Cornered (19 page)

In his mouse house, Little had a marvelous opportunity to conduct similar experiments of his own, which in retrospect could have been of enormous value to society. Instead, short of funds and near retirement at the age of sixty-five, he was persuaded to take another route. He sold himself to the tobacco companies, as their chief scientific administrator and spokesman. Over the years he performed brilliantly for them. Whenever the question of the link between smoking and lung cancer arose, as it did more frequently and more persuasively year after year, Little would counter the statistical evidence with his “constitutional hypothesis,” leaving the public, as the tobacco companies had planned, with a lingering doubt as to whether lung cancer had any direct link to smoking.

The problem in those days with the constitutional hypothesis is the same as today; it's partly right. Medical-science research indicates that the differences in vulnerability to cancer are partly genetic, appear to be partly nutritional, partly chemical, and partly psychological (stress causes breakdowns in the body's immune system, leaving it more vulnerable to cancer growths). In insisting, in his day, on a genetic solution to the exclusion of others, Little was perverting his own hypothesis and using it as a mantra to shield his tobacco-company paymasters from another more obvious scientific fact—that though there are genetic differences in vulnerability, cigarette smoking is dangerous and does cause lung cancer and heart disease in many, if not most, people.

But Litttle's simple and oft-repeated message was that some smokers, even the heavy ones, never got cancer at all even though they lived to a ripe old age when cancers were more prevalent. So, how could smoking be a factor? Confused by the conflicting advice, millions continued the habit, even as others took it up and the lung-cancer rate soared.

Little's dictum placed a formidable legal roadblock in the way of lawyers seeking damages for smokers with lung cancer. When the smoker and his lawyer blamed the cigarette, the tobacco companies would simply say, “Prove it.” And the plaintiffs' lawyers couldn't. There was no scientific “proof” as such; no researcher had identified the chemical or biological agent in tobacco smoke that actually caused tumors to develop. The human medical evidence was only statistical: people who smoked were more likely to get cancer of the lung than people who did not. And the more they smoked the more likely they were to develop the disease.

Little would perform his mission with a zeal that matched the most ardent protesters of the antismoking movement. He even reversed a lifetime's belief in the significance to man of experiments on laboratory mice, agreeing with those who said that the data showing tobacco tars caused cancer in mice were not relevant to humans.

Faced with the conflicting and confusing evidence, jury after jury in tobacco-liability suits concluded that there was, indeed, a reasonable doubt that smoking could cause lung cancer, and the tobacco companies chalked up an unblemished record of courtroom victories. The so-called controversy became one of the most powerful weapons in the industry's legal arsenal and in its argument against government regulation of its business. For more than fifty years, into 1997, doubt about the causal link—Dr. Little's “controversy”—remained the cornerstone of the industry's defense against lawsuits.

From a public health point of view, Little's insistence on scientific proof was a travesty. Scientific proof of a link between a chemical or biological agent and a disease is not, never has been, and never should be required for a government to take action against a substance suspected of causing epidemics. Before the discovery of bacteria by Pasteur in 1860, the control of human plagues depended solely on medical statistics, primitive though they were. In 1796, Edward Jenner recommended vaccination with cowpox for protection against smallpox. He did not know the “cause” of smallpox; he only knew that milkmaids who previously had cowpox had immunity against smallpox. This was a purely statistical association. The virus of smallpox was not discovered until the early 1900s—over a century after the disease had been brought under control in developed countries. In 1854, during an epidemic of cholera in London, John Snow recognized the statistical association between cases of cholera and drinking water supplied by one of London's many water companies. Snow investigated the inner-city Soho area and hypothesized, based on statistical evidence, that a noxious substance was coming from one of the wells, and shut it down. The epidemic subsided, but it would be another forty years before health officials learned that cholera was caused by water polluted with sewage. Percivall Pott, a British doctor in the eighteenth century, suggested, by simple observation, a causal link between coal tar and scrotal cancer in chimney sweeps a hundred and forty years before its experimental confirmation. As public health officials have pointed out, cancer's long latency period, ten, twenty, or even thirty years, requires that the concept of cause be based on a statistical association. In the case of smoking and lung cancer, the early epidemiological studies provided grounds for assuming for all practical purposes that the observed relationship was causal. Little's demand for scientific, or experimental, proof in the presence of a persistent “causative factor” was merely a formula for inaction and delay.

