Carl Djerassi, father of the pill

Interview by telephone with Carl Djerassi, 9. October 2001, in relation to his autobiography 'This mans Pill' (Oxford University Press) released 15. october 2001 on the 50th birthday of the Pill.

Hallo

-This is Rasmus Kragh Jakobsen

Let me ask you firstwhile, have you read anything about me?
Have you seen my website?

-Yes

Ok fine, then at least you have that background, why don't we go ahead.

-First I would like to say I find your book very interesting

Thank you

-and you go through a great length to discuss the good and bad of the Pill, why do you do this? Do you find yourself responsible for the Pill?

Well partly of course, I mean most certainly not entirely as I think I make excruciatingly clear. I think there is no such thing as only one person being responsible for any event, particular not this event. And I have always made a case that the chemist, not just Carl Djerassi the chemist, but any chemist is the mother of invention, the biologist is the father and... I am talking about medical drug invention of course - and the clinician the midwife, and I think you need these three disciplines; chemistry, biology and medicine before any drug can be produced.
Now, that is usually a drug for a disease. The problem with the Pill, both the pros and cons, you know there have been other medical invention that have certainly been more important, but I think none of them have covered so many different social and societal aspect from all the way from religion to womens rights and everything in between. From that standpoint it isn't just the chemist, biologist and clinician who are responsible, but all the people who subsequently are and were involved in distribution and the exploitation you might say of this particular invention...
There are other things that also I am sorry about, and maybe ironic, but there has really been no fundamental new development in birthcontrol since the development of the Pill, there has been minor chemical modification on the then synthesized Pill, but it is still exactly the same method: the woman has to take a pill every day for twenty one days, and certainly one could visualize many other advances including of course male contraception as well, and in my opinion none of these are close to reality.

-The reason I asked you why you go through this, is that it comes through very strongly that you find it very important to deal with matters of society and politics

Yes, correct.

-Do you see yourself as a scientist just being the vessel so to speak of the Pill. Do you think there would have been another scientist instead of you a year or two later.

Sure, absolutely. But not only is the answer yes in the context of Carl Djerassi, but in the context of every scientist. You can take Newton, Einstein, Planck or Watson and Crick, if they had not invented it, someone else would have come up because the time was ripe. Now time whether it's months, years or even decades depends - in the case of the Pill it would not have taken decades, maybe a couple of years later. In the case of, I don't know, lets say Newtons discovery of gravity and motion maybe it would have taken ten years, or Einsteins relativity maybe. But it would have happened. And that is a fundamental difference between scientist and other creative people, which we scientist either don't think or don't like to admit, but we really are, just as you point out, really only surrogates or vessels for the invention. Whereas Shakespeare is, or Mozart, or Bach or Picasso is unique, and if he in this case 'he' you could also picked out some women, had not lived, no-one would ever have done that. And thats a fundamental difference which we don't pay much attention to.
That reminds me of something which has nothing to do with what you asked me, but there is one danish connection, which I think you might as well just chop down, if you have read a chapter you noticed of course

-Isak Dinesen?

No, I want to say, ah, that also haha, no I meant one of my novels that have been translated into danish; the Bourbaki Gambit. It happens to be my personal favorit novel. I don't think it was much of a success in Denmark, and I am surprised about it, because I thought the danish readership would be a more sofisticated one, and would like it.

-Old or mature scientists often turn to societal problems can you explain why?

I think it is because they are getting older. And when they get they get smarter or wiser, and are not quite as driven by continous success I would say. And you are willing to reflect a little more. I think scientist in general, myself included are not very reflective people, we keep thinking all the time about our experiments and so. But as you get older you do get more reflective, especially if you write something autobiographical.
These things come with maturity, and that maturity has nothing to do with scientific maturity.

-You write that your attention was drawn to the societal problems by the Pill, don't you think you would done so anyway?

