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Going Under The 'Boardwalk' With Michael Shannon.

The actor plays a righteous federal agent who succumbs to all sorts of temptations on the HBO drama Boardwalk Empire. To build the character of Nelson Van Alden, he says, he worked out an elaborate back story about the agent's childhood.


Other segments from the episode on October 24, 2011

Fresh Air with Terry Gross, October 24, 2011: Interview with Michael Shannon; Interview with Harriet Washington.








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TERRY GROSS, host: This is FRESH AIR. I'm Terry Gross. One of the standout characters in the HBO series "Boardwalk Empire" is Federal Agent Nelson Van Alden, played by my guest Michael Shannon. Shannon is also starring in the new movie "Take Shelter" as a husband and father who starts having visions about an apocalyptic storm, and he doesn't know if this is prophecy or a sign of mental illness.

Shannon was nominated for an Oscar for his role in "Revolutionary Road." Let's start with "Boardwalk Empire," which is set in Atlantic City during Prohibition. Shannon plays a Prohibition agent with the Department of Internal Revenue, who has left his wife at home while he's on assignment in Atlantic City.

Devoutly Christian, he finds himself surrounded by sinful temptations. He eventually succumbs. Last season, he drank liquor at a speakeasy then had sexual relations with one of crime boss Nucky Thompson's former girlfriends. She's now pregnant with his child. Worse yet, he drowned his partner while baptizing him and feels responsible for another agent who lies dying after having caught on fire in an explosion while investigating a bootlegger's warehouse.

Van Alden's wife is unaware of all of this, but in next week's episode, fearing he's about to be exposed, he calls her.


MICHAEL SHANNON: (As Agent Nelson Van Alden) I want you to know, it's important that you know, that everything I've done is because I love you.

ENID GRAHAM: (As Rose Van Alden) You're frightening me.

SHANNON: (As Nelson) I have sinned, Rose, and a good and decent man has burned for those sins.

GRAHAM: (As Rose) Listen to me.

SHANNON: (As Nelson) It's all right, dear. I've made my peace. I'm neither fit for you, nor am I fit to wear this badge.

GRAHAM: (As Rose) Nelson...

SHANNON: (As Nelson) I love you.

GROSS: Michel Shannon, welcome to FRESH AIR, pleasure to have you on the show.

SHANNON: Thank you.

GROSS: When you accepted the part in "Boardwalk Empire," did you know that this righteous federal agent and Christian was going to succumb to all kinds of temptations in his work and in his personal life?

SHANNON: Not really. I was, kind of, blindsided by it, honestly. Terry did mention in the original...

GROSS: And this is Terrance Winter, who co-created the show.

SHANNON: Exactly. He mentioned that one of the themes of the show was going to be how Atlantic City can corrupt people. I guess it's kind of like, you know, the snake in the garden, how everybody in the story was going to have trials and tribulations because of being in Atlantic City. And, you know, the notion that Atlantic City may be some sort of black hole that you, you know, descend into.

GROSS: I'd like to play what might be your most talked-about scene. This is the scene in which you insist on baptizing your partner, Agent Sebso, in the river. And he doesn't want to be baptized because he's Jewish. Now, you correctly suspect that he's been on the take to Nucky Thompson, the boss of the liquor operation in Atlantic City during Prohibition.

So in this scene, you brought him to a spot on the river where a local African-American church conducts baptisms. And the preacher, who is in the water performing baptisms as you arrive. He sees you and speaks first.


UNIDENTIFIED MAN: (As character) Agent Van Alden of the Bureau of Internal Revenue, have you come here to be accepted into the arms of Christ?

SHANNON: (As Nelson) I have never left him, deacon, though I have at times turned from his love.

UNIDENTIFIED MAN: (As character) You cannot turn from him, sir. Whatsoever the compass point, he's there beside you.

SHANNON: (As Nelson) I do know that to be so. But this man does not. There is a veil over his eyes, deacon, and a darkness in his soul.

UNIDENTIFIED MAN: (As character) Come forward.

ERIK WEINER: (As Agent Sebso) No thank you.

UNIDENTIFIED MAN: (As character) Young sir, come forward.

WEINER: (As Sebso) No thank you.

SHANNON: (As Nelson) Come forward, Mr. Sebso.

WEINER: (As Sebso) I'd really rather not.

