It Looked Good on Paper
Page 19
The advertising promoting the fluoroscope stated that you could get a better fit when buying shoes if you could look and see whether the foot bones had enough room inside the shoe. A better fit meant more comfort, increased health, and a longer-lasting shoe (reduced wear and tear). The machine was very popular in the 1940s and 1950s. It appeared in over 10,000 U.S. shoe stores, 3,000 British shoe stores, and 1,000 Canadian stores. Very few machines appeared anywhere else in the world.
The shoe store fluoroscope first appeared in the middle 1920s, where several individuals have taken credit for its development and popularization. Clarence Karrer, a technician for his father’s medical and X-ray machine supply business, invented an “X-ray shoe fitter” in 1924. The product’s design was later purchased by a fellow employee, who started the Adrian X-Ray Shoe Fitter Corporation.
There was also a Dr. Jacob Lowe, who practiced medicine in Boston. He claimed to have invented the shoe-fitting fluoroscope used for X-raying the feet of injured soldiers during World War I. The machine did a fast exam and did not require soldiers to unlace and remove their mid-calf combat boots (which had a large number of laces). In 1920 he introduced the machine at the National Shoe Retailers Association convention. The patent, applied for in 1919, was finally granted in 1927 and the newly named Foot-O-Scope was produced and marketed by the Adrian Company of Milwaukee and renamed the Adrian line. This firm was later absorbed by the X-Ray Shoe Fitter Corporation, which also introduced the Simplex line of scopes.
In 1924-25 a foot X-ray machine called the Pedoscope appeared in Britain. Made by the uniquely named Pedoscope Company of St. Albans, this unit was similar to the American products but remained, without competition, on the other side of the Atlantic Ocean.
The fluoroscopes were a big hit in most stores. The use of X-rays was novel, the images impressive, and everyone wanted to see their shoes and feet wiggle. Children would go into the shoe stores and spend considerable time watching their feet and those of their friends. Because there were three viewers in each machine, this act became a group event.
There were some problems with the fluoroscopes. They were expensive and took up lots of floor space. They diverted attention from the sale of shoes, since everyone wanted to see the X-ray images of their feet and would line up at the machine.
Long lines of lookers (especially on Saturday mornings) would slow sales and obstruct other shoppers. Every new pair of shoes that was tried on required a time-consuming look at the fluoroscope.
With few exceptions, using the X-ray shoe fitter was pointless. The fit of a shoe is primarily based on the soft tissue of the foot, not the bones. The X-ray images did not show soft tissue. Every store had to have one, though, since customers thought it was modern and technologically important. Shoe stores that had fluoroscopes made more sales and profits than those that did not. So whether the fluoroscopes were a significant benefit or not, they were a sales gimmick, and the stores bought them by the thousands.
Another problem with the X-ray apparatus was that they produced and leaked radiation—a lot of radiation. The 50 KVP X-ray tube used 3 to 8 milliamps, and in the continuous (20-second) mode was a health hazard. Most scopes produced 7 to 14 REM of radiation to the feet for a 20-second exposure. REM is the older system of measuring ionizing radiation. The American Standards Association, in the 1950s, recommended an exposure of not more than 2 REM for a five-second period. Today, the safety threshold is about one thousandth of this number. In addition to the radiation exposure to the feet, scatter radiation to those standing around the machine was significant, often measured at one-tenth REM at a distance of 10 feet.
This was not too much of a problem for the occasional shoe shopper, who might zap herself and her children a couple times a year. It was a big problem for the shoe salespeople, who were exposed to the ever-present radiation scattering from the fluoroscope, which was in use for most of the day. After a few months of this kind of exposure, one could absorb enough radiation to “glow.” Though the unwitting public received significant amounts of radiation, few actual cases of disease were linked to the shoe fluoroscopes. One of these cases, a shoe model, had her feet scoped numerous times. She developed radiation burns and eventually had to have a foot amputated. Another salesperson was diagnosed with radiation dermatitis of the foot, a skin condition caused by radiation burns. Surprisingly, no cases of cancer were linked to the shoe store fluoroscopes.
Eventually, increasing concerns about radiation dangers created a public movement to ban the shoe store fluoroscopes. By 1950, many regulations were imposed by most states as to how and when the fluoroscopes could be operated. The shoe store owners did not protest and, in fact, encouraged the disuse of this sales gimmick gone stale. By 1970, most of the states in the U.S. had banned the use of the machines. In 1981, the last shoe store fluoroscope, found in a department store in Madison, West Virginia, had its plug pulled and was donated to the Federal Food and Drug Administration. It was a great idea for its time. It looked good on paper and played well to the crowds. But in the end, it was less than helpful, finally disappearing into museums across the land.
“One of the first duties of the physician is to educate the masses not to take medicine.”
—Sir William Osler
Thalidomide
Brian M. Thomsen
Morning sickness has always been the bane of pregnancy for most women. Throughout most of history, they simply suffered. Then, in the late fifties, a new wonder drug appeared on the market that finally ended the nausea bedeviling “the expecting masses.”
