Empire of Pain: The Secret History of the Sackler Dynasty

The family saga of the Sacklers begins with Arthur, born in Brooklyn in 1913, the oldest son of Isaac and Sophie Sackler, Jewish immigrants from what is now Poland. The Sacklers had hopes for a new and prosperous life in America and an attachment to success they would deeply instill in their oldest son Arthur: “From an early age, he evinced a set of qualities that would propel and shape his life—a singular vigor, a roving intelligence, an inexhaustible ambition” (12).

Arthur’s parents encouraged religious and cultural Americanization, rarely attending synagogue. Arthur began high school early at Erasmus, which “took the notion of upward mobility and assimilation seriously, providing a first-class education” (13). He studied hard. He also made money selling ad revenue for the school’s publications and doing advertising management for a business school program. Advertising would prove a key skill set for him throughout his life.

Isaac successful grocery suffered in the Great Depression, but Arthur retained a passion for museums and dreamed of a grander existence. Sophie Sackler was similarly ambitious—she wanted all of her children to pursue medicine. This was a common sentiment among Jewish immigrants, who felt the profession had social and moral resonance in addition to providing a solid income.

Arthur enrolled at New York University in 1929, working many jobs to finance his studies, studying art and drawing at night, and continuing to pursue his interest in museums. After graduating, Arthur attended NYU’s medical school: “He loved medicine—loved the riddle of it and the sense of possibility, the way that it could ‘reveal its secrets’ to the diligent investigator. ‘A physician can do anything,’ he would observe” (18). He also understood the profession’s moral weight, remaining haunted for years at letting an incompetent surgeon operate during medical school because he was afraid of intervening and harming his career.

During medical school, Arthur continued his work in advertising: “Arthur had discovered that of all his many talents one thing he was particularly good at was selling things to people” (19).

In the 1940s United States, mass institutionalization of mentally ill people was common, in part due to lack of other treatments or understanding of psychiatric illnesses. To support his family and his brothers’ ambition to also become doctors, Arthur Sackler pursued psychiatric residency at a psychiatric hospital called Creedmoor. Arthur’s mentor was a Freudian, a champion of talk therapy. His brothers, due to anti-semitic quotas on Jewish enrollment in US medical schools, were forced to train abroad and at a then-unaccredited medical school (which has since become Brandeis University).

Arthur’s great passion was finding a practical, scientific alternative to psychiatric institutionalization. He was critical of electroshock therapy, which delivered massive charges into patients’ brains, sometimes causing major memory loss, though it did improve some symptoms. Arthur felt that “the treatment seemed so brutal—tying patients down so that they didn’t hurt anyone when they flailed, adjusting the electrical current like the mad scientist in a Hollywood film—and it often left patients deeply traumatized” (26). Arthur’s brothers shared his distaste, soon compounded by the emergence of lobotomy, a procedure unsupported by science and primarily promoted for profit, which effectively destroyed the human personality by removing major brain centers. Arthur believed more humane treatments might be possible through improved understanding of the brain, though he had little institutional support from hospital leadership. The Sackler brothers discovered that histamine produces similar results to electrical shock, increasing blood flow to organs in a similar way. They tried the treatment on patients with schizophrenia, going on “to publish more than a hundred medical papers. Their aim was, as they put it, to trace ‘The chemical causes of insanity’” (31).

Radden Keefe uses Arthur’s personal life as a framing device: The chapter opens with the arrival of a young German doctor, Marietta Lutze, who was retraining to meet American professional standards at Creedmoor. Sometime after their first meeting, the two drove to Chicago to attend a medical conference. Arthur learned about Marietta’s prominent family, their pharmaceutical business, and her divorce from a German man. She was captivated by his ability to listen to her, and “Only later would she come to recognize in Arthur’s reserve a certain penchant for secrecy” (29). He began to court her, calling regularly and sending flowers—even though he was already married with two children. By 1949, Arthur was insistent he was devoted to Marietta, though he might have continued to juggle his existing family and his new relationship if she had not become pregnant.

Radden Keefe punctuates this story of deception by returning to Isaac Sackler’s final advice to his sons: Material gain is nothing without an honorable reputation; losing that is the worst sin—not failure in business.