Pike and an oncologist named Darcy Spicer have joined forces with another oncologist, John Daniels, in a startup called Balance Pharmaceuticals. The firm operates out of a small white industrial strip mall next to the freeway in Santa Monica. One of the tenants is a paint store, another looks like some sort of export company. Balance’s offices are housed in an oversized garage with a big overhead door and concrete floors. There is a tiny reception area, a little coffee table and a couch, and a warren of desks, bookshelves, filing cabinets, and computers. Balance is testing its formulation on a small group of women at high risk for breast cancer, and if the results continue to be encouraging, it will one day file for FDA approval.
“When I met Darcy Spicer a couple of years ago,” Pike said recently, as he sat at a conference table deep in the Balance garage, “he said, ‘Why don’t we just try it out? By taking mammograms, we should be able to see changes in the breasts of women on this drug, even if we add back a little estrogen to avoid side effects.’ So we did a study, and we found that there were huge changes.” Pike pulled out a paper he and Spicer had published in the Journal of the National Cancer Institute, showing breast X-rays of three young women. “These are the mammograms of the women before they start,” he said. Amid the grainy black outlines of the breast were large white fibrous clumps — clumps that Pike and Spicer believe are indicators of the kind of relentless cell division that increases breast-cancer risk. Next to those X-rays were three mammograms of the same women taken after a year on the GnRHA regimen. The clumps were almost entirely gone. “This to us represents that we have actually stopped the activity inside the breasts,” Pike went on. “White is a proxy for cell proliferation. We’re slowing down the breast.”
Pike stood up from the table and turned to a sketch pad on an easel behind him. He quickly wrote a series of numbers on the paper. “Suppose a woman reaches menarche at fifteen and menopause at fifty. That’s thirty-five years of stimulating the breast. If you cut that time in half, you will change her risk not by half but by half raised to the power of 4.5.” He was working with a statistical model he had developed to calculate breast-cancer risk. “That’s one-twenty-third. Your risk of breast cancer will be one-twenty-third of what it would be otherwise. It won’t be zero. You can’t get to zero. If you use this for ten years, your risk will be cut by at least half. If you use it for five years, your risk will be cut by at least a third. It’s as if your breast were to be five years younger, or ten years younger — forever.” The regimen, he says, should also provide protection against ovarian cancer.
Pike gave the sense that he had made this little speech many times before, to colleagues, to his family and friends — and to investors. He knew by now how strange and unbelievable what he was saying sounded. Here he was, in a cold, cramped garage in the industrial section of Santa Monica, arguing that he knew how to save the lives of hundreds of thousands of women around the world. And he wanted to do that by making young women menopausal through a chemical regimen sniffed every morning out of a bottle. This was, to say the least, a bold idea. Could he strike the right balance between the hormone levels women need to stay healthy and those that ultimately make them sick? Was progestin really so important in breast cancer? There are cancer specialists who remain skeptical. And, most of all, what would women think? John Rock, at least, had lent the cause of birth control his Old World manners and distinguished white hair and appeals from theology; he took pains to make the Pill seem like the least radical of interventions — nature’s contraceptive, something that could be slipped inside a woman’s purse and pass without notice. Pike was going to take the whole forty-year mythology of natural and sweep it aside. “Women are going to think, I’m being manipulated here. And it’s a perfectly reasonable thing to think.” Pike’s South African accent gets a little stronger as he becomes more animated. “But the modern way of living represents an extraordinary change in female biology. Women are going out and becoming lawyers, doctors, presidents of countries. They need to understand that what we are trying to do isn’t abnormal. It’s just as normal as when someone hundreds of years ago had menarche at seventeen and had five babies and had three hundred fewer menstrual cycles than most women have today. The world is not the world it was. And some of the risks that go with the benefits of a woman getting educated and not getting pregnant all the time are breast cancer and ovarian cancer, and we need to deal with it. I have three daughters. The earliest grandchild I had was when one of them was thirty-one. That’s the way many women are now. They ovulate from twelve or thirteen until their early thirties. Twenty years of uninterrupted ovulation before their first child! That’s a brand-new phenomenon!”
