In 2011 preparations for Lyn’s trial were in full swing but the outcome, naturally, was uncertain. All of the members of Lyn’s legal team were hopeful, even optimistic, but it would be an overstatement to say we were certain of victory. So in late 2011 Peter Gordon and his wife Kerri O’Toole began thinking about what they could do to ensure the Rowe family emerged with something even if the case failed. Their focus quickly fell on the old weatherboard house in Nunawading. Home to the Rowe family since 1954, it was now in a bad way. The floors had cracked and sloped. Yawning gaps had opened up between the skirting boards and the walls and floors. The back door was permanently jammed shut. The Rowes had never had the money to improve their home, and even maintenance was a stretch when any extra funds were spent on basic necessities for Lyn, like a specially fitted-out van. The house predated Lyn’s birth and had never been wheelchair-friendly. Thanks to the deterioration over the years, it was now exceptionally wheelchair-unfriendly.
Gordon talked with Melbourne-based building company Watersun Homes about an extensive renovation. Watersun took a look and its assessment was blunt: demolish it and start again. The home was simply too far gone to be saved. From that assessment grew a charitable push to build a new home for the Rowes. If that could be done, then even if the worst were to happen in court, the Rowes’ plunge into the legal system would not be for naught.
Watersun attacked the job enthusiastically. Soon it had persuaded dozens of its usual suppliers and tradesmen to pledge time, materials or expertise, and in many cases all three. Watersun’s designer worked closely with the Rowes and an occupational therapist to assess Lyn’s care requirements and make provision for modern aids and automation. Large sums of money were donated by some individuals—on the proviso of anonymity—to buy what could not be donated, including new furniture. These donors also covered the five months’ rent for the Rowes’ temporary accommodation.
In March 2012 the Rowes watched as their home of fifty-seven years was demolished. Lyn shed tears as the old house came down, the only home she had ever lived in. Over the next few months Lyn and her parents made frequent visits to the site as the new home began to take shape. A month after the demolition the slab was poured and by the end of April 2012 the frame for the new building was up.
At times the construction site had a community feel. The neighbours put on morning tea for the tradesmen, and the concreters wrote ‘Best wishes Lyn’ on the slab. In the rush and enthusiasm to get the job done, tradesmen went the extra mile. Landscape gardeners worked almost around the clock for three days, finally finishing the front garden late on a Sunday night, working in the glow provided by their truck’s headlights. In July 2012, just eighteen weeks after the old home was knocked down, the Rowes moved back in. The difference between old and new was enormous, a contrast highlighted by the fact that the address had not changed. ‘I feel amazed to be here,’ Lyn said after moving in. ‘I just wish everybody who worked on it could see how happy I am.’
Whereas the old home had no specific features for Lyn’s benefit beyond a retro-fitted hoist in the bathroom, the new home was fully twenty-first century. Ramps, a voice-controlled front door and extra-wide hallways and doorways catered for Lyn’s wheelchair. An expanded ceiling hoist system connected Lyn’s bathroom, bedroom and study. Cameras and monitors allowed Lyn to know what was going on in other parts of the home. Lyn’s bedroom and that of her parents were at separate ends of the house, giving them all extra privacy. Lyn’s quarters included a separate bedroom for an overnight carer, and a private entry. Of course with the court case still in progress, there were no funds for private care. To afford that, Lyn would have to win her case. And increasingly our attention had been turning to uncovering thalidomide’s Australian story.
In 1959 the men in charge at Distillers in London turned to Bill Poole to make thalidomide a bestseller in Australia. It must have seemed a sensible choice. Poole was a lawyer, a pharmacist and an Australian. And after many years in the UK, Poole was willing to return home.
He set up base just north of the Sydney Harbour Bridge, hired a sales team and set about putting thalidomide in every pharmacy and doctor’s surgery in the country. Thalidomide was Poole’s big chance, his ticket to success at Distillers, and he was not going to miss his opportunity. For two years he worked hard and impressed his bosses. But then disaster: in late 1961 Poole learned that a Sydney obstetrician suspected thalidomide was damaging babies. Horrified but undaunted, Poole rose to the occasion. He acted quickly and responsibly, withdrew the drug and assured the government, the media and his own employees that Distillers had acted with great care.
