Ten days after he was shot in the abdomen at Johns Hopkins Hospital, Cockeysville resident Dr. David Cohen was released from the hospital Monday.
“He has been released just now,” Stephanie Desmon, a spokeswoman for the hospital, said shortly before 6 p.m. Monday.
“Yes, he’s gone home. I have no idea when he’ll go back to work,” she said.
He is married to a Hopkins nurse, Cynthia Cohen. The couple have two children.
Cohen, an orthopedic and spinal surgeon, was shot Sept. 16, police say, by Paul Warren Pardus, 50, of Arlington, Va., who had been upset about the condition of his mother, a patient. After shooting Cohen, Pardus killed his mother, then himself.
Cohen was taken to surgery and has spent the last 10 days recovering at the hospital.
Though the family has not responded to inquiries at their Cockeysville home, they issued a statement Sept. 20 through the hospital’s communications office.
“We are deeply appreciative of the outpouring of support and concern for us during this difficult time,” the statement said. “We are especially grateful to everyone at Johns Hopkins who worked to make David’s recovery possible.”
Cohen graduated from the University of Rochester School of Medicine and Dentistry in 1990 and completed his residency at Johns Hopkins. He also did postgraduate work at Hopkins’ School of Public Health and a fellowship in spinal reconstructive surgery at Hopkins.
Eugenics never died after its failed implementation during the
early portion of the 20th Century. It has merely been lying
dormant until the social conditions for its deployment
were more hospitable. Why would it disappear? Eugenics is
a perfect complement to the capitalist political-economic
imperative of authoritarian control through increased
rationalization of culture. Why should the body or the
gene pool be sacrosanct? Like a city, a factory, or any other
construction of culture, these phenomena can be molded,
enhanced, and directed to fit the dominant values of a
culture, so that they might efficiently progress into the
future. Eugenics, however, is still waiting on the margins of
the social, partly because the first wave had a conspirato-
*Portions of this article were originally published in Coil, No. 4.
Eugenics: The Second Wave*
120 Flesh Machine
Once eugenics was associated with
Nazi social policy, it was perceived as a top-down manifestation
of social intervention and control that reflected
the values of a fascist ruling class, and which negated
democratic principles of choice. Eugenics is also still
waiting in the wings because medical science did not
have the methods and technology to efficiently implement
eugenic policy during its first wave (eugenic policy
could only be carried out by mandatory sterilization,
selective breeding, and genocide). Not until medical
science began to radically improve its interventionist
practices (particularly on the microlevel) after World
War II did all the various sectors of culture face a crisis
concerning the limits of organic intervention. While
the public could accept intervention in the process of
dying, intervention in the process of birth was suspect.
To inscribe the body as a machinic system that could be
repaired or maintained through medical and scientific
tinkering was (and is) perfectly fine, as long as medical
science does not attempt to appropriate the role of
creator. For example, to biologically support the immune
system through vaccinations that strengthen the
organic system can only be perceived as desirable and
well worth voluntarily acquiring in a secular society,
while creating a new and improved immune system
through genetic intervention is not so desirable (at least
not yet). The goals for eugenicists thus became finding a
way to import the spirit of voluntarism associated with
interventions designed to maintain life into those used to
create it; and, discovering how to construct the perception
that the body, as a machinic system that can be repaired,
maintained, and purified through medical intervention,
can also be improved through genetic intervention.
Eugenics: The Second Wave 121
The eugenic visionary Frederick Osborn already had the
answer to these questions as early as the 1930s when he was
the director of the Carnegie Institute. Osborn argued that
the public would never accept eugenics under militarized
directives; rather, time must be allowed for eugenic consciousness
to develop in the population. The population
would have to come to eugenics rather than vice versa.
Further, eugenic consciousness did not have to be aggressively
and intentionally micro-manufactured; instead, it
would develop as an emergent property as capitalist
economy increased in complexity. All that was needed was
to simply wait until a specific set of social structures
developed to a point of dominance within capitalist culture.
Once these structures matured, people would act
eugenically without a second thought. Eugenic activity,
instead of being an immediately identifiable, monstrous
activity, would become one of the invisible taken-forgranted
activities of everyday life (much like getting a
The set of social structures that Osborn believed had to
become dominant were consumer economy and what is
now known as the nuclear family. To be sure, both of these
social tendencies have come to pass, and are providing the
foundation for a more clandestine second wave of eugenic
practice. Consumer economy is a necessary foundational
component for two reasons. First, if the question of production
is solved, and needed goods (water, food, shelter) are
generally taken for granted, citizens of the economy of
surplus accept all remaining legitimized goods and services
as mere purchasable commodities to be chosen or refused.
Health care is just another service to be acquired. It
becomes neither an unexpected luxury, nor a human right,
122 Flesh Machine
but just another business component of the economy.
Regular medical intervention in everyday life becomes a
desirable taken-for-granted service. If eugenic practices
are offered as just another commodity under the legitimized
authority of medical institutions, as Osborn predicted
they would, they too will be taken for granted.
The second foundational characteristic that consumer
economy offers is purchase strategies that are based on
desire. Consumer economy provides an unending stream
of goods, such that a consumer can always desire more.
While the wealthiest class can take full advantage of the
surplus, and wander into territories of profound waste,
uselessness, and excess, the middle class is also offered
limited participation. Participation in the rituals of surplus
becomes a status symbol, a marker of prestige, a goal-laden
value, if not the reason for existence itself. When this
economic situation develops in tandem with the rise of the
nuclear family, the perception of reproduction begins to
It is very clear that the extreme reduction of the family unit
is a necessary development in late capitalist economy. The
extended family, which functions so well in agrarian-based
economies, becomes an anachronism in an economy with
a capacity for industrial farming. The situation becomes
worse when the extended family is placed in the context of
national/global economy; then it actually stops functioning
efficiently from the perspective of power vectors, and
becomes a detriment to corporate goals. Allowing the
extended family to continue offers individuals participating
in that institution a social and economic power base
which gives them the opportunity to refuse corporate
Eugenics: The Second Wave 123
culture. In addition, it creates a social process that has the
potential to be more satisfying than participation in consumption
processes. Individual loyalty to an institution
(i.e., the extended family) that potentially contradicts or
negates capitalist imperatives of production and consumption
is simply not a possibility that can be allowed to
continue. In an effort to eliminate this social possibility,
capitalist economy has configured itself to make entrance
to or maintenance of middle-class status dependent upon
accepting the nuclear family as the model of choice.
People are financially rewarded for showing an allegiance
to participation in the production and
consumption processes, over and above participation in
extended family processes.
