Experiment Eleven (14 page)

On the morning of May 21, Waksman discussed with Russell Watson, the Rutgers Foundation lawyer, what Mr. Watson described as the “
Schatz claim
.” Although the content of this discussion was not recorded, Watson apparently advised Waksman to get Schatz to clarify his assistant status. The result was a letter typed by Waksman's secretary, thanking him for his guidance and advice and narrowly defining his work in the discovery of streptomycin as that of an “assistant” and no more.

In the letter, Schatz expressed his “appreciation for all that you have done for me both in my undergraduate, graduate and post-doctorate work.

“I feel particularly proud to have been associated with your group in the work on antibiotics, a subject which has raised the status of microbiology to a science second to none.

“In assisting you with the isolation of the streptomycin producing organism and in the isolation of streptomycin itself, I feel that I have rendered my own contribution,
no matter how small
that may appear, to building and developing the science of antibiotics. I hope that the work on streptomycin, carried out under your guidance and continuous active participation,
and in which in addition to myself also Miss Elizabeth Bugie and Miss H. Christine Reilly, have contributed to the best of their ability, will stand as a symbol to cooperative work under your wise and able leadership.”

Schatz signed the letter, never imagining that one day it would be used against him as evidence that whatever experiments he had carried out in the basement laboratory had not really been his experiments, but had always been under the direction of Dr. Waksman.

NEWS OF STREPTOMYCIN'S POWER GAVE WAR-WEARY
Europeans hope that they might be able to counter the
sudden rise of infectious diseases
, including tuberculosis. A number of factors had contributed to the increase. During the war, the TB hospitals and sanatoriums had been cleared to make room for air raid casualties, and the disease had spread more easily in overcrowded homes. Evacuations of cities to the country had introduced a whole new generation to unpasteurized milk. Workers who were desperate for jobs concealed their infections to keep working and spent longer hours in factories, reducing their levels of resistance.

All over the world, doctors were scrambling to find antibiotics to fight infectious diseases caused by Gram-negative bacteria, including urinary tract infections resistant to the sulfa drugs, various types of pneumonia, typhoid,
Salmonella
infections (also known as paratyphoid), acute brucellosis, and tularemia. Patients suffered and died for the lack of a drug like streptomycin. America's closest ally, Britain, was desperate for supplies of it.

As the world war had played a key role in the discovery of streptomycin, so now the cold war was playing a role in its development. The U.S. and British governments would continue to seek antidotes to a possible biological weapons attack, but this time from the Soviet Union. The British knew firsthand of the potential of streptomycin through secret trials at the chemical and biological warfare establishment at Porton Down. Those had shown that streptomycin was effective against the plague, endemic in some of the British colonies, and especially effective against tuberculosis. But for the moment, the U.S. government was keeping tight control over
the distribution of streptomycin, as it had with penicillin, which was still available only in Allied army hospitals. In Europe, a
black market
of vials of penicillin flourished, including many fakes. The Russians, who went through the war with only their version of René Dubos's gramicidin, had started to produce a crude penicillin from a mold lifted from the damp wall of a Moscow air raid shelter.

As the world learned more about streptomycin, including the sweeping claims that resulted from interviews with Dr. Waksman in the popular press, American and British authorities raced to separate out the truth of what streptomycin could do before it spread into the market. For responsible scientists, the drug was still in the testing phase, but that caution did not stop desperate efforts to find supplies. It might be easier, one British official suggested, if “our people” visiting Washington were asked to bring home tiny gram amounts “
in their pockets
.” The British ambassador in Washington, Lord Halifax, managed to find a private supply through an American doctor “
well-known to this embassy
,” but he warned Prime Minister Clement Attlee's new Labor government that American doctors were skeptical about some of the more extreme claims. Halifax cabled London that American physicians were concerned that there had been “a great deal of erroneous information about the efficacy of this drug with the unfortunate consequence that many doctors in England who have not had the opportunity to get first-hand knowledge ... still appear to be under the impression that the drug has far wider uses than has actually been proved to be the case in recent tests.”

Streptomycin was unavailable even to some officials in high office with the right connections. Alexander Fleming and Howard Florey, who with Ernst Chain had won the Nobel Prize in Medicine for the discovery and development of penicillin in 1945, had difficulty finding supplies. American doctors and officials became
increasingly troubled by the desperate calls
from across the Atlantic.

There was another emerging problem: Streptomycin had uncharted side effects. In addition to temporary dizziness after prolonged administration, there were some cases of kidney troubles, and it was not clear whether these effects were due to impurities or to the drug itself.

William Feldman and Corwin Hinshaw continued to urge caution in their reports. Although it was the “most promising drug” of natural or synthetic origin against TB, they did not yet know whether a patient could
be completely cured. Moreover, it was expensive. It was generally agreed that the minimum dose was four grams a day given in six separate doses and that the treatment would probably have to continue for six months, for a total cost of nine hundred dollars, a prohibitive amount for too many patients.

