It’s the early Sixties, and the German pharmaceutical market is booming. A sedative known as Contergan is among the best-selling medicine. Contergan’s lively ingredient is thalidomide, and it’s touted as a marvel drug, a nonaddictive sedative that’s safer than barbiturates.
Within the U.S. the drug is known as Kevadon, and its distributor is impatient to get it in the marketplace. However doctor and pharmacist Frances Oldham Kelsey, a medical expert on the U.S. Meals and Drug Administration, is stalling the approval of Kevadon. She desires extra data from the producer to show it’s secure.
In the meantime docs in Scotland and Australia are starting to suspect thalidomide may, in truth, be very poisonous. And in Germany reviews are starting to emerge of a mysterious epidemic of infants born with lacking limbs and different severe medical circumstances, however docs do not know what’s inflicting it.
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Katie Hafner: It was the Fifties, and Germany had climbed its means out of the rubble of World Battle II—out of famine and chaos and nationwide disgrace—and its financial system was roaring again to life.
Toine Pieters: We all know it because the Wirtschaftswunder, the miracle of the Germans.
Katie Hafner: Toine Pieters is a historian of pharmacology at Utrecht College within the Netherlands. And he says prescription drugs had been an enormous a part of this German Wirtschaftswunder, or financial miracle.
Toine Pieters: There was a powerful perception in miracle medicine. Very a lot so. In magic bullets. And we had actually sensible innovations within the period of prescription drugs with the brand new antibiotics, new antipsychotics, et cetera, et cetera., life saving medicine that got here on the markets.
Katie Hafner: Pharmaceutical firms had been raking within the money. And the second-biggest vendor, proper behind Aspirin, was a sedative known as Contergan. Lively ingredient: thalidomide.
Contergan was made by a small however aggressively formidable firm known as Chemie Grünenthal. And it was because of the wild progress of Contergan gross sales that the corporate’s revenues soared.
And in the event you believed the hype from Grünenthal’s advertising and marketing males, Contergan was a marvel drug, a sedative that was non-toxic, which means no unwanted effects.
Toine Pieters: It is fascinating simply that you simply declare to have a sedative that is non poisonous. I imply, there may be nothing non-toxic within the pharmacy. Each medication we learn about has unwanted effects. I am at all times amazed how can individuals so silly?
Katie Hafner: However let’s step again for only a second. In 1956, the 12 months earlier than the corporate’s official launch of this miracle capsule, one thing curious occurred.
A Grünenthal worker took some thalidomide samples residence and gave them to his pregnant spouse. When the couple’s daughter was born on Christmas Day, 1956, she didn’t have ears.
I’m Katie Hafner, and that is Misplaced Ladies of Science.
In the present day, within the second episode of our particular sequence, Satan within the Particulars, how the risks of thalidomide managed to fly below the radar for FOUR years, and the way Frances Kelsey on the FDA lastly obtained the proof she wanted that this drug was not as secure as its U.S. producer was claiming.
Katie Hafner: Within the fall of 1960, Frances Kelsey was sitting on the lengthy steel desk in her workplace that served as her desk, working her means by way of William S. Merrell’s voluminous software to promote thalidomide within the U.S.. Frances had no thought what was taking place in Europe, the place increasingly infants had been being born with severe, typically deadly, accidents. In truth, neither did Merrell.
From what she’d seen of Merrell’s software thus far, Frances was not impressed. She had sixty days from the date of submission to reply to the appliance. With a purpose to deny it, she had to have the ability to show it was unsafe. However right here’s one drawback: She didn’t have any information to show the drug was harmful. However Merrell simply hadn’t given her any convincing information displaying it was secure both. And the clock was ticking.
Which brings us to a different drawback: If the FDA didn’t reply by the 60-day deadline, the drug would go to market robotically. That’s how the company labored again then.
However Frances had a secret weapon. Somebody with insider data of the FDA’s drug approvals course of. Somebody who was principled…
Trent Stephens: Cantankerous.
Christine Kelsey: Very sturdy. Very opinionated.
Jennifer Vanderbes: She was a dynamo.
Katie Hafner: She was Barbara Moulton, the FDA whistleblower who testified earlier than the Senate simply earlier than Frances Kelsey joined the company. Everybody we talked to made it clear that Barbara left an impression. She was a chain-smoking, straight-shooter, simply not hung up on social conventions. When she obtained married, it was on her massive outdated household farm in rural West Virginia, and the story goes that she interrupted her personal wedding ceremony to assist beginning a cow.