SHANNON: (As Nelson) You insult these good people in their beliefs?

WEINER: (As Sebso) They're not my beliefs.

SHANNON: (As Nelson) What are you afraid of, Mr. Sebso?

WEINER: (As Sebso) I'm not afraid, I...

SHANNON: (As Nelson) Then let these waters wash you clean.

GROSS: So you finally get Agent Sebso, who again, is Jewish, into the water, and you have the pastor's permission to baptize him. You keep dunking his head underwater, and he keeps declining to be baptized. And in your zeal to baptize him, you keep his head underwater so long you end up drowning him.

So let's hear that part of the scene, and in this part of the scene, the pastor is getting worried that you're hurting Agent Sebso, and he tries to intervene, but you keep on dunking him until you kill him. The pastor speaks first.


UNIDENTIFIED MAN: (As character) This is not a battle, sir.

SHANNON: (As Nelson) You are wrong, deacon. It is a battle against the devil himself. I have seen him abroad in the daylight and the night, and by God I will force him out. Thou has fulfilled the judgment of the wicked.

GROSS: Wow, you've just killed this guy, and you're praising God that thou has fulfilled the judgment of the wicked. You say, about this agent who you've just killed, that there's a darkness in his soul. And of course, that really describes your character. There is a real darkness in your soul.

SHANNON: Yes, well, I think with Van Alden, probably like most people, his problems began in childhood. I imagine him coming from a very strict background, probably not a very compassionate background. I imagine his father being somewhat of an ogre and maybe even, you know, physically abusing him from time to time. And so that's kind of the seed of what grows into the adult Van Alden.

But I think he's a very sad character, because I do believe he ultimately has good intentions, and he wants to do the right thing. And he goes to Atlantic City believing that he can do some good in the world. And as many nefarious activities as he gets up to, he's also surrounded by people thwarting him at every turn. So that act of drowning Sebso is the culmination of a great deal of frustration and despair on his part.

GROSS: How do you prepare for a scene like that, where you at such a point of self-delusion that you really feel like you've done God's work in trying to baptize this man and then killing him?

SHANNON: Well, I don't think there's anything premeditated about it. I don't believe that Van Alden leads Sebso out into the water thinking that he's going to kill him. I think the actual murder itself happens very quickly, almost accidentally, and it's followed by an immediate need in Van Alden to justify what just happened, because the alternative is too horrible for him to imagine.

I think these things can happen very quickly in people. You know, you make a mistake, and you can either beat yourself up about it, or you can try and rationalize your way out of it. And I think Van Alden, very quickly, decides to rationalize it.

GROSS: Have you known anybody who is as much, you know, a zealot and delusional at the same time, as the agent who you portray is?

SHANNON: You know, I've known a lot of very religious people. My mother is very religious, but she was also very - is very private about it. She - when I was growing up, she never went to church. She just prayed and read her Bible and kept it to herself. So I'm not from a background of flamboyant believers. It's much more a personal issue.

But, you know, I don't - it's very important for me not to judge Van Alden or to judge people in general. When you're an actor, it's - it can be a hindrance, I think, if you look askance at people, you know.

GROSS: At the same time, though, you've tried to create a back story for him so you can understand what he's been through that shaped him. And you were telling us, for instance, you assume his father might have abused him when he was young. And he abuses himself.


GROSS: There is a scene in the first season where because he feels sexually attracted to somebody who he should not, she's not his wife, and she's Nucky's mistress, you very carefully lay out, like, a towel on the bed. You carefully lay out your belt on the towel, and then you take off your shirt, and then you lift the belt and knot it and then start flagellating yourself.


GROSS: It's, like, such a surprise, like you're not - you know, like you're not prepared - I mean, the viewer is not prepared for that. But is that one of the reasons why you assume that the agent's father beat him when the agent was a child, and now he beats himself?

SHANNON: Yes, I think this behavior he probably learned from his father. Maybe his father practiced it as well. But I think one of the things that's so striking about the scene, like you say, is that it's very ritualistic, and it's not - it's not histrionic, you know, or hysterical. It's very methodical. And that to me is one of the fascinating things about Van Alden's journey, is seeing him not only lose control of maybe his reason or his perspective, but I think along the way he loses control of that methodic, ritualistic sense of himself.

