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Liberator Or 'Fix'? Even a Loose Cannon May Hit the Right Spot

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Liberator Or 'Fix'? Even a Loose Cannon May Hit the Right Spot autumn books one twentieth-century cartoon, more mean- careful placing of US experiences in an inter- nancy. American physicians’ fear of mal- ingful in the American context, again sug- national context provides a more suggestive practice suits raised important issues of gesting that gout is a financial boon to the treatment of social policy issues than ‘informed consent’ when prescribing oral medical profession. Watkins. contraceptives. Susan Sontag argued, at the height of the In 1951, the feminist American philan- Some American feminists also turned AIDS panic, that illness should be seen as a thropists Margaret Sanger and Katherine against the pill in the 1970s. They regarded it scientific category, not a cultural or moral McCormick commissioned the scientist as a technological ‘fix’ which did not address stigma. In their brief epilogue, Porter and Gregory Pincus to develop an infallible oral fundamental issues of oppression. Resenting Rousseau argue the contrary, that social contraceptive, intended to liberate women’s any form of birth control kept within the metaphors may enable the patient to cope sexual acts from anxieties about their ferti- jurisdiction of the medical profession, they with disease. The pain of gout was bearable lity. This stimulated other researchers to advocated the diaphragm and cervical cap as because of its excellent pedigree and its enter the field. In 1957, the G. D. Searle phar- barrier contraceptives that women could apparent promise of insulation from worse maceutical company began marketing personally administer. The identification in maladies. Yet the book also shows how regu- Enovid, ostensibly to treat gynaecological the 1980s of the sexual transmission of HIV larly, and erroneously, medical men believed disorders. Its anovulant and therefore con- led to a revival in the popularity of condoms. that they had understood this elusive com- traceptive properties became so well known, In the early 1990s, Norplant, a subdermal plaint. Underneath its fashionable phraseol- however, that by 1959 half a million US implant that releases a synthetic hormone ogy, which the reader will appreciate accord- women were using it. into the blood, and Depo-Provera, a hor- ing to taste, this entertaining book succeeds Contrary to widespread public and pro- mone injection with contraceptive effect, very well as an old-fashioned treatise on fessional beliefs, the contraceptive revolu- have become available in the United States. medical hubris. tion of the 1960s did not cause a sexual revo- However, further contraceptive innovations Anne Crowther is in the Department of Economic lution. As demographers analysed the con- are unlikely to be developed in the United and Social History, University of Glasgow, Glasgow traceptive habits of married women to docu- States. All but one of its pharmaceutical G12 8QQ, UK. ment the contraceptive revolution (the pill companies were scared out of contraceptive was unavailable to unmarried women in research and development in the 1980s by many areas until the early 1970s), sociolo- the intolerable litigiousness of American gists surveyed the sexual practices of unmar- society. Liberator or ‘fix’? ried women to depict long-term changes in On the Pill, which contains splendid illus- On the Pill: A Social History of Oral sexual behaviour, and journalists bas- trations, is, within its declared limits, an Contraceptives 1950–1970 tardized their findings to present their cari- admirable exercise in social history. It by Elizabeth Siegel Watkins cature of ‘the swinging sixties’. Yet years depicts the cultural and ideological pres- Johns Hopkins University Press: 1998. 202 pp. before Enovid, Alfred Kinsey and other sexu- sures on US medicine while demonstrating $25.95, £21.50 (pbk) al researchers had reported rates of pre-mar- why about 19 million American women still Richard Davenport-Hines ital sexual intercourse steadily rising since use the pill in 1998. the late nineteenth century. During the Richard Davenport-Hines is at 51 Elsham Road, In 1960, the US Food and Drug Administra- 1950s, the US marriage rate reached an all- London W14 8HD, UK. tion accepted the G. D. Searle pharmaceuti- time high, and the average age at which peo- cal company’s Enovid pill as an oral contra- ple married reached its all-time low; by 1959 ceptive. By the thirtieth anniversary of this almost half of brides were aged 18 or less. event, 80 per cent of US women born since Many did not want to be burdened immedi- Even a loose cannon 1945 had used contraceptive pills at some ately with children, but reliable contracep- time in their lives. The pill had been swal- tive information and technology was often may hit the right spot lowed as a daily routine by more humans unavailable. American puritanism flour- Dancing Naked in the Mind Field than any other prescribed medicine. The US ished then as now. In 1960, 30 states of the by Kary Mullis Ladies’ Home Journal declared on this union retained statutes prohibiting or Pantheon: 1998. 