In DC, Barbara rubbed lots of people the fallacious means. However regardless that she wasn’t everybody’s cup of tea, Frances took a shine to her.
By all accounts, these two girls couldn’t be extra completely different. We don’t know what it was about Barbara that Frances was drawn to. Perhaps she admired Barbara’s braveness, her moxy… In any case, The 2 grew to become quick associates.
Christine Kelsey: Dr. Barbara, we at all times known as her.
Katie Hafner: Christine Kelsey, once more, Frances’s youthful daughter.
Christine Kelsey: She was simply very, in our minds, nearly coarse as a result of she actually instructed it like it’s. And mum being Canadian and being reserved, wouldn’t be so direct and forthright in her speech, though they very a lot agreed with one another on fairly effectively every little thing.
Katie Hafner: In order the sixty-day window drew nearer to an in depth, Frances requested Barbara for recommendation. Right here’s Jennifer Vanderbes, creator of the guide Marvel Drug, once more.
Jennifer Vanderbes: So Barbara Moulton says, effectively there’s, you already know, there’s possibility three that nobody tells you about. You do not essentially approve or reject a drug software. There’s this loophole the place you possibly can primarily simply delay- you possibly can name the appliance incomplete, proper. You possibly can simply ask for extra data and stall.
Katie Hafner: So on November 10, 1960, simply as her time ran out, Frances Kelsey despatched Merrell an official letter. The gist was this: the appliance wanted work. The animal research had been incomplete. The medical human research had been incomplete. They hadn’t checked out long-term security. There have been inconsistencies. There have been complicated elements. Frances’s record went on and on. In conclusion, the entire software was incomplete. Not rejected. Not permitted. However incomplete. The clock reset to 60 extra days.
The corporate was nothappy, particularly, one among its workers, Joseph Murray.
Cheryl Warsh: Dr. Murray was the physician for probably the most half that might run backwards and forwards to the FDA. And he had a really good relationship with the opposite FDA individuals earlier than that.
Katie Hafner: Cheryl Warsh once more, a historical past professor at Vancouver Island College.
Cheryl Warsh: They go for, like, lengthy lunches and they might meet one another to have martinis. And it was all fairly outdated boy type of factor as a result of every little thing simply type of obtained handed. So it did not actually matter.
Katie Hafner: Effectively, it mattered now. Merrell had lots driving on this new drug, and Joseph Murray was rising impatient. A couple of days after Frances despatched out her letter, he known as her to ask what was occurring with the Kevadon software. The FDA’s letter nonetheless hadn’t arrived. Frances assured him it was on its means. He requested if it had been okay, and he or she instructed him that there have been some areas that had been incomplete, however she didn’t have a duplicate of the letter on her.
Okay, the man was a pest, however he was below stress. His larger ups had been nonetheless ready on FDA approval. That they had lined up dozens of gross sales representatives to start out hawking the drug in hospitals. The gross sales machine was raring to go.
The following day, a really sad Joseph Murray known as Frances once more. He’d gotten the official letter declaring the appliance incomplete. And he needed her to know he was distressed by the contents.
Katie Hafner: We don’t know precisely what occurred in that cellphone name, however we do know Frances wasn’t budging.
And Joseph Murray grudgingly, little question, saved attempting to win her over. A month handed, and at last, in mid-December, Joseph Murray and a colleague arrived in DC in individual to current their case. Frances, together with a number of others from the FDA had been in attendance.
On the assembly, the Merrell crew trotted out all types of latest information, however Frances discovered none of it convincing.
This assembly wasn’t going to clinch the deal for Merrell. On and on it went. The FDA had questions. Merrell tried to provide solutions. The FDA requested but extra questions. Joseph Murray grew extra annoyed. In January of the brand new 12 months, Murray even known as Frances’s bosses to complain.
Cheryl Warsh: He began speaking to her superiors and say, why do not you get a distinct reviewer and the remainder of it?
Katie Hafner: However Frances was saved on the case.
Weeks handed. It appeared like they could be caught on this dance for a protracted whereas. And the way lengthy may Frances actually preserve this up? Positive, their software was insufficient, however she nonetheless didn’t have any proof the drug was truly dangerous.
However in the midst of this tussle with Murray, Frances got here throughout a disturbing bit of knowledge. It was a letter to the editor within the British Medical Journal about thalidomide. A physician in Scotland had discovered a aspect impact.