Poole is long dead, but that was his story. It is, however, a giant lie. The truth about Bill Poole—when it finally emerged—was one of the most stunning outcomes of our investigations. It reframed the way we viewed Distillers’ responsibility for the thalidomide disaster. Until then, Grünenthal appeared to Lyn’s legal team to have behaved far more outrageously than Distillers. But Poole’s behaviour went some way to balancing the ledger.
The fact is that at one of the critical moments of the unravelling thalidomide saga, Poole chose to put his career and profits above lives. Despite learning in mid-1961 that thalidomide might be killing and maiming babies, Poole kept selling more and more of the drug for almost another six months, including specifically for use in pregnancy and to obstetricians and maternity hospitals. When thalidomide’s deadly effect could be kept secret no longer, Poole realised he might be in deep, deep trouble. So he lied on an industrial scale to cover up his disgraceful behaviour: in writing to the Australian Government, to his colleagues, and to the media. He even lied on oath in court documents. Bill Poole lied and kept lying.
It is not known whether his bosses at Distillers in London knew the real story. Certainly they could easily have discovered it afterwards, and one has to wonder whether they did. But nobody in the inner circle blew a whistle. Poole’s behaviour was covered up. And the blame that should have been heaped on Distillers was deflected as a result.
The only witnesses to Bill Poole’s lies are now gone or very elderly. Distillers’ internal documents remain largely under lock and key. If Lyn Rowe had not decided to pursue the drug companies in 2011, Poole’s outrageous behaviour and the extent to which he and his bosses could have stopped the thalidomide death toll would never have been exposed.
Right from the start, Distillers was anxious to get a licence from Grünenthal to sell thalidomide in Australia and New Zealand. Distillers was a British company and the antipodean countries were very firmly part of the British Commonwealth. Distillers saw it as only right that it be given the chance to exploit thalidomide in the far-flung corners of the empire.
But starting in the late 1950s, Distillers’ entreaties were repeatedly rebuffed. Distillers persisted and finally, in early 1960, Grünenthal relented, granting Distillers the much-sought-after Australian licence, throwing in New Zealand as part of the bargain.
Under the agreement, concluded on April Fool’s Day 1960, Grünenthal insisted that Distillers hire at least twelve salesmen in Australia to promote thalidomide. Distillers also made an important concession. According to the original 1957 contract with Grünenthal, Distillers could have been manufacturing thalidomide at its factory in Speke, Liverpool. But it had never bothered to do that. Instead it had been buying raw thalidomide from Grünenthal which it mixed with other ingredients to make the finished medications. As part of the negotiations over the Australian licence, Distillers gave up the right to make its own thalidomide and agreed to keep buying it, thereby handing Grünenthal a financial windfall. The move also ensured that everyone who took a Distillers thalidomide pill in Australia (including Wendy Rowe)—or the UK or anywhere else Distillers exported its products—was swallowing Grünenthal-made thalidomide.
Relieved to have the licence, Distillers swung into action. A team was already on the ground in Sydney and soon an office-warehouse was established and staff hired. Senior Distillers employees arrived from London to train the Australian recruits. Thalidomide drugs had been dribbling into Australia for some time, but they were now shipped in bulk and stockpiled. Doctors were given advance samples and promotional material. In July 1960 all of the new sales staff were flown to Sydney and given a week of instruction in the art of selling. All was ready for the official launch in August 1960.
It was always clear to Lyn’s legal team that what went on in Australia in 1960 and 1961 was crucial. Our claim was in an Australian court, for an Australian woman whose Australian mother took the drug in Australia. Clearly events in Australia would loom large in the court case. We searched for the twenty or so people employed by Distillers in Australia in 1959–62, and after months of intensive effort managed to find a handful. Many had passed away. All of those we found were happy to speak with us. They offered us a priceless insight into what actually went on.
I found Phil Lacaze’s name on a fifty-year-old letter that the father of one of our thalidomide clients had kept. Lacaze had headed Distillers’ Melbourne sales team in 1961. Fortunately Lacaze is not a common name and there were only a few in the telephone directory.
I cold-called a P. Lacaze in a Sydney suburb one morning in March 2011. After introducing myself and warning that this was a very left-field call, I asked the man who had answered if he had ever worked in the pharmaceutical business. Yes, the man replied. Did he happen to work for Distillers in the early 1960s? ‘Yes.’ I launched into my prepared speech: ‘I’m a lawyer working for victims of the drug thalidomide…’ The man heard me out. ‘I’d be happy to talk to you,’ he responded. ‘I’m sure I have some useful information and I have a pretty good memory.’
