Morning sickness and the Coronavirus

When there’s a problem in life, we want to find a solution. That’s natural. Part of what makes us human.

We sometimes joke about the American way: Give me 3 (or 5 at the most) easy steps to deal with whatever ails me. And make it quick.

So it’s no wonder that we want to find a cure for Covid-19. Right now. Because it’s upended life as we know it. And we just want back to normal. The way things used to be.

But what if in the rush to find a solution, the cure turns out to be as bad as the problem or even worse?

Where does that put us?

Meet the Müllers

(This is a real family’s story — their names have been changed.)

Germany, 1955.

Erika Müller was pregnant with her first baby. She was newly married to Dieter, who was quite a bit older than her. Which was not unusual at that time, given that many men had been lost in the war.

They were both thrilled to start their family. The country was rebuilding and the future looked bright.

Excitement soon turned into frustration. Erika had morning sickness. Not just a little. But debilitating nausea. Many days she was unable to function at all.

Yet somehow she made it through the pregnancy and delivered a beautiful baby girl. They named her Sabine. And rejoiced to be a little family of 3.

The invincible Müllers.

Baby #2

It’s been said that the pains of labor (and presumably pregnancy) are soon forgotten once the new baby is born. That was the case for Erika too.

A couple years went by and she was pregnant again. Quietly they hoped she’d do better with this pregnancy. As in no or very little morning sickness. Which didn’t turn out to be the case.

However, this time, when she talked with her doctor about it, he was quite excited about a new drug that had just come on the market. Early reports were that it did wonders for alleviating that persistent nausea. Letting expectant moms feel like humans again. The new drug was so safe it was sold over-the-counter. No prescription needed.

She decided to give it a try.

And it worked. Erika couldn’t believe how well she did during the pregnancy this time. Hardly sick at all.

Puzzled

Eventually she delivered another daughter. Another beautiful baby. Except for, well, she didn’t have any thumbs. 4 fingers on each hand and no thumb. And the lower arms were a little shorter.

The doctor was very puzzled. He had no explanation. Other than that this just sometimes happens. Human development during the pregnancy is so complex. Who could say what might have caused this little girl to not have any thumbs? Or her arms to be a little shorter?

Erika and Dieter resolved to love their new baby just the same. Named her Heike.

After all, they lived in a place where they daily encountered people with war injuries. Somehow, although it was inexplicable, a little child missing thumbs on both hands did not seem like the end of the world.

Erika and Dieter had always figured they’d have a big family. So 2 children would only be the start.

Many conversations with friends, family and doctors later, they concluded that there was really no explanation for Heike’s deformity. After all, Sabine was perfectly healthy. Doctors told them that Heike’s deformity was an aberration. A one-time thing. Like lightning never strikes the same place twice.

Baby #3

Eventually they tried again. Erika was a bit hesitant, dreading a return of morning sickness. But then again, if that were so, medicine had helped last time.

This time around nausea hit her worse than ever. But medication helped. She made it through the pregnancy and delivered a baby boy. Who was severely deformed. They named him Wolfgang. Hoping that somehow a heroic name would help him make it through life.

Honestly, Erika and Dieter might have given up here. Instead they brought little Wolfgang home and cared for him during what became a rather short life. Not only did he have major bodily deformities, but also severe developmental issues. It didn’t take long to realize that he would never interact like the girls or other children.

After that experience they decided they wouldn’t try to have more children. Because there was clearly something wrong with one or both of them. The way they looked at it now, it was Sabine, their oldest, who was the miracle. The exception. Deformed children was what they could expect if they’d try again.

So they focused on taking care of their 2 girls. Especially since Heike needed some extra help.

Teens

By the time the girls were in their teens, Sabine was the usual teenager. Curious about life, in her mind totally ready to be an adult. Yet outwardly affecting that disinterested teenage look that says “I don’t really care much about anything”. Although she would do anything to help and protect her sister.

Heike turned into an amazing human being. She was sharp. Witty. Quick. Basically not going to take any grief from anybody. She learned the hard way in school. Because kids pounce on anyone who is different.

