A Futile Search For Virility

It seems that the promise of restoring youth to aging men appealed as strongly in days past as it does in the present.

In the 1920s, testicular tissue transplantation was the ‘little blue pill’ of the era, purported in many medical circles to reestablish lost-function in the old and infirm [it was also used to address skin problems, neurasthenia, epilepsy, dementia praecox, senility, alcoholism, prostatic hypertrophy, cancer, rheumatism, gingivitis, paralysis, arteriosclerosis, and the “moral perversions of old age,” whatever that is]. In some quarters, testicular tissue transplantation was attempted as a treatment for male homosexuality, albeit without any measurable success.

One proponent of testicular tissue transplantation was Leo Stanley, the chief surgeon of San Quentin prison in California and a devotee of the theories of the late-Serge Voronoff.

Monkey Bread (aka Monkey Balls)

Monkey Bread (aka Monkey Balls)

Dr. Voronoff, you see, had started his research and resulting scrotal activities using parts from (willing?) monkeys at the turn of the 20th century, opining that “the monkey is superior to man by the sturdiness of its body, the quality of its organs, and the absence of those defects, hereditary and acquired, with which the main part of mankind is afflicted.” Though he had plenty of detractors, Voronoff’s theories were accepted by a large minority of (male) physicians up until WWII, and there was never a shortage of middle aged volunteers desiring to freshen up their manhood.

Given the placebo effect and wishful thinking, it was only a hop-skip-jump from (unsuccessful) monkey-donor tissue transplants to (unsuccessful) human-donor tissue transplants.

[sidebar: Voronoff’s monkey-grafts have been postulated as one possible way in which HIV made the jump from simians to homo sapiens, though nothing has been proven]

Anyway, our Dr Stanley was responsible for autopsies once the condemned at San Quentin were launched into eternity. In May 1928, one Clarence Kelley – having been convicted of multiple counts of murder during an armed robbery spree in San Francisco – swung by the hempen necktie, after which his body was released to the family for burial. Only then was it noticed by then next-of-kin that the corpse was missing that part of the anatomy which renders the bearer male. Upon investigation, it was learned that Stanley had helped himself to the junk of the decedent – he wouldn’t be needing it, right? – and had accordingly transplanted some bits into a patient in a nearby hospital.

Further inquiry revealed that Stanley had been cutting off the balls of hanged inmates and putting them into other men’s coin purses since at least 1918. Being a doctor on one of the nation’s busiest death rows gave him a steady supply of human tissue – that is, when he wasn’t doing futile experiments with the testicles of goats, boars, rams, and stags. And astoundingly, despite threats of lawsuits and the absence of any semblance of informed consent, Stanley kept his job at San Quentin until 1951. He spoke freely of his testicular activities and the >10,000 transplants in which he was involved over his career, basking all the while in the laudatory op-ed pieces of many papers of the day.

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[Copyright 2013 @ The Alienist’s Compendium]


Canadians – by and large a kind and considerate bunch – were once as blindly homophobic as any of the McCarthyites down South. In the late 1950s, the Royal Canadian Mounted Police (RCMP) initiated a ‘scientific’ protocol to weed out homosexuals from the military, law enforcement, and civil service, deeming them a security risk. Section A-3 of the RCMP did nothing else but find and dismiss suspected homosexuals from all branches of the government.

At first this ‘gaydar’ involved following people to nightclubs – costly and deemed inefficient. Then came the “Fruit Machine,” invented by Professor Robt Wake of the Dept of Psychology of Carleton University, an otherwise prominent man of science. His device measured pupillary response, along with respirations, blood pressure, and pulse rate when a subject seated in a dentist’s chair was shown nude pictures of both men and women. Vital signs were also measured when the subject heard the words “gay,” “queer,” “drag,” and other slurs piped through a set of headphones. If the subject’s autonomic responses indicated arousal (physiologic, though not necessarily sexual), they were flagged and likely dismissed.

But the science itself was grossly flawed – depending on the light exposure in each photo, for example, the pupils could react due to nothing more than the brightness.

Never fear! Once funding for the Fruit Machine was caboshed, the RCMP fell back on good old fashioned penile plethysmography (aka ‘the postage stamp test,’ by which erections are measured while subjects are shown erotica). Not as scientifically flawed as the Fruit Machine per se, plethysmography is nonetheless still too unreliable on which to base such summary dismissals.

Both programs were terminated, but not before more than 400 otherwise innocent people lost their security clearances and jobs (and employability).

