Pandora's Lab: Seven Stories of Science Gone Wrong

by Paul A. Offit

Six thousand years ago, the Sumerians discovered a plant called hul gil, “the plant of joy,” which gave birth to a drug that now kills 20,000 Americans every year. More young adults die from this drug than from motor vehicle accidents. In 1901, a German scientist performed an experiment that revolutionized the food industry. A hundred years later, an editorial in the prestigious New England Journal of Medicine stated, “On a per calorie basis, [this product] appears to increase the risk of heart disease more than any other macronutrient.” The Harvard School of Public Health estimated that eliminating it from the American diet would prevent 250,000 heart-related deaths every year. In 1909, another German scientist invented a chemical reaction that won the Nobel Prize, allowed us to feed more than seven billion people across the globe, and unless we do something about it, will probably end life on this planet. In 1916, a New York City conservationist wrote a scientific treatise that caused Congress to pass a series of draconian immigration laws, enabled the forced sterilization of tens of thousands of American citizens, and provided a scientific rationale for Adolf Hitler to murder six million Jews. Echoes of this treatise can be heard today when politicians like Donald Trump denounce Mexican immigrants, calling them “rapists” and “murderers.”

In 1935, a Portuguese neurologist invented a surgical cure for psychiatric disorders that won a Nobel Prize, took only five minutes to perform, caused President John F. Kennedy’s sister to be permanently disabled, and is now a subject of horror films. Remnants of this dangerous quick-fix procedure can be found today in promised cures for one of the most common psychiatric disorders of childhood: autism. In 1962, a popular naturalist—the mother of the modern environmental movement—wrote a book that led to the ban of one particular pesticide. The prohibition was hailed by environmental activists but feared by public health officials. Their fears were well founded; as a consequence of the ban, tens of millions of children died needlessly. In 1966, with the power of two Nobel Prizes behind him, an American chemist elevated the word “antioxidant” into the pantheon of can’t-miss marketing terms. Unfortunately, those who have followed his advice have only increased their risks of cancer and heart disease. Worse, he gave birth to an industry whose harm can be found today in the sudden need for liver transplants in Hawaii or in the strange onset of masculinizing symptoms in women in the Northeast.

ALL OF THESE STORIES ARE UNITED by a myth that dates back to 700 B.C.—the myth of unintended consequences. Zeus, angry that Prometheus had stolen fire from the gods, was intent on punishing mankind. So he gave a marvelous jeweled box to Pandora—its contents, a secret. When Pandora opened the box, which she had been warned not to do, a stream of ghostly creatures representing disease, poverty, misery, sadness, death, and all manner of evil escaped. Pandora closed the box, but too late. Only hope remained. Science can be Pandora’s beautiful box. And our curiosity about what science can offer has allowed us, in some cases, to unleash evils that have caused much suffering and death. In one case, it probably sowed the seeds of our eventual destruction. Because these stories start at the beginning of recorded history and extend to the present day, the lesson of Pandora’s box remains unlearned.

FOR EACH OF THE SEVEN INVENTIONS that follow, we’ll analyze how their deadly outcomes might have been avoided. Then, in the final chapter, we’ll apply what we’ve learned to modern-day discoveries such as e-cigarettes, chemical resins, autism cures, cancer-screening programs, and genetically modified organisms (GMOs) to see if we can distinguish a scientific advance from a scientific tragedy in the making, to see whether we have learned from our past or have once again opened Pandora’s box. The conclusions, no doubt, will surprise you.

it was a relatively unknown physician named Diagoras of Melos who was the first to realize that many of his fellow Greeks had become hopelessly addicted to the drug. As a consequence, he became the first person in history to argue against its use, declaring that it was better to suffer pain than to become addicted to opium. His warnings have been ignored for the last 2,500 years.

