continued, Searle “would have no interest in promoting the product whatsoever.” Raymond said he intended in the future to make certain the Searle label was not attached to the experimental drugs sent to Pincus. The company did not want to be associated with anything that might prove remotely dangerous. “[W]e
will send it to you unlabeled
,” Raymond wrote, “and you can label it as you see fit.”

One little abscess, however, didn’t worry Pincus much. One thing he hadn’t mentioned to officials at Searle or even in his letters to Sanger and McCormick was this reassuring fact: Scientists working at the Worcester Foundation had started giving the progestins to their wives, sometimes for contraception and sometimes simply to control their periods. The wives, said Anne Merrill, who worked as a lab assistant at the Foundation in the 1950s, “
didn’t want to be bothered with menstruals
when they were traveling.”

Pincus knew as well as any scientist in the country the many ways a research project might collapse. Funding might vanish. A competitor might win the race to the finish line. Bad publicity might scare away test subjects or bring down the wrath of the Catholic Church or government. Drug companies might lose interest. Results might prove inconclusive or worse. But as he sat in McCormick’s lavishly decorated home, with temperatures outside dropping quickly but no more snow falling, Pincus didn’t dwell on the many ways the project might fail. Instead, he told McCormick about why he still liked Puerto Rico for trials. A successful birth-control program might become a prototype for other nations. The women were familiar with and often eager for birth control. Many of the doctors and nurses on the island were trained in America and spoke English well. It was true that doctors in Puerto Rico and in the United States initially had had difficulty finding volunteers for the tests, but Pincus settled on a new plan. This time he would begin with nurses and medical students. He would drop the endometrial biopsies, which were extremely uncomfortable and scared off participants. In addition, the students would be required by the faculty to
participate as part of their studies
. If the young women were worried about the stigma of being birth-control subjects, Pincus had a solution to that problem, too: he would label the project a study of the physiology of progesterone in women. And once the nurses and students enrolled, word would spread that the substances were safe and effective. From there, it would get easier.

Pincus told McCormick the new drugs would cost about fifty cents a gram, which would mean expenses of about five thousand dollars for the treatment of one hundred women during the first year of testing. In addition, he would need money for doctors, nurses, secretaries, travel, and printed materials. For the first year, the total operating expenses would probably be about ten thousand dollars. Maybe more.

As usual, McCormick assured him that money would not be a problem. She was prepared to pay for the entire operation.

Once, McCormick had devoted her full energy to the care and possible cure of her deranged husband. Now, it was the Pincus research project that occupied her. She had no other cause, no other mission, although it was inevitable that a woman of great wealth would sometimes find herself tangled in business affairs. Indeed, it seemed at times that her financial affairs were all she had. With no dear friends or family to surround her, and only a maid and butler to keep her company at home, she spent much of her time speaking and corresponding with her lawyers and accountants. She worried a great deal about her Swiss chateau, which was too big to sell as a home and too expensive to be purchased by a school. Meanwhile, upkeep was costing her thousands of dollars a year, sucking away time and money she would have preferred to spend on birth-control work.

McCormick continued to make donations to Planned Parenthood, but she preferred dealing directly with Pincus and Rock. She phoned and met with the men often, putting to use the knowledge of biology she had received at MIT, as well as the expertise in hormones she had picked up while searching for new drugs to help her late husband. Pincus and Rock visited her at home. She sometimes hired a stenographer to take notes on the meetings with the scientists so her reports to Sanger would be complete and accurate. Once Pincus sent his daughter to McCormick’s home with a progress report. Her home was dark and foreboding, but McCormick spoke openly to the young woman about sex, saying how important she believed it would be to separate copulation from procreation, adding that even sex between women might become more meaningful and acceptable once the birth-control pill caught on.
Laura was startled and charmed
. When it was time to go, McCormick offered to pay her subway fare home. She summoned the butler, who brought a silver tray loaded with coins. McCormick picked up two dimes and handed them to her guest. Only later did Laura notice that the coins were dated 1929. McCormick had probably been saving them since the start of the Great Depression.

McCormick’s passion for the birth-control project was so strong she sometimes offered money without being asked. When she heard, for example, that Rock was retiring from Harvard and would be forced to give up his practice at the hospital, McCormick bought a building across the street from the hospital so Rock could continue
seeing patients and conducting experiments
. She did not want to lose any time while he made his career transition.

McCormick behaved liked the owner of a fledgling business. She let Sanger do the marketing and trusted Pincus and Rock with the technology, but she supervised, and she wasn’t afraid to tell the others what they ought to do.

Now, in the first months of 1955, McCormick grew more confident—
confident enough to send Pincus a check
for $10,300 to pay for progesterone experiments in Puerto Rico. That was
in addition to the $20,000
she’d sent to Planned Parenthood in support of the same project. “I do not want him,” she wrote in reference to Pincus, “to be in any way held up on this work
for lack of funds
.”

Important pieces were coming together. Pincus believed in the progestins. Rock was conducting experiments on women. Puerto Rico offered a possible proving ground.

Before, McCormick had urged members of the team to be tight-lipped about their work. Now she changed her mind, believing that the time had come to tell the world an important discovery was close at hand. Perhaps she was encouraged by the progress of Jonas Salk and the others who had worked in search of a cure for polio. In April 1955, newspapers around the country carried banner headlines such as this one, from the
Pittsburgh Press
: “
POLIO IS CONQUERED
.” The stories that ran under the headlines told of mothers crying and doctors cheering the news. New York City even offered Salk a ticker-tape parade, an honor he declined.

If Salk had done it, and done it so swiftly, why couldn’t Pincus? Americans were waking up to the dangers of the population explosion, and they no longer perceived the problem as one affecting only developing countries. The sense of urgency was not as great as the urgency surrounding polio, but it was real and growing. The U.S. Census Bureau issued a report predicting that the nation’s population would reach 221 million by 1975, an increase of about 35 percent. At the same time, farm populations were falling and Americans were moving to the cities and suburbs. It was not difficult to imagine that they might begin to feel crowded, that jobs might become scarce, or even that
food supplies might falter
during hard times.

In February 1955, James Reston of the
New York Times
wrote a story that had people buzzing. “Since Dwight D. Eisenhower became President of the United States, the population of this country has increased by 5,496,000,” Reston wrote. “The total on January 1 of this year was 163,930,000—38,351,237 more than when Herbert Hoover left the White House in 1933.” Every day, there were seven thousand more people being born than dying in the United States, Reston’s story noted. It wasn’t Eisenhower’s fault; it was the booming economy. But if the economy slumped and population growth continued at its current rate, he warned, the United States might suffer a steep decline. The Cold War might be lost. America would struggle to care and provide for its teeming masses, especially its poor and elderly, and lose its edge over the Russians.