Well I can never do that experiment, I can never prove that. Perhaps that is the case because I think I am a socially engaged person and I am one with interests in a lot of different things, but I cannot tell.
The one thing that is crystal clear for me, and I mention that in the book, the year 1969-1970 was a critical year for me. Because by that time I really saw the direction which industry was going and birth control was going. The real problem was not the scientific problems but social problems and these are much more complex, and unless we scientist pay some attention to them and try to change them if we think they have to be changed, no-one else will do it. And yet our own society, I mean the scientific society does not give us many rewards or brownie points for this, which is too bad. And this is another reason I believe why only older scientist do it, because by that time they've gotten the recognition that they perhaps wanted. For instance you know I am a member of the National Academy of Science, well they are not going to kick me out for doing this. But I do say there are examples where people did not get elected because they spent too much time on social problems rather than scientific ones.
So younger people are unlikely to take these chances, yes? they are going to stick to science and to things they will know they get rewards for. Thats what they will get promoted for and not for their social engagements.

-What do you think drives scientists? Fame?

What we all like to say is that our drive is just for the sake of science, namely curiosity. To satisfy intellectual curiosity. Well this is certainly factor number one. I do not believe in the overwhelming number of cases that it is the only one; name-recognition, and to that extent a formal fame is equally important, but it is a different kind of fame from the one you have in movie actors and sports champions, I think, in that you are interested in name-recognition by your colleagues and not by the public. The name recognition of the public for most scientists means very little. Name recognition by their most important colleges means an awful lot. But you know I would use an analogy that many people have used, that scientific curiosity, or scientific research and ambition is like climbing an unclimbed mountain, and many people have used this analogy.
Maybe the first person to have climbed Mount Everest was Mallory - it has never been proved because he died on the way down, or on the way up. When people asked him 'why do you climb mountains?' he would say 'because they are there' or 'because no-one has climbed them before'. That would be analogous to scientists; he wants to climb a mountain or see something that no-one else has seen before, but then if that is enough, then it would be enough to climb the mountain and say 'ahh wonderful now I've done it' and then you climb down and don't tell anyone. But what do most mountain climbers do? They stand there with a flag and they ask their sherpard to take a photograph and then they want to publicize this one.
And thats the same with scientists, after we have made a discovery we are not satisfied with making it or even distributing it anonymously. We publish it under our own name, and we feel very jealous about this, about the priority that it is 'I Carl Djerassi' or 'I Niels Bohr' or whoever you want to pick made this discovery rather than just anonymously.
So it is this combination. I think it is first curisosity, but ambition comes very close to second. And in some cases it may even be the other way around.

- I have another analogy that I would like to tell you. That of a golddigger. That you as scientist go for the gold or for climbing mount Everest, but that you actually don't find the work of getting there very funny. Do you do that?

I don't quite understand

- I mean that you don't enjoy washing the riverbed, but find it very tedious, but do it only because of the chance of striking gold.

Yes, but I hope that you by gold metaphorically, not money, but as a very valuable thing.

-yes

That is true up to certain extent, but I will tell you many sceintists - and I happen to be an example of this - a lot of my... you know I have published a lot of stuff in many different areas, I know you're talking with respect to the Pill, but that was done fifty years ago, and I have done a lot of work since then, much more than I did before, and I have been very much - using your gold metaphore - I was very much interested in research on methodology, in other words in methods on how to dig for gold, developing more efficient ways of digging for gold or unusual ways, that has to a large extent been my research for last thirty or forty years, rather than just synthesis, which it certainly was during the time of the oral contraceptive work.

-You go through some tragic personal events in your book; the colon cancer and the suicide of your daughter, but you also present that these two events were very important to you, and thereby give the impression that there was something good in them...

