“Some measure of defensiveness was to be expected from a corporate official being deposed in a multimillion dollar lawsuit. But this was something else. This was pride. The truth is that she, Kathe, deserved credit for coming up with ‘the idea’ for OxyContin. Her accusers were suggesting that OxyContin was the taproot of one of the most deadly public health crises in modern history, and Kathe Sackler was outing herself, proudly, as the taproot of OxyContin.”

Radden Keefe uses contrast and italics to underscore the surprising aspects of Kathe Sackler’s behavior. Though she is being called to account for Purdue’s actions, she is “proud” of her family, her self-regard evident even under scrutiny. Significantly, Radden Keefe repeats the word “taproot”—in a narrative that is partly about family history, origins have deep significance. Kathe Sackler “outs herself” as a root cause of OxyContin’s existence, conflating herself with the drug.

“But he had always possessed an entrepreneurial sensibility, a keen interest in business, and any vow he made to medicine could not change that. Besides, he had landed an interesting part-time job during medical school, yet another side gig, this time as a copywriter for a German pharmaceutical company called Schering. Arthur had discovered that of all his many talents one of the things he was particularly good at was selling things to people.”

This passage underlines Arthur Sackler’s complex character and varied interests. He made a “vow” to medicine—a vocational commitment—but he also considered divided loyalties in his nature. He has an “entrepreneurial sensibility,” a phrase that suggests that business and profit were part of his temperament and life philosophy, not mere interests. The proliferation of “side gigs” emphasizes his dedication to controlling as many aspects of the world as he could.

“This was the era of the ‘miracle drug’: the postwar years were a boom time for the pharmaceutical industry, and there was a widespread optimism about the potential of scientific innovation to devise unheard of chemical solutions that would cure death and disease and generate untold profits for drug makers. The same utopian promise that the Sacklers had been evangelizing for at Creedmoor—the idea that any human malady might one day be cured with a pill—was beginning to take hold in the culture at large.”

Arthur Sackler was, for all his singularity, a product of historical and social contexts. His entry into pharmaceuticals coincided with broader interest in medicine as an avenue for progress. Radden Keefe uses religious terminology to describe the Sacklers—they are “evangelists” for medicinal treatments of mental illness, as if they had a vocational calling.