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Medicine bottle assembly line
11.22.02
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ANNOUNCER: From our studios in New York, Bill Moyers.

MOYERS: Welcome to NOW. We return to the story of Big Pharma, the pharmaceutical industry.

Big Pharma earns higher profits and spends more to buy influence in Washington than any other industry. Just last week, its representatives met to gloat over what they can expect from Congress in return for the more than $30 million Big Pharma spread around in the last election.

We reported earlier on how they are trying to burn their brands into our psyche with all those ads urging you to "ask your doctor."

Well, it turns out that some of the advertising agencies behind the hard sell have an amazing, and hidden, stake in the game.

Believe it or not, the people who create the ads are taking part in the development and clinical testing of new drugs, the hard science at the heart of Big Pharma.

I am not making this up. See for yourself.

Our report is produced with the NEW YORK TIMES. Walt Bogdanich and Melody Petersen are the reporters, Mr. Bogdanich, the producer.


TELEVISION ADVERTISEMENT: If you're one of the millions of people who live with uncontrollable worry, anxiety...

NARRATION: Through drug advertisements costing billions....Madison Ave has turned patients into a potent sales force...influencing which drugs their doctors prescribe.

NARRATION: For the big pharmaceutical companies, these campaigns have been an unquestioned success, boosting sales...making brand name drugs as recognizable as the latest movie star. It's what advertising agencies do well: to unabashedly promote and sell products.

NARRATION: But now, Madison Ave, is quietly engaged in a much different campaign. To help create the next generation of blockbuster drugs, ad agencies are buying or investing in companies engaged in the actual science of drug development...including organizing clinical trials. Some ad agencies also own companies that ghostwrite scientific journals...and design medical education courses.

BODENHEIMER: The hidden hand of Madison Avenue is having an enormous effect on the prescribing habits of physicians in this country.

NARRATION: And that deeply worries some doctors.

RELMAN: Ad agencies are not in the business of doing science. They're not qualified to do science. They're not qualified to carry out clinical investigation, and they don't belong there.

NARRATION: For 14 years, Dr. Arnold Relman edited the New England Journal of Medicine.

RELMAN: These people make their living by promoting the sales of drugs.

TORRE: Some scientific people are worried that marketing might influence the science of a drug. That really can't happen.

NARRATION: Joe Torre—not to be confused with the baseball manager—is the award-winning, Ferrari-driving chief executive of the ad agency, Torre Lazur. It's known as the launch agency.

TORRE: We've launched over 65 new pharmaceutical products.

NARRATION: And to help launch even more products, Torre Lazur early this year bought its own clinical research firm, Target Research Associates. So the agency no longer merely markets new drugs, it now studies the benefits and dangers of experimental drugs.

TORRE: We provide services that go from the beginning of drug development all the way to the launch of your products.

WALT: From soup to nuts.

TORRE: From soup to nuts.

WALT: Is that new for advertising agencies?

TORRE: I'd say within the last decade it's new. Prior to that, advertising agencies used to be just that—advertising agencies.

NARRATION: According to Dr. Thomas Bodenheimer, clinical drug trials used to be performed mostly by academic medical centers. But in the New England Journal of Medicine, he writes that these trials are increasingly being done by private research companies like Target.

BODENHEIMER: Their only income comes from drug companies that contract with them to do these clinical drug trials, so they really have no independence from the drug companies.

BODENHEIMER: Their purpose is not scientific truth. So they can decide which data to publicize, and which data to bury.

NARRATION: Such worries are baseless, says Lloyd Baroody, who heads Target Research.

BAROODY: It's totally against the rules and it could be criminal. I can't imagine any colleague of mine in my company or in the industry that would put marketing before research in terms of trying to say something about a drug that only emphasizes the most favorable elements but buries the unfavorable elements. You know, it's just, it's just generally - I can't imagine it happening. I really can't.

RELMAN: He kept a straight face when he said that?

WALT: You don't believe it?

RELMAN: On the face of it, that's ridiculous.

NARRATION: A view shared by Dr. Eric Topol, who chairs the department of cardiovascular medicine at The Cleveland Clinic.

WALT: Is there a place for advertising agencies or their representatives in designing clinical trials and promoting the results of those trials?

TOPOL: Well, actually this is pretty scary to me. This is what I would label "bad chemistry." If this is where clinical research is headed, that would be a terrible negative trajectory.

NARRATION: A case in point, says Dr. Topol.... the new pain reliever Bextra. The Food and Drug Administration approved Bextra for mild pain like arthritis, but not for acute pain. Even so, six months later a private research company—Scirex—partly owned by the ad agency Omnicom, released a new study showing that Bextra did relieve acute pain from dental surgery. Bextra can't be advertised for acute pain, but doctors are free to prescribe it for that purpose.

TOPOL: It looked like the deck was stacked for Bextra - no surprise of course.

NARRATION: Dr. Topol said the study's conclusions were based on a sample size ...that may have been too small and too healthy. He has also criticized other studies of pain relievers in the same class of drugs as Bextra.

