Eternally Newborn

I have no patience for the much-repeated quote about the way that people who don’t learn history are doomed to repeat it. Everyone is doomed to repeat history; we move in cycles, doing the same things over and over again, and nothing is ever new.¹ But knowing something about the past spares you some surprises. People who lack a connection to the world that came before them constantly wake up on the shores of a new world, blinking into the light and wondering what’s happening. Like wars and shit, man. Wow.

Viruses, pandemics, vaccines, and the pharmaceutical industry aren’t new.² So it hurts to see people being surprised by predictable events. I’m reading — and you should read — Patrick Radden Keefe’s new book Empire of Pain: The Secret History of the Sackler Dynasty, a history of the family-owned pharmaceutical company that gave the world Oxycontin. Let’s politely say that Keefe and I arrive at the story with, how would one put this, different ideological priors, so a well-reported story frequently descends into some remarkably naive surprise over the fact that people in government, which is good, failed to adequately regulate the behavior of a private corporation, which is bad and controlled by greed.

In Keefe’s story, FDA officials give rapid and underexamined approval to pharmaceutical products, sometimes allowing drug fact sheets to be written like they’re marketing pamphlets and sometimes giving speeches about how excited they are, as regulators, to see brilliant new drugs coming to market; then, and you’ll never believe that this comes next, the FDA officials either go on to get lucrative jobs at the same pharmaceutical companies, or make hundreds of thousands of dollars through backdoor arrangements for consulting and publishing royalties. Gasp and double-gasp, for sure.

Inside pharmaceutical companies — which, I stipulate, make helpful products that save lives, but hold on a minute — Keefe describes the efforts of executives to massage clinical trials to minimize the negative, accentuate the positive, and produce background “research” material that makes for good sales and marketing:

So now we’re shocked — shocked! — to discover that the available COVID vaccines have side effects that are discovered after distribution because they weren’t well-studied in clinical trials, and deaths among test subjects were underreported, and the clinical trials were conducted with questionable techniques, and anyway you can’t see the full trial data for, I don’t know, fifty-five years or so?

All of this is normal. All of this is established practice. But anyway, gasp!

Meanwhile, the emerging evidence suggests with growing clarity that the available COVID vaccines may develop negative efficacy — they appear to make recipients more susceptible to infection and illness than the unvaccinated. This is, again, a shocking and outrageous claim, and don’t try to say any of this on Twitter, because they don’t allow misinformation, you absolute Nazi monster. But vaccines can develop negative efficacy, and have. Some vaccines — some — fail and backfire:

This is why people who believe in science — not performatively, but actually — don’t take a vaccine until the thing has been thoroughly tested for a long period of time.

We’re surprised to find ourselves here:

Why?

1. Sorry ‘bout that

2. If one more goddamn corporation sends me one more goddamn marketing message about “these unprecedented times,” I’m going to strangle someone with my own intestines, and we’ll die together in a puddle of blood and yesterday’s lunch. We at Pudding Co. know that pudding can be a comfort as we struggle to survive in these unprecedented times, so try the butterscotch. It was worse last year: somber music, images of suffering, fade out on close-up of product. But still.