No More Tears

by Gardiner Harris ★★★★★

In No More Tears, Gardiner Harris, former pharmaceutical journalist for both The Wall Street Journal and The New York Times, provides a thorough unmasking of Johnson & Johnson's most egregious missteps over the past fifty years. The result is story after jaw-dropping story of corporate greed, captured in one of the most deeply researched books I read this year and undoubtedly the most infuriating.

Harris's macro premise is that Johnson & Johnson has been trading for years on a reputation steeped in moral superiority. Their reaction to a 1982 event in which someone laced Tylenol capsules with cyanide, killing seven people, resulted in them voluntarily recalling hundreds of millions of bottles at a cost of over $100 million dollars. It's a scenario still presented as a Harvard Business School case study "used to teach thousands of executives in training that if they do the right thing even at considerable expense, customers will reward them—one of many Harvard case studies that collectively describe J & J as a capitalist's nirvana where doing well and doing good are synonymous."

But what if the company isn't as virtuous as it is perceived, or as it goes to great lengths to present itself? On one hand, it would be naive to think that a company that has been in business for more than one hundred years wouldn't have the occasional misstep or bad decision. If someone researched whatever you're company you work for, and pulled out all of the worst decisions and compiled them in a book, it probably wouldn't show well either. But Harris's broader point is the hypocrisy, and the pattern of placing profits over people's health and in many instances their lives, that seems to have continued to trend in an amoral direction.

Harris meticulously recounts major scandals from the last fifty years. From hiding the presence of asbestos in Johnson's Baby Powder to the production of a Covid vaccine that was 65% effective at best (the "third-best option", as Dave Chappelle put it), Harris lays bare some well-publicized missteps, and others that have been painstakingly buried from consumers. "This book is the product of five years gathering tens of thousands of pages of trial transcripts, and contacting hundreds of executives and employees. Among the records I uncovered are secret grand jury files. Providing such documents to a reporter is a criminal offense, but my sources put themselves at considerable risk because they found the company's conduct so singular."

From issues with consumer products (asbestos in Johnson's Baby Powder and a response to the Tylenol-cyanide event that wasn't as virtuous as lore would suggest), Harris moves on to prescription drugs (Procrit, Risperdal, Duragesic) and J & J's central role in the opioid crisis in America. While Purdue and the Sacklers have received the well-deserved scorn (and prison time) for their role in the opioid crisis, Johnson & Johnson was nearly as complicit, yet has escaped most public scrutiny. Harris then moves on to medical devices and known issues with metal-on-metal hip implants and a stomach-turning section on J & J's Prolift vaginal mesh product. Throughout these sections, Harris lays out the history of J & J's role in setting market direction for cash payouts to doctors and a "sell the symptoms" plan for marketing their drugs for non-approved uses.

It all paints a stark and frustrating picture of greed and immorality that should enrage any reader. To Harris's credit, he does provide a small bit of counterargument, giving J & J some flowers near the end of the book when he acknowledges that "it has brought to market a host of drugs and devices that save and improve lives" while documenting several of those. But, as he points out, "At the same time, J & J has knowingly contributed to the deaths and grievous injuries of millions. And for much of the twenty-first century, almost every one of J & J's top-selling drugs benefited from criminal marketing schemes." While the company has clearly helped billions over its existence, Harris contends it has gradually lost its perspective and morality, accepting harm to millions in exchange for increased corporate profits. With decision upon decision by J & J that backs up this thesis, it's hard to come to a different conclusion.

No More Tears is an infuriating look at a cornerstone American company, and despite the anger and frustration reading it will likely induce, it's a throughly researched work of journalism that deserves to be read.