Julian Sancton - 'Madhouse at the End of the Earth'
An extremely wild and entertaining adventure about humanity, life, and death. Men, huh?
Patrick Radden Keefe’s book prior to this one is Say Nothing: a True Story of Murder and Memory in Northern Ireland, one of my favourite non-fiction books in recent years. This book differs very little in quality as it is written by an astute writer and analyst, one who cares about humanism and the written word in equal amounts.
So, what’s this book about? It deals with the advent and the legacy that is left by the start of the Sackler family. The book details widespread wealth, hate, greed, lies, death, divorces, possibly millions (!) of pages of legal documents, and an opioid epidemic that has lasted for decades and killed tens of thousands of people.
Mary Jo White sometimes observed that one thing she loved about the law is the way it forces you “to distill things down to their essence.” The opioid epidemic was an enormously complex public health crisis. But, as Paul Hanly questioned Kathe Sackler, he was trying to distill this epic human tragedy down to its root causes. Prior to the introduction of OxyContin, America did not have an opioid crisis. After the introduction of OxyContin, it did.
The Sackler family had OxyContin made, which is one of the best-selling so-called painkillers that is both legally and illegally available in the USA.
This book could easily be written all guns blazing, out to cover the evil billionnaire Sackler family with a coat of black paint and no nuance. Keefe instead chose to write a well-balanced and rhythmically beautiful book that kept me interested. You know Keefe will deliver something of high quality.
Reading one of his books is the equivalent of visiting an old relative that you love: even though you kind of know the gist of how they’re going to say something, it’s the trip that really delivers.1
This is a fairly straight-forward chronological tale of how a man, Arthur Sackler, built a fortune by using his outstanding advertising skills to drown his competition in a variety of scams and a also ation as the result.
Sackler did everything to make money and increase his wealth. In his halcyon days, he grew Pfizer’s sales force from eight to 300 people.
Arthur felt as if he had seen the future, and it was a future in which drug companies and drug advertisers would bring fantastic innovations to the public—and make a lot of money at the same time.
He made people believe that he was in fierce competition with another advertising company while he actually already controlled it. He hired Jewish people and, when they wanted to leave the company, scared them by saying nobody else would hire Jews. In short, he had no morals and just wanted more: in short, he was a greedy dick.
He marketed Librium, a minor tranquilizer, to enormous success, until Valium came around. Don’t worry, he made Valium happen as well.
Initially, Librium was the most prescribed drug in America, until it was overtaken by Valium in 1968. But even then, Librium held on, remaining in the top five. In 1964, some twenty-two million prescriptions were written for Valium. By 1975, that figure reached sixty million. Valium was the first $100 million drug in history, and Roche became not just the leading drug company in the world but one of the most profitable companies of any kind.
Sackler marketed both drugs which made him very rich. But there were clouds above: the drugs were naturally addictive, but this was solved by Sackler, who solved the matter by roping in doctors that were used as pawns.
They could develop a drug, have it clinically tested, secure favorable reports from the doctors and hospitals with which they had connections, devise an advertising campaign in their agency, publish the clinical articles and the advertisements in their own medical journals, and use their public relations muscle to place articles in newspapers and magazines.
This is a maddening story to read, yet one that is entirely predictable in most ways. There are ups, there are downs, but even though the precipice is there to see for consumers, it’s not visible for the Sacklers, who hawked their way through life without any care for consequences bar for themselves.
I mean, they didn’t and don’t even care much for each other. Greed is the word.
Arthur Sackler collected so much antique Asian art that he could match collections of most international museums. When he found that he didn’t have room for it, he simply donated a lump sum of money to a museum and had them store it. He also donated another batch of money to have the second floor of the museum named The Sackler Gallery. This was the start of the Sackler family’s try to make themselves look respectable via the artistic merits of others.
Keefe does a good job at serving the reader bite-sized paragraphs; Every one nearly works on its own legs, in the sense that they are well-written in the extreme and deal with one specific thing. This is commonly seen with journalists, and Keefe is one. He pieces together a massive puzzle of a family that goes from rags to riches, through death and utter despair, constantly deceiving others, and not giving a rat’s behind about who they kill. They even kill their own and those around them.
The despair isn’t really theirs, to be honest: if somebody dies, it’s not you who dies.
It was a hot July morning. Tourists strolled by on their way to the Metropolitan Museum, and dog walkers and weekend joggers passed as they headed into Central Park. Then Perez heard a noise from above, the sound of breaking glass, then a much louder, closer sound as something heavy landed on the sidewalk. The impact was so intense that it sounded like a car crash. But when Perez looked over, he saw that there was a body on the sidewalk. It was Bobby Sackler. He had fallen nine stories. His head had cracked open on the pavement.
