Wednesday, March 18, 2009

Update: Dead Squirrels and Live Rhinos


In July 2008 I wrote an article suggesting that one of the unintended consequences of quiet, battery-powered cars would likely be a lot of dead squirrels littering our roads.  After all, if the poor, befuddled creatures can’t get out of the way of our noisy, smelly internal combustion engines, what chance do they have when we sneak up on them with a couple of tons of motorized silence? 

This falls into the general category of “unintended consequences of technology,” which also includes the impact of horses on the urban landscape (A Plague of Dead Squirrels), the consequences of light pollution on insects and migrating birds (Don’t Go Toward the Light), and the rise of the automobile in America (see #13 in 14 Takeaways: John Steele Gordon’s An Empire of Wealth).

Other examples abound.  Just today I was reading about the sewing machine, which saved tens of thousands of hours of stitching drudgery but led to the unintended consequence of the sweat shop.  The most recent issue of Time informed us that the interstate highway system, the largest public-works project in history, looks like a “vast monument to the law of unintended consequences”: fossil-fuel consumption and suburban sprawl.

Now, I’ve got another unintended consequence to add to the list, and this one might actually turn out to be a good one. 

I had coffee the other day with a friend who had worked on the team that took Viagra through its clinical trials. 

A clinical trial, as you may know, is part of an FDA process by which a drug company tests the efficacy of a drug on a small, tightly controlled population of patients.  Success in clinical trials is what leads to FDA approval for general release of a drug or medication.  Most clinical trials involve samples of the genuine drug, sometimes samples of the same drug at a reduced dose, and almost always placebos, or inert pills (“sugar pills”).  These various concoctions are dispensed “double-blind”--in other words, the doctors don’t know which is which, and the patients don’t know which is which.

It’s the only way to get a true reading on whether a drug works or not. 

Clinical trials are very difficult to administer for lots of reasons, but chief among them is that neither doctors nor patients can be counted on to behave well.  In particular, everyone wants the active drug—patients to get better, and doctors to get their patients better.  So, everyone is trying to “break the code” the drug manufacturer places on the various drug lots to figure out which is real and which is a placebo.

At the end of a clinical trial it’s important that all active drugs be accounted for, so any in the field that have not been taken are returned, and the final total—those used plus those remaining—must be within a certain percentage of the starting total or lots of extra detective work needs to go on.
Viagra, you may recall, was first tested in clinical trials for cardiac arrhythmia (an abnormal rate of muscle contractions in the heart). 

So, what happened at the end of the Viagra clinical trial?  When Pfizer asked for all active samples to be returned, they received, well, none.  Zero.  Nada.  Nil.  Zilch.  Never in the known history of clinical trials had there been zero active drugs returned.

Obviously, sick patients had figured something out.  Not to mention well doctors, too.  At that point, Pfizer had figured something out as well.
So, one of the unintended consequences of an arrhythmia treatment was a cure for erectile dysfunction.  But--and this is the cool part--one of the possible (still unproven, but logical) unintended consequences of an erectile dysfunction drug is to take pressure off a couple of endangered species—in particular, the black rhino and the tiger. 

Only about 3,000 black rhinos survive today, in large part because their (ground-up) horn has long been thought useful in reviving comatose patients, curing fevers and aiding male sexual stamina and fertility.  (None of this has been scientifically documented, mind you.)  The rhino horn is also carved into ceremonial daggers, which Viagra will not help, but antelope horn as an alternative will. 
The tiger is the other endangered species, killed for the alleged benefits of its various body parts, some of which are made into soup and used also to promote sexual stamina and fertility.
(See here for more on this topic.)

So, here’s your choice: You can hunt, capture and kill a black rhino, cut off its horn, grind it up and hope it helps.  Or you can walk into a drug store and buy a pill for a buck that you can be pretty darn sure will help.  Easy decision, right?  One small step for man, one giant leap for black rhinos.
You might also note, for what it’s worth, that if you decide to invest $300-$400 in a bowl of tiger soup, that tigers have sex for only about 15 seconds.

Seriously.  That might be relevant to your decision making.

In any case, it’s nice to know that, if we’ll soon be killing squirrels with the unintended consequences of our technology, maybe we’ll also be saving a few tigers and black rhinos.