To me, it's much more horrifying to actually see Van Alden take a drink than it is to see him whip himself with the belt because the drink is something that Van Alden has told himself his whole life that he would never, ever do under any circumstances. So for me, playing the part, it was actually a lot more difficult to show up and do the scene where he walks into a speakeasy and has a shot of whiskey and then goes over and talks to Lucy than it was to do the flagellation scene.

GROSS: And you understand this character so well. You've thought him through so carefully. It seems to me you should be, like, writing your part.


GROSS: Do you have any input into the writing of it?

SHANNON: I haven't tried to exercise it, put it that way. There are certain people on the show that I think do a great deal of research and from time to time get to go up to the writers' room - the writers' room - and make a pitch for this or that. But one of the things I find fascinating about working on the show is that I never know where I'm going to wind up. And I enjoy the surprise of it.

And I enjoy seeing where the writers' imaginations take this character. So I trust them.

GROSS: Now, you're very tall. How tall are you?

SHANNON: I'm 6'4".

GROSS: And you use your size in some of your roles in a very imposing way, like in "Boardwalk Empire." And in "Boardwalk Empire," you are so, like, tall and imposing, yet so disconnected from your body. I mean, the body is a source of sin and temptation. There's almost something Frankenstein-ish about it in the sense that, like Frankenstein is a brain inside this body that the brain doesn't belong in. So the body just doesn't know how to move. The body's so stiff and kind of rigid. And, like, that's what your body is. You are so out of touch with it.

SHANNON: Well, I think that's another thing, another aspect of Van Alden that probably germinated in his childhood. I imagine that he was always told not to slouch, to sit up straight and to have good posture. And I think it is a Frankenstein scenario in a way because I think inside of Van Alden is a child, that arrested child that never really got to develop its own identity.

I think as much as he believes that he's operating from these deeply held beliefs, he's actually in a way very hollow. I don't think he has even begun to really explore who he really is. So I think that is very exciting for the trajectory of the character because this season, I mean, you can already see that he's really painting himself into a corner. He's going to have to reinvent himself.

GROSS: My guest is Michael Shannon, and he stars as Agent Nelson Van Alden in "Boardwalk Empire," and he's in the new movie "Take Shelter." Let's take a short break here, and then we'll talk some more. This is FRESH AIR.


GROSS: If you're just joining us, my guest is Michael Shannon, and he plays Agent Nelson Van Alden in "Boardwalk Empire" on HBO, and he stars in the new movie "Take Shelter.

In "Take Shelter," you play a husband and the father of a young girl who's deaf and needs surgery and lessons in American Sign Language. You lose your job during the course of the movie. So things are rough. But throughout the movie, you're having these nightmares and hallucinations of menacing cloud formations, and in the sky you see hundreds of birds in very disturbing formations.

It starts to rain in these nightmares, and the rain is almost like rust-colored. It's like a yellowish brown. And you don't know whether this is some kind of premonition that you're having, if this is some kind of like prophecy that will be fulfilled or if you're losing your mind. And you're afraid that you are entering a stage of mental illness because your mother was diagnosed with schizophrenia when she was in her '30s, which is the approximate age that you are now.

So let me just play a scene from this. At this point, you've decided to seek psychological help. So you go to a counselor who's played by Lisa Gay Hamilton. She speaks first.


LISA GAY HAMILTON: (As Kendra) I'm going to start by asking you some questions.

SHANNON: (As Curtis) Okay. I already answered all the questions on the form.

HAMILTON: (As Kendra) I know. I looked at them. But I need to get a profile started on you.

SHANNON: (As Curtis) Right, well, out of the five possible symptoms needed to be diagnosed with schizophrenia - delusions, hallucinations, disorganized speech, disorganized behavior and the negative symptoms - I've had two: delusions and hallucinations.

(As Curtis) So I took this quiz in the back of the book. I scored a five out of a possible 20. Schizophrenia starts at 12. So they say it might be a brief psychotic disorder. Whatever it is, I need to know what to do or what to get on to get this thing under control.

GROSS: You are in a constant state of anxiety in this movie because you're always expecting the Apocalypse, and you're always imagining the worst-case scenario and needing to protect your family from it. Were you in a constant state of anxiety making the movie?