Katie Hafner: When Frances Kelsey’s daughter Christine thinks again on what was occurring within the Kelsey family in early 1961, she simply remembers it as being a fairly regular time. Christine says her dad and mom didn’t work extra time. The household ate dinner collectively. No matter pressures her mom may need been experiencing on the FDA, she didn’t carry them residence. Nonetheless, science and pharmacology pervaded every little thing.
Christine Kelsey: Within the 50s and 60s, docs would get samples by way of the mail. So, like, every single day, we might get one or two capsule bottles of no matter from the pharmaceutical firms, and he or she at all times saved her medical license in order that she may get these samples, in order that she may see what are they had been sending. We might at all times open the bottles and put them in an enormous jar. So we had an enormous jar of multicolored drugs that we lastly threw out in 2014 or 15.
Katie Hafner: There have been pamphlets for brand new medicine too, testimonials, thinly-veiled advertisements mainly.
Christine Kelsey: And he or she would learn the flyers each evening. That may be her after-work leisure can be studying the medical flyers to make it possible for false commercial wasn’t taking place.
Katie Hafner: After which there have been the medical journals that Frances and her husband, Ellis, used to learn within the evenings.
It was on a type of evenings that Frances learn one thing that alarmed her. It was a letter to the British Medical Journal with some information about thalidomide.
It was in a problem of the journal revealed in December of 1960. However due to a postal strike, it will take a number of extra weeks till Frances’s copy arrived, someday in late January or early February of 1961.
The letter was written by a Scottish physician named Leslie Florence. The title: “Is Thalidomide to Blame?”
He’d observed an odd constellation of signs in 4 of his sufferers. To begin, paresthesia – a sensation of prickling or burning or numbness. It will begin of their ft after which transfer to their palms. Additionally their extremities would get chilly. They usually had leg cramps and poor muscle management.
And there was one thing else. Every of the 4 sufferers had been taking a nightly dose of thalidomide for greater than a 12 months.
The physician famous how everybody mentioned thalidomide was remarkably non-toxic. And but, when he took sufferers off thalidomide, there was “marked enchancment.” So perhaps, he questioned, thalidomide was poisonous in spite of everything? Was anybody else noticing this sort of factor?
It was a disturbing revelation. Thalidomide was purported to be this miraculously non-toxic drug. However these signs gave the impression of peripheral neuritis, often known as peripheral neuropathy, mainly, injury to the nerves that ship indicators from the mind and spinal wire to the remainder of your physique.
This text had been revealed weeks earlier than, and but Frances had heard nothing about it from Merrell. Did the corporate not learn about it?
Murray had been calling repeatedly in February to test in on the Kevadon software, however hadn’t talked about something about this. So when he known as once more, on February 23, Kelsey waited to see if he’d say something. He didn’t. When she requested him immediately, he admitted he’d seen it. However solely not too long ago, and he made it sound like he wasn’t too nervous about it.
Besides that only a week earlier than his cellphone dialog with Frances, Joseph Murray had despatched an pressing letter about this very subject to Distillers, the British distributor of thalidomide. Murray needed to know in the event that they knew something about this peripheral neuritis report. Oh sure they did. Distillers, it turned out, had identified in regards to the peripheral neuritis even longer. The identical creator of the BMJ letter had contacted them about his peripheral neuritis considerations nearly two years earlier, in February 1959, and by August 1960, Distillers put warnings on the labels. So earlier than Merrell had submitted its software to the FDA, there was Distillers placing warnings on its label.
And Distillers weren’t the one ones that knew it. It seems again in Germany, the boys at Chemie Grünenthal had been already conscious of the doable neurological unwanted effects of thalidomide. Historian Toine Pieters once more:
Toine Pieters: We all know in regards to the neurological unwanted effects as a result of they had been reported. It is not that the docs testing the drug had been blind. They weren’t.
Katie Hafner: Grünenthal had its first reviews of hostile unwanted effects even earlier than the drug went on sale. And the primary report of doable nerve injury got here no less than as early as 1959. And regardless of these reviews, the corporate promoted the drug as non-toxic.