TOPOL: The question is, why can't they do the trials right? They have so much revenue and income. To do a trial done in the right way with independent investigators, with the right type of statistics and sample size and population is relatively little cost.

NARRATION: The ad agency Omnicom, which announced that it was investing in Scirex to—quote, "get closer to the test tube"—tells The New York Times in response to our questions that it has no influence over Scirex's management or the design of clinical studies. Scirex would not return our calls.

NEWS BROADCASTS: [Various news broadcasts trumpeting new studies.]

NARRATION: New medical studies, trumpeted frequently on the evening news, are important because they help doctors decide which drugs to prescribe...directly affecting the cost and quality of patient care.

NARRATION: Linda Logdberg knows the importance of these studies. She has written about them for medical journals.

WALT: If I were to look up the research papers that you wrote, would I find your name on them?

LOGDBERG: No, you would not find my name on them.

WALT: You're a ghostwriter.

LOGDBERG: I'm a ghostwriter.

NARRATION: In other words, doctors take credit for authoring studies that Linda Logdberg wrote. Though leading medical journals disapprove of ghostwriting, Dr. Logdberg — she has a doctorate in anatomy — didn't object as long as the research was presented fairly and objectively. But she says that when business executives at advertising agencies began telling her what to write, she grew increasingly uncomfortable.

WALT: You are a bit like the puppeteer. You pull the strings and the doctors dance.

LOGDBERG: I pull the strings after being told how to pull the strings.

WALT: Who is telling you pull the strings?

LOGDBERG: My contact at the medical education company.

WALT: Which is owned by...?

LOGDBERG: An advertising agency.

NARRATION: Dr. Logdberg says that several months ago she got a call from Intramed, a company that educates doctors about new developments in medicine. It's owned by the marketing company, Sudler & Hennessey, which in turn is owned by the global ad agency, WPP.

LOGDBERG: They asked me to rewrite an article that they were not happy with.

WALT: Why weren't they happy with it?

LOGDBERG: They felt it was rambling and that it didn't make the points that they wanted to see made.

NARRATION: The research paper — on Attention Deficit Hyperactivity Disorder — was also deemed unsatisfactory by Novartis, the maker of Ritalin LA, a drug used to treat the disorder. New York Times reporter Melody Petersen obtained a transcript of a telephone conversation that shows just how hard Intramed and Novartis worked behind the scenes to get the paper written the way they wanted it written—even though the relevant clinical trial for Ritalin LA had yet to begin.

PETERSEN: The company wanted what he called a quote, quick, down and dirty article that could be published very quickly.

NARRATION: And while Novartis told the authors to stick to known facts, they should feel free to hint at what future research might show, according to the transcript. And to make sure the article turned out the way the drug company wanted...

PETERSEN: An Intramed executive told the doctors that it would give them an outline and a draft of the paper which then they could edit.

NARRATION: Novartis said it was not the article's intent to promote any specific drug. Intramed declined to appear on camera to discuss this research paper, which is awaiting publication. But Jed Beitler, chief executive of Intramed's parent company, Sudler & Hennessey, did speak to Melody Petersen.

PETERSEN: Mr. Beitler said Intramed may make editorial suggestions to authors but that it does not ghost write. He said that in this case, the doctors had originally written a piece that was far too long. So, Intramed had written a draft to show them how it could be scaled down.

NARRATION: Even so, Dr. Logdberg was called in for a rewrite, which Intramed also didn't like. For now, Dr. Logdberg says she has quit ghostwriting because marketing executives — not scientists or researchers — were shaping what she wrote. Today she teaches science to students... working longer hours for less money.

WALT:You don't have a problem with advertising in and of itself, do you?

LOGDBERG: What I mind is advertising that calls itself education. And I became increasingly uncomfortable with providing content for that.

NARRATION: Someone who says he has been on the receiving end of Intramed's medical education is retired psychiatrist, Dr. Richard Brown. He says that education was accompanied by a $500 check, wine and a free dinner at Daniel, one of the most elegant, and expensive restaurants in New York City.

NARRATION: Dr. Brown invited us to come along to document the free dinners he was getting from the drug industry. He says he wants to end the practice.

BROWN: I am disgusted by the fact that these pharmaceutical companies can charge so much for drugs, such that poor people have to stretch their budgets to pay for food and heating fuel, and so forth, as well as the, the high costs of drugs, and the drug companies, at the same time, can give these lavish dinners. And I think it's disgusting, and I think this ought to be brought to the attention of the American people.

NARRATION: Drug companies that offer such lavish treatment to induce doctors to prescribe certain drugs, have been warned by federal health officials that they could be prosecuted under anti-kickback laws. But Intramed — in this case working for the drug company Forest Laboratories — insists it did nothing wrong because doctors attending the dinners were there as consultants.

RELMAN: It's nonsense. If you look into it, the doctors who are being paid ostensibly as consultants are, are doing nothing of any consequence to earn their money.

WALT: Do you do any consulting?

BROWN: Of course not.

RELMAN: They're clearly there because they are quote, either big prescribers or opinion leaders and they can influence the sales of drugs. So the whole thing is a scam — it's simply a way to sell more drugs.

