Breaking the Mold (Eric Lax’s book on the discovery of penicillin)

Earlier this month I attended the Juvenile Diabetes Research Foundation research benefit for stem-cell research. Although James Taylor’s five-song set and Nancy Reagan’s acceptance speech were each memorable and moving, what I found myself thinking about most that evening was Eric Lax’s new book “The Mold in Dr. Florey’s Coat” (Henry Holt & Company, $25), about the story of penicillin.

In the 60 years since it was first made available, penicillin has gone from miracle drug, to cure-all, to over-prescribed. Today it’s common to hear Westside mothers brag about not using antibiotics. Lax, however, takes us back to a time when a simple infection could lead unexpectedly to death. Doctors for the most part, followed the oath to do no harm, but they could do little proactively to reverse the course of a serious infection.

As described by Lax, the history of penicillin was something of a relay race. Microbiologist Alexander Fleming was the first to explore the special properties of this distinctive mold in his London lab in 1928. However, by 1932 Fleming had abandoned his research, because he saw no way to extract the penicillin. Almost a decade later, Howard Florey had assembled a team of scientists to research antibiotic agents when biochemist Ernst Chain, a German Jewish refugee who had arrived in London in 1933 with 10 pounds sterling in his pocket, came upon Fleming’s original paper. Chain, along with Edward Abraham, was able to solve the mystery of penicillin’s chemical nature. Norman Heatley and Gordon Saunders, for their part, invented homemade solutions for extracting and purifying penicillin from the molds.

Even so, the British discoveries would not, by themselves, have made penicillin the World War II lifesaver it became. Of critical importance, American pharmaceutical companies came up with a more potent variant of penicillin (from a cantaloupe) and ways to increase the amount that could be fermented (think vats of beer). In 1941, Florey could only produce enough penicillin to conduct several tests. By 1944 the United States was producing 100 billion units per month, saving hundreds of thousands of soldiers and civilians.

Lax uncovers the human drama behind the story: Fleming’s reticent nature, which at first worked against him and finally made him credible in the role of “the modest man of science”; Florey’s constant struggle to fund his research, his loveless marriage, as well as his 25-year affair with his colleague Margaret Jennings, whom he married after his wife’s death in 1966; and Heatley’s war-time romance in Iowa. At the same time, we see Chain’s voluble personality and his encounters with British anti-Semitism. This is made all the more dramatic against a backdrop of war — The Battle of Britain, and the Blitz (the book’s title comes from Florey’s suggestion that if the Nazis capture them they should destroy their work but keep the penicillin mold alive in the pockets of their coat). At the same time, Lax chronicles how the story of penicillin took on a life of its own.

Popular accounts gave Fleming all the credit for “discovering” penicillin, although he basically abandoned his research early on. Florey and Chain shared the Nobel Prize with Fleming, and received much professional distinction for their work, but Heatley got very little. The British regarded taking a patent on the process as something that was “not done.” American pharmaceutical companies (Merck, Abbott and Pfizer) felt differently and reaped tremendous royalties. Lax’s tome sets the record straight and gives the right persons their due — all in a very readable fashion. As several reviewers have already noted, Lax has taken his talents as a biographer of famous actors (Woody Allen, Humphrey Bogart) and his abilities as a science writer (“Life and Death on 10 West”) and brought them to bear on Fleming, Florey, Chain, et al.

For Los Angeles author Lax, whom I know from the writer’s human rights organization PEN USA (he’s co-president and a board member of PEN International), the book represents a five-year journey that began when he read the obituary of Anne Miller in 1999, a woman who, in 1942, was among the first to be brought back from certain death by penicillin. Lax is intelligent, charming and has a certain intensity — the book is very much like him. Although much of the story takes place in England, it makes perfect sense that writing it would appeal to someone from Los Angeles.

More than anything else, Lax’s book conveys the sanguine worldview that drove disparate characters to succeed in one of the greatest medical discoveries of our times. This cannot be understated.

Lax came to Los Angeles in 1980 to write an article for New West magazine. The assignment, about the bone marrow transplantation ward at UCLA, turned into the book “Life and Death on 10 West.” Lax stayed on and, as a nonfiction writer in a town of screenwriters, he has been fortunate to make a life here with his wife and two sons. I don’t think it’s a coincidence that a former Peace Corps worker moves to California, has the impact he has had with PEN and now writes a book about “the penicillin miracle.” Los Angeles is a place of enormous optimism, a city driven on hope.

Which brings me back to the Juvenile Diabetes stem-cell research benefit: Much as we may take antibiotics for granted, we still stand powerless before a host of debilitating and fatal diseases, such as Alzheimer’s, ALS, Parkinson’s and diabetes. Lax’s book is a timely and powerful reminder that investing in science and research can be a matter of life or death.