SHANNON: No, I wouldn't say that. You know, we made the movie very quickly. We made the whole thing in - or shot the whole thing in four weeks. So it was a real sprint. And I actually really enjoyed working on the film. I really enjoyed the people I was working with a lot. I really enjoy working with Jeff. I just think he's super-smart and really talented.

GROSS: This is the director-writer you're talking about.

SHANNON: Yes, Jeff Nichols. And for me it was easy because it made sense to me. The movie made sense. I knew why Jeff was making it. And I think even though, in the film, with these nightmares and these visions, they're obviously exaggerated beyond what most people experience.

But I do think they're reflective of a general feeling that people can relate to or a percentage of people can probably relate to, of just feeling frightened and powerless and wondering what the heck is going to happen next.

GROSS: Do you dream a lot?

SHANNON: I go through periods where I dream a lot and then periods where I don't. Oddly enough, when I'm working, I don't tend to dream very much, I guess because what I'm doing during the day has a kind of dream-like quality to it that is very different than if I went to an office and filed data all day long. Then I'd probably want to go home and have a, you know, rich life in my dreams.

But, you know, my life is so surreal. You know, making films is a very surreal business, you know. I mean, right now I'm working on one of the most surreal films imaginable, and...

GROSS: Right, as we speak, you're in Vancouver, and you're working on the new Superman movie, and you're playing General Zod from the planet Krypton. So you're like - you're the heavy in this.

SHANNON: Yes, exactly, and I'm also, you know, an alien, which is weird. It's hard to research.


SHANNON: Being an alien, what it's like to be on Krypton.

GROSS: So wait a minute, you're graduating from being, like, the person who's always considered he's crazy, all his parts are crazy, and now, like, he's the alien.


SHANNON: Yeah, he's the alien, and he's a general, which is also a big deal, being a general. I've played some military parts before, but I've never had that high a rank. So...

GROSS: Well, congratulations on the promotion.


SHANNON: On the promotion, thanks.

GROSS: What do you have to wear?

SHANNON: Well, there's a lot of what they call motion capture, where you wear suits that are designed for the computer to be able to track your movements so that they can add something later on, some sort of costume later on. It's becoming, you know, more and more popular.

So I go back and forth between that, the motion-capture suit, and I do have a costume that is just real, actual costume.

GROSS: I imagine it's a little frustrating sometimes to wear the motion-capture suit because clothes really help you get into a role. I mean, like, probably putting on the clothes for the agent that you play in "Boardwalk Empire" is helpful.

SHANNON: Yes, exactly. I really draw a lot from the costumer on "Boardwalk Empire." Sometimes when I show up in the morning, you'll rehearse the scene in your street clothes before you start shooting, and I always just feel ridiculous because I don't feel anything like Van Alden: I'm wearing a T-shirt and jeans, and it just is outrageous.

But then I go up to the dressing room and put my costume on, I look in the mirror and say oh, there he is. I'm okay. No need to panic.

GROSS: Michael Shannon will be back in the second half of the show. He stars in the new movie "Take Shelter" and plays Prohibition agent Nelson Van Alden in HBO's "Boardwalk Empire." I'm Terry Gross, and this is FRESH AIR.


GROSS: This is FRESH AIR. I'm Terry Gross. Let's get back to our interview with Michael Shannon on the HBO series "Boardwalk Empire." He plays Prohibition Agent Nelson Van Alden. He stars in the new movie "Take Shelter" as a husband and father having visions of an apocalyptic storm, and he isn't sure whether this is a premonition or a sign of mental illness. He was nominated for an Oscar for his performance in "Revolutionary Road."

So you grew up in part in Lexington, Kentucky, and in part in Chicago because your parents were divorced and your father was in Chicago, your mother in Kentucky.


GROSS: So I imagine there were big cultural differences between your Lexington home and your Chicago home. Were you a slightly different person in each city?

SHANNON: Yeah. I'm sure I probably made some modifications in my personality. I tend to have kind of a Zelig-type personality. I like to blend in, or try to blend in to whatever environment I'm in. You know, I acquire the accent of whoever I'm around. You know, I - so because of that, you know, when I tell people I'm from Kentucky, everybody always sounds so surprised because they don't hear a Southern accent. And I say, well, you know, I've lived all over the place. I mean I - it was a very long time ago. I guess they, you know, expect that you would have it your whole life or something.

