Greed and Power Uber Alles

Two new books and one documentary prove that plain old human insatiable hunger for money and power is always the driver for any large-scale tragedy.1 And if I may be so bold,2 the next few years will be our country’s reckoning with the worst examples of this.

Patrick Radden Keefe is one of those nonfiction writers whose work I will read no matter the topic. But Empire of Pain: The Secret History of the Sackler Dynasty combines two things I’m fascinated by into one (heavy) book: public policy and rich, amoral families.3

The Sacklers are, in the modern parlance, real pieces of work. Radden Keefe chooses to focus on how they built their staggering wealth rather than honing in on the people they harmed along the way. Which is an interesting choice and one that works: we’ve heard so many stories about addicts that we’ve grown numb to them. We haven’t heard enough stories about those who’ve profited off of human misery, mostly because those making bank have better lawyers than those barely scraping by.

(Radden Keefe, Doubleday, and The New Yorker4 have a top drawer legal team, btw. Plus, Radden Keefe brings all the receipts in his detailed, meticulous footnotes. They are the journalistic equivalent of “fuck around and find out” and I really hope the Sacklers decide to fuck around because discovery would be epic.)

The precis of Empire is simple: In the 1940s and 50s, the three Sackler brothers built Perdue Pharma5 and they used all kinds of deceptive marketing to build an audience for their products. Thanks to a lenient (and likely complicit) regulator at the FDA, they released OxyContin without much oversight. Mayhem ensued. We will be dealing with the consequences for quite some time.

What was previously unknown was a) how much the Sacklers and their executive team knew about the downsides of Oxy,6 b) how hard they pushed to make all the money they could, and c) how much distance they tried to create between their business and their philanthropy. Radden Keefe methodically lays it all out.

When I finished reading, I was simultaneously incandescent with rage at the family and overwhelmed with admiration for Radden Keefe. Empire should win all of the awards. It should also change the narrative about pharma companies and how they can market their products.

The book can’t do that alone, mind, because most people don’t really read — and even for the most avid reader, a 500+ page book is a big ask. But Alex Gibney7’s two-part documentary The Crime of the Century also gets you where you need to go, if less thoroughly. The first half is about OxyContin and the Sacklers; the second half is all about Insys Therapeutics and Fentanyl.8 The last few minutes of the second part really force home what all of this greed has cost all of us — and how unlikely it is that the consequences could ever match the scale of the crime.

Still. There should be more consequences.

While OxyContin and Fentanyl stories bring the room down, Michael Lewis’ The Premonition doesn’t so much lighten the room up so much as show you who the helpers are. And those helpers deserve every last cent we can give them because they are doing good work.

Lewis is taking on the government response to COVID. Rather than focus on the bad actors, he shines his light on the public health officers and others in or near the government who did their absolute best to mitigate the Federal-level shitshow.

In particular, Lewis showcases Dr. Charity Dean, who started as a county-level public health officer in California and whose orders I would follow into battle. Dr Dean is a force, you guys, and through her story Lewis shows exactly how the CDC failed as well as the very real consequences of underfunding our public health systems.9

Lewis introduces us to Dean with the perfect anecdote. She’s called to a death and winds up removing the deceased’s lungs for testing. The only thing she has on hand is an orange Home Depot bucket, which she scoops the lungs into. The coroner and the other men standing around expected her to wither; instead, she just did her damn job.

“… to her it was almost another day in her life as the local health officer. They had no idea of the things she had done, or what she was capable of. The coroner obviously hadn’t even considered the possibility that she was a trained surgeon. ‘Men like that always underestimate me,’ she said. ‘They think my spirit animal10 is a bunny. And it’s a fucking dragon.’”11

Dean’s story, which you really ought to read the rest of, weaves through Lewis’ tale of the very smart people who knew what we were in for and how they were systemically marginalized by an administration more focused on grift and profit.

These three works prove that we can make better choices if we want to but we can’t until we look at what can happen if we let the worst devils of human nature run the show.


Which is to say: it’s not the Illuminati or any other vast conspiracy. Without fail, the root cause will be individuals deciding they want more power or money (and the two can be interchangeable) and will do anything to get it.


and I can, because this is my newsletter


Speaking of, I cannot wait for the next season of Succession.


which is where a version of this story was first reported


there are some twists and turns before it becomes Purdue but that’s not important right now


Short version: a lot.


Gibney also made Going Clear, which is about Scientology, and The Inventor, which is about Elizabeth Holmes, so he knows a thing about handling litigious subjects.


The popular take is that China is flooding the illegal drug market with Fentanyl, which might be true, but Insys created the market for it in the first place. Those fuckers deserve every consequence that can be meted out to them.


I touched on this in Somebody’s Gotta Do It and had zero idea how prescient it would be.


I know.


Honestly? About half of the public health workers I’ve met are dragons. And I am here for it.