Book Review: “When It Burns: Fighting Fire in a Transformed World” by Jordan Thomas

Jordan Thomas is an anthropologist who spent some time while in graduate school in Santa Barbara as a firefighter in an elite National Forest Service unit, Los Padres Hotshots. This book recounts his experiences as a firefighter and delves into California history in order to provide historical context.

Essentially, this book has two storylines. The first is about firefighting. The accounts of combating various forest fires are vivid, as are the descriptions of the various members of his firefighting group. It is a well-written and engrossing adventure story, and it also makes the case that the firefighters are way underpaid given the hardships, the hours, and the dangers involved.

The other storyline is how civilization has messed up when it comes to fire. There is an underlying anger. Thomas argues that indigenous people in California were ingenious in how they managed their environment with controlled burns, and that this was lost when California was settled by people of European origin. He does not shy away from using the term genocide and is harsh in his judgement of the Spanish priest and missionary Junipero Serra and his treatment of the indigenous population in California. (Junipero Serra was beatified by Pope John Paul II in 1988 and canonized by Pope Francis in 2015 during his visit that year to the United States. These actions were controversial, especially in California).

In contrast to the way the indigenous populations had dealt with fire, the policy of the National Forest Service was to actively suppress all fires and not use controlled burns. While this policy has been changing with some difficulty in recent years, the buildup of the fuel for forest fires resulted in disasters. Thomas is no doubt right about this, but I was surprised that he did not mention the role of the Pacific Gas & Electric Company’s power lines in setting off fires. (PG&E ended up filing under Chapter 11 of the Bankruptcy Code due to its liability in connection with its power lines and fires.) 

Finally, there is climate change that has extended the fire season. This is more evidence of the damage we have done to the environment, with one of its manifestations more large and dangerous wild fires. Thomas is not against fighting fires, especially where it gets close to places people live, but his book is a plea for more intelligent environmental policies to mitigate the dangers from fires and other environmental issues.

Book Review: “No More Tears: The Dark Secrets of Johnson & Johnson” by Gardiner Harris

Johnson & Johnson has had a good corporate reputation. In particular, the company has been much praised for its handling of the cyanide poisoning of Tylenol capsules in 1982, which has been used for a Harvard Business School case study. Gardiner Harris, a former pharmaceutical reporter for The New York Times, argues convincingly in his new book, No More Tears: The Dark History of Johnson & Johnson, that this reputation is undeserved. He offers detailed reporting about various J&J products, including Tylenol, baby powder, Risperdal, metal hip implants, and others. 

It makes for very disturbing reading. For example, J&J tried to minimize the asbestos issue with talc in its baby powder, which eventually has been replaced with cornstarch. The chapter on Risperdal is especially disturbing. This antipsychotic drug with J&J’s encouragement, has been used in assisted care facilities to calm down those living there, an off-label use for which there is convincing evidence can hasten death. This drug has also been prescribed for children with problem behavior. However, this drug can cause disturbing weight gain, and some boys can develop breasts from taking the drug, for which they need to have surgery to remove. 

As for the opiod crisis, while Purdue Pharma and the Sacklers have taken the lionshare of the blame, Harris points out that J&J was selling Duragesic, whose active ingredient is fentanyl, using the same arguments and marketing strategies as Purdue used to sell OxyContin. While fentanyl does not come from poppies, the active ingredient in OxyContin does, and J&J supplied the raw material for OxyContin and other opiod drugs to Purdue and others from a Tasmanian company it bought in 1982. After that purchase, J&J became the largest supplier of active ingredients from opium poppies in the United States to other drug manufacturers.

Harris also shows the effective marketing strategies J&J used to promote questionable uses of its products, including the charming pharmaceutical representatives who visit doctors, the rewards to doctors who write a large number of prescriptions for particular drugs, and the use of ghostwritten studies of particular products. Also, Harris argues that J&J had undue influence with the FDA, both because it could influence FDA appropriation decisions with Congress and could offer jobs to FDA employees when they decided to leave the agency.

To be fair to the FDA, Harris does provide instances when the FDA was trying to do the right thing even as it faced opposition from J&J. As for the pharmaceutical representatives, Harris says that some courageously blew the whistle on their employer and showed greater integrity than the people running J&J.

Unlike Patrick Radden Keefe’s book on the Sacklers and Purdue, Empire of Pain, Harris’s book does not provide the compelling, focused novelistic narrative as Keefe’s book. However, Harris’s book is decently written and is more disturbing from a public policy perspective. Purdue Pharma could be brought down, but that will not happen to J&J, which provides useful and beneficial medical pharmaceuticals and products. One suspects that J&J is not alone in using questionable tactics to sell its products, though they may be particularly good at public relations and lobbying.

Harris’s book has not reached the bestselling heights of Keefe’s book. That is too bad. It deserves greater attention.