NARRATION: Several weeks after the Daniel dinner, we caught up with Dr. Brown after another dinner — this time at a Manhattan steak house. It, too, was underwritten by Forest Laboratories.

BROWN: The dinner is so gigantic that I could only eat part of it. So, I put the rest in my doggie bag.

NARRATION: Days later, we watched as Dr. Brown was about to collect his third free dinner.

WALT: Good night.

BROWN: Good night.

NARRATION: Tonight, Dr. Brown would again pick up a $500 check... this time it was the pharmaceutical company, Eli Lilly, using another marketing firm to arrange the event. Dr. Brown says he had earlier turned down his fourth free dinner at the Four Seasons Hotel. Instead, he organized a protest outside as Forest Labs wined and dined doctors inside.

NARRATION: Forest Labs would not return our phone calls. But Eli Lilly and Intramed told Melody Petersen that their meetings were proper, and were designed to get feedback from doctors on specific drugs.

NARRATION: Joe Torre, the ad agency executive, says dinner meetings, often chaired by other doctors, help drug companies sell their products.

TORRE: Very often doctors are more influenced by what other doctors say than what pharmaceutical companies say. So companies work through medical education companies to have doctors who support their products talk about their products in a favorable way. That's called medical education.

WALT: How do you know that works?

TORRE: They have studies that show before and after in terms of prescribing patterns.

NARRATION: Intramed reaches out to potential prescribers even before they can legally prescribe drugs. Last month, Intramed arranged for medical students from dozens of schools to spend a weekend in Manhattan, including two nights at the Plaza Hotel, dinners and a Broadway play. The purpose of the visit: a university conference on psychiatry and neuroscience, underwritten by Forest Labs, which makes antidepressants.

NARRATION: Lenard Lesser, a medical student at the University of Rochester, sent a letter to conference organizers protesting Forest Labs' involvement.

WALT: Your fellow medical students from around the country right now are settling into what promises to be a very nice dinner at the world-famous Plaza Hotel. Why aren't you with them?

LESSER: Because I believe that Forest pharmaceutical company is sponsoring this conference for an economic gain for themselves. They're trying to establish a relationship with medical students.

NARRATION: Intramed did not want us to videotape the medical students getting their free drinks and dinner inside the Plaza.

RELMAN: If what you're doing cannot be fully disclosed to the public, its wrong.

NARRATION: But the larger question remains: why ad agencies feel the need to get involved in early drug development. Mr. Baroody, the head of Target Research, says marketing executives can help target medical conditions that might be fertile ground for the development of new blockbuster drugs.

BAROODY: Drug development should to a large extent be marketing driven because, after all, drug companies are for profit institutions out to make a profit.

NARRATION: In the creative minds of some advertising executives, this is how promotion comes together with science. Produced by a company partly owned by Omnicom, this ad suggests: "Even good science needs a little magic."

WALT: Well, does science need a little magic every now and then?

RELMAN: No.

WALT: It doesn't?

RELMAN: No.

WALT: What does it need?

RELMAN: It needs hard work, imagination, honesty, integrity, um, logic. It needs data. We don't get anywhere in medicine without objective data. That's the coin of the realm. These companies are not really qualified to do that, and they're not motivated to do that. Their job is to please their clients.

NARRATION: Last year, with health care costs rising sharply once again, spending on prescription drugs rose nearly 14 percent. And Fortune magazine ranks the pharmaceutical industry as the most profitable in America.

RELMAN: Doctors are led to prescribe drugs that may not necessarily be worth the money, may not be better than a generic that's already on the market and that their, that their patients don't really need. It's clearly contributing to the rising costs of prescription drugs and health care in general. And I don't think the public should stand for it much longer. The public ought to say to the medical profession, "stop it." And the medical professional could easily stop it if they want to.


MOYERS: President Bush has been in Europe, assembling a coalition for possible war on Iraq and invoking history as his ally.

He warned Saddam Hussein that Hussein would be entering his "final stage" as Iraq's leader if he didn't give up the pursuit of nuclear weapons.

In his speech, the President alluded not only to the West's failure to stand up to Hitler on the eve of World War II, but to events of the Cold War. Reading that speech, I thought of another analogy the President made recently about Iraq, comparing the confrontation with Hussein to the Cuban Missile Crisis of 1962.

PRESIDENT BUSH, 10/7/02: We cannot wait for the final proof, the smoking gun that could come in the form of a mushroom cloud.

As President Kennedy said in October of 1962, neither the United States of America nor the world community of nations can tolerate deliberate deception and offensive threats on the part of any nation, large or small.

MOYERS: Mr. Bush's allusion to the Cuban Missile Crisis grabbed me. I was in the Kennedy Administration at the time. I can never forget the day we were given a top secret briefing about how we would be evacuated in the event of a nuclear war.

A nuclear war? Not for many years did most of us find out just how close we came.

On October 14, 1962, an American U-2 spy plane provides the first hard evidence that the Soviet Union is placing ballistic missiles in Cuba, offensive weapons capable of hitting the United States.

