THE OCCASIONAL HUMAN SACRIFICE

A striking account of medical malfeasance and the whistleblowers who have fought against it.

Though he graduated from medical school, Elliott, author of White Coat, Black Hat, never practiced and now teaches philosophy, including a course on scandals in medical research and those who blew the whistle. In Hollywood movies, whistleblowers often struggle courageously before crushing the villain. In reality, they generally lose their jobs, pay their own lawyers’ fees, and, blackballed within their profession, disappear into obscurity. Elliott’s account of a handful of experiments makes for fascinating yet painful reading. In every case, many participants disapproved but kept quiet. The author concentrates on those who spoke up, and it is not a pretty picture. He begins with the infamous Tuskegee study, which began in 1932. “For forty years,” writes Elliott, “the US Public Health Service had deceived and exploited hundreds of poor Black men with syphilis.” From the late 1940s through the 1980s at Willowbrook, the massive Staten Island institution for children with intellectual disabilities, researchers deliberately infected children with hepatitis on the excuse that they would have gotten it anyway. A 1960s Pentagon-financed study at Cincinnati Medical Center aimed to determine how much radiation American soldiers could withstand. All subjects developed radiation sickness, and many died. Perhaps the most grotesque researcher in Elliott’s harrowing narrative was Paolo Macchiarini, a charismatic, possibly psychopathic surgeon who became an international celebrity for developing a synthetic trachea that could replace one destroyed by cancer or infections. After years of fruitless whistleblowing, it finally became clear that the replacement trachea was worthless; all patients died after prolonged suffering. Elliott’s whistleblowers have a spotty record; many victories were partial or occurred long after the fact; some failed; none prospered from their efforts. “Whistleblowing is a poor mechanism for institutional reform,” he writes, and “full-blown success” is difficult to find.

A disturbingly eye-opening must-read.