Crazy Is As Crazy Does
Today was spent driving from the middle of Minnesota, from the little town of Austin, which I picked randomly when planning this trip. As I was checking out of the Holiday Inn I noticed a display case in the lobby. It was filled with every manner of promotional item for Spam one could think of. It seems that Austin is the home of that favorite pink canned meat we all grew up loving to hate. Spam is a product produced by Hormel Foods Corporation and is sold in 41 countries. It was introduced in 1937 as a way to push pork shoulder, which was not a particularly popular cut. The name is thought to be a contraction of spiced ham. It became widely used during WWII to feed soldiers on the go. Its color and gelatinous look when plopped out of its rectangular tin can have made it the butt of many jokes, including an entire Monty Python play called Spamalot. The truth is that if you fry up a modestly sliced piece of Spam, its quite a tasty breakfast meat with eggs. Anyone who like bologna has no reason to dislike Spam. Nonetheless, its always an amusing start to the day when you learn something like the fact that you have spent the night in the home of Spam.
Route 90 across Minnesota and South Dakota is a long, straight rolling hill expanse of Great Plains. Other than occasional wind generators, the only thing of note on that ride is Wall Drug in the town of Wall. Actually, the town of Wall is pretty much dedicated to Wall Drug. It’s one of those places that gets advertised on the highway for hundreds of miles in all directions. You almost can’t not stop for a visit. It must be good business because there were lots of people in Wall on a Tuesday and the variety of emporiums (all with the connection to Wall Drug) offered just about anything and everything you might want to buy on a cross-country trip.
I started a new audiobook today called Empire of Pain, the story of the Sackler family and its adventures in hooking the nation on Opioids like OxyContin. I figure I listened to about six hours of the book today and only really got through the life of Arthur Sackler, the oldest of the three Sackler brothers and the titular head of the family for most of the Twentieth Century. We haven’t even gotten to the invention of OxyContin yet, but rather focused on the megalomaniacal missions of Arthur as he “invented” the promotion of branded drugs through the creation and running of a kluge of businesses that focused on the creation, marketing, sale, distribution and exploitation of ethical drugs. It makes one really feel the misnomer of these pharmaceuticals as ethical. It is a fascinating story because it lays out the history of the medication of mental illness. Arthur and his brothers were physicians who focused on the psychological end of the profession. They seemed to start very honorably working at Creedmoor Psychiatric Center in Queens and disliking the use of electroshock therapy and the more invasive pre-frontal lobotomies that were the norm during the 1940s, the Sackler spearheaded the drive into pharmacological solutions to psychiatric problems. This began with Lithium and Valium and while the Sacklers didn’t hold any patents or even made the drugs, Arthur became the prime driver of the advertising and promotion of the drugs to the medical profession and made a fortune.
As fascinating as the history of the Sacklers has been so far, it is also more than a little upsetting to learn about the manipulation of the public in such a critical arena as healthcare and such an especially vulnerable and ubiquitous arena as mental health. When I learned about Bernie Madoff I was shocked by the scale and term of his ponzi scheme manipulations, but as a long-time Wall Street executive, the existence of such fraud was less than fully shocking. But not being a healthcare professional and generally being one of those Americans that tends to trust rather than doubt their physicians, the Sackler story was pretty eye-opening. It was like going into real estate development, as I did briefly after Wall Street, and seeing that the level of corruption and deceit made Wall Street look like the Cub Scouts. Now to learn that the same degree of fraud was underway in a critical area like big pharma was surprising. I am not surprised that big pharma tries to extract maximum profits on its patented “ethical” drugs, but the Sackler’s story brings this all to a new level. I am anxious to hear more of the book.
I turned the book off as we got into the Black Hills and approached our objective for the day, the Crazy Horse Monument in Custer, South Dakota. We spent a few hours at the visitors center and bothered to watch a movie on the history of this massive 500 by 600 foot stone monument that has already been seventy-five years in the making with another few decades yet to go. I last saw this monument in 2002 when I drove cross-country with a seven-year-old son Thomas. In those twenty years Crazy Horse has gotten his face finished and some of the horse head shaped. Crazy Horse’s face is 50% larger (87 feet high) than the faces of the presidents on nearby Mt. Rushmore (60 feet high) and it is fair to say that when it is finished, Crazy Horse will be far more impressive than Mt. Rushmore. Crazy Horse is the chief who led the Little Bighorn attack on General Custer, a bit of American history with very suspect intentions. The story of Crazy Horse is the story of the Sioux nation and other native Americans that were obliterated by American westward expansion, but it is also about the sculptor Korczak Ziolkowski, his wife Ruth, and their ten children and now their children. This Ziolkowski dynasty has dedicated itself to honoring the native Americans who lived in these lands for what is said to be thousands of years (the movie actually says hundred of thousands of years, but that doesn’t jive with my sense of human anthropology).
The striking contrast between a family like the Sacklers that over three or four generations have built great wealth and harmed countless people versus the Ziolkowski family that has dedicated itself to helping others is quite stark. The Sacklers took federal money several times to further their work even though they were suspect of government regulations. The Ziolkowskis have several times turned down federal funding for its long-term public service work, favoring instead raising funds at a granular level from all the Americans who travel to see their work in progress. Korczak simply did not trust the U.S. Government to do the right thing long-term for the native Americans. He was quite outspoken about saying that the government had proven time and again that it could not be trusted to do the right thing for those people.
The intentions of the government are suspect in all directions just like all people’s intentions are often suspect with regard for their intentions towards others. A family of physicians would generally be given the benefit of the doubt and in the case of the Sacklers, that would be misplaced. In the case of the Ziolkowskis, a family of South Dakotan artists probably should be suspect, and that too would be misplaced. The government is left to come down on OxyContin and it looks like they will continue to be kept away from the Crazy Horse Monument. Lots to keep us thinking, right? Just like Spam. I guess crazy is as crazy does.