The Shadow of Thalidomide

As an undergrad student, I studied geography. I was drawn to the idea that there might be some semblance of a systematic framework to understand the intersections between people and the places in which they live, both physically and metaphorically. As a transracial and transnational adoptee, I have always been fascinated by the ways in which people connect with space and place, the ways in which identities are constructed, and the economic interchanges that underpin the movement of people and goods around the world. I continue to be fascinated by the weaving of threads between micro and macro levels of interaction among communities in space.

One of my biggest aha moments came the semester I took a class called Women and Environments. We read Sandra Steingraber’s Living DownstreamTerry Tempest William’s Refuge. We read about the beginnings of the environmental justice movement. We read about Love Canal and Three Mile Island, we read about communities of color around the country and the world demanding that those in a position of privilege see the ways in which oppressions intersect.

We also talked about the ways in which pharmaceutical companies have intersected with the environment of the human body and in particular, with the female body. We learned about the racialized history of medical research and the limitations of drug safety testing for women. It was the first time I had been introduced to the idea that research, however “objective” it may strive to be, is still ultimately funded by “subjective” sources. The stories we read about drugs like thalidomide and pesticides like DDT and their specific effects on male and female reproductive health haunted me. At the time I never imagined I would one day be a student of the health professions, but I can see now, perhaps, how some of the seeds for my future work may have been planted in that class.

Finding this recent RetroReport on the history of thalidomide brought me back not only to my initial shock and disgust at the utter disregard of the pharmaceutical company involved, but also to this time in my life when understanding these intersections of power and privilege were new and empowering. I’ve thought about this a lot over my first term of pharmacology. So many of the drugs we’ve been learning about are classified as Category B or C, which leave a lot of room for unknown:

Category B: 

Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women OR Animal studies have shown an adverse effect, but adequate and well-controlled studies in pregnant women have failed to demonstrate a risk to the fetus in any trimester.

Category C:

Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.

I’m sure I will continue to learn more in our second term of pharmacology, as well as in the advanced courses I will take as a midwife, but as a woman of color, there is still a part of me that harbors a great level of skepticism about the rigor of oversight in the drug approval process. Pharmaceutical companies wield a great amount of power and influence and have a primary incentive for profit, despite whatever else they might say. It took the manufacturer of thalidomide fifty years to issue a formal apology for the thousands of lives and families they devastated.

As someone who came to nursing school without a lot of faith in the pharmaceutical industry, it’s been interesting to set aside some of my own biases enough to truly learn the details I need to learn to become an RN. I have been surprised though, that’s it’s not always been as difficult as I imagined it would be. If anything, I believe knowledge can be translated into power and I want to know as much as I can about the myriad drugs that my future patients might be prescribed. I still find it slightly terrifying to think that I will one day be able to prescribe certain drugs (well, depending on where I practice)…but I am grateful that I will not be moving into this role with the kind of blind faith in “the numbers” that I think many healthcare providers rely on.

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