The process of socializing individuals into nuclear units
begins with the education process. Children are immediately
taught that “success” in life depends on a division of
labor, and on separation from other family members; i.e.,
the adults work, while the children train in school to enter
the workforce. At the end of secondary education, they are
fully adjusted to the idea that it is time to leave home to
join the workforce, or to attend university. In the US, this
process of separation begins almost immediately, because
over the past 30 years, production rates have increasingly
intensified, while real wages have decreased, thus requiring
both parents to work if they want to maintain
middle-class status. Children are placed in daycare until
it is time for them to attend school. Hence, domestic
togetherness in the middle-class family has nearly ceased,
and children spend more time with their socializers—
education services and mass media—than with
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The reward for power vectors in promoting this variety of
family structure is twofold: First, since people are generally
denied social possibilities outside of rationalized contexts,
a profound alienation emerges. The only cures offered by
capitalist society for this condition are “satisfaction”
through success at work, or through acquisition of consumer
goods. Second, the geographic mobility necessary
for the efficient deployment of the upper echelons of the
workforce is assured. People go where their employers send
them without a second thought. Whether individuals are
near their family or friends is of secondary importance;
maintaining class rank (and more and more, simply to
remain employed) is of primary importance.
The nuclear family guarantees both the physical and the
ideological replication of the workforce; however, in terms
of eugenic development, it offers even more. The nuclear
family offers a specific set of concerns that complement
voluntary eugenics. Since the middle-class nuclear family
is generally small, thereby increasing the chances of total
familial erasure, its members express a profound concern
for reproduction. The extended family is also just as
concerned with familial reproduction; the difference between
the two, however, is that while the extended family
is content with the quantity reproduced as a safeguard of
familial survival, the nuclear family is concerned with the
“quality” of reproduction. Quality, in this case, is dictated
by capitalist demands. Quality means the extent to which
a child will be successful, i.e., will be able to obtain a good
job in order to maintain or heighten class rank. What
nuclear family parents lose in nonrational association with
their child, they gain in rationalized association. They can
send the child to good schools. They can provide the child
Eugenics: The Second Wave 125
with health care. They can offer the child a safe and secure
environment in which to mature. The reason parents want
to provide their children with these “advantages” is so the
child will give society he/r best economic performance. In
this thoroughly rationalized situation, quality of life is
equated with economic performance. The perception is that
the better the child performs economically in later life, the
better s/he will be able to satisfy he/rself within the structures
of production and consumption, and the greater the
probability that s/he will be upwardly mobile.
Once the structural conditions of the economy of desire
and the nuclear family are in place, which in turn lead to
equating quality of life (perhaps even social survival) with
economic performance by parents obsessed with their own
genetic and/or cultural replication, the environment is
ripe for voluntary eugenics—a situation which Osborn was
certain would come to pass. If parents are offered goods
and services which will give their few offspring a greater
opportunity for success, would they not purchase them?
Osborn thought that they would, and he believed that
these goods and services would include services which
would genetically engineer the child to insure he/r better
economic performance. He predicted that parents would
want to participate in the design of their children to help
them to adapt economically and socially—eugenic participation
would be a sign of benevolence. To be sure, once
eugenics is perceived as a means to empower the child and
the parent, it loses its monstrous overtones, and becomes
another part of everyday life medical procedure. Capitalism
will achieve its goals of genetic ideological inscription,
while at the same time realizing tremendous profits for
providing the service.
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A Brief Note on Class and Eugenics
Traditionally, eugenic ideology has been deployed in the wealthier
classes. Cleansing the gene pool of the lower classes has
generally been perceived as unnecessary, since the tasks
that the lower classes perform are simplistic and therefore
almost any genetic configuration will do. Most likely,
traces of this ideological tendency will continue in regard
to the working class. At the same time, however, eugenic
ideology will be vigorously deployed down the class scale,
until a point is reached where the purchase of the services
is no longer financially possible. Unlike in the past,
power vectors believe including all levels of the middle
class in genetic design to be more essential than ever, so
that all “significant” populations can make the “evolutionary”
jumps necessary to keep abreast of rapid cultural
The working class will probably not be called to participate
in the new wave of eugenic practice. Since the poor are
reproducing at a rate beyond that needed to keep low-end
labor conditions stable, no reason exists for power vectors
to construct interventions in their replication process
(perhaps with the exception of slowing it down). In the
US, it is riduculous to think that members of the lower
classes—who are not even granted health care—will be
able to participate in costly eugenic practices. Currently,
infant mortality among the poor is absurdly high simply
because of a lack of prenatal care, so it seems unlikely that
the lower classes will be presented with less necessary
elements of “medical care.” In European nations, where
health care is provided for all citizens, a different scenario
could emerge. Eugenic practices may be promoted all the
Eugenics: The Second Wave 127
way down the class scale. Much depends on whether or not
eugenics delivers on its promise to rationalize the gene
pool in a way that seems economically and socially productive
to capitalist forces. Should eugenics fulfill its promises,
the US would also have to comply with full-scale deployment,
in order to stay competitive in the global economy.
Another element that will affect the deployment of eugenic
practices will be the degree to which cyborg
technology seeps down into the lower classes. If organic
platforms are needed for duties below those filled by
members of the middle classes, then eugenic deployment
could go all the way down the class scale. However, this
scenario seems unlikely, as the past record shows that
when modified by technology, working class tasks tend
either to go completely robotic or shift to a smaller number
of low-end technocrats.
More Utopian Promises
As one would expect, eugenic practices are already receiving
mass media support in an effort to build eugenic consciousness
in consumers. Certainly, “eugenics,” “genetic
cleansing,” or any other term suggesting the horror of the
first wave of eugenics is never mentioned in these moments
of spectacle, and the spectacularized narratives of
bio-tech are presented to individuals in a seductive rather
than a forceful way. For example, a consumer can purchase
genetic testing (cleansing) services that promise to assure
the parent of a healthier child. At the four-to-eight-cell
stages, an embryo can be tested for a variety of genetic
diseases and deformations. Some genetic defects can be
128 Flesh Machine
repaired. At the very least, a defective embryo can be
terminated, and the parents can try again to produce a
healthy, normalized one. Of course, no one is forced to
take the test (it must be desired and purchased), and if any
abnormality is found, no one is forced to terminate the
creature. One can even choose to let the creature grow to
the 16-cell stage, at which time it will self-terminate if it
is not implanted in a uterus (perfectly natural). As promised,
services such as this one allow concerned (obsessive)
parents greater assurance that their child will be normal
and healthy, and that they will be spared the financial and
psychological burden of an abnormal child. The subtext,
however, is just as Osborn predicted: The parents make the
decision regarding termination in accordance with the
imagined child’s probability of success in life. They choose
to accept or terminate the imagined child, not so much to
fulfill their own needs as to fulfill the needs of pancapitalist
culture. In spite of all the can-do spectacle regarding the
productive and happy lives of the “differently-abled,” the
emphasis here is not on the “happy” (the nonrational) but
on the “productive” (the rational). To be sure, “healthy”
and “normal” correlate with the projected potential of the
imagined child’s productivity, combined with the parents’
continued need to participate in particularized modes of
consumption that do not include purchasing goods and
services for the defective. Rational patterns of production
and consumption in the economy of desire are presented as
determinants of a happy parent-child relationship, instead
of the happy parent-child relationship being determined
by nonrational characteristics such as love, concern, and
understanding. If the parent-child relationship were based
on these latter qualities, and not those of potential production
and consumption, what need would there be for the
Eugenics: The Second Wave 129
test in the first place? The spectacle promises its viewers
that testing benefits the parents and child by eliminating
sickness, but what these half-truths lead to is a eugenic
consciousness that serves ideological directives implanted
in consciousness by pancapitalist initiatives.
