Wednesday's Style section story on Dr. John Nestor identified Dr. Helen Taussig of Johns Hopkins as the major force in bringing to light the effects of Thalidomide in the early 1960s. Her reports on Thalidomide's effects in Europe -- where the drug was then legal -- provided crucial evidence. But the final decision to reject Thalidomide for use in the United States was made by Food and Drug Administration medical officer Dr. Frances Kelsey, who became a national celebrity as a result.
A Chevy sedan with the speed of eight. A cloud of dust. And a hearty curse for speeders: "They're stealing the road from those of us who pay taxes."
Nestor rides again!
As in John O. Nestor M.D. of Arlington, aged 72, Wheeled Avenger of the Beltway and lately familiar to thousands as the archetypal Left-Lane Bandit.
That's him there at the helm of his trusty Malibu ("It's got 105,000 miles on it -- and listen to that engine"), a defiantly stout man with forearms thick as cordwood, wearing a neat suit and tie, a snap-brim hat ("You can lose 45 percent of your body heat through a bald head") and shod in bright blue Nikes (a foot condition makes leather shoes impossible). He wears a single driving glove -- the serious kind with the little vent holes -- on his right hand.
In the past few weeks, the feisty pediatric cardiologist has been blasted from comfortable demi-obscurity to the kind of public acclaim and revulsion usually reserved for Boy George or Gary Gilmore. And all because of 63 words.
A woman had written a letter to this newspaper complaining of being tailgated on the Beltway by a large truck whose speed-hungry driver wanted her out of the way. Truck lovers fired back, accusing her of wanton lane-hoggery, and a prolonged epistolary squabble ensued. Still, the whole affair might have expired of inanity. But on Oct. 1, in a quiet corner of the letters section, appeared Nestor's modest manifesto:
On divided highways I drive in the left lane with my cruise control set at the speed limit of 55 miles per hour because it is usually the smoothest lane. I avoid slower traffic coming in and out from the right, and I avoid resetting the cruise control with every lane change.
Why should I inconvenience myself for someone who wants to speed?
The public exploded in a partisan frenzy. Nestor's name ("It's as Irish as Paddy's pig -- comes from County Clare") entered the local lexicon: His supporters called themselves "Nestorians," and an editorial minted the term "Nestoring." But for the reluctant eponym, the celebrity rankled. "After all," he protests, "I have really accomplished some important things." Chiefly during his 21 years as a medical officer in the Food and Drug Administration, where he developed a reputation for whistleblowing that makes the Mormon Tabernacle organ sound like a kazoo. Dr. Sidney Wolfe of the Naderite Health Research Group calls him "sort of the ideal public servant."
So obstinately did he refuse to play bureaucratic footsie with the drug industry that in 1972 the FDA abruptly pulled him off the drug-watchdog beat and kicked him into a bureaucratic backwater -- little reckoning on Nestor's tenacity and relish for a scrap. "It took me five years to get back," he says, grinning at the memory. "I suppose it's my nature. I outfoxed the bastards. They had all the power and all the cards, but I won every big battle."
Ditto for his recent skirmish with real-estate developers. Since 1948 he has lived in the same apartment complex off Wilson Boulevard. ("I like to come home at night and read. I don't like a lot of problems.") And when the developers set out to entomb his neighborhood in high-rises, he revealed sufficient anomalies in their planning that they were obliged to change the design. On the Road
Nestor rounds the on-ramp for I-66 westbound, swoops confidently into the far left lane, triggers the Chevy's cruise control, and moves his foot away from the pedal. The engine settles to a monotone thrum. The speedometer needle dips, rises, centers on 55.
"Once we get past the Beltway," he says, expectation catching his voice, "we'll get the trucks. They're the worst offenders." Nestor's nemesis, these pedal-to-the-metal boys: thirty tons of screaming diesel doom riding a few feet off his bumper. "One time all I could see was a big Kenmore radiator filling my back window. I turned on the headlights" -- thus lighting the taillights and presumably terrifying the trucker, who will assume for an instant that Nestor has just hit the brakes. "Or I may put on my flashers."
A Mazda sports car comes up behind him, hangs there briefly, then drops back to a prudent distance. A pickup truck arrives behind the Mazda, a sedan behind the truck. Nestor, cheerfully indifferent, now appears to be leading a very small funeral. A Washington Gas van whips past on the right. "Now then," he says, rotating his gaze in panoramic satisfaction. "I don't think I'm keeping anybody from getting where he wants to go." The 55-mph Barrier
Nonetheless, "I've had a lot of nasty phone calls and letters." Ironically, he feels, since his fast-lane crusade, like the blowing of regulatory whistles, was conceived as a public service. He knew that in its first years, the 55-mph speed limit had reduced the annual death toll by thousands, and watched with a healer's dismay as velocities and fatalities edged upward again. "It became obvious that the police couldn't or wouldn't control speeders," he says, and "I feel it's up to the public to protect themselves." Unfortunately, "The American public are like sheep."
A plot was hatched, fueled by indignation: "By God, I've paid taxes for a long time -- and more than a lot of those trucks." First he consulted with the commonwealth attorney's office and other traffic authorities to ensure that his plan was legal, that passing on the right was acceptable on multilane highways and that traveling over 55, even to pass, was against the law.
Then he saddled up the Malibu and hit the asphalt, braving a torrent of honks and curses and the collective opprobrium of the trucking industry.
