Dr. Culture and Mr. Pain

The two faces of the Sackler family , on your home screens.
By Joan Juliet Buck

(Audio version on Radio Free Rhinecliff/ wherever you get your podcasts)

         On the one hand you have a prize-winning H.B.O documentary about the activism of a fearless world famous artist, and on the other a six-part Netflix series that makes three composite characters the heroes , sets the villain to live in what looks like an unfinished hotel lobby, and keeps showing you closeups, from the back, of the testicles of his singularly unattractive dog, a mastiff  named Unch, which is Wall Street Journal speak for ‘Unchanged’.

The dog is presumably there for comic relief, because the subject matter of both the documentary and the series is grim, and it’s the same: the Opioid crisis.

Both All The Beauty and The Bloodshed and Painkiller are specifically about the narcotic painkiller Oxycontin, and the people who took it. The Netflix series also gives you the man who packaged it, the people who sold it, and the doctors who prescribed it .

All The Beauty And The Bloodshed is made by Laura Poitras, whose documentary Citizen Four not only told you—some-- about Edward Snowden, the whistleblower who might also be a spy, and so much about surveillance, in all its forms, that it might have persuaded you to tape over the camera on your laptop.

All The Beauty And The Bloodshed rises into being a work of art.

 The honesty of its subject Nan Goldin is stunning, and it gathers into a real fight of a story, with a brave heroine leading others to commit provocative actions, and by the end you have a sense of victory.

Whereas the lightly fictionalized series Painkiller gives you more hard facts, it also clubs you with blunt storytelling devices. And after six hours that include a dramatized lobotomy, a few autopsies, some semi-fantasy inserts, ghosts in brown suits and all those shots of the dog's balls, you've paid a high price for any emotions you feel.

But you understand how frustrated the makers of Painkiller were in trying to tell the story of the epidemic addiction to prescription pills that's killed some 600,000 Americans and hooked millions more, while the billionaire Sackler family— who made and pushed Oxycontin— had managed to avoid liability, by reaching a settlement through which their Purdue Pharma could declare bankruptcy , and thereby shield their wealth.

The multi-billion dollar agreement would have provided the Sacklers with legal protection against any further litigation. However, on August 11th of this year, president Biden's Justice Department challenged the settlement, and the Supreme Court agreed to pause the bankruptcy, until they could hear oral arguments in December of this year.

So what had seemed to be a win for the Sacklers now looks like it might be something else.

We live in unjust times, and the big stories are horrifyingly complex. The Sackler family story was told two years ago in Hulu's Dopesick, and it will have to be told over and over again until something is resolved, at which point possibly no one will care anymore. That's the problem with topical subjects.

I suggest you watch Painkiller first, and save All The Beauty In The Bloodshed as your reward.

Painkiller on Netflix is directed by Peter Berg, whom you may know as the person who developed and directed the television hit about high school football , Friday Night Lights. This series is based on two books about the Sackler family. The first is Barry Meier’s 2003 Pain Killer --in two words-- which was meekly subtitled The True Story Of A Prescription Drug Disaster . Twenty years ago, the Sackler name meant Big Culture. It was spelled out in golden capital letters nailed into the travertine walls of the great museums and venerable institutions of the Paris-London-New York axis: the Guggenheim Museum and the Metropolitan Museum of Art in New York— where the Sackler wing displayed the temple of Dendur almost as a private possession upon which the paying public was merely , and annoyingly, trespassing.

The Sackler name was on the Louvre in Paris; in London it was on the National Gallery, the National Portrait Gallery, the Victoria and Albert Museum, on both the Tate Modern and the Tate Britain. The Sackler name was on the Harvard University Museum , at Oxford University, and on and on.

I would see that golden Sackler surname on wall after wall, and wonder who in hell were these teeming , ubiquitous Sacklers ?

So here's what I didn't know.

Arthur Sackler and his two brothers, Mortimer and Raymond, all began as psychiatrists at the infamous Creedmoor Institution , where the treatments ran from electroshocks to lobotomies .