But when I would go up to Chicago - eventually in high school, I started going up there more and more and actually going to school there. I was going to a very, very large high school, which was unlike any school I'd ever been to. I was use to very small schools down in Kentucky, and this school was like almost college size, it was so big. And I really kind of struggled to make friends, and I kind of retreated a little bit. But then eventually, once I got out of high school, I started to get involved in the Chicago theater scene. And then I started to really - and that's when I really started to discover, I think, who I was and what I wanted to be.

GROSS: I imagine what you describe as you Zelig-like personality was a real asset as an actor, if you're naturally just picking up accents from where you are and characteristics of the people you're around.

SHANNON: Yeah. I think so. Although, I don't - you know, it's never crafty, you know, the way I do it. And ironically, it seems like a lot of the characters I wind up playing are not like anybody. You know, they're unusual people.

GROSS: True.

SHANNON: So you would think, yeah. But I'm not - it's different than, like - it's different than mimicry, you know what I mean?

GROSS: Mm-hmm.

SHANNON: I'm not a good impersonator.

GROSS: Mm-hmm.

SHANNON: Like, I couldn't impersonate anybody, really, that I can think of. But it's just more about trying to find somewhere to feel comfortable, I guess.

GROSS: I just want to say something about your face. We talked a little bit about your height earlier.

SHANNON: Mm-hmm.

GROSS: A couple of distinctive things about your face is that you have very full lips, and they're often, like, depending on the role, like, when there's a lot of tension in your face or pain or inwardness, they tend to like really turn down your lips, you know, like turn down with the expression of tension. And I never know whether you're thinking about that or whether you're just thinking the emotion, and that's what happens.

SHANNON: Aw, gee. Boy, you can get into pretty dicey territory there if you're...

GROSS: With trying to like move your lips or not?

SHANNON: Yeah. If you're just trying to manipulate - it's a very delicate thing because, you know, film and television, it's photography. And this is going to sound kind of ridiculous, but in a way, you're kind of modeling a story. You know, you have to be conscious of the fact that it's being photographed, whereas in theater, you really are just trying to get to the heart of the matter.

You know, I've had experiences on film where I really felt what was happening and I felt like it couldn't be any more perfect than what it was. It just seemed like exactly what it needed to be. And then I've seen it and it's completely the opposite of what I thought, or you don't see anything. So it's a really confounding medium, actually. I still struggle with it.

I had this experience recently where I was working on something and doing a take and - over and over. And I had talked to the director, and he'd say, well, what about this or what about that? And I'd say, okay, okay. And then finally I just did a take where I kind of turned my head a slightly different angle, and it worked. He was like, oh, that's perfect. I was, like, all I did was I just turned my head a little bit. And he's, like, well, trust me. It's exactly what I wanted. So we'd been having all these, you know, high-minded conversations about what my character was thinking or what he wanted, and really, I needed to do was, you know, turn my head 45 degrees.

But by and large, to your original question, I'm trying not think about that aspect of it. I still try to focus just on what my character's trying to do.

GROSS: So, you've played so many eccentric characters - bordering, some of them, on crazy. Do you think of yourself as eccentric?

SHANNON: Hmm. I, you know, I guess I do. Partially, it's just the life of an actor. It's an unusual life. It's hard, you know, if you walk downtown past all the people with, you know, their briefcases and going about their daily routine, that it's hard to feel like a member of that society, I guess, because it's just not what you do. You know, I feel like I'm settling down. I had a very long period where I had led this kind of gypsy-like existence, traveling a lot and not really putting roots down anywhere. But now I'm, you know, starting a family and settling down.

It's also my life is a little less - you know, I used to not have much money, and it was hard to get by sometimes. And now I have a little bit more comfort and security in that department. But I think more than anything what it is is that I'm just a very incredibly sensitive person. I think most actors are, you know. I'm very sensitive to what goes on around me and I'm very - I feel like I'm always kind of paying attention to everything, like I don't have blinders or I don't have a lot of, maybe, defense mechanisms that other people have. I'm very - you know, you're supposed to be very present if you're an actor, and I feel like I am.

GROSS: And at the same time when you're an actor, you're facing so much rejection and not getting roles and getting bad reviews - not that you've gotten bad reviews, but I mean like what actor doesn't have to face that? So, like, the sensitivity can be a real problem.


