The 1st Patient
In 1948, “Mrs. G” came to the Mayo Clinic with severe RA, determined not to leave until she was cured. Drs. Kendall and Hench finally procured a supply of compound E from Merck, and they treated Mrs. G in September of that year (but not before dropping the glass vial with 5 grams of the substance on a marble floor—it somehow didn’t break).
They were stunned by the results. Mrs. G seemed transformed, going out shopping within days of the treatment when before she had barely been able to get out of bed. They gave the substance to other renowned rheumatologists to try in their clinics. These physicians found it worked for their patients, too.
The assessment of one Mayo Clinic physician? “It was like God had touched them.”
Although the drug produced wondrous results, Mrs. G’s case also became a lesson in the drug’s troubles. Her joints improved by at least “50%” a few days after the initial treatment, according to notes. But the dose was eventually reduced, and she suffered increasing musculoskeletal discomfort. Later, she became anemic and needed blood transfusions.
The relationship between Mrs. G and her doctors deteriorated. Later, in a letter, she referred to the “cruel things” done to her at the Mayo Clinic.
She died in 1954. The cause was unknown, but she had pulmonary edema, and Dr. Matteson said it’s possible she had a massive gastric hemorrhage from a probable ulcer.
Although use of the drug in Mrs. G’s case was done according to the best practices of the time, the case has left a long legacy, Dr. Matteson said.
“Lessons from this experience and other early clinical trials have led to better understanding of patient expectations,” he said, “and, in a positive way, helped to develop tools to address patient and investigator concerns, and foster patient and investigator protection in the conduct of clinical trials.”
Acknowledgment: Dr. Matteson noted the help of his colleague Thom Rooke, MD, a vascular medicine specialist at the Mayo Clinic and author of The Quest for Cortisone, in preparing the lecture.
Thomas R. Collins is a freelance writer living in South Florida.
