“Born in Sin.” Patrick Radden Keefe Talks Narrative Nonfiction

The latest episode of The Read Smart Podcast features Prize Director Toby Mundy speaking to Patrick Radden Keefe, who won the prize in 2021 with Empire of Pain: The Secret History of the Sackler Dynasty. Radden Keefe and Mundy together explore the dark and murky methods of the Sackler family, as well as the consequences of the crisis that are still seen in America today. Detailing the story of 21st century greed, the book explores the family’s creation and marketing of Oxycontin, a painkiller that was a catalyst for the opioid crisis that nearly killed half a million people.

Listen now to hear all about it. The podcast is generously supported by the Blavatnik Family Foundation. For more podcasts from The Baillie Gifford Prize, click here. Follow @BGPrize on Instagram, Facebook, Twitter, TikTok and YouTube.

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On corruption in American institutions

Patrick Radden Keefe: I thought of Empire of Pain as a sort of sweeping history of one American dynasty, three generations of this one family in the foreground. But the backdrop for this story is the total absence of checks and accountability when it comes to big corporate interests, the moneyed elite.

And so in this case, it’s about the pharmaceutical industry and the failures of the Food and Drug Administration and the Department of Justice and various other big institutions. But the truth is, I think you could look at almost any big industry, be it the gun lobby or the petroleum industry or you name it, and find a similar level of dysfunction when it comes to regulation, or the absence thereof.

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On history repeating itself

Patrick Radden Keefe: So there are these patterns that you find in the 1990s and the early aughts in the story of Purdue Pharma and OxyContin, which actually have these precursors in the 1950s when Arthur Sackler, the oldest of the three original Sackler Brothers, is getting started in pharmaceutical marketing and advertising.

So there’s a story there I tell about a particular official at the FDA who was in charge of antibiotics and who was corrupted basically by one of Arthur’s Sacklers clients, which was Pfizer. At the time there was a particular speech that he had given and there were reprints of the speech, and he would be compensated for each reprint of the speech.

And Pfizer purchased 250,000 reprints of the speech. Their cover story was, oh, we’re just buying these reprints because we want to distribute them to our customers. But in truth, they just piled up in the store room someplace.

This was a way to bribe to launder a bribe to a government official. And then you hop forward decades and there’s a guy named Curtis Wright, who was the main FDA official in charge of approving OxyContin for sale and approving the marketing claims that could be made about the drug. And he signed off on everything in record time and then about a year later, went to work for Purdue Pharma, the very company whose product he’d signed off on, at three times his government salary.

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On Truman Capote’s In Cold Blood

Patrick Radden Keefe: I was in high school when I read In Cold Blood. I fell for Capote, his own spin on it. Which is that he was inventing a new genre, that it was the non-fiction novel. And I think if you look at a book like Empire of Pain, there’s an argument that you can make that I’m working in a field that can trace its origins back to that book.

Toby Mundy: But the challenging thing when you look at In Cold Blood today is that a lot of it was made up.

Patrick Radden Keefe: Yes. I mean, he broke all the rules. And so it’s a tricky book to talk about today.

And in a way, I end up uncomfortable with the notion that the genre started there. Because if that’s the case, then we were sort of born in sin.