GROSS: You have to be kind of thick-skinned.

SHANNON: Yeah, and I have.

GROSS: Yeah.

SHANNON: Yeah. I've dealt with a lot of that. You know, I think with anybody you see who makes it to the, I don't know, this level of the public eye, you know, it's easy to forget that everybody - even the famous people - have put up with a lot of rejection. You, know, there's a lot of parts I haven't gotten and I have gotten a lot of bad reviews. Some of - you know, right when I started in Chicago, the first play I got cast in outside of, you know, an academic environment, I was fired from.


SHANNON: Yeah. It was a little tiny storefront theater in Chicago, you know, folding chairs and clamp lights, the whole nine yards. And it was called - I think it was called "West Bank Story." And I rehearsed for a couple of weeks. And then one day the director walked up to me and said, you know, you have a lot of raw talent, but you should go to the conservatory or something and learn some technique, because you're just too - we can't figure out how to get you to do what we want you to do. And so I gave her the finger and left, and then...


GROSS: Did you go to the conservatory?

SHANNON: No. No, I didn't go to the conservatory. I went - and actually I went and did some electrical work, laying cables in a theater. And then a few months later, I went back and gave it another shot. And the rest is history.

GROSS: Right.


GROSS: Okay. It's been great to talk with you. Thank you so much.

SHANNON: Thanks, Terry.

GROSS: Michael Shannon plays Prohibition Agent Nelson Van Alden in HBO's "Boardwalk Empire," and stars in the new movie "Take Shelter."

Coming up, medical ethicist Harriet Washington talks about how the patenting of genes, cells and tissues is affecting medical and pharmaceutical research. This is FRESH AIR.











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TERRY GROSS, host: When you think about patents, you probably think about new inventions and products. But now genes, tissues and living organisms are being patented. How these new biological patents are affecting medical and pharmaceutical research is explored in the new book "Deadly Monopolies" by my guest Harriet Washington. She's been a fellow in Medical Ethics at the Harvard Medical School, and is senior research scholar at the National Center for Bioethics at Tuskegee University. Her earlier book, "Medical Apartheid," won a national Book Critics Circle Award.

Harriet Washington, welcome to FRESH AIR. So living organisms, plants, are now being patented, which is a really kind of interesting development. Would you give us an overview of some of the living material that's being patented now?

HARRIET WASHINGTON: Well, according to a 1980 Supreme Court decision, Diamond versus Chakrabarty, anything that's living can be patented, in theory. Now, usually, experts exclude entire human beings from that, because it's thought to be precluded by anti-slavery statutes. But aside from that, your cells, your tissues, almost anything - medically important plants and animals such as Harvard's Uncle Mouse, a mouse that was genetically modified to (unintelligible) certain cancers. Anything can be patented. And once patented by a university, the patent is then sold or licensed to corporations typically, and the corporations exploit those patents.

GROSS: So tell us the story of John Moore, whose tissues were patented. He discovered that his doctor had patented the unusual products of his oversized spleen. What was the doctor patenting from John Moore's spleen?

WASHINGTON: Exactly. This happened shortly after the 1980 ruling that allowed patenting of living things. John Moore had developed hairy-cell leukemia, and his doctor told him that he would need immediate surgery to save his life. His father, Moore's father, who was also a doctor, urged him to come back to L.A. and be treated by a blood expert there, Dr. Golde. Dr. Golde oversaw John Moore's surgery, and during the surgery, Moore's 22-pounds spleen was excised. It's a mammoth spleen - roughly, you know, 10 times the size of a normal spleen.

It was producing medically valuable products - antibodies, cytokines, various things that were very medically valuable - and Dr. Golde realized this. Dr. Golde established a laboratory and entered in partnership with Sandoz on the basis of the patent he took out on John Moore's spleen. But none of this was shared with John Moore. John Moore was told only that he had to come repeatedly to Dr. Golde's lab for tests and for Dr. Golde to collect blood, semen, tissues. And he was told all this was being done in the name of vigilance against cancer to keep him healthy and to treat his cancer.

GROSS: So what are the cells from John Moore's oversized spleen being used for?