Of course, like most other drugs, certain side effects were later discovered. The most common of these included “fatigue and constipation, an increased risk of deep vein thrombosis, pulmonary edema, atelectasis, aspiration pneumonia and low blood pressure,” all of which were fairly treatable by other miracle drugs given the times, and none were likely to cause irreversible damage—at least not enough damage to make it worth taking this popular, best-selling pregnancy aid off the market.
Unfortunately, there was also another unknown side effect. The drug was called thalidomide.
Thalidomide was developed by a German pharmaceutical research firm in the early fifties as a facilitator for the development of antibiotics, a use that was later set aside as being both impractical and nonfeasible given the research data. The only plus side of the research at that stage was that the drug itself seemed to be completely non-toxic on test subjects, even when administered in unreasonably high doses.
Given the loss of its original purpose, researchers had to find a new use for the drug in order to recoup the high cost of development. After a preliminary test in Switzerland, the drug showed promise as an anti-seizure aid in the treatment of epilepsy, but proved ineffective against seizures during the trial study
What followed was an eventual quasi-trial-and-error series of applications from which it was eventually determined that thalidomide could be marketed as a generic sedative with practical applications for the treatment of morning sickness. It was marketed as 100 percent safe—no test animals had been harmed in any of the trials.
The case was open and shut, and by October of 1957 the drug had made its way to the world market under a variety of names.
The way to approval in the United States, however, proved rocky. Several at the FDA were skeptical of the claims of efficacy of the drug and requested additional information. But the law at the time allowed the drug to be distributed for a limited time prior to approval under the auspices of a category called “experimental or investigational use.” Under that law the limited time would be reset each time that the drug was resubmitted for approval. This loophole led to numerous case of the drug being submitted for approval, being denied due to insufficient data, being withdrawn from approval process, only to be immediately resubmitted for approval with the new data that had been amassed/produced during the time it had been under submission before. During the entire process of repeated submissions and denials the drug remained
in distribution.
One of the excuses/explanations for the lack of data handed over by the drug company was that the actual application to the FDA was being handled by the sales and marketing side of the business because the drug’s effectiveness was discovered after its developmental stage and not as part of its initial developmental regimen—but since it had already been proven to be non-toxic at that time, such a conclusion was obviously transfered to its new uses.
The problem, however, was in the lax method that had actually determined the drug to be safe. No rigorous study appeared to have gone into the original declaration that, in turn, produced the determination that thalidomide was non-toxic. The animal studies alone were insufficient, and no long term or extensive studies on humans had even been set up. Instead of good science, it seemed nothing less than an effort to recoup the losses from a failed research project.
As a result, at least in the United States, the drug was never approved for market. Despite this fact, however, 2.5 million tablets had been given to more than 1,200 American doctors during the “approval process,” and nearly 20,000 patients received thalidomide tablets, including several hundred pregnant women. Many of these women (not to mention those outside of the U.S. market) soon discovered that thalidomide was not only ineffective against morning sickness (the use for which it was marketed), but that the drug also increased the risk of birth defects. Women began giving birth to babies with abnormally short limbs, “flippered” appendages, eye and ear defects, and large and small intestine malformations. The drug was also linked to peripheral neuropathy in the mother. As a result the U.S. drug laws were rewritten to eliminate the loopholes through which thalidomide (and probably many other potentially harmful drugs) made their way to the consumer before a proper vetting.
After the drug’s elimination as a sedative/cure for morning sickness, the company continued to look for an applicable use for the drug itself. Several were indeed found—and in 2006 the Bush administration FDA granted it accelerated approval for certain treatments, none of which had anything to do with morning sickness or the stimulation of antibiotics.
“Then there was LSD, which was supposed to make you think you could fly. I remember it made you think you couldn’t stand up, and mostly it was right.”
—P. J. O’Rourke
A Mainstream Wonder Drug
Brian M. Thomsen
“The visions were not blurred or uncertain. They were sharply focused. I felt that I was now seeing plain, whereas ordinary vision gives us an imperfect view; I was seeing the archetypes, the Platonic ideas, that underlie the imperfect images of everyday life.”
The above quote was taken from an article on LSD and is partially credited with beginning the “turn-on” generation of people who believed in a better perception of life through chemical enhancement.
It did not appear in Rolling Stone or High Times or even Mother Jones or the Village Voice.
Its source was a much more mainstream publication.
It appeared in the issue of Life magazine published on May 13, 1957, as a part of an article that was a “first person narrative” of an experience under the influence of LSD by Gordon Wasson, a banker with the firm J.P. Morgan.
By the following year many of the elite of New York society were experimenting with the drug, using it to expand their perceptions. These notables included Time, Inc. co-founder Henry Luce and his wife Clare Booth Luce. (According to The New Yorker magazine, Mrs. Luce thought that LSD ought to be kept out of the hands of ordinary people. “We wouldn’t want everyone doing too much of a good thing,” she said.)