Now, we may give them the advantage of the doubt on this level. Everytime you give a drug to a lot and many sufferers over a protracted time frame, a few of them are going to get sick, simply randomly. A few of them may have coronary heart assaults, a few of them will get most cancers. And which may have completely nothing to do with the drug. One of the best ways to search out out a drug’s particular results is to conduct randomized, placebo-controlled research over a ample time frame on an enormous group of sufferers. However it seems that in Germany in these years, a drug could possibly be permitted with out that type of rigorous research.
Toine Pieters: We did not have obligatory medical trials at the moment. Major proof was the proof of particular person docs on the premise of observations of their sufferers taking a brand new drug. It’s anecdotal proof, actually.
Katie Hafner: What he’s saying is that docs can be given new experimental medicine, and in a completely non-rigorous means, they’d form of let the businesses, you already know, know the way it’s going.
Grünenthal remains to be round in the present day. We contacted them as we had been reporting this story, and an organization consultant instructed us that in response to those reviews of nerve injury, the corporate did take motion. They ultimately utilized for prescription-only standing as an alternative of over-the-counter. That didn’t occur till Might 1961. However in addition they did one thing in 1960. It added a warning label.
The label mentioned that after roughly extended use of thalidomide, signs may happen in sufferers predisposed to them. Such unwanted effects, mentioned the label, “might embody sudden pores and skin rashes or fixed restlessness, trembling, tingling or numbness within the palms or ft. These allergic reactions subside after speedy discontinuation.” That was the label.
Now word, that the label calls these “allergic reactions” – extra importantly, it says these reactions will go away after you cease taking the drug. We now know that’s not at all times true. For some sufferers, nerve injury from thalidomide is irreversible.
In any case, if it was proven that Grünenthal was intentionally discounting these nerve injury reviews, which may have was a scandal for the corporate. However because it occurs, Grünenthal was about to have a MUCH larger scandal on its palms that might flip that aspect impact of thalidomide right into a footnote.
On April 24, 1961, in a hospital in Hamburg, Germany, Karl and Linde Schulte-Hillen had been about to turn out to be dad and mom.
Jennifer Vanderbes once more:
Jennifer Vanderbes: So Karl and Linde are this, you already know, beautiful younger pupil couple dwelling in Germany they’re wildly in love, they’re newly wed, they’re having a child, over the moon.
Katie Hafner: Karl was in his final 12 months of regulation college, and was in a gathering on campus when Linde delivered their child boy. He rushed again to the hospital as shortly as he may.
Jennifer Vanderbes: He is met on his means in, one thing’s fallacious.
Katie Hafner: His son was born with shortened arms, and three fingers on every hand.
Jennifer Vanderbes: And his spouse has been there alone within the hospital with these nurses appearing very unusual. She’s confused and devastated. They’re each fraught. However the actually gorgeous second for that is that his sister a number of weeks earlier had given beginning to a child with related malformations.
Katie Hafner: Six weeks earlier, Karl’s sister had had a child with shortened arms. However Karl hadn’t instructed Linde. He didn’t wish to fear her. However now that his personal son, a smiley child named Jan, had the identical situation Karl was determined to know why.
Jennifer Vanderbes: He begins type of asking round, he finds out, he hears a rumor that there are extra infants born like this at different hospitals within the space. So he begins looking for somebody with medical experience who’s keen to interact in a dialog and never only a type of cowl up. And he lastly will get related with this pediatrician and geneticist, Widukind Lenz.
Katie Hafner: Widukind Lenz was the son of Fritz Lenz, a infamous Nazi geneticist who was a staunch advocate of racial cleaning and the sterilization of disabled individuals in Germany. In truth, Fritz Lenz thought one thing like a 3rd of Germans shouldn’t be allowed to breed. His son, Widukind himself was a part of the Hitler Youth. Now, we don’t know if that was one thing his father pushed him into or if he was a real believer as a youngster. However we do know his legacy would find yourself being very completely different from his father’s. Widukind Lenz’s first assembly with Karl Schulte-Hillen would set him on a course to turn out to be one of the crucial distinguished advocates for disabled individuals in twentieth century Germany.
Jennifer Vanderbes: So he took the assembly. and he listens to Karl’s story. And, the very first thing he says is, Oh, that is most likely genetic.
Katie Hafner: However Widukind agreed to look at Karl’s son, Jan. And when Karl introduced Jan into Widukind’s workplace every week later, Widukind instantly acknowledged Jan’s situation as one thing known as phocomelia.
Jennifer Vanderbes: Which roughly interprets to seal limbs, the place you have obtained type of palms and ft nearly sprouting immediately from the shoulders or hips.