OPIUM FIRST MADE ITS WAY TO China in the seventh century A.D., where it was used primarily for medicinal purposes, although sometimes it was added to sweets and cakes. At first, opium was a pleasant distraction. But when the Portuguese brought the smoking pipe to China, everything changed. Chinese citizens couldn’t get enough of the drug. In 1660, British-owned companies shipped 1,350 pounds of opium from India to China; by 1720, 33,000 pounds; and by 1773, 165,000 pounds. About three million Chinese citizens were addicted. In response, the Chinese government banned opium smoking. It didn’t work. By 1839, the British were exporting a startling 5,600,000 pounds. At least 25 percent of the Chinese population was addicted to opium; in some regions, the addiction rate was as high as 90 percent. Chinese society was on the verge of collapse. In response, the Chinese government pleaded with British officials to stop exporting opium from India. When they refused, Chinese officials, desperate to end the massive epidemic of addiction and crime that had overtaken their country, took the next step. In 1839, Commissioner Lin Tse-hsu seized and destroyed 2,600,000 pounds of British opium. War ensued. Between 1839 and 1860, China and Britain fought two Opium Wars. China lost both times. As a consequence, China had to open more ports for opium importation, pay Britain $21 million in reparations, and cede Hong Kong to British rule (which, by treaty, wasn’t returned to China until 1997). Ev...

Opium addiction became so widespread and so perverse that in 1875 San Francisco city officials passed the Opium Den Ordinance, prohibiting public smoking of opium. Other cities followed. Then, the United States government stepped in. In 1909, Congress passed the Opium Exclusion Act, banning importation. But it was too late. Many Americans were already addicted to the drug. And, as reflected by a new American lexicon, people addicted to opium were no longer sympathetic figures. They were called junkies, because they often sifted through junkyards to find salable items.

In 1914, the United States Congress passed the Harrison Act, forcing doctors to register and maintain records of all narcotic prescriptions. (In addition to relieving pain, opium is a narcotic, a word derived from the Greek narkoun, meaning “to make numb.” All narcotics, by definition, suppress the central nervous system, causing drowsiness, stupor, and occasionally coma.) In 1919, the U.S. Supreme Court extended the act, making it clear that doctors were prohibited from prescribing narcotics to maintain an addiction. Almost a hundred years would pass before doctors were held accountable for violating this law.

ALTHOUGH OPIUM WAS CLEARLY addictive to individuals and destructive to society, its pain-relieving properties were undeniable. No other drug could match it. Scientists were desperate to find a way to retain opium’s analgesic properties while jettisoning its addictive properties. In the early 1800s, a young German chemist became the first to try. In 1803, Friedrich Sertürner, a 20-year-old chemist’s apprentice, isolated opium’s most abundant and most active ingredient. He named it morphium after the Greek god of dreams: Morpheus. Later, the name was changed to morphine. Sertürner never trained at a university, never earned a degree, had no professional standing, made his own laboratory equipment, and tested the effects of his newfound product on the only person he could find to do it: himself. A shy and solitary man, this remarkably young chemist’s apprentice would soon change the face of medicine. Sertürner found that morphine was about six times more powerful than opium, causing almost immediate euphoria followed by depression and dependence. When he finished his studies, he was addicted to the drug. Worried that he had created a monster, Sertürner warned, “I consider it my duty to attract attention to the terrible effects of this new substance I called morphium in order that calamity may be averted.” Sertürner’s warning went unheard. By 1827, the German pharmaceutical company Merck began mass-producing the drug. European doctors soon prescribed morphine for a variety of ...

In 1898, Bayer launched their new drug, calling it heroin. Aspirin, which physicians worried might cause gastritis, could be obtained by prescription only. Heroin, which was believed to be much safer, could be purchased over the counter.

In 1924, Congress passed the Heroin Act, making manufacture and sale of the drug illegal. As a consequence, heroin went underground. In the 1920s and early 1930s, heroin’s principal distributors were mobsters Meyer Lansky, Dutch Schultz, and Legs Diamond. (Because all three were Jewish, heroin was often called “smack,” from the Yiddish word schmecher, meaning “addict.”) In the mid-1930s the Italian Mafia took over, specifically, Charles “Lucky” Luciano, who established the “French connection.” Opium grown in French Indochina or Turkey was shipped to Lebanon where it was converted to morphine and then shipped to the French port city of Marseille where it was processed into high-quality heroin and smuggled into the United States.