Well I tell you, if you want to pick the tragedies in my life you can go a little bit further back, and to answer your question: Yes. you can say that the first one in a way was my skiing accident when I was 16-17 years old which led to my fused knee I have a completely stiff left leg which I cannot bend, well that happened in Bulgaria just before I emigrated to the US. You can say that is a terrible thing to happen to a young man, but on the other hand it kept me out of the war. Because I wanted to serve in the army - the american army, but was of course not accepted because of my bad knee. So I had the oportunity as a very young man to go to school and university, whereas many of my contemporaries went to the army, and many of them were killed, but they most certainly lost a lot of years. The second very closely related to it, was the whole Hitler episode, that I was kicked out of my own country - Austria, if you think about it there is an interesting connection to Denmark again if you wish, there were only two countries in Europe where the jews really all survived: Denmark and Bulgaria, and I went to Bulgaria because my father was bulgarian and he stayed the entire war in Bulgaria - and survived it. But it is this emigration from Europe that in the end converted me to a scientist, because my parents were both practicing physicians and I am sure I would just have become a practicing physician if I had continued living in Europe in a normal life.
So the two great misfortunes in my early days, my knee and the Hitler episode, certainly in the end worked out to my benefit.
And you could say that in the context of my daughters death, that it is why I founded Artist Colony which now has benefitted over a thousand artists, now thats a significant thing which I am pretty sure I would not have done otherwise, and the fact the colon cancer episode no question was the one that really drove me into litterature and right now into playwriting, which is what I do right now.

-I would like to come back to the playwriting. But it occurs to me that some of the statements you give about the Pill is that it is a good society if we can only have wanted children. But these accidents or tragedies in your own life also proves that there is something good in sickness and in tragedy, that something good comes out of it.

Something good comes out of it. But I will tell you, that should not be the argument, that would be like saying this is an argument in favor of getting cancer, if you get cancer you are going to be lucky if something will work out. You never can prove what would have happened if I didn't have that. I mean under no condition would I want to say if my daughter were a live I would do worse, I mean who knows?
I think the only thing you can say is that one has to make the best out of what luck life gives you.

-But no no, it is more an argument that by eradicating all tragedies you will create a blunt society

Oh I see what you mean. you mean like the same thing in children, if all the children are perfect children

-exactly, all would be the same

I am sorry I misunderstood you, look you have point there, I am not going to argue, you have a point there.
Let me ask you a question. How old are you?

-Ehrrmm, I just turned thirty.

Really? You sound like a very wise man, ok.
I thought you probably were 59, yes.

-Ok, so one of the problems in Denmark right now is recruiting people into science, that the best brains go elsewhere, mainly into humanities and social sciences. Do you see that as well in america and do you have an opinion or solution?

Well I think qualitatively this is a move everywhere. You find it in central Europe, in the UK, in america that fewer student, graduate student major in science. There is no question that it is the case. That is also the case in the US. Whether there is a subcritical mass that we have now is a different question, but that it has gone down that it is less popular is quite true, and I think that it is probably true of most countries. Not all, and it is for instance quite interesting, and thats a distinction between america and Europe, what I call the asian invasion of american science during the last thirty or so years, many more asians have not only immigrated into the US, usually it was people from India, now China, Japan and Korea of course.
And you know in our schools for instance Stanford where I teach, which is one of the best schools in our country, over 30 percent of our students are asians, well that was unheard of thirty years ago.
Yet early of the 1990's I was on commitee of the swedish research council and was supposed to evaluate the state of swedish chemistry - they do that once every 20 or 30 years - and the one thing that struck us enormously of the swedish, and I am sure Denmark is no different, was the enormous homogeneity of the swedish student academic population, you know they were all Gustavsson, Samuelson, Karllson and you didn't find any Lee's, Levi's, Huangs or something like that and that is a fundamental difference.
And that is not unrelated to the earlier question you asked, that is you are homogenous into that extent you have a better average cultural standard you don't have all the mixtures, but the mixtures help, we do know that. And it turns out when it comes to science in many american universities sometimes half the student in certain departments are asian students which is not the case for instance in humanities. In other words you do have a case that there a certain cultures that are still tempted by the science and technology which is less true of anglosaxan european population. And is it good? Well I think it is a reflection of really the chemifobia, the antiscientific feeling that have been generated at a time, which is completely understandable.
I am not saying these stupid idiots. There are good examples; the green movement - politically, and the environmental movement of the 1960's, the civil right movement of the 1960's, the feminist studies movement of the 1960's the consumer advocacy movement, these were all movements of the 1960's early 1970's very important ones. Each of them is intrinsically suspicious of technology and ipsi facto therefore science because they mix science and technology as being the same thing. That is not difficult to understand, particularly if you talk about environmental protection, but then it of course leads to completely things when they talk about organic food which is a good word and organic chemistry which is a bad word, and of course the same thing synthetic is bad and natural is good. When some of the worst things we know chemically are natural and some of the best things we know chemically are synthetic.
So you are leading then to something which I think is much more the cause to departure from science these days which is another reflection of the big gulf between the sciences and the social movements, and I think it is a very unfortunate one, and I think part of it is not just the ignorance of the non scientific community, but the fact that we scientists spend very little time conversing with the non-scientist. We don't put much value on this, and that is what we clearly are a paying a price for.

