The Fertility Doctor: John Rock and the Reproductive Revolution

Chapter 4 Firing the First Shot in the Reproductive Revolution

[ 87 ] Boston, 1937. An unsigned editorial in the New England Journal of Medicine hints at the possibility of creating human embryos outside the uterus by means of in vitro fertilization. Brookline, Massachusetts, 1938. John Rock and Arthur Hertig set forth on a fifteenyear quest to trace the path of the fertilized egg from fallopian tube to uterus, providing the first visual record of the early days of human conception. Science magazine, 1944. Rock and his technician Miriam Menkin electrify the scientific world with the announcement of the successful fertilization of four human ova outside the womb, firing the first shot in the twentieth century’s reproductive revolution. In January 1938, John Rock, nearly forty-eight years old, was in his twelfth year as director of the Fertility and Endocrine Clinic at the Free Hospital for Women. He had become a prominent Boston obstetrician and gynecologist and had developed a respectable reputation in research. He could take pride in a satisfying, if not stellar, career. Fast forward a decade, to 1948, when Rock would enjoy an international reputation as an infertility expert, receive one of his profession’s most coveted honors, and astonish the nation with an announcement of the first successful fertilization of a human ova outside the uterus. His name was not yet a household word, but women from around the globe could nevertheless come to any Boston hospital, ask for the “fertility doctor,” and be directed to Rock. Articles about his work appeared regularly in national magazines. Men and women from across the nation and the world sought his advice about their difficulties in having a child, and young physicians from everywhere vied for a chance to work with him. John Rock’s metamorphosis from prominent local gynecologist to internationally recognized fertility expert was the result of determination, hard Chapter 4 firing the first shot in the reproductive revolution t he fer t ilit y d o c tor 8 8 work, and good fortune. People who had known him only socially were sometimes caught off guard by his ambition. His bonhomie, self-mocking sense of humor, and obvious pleasure in society life could deceive the casual observer. Hiscultivatedmodestyandgenuinegracewereamonghisnotablepubliccharacteristics . But beneath that charming exterior dwelt a driven temperament.1 Two studies formed the twin centerpieces of a large and ambitious research program that Rock directed and that helped to lay much of the groundwork for the development of reproductive medicine in the second half of the twentieth century—the first was on the process by which a fertilized ovum becomes an embryo and the second, on the fertilization of ova outside a woman’s body (what came to be called in vitro fertilization). In these studies, he and his collaborators, including Arthur Hertig for the embryo project and Miriam Menkin for what was called the ova study, sought answers to what had been insoluble mysteries of human fertility. By the time Rock embarked on these two studies in 1938, his personal situation had become more stable. He had learned to pace himself; he no longer, even privately, agonized so much about his ability to manage his myriad responsibilities . His brother Charlie, in spite of a health scare three years before , remained at the helm of the family and provided financial assistance whenever John needed it. John and Nan had completed their family; their youngest child, Ellen, was nearly five. It was now easier for him to focus on his research interests. John was lucky in his wife. Nan was both a supportive spouse and a woman of independent interests who had a life of her own. As a couple, they often entertained and had friends to stay with them. She would accompany him to professional meetings, but she would also travel without him, either alone or with one or more of the children, to visit her friends or her family. She seemed in general the more self-reliant of the two—she, after all, could take apart and reassemble an automobile engine; he couldn’t be bothered even to put in a quart of oil. She also relished her times away more than he did. He did not like to travel without her.2 Rock worked hard, but he and his wife both liked to socialize; he had a close circle of friends and a broader one of friendly acquaintances, many of them physicians. Thanks to Nan’s social connections, the Rocks belonged to the exclusive country club in Brookline (always referred to in Boston simply as the...