Initially, heroin abuse was confined to a poor, urban underclass. By the 1940s, however, heroin addiction had spread to the Harlem jazz scene, and by the 1950s—through the writings of Jack Kerouac and William Burroughs—to the beat generation. By the mid-1960s, more than 500,000 Americans were addicted to heroin. Virtually all major U.S. cities, as well as countries like Britain, France, and Germany, were caught in heroin’s snare. The U.S. government took action, pressuring Turkey to stop producing opium and eliminating importation of heroin from France. (This success was dramatized in the 1971 movie The French Connection, starring Gene Hackman and Roy Scheider.) By the 1970s, opium production had moved to an area in the highlands of Laos, Thailand, and Burma (now Myanmar), known as the Golden Triangle. No group suffered this switch in opium production more than American soldiers in Vietnam, about 15 percent of which became addicted to heroin. In the summer of 1971, President Nixon declared an “all-out war on drugs.” “America has the largest number of heroin addicts of any nation in the world,” he said. “If we cannot destroy the drug menace in America, then it will surely in time destroy us.” Nixon chose Elvis Presley to be the public face of his war on drugs. Ironic, given that at the time of Presley’s death in 1977, Valium, methaqualone, morphine, codeine, and barbiturates were found in his bloodstream. Presley wasn’t the only celebrity to die from a drug overdose: Janis ...

SCIENTISTS HAD HOPED that morphine could treat opium addiction. Then they had hoped that heroin could treat morphine addiction. It was time to try something else. Again, they would synthetically modify a drug to separate pain relief from addiction. And again, they would fail. This time, spectacularly. To find the next wonder drug, scientists turned to another component of opium: thebaine, named for Thebes, a town in ancient Egypt where the opium poppy was grown. The first synthetic version of thebaine was produced in 1916 by two German chemists working at the University of Frankfurt. They called it oxycodone.

On April 20, 1948, Cicely Saunders, a nurse, joined St. Luke’s Hospital for the Dying in East London. Saunders believed that patients with terminal illness shouldn’t have to spend their last few weeks crying out in pain. Rather, they should die a dignified death—one as pain-free as possible. Saunders reasoned that it was better to prevent pain than to treat it. So, in 1967, she founded the hospice movement, providing dying patients with large quantities of addictive, pain-relieving medicines. Saunders’s movement crossed the ocean. In 1984, the United States Congress passed the Compassionate Pain Relief Act, making it legal to treat terminally ill patients with heroin. In 1986, Wisconsin launched the first state-based pain management program for cancer patients. Other states followed. For many patients suffering from terminal illnesses, vigorous pain management was a godsend. But a door had now been opened for doctors to prescribe long-term, high-dose narcotics. Initially, use was limited to patients with terminal cancer. Then a respected doctor from New York City took the liberal use of narcotics one ill-fated step farther.

IN LATE 1995, at the same time that Russell Portenoy was urging American physicians to get over their fear of painkillers, the FDA approved Purdue Pharma’s timed-released version of OxyContin. Purdue’s sales force promoted the drug for the treatment of lower back pain, arthritis, trauma, fibromyalgia, dental procedures, broken bones, sports injuries, and pain resulting from surgery. In other words: everything. And they constantly repeated Portenoy’s mantra that less than one percent of patients would become addicted to the drug. In 1996, more than 300,000 prescriptions for OxyContin were written for a net profit to Purdue Pharma of $44 million. Realizing it had created the right drug at the right time, Purdue doubled its sales force, offered coupons for a free 7- to 30-day supply of the drug (34,000 coupons were redeemed), increased its yearly advertising budget to $200 million, and paid $40 million in incentive bonuses. In 2001, Purdue reaped $1.45 billion from the sale of OxyContin, the highest retail sale of any named pharmaceutical product, including Viagra.