A few days later I pulled up outside Phil Lacaze’s unit in a rented car after an early morning flight from Melbourne. Phil, then eighty-two, handsome and slightly stooped, welcomed me and ushered me inside, where I met Johnny, his wife of fifty-nine years. I had brought a good bottle of red wine as a gift, and a quiche for morning tea. But since neither drank, and both were on restricted diets for health reasons, my gifts fell a little flat. Then I found the pen in my pocket had leaked all over my shirt and in the ensuing slapstick the ice was broken. Unfussed, Johnny insisted I change my shirt (I had a spare) and quickly removed the stain.
In the months that followed I spoke regularly with Lacaze and met with him several times. Both he and Johnny, who died suddenly in June 2011, were welcoming and all too happy to help. Lacaze had studied medicine for several years before becoming a pharmaceutical salesman and had a deep knowledge of drug chemistry and the pharmaceutical industry in Australia. He was a man with an inquiring mind and was keenly interested in Lyn’s claim.
Lacaze only worked for Distillers in Australia for about a year, but fate dictated that it was the critical final year that thalidomide was on the market. Early on he told me he had spent the subsequent fifty years regretting having worked for Distillers.
Another salesman I tracked down, also in March 2011, was Hubert Ollyet Woodhouse, known to all as Woody. Woodhouse was eighty years old, and had spent the last twenty years of his career running his own pharmaceutical company before retiring in 2000. I visited him at the beautiful home in Sydney’s northern suburbs he and his wife Ursula had bought about forty-five years earlier. The house was perched high on a wide tree-lined street. At the bottom of the hill were picturesque sea baths where the couple’s three children had learnt to swim.
Woodhouse and Phil Lacaze had known each other only slightly in 1961, when Lacaze worked for Distillers in Melbourne and Woodhouse in the Sydney head office. In the aftermath of my meeting them, they arranged to have lunch, meeting for the first time in half a century. Both men were interested in Lyn Rowe’s personal story and empathetic about her circumstances. Both were willing to help Lyn and her parents by telling me all they could remember about the thalidomide operation in Australia. Woodhouse and Lacaze were delighted by our eventual success on Lyn’s behalf, and wrote warm personal notes to the Rowe family in the aftermath of the settlement. The litigation gods could not have delivered us two more willing witnesses, both of whom had front-row seats at crucial times during the thalidomide story.
Woodhouse was a charming man, fond of a good story and conversation. This, I soon realised, is a feature of many former pharmaceutical salesmen. It makes sense of course: salesmen rely on their charm and wit for appointments and sales. Woody, as he insisted I call him, initially seemed a little cautious. I had no problem with that. I was grateful that he was talking with me at all. Every potential witness I spoke to about thalidomide would have been entirely within his or her rights to say, ‘No thank you, not interested.’ Woodhouse did not do that. But he did seem to hold back a fraction.
I thought I knew why. Woodhouse had worked at Distillers headquarters in Sydney. I had seen documents revealing that in the late 1960s the German criminal prosecutors had tried to get a statement from Woodhouse to help in their prosecution of the Grünenthal executives. Woodhouse refused, on legal advice from his former employer Distillers. Obviously the German prosecutors thought Woodhouse might know something of value, and, I suspected, even all these years later that thalidomide would remain a somewhat painful topic. As it would for anyone intimately involved in selling it.
Woodhouse had started medicine at Sydney University in 1949, but after three years dropped out and entered the pharmaceutical industry. For five years he worked as a sales rep in Sydney and Adelaide, and then in April 1957 he and his wife Ursula moved to London. Ursula, an actress, had a role in the movie Robbery Under Arms, which had been part-filmed in South Australia and was to be completed at Pinewood studios in England. The couple had wanted to live overseas so they traded Ursula’s first-class return trip to London for two economy-class one-way tickets and pocketed the change.
After a few casual jobs in London, including selling soap, Woodhouse found work with the Distillers pharmaceutical offshoot, Distillers Company Biochemicals Ltd (DCBL) as an assistant in the sales manager’s office. Woodhouse looked after about eighty sales reps all over the UK, read their reports, highlighted anything interesting for the attention of the sales managers, and ensured the reps were kept supplied with drug samples and promotional literature. Woodhouse would later perform much the same role for Distillers in Sydney.
