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[ 116 ] Baltimore, Maryland, 1934. Samuel Meaker’s Human Sterility: Causation, Diagnosis, and Treatment: A Practical Manual of Clinical Procedure is published, setting a new standard of practice for the diagnosis and treatment of infertility in both men and women. Brookline, Massachusetts, 1936. John Rock opens the rhythm clinic at the Free Hospital, which becomes the state’s first free clinic for providing contraceptive advice, offering the only contraceptive practice that is legal in Massachusetts. Brookline, Massachusetts, 1949. Rock finally persuades the Free Hospital to establish a male infertility clinic and to hire Dr. Fletcher Colby as its director. In 1948 John Rock told one of his colleagues, “I am not a research man nor have I a research mind. All I know are some of the problems I want answered .”1 This statement is surprising given his research accomplishments during the 1930s and 1940s. But Rock was not just being modest; he was also describing his priorities in a way that made sense to him. For him, research was a means to an end, not an end in itself. He wanted to find solutions for the problems of reproduction that beset his patients and the millions of men and women around the world who joined them in suffering either from infertility or repetitive childbirth. Although he started out in 1926 to direct a sterility clinic, his experiences over the next two decades changed him. By the 1940s his interests encompassed fertility matters in all their complexity—infertility , what he called overfertility, and marital sexuality. This chapter explores Rock’s medical practice in the 1930s and 1940s through the lens of his patients’ experiences. In many ways, Rock’s own beliefs and behavior evolved through his patients’ influence. His interactions with them helped to shape his ideas about infertility, contraception, and broader issues of sexuality and reproduction. They started him down new the world of the patients Chapter 5 t he world of t he pat ient s 117 lines of inquiry, led him to develop new treatment protocols, and changed his attitudes toward reproductive questions and problems over the years. Rock built his professional life around “the problems I want answered.” He cared little for abstract scientific questions; he sought practical clinical solutions . How can we determine the time of ovulation in women, not just in rats or rabbits? How exactly is a human ovum fertilized, and what happens to that fertilized ovum as it travels from the fallopian tube to the uterus? Are some embryos destined to abort, either because of their own abnormalities or because they fail to implant and develop in the uterus? Can we make it possible for women with blocked or absent fallopian tubes to become pregnant? How exactly do hormones function in a woman’s body—on a daily basis, during pregnancy, or during menopause—and can artificial versions of them be used to treat such conditions as menstrual disorders or infertility? When he first took up these questions in the early 1930s, there really had been no answers. Scientists who did possess “a research mind,” as Rock called it, had hypotheses and conjectures about human reproduction based on laboratory or agricultural research.2 Basic science had come to serve as the underpinning for all reputable medical education. Insights from the laboratory infused the practice of medicine, and Rock never minimized the significance of these landmark laboratory discoveries and achievements of others. He followed their work with great interest. He found the discoveries that came from the laboratory of Gregory Pincus particularly useful, and he was deeply indebted to the scientific research staff at the Carnegie Institution for their expertise in embryology. But Rock did not do that kind of laboratory work himself, had a tendency to express a good-humored but decided skepticism toward any literal reliance on animal analogies to explain the problems of human reproduction, and always declared that any interest he had in basic science lay in its application to clinical conditions.3 More than once he laughingly recounted a discussion he had with the great biochemist Otto Folin, his former medical school professor and now a colleague at Harvard. Rock was telling Folin about his plans for a new study. Folin listened for a while, then finally, exasperated by Rock’s casual attitude toward accepted research protocols, shot back, “I think you have a good idea, but I would have no confidence in your results.”4 Rock was impervious to Folin’s retort, since as far as he was...

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