5.
John Rock’s long battle on behalf of his birth-control pill forced the Church to take notice. In the spring of 1963, just after Rock’s book was published, a meeting was held at the Vatican between high officials of the Catholic Church and Donald B. Straus, the chairman of Planned Parenthood. That summit was followed by another, on the campus of the University of Notre Dame. In the summer of 1964, on the eve of the feast of St. John the Baptist, Pope Paul VI announced that he would ask a committee of Church officials to reexamine the Vatican’s position on contraception. The group met first at the Collegio San Jose, in Rome, and it was clear that a majority of the committee were in favor of approving the Pill. Committee reports leaked to the National Catholic Register confirmed that Rock’s case appeared to be winning. Rock was elated. Newsweek put him on its cover, and ran a picture of the Pope inside. “Not since the Copernicans suggested in the sixteenth century that the sun was the center of the planetary system has the Roman Catholic Church found itself on such a perilous collision course with a new body of knowledge,” the article concluded. Paul VI, however, was unmoved. He stalled, delaying a verdict for months, and then years. Some said he fell under the sway of conservative elements within the Vatican. In the interim, theologians began exposing the holes in Rock’s arguments. The rhythm method “ ‘prevents’ conception by abstinence, that is, by the non-performance of the conjugal act during the fertile period,” the Catholic journal America concluded in a 1964 editorial. “The Pill prevents conception by suppressing ovulation and by thus abolishing the fertile period. No amount of word juggling can make abstinence from sexual relations and the suppression of ovulation one and the same thing.” On July 29, 1968, in the “Humanae Vitae” encyclical, the Pope broke his silence, declaring all “artificial” methods of contraception to be against the teachings of the Church.
In hindsight, it is possible to see the opportunity that Rock missed. If he had known what we know now and had talked about the Pill not as a contraceptive but as a cancer drug — not as a drug to prevent life but as one that would save life — the Church might well have said yes. Hadn’t Pius XII already approved the Pill for therapeutic purposes? Rock would only have had to think of the Pill as Pike thinks of it: as a drug whose contraceptive aspects are merely a means of attracting users, of getting, as Pike put it, “people who are young to take a lot of stuff they wouldn’t otherwise take.”
But Rock did not live long enough to understand how things might have been. What he witnessed, instead, was the terrible time at the end of the sixties when the Pill suddenly stood accused — wrongly — of causing blood clots, strokes, and heart attacks. Between the midseventies and the early eighties, the number of women in the United States using the Pill fell by half. Harvard Medical School, meanwhile, took over Rock’s Reproductive Clinic and pushed him out. His Harvard pension paid him only seventy-five dollars a year. He had almost no money in the bank and had to sell his house in Brookline. In 1971, Rock left Boston and retreated to a farmhouse in the hills of New Hampshire. He swam in the stream behind the house. He listened to John Philip Sousa marches. In the evening, he would sit in the living room with a pitcher of martinis. In 1983, he gave his last public interview, and it was as if the memory of his achievements were now so painful that he had blotted it out.
He was asked w
hat the most gratifying time of his life was. “Right now,” the inventor of the Pill answered, incredibly. He was sitting by the fire in a crisp white shirt and tie, reading The Origin, Irving Stone’s fictional account of the life of Darwin. “It frequently occurs to me, gosh, what a lucky guy I am. I have no responsibilities, and I have everything I want. I take a dose of equanimity every twenty minutes. I will not be disturbed about things.”
Once, John Rock had gone to seven-o’clock Mass every morning and kept a crucifix above his desk. His interviewer, the writer Sara Davidson, moved her chair closer to his and asked him whether he still believed in an afterlife.
“Of course I don’t,” Rock answered abruptly. Though he didn’t explain why, his reasons aren’t hard to imagine. The Church could not square the requirements of its faith with the results of his science, and if the Church couldn’t reconcile them, how could Rock be expected to? John Rock always stuck to his conscience, and in the end his conscience forced him away from the thing he loved most. This was not John Rock’s error. Nor was it his Church’s. It was the fault of the haphazard nature of science, which all too often produces progress in advance of understanding. If the order of events in the discovery of what was natural had been reversed, his world, and our world, too, would have been a different place.