Katie Hafner: Phocomelia is extremely uncommon. Lower than one out of each 100,000 infants is born with it. Nearly all obstetricians will go their whole careers with out ever seeing a single case. And right here, Karl was telling Widukind all about two circumstances, born inside weeks of one another.
Widukind and Karl began compiling an inventory of different infants born with phocomelia. In Munster, which is about six hours southwest of Hamburg, twenty infants had been born with out arms at one hospital. And 13 extra in two neighboring cities. In the summertime of 1961, when the 2 males put advertisements in newspapers, extra reviews flooded in. So that they went to see what they may discover. Right here’s Jennifer Vanderbes once more.
Jennifer Vanderbes: They set out on like a highway journey in an outdated VW Beetle, they usually go form of home to accommodate.
Katie Hafner: In addition they go to eating places and bars they usually ask if anybody is aware of of infants with quick legs or quick arms. Karl exhibits individuals an image of Jan. And the reply is sure.
Jennifer Vanderbes: They usually in a short time understand that there’s truly what may most likely be known as an epidemic of this very particular beginning malformation. There are tons of of those infants throughout Germany rapidly.
Katie Hafner: They interview one household, then two, then extra. They ask them as many questions as they’ll, attempting to determine what’s inflicting this.
Jennifer Vanderbes: They believe that one thing has one way or the other–some type of toxin has entered the system of those pregnant girls.
Katie Hafner: However what sort of toxin was it? There was no apparent hyperlink between the meals these moms had eaten, the cosmetics they used, the locations they’d been.
And I wish to pause right here for a second. That is the summer time of 1961. Thalidomide has been in the marketplace for nearly 4 years at this level. Hundreds of infants have been affected. So that you could be considering, how was this missed? How is it that it took this lengthy for individuals to even discover there’s an epidemic taking place? How was it nobody made the connection to thalidomide?
Effectively, a part of the issue is that phocomelia does happen naturally too. If one child is born with shortened arms, effectively, that occurs. However a number of infants in a single hospital in a brief span of time? That’s unusual, however perhaps there’s one thing taking place domestically. May it even be one thing within the native gene pool? Or a coincidence?
To uncover the reason for an epidemic, what you actually need is nice report retaining over a protracted time frame throughout a big space and somebody to look over all that information. Pair that with dependable case histories for all of the sufferers, and also you may even determine the trigger with some measure of effectivity. Apparently, none of that occurred.
However regardless of all these obstacles, it’s not like Widukind Lenz was the one one which observed. In September 1961 a health care provider from Krefeld not too removed from Dusseldorf, revealed a paper describing a surge in unusual births. He’d discovered 27 circumstances of infants born with extreme malformations, and infrequently blocked intestines, coronary heart defects, and lacking ears.
It was an odd assortment of signs, with no apparent connection between them. Dr. Wiedemmann dominated out infections, endocrine issues, and a wide range of different doable culprits, and similar to Widukind Lenz and Karl Schulte-Hillen, up north in Hamburg, this doctor concluded it needed to be some type of poisonous substance. And, simply because the touring duo from Hamburg, Dr. Wiedemann was stumped. What may that poisonous substance be?
It’s not as if there have been no clues pointing to thalidomide. The timing appeared roughly proper. Wiedemann traced the earliest circumstances within the samples he’d acquired again to 1959. Grunenthal had launched its hit drug two years earlier. And one other fascinating factor was that the epidemic didn’t appear to be affecting East Germany, which was then a separate nation. Contergan wasn’t offered there.
However there have been additionally different issues that threw these sleuths off the path. And get this one: Dr. Wiedemann in Krefeld was below the impression that thalidomide was being taken broadly in the USA. We don’t know the place he obtained that impression, however that’s what he thought.
And so that is simply so ironic. In the USA, Merrell thought thalidomide should be secure as a result of so far as Merrell knew, it had been in Europe for just a few years with out incident. Effectively, apparently, some Germans thought the identical factor about the USA. Wouldn’t they’ve heard if there was an issue over within the US? Completely fallacious on either side. And as my husband, the medical errors knowledgeable, would say: This was to turn out to be one gigantic affected person security drawback.
However we digress.