The spectacle of reproductive bio-tech also promises to
assure fertility in a majority of cases. Even if a reproductive
system is in disrepair, it can be technologically
modified and/or coaxed to function as expected. The
demand for such technological insurance is peculiar,
since there is no shortage of children in need of a parent.
Certainly, nonrational beliefs explain much of this
economic riddle: Perhaps parents value participation in
the “magic” of the reproductive process; perhaps they
want to see their own physical characteristics duplicated
in the next generation; or perhaps successful
reproduction validates their (essentialized) gender positions.
The list of entries and the manner in which they
can be combined is quite extensive, but not exhaustive.
While nonrational associations with reproduction are
useful in selling reproductive goods and services, rational
concerns also come into play. Would-be parents
tend to find it desirable to have total control over the
physical care and early socialization of the child, so they
can be certain that nothing can disrupt the future
success of the child. The only way to have this assurance
is to be a primary participant in these processes from
conception until the child is turned over to the education
system. (This would, in part, explain why obtaining
genetic materials from outside sources is preferable to
130 Flesh Machine
One must also ask, why are there problems with individual
fertility in the first place? Much of the answer lies outside
the realm of cultural design, but part of the answer lies in
the economy of investment for medical research: In regard
to funding, research which could help to prevent infertility
takes second place behind research that can insure fertility.
(For example, funding for research aimed toward
eliminating pelvic inflammatory disease, which can cause
infertility in some women, is relatively meager when
compared to investments in research to create products
and services for assisted pregnancy). This funding tendency
creates an expanded demand for the fertility products
and services by underfunding research that could lead to a
cure for root causes of infertility. Rather than investing in
research that could produce preventive care, funding agencies
invest in research to develop more profitable means to
repair an injured reproductive system. In turn, the increased
likelihood that women will need assisted
reproductive care channels the target population into
medical institutions where they are likely to engage additional
Extending fertility has similar consequences. This utopian
promise does seem desirable for women in many ways. If
reproductive assistance can increase the span of years
during which a woman can reproduce, she would have far
greater choice in how to plan her life. (Currently, the
fertility range has not been significantly altered, since the
success rate for assisted pregnancy drops dramatically after
the age of 40). If a woman knew she was able to have a
child after age 40, it would allow her uninterrupted time to
establish herself in the workforce and acquire the wealth
needed to best provide for the child. The option of being
Eugenics: The Second Wave 131
both a successful mother and a professional woman would
increase in likelihood. Obviously, the state would also
benefit by delaying reproduction to later years (a trend
which is occurring among middle-class women), since
there is a greater structural demand for women to enter the
workforce, and deferral of reproduction would allow them
to function better within it. In addition, the prevalence of
middle-aged pregnancy would channel (middle-class)
women into medical institutions where they would be
most likely to engage in voluntary eugenic practices. As
with most seeming social benefits, the majority of them
are gains for the state, while those the individual receives
are primarily incidental consequences of state
sanctioned social policy.
The Spectacle of Anxiety
The spectacle of anxiety also hides itself in utopian spectacle, but
rather than aiming the presentation at individuals, this
spectacle is normally directed at social aggregates. For
example, there is considerable coverage of breakthroughs
in medical science in media ranging from knowledgespecific
journals to popular newscasting. The most
glamorous subjects tend to be concerned with the rationalization
of death (cancer, heart disease, AIDS, and so on),
but genetic research, concerned with the rationalization of
birth, also makes the list. For the most part, these discoveries
are framed by a national identity. On the individual
level, the nationality of the scientists who made a given
breakthrough is fairly irrelevant, and most are relieved
that medical science is constructing a healthier tomorrow.
However, at the national level, who discovered what has
132 Flesh Machine
very deep economic implications. Each announcement of
a surge in applied medical science that is beyond the
national borders represents lost profits and an increase in
the national research gaps. (The real loss, of course, is to
other competing multinationals, rather than to nation
states). The public perception of losing national economic
advantage is a tremendous fuel to create a popular consensus
for high-velocity research (a permanent corporate
R&D policy, whether the public agrees or not) as opposed
to cautious and critical low-velocity research. As with the
individual purchase of goods and services that offer an
economic advantage, will the development of goods and
services that are perceived to give a nation an economic
advantage also be pursued without question? This has
certainly been the case in the past, and continues to be true
now. Such a situation seems to indicate that the time is
right for eugenic practices to flourish on the macro as well
as on the micro levels of society.
Jamming the Eugenic Failsafes
In addition to utopian promises, medical science makes numerous
ethical promises to the public designed to reassure
populations that the eugenic beast will not be reborn. As
far as involuntary eugenics is concerned, these promises
have merit, although the promise not to engage in statesanctioned
involuntary eugenic practices is an easy one to
keep, since the strategies to develop privatized voluntary
eugenic practices are proceeding so smoothly. On the
other hand, the ethical promises to forbid practices which
either lay the foundation for the implementation of voluntary
eugenic policy, or which are eugenic in and of
Eugenics: The Second Wave 133
134 Flesh Machine
themselves, can be looked upon with a great deal of
skepticism. For example, one key promise from medical
science is that human organic matter will not and cannot
be sold. In some cases, medical science has lived up to this
promise. In the case of organ sales, there are other options
to pursue, such as artificial, cloned, and transgenic organs
(all of which are still in various stages of experimentation).
These organ replacement products can be sold. The promise
of zero sales of human organs is also fortified by the fact
that it is difficult to find donors willing to sell their organs,
since doing so will either kill them or decrease their life
expectancy. However, with human reproductive matter,
the situation is much different. Sperm and eggs can be
harvested without threatening the life of the provider. In
this situation, medical science has legally kept its promise.
Sperm, eggs, embryos, etc., are not being bought and sold;
they are being donated. However, while the organic matter
cannot be bought and sold, the harvesting and the
implanting processes are salable services. The medical
establishment has jammed this ethical failsafe simply by
building the fiscal structure of the industry around the
process, rather than around the product.
To make matters worse, eugenic screening practices are
used to acquire suitable reproductive materials. Potential
donors are thoroughly tested physically and psychologically
to make sure they meet industry standards of health
and normalcy. Family histories are acquired and scrutinized
so that those receiving the materials can be sure that
there are no latent genetic defects that could lead to a
problematic outcome. If a potential donor is found to be
suitably pure, then s/he can become an actual donor. Of
course, no clinic would admit that it is constructing a pure
Eugenics: The Second Wave 135
gene pool—a purity which is dictated by the political and
economic demands of pancapitalism. Rather, such institutions
claim that they are only attempting to provide
consumers with top value for their purchasing dollar, and
preserving their own reputations as institutions of high
integrity that provide high-quality products and services.
Screening is done for economic purposes, and not for
political purposes. To an extent this is true. It seems very
unlikely that conspiratorial teams of doctors are plotting a
new master race; however, just as Osborn predicted, eugenic
mechanisms are emerging out of the rationalized
reproductive process which reflect the ideological values
of the social context in which the process occurs (the
primary value, as Osborn believed would come to pass in
consumer economy, is that people’s value is determined by
their economic potential).