As the liability lawyers fashioned their new legal weaponry, the life and times, not to mention the sayings, of Dr. Clarence Cook Little became a key part of their arsenal in the Third Wave of tobacco litigation. While the rest of the scientific world began to accept the link between smoking and disease, Little adhered absurdly to his “not proven” line. Some of his sayings were almost too good to be true for plaintiffs' counsel. By 1960 many government agencies, including the American College of Health Physicians, the U.S. [Government] Study Group on Smoking and Health, the British Medical Council, the British Ministry of Health, the Danish National Health Service, the National Cancer Institute of Canada, the Netherlands Ministry of Social Affairs and Public Health, the Royal College of Physicians, and the World Health Organization, had concluded that there was sufficient evidence to establish a cause-and-effect relationship between smoking and lung cancer. Little had rejected them all as “oversimplified and perhaps superficial conclusions … that concern themselves solely with suggestive or incomplete data.” He claimed such surveys “stifle or delay needed research to find the basic origins of lung cancer and cardiovascular diseases, which are most powerful, diversified and deadly enemies to our well-being.”

After his death in 1971, no one showed much interest in Dr. Little, but in the internal company documents unearthed during the Third Wave of litigation against the tobacco companies, his name popped up time and again. His papers, which had been stored largely untouched in the archives at the University of Maine, were suddenly in demand. In the spring of 1995, much to the astonishment of the archivists, lawyers arrived and burrowed into the files. Their aim was to create a portrait of the man who had taken tobacco's shilling. Little's story became an essential part of the plaintiffs' case: that the tobacco companies had engaged in a massive deception of the scientific evidence by intentionally promoting the “controversy” about smoking and cancer. The industry's choice of Dr. Little, a retired biologist not on the cutting edge of scientific research, demonstrated how the tobacco companies never had any intention of supporting the best research into the effects of their product.

For as long as biologists have studied cancer they have assumed that damaged cells can result in odd, cancerous growths. That these cells could be inherited was also accepted. The question was what “initiated” the abnormal growth. Was it the damaged cell itself, or was it an outside agent? One of the man-made chemicals then proliferating in industrial plants, perhaps? Was it the exhaust from automobiles? Was it agricultural pesticides and insecticides? Or could it be some of the thousands of chemicals formed when tobacco is burned in a cigarette? When it was found that condensed tobacco smoke did cause cancer on the shaved skin of laboratory mice, Dr. Little said it wasn't relevant to human beings. As the evidence of the link between smoking and lung cancer grew from medical statistics, Dr. Little told his audience not to worry, some smokers live to a ripe old age so smoking couldn't be a cause of cancer. For all his pledges to be concerned with “pure science,” Dr. Little promoted “junk science.” As the liability lawyers sought to paint the tobacco industry as the Evil Empire, they could not have wished for a better image than the socially privileged peddler of their junk science himself, Dr. Clarence Cook Little.

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T
HE SON
of Boston Brahmins—his mother a descendant of Paul Revere and his father the son of a textile and shipping merchant—Little grew up in luxury at the end of the last century on a huge estate in the suburb of Brookline. There the young Clarence was indulged, even encouraged in his youthful obsession with breeding pets. His father, who lived off a trust fund, bred dogs. At the age of three, Little was given some pigeons and by the time he was seven had bred a pair that won first prize in a local show. He became fascinated by the inheritance of color in his menagerie of mice, dogs, doves, and canaries. By the time he went to Harvard to study biology, he took with him a pair of mice inbred over several generations and he studied their descendants in the college genetics department.