-And that is what you give an example of when you [in the book] mention the OJ SImpson case and the PCR reaction?

Absolutely.

-And this is your motivation for the plays and the novels?

Absolutely, that is exactly why I am doing this.
Incidently I tell you something, you are unfortunate because of an e-mail I only got today.
Because my second play called 'Oxygen' written by myself and Roald Hoffman, who won the Nobel Prize in chemistry with Kinechi, takes communication to the public just as serious as I do, he does it partly for portraits.
That play is about the centennial of the Nobel Prize and it is going to be opening next month here in London, and it opened in the US earlier in the year and we had wonderful premiere just now in Germany, well he visited Copenhagen last year and tried to promote the danish translation, because it is now also being translated into french, polish, rumanian and spanish and you are going to have a festival this year or next year associated with the Nobel Prize centennial for all the danish Nobel Prize laureates, I think there are ten danish laureates, and that would have been a very interesting play around that time. And they just were not interested.
Actually a very good friend of ours Karl Anker Jørgensen, tried to help us, he is very well known, young and very enthusiastic, it is ironic because I thought it would really work very well in Denmark, but we haven't had much luck there.

-You raise a strong critique of the mechanisms that drive Pharmaceutical companies. Problems with health versus earning money. But you don't really present a solution, how do we get a better society.

I tell you, you have to be realistic. About the only way that drugs get disemminated to the general public is through the pharmaceutical companies, and here I talk primarely of the multinational companies. These are private companies and not philantropic organisations, they are there to make money and I accept that. You know we are fortunately and unfortunately living in a capatilist system and here we are talking about one of the drawbacks of it.
It is crystal clear, that if I want to make money I would not work on diseases of millions of people in Africa, I would not work on particularly parasitic diseases malaria, sleeping sickness, worm infection, there is no money in this even though children die, the money is in Alzheimer disease and in cancer, which are not problems for those people because they don't live long enough, these are the diseases of the geriatric society.
Unfortunately today the world is divided into a geriatric world and a pediatric, and thats sad. And the geriatric is Northamerica, Europe and Japan, thats where the money is, and its not in the pediatric which is basically Africa, Latinamerica and Asia, therefore that work is not being done, and it is unrealistic to say that the pharmaceutical companies should do this, because one do not offer them an incentive. Now I have often suggested there should be some financial incentive for the pharmaceutical companies to go into things like vaccines and contraception which are important things but not the sort of thing they are working much on.
But I am also realistic, what politician are going to promote this, because people consider - and justifiedly so - that pharmaceutical industri is one of the most profitable industries, so you will say 'what I am to put the tax payers money into a profitable company making it a profitable one'.
But the answer is either we do that or we find an additional or alternative mechanism whereby social institutions governments and so on go into the pharmaceutical manufacturing and distribution business, and thats totally unreallistic because I dont know of any countries where it has worked. So this is an almost insolvable problem.