This same process is replicated in the implementation of
selective reduction. To increase the probability of a successful
implantation procedure, a small set of embryos
(three to eight) is placed into the uterus; the number
depends on the quality of the embryos and the age of the
woman. The results vary; however, the probability of
successful implantation (when a embryo attaches itself to
the uterine wall) is increased. At times, the procedure is
too successful, and produces more than one fetus. This
leaves the client with the choice of bringing all the fetuses
to term, or of reducing their number. Many times, the
reduction is necessary as the number of fetuses conceived
could pose a threat to the life of the client, but just as often,
fetus reduction is implemented because the client desires
a specific number of fetuses. The client can select (often in
accordance with viability) which fetuses she wants to
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keep. In the cases where the fetuses are equally viable, the
client can select for aesthetic characteristics (such as the
number of children, the gender, or the gender combination).
Like donor screening, there is nothing genetically
conspiratorial about the process; clients are simply purchasing
the specific goods that they want. Yet once again,
the desire for a specific product is manufactured by spectacle
that is directed by ideological as well as marketing
concerns. The process of selective womb cleansing is political
and eugenic, and is an emergent byproduct of
Osborn’s predictions are coming to pass. The time is right for the
second wave of eugenics because the economic foundation
has been laid. Eugenics complements the grand
pancapitalist principle of the total rationalization of culture.
The foundation for consumer consciousness is
replicated in the foundation for eugenic consciousness.
Reproduction is spectacularly represented and publicly
perceived as an object of surplus that can be produced to
meet consumer desire. Desire itself does not emerge from
within, but is imposed from without by the spectacular
engines of pancapitalist ideological inscription. However,
the situation has yet to reach catastrophic proportions.
Eugenic practices are still crude and experimental; they
still have to work their way across class levels and down the
class ladder. Thus far, power vectors have not been able to
turn perception into activity (the product is recognized,
but few are buying). In order to truly accomplish the goal
of making eugenic activity a part of everyday life, the
Eugenics: The Second Wave 137
public must be convinced that rationalized processes of
reproduction are superior and more desirable than the
nonrational means of reproduction. In other words, large
segments of the population (with an emphasis on the
middle class) must still be channeled into this frontier
market. This will take time, during which counternarratives
and resistant strategies and tactics can be developed.
Unfortunately, in order to seduce all who look upon it,
eugenics has masked itself in the utopian surface of free
choice and progress. In this sense, power vectors have
stolen and are cautiously using the strategy of subversion
in everyday life to create a silent flesh revolution.
flesh6 (pdf file)
FOR many longtime readers of W, the elite society bible, the appearance of the reality television star Kim Kardashian on the cover of its November issue was an outrage — “No iteration of W should give credence to such banalities,” wrote one angered reader. For many residents of SoHo, the appearance of a Kardashian-owned clothing boutique in their neighborhood two weeks ago was also an unwelcome event, made more upsetting when a mob of fans turned up and prompted calls to 911. (Sean Sweeney, the director of the SoHo Alliance, was quoted in The Villager describing those fans as “a generation of classless, tasteless and clueless sheep.”)
The amount of hostility toward Ms. Kardashian seems to raise the same question you might ask when presented with the amount of admiration for her, or the fact that, on her Twitter account, she has 5.3 million followers: Why do people care?
This much is known to anyone: Ms. Kardashian is famous, gorgeous and lives her life voluntarily under the microscope of reality television. More to the point, as the branding expert Robert K. Passikoff put it in a phone interview this week, “You would have had to be living in a cave in Nepal to have not been exposed in one way or another to the celebrity ilk of Kim Kardashian.” The scene on the corner of Broadway and Broome Street on Tuesday at noon suggested there were few, if any, cave-dwelling Nepali tourists in the vicinity of SoHo that day. There was a line of more than 100 men and women of varying nationalities, most in their 20s, waiting behind a sign in front of the Bebe store that invited them to meet Ms. Kardashian.
As her black SUV pulled up to the curb, precisely on schedule, it was as if another 100 had instantly materialized to document her arrival with cellphone cameras. She was wearing a black blazer with velvet panels, black Bebe leggings and her hair in a bun. Turning toward the cameras, she offered up her signature look — the head tilted slightly, lips apart, as if she had just blown a kiss.
The occasion was the introduction of a jewelry collection designed by Ms. Kardashian for Bebe, which is being sold alongside the dresses, leggings and tops she already designs for Bebe. This is a different jewelry collection from the one Ms. Kardashian announced last month, which she is creating with Pascal Mouawad and calls Belle Noel, and different from the jewelry collection she designed in February with Virgins, Saints & Angels. And the clothes are different from the dresses, leggings and tops Ms. Kardashian sells on QVC under the label K-Dash by Kardashian.
It is true that Ms. Kardashian, along with her sisters Kourtney and Khloé, and their mother, Kris Jenner, command a branding empire that includes fashion boutiques, fitness videos, credit cards, a best-selling fragrance, skin care products and a self tanner. Ms. Kardashian herself has represented many other products in advertisements, including some that a reasonable person might consider to be sending mixed messages. In one ad she promotes QuickTrim weight-loss products; in another, Carl’s Jr. While it is not unusual for celebrities who are famous for being famous to aggressively capitalize on their exposure, Ms. Kardashian, who made her debut on the public stage in the form of a sex tape, stands out for the fact that she is generally still regarded in a positive light by many consumers.
Mr. Passikoff, the president of Brand Keys, a New York research company that monitors consumer perception of brands, noted that Ms. Kardashian is currently tied with Snooki at the top of its celebrity loyalty index, a survey that gauges consumer engagement with celebrities. Kourtney and Khloé Kardashian also figure in the top seven.
“There was a time when Paris Hilton topped that list, when she was the most famous person for being nothing we had ever seen,” Mr. Passikoff said. (Ms. Hilton is now in third place.) Interestingly, he noted, many consumers associate Ms. Kardashian with entrepreneurship, far more so than other celebrities.
Outside Bebe, though, a more complicated picture emerged as to what draws all these young people to Ms. Kardashian. Most of them had heard about the event on Twitter, and most said they saw something inspiring in her example. But what does she represent?
“The average girl,” said Julie Sunday, 22, from Scranton, Pa., who recently left a job doing accounting work for a political media buying company in Washington.
“She represents fashion,” said Wendy Sosa, 22, a waitress from the Bronx. “I like the way she dresses.”
“She has an ethnic sex appeal,” said Sarah Harooni, 26, a paralegal from Queens. “I like how she created a franchise with her sisters. That opens a lot of opportunities for women who have a spark of beauty and want to shine. She reminds me of Sophia Loren.”
“She stands out from every other celebrity in the world,” said Emma Brodel, 21, a journalism student from Queensland, Australia. “She is natural and curvaceous. There are too many thin celebrities out there who make women feel they are overweight.”
Ms. Kardashian, who is 30, is unfailingly polite when discussing her brand, one that was largely created through her public exposure since 2007 on the E! reality show “Keeping Up With the Kardashians.” She does not talk about fashion and image as most designers and celebrity designers do, with platitudes about quality and authenticity, but rather as a person who seems wholly content to allow consumers to project upon her whatever image they wish.
“I really do believe I am a brand for my fans,” she said.
