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As a child in the 1930s, Carl Djerassi had planned to study medicine in his native Vienna, as both his mother and father had done. But in 1938 Nazi Germany annexed Austria. His parents were Jewish, and Djerassi and his mother fled, eventually settling in the USA. Mainly because of tight family finances, Djerassi would not study medicine. But as a chemist he would have a key role in one of the most important medical achievements of the 20th century-the development of oral contraceptives, known around the world simply as the pill.
In 2007 a panel of The BMJ 's editors and advisers named the pill as one of the top 15 medical milestones since 1840, 1 the year when The BMJ was first published. Writing in The BMJ at the time, Djerassi agreed with this assessment. He noted that the two words-the pill-needed no additional explanation and were understood by almost everybody to mean oral contraceptives. 2
"What single procedure or vaccine would be known by the equivalent labels of 'the operation' or 'the jab'?" he wrote. "The answer is, none." He added that "no other milestone has had as many societal, 'non-medical' consequences; the pill is a stone thrown into water that has produced ripples and waves way beyond any reasonable expectation."
The first step toward the development of the pill's key ingredient began in 1949, when the 26 year old Djerassi accepted a position as associate director of research in a small laboratory in Mexico City, operated by pharmaceutical firm Syntex. Djerassi had already attracted attention as a "wunderkind" chemist when he helped develop tripelennamine, the first commercial antihistamine, 3 at the pharmaceutical company Ciba in New Jersey. At Ciba he had also developed a deep appreciation of the powerful connection between chemistry and human health.
In Mexico, Djerassi initially focused on developing a simpler synthesis of an anti-inflammatory cortisone from the steroid diosgenin, which was derived from Mexican wild yams. After successfully completing this task in mid-1951, Djerassi focused on...