American Fruit Machine

American Fruit Machine

Interestingly, no Canadian versions of the Fruit Machine are known to exist, though an American model is on display at Canada’s War Museum.

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[Copyright 2013 @ The Alienist’s Compendium]

Willie Ervin Fisher

I am delighted to have been designated as this date’s guest-author for Executed Today. Don’t be turned off by the site’s macabre title; Executed Today is widely-read and award-winning (Clio for best history blog of 2009) thanks to its daily digest of vintage and ancient sociology, biography, psychology, politics, criminology, oddity, and the (ever-changing) law – offering an arresting view of the human condition from the vantage point of the scaffold or chopping block.

Or in this case, the Old North State’s lethal injection chamber and its aftermath.


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[Copyright 2013 @ The Alienist’s Compendium]

Thinking Outside The Box

I was in Dallas over the weekend for a meeting of the American College of Legal Medicine. Despite being in the Lone Star State (stereotypically associated with hot and dry), Dallas received an icy wallop yesterday and just about all flights at DFW Int’l were cancelled. Luckily, I had flown Southwest Airlines, and they operate out of the smaller, older, Love Field. And for some odd reason, Love stayed open. And flights, while delayed, were still coming and going. I didn’t get home til after 0100 today, but I made it, and I didn’t have to sleep in an airport lounge.

In honor of Southwest’s exemplary performance, this post is dedicated. And fittingly, it’s about Southwest.



When large companies tangle with each other, lawyers inevitably get involved. And things drag out in court. And the lawyers make a lot of money. And it becomes a war-of-attrition, with the larger corporation with the deeper pockets often prevailing it seems.

But it doesn’t have to be this way. And once, it wasn’t.

Prior to 1978, fares in the domestic airline industry were dictated by the Civil Aeronautics Board, under the commerce clause of the U.S. Constitution, which allows the feds to regulate interstate business transactions. And airlines are almost always interstate, right? They fly from City A in State X to City B in State Y, and the feds were well within their right to regulate same.

But what about a really big state, like Texas? Mightn’t an airline have operated wholly within its borders and not have triggered federal oversight?

When Southwest Airlines was formed by Rollin King and Herb Kelleher, they found that loophole. Operating at first entirely within Texas – Dallas, San Antonio, and Houston – they markedly undercut the fares of their competitors, and there wasn’t anything that the feds, or the competitors, could do, since no ‘interstate commerce’ was involved.

This allowed Southwest to get a toehold in the market, so that when airline deregulation finally occurred in 1978, the company was poised to expand well beyond the home state’s borders.

Southwest carved itself a niche, relying on their zany approach to the business. Stewardesses wearing orange hotpants and go-go boots. Low no-frills fares. And fun ad campaigns; since they are based out of Love Field, many of Southwest’s slogans did, and still do, incorporate mild double-entendres with the word ‘love’: “Love Is Our Field.” “Somebody Up There Loves You.” “You’ll Love Our Low Fares.” “All-Day Love” (for multiple daily flights).

But on 22 October 1990, they tried a new slogan minus love: “Just Plane Smart.” And that’s when the lawyers almost got involved, because Stevens Aviation, based in Greenville SC, had been using “Plane Smart” as their slogan well before Southwest decided to appropriate it. And Stevens let Southwest know this.

However, the chairman of Stevens, Kurt Herwald, aware that he was on sound legal footing but dealing with a much larger entity, and wanting to avoid a Pyrrhic victory after years of litigation, and realizing that Southwest was a bit funky anyway, decided to rein in the lawyers. He instead challenged Southwest CEO Kelleher to an arm-wresting match for the rights to “Plane Smart,” with the loser relinquishing the slogan and donating $15,000 to charity.

Needless to say, in typical Southwest style, Kelleher jumped at this opportunity.

The days leading up to the match were a marketer’s dream. Both companies heavily promoted the match. Kelleher rec’d boxes of Wheaties and cans of spinach from supporters. Herwald was mailed at least one bottle of anabolic steroids from Mexico.

On 20 March 1992, at the Sportatrium in Dallas, the men met for the best-of-three showdown. Limos and cheerleaders were there. Satin boxer robes and shorts with logos were everywhere. The theme from ‘Rocky’ was played. Kelleher, at the last minute, claimed to have ‘injured’ his arm and asked for a stand-in: J.R. Jones, the 1986 Texas state arm-wrestling champion. The score quickly became Southwest 1, Stevens 0.