222 pp. $24 anniversary that the pill had “transformed restricting the sale or advertisement of con- Daniel S. Greenberg our lives” even more than “winning the right traceptives. Only in 1972 did the Supreme to vote”, while The Economist included the Court declare unconstitutional a Massachu- In addition to scientific immortality and a pill as one of the seven wonders of the mod- setts law prohibiting the sale of contracep- wad of cash, the Nobel Prize provides an ern world. tives to unmarried people. irrevocable licence to pontificate publicly on Elizabeth Siegel Watkins set herself the Watkins summarizes medical controver- any topic, relevant or not to the recipient’s tasks of testing these claims in her intelligent sies surrounding the pill’s safety. From the expertise. Winners at other great competi- and well-structured monograph, and of 1960s, medical studies linked the pill with an tions, for example, the Academy Awards and documenting changing perceptions of oral increased risk of strokes and breast cancer the Miss America contest, may assume an contraception from a “private vice” to a (although other studies reported that oral unrestricted right to mount the soap box “public virtue” and finally to an issue of indi- contraceptives protected against uterine and and pronounce on issues of the day. But, for vidual discretion. There is one drawback to ovarian cancers). The validity of these find- drawing a respectful, guaranteed audience, her approach. Her evaluation is exclusively ings has never been conclusively settled. no honour can match the Nobel Prize. And concerned, by her own admission, with “the Indeed, during the 1970s, the subject was no Nobel laureate comes close to Kary Mullis impact of the pill on middle-class American confused by an often sensationalist ‘media in the exercise of the accompanying pontifi- society”. In confining her researches to the blitz’, and mired by the intervention of indi- cal rights. United States, and by focusing on the experi- viduals who objected to ‘planned parent- Mullis earned a place in scientific history ences and practices of that nation’s more hood’ on religious grounds, or to sexually in 1983 as the inventor of the polymerase articulate citizens, her work can seem insu- independent women for other reasons. As a chain reaction (PCR), which quickly lar. Bernard Asbell’s The Pill: A Biography of result of these ‘health scares’, by 1988 almost became the indispensable laboratory tech- the Drug That Changed the World (Random half of US married couples relied on either nique for genetics research. For this achieve- House, 1995) is more journalistic, but his male or female sterilization to avoid preg- ment, he shared the 1993 Nobel Prize for 38 Nature © Macmillan Publishers Ltd 1997 NATURE | VOL 396 | 5 NOVEMBER 1998 | www.nature.com autumn books AP notes, “no door in the world will fail to open for you at least once. It is a free pass for the rest of your life” — even in the case of Mullis, self- Seeking certainty in described as “a loose cannon on the deck”. His recognition of the “at least once” lim- an unreliable world itation on doors opening for Nobel laureates The Golem at Large: What You is based on experience. Several years ago, Should Know about Technology Mullis was invited to lecture on PCR to the by Harry Collins and Trevor Pinch European Society for Clinical Investigation. Cambridge University Press: 1998. 155 pp. According to an indignant report by the out- £12.95, $19.95 raged president of that organization, Mullis’s Barry Barnes “only slides (or what he called his art) were photographs he had taken of naked women Of the many impressive texts that use case with colored lights projected upon their studies to convey ‘what you should know bodies”. The president added that, in about technology’, The Golem at Large is the remarks to the audience, Mullis “accused sci- clearest and simplest. The authors rework Mullis: as a Nobel laureate “no door in the world ence of being universally corrupt with wide- existing materials with great care to produce will fail to open for you at least once”. spread falsification of data to obtain grants”. a valuable introduction to their topic that is In a published warning to colleagues, the accessible to anyone. It is, however, necessary chemistry. Beyond that distinction, Mullis president declared that his society “will not to clarify just what that topic is. The case stands out for a number of reasons, includ- be inviting Dr Mullis to further meetings”. studies presented here are all controversies, ing behaviour that oscillates between merely For those who might be similarly offend- about the efficacy of technological artefacts, eccentric and obnoxious, and utterances ed by his words and slides, Mullis later or the adequacy of technical knowledge or that, when not loony, are reminiscent of the announced that for a minimum of $500 he advice.
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