Commentary: America's Clinical Trial

Dec 26, 2017

A few years ago in an airport gate area I overheard a man on his Bluetooth talking about his business.  When he was free I asked him about it.  He said he owned a startup biotech firm that had patented a drug that was in clinical trials.  I asked about the drug and he said it was an ointment for joint pain.  He said the key ingredient was cocaine.

I was intrigued, got his card, and checked the company’s website.  Sure enough, the drug was in the second phase of trials and the publicly-traded stock was becoming more valuable every day.

I knew only the basics about clinical trials, so I did some research and learned that new drugs go through three levels of trials to find out two things: Are they safe?  And are they effective?  Both are necessary before the FDA will approve them.

What I knew before about clinical trials is that very sick people get into them when no other treatment helps.  Sometimes the drug doesn’t work on anyone.  Sometimes the drug works on some but not others.  Sometimes it works on everyone but is not safe.  But the commonality is that people in clinical trials are usually desperate.

It occurred to me that in the months before the 2016 presidential election lots of Americans felt like traditional politics weren’t working and their economic or social or cultural situation was desperate.  The usual policies were failing.  The promises were hollow.  They believed that people in government who were supposed to know everything actually either knew nothing or what they knew was wrong.

So millions of anxious and hurting citizens identified a clinical trial.  It was called Donald Trump.  Except that there are three differences between this political clinical trial and an actual medical clinical trial.  The first is that the participants didn’t care if the treatment was safe or effective.  All they needed to know was it was new and unlike anything they’d tried before.  The second is that no one was given a placebo.  Everyone who joined the trial got a real pill.  The third is even people who didn’t sign up for the trial became part of the experiment.

The ointment with cocaine in it I talked about earlier made it through the second level of its trial.  At stage three it was still safe but proved not to be effective.  The share price of the company dropped to zero and it went bankrupt.

We await the final results of America’s ongoing political clinical trial.

Terry Smith is a political science professor at Columbia College and a regular commentator on KBIA's Talking Politics.