WASHINGTON: Well, Sandoz decided that the cells were worth $3 billion, and had given Dr. Golde hundreds of thousands of dollars in order to establish this laboratory. The hope was that John Moore's extraordinarily potent anti-cancer elements would actually be used to develop a cancer remedy, but this never happened. But very often, people find that their bodies have been transformed by medical treatment. That wasn't the case with John Moore, but it's a very good example. And they find the treatments they have given give their bodies the ability to crank out, on their own, potent anti-disease factors.

A really good example was a man named Ted Slavin, who was a hemophiliac. He'd been treated with traditional hemophiliac factors. However, his body an unusual response. His body, in response, began cranking out the same medical factors he was given, only in a highly concentrated way. And Slavin's doctor warned him: Your blood is extraordinarily valuable. You can make a lot of money selling your blood. And Slavin did. He started a company called Essential Biologicals, and he began selling his blood.

However, Slavin also began giving his blood away to researchers who were seeking disease cures. He began giving his blood away to benefit charities. So Slavin recognized that there is more than money at stake here. He also recognize that there's a market here. But one isn't constrained to only fulfilling market criteria. One can exercise altruism and be part of the market, being knee-deep in the stream of commerce at the same time.

GROSS: So it's not just one company that has access to this blood for research purposes. It's several. So there's more of a possibility that something will come of it.

WASHINGTON: I think so. I think you increase, you know, the possibility that you're going to have a successful result when researchers collaborate, or when researchers at least are able to work on the product unrestrained. That's another problem with the patent system. When you patent an entity, you are able to block anybody else from working with it. You can keep anybody else, any other researcher from working on that gene unless you choose to sell them a license. And often, companies choose not to sell a license, effectively barring anyone from working on it.

And what does that mean? That means that a very important gene that predisposes people to cancer is only being worked on by one company, whereas there are many researchers who would like to work on it, and work on a cure, and in fact, have been sent cease and desist letters and so cannot do that. So we're immediately winnowing our chances of coming up with an effective cure or treatment.

GROSS: Let's go back to the Salk vaccine, which did so much to end the polio epidemic. Did Jonas Salk patent the vaccine or try to patent the virus from which the vaccine was derived?

WASHINGTON: No. And there was a very interesting exchange about that. Edward R. Murrow said to him: This vaccine is going to be in great demand, in global demand. Everyone's going to want it. It's potentially very lucrative. Who holds the patent? And Salk said, the American people, I guess. Could you patent the sun? This was the norm. During this period, researchers tended not to patent their discoveries.

GROSS: So he had the option of patenting it, and he chose not to.


GROSS: And was the Salk vaccine connected to a pharmaceutical company, or was it invented in an independent research organization?

WASHINGTON: It was a combination of - no, corporations were not involved. The March of Dimes contributed extremely heavily. Salk himself got some modest funding from other sources, including university funding. Some funds came from the government. But frankly, it was the American people that largely funded the development of this vaccine.

GROSS: Through tax money?

WASHINGTON: Through...

GROSS: Oh, no, through March of Dimes money. Yeah.

WASHINGTON: Through contributions. Yeah, March of Dimes money.

GROSS: Right.

WASHINGTON: I'm actually old enough to remember the March of Dimes campaign. And even school children were encouraged to save their nickels and dimes and, you know, collect them in these clever little cardboard slots. It was actually a national obsession at the time.

GROSS: My guest is medical ethicist Harriet Washington, author of new book "Deadly Monopolies." More after a break. This is FRESH AIR.


GROSS: If you're just joining us, my guest is medical ethicist Harriet Washington. She writes about the history of medicine, African-American health issues, and the intersection of medicine, ethics and culture. Her new book is called "Deadly Monopolies."

Let's talk a little bit about generic drugs, which you also write about in your new book. Can you explain when a drug can go generic?

WASHINGTON: Sure. The long governing patent rights gives the patent holder 20 years of exclusivity, 20 years during which nobody else can work on that entity, no one else can sell that entity without the patent holder's permission. After that 20 years, in theory, the drug goes into the public domain, and any corporation can apply to the FDA to sell its version of that drug. But in reality, corporations have become geniuses at extending patent life. So what they will do is come up with many, many ways in which to extend the life.

Some of them are pretty straightforward. For example, if you have a drug that has not been tested in children and you're willing to take tests in children, that automatically gives you an extension - a patent extension of six months. Also, patents are extended by suddenly changing the formulation of drugs - I mean, very subtly changing them. And patent extensions are also achieved by - or even new patents. New 20-year patents can be achieved by taking a molecule that's not changed, but changing the formulation of the drug.