She does not talk about design in terms of cut or craft, either, but of Twitter and Facebook, of blogs and text messages. When fans ask her what she is wearing or what lip gloss she uses, she answers them and then creates products in the vein of what they like. When she was deciding on a color for her Kim Kardashian perfume bottle, she asked her followers on Twitter whether they preferred a hot pink or a light pink. (It was light pink, by far.) “Twitter is the most amazing focus group out there,” she said.
But ultimately, what Ms. Kardashian and her sisters create and sell are products based on their own image, and not much of it is particularly distinctive from the standard uniforms of Southern California nightclubs. At Bebe, the best-selling item has been a slinky one-shoulder dress for $98. At QVC, one of the most popular items on its Web site has been a slinky one-shoulder dress for $49.75. Both collections have leggings that can be worn with cute printed tunics. All of her jewelry collections have a slightly vintage feel and strong influences of Armenian design, reflecting Ms. Kardashian’s familial roots.
“I try to find inspiration from what is on the runway,” Ms. Kardashian said. “But I think hoops are a staple. Whether or not they are in, we always get compliments on them.”
The Bebe jewelry, priced from $24 to $98, includes Lucite hoops accented with gold flakes and gold hoops trimmed with what look like tiny jewels, which Ms. Kardashian wore to her store appearance Tuesday.
“We make the kind of clothes we like to wear,” she said. “We give answers to the questions our customers are asking. I think that’s why we’ve been successful.”
Mahatma Gandhi was once asked by a reporter what he thought about western civilization, and in light of the uncivilized treatment by the British government of his nonviolent actions, he immediately replied, “Western civilization? Yes, it is a good idea.” Likewise, if he were asked what he thought about “scientific medicine,” he would probably have replied in a similar manner.
The idea of scientific medicine is a great one, but is modern medicine truly, or even adequately, “scientific”?
Modern medicine uses the double-blind and placebo-controlled trial as the gold standard by which the effectiveness of a treatment is determined. On the surface, this scientific method is very reasonable. However, serious problems in these studies are widely acknowledged by academics but remain unknown to the general public. Fundamental questions about the meaning of the word “efficacy” are rarely raised.
For instance, just because a drug treatment seems to eliminate a specific symptom does not necessarily mean that it is “effective.” In fact, getting rid of a specific symptom can be the bad news. Aspirin may lower your fever, but physiologists recognize that fever is an important defense of the body in its efforts to fight infection. Sleep-inducing drugs may lead you to fall asleep, but they do not lead to refreshed sleep, and these drugs ultimately tend to aggravate the cycle of insomnia and fatigue, while conveniently (for the drug companies) tend to create addiction. Long-term safety and efficacy of many modern drugs for common ailments remains unknown, despite the high hopes and sincere expectations from the medical community and the rest of us for greater certainty.
The bottom line to scientific research is that a scientist can set up a study that shows the guise of efficacy. In other words, a drug may be effective for a very limited period of time and then cause various serious symptoms. For example, a very popular anti-anxiety drug called Xanax was shown to reduce panic attacks during a two-month experiment, but when individuals reduce or stop the medication, panic attacks can increase 300-400 percent (Consumer Reports, 1993). Would many patients take this drug if they knew this fact, and based on what standard can anyone honestly say that this drug is “effective”?
To get FDA approval to market a drug, most of the studies for psychiatric conditions last only six weeks (Angell, 2004, 112). In view of the fact that most people take anti-depressant or anti-anxiety medicines for years, can these short studies be scientifically valid? What is so little known and so sobering is that research to date has found that placebos are 80 percent as effective and have fewer side effects and a lot cheaper (Angell, 2004, 113).
Marcia Angell, MD, the former editor of the New England Journal of Medicine and author of the powerful book The Truth about Drug Companies, said it plainly and directly: “Trials can be rigged in a dozen ways, and it happens all the time” (Angell, 2004, 95).
She further expresses real concern about research reliability:
It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines. I take no pleasure in this conclusion, which I reached slowly and reluctantly over my two decades as an editor of The New England Journal of Medicine. As reprehensible as many industry practices are, I believe the behavior of much of the medical profession is even more culpable.
Angell gives many examples of why reading research studies is not reliable:
A review of 74 clinical trials of antidepressants, for example, found that 37 of 38 positive studies were published. But of the thirty-six negative studies, thirty-three were either not published or published in a form that conveyed a positive outcome (Turner, 2008).
Conventional drugs used today are so new that there is very little long-term research on them. There are good reasons why a vast majority of modern drugs used just a couple of decades ago are no longer prescribed: they don’t work as well as previously assumed, and/or they cause more harm than good.
Sadly and strangely, many physicians do not see that there is something fundamentally wrong with the present medical model. Once a drug is found to be ineffective or dangerous, doctors and drug companies simply find another drug that, at least initially, seems to have good short-term results, that is, until longer term studies establish that it doesn’t work as well as assumed and/or is more dangerous. Although some people consider these failures as evidence of the wisdom of the scientific process, these problems are evidence of the limitations of a model of medicine that over-emphasizes a biochemical, biomechanical pharmacological approach to healing that ultimately seeks to “attack” disease, “combat” illness, and wage “war on cancer” or on the human body itself (Ullman, 2009) This paradigm can be invaluable in emergency medicine and help us survive certain infectious diseases, but for the large majority of people facing day-to-day chronic illnesses, it provides short-term results, serious side-effects, and stratospherically high costs.
The vast majority of drugs have a quick turnover in the medical marketplace, making them more akin to fashion more than science. Despite this recurrent pattern, doctors are prescribing drugs at record-breaking rates. Polypharmacy (the use of more than one drug concurrently for a patient) is becoming routine, even though there is very little evidence for the safety or efficacy of such practice. Some scary details about the serious problems that result from polypharmacy was discussed in an earlier article.
The primary reason that modern medicine fails so many times is that it tends to assume that symptoms are just something “wrong” with the person that then needs to be managed, controlled, or suppressed. Distinct from this medical viewpoint is an ancient and futuristic model that recognizes that symptoms represent DEFENSES of the body that should be nurtured and augmented as a way to treat disease processes. This latter approach to treating the sick is the naturopathic and homeopathic models of the West, the Ayurvedic approach of India, and the various styles of acupuncture from the East.
One hopes that the American public would greatly benefit from receiving the “best” and certainly most expensive care that modern medicine has to offer. However, this simply isn’t true. In fact, the following statistics powerfully state the results from what some people mistakenly refer to as the “best” medical care in the world:
* According to 2006 data, the infant mortality rate in the United States was ranked twenty-first in the world, worse than South Korea and Greece and only slightly better than Poland.
* Data from 2006 also showed that the life expectancy rate in the United States was ranked seventeenth in the world, tied with Cyprus and only slightly ahead of Albania (InfoPlease, 2007).
Even “Good” Research is Often Bad
Medications that can allay pain or any type of serious discomfort are a great blessing, but let’s not fool ourselves into believing that modern pain drugs are curative agents. In fact, although they provide blessed short-term relief, they create their own pathology, addiction, and demand for increasing doses over time.
Such pain relief is akin to unscrewing a warning light in your car. It does turn off that irritating light, though it does nothing to change the underlying problem.