Our intelligence, however, sees no evidence of nuclear warheads. It will be almost 30 years before America learns that, in fact, the Soviets had put 162 nuclear weapons in Cuba.

Ignorant of that knowledge at the time, some senior advisors to President Kennedy push preemptive action, a first strike, and possibly an invasion.

PRESIDENT KENNEDY, 10/22/62: Good evening, my fellow citizens.

MOYERS: The President's first report to the nation comes nine days into the crisis.

PRESIDENT KENNEDY: Within the past week, unmistakable evidence has established the fact that a series of offensive missile sites is now in preparation on that imprisoned island.

MOYERS: He orders a military blockade of Cuba and puts American forces around the world on a war footing.

TV BROADCAST: The Kremlin, Tuesday...

MOYERS: In Moscow, Nikita Khrushchev responds, ordering communist forces in the Soviet Bloc to the ready. Castro expects an American invasion and mobilizes over a quarter of a million Cuban soldiers.

TV BROADCAST: Mankind teeters precariously on the brink of a thermonuclear war...

MOYERS: On October 24, two Soviet ships, escorted by a Soviet submarine, approach the blockade and show no signs of stopping. Only recently would we learn from former Soviet officers that their submarines were equipped with nuclear tipped torpedoes. For the only time in our history, American forces go to DEFCON 2—the highest state of alert.

At the U.N., American Ambassador Adlai Stevenson confronts the Soviets about the missiles:

STEVENSON: You have denied that they exist? I want to know if I've understood you.

SOVIET REPRESENTATIVE: You will have your answer in due course.

STEVENSON: I'm prepared to wait until hell freezes over.

MOYERS: But this is for show. Behind the scenes, Khrushchev and Kennedy are communicating secretly, each man desperately probing for a way out.

Khrushchev offers a proposal: if America pledges not to invade Cuba, the Soviets will withdraw the offensive weapons.

Before Kennedy accepts the offer, and unknown to the United States until years later, Castro sends Khrushchev a cable.

The Cuban leader still fears the Americans are about to invade. If that happens, he wants the Soviets to launch a nuclear strike against the United States. Castro is prepared to go down as a martyr.

Now Khrushchev is more alarmed, believing events are spinning out of control.

On October 28, without informing Castro, Khrushchev announces the offensive weapons will be removed from Cuba. Kennedy, in turn, will secretly agree to take American weapons out of Turkey near the Soviet border.

The crisis is over.


MOYERS: The fall of '62. We had a lot to give thanks for on that Thanksgiving day, 40 years ago.

Once President Bush raised the analogy to the Missile Crisis, I wanted to talk about it with one of America's leading scholars on the subject.

James Blight started out in cognitive psychology and now teaches international relations at Brown University.

Among the highly acclaimed books he's written or edited is WILSON'S GHOST: REDUCING THE RISK OF CONFLICT, KILLING AND CATASTROPHE IN THE 21ST CENTURY, and this one on the Cuban Missile Crisis.

The research done by James Blight and his colleagues has changed how we see the Missile Crisis.

Most recently he spearheaded a conference in Cuba attended by Americans, Russians, and Cubans, including Fidel Castro, who were key players in that close call 40 years ago.

MOYERS: Welcome to NOW. President Bush recently indirectly invoked the Cuban Missile Crisis to talk about the confrontation with Iraq.

Can we possibly compare what's happening in Iraq to Cuba?

BLIGHT: Sure, in certain ways that I think are illuminating about the current situation. You felt in 1962 that the situation was spinning out of control...

MOYERS: That's the...

BLIGHT: ...that the unthinkable could actually happen.

The question, was it as dangerous as many people thought it was? I think the answer is it was much more dangerous than many people thought it was.

It was certainly more dangerous than was understood by the hawks—the so-called hawks within the Kennedy Administration, who were recommending day after day, both civilian and military advisors to President Kennedy—that the proper approach to discovering these missiles on the island of Cuba was to attack with an air strike, but probably also invade the island because it would be necessary to determine if any of them were hidden.

While you were there, get rid of the Cuban leadership of Fidel Castro, Raoul Castro, and Che Guevara. Replace it with a leadership, a regime change, so to speak—as is now said. Replace it with a leadership that was more in tune with the wishes of Washington.

Kennedy... Kennedy was cautious.

We must... think about what happened to him the year before, during the Bay of Pigs Invasion in April of 1961. He was humiliated. The whole country was humiliated. And he had been in office less than three months. And if he hadn't handled it so expertly, hadn't taken full responsibility for it, it's possible that he could've even been impeached.

Now Kennedy learned from the Bay of Pigs invasion and its failure that he had to take with a grain of salt advice given to him by both the intelligence community and by his military people.

He was a man who worried about what he did not know, because it was what he didn't know in the Bay of Pigs that really harmed the American situation.

Now, in the Missile Crisis, now we know now that were 162 nuclear warheads on the island. We thought that there were none.

About 90 of these nuclear warheads were for war fighting. They weren't for launch against the United States. They were for launch against an invading force of U.S. Marines or U.S. Navy ships out at sea.

