The Fertility Doctor: John Rock and the Reproductive Revolution (review)

This book is, in some senses, long overdue—but it was certainly worth the wait. Tribute has always been paid to John Rock’s role as a clinician in the development and evaluation of the Pill. Much of the attention, however, has focused on the clinical trials leading up to the drug’s approval, especially in light of subsequent charges that the trials were unethical. His acceptance and eventual advocacy of the Pill, especially in the face of opposition from his own Catholic Church, has also fascinated researchers. He has not been convincingly portrayed as a central character in the Pill drama, however. Although his correspondence with Katherine McCormick is tantalizing, the principal roles were assigned to the independent and intrepid research scientist, Gregory Pincus; the wealthy, demanding, and impatient Katharine McCormick; and the pioneering birth control maverick, Margaret Sanger. In the past decade or so, loosely surrounding the fortieth anniversary of the approval of Enovid, the first oral contraceptive, new literature on the history of the Pill has emerged. Although Rock is clearly identified as a co-inventor of the pill whose expertise was integral to the whole story of hormonal contraception, he has nonetheless remained, even in these new narratives, a slightly shadowy and underdeveloped figure.

What this book does and does exquisitely is to bring John Rock’s life and life’s work to the forefront, not of the Pill drama per se, but of the decades of hormonal history before and after the point in time, midcentury, when it became possible to envision and ultimately create a synthetic hormonal combination drug which served as BOTH an oral contraceptive AND as an aid in treating infertility and related menstrual irregularities. Women have come to appreciate the benefits of each—albeit at different milestones—in their reproductive lives. Rock, however, early in his career, preferred to emphasize conception over contraception, a position that has always made his later views important in understanding the history of contraception. However, it was his eminent presence as the “fertility doctor” and his brilliant career overall which provide touchstones related to so many of the changes in all aspects of reproductive medicine that took place within his lifetime as well as his own contribution to many of them. John Rock’s biographers have richly rewarded us with a portrait of a physician and researcher whose central role in twentieth-century reproductive medicine could certainly have been acknowledged prior to their collaborative research, but not truly appreciated without it.

John Rock’s path to greatness was a circuitous one, especially for a young man during his era. He and his twin sister were born into a Catholic family of five. John’s father was a businessman frequently caught up in the economic boom and bust cycles of the late nineteenth century. John was, according to his biographers, a rather unusual child, preferring music to sports, and demonstrating an early gift of empathy. Shunning college in order to pursue bright new business opportunities in Latin America, John’s family arranged for him to work for United Fruit Company as a timekeeper on a Guatemalan plantation. John’s tropical adventure came to an end when he showed support for black plantation workers who had been subjected to a wage cut. Upon his return, his family was forced to acknowledge that he had no interest in or inclinations toward business. While in Guatemala, however, he had been inspired by the work of a Scots physician, and determined to enter Harvard to begin his medical journey. He completed his undergraduate work in 1915, but he completed four residencies (surgery, obstetrics, urology, and gynecology) before he actually began his career as an assistant in surgery at Massachusetts General Hospital in 1921. His Harvard credentials, gained during a period in which the prestigious university had been attempting to broaden its student base, served him well and afforded him some unique opportunities in medicine at a critical crossroads in the history of ob...