Not to be outdone, for the second round, Herwald pulled a fast one and substituted a last-minute burly replacement against the now-“healed” Kelleher. Score Southwest 1, Stevens 1.

In round three, the only one in which Kelleher and Herwald actually met, after 35 seconds of intense straining, Herwald pinned Kelleher. Stevens Aviation had prevailed and could keep its slogan!

But realizing that the (almost universally) positive publicity was worth a fortune, Herwald said that Southwest could keep the slogan, his way of thanking Southwest for thinking outside the box and saving years and hundreds of thousands of dollars for both companies.

No one remembers the slogan today. But in the three years after the match, the gross income of Stevens Aviation increased four-fold. Southwest estimated that it gained $6M in publicity, with its stock price doubling in less than 18 months. And Ronald McDonald House charities gained $15,000 from the ‘loser.’

Truly a win-win for everyone. Except the lawyers.

[Have an idea for a post topic? Want to be considered for a guest-author slot? Or better, perhaps you’d like to become a day-sponsor of this blog, and reach thousands of subscribers and Facebook fans? If so, please contact the Alienist at vadocdoc@outlook.com]

[Copyright 2013 @ The Alienist’s Compendium]

PLIVA v. Mensing

I was once a big fan of generic medications, seeing them as a way by which to contain healthcare costs and loosen the deathgrip that Big Pharma exerted on the American economy and our individual wallets.

Then I worked briefly for a pharmaceutical contract research organization. And I went to law school.

I’m not so sure any longer.

With that in mind, you know it’s going to be a bad day for constitutional scholars when the high court says that its own ruling from only two years prior “makes little sense.” In this instance, SCOTUS was referring to PLIVA v. Mensing and that decision’s deleterious effect on some of those who have been harmed by prescription medications but now are left with few if any avenues for redress.

Two patients, Gladys Mensing and Julie Demahy, each saw their family physician and rec’d a prescription for Reglan, a medication used to treat nausea/ vomiting and other digestive problems. In both cases, local pharmacists substituted the generic version when filliing the prescriptions – dispensing metoclopramide and not branded Reglan. After each woman had taken the Rx as instructed for several years, both developed tardive dyskinesia (TD), an uncommon but serious and usually irreversible neurological condition more often seen in chronic psychiatric patients taking antipsychotic Rx.

The women filed state tort suits, later joined, claiming that the makers of the generic version of their Rx had failed to provide adequate label warning of this risk.

Metoclopramide was first isolated in the 1960s, when the risk of TD was not fully appreciated. Once approved in the U.S., branded Reglan became very popular, though its use was predictably later supplanted in the marketplace by newer agents. In 1982, Reglan went generic.

And there the story might have ended with Reglan eventually fading to obscurity. But it enjoyed a resurgence in use when one of the newer agents that replaced it was unexpectedly yanked from the market. So before long, millions of American were again taking Reglan (from Schwarz Pharma) and metoclopramide (from twenty-three different generic manufacturers).

Once enough Phase IV data suggested a possible problem, in 2004 a research team published a study that noted a definite TD-metoclopramide association, saying in pertinent part: “given [the Rx’s recent surge in usage], the incidence of TD may increase accordingly. Thus, TD risk factors relative to the intended benefit and duration of use should be considered in metoclopramide prescribing.”

And it was not until several years later that this warning was widely circulated in the medical community.

FDA regulations permit manufacturers of branded drugs to update their labels when new data comes to light, without having to petition first for FDA approval of the changes. However, FDA regulations do not allow makers of generic drugs to change labels on their own; those companies must use exactly the same labels that were originally approved for the branded drug when it was first marketed. Only under an FDA directive mandating such a change can the generic manufacturers update their labels.

Given the clinical findings, Reglan labels were accordingly updated by the brand name manufacturer. But the generic labels were not, as no such FDA directive was then issued.

Had Mensing and Demahy taken brand name Reglan, as their doctors prescribed, their injuries would have been potentially actionable under a failure-to-warn theory (depending on the wording of the added cautionary statement).

But the plaintiffs took generics. The generic labels had no mention of TD as a risk at all, because that informaton was not part of the original Reglan package insert. And the generic manufacturers couldn’t have updated their labels absent an FDA directive to do so.

Thus, held SCOTUS, state tort law was preempted in this instance by (very imperfect) federal generic drug regulations, and the lawsuit of Mensing and Demahy could not go forward.