If the attack had gone forward and the invasion had occurred, the U.S. Marines would've met nuclear fire and would've been torched and totally destroyed in a mushroom cloud on the beaches of Cuba.

What would Kennedy have done?

I mean, I'm not... I don't want to appear to be hyperbolic. But if that had happened, Kennedy would've had to respond with nuclear weapons. Kennedy felt that was true at the time. It would've taken two hours for this nuclear counterstrike to occur.

Another thing is that there were 43,000 Russians on that northern perimeter of the island. Most of them would've been destroyed.

And so with a war fighting capability that could've sunk every American ship within 50 miles of Cuba with nuclear torpedoes, with the ability to totally destroy any American forces that would've reached the island, and having killed many thousands or tens of thousands of Russians, we ask, "What would Khrushchev have done?"

Sergei Khrushchev, Khrushchev's... Nikita Khrushchev's son, is a colleague of mine at Brown University. His office is right down the hall. He's written several books about his father.

And I ask him this, and many people have asked him this, "Sergei, what would your father have done in the event of that attack knowing what we know now about the capabilities on the island?"

He said he would've had the following choice: resign—maybe get shot if he did—or respond militarily, either by seizing West Berlin, which would've required the United States and NATO to use tactical nuclear weapons against Soviet forces, or to attack NATO nuclear missiles in Turkey, which would've required a full retaliatory response against the Soviet Union. We were two or three moves away from that if the attack had occurred.

MOYERS: The analogy breaks down, it seems to me, at this point. No one is suggesting that Saddam Hussein has any capacity now to strike the United States or anybody else.

So a preemptive strike now, Bush's advisors claim, would have no unintended consequences such as those would've... that would've happened in Cuba.

BLIGHT: If we were to attack Iraq, without giving Saddam Hussein and his people an opportunity to launch, let's say, chemical and biological tipped missiles at Israel—that's the scenario that I think most people fear the most—but the reason that it's important to think a little harder about this, I think, with the example of Missile Crisis in mind, is that very, very bright people in that administration believed exactly the same thing in October of 1962.

"If you go now and you go quickly," as Paul Nitze the...who was an assistant Secretary of Defense, argued, "Nothing will happen. Nothing bad will happen. You will get rid of this infernal, communist devil in the Caribbean, Fidel Castro, who's causing us so much grief and getting away with it. And you will also teach the Russians a lesson. They have a sphere of influence over there. Ours is here, and they'd better stay put."

Well, it was a very persuasive argument, except that they were wrong. And if the... I think...

MOYERS: They were wrong because they didn't know that Cuba had all...they had all these missiles, they had all these warheads, and they had authorization to use the...

MOYERS: But Jim, Cuba was heavily armed, 90 miles of the United States coast. That mistake would've been very costly. What the Bush people are saying is, "It's impossible. He may... yes, he may have can... He may have gas to use against his neighbors, against Israel, but he can not retaliate in the same way that Castro could have."

And so the analogy breaks down on the weight of the threat to the world from Iraq today and Cuba then.

BLIGHT: It's true. I mean the analogy is an analogy. It doesn't say anything about what Saddam Hussein has or what... how he would use them. There's several points, though, I think, that are worth making.

One is, George Bush has not had his Bay of Pigs. He is not... he has not been humiliated.

He has not seen the extent to which the intelligence community and giving information about what capabilities are, and to a certain extent, intentions of Saddam Hussein and his regime. He has not seen that often these reports are wrong.

Likewise, with his military advisors who are giving, apparently, a very rosy view of what will happen when this regime is changed due to a multi-faceted attack by U.S. and British, or other forces. If it comes to that, if the inspections don't work some time in the next few months, the war would begin.

I don't know if you or your viewers are—again this is so long ago, I hate to even say anything about it—but one of my favorite movies is BUTCH CASSIDY AND THE SUNDANCE KID.

And at the end of this, Redford and Newman are holed up in this hut in Bolivia. And the hills are just full of people with guns. And at the very last minute they look at each other, they smile, they draw their guns, and they come roaring out of there. And the frame freezes as they're smiling, shooting off their guns.

But what you hear is hundreds and thousands of rifles being fired in their direction. They're dead. They're obviously dead. But they may have taken a few people with them. And that's how a hero goes down.

Well, okay, for Butch and the kid, they may have taken one or two or three of these guys with them. But a leader with weapons of mass destruction—whether nuclear or chemical or biological—can take not a few, but thousands, tens of thousands, maybe hundreds of thousands of people could die.

Maybe many of them would be Iraqis. I would not be happy about that.

Maybe they would be Israelis. I wouldn't be happy about that.

They have different kinds of consequences. Biological weapons are notoriously difficult to control. Nobody knows where they're going to go. It depends which way...literally which way the wind is blowing.

MOYERS: So what do you think is the psychological game going on now, this weekend, between George W. Bush and Saddam Hussein? Kennedy and Khrushchev gave each other a way out.

BLIGHT: Two things about that strike me. One is that George Bush may not have this capacity for...worrying whether he can be hurt by something he doesn't know or he can't even imagine, such as nuclear weapons in Cuba. See, we didn't imagine that.