He could take it. As one of 10 children, "I always had to battle. I don't think I was obnoxiously aggressive, but I always had to fight for what I wanted. I suppose this is one reason I speak out so much." Moreover, he was practically weaned on a sense of corporate power. He grew up in "a typical company town" -- Franklin, N.J., a zinc-mining hamlet near the New York border -- where his father was the mine's personnel manager.
He graduated from Georgetown medical school in 1940, planning to specialize in internal medicine. But after serving 4 1/2 years as an Air Corps flight surgeon, there were no residencies available. Fortunately, an old friend from the Seton Hall pre-med program was at Children's Hospital, and Nestor went there -- eventually becoming chief resident.
He established the diagnostic unit ("though if you mentioned my name now, nobody would know it") and came to love the pace and urgency of hospital medicine. And though he had become intensely interested in cardiology, studying at Johns Hopkins under the celebrated Dr. Helen Taussig -- co-inventor of the blue-baby operation and the major force in bringing the Thalidomide scandal to light -- he found his inadvertent new specialty ideally suited to his own innate optimism: "It's the best thing that ever happened to me. I was not ready psychologically for the terrible problems of adults. But in pediatrics, you're dealing with hope, rapid healing, the future and progress." Uncovering Scandals
He was to arrive at the FDA via another accident. By the late '50s, well established in private practice, "I was already disturbed by the information being given to me by drug salesmen, already thinking, 'What in the hell's wrong with the FDA?' " He got the answer on a trip to Florida.
Nestor developed a sore throat while driving down, and found that the only antibiotic he had with him was a sample of a newly released product. He examined the printed warnings, took the stuff, and very soon "I had a tremendous phototoxic reaction to sunlight. It might well have killed me," since he'd planned a sunbath. Luckily, the day was too cool. As it was, "I developed second-degree burns." Being Nestor, "I called the FDA to raise hell. There was nothing in the labeling about phototoxicity. But I just got sloughed off."
While his anger was festering, two other vectors were converging: Sen. Estes Kefauver was heading a congressional investigation into drug regulation, and announced that the FDA was having trouble recruiting doctors; at the same time, "I was getting bored with routine pediatrics -- treating diaper rashes, inflamed noses and ears." So in 1961, he joined the FDA and "immediately I started uncovering one scandal after another," most involving inadequate testing of new drugs. Approval was "an assembly-line process," Nestor remembers, "and if you held up an application, then you were in trouble." He soon was.
His in-house resistance and dramatic testimony on the Hill ("If you don't get the committee members' attention in the first 60 seconds, they go off to the bathroom or something") proved instrumental in ridding the market of Thalidomide, MER/29 (an anticholesterol agent that caused cataracts) and many more. Eventually he dropped his private practice. "I was single. I never married, and I didn't need a hell of a lot of money. What I wanted was interesting work." It would get extremely interesting.
By 1972, the cardio-renal-pulmonary division -- and its member John Nestor in particular -- had become conspicuous embarrassments to the drug industry. And one morning he found himself abruptly ousted. He "got half an hour's notice" that he was being transferred, and "I was put in an office with, well, nothing to do." He filed a grievance. It would be 1977 before a congressional investigation resulted in Nestor's reinstatement and a public apology.
But Nestor had not gone idle for five years. "What the FDA didn't realize was that I had amassed extensive files. And right down the hall was a Xerox machine. So all that time I was feeding reporters, congressional committees, the Nader groups. To this day they don't know how much I did to them." The Passing Lane
Below I-66, the Beltway widens to five lanes. Nestor holds to the far left. Soon a constant stream of vehicles is passing him on the right, many drivers shooting over an exasperated glance as they draw even with the Chevy. But no lunatic tailgating, no flashing headlights, no maniacal 18-wheelers.
"All of these truckers are acting a hell of a lot more sedately," says Nestor, still seething for combat as he turns onto I-395 northbound. Thanks to the outcry stemming from the recent bevy of Beltway accidents, troopers have cracked down. "It's not a typical run today."
The disappointment is palpable. The lip of the snap-brim points down for a moment. "I'm really dismayed," he says with a small sigh. "Still, this shows you what can be done if the police will enforce the laws."
Anyway, the scourge of pill barons and Lone Beltway Retaliator has already leaped to another fray. "Being a bachelor, I eat out all the time," Nestor says, mood lifting, words tumbling out again. "And when I stop in fast-food restaurants, I'm horrified by what I see. They've got so many of these immigrants from foreign countries, many of them illegal so they've never had a physical exam. I see them with infections, rashes, picking up the plastic forks by the business end, picking up the cups . . ."
So he called Arlington County health officials to ask what, if any, exams are given to restaurant employes. Especially those who might be carrying diseases like tuberculosis that are now rare in the United States. When an official replied that TB isn't spread by touch, Nestor was incensed. Although the disease is usually carried in the air, "my father died of an abdominal tuberculoma from digesting infected food." And besides, "when you're dealing with a waitress, she can breathe in your face or touch your food.
Dr. Martin Wasserman, director of the county's Department of Human Services, says he informed Nestor that though physicals are not required of restaurant employes, facilities are inspected at least twice a year. Moreover, "tuberculosis is primarily an airborne disease," he says, and "an abdominal tuberculoma is now so rare that it would rate an article in a medical journal." Nestor remained obdurate. "After the third letter," Wasserman sighs, "we referred him to the state health director."
Municipal-fracas buffs may want to watch that space. Because somewhere out there amid the suspect burgers and dubious fries, Nestor is riding again.