Selman Waksman (far left) in front of one of the fifteen-thousand-gallon fermenting tanks for mass production of streptomycin at Merck's Elkton, Virginia, plant in December 1945.
(The Merck Archives, 2011
)

The London
Times
medical correspondent was also cautious: “Great things are hoped for with streptomycin, but
early optimism
must be guarded. In any case, its use entails considerable discomfort for the patient, with six or so injections each day for possibly weeks ... Streptomycin, which is similar to penicillin, the product of a mold and equally harmless to human beings ... It is especially with regard to tuberculosis that experiments now made possible in this country will be watched with interest.”

The British government controlled what little was available, but the controls didn't always work, of course. Some black-market supplies got through. And the
British press
and the BBC featured heartrending appeals for children in desperate need of the drug. Government officials were embarrassed; the new miracle drug was in use in America, Britain's closest ally, and none was available in Britain. “Is there
really any justification
for these BBC SOS messages?” growled one government official. “... These
imply that there is no system by which the available supply can be distributed to cases of greatest need.” The government feared the rise of a wider
black market for streptomycin
, just like the one for penicillin. In America, there were reports that such a market already existed.

The public reaction might have been more extreme if it had been generally known that at Porton Down supplies had been found to test for antidotes to biological weapons that so far had not been used, even in the last brutal months of the world war.

Merck had supplied Porton with two batches of streptomycin for its own tests on the plague, which particularly interested the British. The
Porton scientists
used two strains of the plague from Africa and found that streptomycin was “highly efficient and non-toxic.” In a top secret report in 1945, government scientists at Porton concluded that streptomycin had great promise in combating half of the possible biological weapons then being considered. Its activity against TB was “particularly noteworthy.” Each of the potential weapons was letter coded, and in total they are a measure of how far the biological weapons program had advanced on each side of the Atlantic. Decoded, with results, they included N (anthrax), “apparently highly effective”; US (porcine brucellosis), “good protection in chick embryos”; and UL (tularemia), “strikingly successful.” But streptomycin had “no protective effective” against LA (glanders, which occurs primarily in horses, but has a high death rate in humans) or SI (psittacosis, or parrot disease, spread in bird feces and producing severe pneumonia-type symptoms in humans).

Of the sixteen copies made of the report, three went to Fort Detrick, the U.S. biological weapons research center, and one went to George Merck, still head of the U.S. Biological Warfare Committee. The British public was fed a different story.

The British answer to the shortage of supplies was to emphasize streptomycin's problems. A government statement to the
Times
warned that “in the very small number of patients with tubercular meningitis whose life has been prolonged by the treatment there has nearly always been permanent serious mental derangement, blindness and deafness. Steps are being taken to speed up production in this country, but not enough is known about this drug at present to justify the Government making it more freely available.”

Selman Waksman had been an extraordinarily effective salesman in
the U.S. media for streptomycin's therapeutic powers—and had also been nominated (unsuccessfully) in 1946 by an American physician for the Nobel Prize in Physiology or Medicine. If Waksman knew about his nomination he didn't mention it, but he was furious at the British for their public disparagement of his wonder drug. He cabled one of his contacts in the British drug industry, Sir Jack Drummond, research director of the drug company Boots, and asked him for background to the
Times
article. The situation was a “rather complicated one,” Drummond replied. First, it was natural for physicians to be impatient because the drug was unavailable. Britain was behind in producing it, and there was a “real danger” that “happy-go-lucky” trials would be made in a “
hit-and-miss
” fashion with “little sense of scientific control or accuracy.” Any supplies had been allocated by the government for official clinical trials. In the circumstances, the government's position was “a fair one, even if it erred on the side of caution.”

NO COUNTRY NEEDED
antibiotics of all types more desperately in the post-war world than Japan. Remarkably, the Japanese had managed to smuggle scientific papers describing penicillin production through Germany, and by 1944, when U.S. marines landed in the Marshall Islands, the Japanese had started to plan their own production. But only tiny amounts were available, and they also needed streptomycin. Five hundred TB patients were dying every day, but it would be some years before Waksman and Rutgers could agree on the terms of production with Japanese companies. In the meantime, the United States began testing its new atomic bombs in the same Marshall Islands, an exercise that surprisingly led to the discovery of yet another antibiotic, just like Albert Schatz's but from a different actinomycete. This time, however, the discovery was not exactly welcomed by Waksman.

On July 1, 1946, at eight o'clock in the morning, the U.S. Air Force dropped an atomic bomb on the Bikini Atoll, in the Pacific. It was the fourth atomic detonation, after the test in the New Mexico desert at Alamogordo and the bombing of Hiroshima and Nagasaki.

Watching the test
from the deck of a hospital ship, ten miles upwind, was a lanky, fair-haired Ph.D. student from Selman Waksman's laboratory named Donald Johnstone. Like Schatz, he had been drafted into the army
in 1942, but unlike Schatz, he had been sent to the European front. He spent the last months of the war in a field hospital in Germany.