Woodhouse’s first brush with thalidomide came in early 1958, when Distillers started selling Distaval in the UK. In early 1959 Woodhouse left Distillers for another job, but soon afterwards he and Ursula started talking about returning to Australia. By now they had two children and were missing the Sydney sunshine.
So in early 1960, Woodhouse was delighted when he heard that Distillers was setting up an Australian arm. This was his ticket home. After an interview he was quickly employed as assistant sales manager in the Australian business.
The Woodhouse family arrived back in Australia in June 1960 and Bill Poole met them at Sydney airport. Ursula’s celebrity was such that their arrival home was noted in the newspapers. Woodhouse started work immediately at Distillers’ premises on Campbell Street in Artarmon, where the small staff featured some memorable characters.
Fred Strobl, a Czech fluent in five languages who claimed to have played water polo at the Olympics, was the national head of sales. Trading on his good looks and charm, Strobl had moved to Australia during the 1950s and after a series of jobs in the pharmaceutical industry was hired by Distillers. Strobl’s former colleagues at Distillers remember him as an entertaining charmer, a ‘cool customer’, according to Woodhouse. One of Strobl’s party tricks was to arrange dates with multiple flight attendants on short interstate flights.
In a career arc that is hard to believe, Strobl later became a famous film star. Two years after the thalidomide disaster was exposed, Strobl was holidaying in Bangkok when he was approached by a French film director. The director is said to have offered Strobl a career in the movies solely on the strength of his movie-star looks. ‘Why not?’ Strobl apparently replied. He subsequently adopted the more debonair nom-de-film Frederick Stafford, starred in a series of French action films and was dubbed the French James Bond. He also played the lead in Alfred Hitchcock’s Topaz and married the German film star Marianne Hold. Not bad for a former salesman whose biggest claim to fame until then had been promoting the most notorious drug of the century. Strobl’s acting was sometimes panned as wooden but he appeared in about twenty movies before his death at fifty-one, in a light plane crash in Switzerland in 1979.
Another big personality working for Distillers in Sydney, and almost universally disliked, was Walt Hodgetts, the senior New South Wales sales rep. Hodgetts was responsible for visiting the city’s leading medical specialists and the major hospitals. One former Distillers salesman remembered Hodgetts ordering him to steal drinking glasses from a city hotel where the pair were meeting. Hodgetts wanted them as a gift for his wife. Curiously, for a man reviled by his colleagues who took delight in sacking staff, Hodgetts later felt so overcome by guilt over thalidomide that he turned up at an early meeting of the afflicted families.
Hodgetts’ remorse had another outlet. In April 1963 he voluntarily presented himself at the German embassy and offered to give a statement for use in the German trial of thalidomide executives on the sole condition that Distillers not be told what he had done. A copy of Hodgetts’ statement is still in the Düsseldorf archive of the German trial papers. While an unpleasant man, known as a bully and a racist, Hodgetts does not appear to have been a liar, at least not about thalidomide. His various accounts of the thalidomide disaster often reflected poorly on himself and appear entirely truthful.
The Australian operation was only ever a sales office. There were no doctors or scientists on staff and any medical questions were referred to London, if indeed anyone bothered to refer them at all. Poole, Strobl, Hodgetts and every other member of the Australian team were focused on selling thalidomide. The company’s sales staff fanned out across Australia, visiting hospitals, doctors and pharmacists in cities and country towns alike, always spruiking Distaval as a new wonder drug, perfect for a wide range of maladies. Extravagant double-page advertisements in medical journals promoted the sensational and ultra-safe product. The first and most popular thalidomide drug was Distaval, a sedative and hypnotic, which also came in a stronger version, Distaval Forte. But the thalidomide range ultimately included Valgraine (for migraine), Asmaval (asthma), Valgis (headache) and Tensival (PMT).
The Distillers team in Australia was following the UK lead in promoting thalidomide as overdose proof and free of significant side effects. ‘This safety quality was its main selling point and contributed enormously to its popularity,’ Woodhouse remembered. ‘Our ticket into doctors’ surgeries,’ is how another former salesman puts it. The drug was also popular among Distillers staff. At least four salesmen in Australia and New Zealand ultimately suffered family tragedies as a result.