The Sackler brothers moved on to using drugs such as Thorazine, but Arthur Sackler’s greatest talent was for strategic publicity, and clever marketing.

His billions began to accumulate when he promoted Hoffman-La Roche's tranquilizer Valium, and so effectively that it became the best-selling happy pill of all time.

As a relentless showman impresario, Arthur Sackler quickly set about making his family into the most respected name in culture of all time.

Through gift after gift after gift,  Arthur Sackler welded the Sackler name to any cultural institution that would take his money. The name went up in gold on all the walls.

Arthur died in 1987. A few years later, the patent was about to expire on a Purdue Pharma narcotic so strong that it was used to ease the pain of the dying. Arthur's nephew Richard Sackler tinkered with the formula, made it time-release, renamed it Oxycontin, and marketed it to doctors as a non-addictive cure-all. He then deployed a seductive sales force of pretty young women at doctors across the heartland, showered their receptionists with Oxycontin-related-cushions and such, in rural areas where health care follow-ups are perhaps a little less available, and patients more loosely monitored than in countries where even the poor have medical insurance.

American methods of pharmaceutical marketing are nothing new, but lying about the potency of the medicine is still, for the moment, illegal.

In 2007, four years after Barry Meier's book came out, Purdue Pharma paid $634 million in fines for misleading marketing.

Nine years later , on his HBO show, John Oliver talked about the ravages caused by Oxycontin, and explained that the drug's claims to non-addictive status were based on nothing more than a letter that had been written to, and published by, the New England Journal of Medicine.

Just a letter.

So the tide was slowly turning.

In 2017, Patrick Radden Keefe wrote a New Yorker story about the Sacklers, their company, Purdue Pharma, and Oxycontin. It was titled The Family That Built an Empire of Pain, which made it legitimate to use the word ‘empire’, with its Star Wars connotation of evil. The New Yorker piece became Patrick Radden Keefe’s 2021 book, Empire of Pain. By then, Barry Meier's book had been updated and republished, its subtitle changed to An Empire Of Deceit And The Origin Of American's Opioid Crisis.

Empire of Pain, Empire of Deceit, painkiller.

The series Painkiller begins with Uzo Aduba , (whom we first registered as Crazy Eyes in Orange Is The New Black) playing Edie Flowers, a state lawyer from Virginia, grumpily wheeling her overnight bag to a deposition, then refusing to sit in the chair that's been occupied by Richard Sackler.

The series follows three composite protagonists archetypes : Edie the Implacable Detective, Shannon the Innocent Nymph, and Glen the Gentle, Handsome Martyr.

Edie is an angry, determined, solitary composite for many investigators.

Shannon Schafer, a naive young Ohio woman, is a composite for some on the Purdue sales force who are described by one character as “those little Purdue Malibu Barbies”. She's played by West Duchovny , daughter of David Duchovny and Tea Leoni.

Glen Krieger, a composite for too many blue-collar rural addicts, is a thoroughly nice auto mechanic who, once he’s discharged from hospital after an accident, falls helplessly into an addiction to Oxycontin. He’s played by the symmetrically handsome Taylor Kitsch from Friday Night Lights.

As antagonist and enemy, you have Matthew Broderick inside an impasto of prosthetic latex playing the non-composite Richard Sackler as a strangely impacted puppet . There are actors in brown suits playing other male Sacklers, some dead, and there is rather a lot of the ugly dog with his meaningful dangling balls.

You learn in Painkiller how millions took the Oxycontin and became hooked.

This was easy: Purdue actively pushed doctors to ‘titrate up’, which means to double and quadruple their patient's doses— from 10 milligrams to 20, to 40, to 80, even to 160 milligrams, a dose known to the hardcore addicts as ‘OxyCoffin’. The higher the dose, the more the insurance companies paid Purdue, and on it went and on it goes, the rural carnage.

But despite the drama of seeing 18 undigested Oxycontin pills inside the stomach of an autopsied addict , despite the Rah-Rah-Va-Voom of dancers dressed as Oxycontin pills at a promotional Purdue party, despite the pathos of the auto mechanic awed by the swag in a Purdue gift bag, despite the prettiness of the cute saleswomen in hot sports cars, the episodes drag.