Doctors took advantage of the OxyContin gold rush, selling prescriptions for money or sex. Dr. Randolph W. Lievertz of Indianapolis wrote more than $1 million in prescriptions paid for by the state’s Medicaid program; $130,000 of that total was written for one female patient who was part of a drug ring that sold OxyContin on the street. To honor the prescription, the woman would have had to ingest 31 tablets every 12 hours instead of the one tablet recommended by the manufacturer. Lievertz wasn’t alone. Pill mills sprang up across the country. One eastern Kentucky doctor saw 150 patients a day, writing prescriptions for painkillers after spending less than three minutes with each patient. Florida alone was home to hundreds of these facilities.

Doctors were arrested and charged with manslaughter and murder. Some were jailed. No case, however, drew more national media attention than that of Dr. James Graves, a 55-year-old Florida physician who was charged with manslaughter in the overdose deaths of four of his patients. Graves’s prescription mill was widely known among addicts. “The word spread that he was the go-to doctor to get pills,” said Russ Edgar, the assistant state attorney. Edgar argued in court that Graves had bragged that writing prescriptions for painkillers was a “gold mine” because he had rarely examined patients and didn’t have to fill out medical records. Edgar also claimed that Graves had ignored the pleas of pharmacists and parents to change his prescribing habits. Indeed, Graves’s parking lot often resembled scenes more commonly found at sporting events. Patients would eat, work on their cars, and give each other high-fives when they emerged with their OxyContin prescriptions. “You’ve got to realize something’s wrong when outside your office people are having tailgate parties,” said Edgar. During the trial, Edgar argued that, “Mother after mother after mother called the defendant’s office and asked him to quit giving their children drugs or they would die. The defendant did not quit and they continued to overdose.” Graves countered that no one would have died if patients had simply used the drugs as prescribed. And he railed against the prosecutor, whom he considered ungodly, telling the judge,...

In 2012, 12 million Americans aged 12 and older reported the recreational use of prescription painkillers; 16,000 of those users died from overdoses. Painkillers were now the most widely prescribed class of drugs in the United States; every 19 minutes someone died from an overdose. (OxyContin overdoses were indistinguishable from overdoses of opium, morphine, or heroin, all of which suppress the rate and depth of respiration. Patients breathe as few as four times a minute; blood pressure begins to drop, body temperature falls, and the skin becomes cold and clammy. Because the brain isn’t getting enough oxygen, the patient seizes and eventually dies from respiratory failure.)

Few insurance companies did much to discourage abuse. Before OxyContin burst onto the scene, chronic pain was treated with a combination of psychotherapy, biofeedback, exercise, and physical therapy. The goal was to leave the painkillers at the door. Although several studies had showed that this multidisciplinary approach to relieving pain worked just as well if not better than chronic drug use, the fact remained that the drugs were less expensive than the therapies. Unfortunately, many insurance companies encouraged the drugs. At best, this was shortsighted. Workers who took high doses of painkillers were out of work three times longer than those with similar injuries who took lower doses of the drugs.

ON MAY 10, 2007, Purdue Pharma, along with three company executives, pleaded guilty to one count of “misbranding” OxyContin. The court ruled that Purdue had minimized risks, made unsubstantiated claims, and failed to include clear warnings about how, under certain conditions, the drug could be fatal. Just as Bayer had continued to market heroin when it was evident that the drug was causing harm, Purdue had been slow to inform the public about the potential dangers of OxyContin. The three executives were fined $34.5 million (which Purdue paid), barred from working for any company that sold medical products for the next 12 years, and required to perform 400 hours of community service in drug-treatment centers. Purdue also paid an additional $634 million penalty. Many of the parents whose children had died from OxyContin were present during the sentencing. “Our children were not drug addicts; they were typical teenagers,” said one woman, whose 19-year-old son had died. “We’ve been given a life sentence.” Judge James P. Jones, who presided over the trial, said he would have liked to have sent company executives to prison, but was bound by the plea bargain.