His was the class of 1910 that included Walter Lippmann, John Reed, and T. S. Eliot, and although he was not a brilliant student, Little was an all-round success. Tall, square-shouldered, and athletic, with a closely clipped black mustache, he cut a dashing figure on the track team. He was articulate, witty, and charming. He had two nicknames, “Prexy” and “Pete,” which endured for his lifetime.

After Harvard, he first attracted national attention as a college administrator. At thirty-four, he was made president of the University of Maine, then later of the University of Michigan. (He left Maine under the cloud of an extramarital affair, and he eventually divorced his first wife and married his assistant.) Like others of his generation, Little had great faith that science would improve the human race. He embraced the Eugenics Movement, a turn-of-the-century club of intellectuals who believed the human race could be improved by selective breeding. By the 1920s, they had picked up adherents among the members of America's Yankee ruling class, fearful of being overrun by the “lower elements,” as they saw the Slavs, Latins, and Jews who made up the tide of immigrants. If something were not done to stem the tide, the Anglo-Saxon stock would be tainted beyond recognition. These fears, which led them to support restricted immigration laws, created a climate of approval for eugenic theories. The eugenicists advocated institutional isolation and sterilization of incorrigible criminals, the insane, and the mentally retarded. By the end of the 1920s, twenty-four states had laws permitting involuntary sterilization.

At the University of Michigan, where Little had landed after Maine, the college authorities were outraged by his advocacy of “selective birth control.” The “uncontrolled and unintelligent addition of more people to the world by the production of undesired and neglected children is in my opinion as great a sin as the murder of these children by slow means,” Little declared at his inaugural address on November 2, 1925. He advocated the sterilization of “criminals and mental defectives,” and called state legislators who opposed such moves “nincompoops.” His continuing speeches on this theme made headlines and horrified many of the God-fearing midwesterners who had hired him, especially the Catholics. The university forced him to resign. A former Michigan governor observed at the time, “Little is an ass.”

He returned to the East Coast intending to devote his life to cancer research, using his fast-growing colonies of inbred mice. He said he frankly preferred mice to people, a statement that has the ring of truth in retrospect. Always short of funds, Little ran the “mouse house” like a summer camp, encouraging and comforting his staff with potluck dinners, holiday picnics, fishing expeditions, and campfire songs. In return, the staff worked hard and built up an international laboratory-mouse business.

In 1929, the year the lab opened, Little agreed to serve part-time as managing director of the fledgling American Society for the Control of Cancer, which later became the American Cancer Society. Run by medical doctors, it had been largely ineffective in its primary mission of public education about the disease. Little launched a nationwide program to teach local physicians better methods of examining patients in the early search for cancer and also persuaded the matrons of the American Federation of Women's Clubs to start a project to teach their members how to detect signs of unusual growths. The program was a big success and brought him considerable praise. It was only when a group of industrialists wanted to transform the society into a vast volunteer health organization, with a board made up of an equal number of doctors and laymen, that Little, voicing his disapproval, returned once again to Maine.

In those days, Little's view of the effects of smoking was no different from the one essentially shared by scientists, doctors, and most thinking people through the ages: that repeatedly filling one's lungs with the fine particles of tobacco smoke could not be good for you. “It is difficult to see how such particles can be prevented from becoming lodged in the walls of the lungs and when so located how they can avoid providing a certain amount of irritation,” he wrote in 1944.

But that was before the tobacco companies offered to pay him to sing a very different song. Desperately short of funds for the lab, he began casting around for support from his friends and relatives. At the beginning of 1954, after a particularly lean year at the mouse house, he was advised by a relative to try R. J. Reynolds, the tobacco company with headquarters in Winston-Salem, North Carolina. “There is a tremendous amount of money in Winston-Salem,” he was told. “Under the proper auspices you might get something out of it if you made a speech there.” As it turned out, the tobacco companies needed him quite as much as he needed them.