MOYERS: No.

BLIGHT: We don't imagine there are any in Iraq. Maybe there aren't. Maybe. But how much, if you're a betting person, do you want to stake on that?

MOYERS: You know, we didn't imagine 9/11 either. That was a real attack, a bloody attack, a calculated, deliberately, brilliantly executed attack by guys who want to kill us. And I must imagine that that's what George Bush is thinking Saddam Hussein could make happen one day. Do you?

BLIGHT: Well, yes. But I wonder if an attack on Iraq were to go forward... One thing that 9/11/01 showed us is that we're very vulnerable. I think it's the first time, I would argue since the Missile Crisis. When people woke up on the 12th, the 13th of September wondering, "Now what else going on? I mean, are they...what else can possibly happen?"

If we attack...I mean how many ways are there to attack the United States of America and hurt us where it will really hit us where it will really hurt us? It's an infinite set.

MOYERS: Yeah. If Castro had had human bombers, he would not have needed the Soviet missiles.

BLIGHT: No. And he would've used 'em in fact. Che Guevara, who some people may remember as a...as sort of the ultra left-wing of the left-wing of the Cuban revolutionary leadership, was upset, terribly upset after the crisis, because after the Missile Crisis, because the United States hadn't been destroyed.

And when he was asked by a Mexican interviewer in early '63, "Well, but...but surely, surely you must be satisfied or happy that Cuba wasn't destroyed?"

He said, "No, no. I'm not happy about that—if the United States had been destroyed at the same time."

MOYERS: Put your psychologist hat back on. In terms of what's at stake, what do you think is going through Saddam Hussein's mind now? Does he want to be a martyr?

BLIGHT: My opinion is no. I mean he's...he's a survivor. He's survived all kinds of things. He doesn't want to be a martyr.

But it's in his interest right now, I think, to give the impression that he would not mind being a martyr if it comes to that... That he's tough, his people are tough, and they're fighting for Arab... I mean, it's a little harder to figure out what the cause is.

It's interesting that this tape that's come in recently that may or may not be from Osama bin Laden, seems to show a certain amount of respect for the Iraqis.

I mean, there's...is there any leader in the world who's killed more Muslims in the last 30 years than Saddam Hussein? I don't know who it would be.

But, you know, the enemy of my enemy is my friend.

MOYERS: But if like Castro, Hussein feels he has nothing to lose, what does he do? He can't call in the Soviet Union to rain death and destruction on the United States...

BLIGHT: Right.

MOYERS: ...on the United States. What does he do?

BLIGHT: I would guess that what Saddam Hussein would do would be to try to destroy Israel. That... I... whether he can do that, whether he can destroy it with chemical and biological weapons, maybe some other conventional weapons, I'm not sure. But that would seem to me to be the analogy of interest here.

MOYERS: The Pentagon has already started using psychological language to...against Iraq, against Saddam Hussein. Does that mean they're just narrowing the exit a little further, that it's getting harder and harder to reverse course and get out of the inevitable?

BLIGHT: Sure. I think it is hard—for me, anyway—to imagine now how a Bush Administration is going to be able to walk back from the threat of massive violence, short of a full...what will amount to a full capitulation. We go into Iraq. We stay in Iraq for a long time. We look under every blanket and every nook and cranny.

How much of this are the Iraqis going to tolerate? I don't know.

How much should they tolerate? I'm not sure.

But if the inspectors are given, whatever they...the free reign that is required by the...by the U.N. resolution, as interpreted by the inspectors and by the U.S., if that happens, they will have done something, the Iraqis will have done something that the Cubans never did.

They will have allowed their sovereignty to be violated in a way that was unthinkable to the Cubans.

Now, that in itself, having occurred within the context of the U.N. Security Council, I don't think the Bush Administration had that in mind initially. I thought probably we'd be at war by now, but the U.N. has slowed this process down and has rationalized it. It's like the Missile Crisis, I think.

I'm surprised daily by the kind...by the Bush Administration going to the U.N., by them sticking with it, by the U.N. agreeing, including Syria, 15-0, that they should move ahead with inspections if the Iraqis agree, and if they don't, then military action will take place. And now the Iraqis have agreed.

MOYERS: So let's sum all this up. Let me ask you this question. What can we learn about taking a look at the Cuban Missile Crisis in the year 1962—40 years ago—that applies to the confrontation with Iraq in 2002? What lessons?

BLIGHT: I'll give you two. One is, be very cautious about what you don't know. If an advisor tells you that they can get 100% of the known missiles, known airplanes, known factories, don't believe it. We didn't get 100% of the scuds during the Gulf War, or anything close to it. So be cautious about what you don't know. Because in the Missile Crisis, it came so close, not only to hurting John Kennedy, but to leading to events that are scarcely even imaginable.

On the other hand, it's possible to talk with dictators. Khrushchev was the secretary of the Communist Party of the Soviet Union, the mortal enemy of the United States, who said just a year before the Missile Crisis that "We will bury you"—they will bury us.

These people don't want to die. They don't want their countries to be destroyed. They want to remain in power. And if the situation is sufficiently dangerous, then they need to be given a way out.

