Cocaine: How ‘Miracle Drug’ Nearly Destroyed Sigmund Freud, William Halsted

bjbjLULU JEFFREY BROWN: Now, a tale of cocaine
addiction involving two leading figures in the history of medicine. NewsHour health correspondent
Betty Ann Bowser has our book conversation. BETTY ANN BOWSER: Sigmund Freud and William
Halsted were two medical revolutionaries, Freud, the well-known father of psychoanalysis,
Halsted, the less well-known father of modern surgery. But just beneath the black-and-white
success, there’s another story. Both men shared a blinding addiction to cocaine. In a new
book called “An Anatomy of Addiction,” pediatrician Howard Markel tells how the two tried to ward
off self-destruction in the quest for knowledge. We caught up Markel at Johns Hopkins Hospital
in Baltimore, where Halsted connected some of his greatest work. Dr. Markel, thank you
so much for doing this. DR. HOWARD MARKEL, “An Anatomy of Addiction”: Thanks for having
me. BETTY ANN BOWSER: So, what was the connection between Sigmund Freud and William Halsted
DR. HOWARD MARKEL: Well, they both were contemporaries. They never met, or at least I can’t find any
evidence. But they were braided — their lives were braided together. They were bound together
by a fascination with cocaine and several medical papers that some they each wrote or
some they read about the latest, newest miracle drug of their era, 1884. BETTY ANN BOWSER:
So, here we are, in the medical library of William Halsted at Johns Hopkins University,
one of the great medical centers in the world, and he was a first here. What did he do? DR.
HOWARD MARKEL: Most of the modern safety procedures we take of how to cut open a body, how to
handle the tissue very delicately and gently, so that it heals well, how to suture it correctly,
this was all William Halsted. He was also fascinated with aseptic surgery, not introducing
germs into the surgical wound. BETTY ANN BOWSER: So, at this point in medical history, cocaine
was found to do what that would allow Halsted to do all these things in surgery and Freud
to do all these things with his medicine? DR. HOWARD MARKEL: Here, you had something
you could inject or treat or rub on there, and it numbed it to the surgeon’s knife. And
so Halsted became fascinated with using this deeper and deeper into the body to do all
sorts of procedures without putting a patient under. BETTY ANN BOWSER: So, Halsted got involved
with cocaine by experimenting with it in ways to use it in surgery? DR. HOWARD MARKEL: Yes.
It was very common for many a doctor in the late 19th century and the early 20th century
to use themselves as guinea pigs. And no doctor at this time knew of the terrible addictive
effects of cocaine. None of this had been figured out yet. And so the first arm to be
put out and injected was Halsted’s. BETTY ANN BOWSER: Did Halsted understand at the
time what he was doing to himself? DR. HOWARD MARKEL: At some point, he did, when he still
lived in New York and he was literally ruining his career. He stopped going to the operating
room. He stopped going to the hospital. He stopped going to medical meetings. And, in
fact, at one point, he was called down to the emergency room, bombed on cocaine, and
he literally pulled away from the table and said, “I can’t operate,” and walked out, took
a cab back to his townhouse and skittered away the next seven months high on cocaine.
BETTY ANN BOWSER: Halsted eventually committed himself to an insane asylum in Rhode Island,
hoping to be freed of his addiction. But in those days, there was no real treatment. So,
for the rest of his life, he struggled with the disease. Across the Atlantic and long
before psychoanalysis, a young Dr. Freud also believed that cocaine might be his ticket
to fame and fortune. One of his closest friends was addicted to morphine. And Freud published
journal articles proclaiming cocaine was the cure. But he also had a more personal interest
in the drug’s effects. DR. HOWARD MARKEL: Freud loved the way cocaine made him feel.
And he was very interested in its psychological components. For one, it did make him feel
better when he was sad. He also was amazed at how it made him talk about things endlessly
that he thought were locked away in his brain. Sound familiar? That’s talk therapy, but without
the toxic side effects of cocaine. But he got to like it a little bit too much. BETTY
ANN BOWSER: Did any of his writings, the dreams, the sense of euphoria, all the things that
he got from using cocaine, did any of those lead to anything that we now see in psychiatry
today? DR. HOWARD MARKEL: Well, it did. It did. To begin with, the idea of talk therapy
where you talk freely or free associate from one thing to another, may have been inspired
by the cocaine unleashing his tongue or his repressed memories. But most importantly,
cocaine haunts the pages of “The Interpretation of Dreams.” The model dream is a cocaine dream,
what addiction therapists would call a using dream. He was using cocaine quite a bit in
1895 on himself, to the point he was having chest pain. He was depressed. And he also
— his nose was so congested, he had to have a surgeon open it up with a knife so he could
breathe, lots of signs that you might want to lay off the stuff. BETTY ANN BOWSER: In
the 1890s, after almost killing a patient while under the influence of cocaine, Freud
stopped using the drug. It was after that when some of his most famous work was produced.
When cocaine was being used by Freud and Halsted at this point in time, did the world look
at cocaine as something fantastic or something to be experimented with? How was it viewed?
DR. HOWARD MARKEL: All they saw were the good aspects. No one knew — down the road, it
was very obvious when you had all these addicts that were created. And it was overprescribed,
as was morphine and opium, for everything. And it wasn’t until about five or 10 or 20
years later, that people started to say, hey, everybody I know is addicted to this stuff.
There was no such thing as controlled substances either. You didn’t need a prescription. You
could just buy it at a drugstore on your own. It really outlines the morality play that
continues to this day of every blockbuster pharmaceutical agent: This drug, when it comes
out, is the greatest, the newest, the best. And then, as we find out more and more, well,
it’s not so great. It has to be used under certain conditions. BETTY ANN BOWSER: So,
would you say beyond this old story is a contemporary cautionary tale? DR. HOWARD MARKEL: Absolutely.
It’s a morality play for today, as well as yesterday. And that’s why I could find all
of these issues in their two lives about addiction in general. And we had to be very careful,
because, as we’re learning more and more about addiction, not just one’s environment or the
drug they use or the root of administration, but also one’s genetic predisposition — so
think of it as a wheel of misfortune. And as it goes around, if you wind up on the bad
wedge, you could become an addict. BETTY ANN BOWSER: Dr. Markel, thank you for being with
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