On March 15, 2016, the Centers for Disease Control and Prevention (CDC) finally offered guidelines for the sensible use of prescription painkillers, stating that doctors should prescribe them: (1) only after nonprescription painkillers like ibuprofen and physical therapies had failed; (2) in quantities not to exceed a three-day supply for short-term pain and rarely longer than seven days (typically, patients are given two weeks or a month worth of pills); and (3) only when improvement was significant. The guidelines did not apply to patients who were receiving painkillers for cancer or end-of-life treatment. The American Academy of Pain Management—a group that receives funds from Purdue and Teva Pharmaceuticals—and the Washington Legal Foundation, which frequently represents pharmaceutical company interests in court, opposed the new guidelines. After all, painkillers were now a $9 billion a year industry. Robert Twillman, executive director of the academy, didn’t like the three- to seven-day dosing recommendation. “The numbers are still arbitrary,” he said. But Tom Frieden, director of the CDC, had had enough. “For the vast majority of patients with chronic pain,” he countered, “the known, serious, and far too often fatal risks far outweigh the transient benefits. We lose sight of the fact that prescription opioids are just as addictive as heroin.” Today, 80 percent of the world’s opioid prescriptions are written in the United States, even though only 5 percent of the worl...

In the early 1900s, most people died from bacterial and viral infections. But, during the 20th century, advances like antibiotics, vaccines, safer drinking water, and purer foods have allowed us to live about 30 years longer—long enough to die from heart disease. To understand why, we first need to understand what makes the heart so vulnerable. The heart is a muscle that, like any other muscle, needs the constant flow of blood, which supplies oxygen. Two major arteries, called coronary arteries, do this. If either of these arteries is blocked, then blood flow is disrupted, causing damage to the heart muscle and occasionally sudden death (that is, a heart attack). When researchers studied these blockages, they found cholesterol, a substance made by the body that is an essential component of cell membranes. They also found triglycerides, the main constituent of body fat. Doctors would eventually call the disease atherosclerosis, literally meaning “hardening of the arteries.”

During the next 20 years, three major studies involving 300,000 people and costing about $100 million determined the relationship between dietary fat and heart disease. The answer: There wasn’t any.

Ancel Keys and the McGovern committee had been wrong about dietary fats because they had assumed that all fats were the same. They hadn’t accounted for the different types of fats, specifically, saturated fats, unsaturated fats, cis fats, and—most important—trans fats. In the years that followed, Americans would pay a high price for their ignorance.

TO UNDERSTAND WHAT TRANS FATS ARE, let’s go back to our description of an unsaturated fat. In the diagram below, look at the carbon atoms shown in bold. The hydrogen atoms connected to those two carbon atoms are both on the same side. This is called being in the “cis configuration.” Cis, in Latin, means “on this side of.” When both hydrogen atoms are on the same side, they repel each other, causing a bend in the molecule. This bend makes it harder to stack one molecule on top of another. Molecules that don’t stack well are hard to crystallize or, said another way, they are hard to make into a solid. As a result, cis unsaturated fats are invariably liquid oils, like canola and sunflower oils.

Sometimes, as shown in the example on this page, the hydrogen atoms of an unsaturated fat are on the opposite side. Now the hydrogen atoms are said to be in a trans configuration. Trans, in Latin, means “on the other side.” When hydrogen atoms are on the opposite side, the molecule is straight. Now it’s much easier to stack one molecule on top of another. Molecules that stack neatly and tightly are easy to crystallize, converting a liquid into a solid. That’s why common vegetable shortenings, even though they are made of vegetable oils, stay solid in a can on your kitchen shelf. For the most part, large quantities of trans fats are not found in nature. They are created when hydrogen atoms are purposely added to unsaturated vegetable oils, a process called hydrogenation. The end product is typically referred to as a “partially hydrogenated vegetable oil.” The designation partially means that the product isn’t completely saturated or, said another way, is still unsaturated. It also means that the product is loaded with trans fats.

Americans first became aware of unsaturated fats containing large quantities of trans fats in the 1980s. But in truth, these products were actually born more than a hundred years earlier in the form of one of America’s most popular cooking products.