And the evidence is that not only would... not only did Khrushchev seek a way out at the last minute, but that Castro would've, too. But nobody asked him. And so he felt that he had no... the only way he could get our attention was to start shooting down our airplanes, possibly attacking Guantanamo Bay.

So the one lesson is to be very, very cautious where weapons of mass destruction are involved about what you don't know, or are not 100% sure of.

And secondly, talk to each other. Don't signal each other with bombs or with alert levels or with how many planes are going to over-fly. I mean, you might get to that, but talk even if you're doing that. Provide some kind of carrot that is understood as a carrot, as well as the sticks, as well as the bombs, the airplanes, the soldiers, the aircraft carriers, and that whole...that whole pressure-cooker that we're trying to build around Iraq.

MOYERS: Thank you very much, James Blight. I appreciate you being with us.

BLIGHT: You're welcome.


ANNOUNCER: Next week on NOW, Bill Moyers interviews his favorite storytellers to learn how they feed the fires of their creativity.

TAYMOR?: I'm an entertainer but I also firmly believe in provoking.

ANNOUNCER: Exploring the deep roots of artists' very personal visions. That's next week on NOW.


ANNOUNCER: And coming up on NPR radio.

INSKEEP: Hi, I'm Steve Inskeep.

Join me on the radio for all things considered from NPR news. This weekend we'll examine Saddam Hussein's long-time interest in nuclear, chemical and biological weapons. Also we'll look at changing U.S. attitudes toward the Iraqi leader. You can find your local public radio station at our web site, NPR.org.


MOYERS: We turn now to a quiet story about a quiet man. Once up on a time, when he was much younger, he put himself on the line for something he deeply cared about. Many said he was a hero, a claim he dismissed. Then, that battle over, he left the country to live a simple live abroad, in Africa.

He is back now, and once again he's helping people get the most out of their lives. His was an essential voice of the 20th century. Now in a different way, he is an important voice of the new century. Quite a story. Producer Keith Brown reports.

KEITH BROWN: It's like any urban high school in the country.... only here at Lanier High in Jackson, Mississippi, this former civil rights activist is on a crusade to change the course of his students' lives — and he's doing it through mathematics!

Meet Bob Moses, founder of The Algebra Project, a national program aimed at providing poor and minority students with the math skills needed to compete in the 21st century.

BOB MOSES: For poor kids, they have to get ready to go to college. I don't think that poor children have an option out here today. The message has to be very clear to them, you may not think you want to go now, but you have to prepare yourself so when the time comes, you have an option to go.

KEITH BROWN: To Moses it's clear — a solid math education provides students with that option — and can begin to free those whose families have been trapped for generations in poverty.

In the sixties, Bob Moses put his life on the line here in Mississippi organizing so that Blacks could gain the right to vote. Now he's back, involved in another struggle, a battle he says is as crucial as the one waged here almost forty years ago.

ARCHIVAL FILM: We don't serve niggers here.

KEITH BROWN: At the dawn of the 1960s America was just beginning to see the racial injustice of the South, and the protests against it.

So in 1961 Harvard-educated Bob Moses headed South... leaving his comfortable teaching position at a private New York City school.

He eventually became a field director in the Mississippi Delta for the Student Nonviolent Coordinating Committee. Moses led with fierce, even revolutionary determination.

BOB MOSES ON ARCHIVAL TAPE: The world is upset and they feel that if they are ever going to get it straight they must upset it more.

KEITH BROWN: Moses remembers how daunting the task was before him. At the time Mississippi was 42 percent Black, yet only 6 percent of Blacks were registered to vote.

BOB MOSES: How do you get the people that are targeted, who are oppressed by this system to actually rise up. The issue was are you going to be able to actually create in this oppressed targeted population this demand for their political access.

KEITH BROWN: Moses's strategy to gain voting rights was slow and steadfast: change from the bottom up, registering voters sharecropper by sharecropper, church by church, town by town.

But what does any of this have to do with this? Everything, say his students.

STUDENT: Back then he was trying to get everybody to vote because voting was the key for them to make themselves better. And now we need to know math. And math is the key for us to do any kind of job.

KEITH BROWN: She's right. According to the Department of Labor, the highest paying and fastest growing job sectors all require significant technical skills. Without advanced math, Moses believes many poor and minority children will be effectively cut off from a living wage.

BOB MOSES: I think we're growing serfs in our cities, young people who graduate with eighth grade education that can't access economic arrangements to support families.

KEITH BROWN: In Mississippi, more than 40 percent of Black children are growing up in these serf-like conditions. Changing that is what motivates teacher Peggy Quinn.

KEITH BROWN, ADDRESSING QUINN: This is more than just teaching math to you. This is political.

PEGGY QUINN, ALGEBRA PROJECT TEACHER: It's very political to me because....

KEITH BROWN: How is math political?

PEGGY QUINN: Because I think that we are shortchanging a majority of students in our country and we don't make the demand for math literacy the same way that we do for reading literacy.