Little consoluation, but the FDA has since ordered all manufacturers of Reglan/ metoclopramide to include a “black box” warning regarding TD on package inserts.

And as a postscript, I don’t know if the plaintiffs’ theory of failure-to-warn might extend to the pharmacists who substituted? I’ve not been able to ascertain if that’s an option or not.

Either way, the plaintiffs may just be SOL.

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[Copyright 2013 @ The Alienist’s Compendium]

Theatre Shooting

The sullen appearing patron in the back row became angry when a group of kids started making noise in a movie theater during the show. He threatened them if they didn’t hush, but instead of compliance, the audience started laughing at his apparent bluster. Drunk and enraged, the man began yelling and then produced two large-caliber handguns from inside his jacket, pistol-whipping one nearby adult who had been laughing, and then shooting him thrice in the head as he lay stunned on the floor. The murdered man’s son, sitting nearby, was himself armed and shot at the attacker, who was uninjured because he was wearing a bulletproof vest. An exchange of gunfire ensued, several more were wounded, and one more killed in the crossfire. Then, for some time after the attack, the drunken shooter stalked the auditorium, brandishing and reloading his pistols. He kept all of the filmgoers in a state of terror while ranting, threatening, and taking pot-shots at convenient targets who peered over seats. He threatened to kill everyone. The police arrived after what seemed like an eternity and were finally able to subdue and arrest the assailant without further loss of life.

We hear all too commonly today about senseless shootings in public venues – it seems that weekly there is a new story of innocents cut down while going about their business. Our 24-7 news cycle permits us to learn of events from around the world in real-time. But despite appearances, there is really nothing new under the sun. The shooting above took place in Robbins, TN, on 5 March 1927, and the drunken assailant was one Ben Fowler, an off-duty deputy sheriff who was carrying his service sidearms. Justice did, however, move more swiftly in those days. The murders happened on a Saturday night, Fowler was indicted on Monday, his trial started on Thursday, and the jury got the case the following Monday. Fowler’s defense was (admittedly voluntary) intoxication, as he claimed he was too sauced to know what he was doing; if successfully argued, that would have reduced his charges to two second-degree murders, non-capital offenses. This diminished capacity defense went nowhere, though, and the jury convicted Fowler of capital murders after two minutes of deliberation. He was then electrocuted in the state prison in Nashville on this date in 1928.

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[Copyright 2013 @ The Alienist’s Compendium]

Fido Cotoletta alla Milanese

[Disclaimer: this post references an act of animal abuse. I’ve tried not to be lurid, but in order to illustrate the scenario and the legal question it raises, it is unavoidable to discuss the actual event]

Recently, one Thomas Huggins in Orlando, Florida, decided that his pit-bull mix, Bandit, was getting too aggressive to safely handle or keep. So he did the only thing logical (to him). He killed her. By strangulation. With a plastic bag and his bare hands.

Pretty bad, huh? Unfortunately, we’re just getting started.

After killing Bandit, Huggins proceeded to skin the carcass, eviscerate the torso, decapitate her, and then dismember and dice her with a steak knife.

When the police arrived (it’s not immediately apparent how they were tipped), they found Bandit’s ribs cooking in a pot on the stove, along with veggies and seasoning. Other body parts were in the freezer in plastic baggies. The head, skin, and entrails were in the trashcan. Huggins was arrested on the spot.

Initially at trial (and apparently prior to Huggins’ confession), veterinarian Bill Zingalie testified that he was unable to determine the exact cause of death, as “the evidence came in four different bags.” And had been cooked.

But later, once the details were known, the dismembering of the pet was deemed inadmissible by Judge Samantha Ward, as it lacked relevance.

Lacked relevance?!

As a prison psychiatric director, I see a lot of people who have been convicted of both animal cruelty as well as homicide. It is accepted within forensic circles that a killing that occurs with bare hands against a struggling victim – as opposed to those performed more remotely – often involves rage and, not uncommonly, a degree of psychopathology not found in garden-variety shootings.

It’s also known that those who abuse humans usually commence their careers with animals.

I would offer that the culinary experiment is very relevant. But Judge Ward differed, holding that cooking of the dog couldn’t be considered cruel because, by then, the dog was already dead.

Nevertheless, last month after only one hour of deliberation, Huggins was convicted of (3d-degree) felony animal cruelty, carrying a maximum of five years in prison. The results of his psychiatric evaluation have not been made public as of this writing. He will be sentenced this coming Thursday, December 19th.

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[Copyright 2013 @ The Alienist’s Compendium]