However, when a drug company’s scientific trial “proves” that their drug reduces pain, it then markets this treatment as “scientifically proven” and is able to sell the drug to doctors and to consumers with a marketable spin that makes them the big bucks. What is so brilliant about the cozy relationship that drug companies have with “science” is that most people have insurance these days and don’t have to pay out-of-pocket for these “proven” drugs. Even though their (and our) insurance premiums sky-rocket, many employers distance the patient from the real costs of paying the bill.
It is so impressive how proving that one can use conventional drugs to “unscrew a warning light” can make big big bucks. My previous article noted that the combined profits ($35.9 billion) of the ten largest drug companies in the Fortune 500 in 2002 were more than the combined profits ($33.7 billion) of the remaining 490 companies together (Angell, 2004, 11). In a civilized world, no industry should have this amount of profit without being considered a criminal enterprise.
And let’s also not fool ourselves into believing that conventional medical treatment is the sole method of providing pain relief. Back in 1983, I coined the term “medical chauvinism” as a common assumption that there is only one type of education with which to learn the science and art of healing or that there is only one type of health professional suitable to provide health care (Ullman, 1983a; 1983b). Despite its recent prevalence, medical chauvinism is an anomaly historically and internationally.
Equally problematic to medical chauvinism is “scientism,” which is the common assumption that science is the only way to acquire knowledge about reality. There is a great amount of human experience that cannot be tested in a “double-blind and placebo controlled trial,” and the lack of “scientific evidence” for these experiences does not make them invalid, unproven, or non-existent.
It is more than a tad ironic that there are extremely few double-blind and placebo-controlled trials testing surgical procedures, and yet, physicians and skeptics do not refer to surgery as “quackery.” Surgeons appropriately note that it is impossible to conduct such studies because it is unethical to open up a patient for surgery to provide a “placebo surgery.” And yet, these same physicians and skeptics use this offensive term, “quackery,” with regularity and without parity, to a host of alternative therapies that have similar challenges to providing placebo treatment. How does one give a placebo meditation, and how can many naturopathic protocols be tested when the combined treatment regiment includes an herb, a vitamin, a homeopathic medicine, AND some type of physical therapy.
Scientism is a type of fundamentalism where science is the religion (Milgrom, 2010). A significant problem with scientism is that its believers are often even more arrogant than religious fundamentalists. Perhaps worse, they don’t even acknowledge that their belief system is a belief system. This problem may explain the lack of humility of many doctors and scientists.
Understanding and Rewriting History
Who controls the past controls the future: who controls the present controls the past.
George Orwell, author of 1984
History provides us with diverse evidence about our past, but ultimately, only a small portion is told in history books. The interpretation of our past and the select use of facts and figures influence our understanding of what happened.
Historians commonly remark that whichever country wins a war or whichever worldview dominates another, the history is told through that country’s perspective or that dominant point of view. This is certainly true in the history of medicine. For instance, medical historians commonly portray conventional medical practice of the past as barbaric and dangerous, and yet they have asserted that today’s medical care is at the apex of “scientific medicine.” The assertion that today’s medical care is “proven” is a consistently repeated mantra.
History also tends to portray those who lose a war and who represent a minority point of view as having less than positive attributes. For instance, those physicians practicing medicine differently than the orthodox medical practice might be called cranks, crackpots and quacks. Such name-calling is a wonderfully clever way to trivialize potentially valuable contributions, whether or not one understands what these contributions really are.
Besides name-calling, practitioners of the conventional and dominating paradigm often spin facts to make the strong and solid features of a minority practice into something strange and weird. Homeopaths are accused of using smaller doses than used in orthodox medicine, and this is portrayed as homeopaths using doses that “theoretically” could not have any physiological effect. The medical fundamentalists purposefully ignore the significant literature that posits different theories about how homeopathic medicines work (Chaplin, 2010; Bellavite and Signorini, 2004; Homeopathy, 2010), and they (again) show their lack of humility because there are innumerable conventional medical treatments today for which the mechanism of action remains unknown. Even good skeptics know that we still do not understand how tobacco smoking causes cancer, and yet, no one advocates that we ignore this good health information just because the precise mechanism remains a mystery (Spector, 2010).
Accusations that homeopathic medicines could not possibly have any effect are made without knowledge, experience or humility. Such accusations simply become evidence of the accuser’s unscientific attitude and his or her ignorance of the diverse body of basic scientific work on the effects of nanodoses of certain substances in specific situations.
The fact that homeopaths have used their medicines for more than 200 years is spun as evidence that this system of medicine has not “progressed.” Another interpretation here is that the same homeopathic medicines used 200 years ago are still used today, along with hundreds of new ones, primarily because the old ones still work. The art of using homeopathic medicines is that they are not prescribed for a localized disease but for a syndrome or pattern of symptoms of which the localized disease is a part. It is clever how some people try to spin positive attributes in hyper-negative ways.
The fact that homeopaths interview a patient to discover his or her unique symptoms has been spun to make homeopathy seem like a quirky system that revels in inane facts about a patient. However, the detailed symptoms and characteristics of the patient that homeopaths collect may not be comprehended by those unfamiliar with the unique and critical nature of individualizing features in each person. Homeopathy provides a sophisticated method by which a patient’s characteristics are applied to selecting and prescribing the most effective homeopathic medicine. Today, a large majority of practicing homeopaths use expert system software to help them prescribe their medicines in a highly individualized way to patients.
Homeopaths use the term “vital force” in a fashion similar to how acupuncturists use the term “chi” to refer to the underlying forces in a living system that connects mind and body. Although antagonists to these systems of natural medicine try to make them sound “woo-woo,” homeopaths and acupuncturists confidently respond by asserting that living systems are not machines or simply bodies of chemical interactions.
I personally have no problem with “skeptics” of homeopathy, though most people who think of themselves as skeptics are really simply “deniers” or “medical fundamentalists.” A skeptic is one who may not believe that homeopathy works, but che (my preferred alternative to s/he) strives to be familiar with the body of literature, not just the “negative” trials. Further, a good skeptic evaluates clinical trials, basic science trials, animal studies, cost-effectiveness comparisons, outcome studies, consecutive case reports, and epidemiological data. A good skeptic is simply a good scientist who evaluates a whole body of evidence.
Sadly, most deniers of homeopathy simply and directly lie about the subject. They commonly assert that “there is no research on homeopathy” or “there is no possible mechanism of action for how homeopathic medicines work”. These fundamentalists KNOW that this is not true. Several of my previous articles have referenced this body of evidence (Ullman, 2009b; Ullman 2010a, Ullman, 2010b).
Some of the most recent reviews of research include one meta-analysis of clinical research published in the prestigious Journal of Clinical Epidemiology (Ludtke, Rutten, 2008) and two full issues of the peer-review journal, Homeopathy (2009, 2010) which reviewed basic sciences research.
What is so interesting to watch is the questionably honest or ethical behavior of these medical fundamentalists. They have been informed of the many studies and meta-analyses that have verified the clinical efficacy of homeopathic medicines, as well as hundreds of basic sciences trials, many of which have been replicated by other researchers. One review of replications of basic science work is of special interest (Endler, et al, 2010).