For many reasons, the partially hydrogenated vegetable oils containing trans fats in Crisco were superior to every other cooking oil or shortening ever invented: (1) Trans fats are more stable when exposed to oxygen, so they have much longer shelf lives than animal fats like butter; (2) trans fats burn only at extremely high temperatures, so cooking oils don’t cause much smoke and don’t need to be changed as frequently—a godsend to any employee who works all day over a fryer; (3) trans fats have a neutral flavor, so they don’t interfere with the taste of any food; (4) trans fats look so much like butter that they can easily replace it; and (5) trans fats are extraordinarily cheap. Starting in the 1930s, they were made from oils left over from crushing soybeans used to make animal feed. Finally, because of their variations in texture, structure, lubrication, and aeration, semisolid fats like Crisco allowed bakers to make cakes fluffier, cookies crumblier, crackers crispier, pies flakier, chicken crunchier, and croissants more delicate.

By pummeling companies that used tropical oils like coconut and palm oil and animal fats like butter—all of which were high in what were believed to be evil saturated fats—CSPI and NHSA had inadvertently caused Americans to use a far more dangerous product: trans fats. Suddenly products like margarine, which contained 25 percent trans fats, became the “healthy alternative.” By the early 1990s, tens of thousands of products were made using partially hydrogenated vegetable oils. Because they were cheap, kosher, and promoted as heart-healthy alternatives, they flew off the shelves.

Unlike studies of total fat, total cholesterol, and unsaturated fats—where findings had been contradictory or inconclusive—no researcher has ever published a paper showing that trans fats are anything other than one of the most harmful products ever made. As researchers got better at understanding that not all unsaturated fats were the same, the problem with trans fats became painfully clear.

So, in summary, neither saturated fats nor certain types of cholesterol are necessarily bad for you. Trans fats are a different story. Not only do trans fats dramatically increase vLDL, the worst kind of cholesterol, but they also dramatically decrease HDL, the helpful cholesterol. For that reason, in 2006, an article in the New England Journal of Medicine declared, “On a per calorie basis, trans fats appear to increase the risk of coronary heart disease more than any other macronutrient.”

WHEN HEALTH ADVOCATES THOUGHT cholesterol or total fat or saturated fats increased the risk of heart disease, they simply launched public relations campaigns to inform consumers. Trans fats, on the other hand, were so clearly dangerous that their presence in foods launched government efforts to ban them. It started in Europe. On January 1, 2004, Denmark introduced legislation to restrict trans fats to no more than 2 percent of the total fat in any food. Consumption of trans fats fell from 4.5 grams a day per person in 1975 to 2.2 grams in 1993 to 1.5 grams in 1995 to almost 0 grams by 2005. By 2010, the incidence of heart disease and related deaths in Denmark had dropped 60 percent.

If products contain less than 0.5 gram of trans fats, the FDA allows manufacturers to claim 0 grams of trans fats on the nutrition label. Because many products contain slightly less than 0.5 gram of trans fats, it’s still possible to consume more than the 2-gram limit of trans fats a day set by the American Heart Association. For example, crème-filled sponge cakes contain 0.46 gram of trans fats but are listed as having 0 grams on the label. And microwave popcorn, which contains 0.25 gram of trans fats, also is listed as having 0 grams. Trans fats are also still contained in some brands of margarines and coffee creamers. And they’re still contained in Berger cookies. The key to avoiding the problem of hidden trans fats is to look for the phrase “partially hydrogenated vegetable oil” on the nutrition label.

Perhaps Madison Grant’s most cynical alliance was with Marcus Garvey, an African American. Garvey wanted blacks to take pride in their race, pride in their accomplishments; he didn’t want them to feel compelled to assimilate into society. Garvey condemned interracial marriage, preached racial purity, and yearned for an African homeland. By 1920, when blacks were routinely being lynched in the South, Garvey’s Back-to-Africa campaign had two million members. Where Marcus Garvey sought a homeland for men and women who were treated poorly because of the color of their skin, Grant sought deportation of what he believed to be a subspecies of humans who were poisoning the gene pool. The eugenics movement produced no pairing sadder than this one.

Francis Galton, Charles Davenport, Harry Laughlin, Madison Grant, and Adolf Hitler all shared several features: All were, by their definition, Nordic; all believed that Nordics should procreate freely while non-Nordics should be prevented from procreating; and all were childless.