“Heaven and Hell, Rome, all the Church stuff — that’s for the solace of the multitude,” Rock said. He had only a year to live. “I was an ardent practicing Catholic for a long time, and I really believed it all then, you see.”*
March 13, 2000
What the Dog Saw
CESAR MILLAN AND THE MOVEMENTS OF MASTERY
1.
In the case of Sugar v. Forman, Cesar Millan knew none of the facts before arriving at the scene of the crime. That is the way Cesar prefers it. His job was to reconcile Forman with Sugar, and, since Sugar was a good deal less adept in making her case than Forman, whatever he learned beforehand might bias him in favor of the aggrieved party.
The Forman residence was in a trailer park in Mission Hills, just north of Los Angeles. Dark wood paneling, leather couches, deep-pile carpeting. The air-conditioning was on, even though it was one of those ridiculously pristine Southern California days. Lynda Forman was in her sixties, possibly older, a handsome woman with a winning sense of humor. Her husband, Ray, was in a wheelchair, and looked vaguely ex-military. Cesar sat across from them, in black jeans and a blue shirt, his posture characteristically perfect.
“So how can I help?” he said.
“You can help our monster turn into a sweet, lovable dog,” Lynda replied. It was clear that she had been thinking about how to describe Sugar to Cesar for a long time. “She’s ninety percent bad, ten percent the love.…She sleeps with us at night. She cuddles.” Sugar meant a lot to Lynda. “But she grabs anything in sight that she can get, and tries to destroy it. My husband is disabled, and she destroys his room. She tears clothes. She’s torn our carpet. She bothers my grandchildren. If I open the door, she will run.” Lynda pushed back her sleeves and exposed her forearms. They were covered in so many bites and scratches and scars and scabs that it was as if she had been tortured. “But I love her. What can I say?”
Cesar looked at her arms and blinked. “Wow.”
Cesar is not a tall man. He is built like a soccer player. He is in his midthirties, and has large, wide eyes, olive skin, and white teeth. He crawled across the border from Mexico fourteen years ago, but his English is exceptional, except when he gets excited and starts dropping his articles — which almost never happens, because he rarely gets excited. He saw the arms and he said, “Wow,” but it was a “wow” in the same calm tone of voice as “So how can I help?”
Cesar began to ask questions. Did Sugar urinate in the house? She did. She had a particularly destructive relationship with newspapers, television remotes, and plastic cups. Cesar asked about walks. Did Sugar travel, or did she track — and when he said track he did an astonishing impersonation of a dog sniffing. Sugar tracked. What about discipline?
“Sometimes I put her in a crate,” Lynda said. “And it’s only for a fifteen-minute period. Then she lays down and she’s fine. I don’t know how to give discipline. Ask my kids.”
“Did your parents discipline you?”
“I didn’t need discipline. I was perfect.”
“So you had no rules.…What about using physical touch with Sugar?”
“I have used it. It bothers me.”
“What about the bites?”
“I can see it in the head. She gives me that look.”
“She’s reminding you who rules the roost.”
“Then she will lick me for half an hour where she has bit me.”
“She’s not apologizing. Dogs lick each other’s wounds to heal the pack, you know.”
Lynda looked a little lost. “I thought she was saying sorry.”
“If she was sorry,” Cesar said softly, “she wouldn’t do it in the first place.”
It was time for the defendant. Lynda’s granddaughter, Carly, came in, holding a beagle as if it were a baby. Sugar was cute, but she had a mean, feral look in her eyes. Carly put Sugar on the carpet, and Sugar swaggered over to Cesar, sniffing his shoes. In front of her, Cesar placed a newspaper, a plastic cup, and a television remote.