The deniers of homeopathy love to say that homeopaths “cherry-pick” the positive studies and ignore the negative ones. They then incredulously assert that we should ignore ALL of the positive trials. Such statements and viewpoints are profoundly misguided and simply daft. Will these same people say that Thomas Edison “cherry-picked” his positive study and ignored all of his “negative” studies in his efforts to invent electric lights? The (il)logic of the deniers is that they would recommend ignoring Edison’s discovery because the vast majority of his studies were not positive.
Finally, medical history sheds light on what is and isn’t real.
In 1832, the esteemed founder of homeopathy, Samuel Hahnemann, MD, was granted honorary membership in the Medical Society of the City and County of New York. And yet, 11 years later, the minutes of this medical society confirm that once this conventional medical association recognized the “major ideological and financial threat” that the growth of homeopathy represented, the medical society rescinded his membership (Gevitz, 1988, p. 102). It is the ideological and financial threat that homeopathy poses that motivates the antagonism to it, not whether it works or not.
In light of the fact that history tends to be written by the victors, this writer predicts that history will soon be rewritten.
Angell M. The Truth about Drug Companies. New York: Random House, 2004. This fact is extremely startling, but the source is reputable: Marcia Angell, MD, is former editor of the New England Journal of Medicine.
Angell M. Drug Companies & Doctors: A Story of Corruption. The New York Review of Books. 56, 1: January 15, 2009. http://www.nybooks.com/articles/archives/2009/jan/15/drug-companies-doctorsa-story-of-corruption/
Bellavite P and Signorni A. The Emerging Science of Homeopathy: Complexity, Biodynamics, and Nanopharmacology. Berkeley: North Atlantic, 2002.
Consumer Reports, High Anxiety. January 1993, 19-24.
Endler PC, Thieves K, Reich C, Matthiessen P, Bonamin L, Scherr C, Baumgartner S. Repetitions of fundamental research models for homeopathically prepared dilutions beyond 10-23: a bibliometric study. Homeopathy, 2010; 99: 25-36
Gevitz N. The Other Healers: Unorthodox Medicine in America. Baltimore: Johns Hopkins University: 1988.
Homeopathy (a peer-review journal published by Elsevier) (October, 2009)
Homeopathy (January, 2010)
Levi R. Science Is for Sale, Skeptical Inquirer, July/August 2006, 30:4, 44-46.
Ludtke R, Rutten ALB. The conclusions on the effectiveness of homeopathy highly depend on the set of analyzed trials. Journal of Clinical Epidemiology. October 2008. doi: 10.1016/j.jclinepi.2008.06/015.
Milgrom L. Beware scientism’s onward march.
Roberts WH. Orthodoxy vs. homeopathy: Ironic developments following the Flexner Report at the Ohio State University, Bulletin on the History of Medicine, Spring 1986, 60:1, 73-87.
Spector R. The War on Cancer: A Progress Report for Skeptics. Skeptical Inquirer. January/February, 2010.
Turner EH, et al., “Selective Publication of Antidepressant Trials and Its Influence on Apparent Efficacy,” The New England Journal of Medicine, January 17, 2008
Ullman D. Beyond Medical Chauvinism, California Living (the Sunday supplement magazine of the San Francisco Chronicle and San Francisco Examiner, August 21, 1983a, 4-7.
Ullman D. Medical Monopoly vs. Alternative Health Care, Social Policy, Summer, 1983b, 27-28.
Ullman D. 2009a. When Militarism ‘Invades’ Medicine…Doctatorship Happens
Ullman D. 2009b. The Epidemic Of ‘Medical Child Abuse’ And What Can Be Done.
Ullman D. 2010a. The Case FOR Homeopathic Medicine: The Historical and Scientific Evidence
Ullman D. 2010b. Homeopathic Medicine: Europe’s #1 Alternative for Doctors
Walsh JJ. History of the Medical Society of the State of New York. New York: Medical Society of the State of New York, 1907.
Dana Ullman, MPH, is America’s leading spokesperson for homeopathy and is the founder of http://www.homeopathic.com. He is the author of 10 books, including his bestseller, Everybody’s Guide to Homeopathic Medicines. His most recent book is, The Homeopathic Revolution: Why Famous People and Cultural Heroes Choose Homeopathy. Dana lives, practices, and writes from Berkeley, California.
An estimated 15,000 Medicare patients die each month in part because of care they receive in the hospital, says a government study released today.
The study is the first of its kind aimed at understanding “adverse events” in hospitals — essentially, any medical care that causes harm to a patient, according to the Department of Health and Human Services’ Office of Inspector General.
Patients in the study, a nationally representative sample that focused on 780 Medicare patients discharged from hospitals in October 2008, suffered such problems as bed sores, infections and excessive bleeding from blood-thinning drugs, the report found. The federal Agency for Healthcare Research and Quality called the results “alarming.”
“Reducing the incidence of adverse events in hospitals is a critical component of efforts to improve patient safety and quality care” in the U.S., the inspector general wrote.
The findings “tell us exactly what some of us have been afraid of, that we have not made much progress,” said Arthur Levin, director of the independent Center for Medical Consumers and a member of an Institute of Medicine committee that wrote a landmark 1999 report on medical errors. “What more do we have to do to make sure that sick people can rest assured that they’re not going to be harmed by the care they’re getting?”
Among the findings in the report obtained by USA TODAY:
•Of the 780 cases, 12 patients died as a result of hospital care. Five were related to blood-thinning medication.
Two other medication-related deaths involved inadequate insulin management resulting in hypoglycemic coma and respiratory failure resulting from oversedation.
•About one in seven Medicare hospital patients — or about 134,000 of the estimated 1 million discharged in October 2008 — were harmed from medical care.
•Another one in seven experienced temporary harm because the problem was caught in time and reversed.
About 47 million Americans are enrolled in Medicare, a government health insurance program for people 65 and older and those of any age with kidney failure.
The adverse events found in the study weren’t necessarily due to medical mistakes, said Lee Adler, a University of Central Florida medical professor who was involved in the study. For example, he said, an allergic reaction to a penicillin injection is an adverse event, but it’s a medical error only if the patient’s allergy was known prior to the shot.
Among the problems identified in the report were Medicare patients who had excessive bleeding following surgery or a procedure. For example, one patient had excessive bleeding after his kidney dialysis needle was inadvertently removed, which resulted in circulatory shock and an emergency insertion of a tube to allow breathing.
When the tube was removed the next day, the patient inhaled foreign material into his lungs and needed lifesaving medical help, the report said.
Peter Pronovost of Johns Hopkins University, co-author of the book Safe Patients, Smart Hospitals, said medical mistakes are “an enormous public- health problem.”
“We spend two pennies trying to deliver safe health care for every dollar we spent trying to develop new genes and new drugs,” Pronovost said. “We have to invest in the science of health care delivery.”
ImClone Ex-Chief Embarks on New Biotech Venture
Samuel D. Waksal is not letting his past stand in the way of his future.
The former chief executive of the biotechnology company ImClone Systems, Mr. Waksal spent five years in federal prison after admitting to insider stock trading and other crimes.
Now, less than two years after regaining his freedom, Mr. Waksal, 63, is mounting an audacious effort at redemption, again in biotechnology.