When Lillian Hellman refused to participate in Senator Joseph McCarthy’s communist witch hunt in the 1950s, her letter to the House Un-American Activities Committee contained a now famous quote: “I cannot and will not cut my conscience to fit this year’s fashions.” Hellman’s comment should serve as a warning for all those who try to shoehorn scientific evidence into their cultural or political biases—advice that, as we’ll discuss in the last chapter, remains unheeded today.

Those inspired by Silent Spring had spared mosquitoes from the killing effects of DDT. But they hadn’t spared children from the killing effects of mosquitoes.

In the 16th century Paracelsus, a Swiss physician and philosopher said, “the dose makes the poison.”

In 1942, about 30 years before Pauling published his book on vitamin C, a group of researchers from the University of Minnesota published a study in the Journal of the American Medical Association of 980 people with colds, finding that vitamin C did nothing to lessen symptoms. After Pauling published his book, and largely in response to its popularity, researchers at the University of Maryland and the University of Toronto and in the Netherlands performed several studies of volunteers who had been given 2,000, 3,000, or 3,500 milligrams of vitamin C a day for the prevention or treatment of colds. Again, large doses of vitamin C were found to be useless. Because of these and other studies, not a single professional medical, scientific, or public health organization recommends vitamin C for the prevention or treatment of colds. Unfortunately, it’s been hard to unring the bell. Once Pandora’s box is opened, you cannot put anything back inside; once Americans had become convinced that vitamin C was a wonder drug, there was no going back. Then Linus Pauling doubled down, claiming that vitamin C also cured cancer.

When anybody contradicted Einstein, he thought it over, and if he found he was wrong, he was delighted, because he felt he had escaped from an error.

PAULING’S ADVOCACY GAVE BIRTH TO a vitamin and supplement industry built on sand. Evidence for this can be found by walking into a GNC center—a wonderland of false hope. Rows and rows of megavitamins and dietary supplements promise healthier hearts, smaller prostates, lower cholesterol, improved memory, instant weight loss, lower stress, thicker hair, and better skin. All in a bottle. No one seems to be paying attention to the fact that vitamins and supplements are an unregulated industry. As a consequence, companies aren’t required to support their claims of safety or effectiveness. Worse, the ingredients listed on the label might not reflect what’s in the bottle. And we seem to be perfectly willing to ignore the fact that every week at least one of these supplements is pulled off the shelves after it was found to cause harm. Like the L-tryptophan disaster, an amino acid sold over the counter and found to cause a disease that affected 5,000 people and killed 28. Or the OxyElite Pro disaster, a weight-loss product that caused 50 people to suffer severe liver disease; one person died and three others needed lifesaving liver transplants. Or the Purity First disaster, a Connecticut company’s vitamin preparations that were found to contain two powerful anabolic steroids, causing masculinizing symptoms in dozens of women in the Northeast.

Don’t be blinded by reputation. Every claim, independent of a scientist’s reputation, should stand on a mountain of evidence. No one should get a free pass.

Pauling counted on the “Wizard of Oz” effect to promote his belief that vitamins and supplements were miracle drugs. He hoped that people would ignore the little man behind the curtain (his lack of data) and pay attention only to the booming voice that came with having won two Nobel Prizes. Similarly, Rachel Carson was seductive because she was a dynamic storyteller: the most trusted science writer in America. Like Linus Pauling, Russell Portenoy’s claim that oxycodone could offer pain relief without addiction and Walter Freeman’s claim that lobotomies could cure psychiatric illnesses were persuasive because both men were respected members of the medical and scientific community. They were convincing because they wore the badge of academic success, not because they had reproducible data showing that they were right. Finally, Peter Duesberg’s claim that HIV wasn’t the cause of AIDS or Luc Montagnier’s claim that bacteria caused autism were granted full public hearings because both men were brilliant, highly acclaimed virologists. The point is that all scientists—no matter how accomplished or well known—should have unassailable data to support their claims, not just a compelling personality, an impressive shelf of awards, or a poetic writing style.