Soon Distillers was asking Australian doctors to run ‘trials’ with Distaval. These were essentially promotional gimmicks designed to introduce doctors to the new product and build sales. There was a further reason for the trials. Distillers’ Australian team was desperate to get Distaval onto the ‘free list’. Drugs judged vital in health care were ‘free listed’ by the Australian Government—placed on the Pharmaceutical Benefits Scheme, thereby attracting heavy government subsidies, which in practical terms meant increased sales. Australian trials and doctor testimonials would help Distillers persuade the Australian Government that a thalidomide subsidy was warranted.
But then during the second half of 1960, Distillers salesmen in Australia began approaching obstetricians and maternity hospitals, promoting thalidomide for use in pregnancy. The drug was now being aimed squarely at pregnant Australian women who were effectively, if unintentionally, being used as laboratory animals.
On 18 August 1960, Distillers sales manager Walt Hodgetts visited John Newlinds, the medical superintendent of the Crown Street Women’s Hospital, the biggest maternity hospital in Sydney, where almost five thousand babies were born every year. When we visited Newlinds in retirement at his outer-suburban Sydney home in 2011 his memory of the events of 1960 and 1961 was very clear, seared into place by subsequent developments.
Once installed as medical superintendent, one of Newlinds’ new duties was to meet the drug reps selling new products, and so it was that one Thursday morning Newlinds saw Walt Hodgetts about a drug called Distaval. ‘Hodgetts tried to persuade me of its value as a sedative generally and especially for use in pregnancy and labour. Certainly he said nothing about any significant side effects.’
Newlinds was not especially interested in Distaval as there were many satisfactory sedatives. ‘I agreed, however, to try Distaval. Hodgetts left me a large bottle of pills which I sent to the hospital pharmacy. I did not give Distaval much further thought in the months after this.’
Pregnancy was a lucrative market opportunity for the drug, and Distillers was just getting started. On 16 September 1960 Fred Strobl (the future movie star) and Hodgetts (the bully later consumed by guilt) visited thirty-three-year-old William McBride, a well-known obstetrician. McBride had a flourishing private practice and often delivered his patients’ babies at Crown Street. Distillers wanted McBride to adopt its drug, and, hopefully, write a positive report that could be used to boost sales. Hodgetts and Strobl gave McBride the prepared speech about how effective and safe Distaval was, and they handed over promotional literature and samples. The visit was a success. Hodgetts’ report noted that McBride had agreed to do a Distaval trial at the Crown Street Hospital.
That meeting set McBride’s life aboard a rollercoaster of adulation and bitter controversy. McBride would later be feted as the hero of thalidomide, and, later still, found guilty of doctoring the results of scientific experiments and stripped of his licence to practise medicine. But all that lay ahead. Within weeks of his meeting with the Distillers salesmen, McBride was enthusiastically dosing his pregnant patients with thalidomide, certain that it was relieving morning sickness. Why was he so taken by the drug? McBride offered one explanation in his autobiography, written during the 1990s as he attempted to repair his tattered reputation. He wrote that one of his pregnant patients had been vomiting non-stop for several days, to the point where he feared a miscarriage. On a whim McBride gave the woman a prescription for Distaval. The vomiting stopped, and McBride became perhaps the most prolific prescriber of thalidomide for morning sickness anywhere. As one journalist who interviewed McBride in the 1970s observed: ‘He was, by this time, handing it out like lollipops.’
McBride offered a further explanation for his initial experiment with thalidomide when I visited him at his home in Sydney in April 2013.
This [1960] was before the [contraceptive] pill and women did not have much control over whether they got pregnant. So a lot of the women I saw were either very distressed to be pregnant or really giddy with excitement. Some were worried they were going to lose the baby. In any event a lot of them had high emotions and that contributed to anxiety and nausea. So it stood to reason that an effective sedative or sleeping pill would work. It would calm them down and lower their emotions.
By modern standards that’s an odd view of morning sickness, but it was a very common approach at the time and McBride was far from alone. Whatever their reasoning, a lot of doctors used thalidomide for morning sickness. Some doctors were told it was useful for nausea by drug salesmen, some by other doctors, and some struck out on their own. No blame attaches to the doctors. Distillers and Grünenthal had both pitched the drug as a revolution in drug safety, so doctors felt reassured that it was fit for use in pregnancy. And both Distillers and Grünenthal clearly wanted pregnant women to take their drug.