KEITH BROWN: Quinn is as passionate about math literacy today as she was about civil rights in the Sixties when she was organizing in Mississippi. She recently took a year's sabbatical from her high school in Connecticut to work with Moses.

PEGGY QUINN: You have to be able to use a calculator, a computer, and you have to really have all the skills that they provide to students in the wealthier areas of this country and we have to make that demand for all students.

KEITH BROWN: Where schools across the country have failed, The Algebra Project is making inroads.... by making math relevant and above all, making it fun!

Teachers use innovative methods like this stock market game. Playing interactive games introduces complex mathematical concepts and principles.

GINA WILKERSON, YOUNG PEOPLE'S PROJECT VOLUNTEER: You're interacting and you're learning instead of just sitting there — your teacher just talking and talking and you're not understanding nothing she's saying — but if you're up and both of you are interacting and asking questions and answering them — it's better.

KEITH BROWN: Gina Wilkerson is a member of what's called The Young People's Project. It's a group of upperclassmen and college students — who've studied with Moses. Now they pass on their math knowledge to younger students.

STUDENT: When I was in middle school I was the class clown. One day Dr. Moses had me to get up and start explaining something to the whole class so once I made my explanation I thought about it I was like I got a whole lot of attention from somebody for being smarter than being silly.

GINA WILKERSON: I can go out here and I can change the world if I wanted to because I don't have to accept what the people or the system is giving me.

MAISHA MOSES: I see that they definitely have a sense that they can go out in the world and do something.

KEITH BROWN: Maisha Moses has been working with The Algebra Project for the past 10 years. In fact, in 1982 she was the program's catalyst. As an eighth grader Maisha was ready for algebra but her school didn't offer it. So her father Bob Moses decided he would fill the void.

MAISHA MOSES: I had already learned what the teacher was able to teach. He showed up in my class one day and I had to do his math in school.

KEITH BROWN: The instruction paid off in ways Moses could not have predicted. Maisha — a Harvard graduate — didn't just learn math, she's been instrumental in helping to make her father's vision a national reality. Today, The Algebra Project is in close to 40 schools, in 10 different states, reaching close to ten thousand students each year.

MAISHA MOSES: The fact that he has given his life to it I think made us want to also do the same. I understood that there was a really deep connection between him and Mississippi. And as I got older — what I came to understand was that he really found his life in Mississippi.

KEITH BROWN: And he found his life's work in Mississippi.

MAISHA MOSES: He found his life's work.

KEITH BROWN: An account of that work can be found in Moses' book, RADICAL EQUATIONS: MATH LITERACY AND CIVIL RIGHTS. Recently before educators and employees of the U.S. Department of the Interior in Washington, DC, Moses discussed the book. He shared with them — as he does with his students in Mississippi — the sacrifices and rewards of social change.

BOB MOSES: In this country, there's a tradition of people who have lived a life in struggle. One of the best things about the country is that you can actually live a life of struggle in the country. You can find yourself, in relationship to your history and your people. You can have really deep purpose in your life.

KEITH BROWN: Are you in this until the end?

BOB MOSES Yes. I'm here.


MOYERS: I've been reading a new biography of the late great curmudgeon H.L. Mencken. During his long career as journalist, editor, and critic, Mencken butchered more sacred cows than the Chicago stockyards.

He began his career as a police reporter. And his time on the crime beat served him well when he turned to writing about politics, the biggest crime scene of all.

Today, Mencken wouldn't spend much time reporting the speeches in Congress, he would be prowling the den of thieves on K Street, lobbyist row, where the crimes are hatched and the money stashed until the payoff on Capitol Hill.

Mencken would read the Homeland Security Bill passed by Congress this week the way he read the police blotter. And he would discover in the fine print skullduggery worthy of Jay Gould and the robber barons. One corporate giveaway after another was added to the bill.

Remember how outraged the public was last summer at runaway corporations that had set up sham post office boxes overseas to avoid paying U.S. taxes? The House of Representatives in July pulled up its socks and cracked the scoundrels across the knuckles. Skip out on your country, the House said, and there won't be any more government contracts.

Well, this week Congress took it back. Quietly, in the name of Homeland Security, Congress undid what it had done this summer. It took the rascals off the hook.

The pharmaceutical industry turned the bill into an orgy of looting. So now if you or your child dies from a bad smallpox vaccine, don't expect the negligent company to be accountable. Congress has relieved the industry of liability. Eli Lilly, a Big Pharma giant, got off with such a heist it put Jesse James to shame. Over and over this week, the big contributors got their money back. Like burglaries in old movies, these took place in the dark of the night, while we slept, with not a fingerprint to be found on the windowsill.

So put Terry Teachout's new biography about H.L. Mencken side by side with the Homeland Security Bill and read them together. Mencken was not a nice man, and his own bias could blind him. But if there were a few more Menckens around, we'd find out a lot sooner how democracy gets burglarized in the name of patriotism. It was Mencken the crime reporter who said that when you hear some men talk about their love of country, it's a sign they expect to be paid for it.

That's it for this week. Don't be bashful. Sound off on pbs.org. I'll read your mail.

For NOW, I'm Bill Moyers.




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