The GMO controversy reached its illogical end in 2015, when New York Assemblyman Thomas J. Abinanti introduced Bill 1706, banning all genetically modified vaccines. Not surprisingly, most vaccines are genetically modified. If not, then people would be injected with the “natural” bacteria or viruses that caused the disease. For example, by genetically modifying poliovirus, we’ve eliminated polio from the United States and from much of the world. Vaccines have to be genetically modified.

In 2011, a review of studies in people found no evidence that low doses of BPA caused harm. The reason that studies in rodents had found that BPA had caused problems was that the rodents had been injected with BPA; injection bypassed the liver, which typically inactivates BPA within five minutes. When rodents were fed BPA instead of being injected with it, those given 40, 400, or 4,000 times the typical human exposure remained healthy.

Animal studies can also be misleading for another reason: They can show that something is valuable even when it isn’t. For example, early studies of a vaccine to prevent HIV were promising in experimental mice and monkeys. But studies in people have been far less promising. “Mice lie and monkeys exaggerate,” says University of Pennsylvania vaccine researcher David Weiner.

Desperate to do something, anything, to cure the incurable, we continue to punish the afflicted.

These hospitals had wrongly assumed that the harm from a thimerosal-containing hepatitis B vaccine (which was theoretical at best) was greater than the risk of getting hepatitis B (which wasn’t theoretical at all). Within a few years of the removal of thimerosal from vaccines given to young children, seven studies showed that it hadn’t caused harm. The only harm had come from elevating a theoretical risk above a real risk.

It’s not hard to understand how this could have happened. Mercury is never going to sound good. (There’s no such thing as the National Association for the Appreciation of Heavy Metals.) Large quantities of mercury have clearly been shown to cause harm. Indeed, environmental mercury contaminations caused by a chemical spillage in Minamata Bay, Japan, or by fumigating grain in Iraq damaged hundreds of babies and fetuses. Mercury, however, which is present in the Earth’s crust, is hard to avoid. Anything we drink that’s made from water on this planet (including breast milk and infant formula) will contain small quantities of mercury. These small quantities of mercury aren’t harmful. Only large quantities are harmful. If small quantities of mercury were harmful, we’d have to move to a different planet. Of interest, the quantities of mercury contained in vaccines were far less than those contained in breast milk and infant formulas. And mercury isn’t the only heavy metal to which we are routinely exposed. We all have trace quantities of metals like cadmium, beryllium, thallium, and even arsenic in our blood. But at quantities far less than those required to do harm. Unfortunately, we seem incapable of learning the most important lesson in toxicology: The dose makes the poison. For example, if people drink several gallons of water quickly (as has occurred during fraternity hazings), they might exceed their body’s ability to hold onto the mineral sodium. As the level of sodium in...

During the past 50 years, doctors and scientists have proven that some cancers can be prevented. Sunblock can prevent skin cancer. The hepatitis B virus vaccine can prevent the most common cause of liver cancer. The human papillomavirus vaccine can prevent the only known cause of cervical cancer. And cessation of cigarette smoking can prevent a common cause of lung cancer. The results of these four strategies are clear. The definition of cancer, however, is changing—and not for the better. Medical textbooks 20 years ago defined cancer as a “disease the natural course of which is fatal.” No longer. Now we detect cancers that aren’t fatal—the kind of cancers that you are more likely to die with than from. In the process of detecting these nonfatal cancers, we are probably doing more harm than good. Gilbert Welch, a professor at Dartmouth Medical School, offers the best analogy to our current dilemma. It’s a barnyard analogy. Imagine, writes Welch, three animals in a barn that are trying to escape: a bird, a turtle, and a rabbit. When you open the door, they will escape at different rates. The bird, which will invariably fly out before you have time to close the door, is analogous to the kind of cancer that will kill you no matter what you do. Even if you detect the cancer early, it doesn’t matter—you’ll die from it anyway. It’s just too aggressive. The turtle, which is so plodding that it will never effectively escape, is analogous to a cancer that is so slow growing, so non...