McBride, meanwhile, had thoroughly embraced thalidomide. Believing it was the cure for morning sickness, he prescribed Distaval for scores of pregnant patients in 1960 and during the first months of 1961. McBride kept Distillers informed about his success with morning sickness, and Distillers salesmen began promoting the drug particularly for that use. On 9 May 1961, McBride wrote Distillers a note. ‘I have used your Distaval tablets for an extended period, both in the treatment of morning sickness and hyperemesis gravidarum [uncontrolled vomiting in pregnancy], and have found that it is extremely efficient in controlling these conditions.’ McBride added that he would be ‘only too pleased’ to support Distillers’ application to have the drug placed on the government’s pharmaceutical benefits scheme.
Distillers was delighted and Strobl responded with a note of his own. ‘[I] would like to take this opportunity to express our appreciation for your interest and cooperation. Should there be an occasion when we can be of service to you, please do not hesitate to contact this office.’
All very lovely. But even before McBride wrote his testimonial for Distillers, he had started to see the catastrophic consequences of his thalidomide ‘trial’. Five days earlier, on 4 May 1961, McBride had delivered a baby with malformed arms (the radius, one of the forearm bones, was absent in each arm), and a bowel without an opening. The baby died within a week. McBride had not previously seen this combination of malformations and justifiably assumed it was a random and thankfully rare occurrence.
Three weeks later, on 24 May 1961, McBride delivered another baby with almost identical malformations. That baby also died within days. And then on Thursday 8 June 1961, came the third of McBride’s babies with similarly devastating limb and bowel malformations: as with the two earlier babies, death soon followed birth.
Now McBride was seriously worried. Something was maiming and killing his patients’ babies. In McBride’s retelling of the story, he took the files home and spent the whole Queen’s Birthday long weekend puzzling over the cause. McBride has recounted how he pored over the medical literature, wondered whether radioactivity from a nuclear reactor in Sydney or polluted food could be the villain, and searched for signs in each of the mothers’ medical histories, before finally his gaze fell on Distaval, which he had prescribed in each of the cases. McBride examined the Distillers information about thalidomide, and read John Thiersch’s 1952 work on aminopterin, the cancer drug which had caused severe foetal malformations and had a superficial similarity to thalidomide. McBride then found a medical journal note about thalidomide’s damaging effect on nerves, before finally deciding, late at night in his study, that thalidomide must be the culprit. He went to bed confident he had cracked the riddle, and resolute about taking action the next day.
The story is no doubt an approximation of what actually happened. And McBride certainly deserves credit for an astute clinical observation. But the story raises several questions, not least about the notion later pushed by McBride and some of his allies that unmasking thalidomide and his subsequent research was a work of genius. ‘Make no mistake about it, there is a Nobel Prize hanging on this,’ McBride once wrote to a colleague.
For a start, McBride had not chanced upon thalidomide. He was trialling it on his patients at the request of a drug company. A doctor trialling a drug must above all be alert to any negative side effects. McBride had been enthusiastically giving heavy doses for morning sickness, starting in about September 1960. His patients receiving the drug started giving birth in about May 1961, delivering severely malformed babies at an astonishing rate. What had changed in McBride’s management of his pregnant patients? One thing: he was giving them large doses of a ‘trial’ drug. No wonder he noticed. And it’s a little surprising that, according to his recounting of the dramatic events of that long weekend, it took him so many hours of agonising to suspect thalidomide.
On the Tuesday after the June 1961 long weekend McBride visited Crown Street Hospital to talk with Newlinds, the medical superintendent. Newlinds himself had been growing increasingly concerned about the rising malformation rate at the hospital.
‘McBride told me he was certain that the drug Distaval was causing the malformations,’ Newlinds recalled.
He said it was the only common factor in the cases of the three malformed babies in May and June. He suggested that the drug was interfering with glutamic acid metabolism in the embryos. McBride appeared convinced. His explanations seemed reasonable, or more reasonable than anything I had heard or considered previously, and I respected his judgment. I knew that drugs could cross the placental barrier and that drugs could damage the embryo. It was also well known that the embryo was particularly sensitive during the first trimester of pregnancy.
Newlinds decided that he had to act, even though the evidence was not overwhelming. ‘Distaval was not a crucial drug—it did not save lives. This aspect should be stressed. The decision to withdraw a basic sedative in case it caused malformations, even if it was only a small chance, was easy.’ Newlinds telephoned Mrs Sperling, the hospital pharmacist, and told her that Distaval should no longer be used.
