The Quest for Cortisone

Chapter 26. The Prize

183 Chapter 26 The Prize Watson here will tell you that I never can resist a touch of the dramatic. —sherLoCK hoLMes, THE NAVAL TREATY in 2006 a historical vignette about Walter Alvarez was published in the Mayo Clinic Proceedings; it mentions that John f. Kennedy spent one month at Mayo undergoing an evaluation for Addison’s disease— and that he “had lunch” with Dr. Alvarez.1 if so, Kennedy must have been among the last patients that Alvarez saw as a Mayo physician. The renaissance gastroenterologist retired from the clinic at about this time and moved to Chicago, where he signed on as a medical columnist for the Chicago Tribune syndicate. soon known as “America’s family doctor,” Alvarez became famous; his newspaper column was read by millions. he also wrote numerous books and made regular appearances on television and radio. Alvarez’s success as a public educator was a stunning career-capper for a man who had already excelled in both research and patient care. The Mayo Clinic logo consists of three interlocked shields, which are said to represent research, patient care, and education. True to form, Walter Alvarez was now the undisputed master of all three “shields”—he’d hit the academic trifecta. Things were going even better for his son Luis. When the war ended, young doctor Alvarez returned to the university of California at Berkeley and was quickly promoted to full professor. The rapidly maturing scientist changed his focus of interest again, this time to the field of high-energy particle physics. he began designing and constructing particle accelerators that could propel electrons and protons at high velocity. By 1947 Luis 184| Chapter 26 had an operational forty-foot-long proton accelerator.2 But an even more interesting physics device lay in his future. it didn’t take someone like sherlock holmes to deduce that the response to Mayo’s announcement on compound e would be big. news of the breakthrough spread contagiously through the scientific community. Within days Kendall and hench were invited to address the prestigious national Academy of sciences. it was only the first of many major speaking invitations to come. The two scientists decided to change the name of their discovery. until now it had been referred to as “compound e” because it was the fifth substance Kendall had isolated from the adrenal cortex (the first four had been called A through D). But as the nondescriptive name hit the media, it immediately became confused with more familiar entities like vitamin e.3 A better moniker was needed. in May 1949 hench came to Kendall’s laboratory and suggested that they come up with a “more distinctive name.” it was normally up to the pharmaceutical company to invent snappy, marketable names for new drugs, but in this case hench and Kendall opted to do it themselves. since they had been searching for “cortin,” it made sense that the word they chose would conjure up the notion of cortin. Kendall suggested “corticosterone,” and then removed the “ticoster” to leave the word “corsone.” hench balked at this; to a clinician, anything that began with the syllable “cor” implied something cardiac in nature. According to Kendall, hench suggested adding the letters “ti” back into the middle of the word, creating “cortisone.”4 That account of the episode sits well with the recollections of Dr. hench’s junior colleague, howard Polley. in his unpublished notes, Polley disputes a once-popular theory of how the word “cortisone” came into existence—the idea that it was a shortened version of the drug’s chemical name. “The letters in the word cortisone are easily identified in the chemical name, 17-hydroxyl-11-dehydrocorticosterone,” Polley notes, “but Dr. hench had so much trouble with this chemical name that it’s problematical that he used that chemical word to generate the term cortisone .” in other words, Polley doubts that his boss simply shortened a word that, given his speech impediment, he would have found unpronounceable in the first place. Percy Julian was still working at the Glidden Company when news about cortisone grabbed the nation’s attention. As the price of cortisone quickly The Prize| 185 rose to over $4,000 an ounce, Julian realized that a more economical way of manufacturing the drug was necessary. sarett and his colleagues at Merck had made the commercial production of cortisone possible. now someone needed to make it practical. Julian...