Frankly, if you just met her casually, you might not notice anything amiss at first. She had figured out how to use her pointer finger as the missing opposable thumb and grab things like nobody’s business. Not going to be left behind.

She was, as they’d say about Tigger, full of energy and fun, fun, fun.

It wasn’t us, it was them

But this isn’t just a story about the Müller family overcoming and staying together through all the challenges. Although that is a remarkable story in itself. All too many families when faced with this kind of adversity fall apart.

A few years after Wolfgang was born, that wonder drug for morning sickness was finally pulled off the market. Heike and Wolfgang were not random flukes. Their deformities were caused by the wonder drug Contergan. Also known as Thalidomide.

Thalidomide turned out to cause birth defects in an estimated 15,000 babies worldwide.

But it was initially marketed as a perfectly safe sedative and loads of free samples given away to pregnant women. Because morning sickness was very real and they wanted a cure fast. This new drug promised that.

Eventually it became clear that the makers of the drug had not done their homework. They had no reliable evidence to back up their claims that the drug was safe. Within a few years after the drug came on the market, doctors in Germany and elsewhere reported many, many cases of mild to severe nerve damage.

Cover-up and lasting effects

The drug makers continued to market the drug to pregnant women, in spite of mounting evidence of babies born with a wide range of physical and developmental deformities.

It finally took regulatory action to remove the drug from the market.

The wonder drug was thought to be the longed-for solution to a very real, debilitating problem. Yet it turned out the “solution” caused far worse problems.

Morning sickness, as bad as it is, will eventually pass. The babies born with deformities had to live out their entire lives with those deformities.

Wolfgang didn’t live very long. Barely made it to his 10^th birthday. Heike is still alive. She’s one of the lucky ones.

As they age, many thalidomide babies, now adults, find that their bodies wearing out much faster than other people’s bodies. The deformities put extra strain on joints and organs.

Heike was extremely adept at using her 4 fingers almost like if she had her thumbs there. But in the end, that put more strain on her joints and left her hands damaged. Hello arthritis and constant pain.

Could all this have been avoided?

Yes.

The drug maker failed to conduct enough testing and clinical trials. Because that takes time. And they had a wonder drug on their hands. That people wanted now.

The testing and trial process also requires absolute honesty. Because there’s the possibility of failure. The promising drug might turn out to not be so promising after all. It might not actually heal the patients or the side effects might be far worse than the original illness.

In which case all the work of development is sunk money. Gone.

Once the (not thoroughly tested) drug was on the market, the makers then worked hard to hide and deny any hints that it wasn’t such a wonder drug after all.

In the time of Coronavirus

That was 60 or so years ago. What does that have to do with the new Coronavirus?

Just that in Covid-19 we have a major public health problem. A virus that we don’t understand well at all. It’s wreaking havoc with our populations. Of course we want a cure as quickly as possible. A vaccine ready by yesterday. Or the day before.

Or maybe it’s a drug we already have. That could work for this. Because surely if it helped with disease X, it can help with this new disease.

New vaccine or existing drug: it will be the wonder drug. That makes everything all right. So we can get back to life as we knew it again.

So if someone says it works, then why not just give it to everyone?

Because it’s not that easy. Or quick.

So we might have a seemingly quick and easy solution that “everyone” says works. Except at best it turns out to work some of the time, while not actually killing too many patients.

Or we get a solution that really works and is safe to use for the long haul. One that won’t come back to haunt us in years to come. Because now that it’s here, Covid-19 will not just go away. It will be with us for the long haul.

Just like the bubonic plague still exists today. Only it doesn’t kill massive numbers of people, because we’ve learned to understand it and have a simple, effective and safe treatment.

The Thalidomide generation should teach us to not rush forward like fools where angels fear to tread.

Note: There were very few Thalidomide babies born in the US, because the FDA steadfastly refused to approve the drug for use in the US. The damage here was because some doctors found ways around the FDA to still use it for pregnant women.

For more information about Thalidomide and what it did to a generation of babies:

A short history of Thalidomide

1968 LIFE Magazine article about the Thalidomide generation (page 47ff)