So over in Germany, docs had been puzzling over these births, not fairly connecting the dots. However as we all know, thalidomide was used all around the world, so why weren’t others noticing the issue? Effectively, truly, somebody did. Over in Australia, an obstetrician named William McBride started to suspect thalidomide proper across the time Widukind and Karl began their investigations. McBride had delivered three infants with severe malformations inside only a few weeks of one another, and realized the moms had taken thalidomide in each case. He even known as the British firm, Distillers, to warn them, however nothing got here of it on the time.
And so for months, docs had been circling round thalidomide, getting nearer, then thrown off the path. And that was the state of affairs in Germany in September of 1961, 4 years after Contergan first went on sale, and 5 years after a child with out ears had been born to a Grünenthal worker.
Again on the FDA, that very same month, late September 1961, Frances Kelsey obtained one more name from the very persistent Joseph Murray at Merrell. One other vacation season was simply across the nook, so he actually needed to get these drug brochures printed in October. They wanted to get a transfer on in the event that they had been going to fulfill their Christmas deadline, proper? The season for sedatives was upon us!
For her half, Frances nonetheless discovered issues of concern. First, there was the unresolved subject of peripheral neuritis. However Frances additionally talked about one other, extra pressing concern. What about the usage of the drug throughout being pregnant? It was a query she had requested earlier than however had by no means acquired an satisfactory response.
It wasn’t that Frances Kelsey had any particular data of thalidomide’s results at this level, or that she’d heard something in regards to the rise in these uncommon births over in Europe. That information hadn’t reached the US.. And even in Germany, Widukind Lenz solely had his suspicions, no agency conclusions at this level. However Frances Kelsey simply knew that the corporate hadn’t proven thalidomide was secure in being pregnant. So no, there weren’t going to be shortcuts, or quick monitoring or a assure of a Christmas launch. No FDA approval for now.
However right here’s the factor. FDA approval or not, Merrell was already distributing the drug. It had already been given to 1000’s of sufferers throughout the US–And the primary American thalidomide infants had already been born.
Subsequent time, on The Satan within the Particulars:
Gwen Reichman: I mentioned, I do know that is genetic and I will cross it on. And my mother mentioned, effectively, that is not truly the case. And I mentioned, effectively, what’s it then? And that is when she mentioned, it is from a drug known as thalidomide that I used to be given after I was pregnant with you. And that was it. Dialog over.
Katie Hafner: This episode was produced by Sarah Wyman with our senior producer Elah Feder and me, Katie Hafner. Our affiliate producer is Mila Rahim. Sophia Levin and Eva McCullough offered analysis help.
Our music was composed by Lizzy Younan. We had reality checking assist from Lexi Atiya. Sophie McNulty and Alexa Lim did audio enhancing and sound design. And Lisk Feng created the artwork for this sequence.
Thanks, as at all times, to my co-executive producer, Amy Scharf, and to Eowyn Burtner our program supervisor, Deborah Unger, our senior managing producer, in addition to to Jeff DelViscio at our publishing associate, Scientific American.
We’re funded partly by the Alfred P. Sloan Basis and the Anne Wojcicki Basis. We’re distributed by PRX.
For a transcript of this episode or to be taught extra about Frances Kelsey, please go to our web site, lostwomenofscience.org, and don’t neglect to click on on that all-important, omnipresent, donate button!
See you subsequent week!
HOST: Katie Hafner
Katie is the co-founder and co-executive producer of Misplaced Ladies of Science. She is the creator of six non-fiction books and one novel, and was a longtime reporter for The New York Occasions.
PRODUCER: Sarah Wyman
Sarah is an audio reporter and narrative documentary producer. Her work has aired on the Atlas Obscura Podcast, 99% Invisible, The World from PRX, and Enterprise Insider’s Dropped at you by…
SENIOR PRODUCER: Elah Feder
Elah is a journalist, audio producer, and editor. Her work has appeared on Science Friday, Undiscovered, Science Diction, Planet Cash, and numerous Canadian Broadcasting Firm radio exhibits.
GUESTS:
A.H.L.M. (Toine) Pieters is chair of historical past of pharmacy and allied sciences at Utrecht College
Trent Stephens is a developmental biologist and author
Jennifer Vanderbes is a novelist, journalist and screenwriter
Cheryl Krasnick Warsh is professor of historical past on the College of Vancouver Island
Christine Kelsey daughter of Frances Oldham Kelsey
Unique Artwork: Lisk Feng
Artwork Design: Lily Whear
FURTHER READING:
Autobiographical Reflections. Frances Oldham Kelsey. U.S. Meals and Drug Administration