Sugar grabbed the newspaper. Cesar snatched it back. Sugar picked up the newspaper again. She jumped on the couch. Cesar took his hand and “bit” Sugar on the shoulder, firmly and calmly. “My hand is the mouth,” he explained. “My fingers are the teeth.” Sugar jumped down. Cesar stood, and firmly and fluidly held Sugar down for an instant. Sugar struggled, briefly, then relaxed. Cesar backed off. Sugar lunged at the remote. Cesar looked at her and said, simply and briefly, “Sh-h-h.” Sugar hesitated. She went for the plastic cup. Cesar said, “Sh-h-h.” She dropped it. Cesar motioned for Lynda to bring a jar of treats into the room. He placed it in the middle of the floor and hovered over it. Sugar looked at the treats and then at Cesar. She began sniffing, inching closer, but an invisible boundary now stood between her and the prize. She circled and circled but never came closer than three feet. She looked as if she were about to jump on the couch. Cesar shifted his weight, and blocked her. He took a step toward her. She backed up, head lowered, into the furthest corner of the room. She sank down on her haunches, then placed her head flat on the ground. Cesar took the treats, the remote, the plastic cup, and the newspaper and placed them inches from her lowered nose. Sugar, the onetime terror of Mission Hills, closed her eyes in surrender.
“She has no rules in the outside world, no boundaries,” Cesar said, finally. “You practice exercise and affection. But you’re not practicing exercise, discipline, and affection. When we love someone, we fulfill everything about them. That’s loving. And you’re not loving your dog.” He stood up. He looked around.
“Let’s go for a walk.”
Lynda staggered into the kitchen. In five minutes, her monster had turned into an angel. “Unbelievable,” she said.
2.
Cesar Millan runs the Dog Psychology Center out of a converted auto mechanic’s shop in the industrial zone of South-Central Los Angeles. The center is situated at the end of a long narrow alley, off a busy street lined with bleak warehouses and garages. Behind a high green chain-link fence is a large concrete yard, and everywhere around the yard there are dogs. Dogs basking in the sun. Dogs splashing in a pool. Dogs lying on picnic tables. Cesar takes in people’s problem dogs; he keeps them for a minimum of two weeks, integrating them into the pack. He has no formal training. He learned what he knows growing up in Mexico on his grandfather’s farm in Sinaloa. As a child, he was called el Perrero, “the dog boy,” watching and studying until he felt that he could put himself inside the mind of a dog. In the mornings, Cesar takes the pack on a four-hour walk in the Santa Monica mountains: Cesar in front, the dogs behind him; the pit bulls and the Rottweilers and the German shepherds with backpacks, so that when the little dogs get tired Cesar can load them up
on the big dogs’ backs. Then they come back and eat. Exercise, then food. Work, then reward.
“I have forty-seven dogs right now,” Cesar said. He opened the door, and they came running over, a jumble of dogs, big and small. Cesar pointed to a bloodhound. “He was aggressive with humans, really aggressive,” he said. In a corner of the compound, a Wheaton terrier had just been given a bath. “She’s stayed here six months because she could not trust men,” Cesar explained. “She was beat up severely.” He idly scratched a big German shepherd. “My girlfriend here, Beauty. If you were to see the relationship between her and her owner.” He shook his head. “A very sick relationship. A Fatal Attraction kind of thing. Beauty sees her and she starts scratching her and biting her, and the owner is, like, ‘I love you, too.’ That one killed a dog. That one killed a dog, too. Those two guys came from New Orleans. They attacked humans. That pit bull over there with a tennis ball killed a Labrador in Beverly Hills. And look at this one — one eye. Lost the eye in a dogfight. But look at him now.” Now he was nuzzling a French bulldog. He was happy, and so was the Labrador killer from Beverly Hills, who was stretched out in the sun, and so was the aggressive-toward-humans bloodhound, who was lingering by a picnic table with his tongue hanging out. Cesar stood in the midst of all the dogs, his back straight and his shoulders square. It was a prison yard. But it was the most peaceful prison yard in all of California. “The whole point is that everybody has to stay calm, submissive, no matter what,” he said. “What you are witnessing right now is a group of dogs who all have the same state of mind.”
What the Dog Saw and Other Adventures Page 12