Then he and McBride discussed what further steps should be taken. ‘We agreed he would contact Distillers and tell them that Distaval had been withdrawn from use because we suspected it of causing malformations. I also understood that McBride would write to one of the medical journals with his suspicions. I was quite sure that Distillers would take action to withdraw the drugs while investigating McBride’s concerns.’
At some point that week McBride telephoned Distillers. For many years he thought he had spoken with Bill Poole, but when Bill Poole denied it, McBride said he just asked for the man in charge and assumed it was Poole. McBride says the man at the end of the telephone was sceptical that Distaval could be maiming and killing babies and told McBride that the drug had been on sale in Europe for years and nothing similar had been reported. The man told McBride that he would pass the concerns on to head office in London, but was not receptive to McBride’s suggestion that Distillers stop promoting the drug until his thesis had been checked.
This was the week starting Monday 12 June 1961. Across the world thalidomide sales had peaked and more (perhaps many more) than two thousand malformed babies had been born in Germany alone. About half of them subsequently died. The toll was rising fast in a dozen other countries as well. Yet the epidemic of death and injury had barely been noticed, and nobody had publicly connected it to thalidomide. Had McBride’s report quickly led to the withdrawal of thalidomide, at a bare minimum one thousand survivors alive today might have avoided their fate, as would a roughly equal number of babies who were either stillborn or died shortly after birth. Thousands of others who died in utero would have survived. The scale of the disaster would have been far smaller.
Lyn Rowe was one of the babies who could have been saved. Wendy Rowe took thalidomide in the last week of June or the first week of July in 1961. Had Distillers taken McBride seriously in early June 1961, immediately got the word out to the medical profession, including Wendy Rowe’s doctor, and withdrawn the drug, Lyn Rowe would have been born with normal, functioning limbs. Her life and the lives of her family would have been radically different.
But nothing happened. Nobody at Distillers got back to McBride. The drug remained on the market. McBride has claimed that he took a second step in June 1961 to get the warning out. He said he posted an article briefly outlining his concerns to the prestigious British medical journal, The Lancet. Sadly, McBride said, The Lancet wrote back, rejecting his article.
McBride’s claim angered The Lancet’s deputy editor Ian Munro, who vehemently denied it. Munro claimed the journal had never received any such letter from McBride and therefore, obviously, had never rejected it. McBride could produce nothing to prove he had written to The Lancet. It is impossible to know with certainty where the truth lies, but in view of McBride’s later troubles, there has to be a question mark over his account.
After telephoning Distillers, and possibly writing to The Lancet in London, McBride decided he had done enough to raise the alarm. He did not try to contact Distillers’ London headquarters, nor did he contact any Australian medical journal. He does not appear to have warned other doctors to stop using the drug. Instead he started testing his thesis on laboratory animals at the Crown Street Hospital by force-feeding Distaval to pregnant mice and guinea pigs.
McBride was not a scientist, certainly not a teratologist, and did not really know what he was doing. He had only a small number of test animals, not even enough for a control group. That meant he couldn’t compare litter numbers between dosed and non-dosed groups, or look for resorption sites (certain drugs, including thalidomide, reduce the litter size in some laboratory animals by killing a number of the foetuses, leading to their resorption into the placental lining). All he was able to do was stuff Distaval into pregnant animals and then look for malformations in their offspring. He found none, and as his experiments wore on he began to wonder about the accuracy of his theory.
But on 6 July 1961, prior to doubt setting in and while still convinced that thalidomide was a killer, McBride bumped into the Distillers sales rep Walt Hodgetts on a Sydney street. He asked Hodgetts to walk with him to his surgery. Once there he told Hodgetts that he believed Distaval was causing shortened limbs, internal malformations and other injuries in babies, problems so severe the babies had subsequently died. McBride told Hodgetts that thalidomide drugs should be taken off the market.
Hodgetts was shocked. He told McBride he would immediately report the matter to his company. Later that day he wrote a report of the meeting for his bosses, somehow turning McBride’s three dead babies into four.