-There is a move to demand political statements from multinational companies, do you think there is realism in this?

Yes and no. But it is not unreasonable to say... It is not that they are working on unimportant diseases, let me say. Consider me at my age, the fact that all of them are working on Alzheimers and very few of them are working on parasitic diseases, well why should I complain?
Why should anyone in the western world complain, where Alzheimer in terms of social costs - I don't mean just to the individual - is enormous. And its going to grow and grow because it happens only to old people. So it isn't like they are not paying attention to diseases, they are just picking diseases they consider important, and they are not trivial diseases. Something else if they worked on trivial diseases, you might say, hrm trivial it's not really trivial. But something like Viagra when you talk more about quality of life than survival, but even that. What are you going to do? Are you going to tell that to an impotent man? What right do you have to deny me that pleasure, it is a very difficult thing, and pharmaceutical companies are not homogenous, you have some that are much more socially responsible than others

-Can you mention one?

I wouldn't want to, because its an unfair thing for me to do. But there are some.
Well I can certainly tell you that the company I was at the time, Syntex, which has now benn completely digested and metabolized during an aquisition by giant Roche, which is not one of the ones I would put on that list, but Syntex at one time was that way.
To give you an example, and I don't know if that applies to that company now, in the 1980's Merck had developed a very important and profitable drug Avernectin and it was very profitable drug particularly in animal health but also in other things. But it also turned out to be very effective in onco psochiasis -a complicated word for riverblindness - now onco psochiasis is one of these horrible diseases which is particular typical of Westafrica where high proportions of people become blind. A horrible disease, that is carried by a vector by a black fly. Avernectin was about the only agent that turned out to be effective against the parasite that this fly distribute that cause eventual blindness, well they gave it free of charge to the WHO, for the riverblindness, and there were several million people in Westafrica who benefitted from that. Now that I would say is a realistic thing. I can give you a second one from my days at Syntex. The price per month for an oral contraceptive was at that time around three dollars a month for an american woman, ok it is now ten times as much. At the time the same company, Syntex sold the same thing in millions of women units, twenty- a hundred units, to the US agents of international aid - USAID - at the cost of about twenty cents per woman. Well here is an example, and I think it is not an unusual one; to charge a much higher price to the affluent population and out of this profit they are willing to sell much larger quantities to the poor people at a price that was one tenth of that. Visualize that in a number of other diseases, after all why should the rich not pay for something? we are not right now supporting the poor people of the world very much, it used to be much more politically exciting.

-You earlier mentioned that perhaps in thirty years we would have a different Pill, one that would be taken only once per month or in much lesser doses, do you still believe that?

Less so, for only a reason that really is a play of mine 'The immaculate misconception', which has Broadway premiere tomorrow, the subtitle is sex in age of mechanical reproduction. And as I say in one or two of the chapters in the book, that we are going in the direction of sex and fertilization being separated, and if they are separated that men and women can and will store their gametes - their eggs and sperm, then of course they can get sterilized while they are young, and therefore contraception will not get a high priority anymore. It will be conception namely to be sure that we get children and qualitative children, and that bring us right back to the very first question that you asked me. Everyone wants to have the best and most wonderful child and what happens to the misfortunes? But I really think that higher tendency go towards conception and not towards contraception anymore, so to that extent I think there is even less and less work being done in the area of contraception.

I think we better call it quits my friend

-Ok, can I ask you one last question?

Yes

-Do you look upon the future brightly?

Well, after the 11th of September I would say no. Because that I think it really changed something quite fundamental in this world, and I don't mean inconvenience in terms of flying. I really think that this will be a conflict of an enormous order not just a war, but much more a conflict between cultures, and I see no easy solution to that and that will affect lots of things. I am not total pessimist, but I am a realist and don't think it is gonig to be fantastic, no.

Copyright © Rasmus Kragh Jakobsen