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BOOK REVIEW / NONFICTION : Exploring the Pill's 'Unplanned' Birth : THE PILL: The Biography of the Drug That Changed the World by Bernard Asbell ; Viking $25, 402 pages

June 26, 1995|CHRIS GOODRICH | SPECIAL TO THE TIMES

In the annals of corporate fumbling, G.D. Searle's refusal to back the work of research scientist Gregory Pincus would seem, at first glance, to rank near the top.

After spending $500,000 in Searle funds trying unsuccessfully to manufacture cortisone, Pincus asked the drug company to sponsor development of an oral contraceptive for women. Searle's director of research was incensed by the suggestion: "To date your record as a contributor to the commerce of the Searle Company is a lamentable failure," he wrote, "replete with false leads, poor judgment, and assurances from you that were false."

Searle, needless to say, denied Pincus' request--and would have assured itself a place in the Hall of Business Miscalculation had the company not recognized its mistake a decade later. Going out on what has been called "the longest limb in pharmaceutical history," Searle in the late 1950s would ask the Federal Drug Administration to license Enovid, a synthetic hormone recognized by Pincus as an almost foolproof contraceptive--and thus forever change human sexual relations.

"Victory has a hundred fathers, but defeat is an orphan"--so wrote Mussolini's son-in-law Count Ciano, and the epigram heads the first chapter of "The Pill." Bernard Asbell, a journalist, uses the truism ironically, and not only because the subject of his "biography" inhibits parenthood; most of the scientists described as "father" to the Pill--Pincus, Russell Marker, Carl Djerassi, John Rock, Frank Colton--deny that characterization, finding it grossly oversimplified.

The contraceptive's matrilineage, by contrast, is less clouded . . . though it does turn out to have two mothers, namely birth control advocate Margaret Sanger and her wealthy ally Katherine McCormick. Their search for the "perfect contraceptive" took decades and millions of dollars, but it was fruitful--and one doubts they wasted any sleep over the fact that the Pill, as Asbell wryly notes, was "born unplanned."

"The Pill" is part mystery, part history and often fascinating. The second half bogs down in religious and political quarrels, but the first-half account of the Pill's development is replete with eccentric characters, sudden connections, and opportunities overlooked as well as actively avoided.

Pincus, for example, knew it would be controversial to test an oral contraceptive on humans--but fortuitously learned that Rock, a gynecologist, was already injecting patients with progesterone and causing temporary infertility as a side effect while attempting to cure long-term barrenness.

Both Pincus and Rock needed large quantities of progesterone for their work--but could acquire it only from a Mexican company, Syntex, because Marker, who discovered how to synthesize the hormone from a Veracruz-area yam, couldn't find a U.S. pharmaceutical company willing to support his research.

Marker, railing about the dishonesty of chemists, would later abandon science, but Syntex would go on to hire Djerassi, who would synthesize a much more effective progesterone that could be taken orally--at about the same time Colton was doing the same for Searle, and a year after Sanger had asked Pincus to develop the "perfect" contraceptive.

Add to these coincidences the discovery by Pincus and Rock, now working together, that some batches of Enovid (based on one of the "new progestins" developed by Djerassi and Colton) had been accidentally contaminated with synthetic estrogen, and that the adulterated Enovid produced fewer unwanted side effects than pure progestin, and the major puzzle pieces for the modern Pill fell into place.

What's remarkable about the Pill's genesis is that none of these scientists, Pincus aside, were particularly interested in birth control.

Marker and Djerassi were fascinated with steroid hormones, then a hot field; Rock, a devout Roman Catholic, by infertility (and able to justify doing birth-control research by saying the Pill simply extended natural hormone cycles and prevented conception rather than destroyed a fertilized egg). Rock proved a consummate front man; his Catholicism led Sanger initially to oppose his involvement, but she would later say, having learned of his stature in the medical community, "Being a good R.C. and as handsome as a god, he can just get away with anything!"

The last half of this volume deals with the Catholic Church's notions about birth control and the social effects of the Pill. The details are often interesting--we learn, for example, that Pope John VI was ambivalent toward birth control, his hard-line encyclical against it being written mainly by a very conservative adviser, Cardinal Ottaviani--but the general outline quite familiar.

Overall, though, "The Pill" is engrossing, in no small measure because today it's hard to imagine a world in which birth control isn't generally accessible, uncomplicated and reliable.

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