Bad Company
For decades, Johnson & Johnson was one of the most trusted brands in the world. The maker of bandaids and baby shampoo, its name was associated with care for our health and our bodies and, more importantly, for our children. Even when in 1982, one of the company's best-known and most widely-used products, Tylenol, was found to have been tampered with, resulting in the deaths of at least seven people in the Chicago area, Johnson & Johnson seemed to emerge from the scandal unscathed. Indeed, its reputation was even burnished as, according to the repeatedly-told tale and the subject of so many business school case studies that hailed it as a model of "ethical capitalism," Johnson & Johnson quickly added, at some expense, the anti-tampering packaging we now find on all pill bottles. The company actually ran the investigation into the poisoning, incidentally, so no surprise, it found that its own operations bore no responsibility for people's deaths. Within several years of the cyanide scare, Tylenol had not only regained but exceeded its initial market share, as the dominant over-the-counter analgesic – and also as the most dangerous over-the-counter medicine, with Johnson & Johnson resisting warning labels to that effect all along the way.
No More Tears, the new book from The New York Times's health reporter Gardiner Harris, explores, as the subtitle suggests, "the dark secrets of Johnson & Johnson," blowing a giant hole in the mythology surrounding the company's supposedly good behavior – in the Tylenol case and beyond.
Again and again and again and again, Johnson & Johnson has released products that it knew were dangerous (and refused to remove from the market those that it learned were harmful): it knew there was asbestos in its baby powder, and it knew that asbestos and talc were carcinogenic; it knew that its anti-psychotic drug Risperdal caused weight gain in children and increased the likelihood of strokes in the elderly; it knew that its new hip implant was likely to fail; it knew that its opioid Fentanyl was highly addictive; it knew that its birth control patch Ortho Evra contained estrogen levels that far exceeded allowable levels. It knew and it still pressed its pills and procedures into the hands of doctors and patients.
Johnson & Johnson is just one company but surely representative of an entire industry – a company, an industry that is not adequately regulated and that clearly refuses to regulate itself. Harris's book is a thorough and devastating indictment not just of J & J but of the entire American healthcare system, in clinics and hospitals, in prescription and over-the-counter medications, in home health and beauty products. The book showcases how corporate greed affects product development, how corporate marketing influences not just consumers' purchases but doctors' prescriptions, how corporate funding shapes science, and how corporate lobbying constructs and stymies government regulation.
It's Harris's insights into the latter that are particularly damning, as I think most Americans (at least until recently) have believed that "good science" leads to "good products." They have trusted the FDA to evaluate the science and the products and to keep them safe – to only allow products on the market that "work" and to pull from shelves those that are dangerous, those that don't. But not only does the FDA's regulatory power not function as most people imagine (almost half of the agency's funding comes from the fees that the industry pays for its services), "the sad truth is that the FDA ignored, enabled, or encouraged every Johnson & Johnson disaster in this book,” as Harris writes.
All of this has proven a real challenge to address, even more so now that we find ourselves in a political moment where the anti-science and anti-regulatory forces are quite literally in power. But to move forward (and bless his heart, Harris does end the book with a list of suggestions for how we do so), we should start by recognizing why people have lost faith in scientific expertise and in government regulation. Companies and governments lied (and lied repeatedly); people suffered and died. People are right to be angry.
According to Harris, "few companies in American history have had a wider gap between their public reputation and their actual conduct than J & J — a gulf it bridged with enormous advertising budgets, ingenious public relations campaigns, and massive piles of money."
But I can think of a few more, namely the tech companies that have spent the last few decades infiltrating the classroom, spending vast amounts of money to promote their products to teachers and administrators and students, successfully convincing the public that doing so is an act of magnanimity not marketing. Google. Microsoft. Apple.
And I'd argue that, as with the incorrect assumption that the FDA ensures that unsafe products never make it to market, too many people believe in error that the technology products that are used in schools "work" – that they're well-researched and well-tested... and that that research that occurs before these products are placed in front of students is unbiased, not designed or funded by the industry itself.
Must as we have continued to have faith in Johnson & Johnson – despite all the evidence to the contrary – many of us still believe these tech companies are committed to improving our lives, to making us healthier, happier, smarter; that their products are not just scientifically beneficial (medically, educationally) but absolutely necessary.
Honestly, I'm not sure how anyone can argue with a straight face that what Silicon Valley offers is good for children, good for schools, good for the planet, but again just as Harris chronicles with J & J, the industry's advertising budgets are immense, its psychological manipulations pretty extraordinary. Something about that weird smell of baby powder, that weird thrill of operant conditioning, that weird appeal of new gadgetry – it all makes people coo fondly at these products rather than say "damn, this is some cancerous shit that does not actually solve any problem at all."
