"No More Tears" - A Book Review

Gardiner Harris was the public health and pharmaceutical writer for the New York Times, and before that he wrote for The Wall Street Journal. He is now a freelance journalist. Harris is also the author of a novel called "Hazard", which centers around the toxic effects of exposure to coal dust. I first became aware of the author through a documentary called "Painkiller: The Tylenol Murders", and he was a contributor to that project. "No More Tears" was published in 2025.

This book is a comprehensive examination of the history of Johnson & Johnson. For all of its breakthroughs and positive contributions as a healthcare conglomerate, J&J also has a very dark history that it would rather you not know about. The company was founded in New Brunswick, New Jersey in 1887 by three brothers: Robert Wood Johnson, Edward Mead Johnson, and James Wood Johnson. J&J initially focused on mass producing cotton and gauze bandages, and mostly concentrated on selling to doctors and hospitals. The company's first big money-making product was introduced in 1894 - Johnson's Baby Powder - which contained Italian talc (in blocks it is known as soapstone, and is also used to make sinks, stoves, and electric switchboards). By 1967 there was concern about the safety of talc, and an internal memo acknowledged that it contained trace quantities of two kinds of asbestos, which is known to cause cancer. Rather than publicly acknowledge and solve the problem, company executives devised a plan to discredit the studies that confirmed the dangers. By 1989, most other companies had switched to using corn starch in their baby powder; J&J continued to use talc because it created higher profit margins. A class action lawsuit ensued, and the plaintiffs were awarded a total of $550 million dollars in compensatory damages. Punitive damages totaled $2.5 billion dollars. Years later, it would be acknowledged by a J&J representative that false statements were made under oath about the safety of Johnson's Baby Powder.

Tylenol is probably the most well-known over the counter pain reliever on the planet. It was developed by McNeil Laboratories and became part of the J&J line of consumer products when J&J acquired McNeil in 1959. Most people who were alive in the 1980s are aware of the Tylenol Murders case of 1982, where several people died after ingesting Tylenol capsules laced with cyanide. This was the impetus for the tamper-resistant packaging that is so ubiquitous today. Unfortunately, these are not the only deaths connected to Tylenol. The active ingredient in Tylenol is acetaminophen; according to the author, "More than a century after its discovery, scientists still don't know how acetaminophen works." Anthony Benedi, a former staffer for president George H.W. Bush slipped into a coma and sustained brain swelling and liver failure following a bout with the flu in which he consumed the recommended dosage of Extra Strength Tylenol. On average, Benedi drank between two and three glasses of wine per night, which is the average alcohol consumption for American men. Following a liver and kidney transplant, Benedi sued J&J and was awarded $9 million dollars in damages. Harris goes on to say, "Documents revealed in Benedi's case showed that Johnson & Johnson had known for years that moderate drinkers - a description that applies to most Americans - could suffer catastrophic liver damage from ordinary doses of Tylenol." Finally, the author says, "Acetaminophen has for decades been the nation's leading cause of acute liver failure."

Erythropoietin (EPO) is a synthetic form of a protein that increases the body's production of red blood cells. It is a banned substance in competitive athletics; many of us remember that Lance Armstrong won seven Tour de France titles in part due to his secret use of the drug, and he was subsequently stripped of those titles. The reason it is a banned substance is because the stimulation of red blood cell production thickens the blood, leading to an increased risk for heart attacks, strokes, and embolisms. Even worse, according to the author, "A researcher named Athanasius Anagnostou from Brown University added EPO to a petri dish filled with cancer cells and found that the drug supercharged the cells' growth - the opposite of what anyone wanted to happen." Johnson & Johnson developed their own version of EPO - called Procrit - and by 1998 it had become the company's most profitable product. The problem was the increased risk for cancer in patients that took the drug. In the words of Dr. Otis Brawley, the longtime chief medical officer of the American Cancer Society, "What data do you have to assure me that this is not Miracle-Gro for cancer?" J&J started an EPO study in cervical cancer patients in 2001, with 109 patients participating. Within two years that study was stopped because patients given EPO were dying at a much more rapid rate than in the control group. J&J knew this, yet the results of the study were never published.

Johnson and Johnson entered the medical implant business in 1998 when it purchased DePuy Orthopaedics. Hip implants were first invented in the 1950s, and the linings between the steel cups and balls were made of Teflon, which worked well for a while but eventually wore away and required revision surgeries. Eventually the linings were made of heavier plastics, but in the 1960s two surgeons came up with the idea of using metal instead of plastic so that the implant would last a lifetime. Unfortunately, friction between the ball and the cup could result in tiny metal shavings that "killed surrounding tissue, loosened the joints, and released toxic ions that poisoned patients' hearts, brains, and eyes." J&J's metal-on-metal hip implant was called the ASR XL; they stopped selling it in 2013 after the FDA strengthened hip implant regulations. According to the author, "Johnson & Johnson settled the many lawsuits involving problems with ASR XL implantations for $2.5 billion."

These are not the only examples of unethical behavior. In the early 1970s J&J hired Dr. Albert M. Kligman to conduct a study as to what would happen to humans and rabbits if they were injected with talc and asbestos. As the author explains, "Kligman was a problematic researcher, to say the least. For many years, he had conducted tests of Johnson's Baby Powder, as well as Band-Aids, shampoos, and other drugs, on African American prisoners and mentally disabled children. These experiments were often exquisitely painful for his vulnerable subjects." Finally in 2021, J&J expressed remorse for allowing such experimentation to be conducted. Too little, too late.

Why is this book important? Most people don't realize just how many products fall under the J&J banner (I did not either, until I read this book). Pharmaceutical companies pay enormous fines for misdeeds and look at it simply as the cost of doing business. J&J is no different. Harris states, "Between 2010 and 2021, J&J spent $25 billion on litigation." That doesn't even include the bribes given to doctors and hospitals to get them to prescribe their drugs and other products. Another point to consider is that the FDA is not really looking out for you. There are numerous examples given where the agency looks the other way or is actively complicit in J&J's unethical behavior.

Gardiner Harris has done an outstanding job of writing and researching "No More Tears." Near the end of the book, he lists several suggestions for how the system can be dramatically improved. You deserve better than the corruption that has gone on for decades. I encourage all of you to read this book and decide for yourselves.