A fighter for sexual health
THE FERTILITY DOCTOR:
John Rock and the Reproductive Revolution
By Margaret Marsh and Wanda Ronner
365 pp. Johns Hopkins $29.95
Reviewed by David Hoekenga, M.D.
Separate sex from reproduction? Let women prevent conception with a simple pill? Facilitate pregnancy in infertile women? John Rock changed the answer to all of these important questions forever. The Fertility Doctor is his life story.
Between 1921 and 1972, the years Rock practiced, the modern world probably changed more than in any previous fifty-year period. During those decades he worked relentlessly to change what we knew, what we could do, and what we thought about human female reproduction. His wasn’t a sudden eureka, like Einstein’s connection of time and matter, but the product of decades of precise clinical research involving thousands of helpful women. Rock didn’t just do research; he also fought through those years for any method that would improve women’s sexual health.
John Rock was born in Massachusetts in 1890. His father, a saloon keeper, dabbler in horse racing, and real estate speculator, didn’t make much money, so he sent his son to Guatemala to work for United Fruit for a while to improve the family finances. Despite Rock’s difficult family background, he attended Harvard College, and then medical school. His family expected him to develop a successful medical practice in a hurry and funnel money back to his parents. Instead, he took a residency at the Free Hospital for Women and received a pittance for his exceptional clinical work and research over the next few decades. Luckily, Anna Thorndike, the woman Rock married in 1925, supported his work and had her own interests, so Rock’s oppressive schedule caused few problems. They had five children—four girls and a boy. When his wife died from colon cancer in 1961, Rock was devastated. But he survived six heart attacks over forty years and died at 94.
The fundamental questions he tried to answer were: What triggers ovulation? What is the relationship between ovulation and menstruation? How can it be determined if a woman has ovulated? And is it possible to predict in advance when ovulation will occur? Any one of these questions could have been a life’s work.
His first project involved studying development of the fertilized ovum in 211 women who had hysterectomies for various reasons. Arthur Hertig, Rock’s associate, looked through tissue specimens daily for fertilized ova (which, by the way, are much smaller than the period at the end of this sentence). In 1942 they presented pictures of the earliest human embryos ever seen—seven to ten days old. They also determined that, unfortunately, the time of ovulation couldn’t be deduced from the preceding menstrual period.
The second huge research study involved reproductive organs surgically removed from 947 women. Rock and his assistant Miriam Merkin combined harvested ova with sperm to attempt what is now called in vitro fertilization—the initiation of life outside the body. Rock and Merkin tried weekly to achieve fertilization for six long years.
Through all those years Merkin had washed the sperm in Locke’s solution three times, keeping egg and sperm in contact for twenty minutes. On that day, because of fatigue, she washed the suspension only once and used a more concentrated suspension of spermatozoa. “I was so exhausted ... ,” she said, “that I couldn’t get up, so I just sat there, watching this remarkable sight, . . . which never fails to fascinate me—the human egg, with a mass of spermatozoa on its surface. . . . So great is the force of their combined effort that the egg is made to rotate around and around.” She sat for at least an hour, transfixed.
But thirty-six years passed before the process produced an IVF human birth.
Nearly every one of Rock’s patients was too poor to pay for health care. Later, critics charged that his subjects couldn’t give truly informed consent. Most reviewers found, however, that Rock acted compassionately, and was always willing to take time to explain to his patients the goals and reasons for the things he did.
When others proposed that hormones taken orally could work as birth control, Rock became an enthusiastic promoter. He helped arrange some of the first trials of oral contraceptives in Puerto Rico and rural Kentucky. Even though the number of participants was small, the “pill” was found to be very effective at preventing pregnancy, and few side effects surfaced at first. Well acquainted with the risks of pregnancy, Rock, even though a practicing Catholic, enthusiastically promoted Enovid in his medical talks and in the media, and wrote a book on the subject. He had delivered too many women who religiously practiced the rhythm method approved by the Pope to regard it as a viable means of contraception.
How much did oral contraceptives have to do with the “sexual revolution” in the later 1960s? I was there among the revolutionaries, and the answer is only a bit. The revolution had much more to do with flouting all authority, and striking out at social mores, although better contraception did guarantee that forty or so percent of the female members of the Student Nonviolent Coordinating Committee and Students for a Democratic Society didn’t find themselves sidelined by unwanted pregnancies.
Rock enthusiastically promoted women’s health and the pill. He is a major reason that sixty million women were taking oral contraceptives in 1980. He enjoyed his celebrity, and never shrank from speaking his mind to medical and lay audiences. Listeners described him as, “courtly, energetic and younger looking than his age.” Despite being a household name, Dr. Rock received no major prizes. Esquire picked him as one of “Fifty Who Made a Difference.”
Marsh and Ronner have written a careful, complete, scholarly work about a humble and brilliant doctor who profoundly changed the ways we handle sexuality in most of our lives. The writing, while dry, is accessible to a medical as well as a lay audience.
David Hoekenga is a retired professor of cardiology turned author. He came to New Mexico in the ‘70s, and never found
a reason to leave the friendly people and panoramic vistas. David writes short stories and mysteries. Two of his books feature
Signe Sorensen, a suave homicice detective from Denmark. His first mystery, Santa Fe Solo, was published in December 2007 by
Xlibris. David is a juggler, opera fan, cook, swimmer, gardener, traveler and lover of warm summer nights.
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