So a drug that had been sold in pill form now becomes a powder, or a lotion or a cream or a liquid, and each one of these formulations will achieve either an extension of the patent or a brand-new, 20-year patent. So in reality, this 20-year patent is bolstered by the corporation's fleets of lawyers into, you know, perhaps another decade of life. It can go as long as 30 years.

After all the patent permutations are exhausted, the drug now goes into the private domain and individual companies can apply to the FDA to market their version of the drug. It has the exact same active ingredient, but the formulations of generic drugs can differ. So what...

GROSS: How do they differ?

WASHINGTON: In many ways. For example, a drug that had been a liquid can now become a pill. Or another really popular way of changing it is having two different drugs - both of which are now generic - being combined, and the combination now has a patent. But even on the formulation of inert ingredients - the fillers being used in pills, that sort of thing - those are changed frequently by the generics company, so that you end up with a - the same active ingredient, but a formulation that's different.

GROSS: So, you know, when you're getting a medication, if you have insurance, you're kind of automatically, I think, in most cases, going to get the generic version of it, because it's cheaper. So are generic versions of drugs the same as the original in terms of their efficacy? I know the non-active ingredients are probably a little bit different. You know, like the stuff in the pill or the stuff in the cream or the stuff in the suppository, it's not going to necessarily be the same stuff that was in the original medication. It's the active ingredient that's the same. So does that make a difference?

WASHINGTON: To some people, it makes a difference. The FDA says that it has to be bioequivalent. That means essentially performing the same way as the branded drug did. But, you know, these subtle changes can have import for some people, because if you have allergies, for example, perhaps your allergies are provoked by the inert ingredients in the generic drug, and they're not provoked by that in the branded drug. So there are subtle differences, and for some of us, they're not so subtle. For most people, they performed pretty much identically. And that, of course, is a legal requirement.

But I have to point out that the bio-identical label is much more a legal label that a medical label. You will often have physicians, you know, bemoaning the fact that generics do not behave exactly as do the branded drugs.

GROSS: So let me change the subject to a new development in medicine. And this is about a new malaria vaccine. The first large-scale trial of the first vaccine against malaria shows that it lowers the risk of infection by about 50 percent. And this is based on results of a trial on children between the ages of five and 17 months of age in sub-Saharan Africa. And this study was sponsored by a group called PATH Malaria Vaccine Initiative. It's a non-profit that's received $200 million in funding from the Gates Foundation. And the pharmaceutical company that is manufacturing and researching this vaccine is GlaxoSmithKline.

So I don't know how familiar you are with this trial, but what do you think of this model of, you know, of a non-profit funded by the Gates Foundation, working in conjunction with a pharmaceutical company?

WASHINGTON: This model should sound very, very familiar, because this model is actually the old model. Before 1980, this is how researchers worked. They collaborated, because, of course, we have the Gates Foundation. We have PATH. And there are other vaccine initiatives that have been very, very successful recently. And they all include funding from entities such as the governments of developing countries, the Gates Foundation, PATH, groups of independent researchers, and often in collaboration with pharmaceutical companies. I think what's really important, though, to note is that pharmaceutical companies are, indeed, understanding that the people of the developing world represent a rich new market for them.

And the other thing to understand is that they're not doing a lot of this research in a vacuum. The pharmaceutical companies are working with these organizations, and in many of the recent successful vaccines trials for sub-Saharan Africa and for India, and many of the recent successful attempts to develop drugs for illnesses that affect people in the developing world, they are working subsidized by the people in developing countries.

GROSS: Well, Harriet Washington, I want to thank you so much for talking with us.

WASHINGTON: Terry, it has been a great pleasure. Thank you so much for having me.

GROSS: Harriet Washington is the author of the new book "Deadly Monopolies." You can read an excerpt on our website,, where you can also download podcasts of our show. And you can join us on Facebook and follow us on Twitter @nprfreshair.





Transcripts are created on a rush deadline, and accuracy and availability may vary. This text may not be in its final form and may be updated or revised in the future. Please be aware that the authoritative record of Fresh Air interviews and reviews are the audio recordings of each segment.

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