Like many limited series , Painkiller dips in its fourth episode, before the story rallies, intensifies, and heads towards fulfillment-- if not victory.

Last year, and until a few weeks ago, it looked as if the Sacklers were getting away with it, through their deal with the various state attorneys general.

So the series ends with what feels like defeat. That's the problem with topical subjects. They keep moving, which is why the Laura Poitras documentary about Nan Goldin, All the Beauty and the Bloodshed is what you have to watch after Painkiller. It has a clear ending . Poitras’s skill and Nan Goldin's genius for candor combine to demonstrate that, in a way, art is hope.

Nan Goldin made her name through a defiantly subjective chronicle of her intimate life and the lives of her friends, in color photos that told the tragic understory of the bacchanal.

She was, for a while, a heroin addict, and also a stripper, and for a short times, a sex worker.

She lived with gay guys and transsexuals. Her photos are of men, women, in-betweens, alone or in pairs, on beds, on the toilet in party clothes, sweating through the agony of sexual longing and drugs, displaying new bruises, caught on the road to uncertain outcomes in downtown New York City in the seventies.

She forced her experience to count through her slideshows, which she began showing in 1973.

Her raw photographic diary, The Ballad of Sexual Dependency, was published by Aperture in 1986.

Nan Goldin became world famous. Her messy milieu and her personal times have become mythologized into an aesthetic so overwhelmingly influential that , for over forty years, young photographers have had to fight their way beyond looking at the world through the eyes of Nan Goldin.

As Goldin's fame grew museums bought her work. Shebecame an activist to protect her misfit tribe against the dangers that threatened it. First, she fought Aids, then she fought opioids.

As she coolly tells Laura Poitras,  she got addicted to Oxycontin overnight, after wrist surgery in Berlin.

In the beginning, she says, “40 milligrams was too strong, but as my habit grew, there was never enough. I went from three pills a day, as prescribed, to 18.”

“My life revolved entirely around getting, and using, Oxy, counting and recounting, crushing and snorting. When I got out of treatment, I learned that the Sackler family — whose name I knew from museums and galleries—were responsible for the epidemic.”

Nan Goldin started a group she named PAIN : Prescription Addiction Intervention Now, to hold the Sacklers accountable.

The fame she'd earned became a weapon against the Sackler’s drug of choice, which was the exalting dignity of cultural status.

“To get their ear,” she says in the film, “we will target their philanthropy. They've washed their blood money through the halls of museums and universities around the world.”

All The Beauty and The Bloodshed opens directly into Nan Goldin's first protest, a Die-In in 2018 , at the Temple of Dendur in the Sackler Wing at the Metroplitan Museum.

It's cold , there are some 20, 30 people with her, and there are plastic bags full of empty orange pill bottles. She's nervous. Once they're all inside the museum , the demonstrators throw the bottles into the temple's reflecting pool.

Next, Goldin’s group are in the Guggenheim Museum , wafting a blizzard of prescriptions down the center of the snail atrium.

Then comes the moment: The National Gallery in London has planned a retrospective Nan Goldin's work. She flexes her own power , and declares that she will not show there if they accept a million-dollar donation from the Sacklers.

The National Gallery rejects the Sackler’s money.

Nan Goldin's activism, tentative at first, then committed, then fierce , and all along brilliantly targeted at the egos of the Sackler family, is shown to be more effective than any slow procedural mechanism.

She attacked the Sackler name, and broke its aura.

That Sackler name has now been rejected by the Paris-London-New York axis of high culture. The Guggenheim, the Metrpolitan Musem of Art, the Louvre, both Tates, the Victoria and Albert, the National Gallery and the National Portrait Gallery, and Oxford University have all taken down the Sackler name . Only Harvard retains a museum named after a Sackler, but that's Harvard.

The Sacklers are now in Florida. The story's not over. We will see how the Sacklers react to being demoted from Dr. Culture to Mr. Pain, and we'll see how they react to the oral arguments coming up in December.