For an instant, everything stood still. Then Perez heard a telephone ring. It was the front door phone. When he answered, he heard the voice of Muriel Sackler. “My son jumped out the window,” she said. “He broke the window with a chair.” She was distraught. She asked Perez, “Do you think he’s dead?” Perez looked at the body. There was no question. “I’m sorry to tell you,” he stammered. “He’s dead.” Perez hung up the phone. A crowd had gathered. People were stopped in their tracks, staring. The police were on the way. Somebody found a blanket and Ceferino Perez placed it, like a shroud, over Bobby Sackler.
Reading the book, I couldn’t help feel sorry for the Sackler family. Here they were, wealthier than most people on Earth, while completely oblivious to the damage they’d make. No, not really. They weren’t oblivious. It was all there in front of them. They just chose to ignore it.
Then they made OxyContin, a morphine pill, which increased their wealth from hundreds of million of American dollars to the billions.
Richard was a kid who - via one of the Sackler family trusts - bought a New York hospital and had it refurbished into one of his private residences.
Born into extreme wealth and affluenza, Richard went off to make more money than Arthur, his uncle, could have dreamt of making. And Richard didn’t want to share more than he had to.
There’s so much in this book that make a head spin. Stories of how the Sackler family tried to cover up their knowledge of the damage that OxyContin could do, even before releasing it onto the American population.
There are so many stories that point to the family’s blatant and cynical view of money. Too bad, for them, that it’s easy for emotionally undamaged people to so easily spot how greedy people work; Still, that doesn’t safeguard us from morphine.
Keefe masterfully shows how people fight against this epidemic. How Nan Goldin, the artist, succumbs to OxyContin for years, only to return, get well, and start fighting the Sacklers. It’s breathtakingly inspirational. Keefe describes how entire families are killed by OxyContin, how cities are affected, while the Sacklers profit near-infinitely from it. For a while. Until their true legacy caught up with them.
Here’s a magnificent excerpt from the book and I include some videos that the book mentions. This is from the latter part of the book and shows how the Sacklers cherished the public perception of them far more than the truth.
The late-night host Stephen Colbert did a segment on the Sacklers, joking that they had amended the Hippocratic oath to “First, do no harm. Unless harming is incredibly profitable.” He displayed a photograph of Richard, Jonathan, Raymond, and Beverly, “seen here not giving a fuck.”
John Oliver, of the satirical news program Last Week Tonight, also aired a segment on the family. The long-standing invisibility of the Sacklers “feels deliberate,” Oliver mused. He pointed out that Richard Sackler never gave interviews. But the litigation was providing “glimpses of the depths of Richard’s involvement.” Oliver mentioned Richard’s leaked Kentucky deposition, and he articulated a subtle point: because only the transcript had leaked, and not the video, it was difficult to do much with the deposition on the nightly news. How do you illustrate words on a page? The show devised a diabolically creative solution. [Oliver enlisted a series of prominent actors to deliver dramatic renditions of Richard’s deposition and correspondence}(https://www.sacklergallery.com).
The actor Michael Keaton, with an indifferent scowl, reenacted the moment when Richard was sent an article saying that fifty-nine people from a single state had died from overdoses, and responded, “This is not too bad.”
Bryan Cranston, who played the meth kingpin Walter White in Breaking Bad, delivered a rendition of Richard’s speech at the OxyContin launch at the Wigwam.
Michael K. Williams, who played Omar Little in The Wire, offered a third interpretation, his features twisted into a bloodless grimace.
And a fourth actor, Richard Kind, did a comedic send-up of all the many times Sackler replied to questions about his company and his own conduct with the words “I don’t know.”
Oliver told viewers that he had set up a website, sacklergallery.com, where they could watch more of these clips. He’d chosen the web address, he said, because “they love having their name on fucking galleries.”
The family had learned, in advance, that Last Week Tonight was preparing a segment. Mortimer’s wife, Jacqueline, panicked. In an overture to the producers, representatives for the family suggested that Jacqueline would like to meet with John Oliver personally, to plead her case. But Oliver did not generally meet with the subjects of his program, and declined to take the Sacklers up on this offer.
Jacqueline sent an irate email to others in the family. “This is my son’s favorite show,” she wrote. “He watches it every week with all of his friends. This situation is destroying our work, our friendships, our reputation and our ability to function in society. And worse, it dooms my children. How is my son supposed to apply to high school in September?” Like her husband and others in the family, Jacqueline felt a vivid sense of persecution, an angry conviction that she and her relatives were being made to suffer.
“I’m done having our family serving as the nation’s punching bag for problems that existed long before OxyContin and will exist long afterwards,” she wrote. “I have yet to see ANYTHING illegal or even immoral that this company has done.” This vilification was a “punishment” that was “being handed out to every man, woman and child, past present and future for an entire family,” Jacqueline Sackler proclaimed. “Lives of children are being destroyed.”