A decade after the Life article, Congress made the sale of LSD a felony and possession a misdemeanor, and its control and regulation was handed over to the Bureau of Narcotics and Dangerous Drugs.
Two years later psychedelic drugs as a group were classified as drugs of abuse, with no medical value—which did nothing to diminish their popularity among the counterculturalists who had come to embrace them.
Pandora’s box had been opened and it would not be closed.
LSD (the abbreviation for lysergic acid diethylamide) was first synthesized from a fungus that grew on rye grain in 1938, by Albert Hofmann working for the Swiss pharmaceutical company Sandoz. Hofmann was hoping that this new drug could be used to stimulate circulation and respiration, but unfortunately the results of these tests were deemed inconclusive or negative in terms of their effectiveness. Its pulmonary effectiveness was far outweighed by its perceptual one.
Five years later Hofmann accidentally ingested or came into interactive contact with a bit of leftover LSD. He soon experienced some of the psychedelic effects of the drug including dizziness, visual distortions, and restlessness. Though not strictly a hallucinogenic, LSD does cause a distortion and/or enhancement of stimulus and input as well as time recognition resulting in an extreme sensory experience. It quickly became the subject of several studies as scientists searched for a use for its newly discovered properties.
A 1950s survey article cited the following in terms of the therapeutic uses of the drug: “Types of conditions repeatedly stated to respond favorably to treatment with LSD and other psychedelics include chronic alcoholism, criminal psychopathy, sexual deviations and neuroses, depressive states (exclusive of endogenous depression), phobias, anxiety neuroses, compulsive syndromes, and puberty neuroses.” Later studies added, “Psychedelics have been used with autistic children, to make them more responsive and to improve behavior and attitudes; with terminal cancer patients, to ease both the physical pain and the anguish of dying; and with adult schizophrenics, to condense the psychosis temporarily and to help predict its course of development.”
And furthermore: “One additional interesting possibility of therapeutic use was based on the activating or ‘provocational’ effect of LSD. The drug can mobilize and intensify fixated, chronic, and stationary clinical conditions that are characterized by just a few torpid and refractory symptoms, and it was hypothesized that such chemically induced activation might make these so-called oligosymptomatic states [having few or minor symptoms] more amenable to conventional methods of treatment. By far the most important use of LSD was found in its combination with individual and group psychotherapies of different orientations. Its effectiveness is based on a very advantageous combination of various aspects of its action. LSD psychotherapy seems to intensify all the mechanisms operating in drug-free psychotherapies and involves, in addition, some new and powerful mechanisms of psychological change as yet unacknowledged and unexplained by mainstream psychiatry.”
Thus not only was the drug a tool for elites to, in the words of Aldous Huxley, “open the doors of perception,” but also for combating/treating mental illness.
In addition to all of the above benefits, a 1963 report concluded: “LSD has a wide safety margin and in the hands of experienced investigators does not produce hazardous side-effects.”
And there was the rub: “…in the hands of experienced investigators.”
“Experienced investigators” means trained professionals. In other words, “kids, don’t try this at home”—and that includes overgrown kids, or as they like to call themselves, mature adults as well.
Given the fact that the drug directly affected one’s perception of outside stimulus, it was important to control that stimulus to assure that the subject would encounter minimal hazards. This was hard enough to do in a laboratory or a hospital, let alone at a Park Avenue party or in a Greenwich Village loft. Moreover the drug was also linked to more nebulous “spiritual” experiences, which became harder to explain, let alone control.
Worse, its use was linked to various incidences of unstable behavior, with some specific high-profile cases that led to suicide and accidental death.
Even samples of the drug that had been requisitioned for serious study sometimes found their way into amateur experimentation, so that many who fell far short of the label “experienced investigator” soon found themselves in way over their heads.
This was a gross overreaction.
It was dangerous, however, and its use did need to be controlled, something which criminalization didn’t really allow.
LSD, the wonder drug of the mind, had been labeled a demon drug of the soul, and its original acceptance by the mainstream was quickly forgotten in the wake of the newly inaugurated war on drugs.
That Sinking Feeling
When you build a bad building sometimes it falls down. When you create a stupid plane it never takes off. Ships, too, have a way of telling you when something is very wrong. This is called sinking. As with planes, autos, and weapons, there has always been a competition to make each new ship bigger, faster, or deadlier. To achieve these ends things are occasionally taken to extremes, often with disastrous results.
“You can’t say that civilization don’t advance…for in every war they kill you a new way.”
—Will Rogers
The Courageous Saga of the First Submarines
Douglas Niles and Donald Niles, Sr.
Since the days of the ancient empires of the Mediterranean, control of the sea has consistently been an important goal of any military regime with access to a sea. Nations that have the strongest navies, such as England during the Napoleonic Wars, or the Union during the American Civil War, have been able to blockade enemy ports, disrupt or inhibit enemy troop movements and supply lines, and deposit armies along coastlines with a freedom of movement that states lacking naval prowess cannot employ.