Just What The Doctor Ordered/Watson, The Needle!

BRIAN: We’re back with BackStory. I’m Brian Balogh, here with Ed Ayers.

ED: Hey.

BRIAN: And Peter Onuf.

PETER: Hey.

BRIAN: Today on the show, we’re taking a look at drugs, how have Americans drawn the line between use and abuse.

PETER: Before the break, we heard about the Valium addiction scare of the 1970s and want feminists made of it. And one of the most interesting points there was this growing feeling that doctors might not be all that reliable.

BRIAN: Which is especially interesting, because 100 years earlier, doctors established their authority by prescribing drugs, drugs that would raise eyebrows today, drugs like morphine and heroin. So guys, let’s take a couple minutes and talk this through. Where did doctors weigh in on this, Ed?

ED: Yeah, doctors are ambivalent about this, Brian. They prescribe opiates themselves. And what’s interesting to me, of course, from my parochial, 19th century perspective, is that doctors are being pulled in two directions by these opiates.

On one hand, they make you look great if you’re a doctor. Somebody comes in, they’re feeling terrible. And really, whatever ails them can be improved by giving them an opiate distillate. And so their claims of making you feel better–

PETER: Well, I guess.

ED: Were probably true. On the other hand, they kind of undermined doctors’ authority. Who needs a doctor, when you can open up any newspaper or magazine and order a patent medicine through the mail. It creates an environment in which doctors are saying, what kind of leverage do we have to get this under control?

PETER: Right, and that impulse to regulate is an impulse to establish a professional monopoly that is the expertise that doctors claim to have about the effects and the proper dosages of various medicines. That has to be something that regulates the entire industry. So in other words, it’s monopoly against free enterprise.

BRIAN: That’s right, Peter. And it undermines the real basis for what will become doctors’ authority in the 20th century, and that is the diagnosis. If you have these opiates that are cure-alls, then what do you need a diagnosis for, i.e., what do you need a doctor for?

PETER: It’s like the internet, isn’t it?

[LAUGHTER]

ED: Well, it’s not an accident that these patent medicines are pretty much killed by the medical profession, right, Brian?

BRIAN: Well, in the first decade of the 20th century, you have the American Medical Association. And as part of this campaign, they decide to take on patent medicines. Because, of course, as Ed pointed out, they’re completely unregulated.

ED: Well, in addition to opiates and alcohol, many patent medicines contained powerful stimulants, like cocaine. The drug was first isolated from the coca leaf in the mid-1800s and, in America, quickly moved from popularity to infamy.

And one of the witnesses of this transition was a certain British detective. Chioke Iansen has the story.

CHIOKE IANSEN: In 1890, readers of the American magazine, Lippencott’s Monthly, were introduced to Sherlock Holmes and his faithful companion Watson. The first story the magazine ran was called “A Sign of Four.” here’s how it began.

MIKE JAY: Sherlock Holmes took his bottle from the corner of the mantelpiece, and his hypodermic syringe from its neat Morocco case. With his long, white, nervous fingers, he adjusted the delicate needle and rolled back his left shirt cuff. Finally, he thrust the sharp point home, pressed down the tiny piston, and sank back into the velvet lined armchair with a long sigh of satisfaction.

CHIOKE IANSEN: Cocaine use may not be the first thing people today associate with the world’s greatest detective. But would readers, at the time, have also found it strange. To find out, I called Mike Jay.

MIKE JAY: I’m an author and historian. And I’ve written a lot about the history of drug use.

CHIOKE IANSEN: Jay says that while Americans might have raised an eyebrow at the needle, they would not have been surprised by the drug itself. To understand why, we have to look at the public perception of cocaine around the turn of the century.

The drug became available in American drugstores six years before Sherlock Holmes’ debut. It was touted as a cure-all and even added to soft drinks, especially as localities started cracking down on alcohol. The most famous of these drinks, of course, was Coca Cola, which sold itself as quote, “the temperance drink.”

MIKE JAY: The idea would be that while everybody else was kind of getting sozzled in taverns, then the smart, urbane Coca Cola drinker was staying sharp and taking care of business.

CHIOKE IANSEN: As Coca Cola was coming into its own in America, Sherlock Holmes was on his way out. In 1893, readers were shocked to find the detective killed in a fight with his nemesis Moriarty. At the height of Holmes’ popularity, his creator, Arthur Conan Doyle, had lost interest.

Meanwhile, over the next few years, Americans’ perception of cocaine would continue to shift. By the mid 1890s, doctors were warning that the use of cocaine was habit forming. By the turn of the century, there was a new image, the image of the coke fiend, which was often associated with the veterans who are coming back from the Spanish American War.

MIKE JAY: Specifically, in the southern states, the idea that this is something that’s spreading like wildfire through that negro population.

CHIOKE IANSEN: A New York Times headline read, “Negro Cocaine Fiends are a New Southern Menace,” and said that cocaine made black gun wielding criminals better marksman. There’s no evidence that African Americans used cocaine disproportionately more than whites. What’s clear is that this Jim Crow narrative had lasting effects on the perception of cocaine throughout America.

But let’s get back to Sherlock Holmes. Years after his literary demise, Americans were still clamoring for more. A popular American magazine, Collier’s Weekly, offered Doyle a hefty financial incentive for the detective’s resurrection. Doyle accepted, and, by 1903, Sherlock Holmes was back. But there was one crucial difference, as Watson explains, in a story called “The Missing Three-Quarter.”

MIKE JAY: For years, I had gradually weaned him from that drug mania, which had threatened once to check his remarkable career.

CHIOKE IANSEN: Doyle had given the world a Sherlock Holmes who was clean. Again, Mike Jay.

MIKE JAY: I mean, I think the reason that Doyle started easing back on it was, once it started selling into Collier’s, he realized that it just this wasn’t going to fit for an American audience.

CHIOKE IANSEN: An audience that, in less than 20 years, had gone from ambivalence or even enthusiasm for cocaine, to deep anxiety about it, an anxiety articulated by Watson.

MIKE JAY: Now I knew that under ordinary conditions, he no longer craved for this artificial stimulus. But I was well aware that the fiend was not dead but sleeping.

CHIOKE IANSEN: Doyle hadn’t simply made cocaine go away. The drug was, for Sherlock Holmes, the same thing that it had become for America, a threat that needed to be watch.

It’s appropriate that Americans learned of Holmes’ sobriety in the pages of Collier’s Weekly. The magazine was partnered with the American Medical Association. And it would go on to campaign against the unregulated use patent medicines.

MIKE JAY: A campaign that eventually led to the establishment of the first Pure Food and Drug Act in 1906.

CHIOKE IANSEN: The act resulted in Coca Cola removing the drug from its soda. Sales of cocaine would finally be criminalized in 1914, with the Harrison Act. Of course, cocaine didn’t go away and neither did Sherlock Holmes.

Today, Holmes is as popular as ever, while different movies and TV shows depict the detective differently.

MIKE JAY: They all have the same problem, which is, what do we do with the drugs thing? So there’ve been various– I mean, you’ve got Elementary running in the States. They all have this problem. And they all, basically, come up with the same solution, which is, one way and another, to turn this into a recovery narrative.

So in Elementary, Sherlock Holmes is in rehab. And that kind of allows you to have it both ways, because you can have the sort of arch, slightly snickery drug culture references, but also your hero isn’t actually tainted. In fact, this becomes a kind of tragic bit of his back story, something he has struggle against, something that gives him depth.

CHIOKE IANSEN: For BackStory, I’m Chioke I’Ansen.