I interviewed Dr W. G. McBride…this is what he said: ‘I have discovered that Distaval is the answer for morning sickness. When the early symptoms of nausea come I can stop the vomiting…I have had 4 deaths at birth in the last 8 weeks. One baby was born with 6 fingers, one with fingers joined together, one with malformed toes but all four died from intestine collapse. I studied all four case histories of the mothers and there was nothing abnormal. The only common thing I found was that all four had received Distaval for morning sickness. I am now waiting for this next two weeks to seek any further information, with my fingers crossed. I would like some 100 mg for myself and I want this information confidential as I have a responsibility to myself. I know Distaval is not indicated for morning sickness but it is not contra-indicated.’ They were his words to me.
Hodgetts later said that on arriving back at the office that day, he told Fred Strobl about McBride’s report and then the two of them went to see Bill Poole. Hodgetts’ memory, years after the event, was that Poole telephoned Ernie Gross, Distillers’ senior employee in Australia, to report the potential disaster. Hodgetts then left, confident he had done his duty. Later Poole denied on oath that Hodgetts ever said a word to him about McBride at that time. Poole would forever claim that Hodgetts kept McBride’s terrible news to himself, or maybe shared it with Strobl. Had he known, Poole claimed, he would have responded immediately.
What is clear is that throughout the second half of 1961 Distillers in Australia kept promoting the drug: including specifically for morning sickness.
Phil Lacaze joined the company in early 1961 and was given the standard company sales pitch. ‘Distaval was safe at any dosage. I was told that people who had tried to commit suicide by taking an overdose of Distaval woke after a long sleep feeling physically well.’
Not long after starting with Distillers in Melbourne, Lacaze was told by the Sydney office to start pitching Distaval as a morning-sickness drug. ‘[Strobl] told me that Dr McBride in Sydney had trialled Distaval on patients with morning sickness and had had great success. He suggested that we promote Distaval as a morning-sickness drug—in addition to its other indications. I thought that was a ridiculous suggestion, and I told Strobl I thought it was a ridiculous suggestion.’
Lacaze, who had studied medicine for three years, said he thought ‘one doctor’s feedback’ did not give an acceptable basis for promoting Distaval for morning sickness, and he refused to do so. Decades later when we interviewed him Lacaze was happy to concede that his refusal was not as a result of safety concerns. ‘In Melbourne we promoted Distaval as a safe and effective drug, including to obstetricians and GPs for use in pregnant women. But so far as I was aware we did not promote it specifically for use in cases of morning sickness. There was no medical basis for doing that.’
Meanwhile McBride’s experiments with animals during the middle of 1961 wore on and none of his mice or guinea pigs gave birth to malformed offspring. And among his patients, the expectant mothers to whom he had prescribed thalidomide also gave birth to healthy babies. McBride began to wonder about his thesis. Was he missing something? But then in September two more of his patients gave birth to babies with malformations very much like the May–June babies. McBride sought advice from Professor Roland Thorp, a renowned pharmacologist at Sydney University who was unconvinced by McBride’s thesis and wanted more evidence.
McBride’s recounting of what he did next has varied. He has said he telephoned Distillers in Sydney in October and adopted a tougher line, demanding action. While there’s no independent proof of that, it is certain that on 14 November 1961, McBride spoke to another Distillers salesman, described the malformations and somewhat angrily said he had already reported the matter to the company but nothing had been done. That salesman went back to headquarters and reported his conversation to Poole.
Woodhouse takes up the story: ‘Poole told me I should arrange to go and see McBride and get further detail about his cases of injured babies and the connection with Distaval.’ Woodhouse spent a couple of hours with McBride, who was happy to cooperate. ‘When I got back to the office I talked with Poole and put together a fairly detailed report. It mentioned six injured babies all of whom died shortly after their births.’ The report was mailed to London. Poole apparently did not think the report important enough to telephone his bosses. Woodhouse’s report reached London just as Widukind Lenz in Germany was reporting multiple thalidomide injuries and deaths to Grünenthal. ‘Within a week or so Poole got word back from London that we were to stop selling thalidomide pending the results of investigations into whether thalidomide really did cause birth defects,’ Woodhouse said. ‘We stopped selling thalidomide drugs immediately.’
So that’s the Distillers story in a nutshell. McBride’s June–July 1961 report of malformations got stuck with one or two irresponsible salesmen. McBride then laid low. It was not until October–November 1961 that McBride made another effort to bring his concerns to the attention of the Australian branch. This time Poole learned of McBride’s fears. He performed, via Woodhouse, a quick investigation, reported the concerns to London, and the drug was withdrawn from sale.
Except that’s not at all what happened.