Call it ImClone II, only bigger, broader and faster.
ImClone took two decades before its first drug came to market, the typical biotechnology development route. But Mr. Waksal says his new venture, Kadmon Pharmaceuticals, will be “a fully integrated biopharmaceutical company from the get-go,” replete with everything, including its own research and products on the market or in clinical trials that it acquires from others.
“You’ll see a company that next year will be doing significant revenues in a growth area, with earnings, probably five Phase 3 programs and a couple of Phase 2 products,” Mr. Waksal said Sunday in a telephone interview. Phase 3 and Phase 2 are the late and middle stages, respectively, of clinical trials.
Several of Mr. Waksal’s former colleagues from ImClone have joined him at Kadmon, a name from kabbalah, the Jewish mystical movement. He even looked into leasing the Lower Manhattan headquarters ImClone is vacating.
Kadmon, which will focus on cancer, infections and autoimmune diseases, has started to make deals. On Monday it is expected to announce it has licensed an experimental hepatitis C drug from Valeant Pharmaceuticals International, a person close to the transaction said. That follows the disclosure last week that it had acquired Three Rivers Pharmaceuticals, a Pennsylvania company specializing in hepatitis drugs.
Kadmon circulated a private placement memorandum in February to raise $50 million to $175 million. As of July, it had raised $10.8 million from 26 investors, a filing with the Securities and Exchange Commission said.
But David Pitts, a spokesman for Kadmon, said that other debt and equity offerings had raised more than $200 million, with the biggest investor being SBI Holdings of Japan. That indicates at least some investors are willing to look beyond Mr. Waksal’s past. For many investors, “there are few judgments beyond whether you made me money,” said Samuel D. Isaly, managing partner at OrbiMed Advisors, a big investor in biotech companies that was not asked to invest in Kadmon. “Sam Waksal made a lot of people a lot of money with ImClone.”
Mr. Waksal led ImClone as it developed the cancer drug Erbitux, which was approved in 2004, after he had gone to prison. In 2008, Eli Lilly & Company acquired ImClone for $6.5 billion.
One investor in Kadmon, who also sits on its board, said Mr. Waksal’s energy and his acumen in spotting promising drugs far outweigh his past problems.
“He is irrepressible,” said this investor, who spoke on the condition that she not be named because her company has a policy against being quoted in the media. “I don’t think what happened to Sam in the past is going to have a negative effect on my investment in this business.”
Yet some biotech investors said they were wary of putting money into Mr. Waksal’s new company, and others said their clients would not allow it.
“The state of Oregon is one of our investors,” said Mr. Isaly of OrbiMed. “They don’t explicitly tell us you can’t invest with felons, but we would know how they feel.”
Mr. Waksal, who earned a doctorate in immunology, is charming to the point of being seductive. He was a fixture in New York social circles, befriending celebrities and dating many women, including Alexis Stewart, daughter of his friend Martha Stewart. He lived in a spacious SoHo loft with millions of dollars in art, where he hosted extravagant parties and intellectual salons attended by leading lights in literature, art and science.
That started to come undone in December 2001, when Mr. Waksal got word that the Food and Drug Administration was not going to approve Erbitux. Before the company announced the news, Mr. Waksal alerted relatives to sell their ImClone stock and tried to sell some of his. Martha Stewart sold her ImClone shares and was given a five-month prison sentence and five months of home confinement for lying to federal investigators about it.
Mr. Waksal pleaded guilty to securities fraud bank fraud, perjury, obstruction of justice and conspiracy. He is prohibited by a settlement with the S.E.C. from serving as an officer or director in a publicly traded company.
While Mr. Waksal says he retained some of his wealth — he would not comment on whether he had made money from stock options when ImClone was sold — he lives less flamboyantly now. His home is one floor of a town house off Fifth Avenue, and he generally keeps out of gossip columns.
“I’m far more circumspect in every single thing I do in life,” he said.
Still, prospective investors say his trademark exuberance and penchant for hyperbole remains.
“He hadn’t changed,” said a prospective investor who met with Mr. Waksal and spoke on the condition of anonymity to retain relations with him. “He was spinning big stories about big money, big deals.”
Another prospective investor said Mr. Waksal had told him that Carl C. Icahn, the billionaire who is a friend of Mr. Waksal and had invested in ImClone, had committed $30 million to Kadmon. Marc Weitzen, a lawyer for the investor, said Mr. Icahn had evaluated Kadmon but “decided to pass.”
The private placement memorandum circulated in February said Kadmon had “a simple yet revolutionary plan for creating the pre-eminent 21st century biopharmaceutical company.”
Whether Mr. Waksal’s comments will prove to be hyperbole or fulfilled ambitions may depend on acquisition acumen. In its first big deal, Kadmon announced last Monday that it had acquired privately held Three Rivers for more than $100 million.
Three Rivers, whose main products are drugs for hepatitis C, is meant to be the commercial base of Kadmon, its revenues helping to defray the cost of developing new drugs.
The deal, an investor familiar with the structure said, is highly leveraged, to the extent that Three Rivers’ earnings might not be sufficient to cover the debt. But Mr. Waksal is betting that sales will soar because new pills being developed by other companies will make treatment more effective, enticing more people with hepatitis C to be treated.
“The hep C market is going to undergo a real sea change next year,” Mr. Waksal said. Three Rivers has a proprietary form of the drug ribavirin that requires two pills a day, instead of the standard six to eight. Even with new drugs coming, ribavirin will remain a mainstay of treatment.
In fact, Mr. Waksal is increasing that bet. On Monday, Kadmon is expected to announce that it has obtained exclusive worldwide rights to taribavirin, a form of ribavirin that may have fewer side effects. Kadmon is paying $5 million initially, with other payments possible later, to Valeant Pharmaceuticals, which has been testing the drug in clinical trials, according to the person close the transaction. Valeant will pay $7.5 million for rights to sell Kadmon’s ribavirin in Eastern Europe.
Kadmon has bought a tiny company started by Princeton professors that has a way to measure cell metabolism. Influencing a cell’s use of nutrients is emerging as a novel way to treat cancer and infectious diseases.
It has acquired a cancer drug based on Chinese medicine developed at Yale and by a company called PhytoCeutica. It has also acquired rights to a cancer drug, XL647, initially developed by Exelixis, from an investment firm called Symphony Capital.
Drugs picked up on the cheap from other companies are not always the best drugs.
But the investor on Kadmon’s board said the company’s pipeline is “like a puzzle that fits together perfectly,” so the drugs being acquired have more value in Kadmon’s portfolio than they would elsewhere. For instance, two cancer drugs might be used together for a greater effect.
Richard C. Mulligan, a professor of genetics at Harvard and a close friend of Mr. Waksal, said in an interview that he was talking to Harvard about taking a leave so he could be in charge of science at Kadmon. “I’m excited about the venture, and I do want to participate, and it’s very, very likely that I will,” he said.
Mr. Waksal said he wanted to learn from his mistakes.
“We’re meant to use every single experience in our lives to move forward,” he said. “Because there was that interregnum in my life, I have more of an emphasis to do it very well, without tarnishing, this go-around.”