An American Sickness
There are certain names so deeply woven into the fabric of American life they feel less like corporate entities and more like foundational elements of our collective identity. Coca-Cola is one. Ford is another. And then there is Johnson & Johnson. For over a century, its cursive red script has been synonymous with care, safety, and a uniquely American form of gentle, domestic benevolence. It is the brand of first baths and scraped knees, of fevers broken in the night and the sterile hush of the operating room. The company’s promise, “No More Tears,” was more than a marketing slogan for baby shampoo; it was an implicit social contract, an assurance that in the vulnerable moments of life, J&J was a trusted guardian. It is this foundational myth—this bedrock of American cultural and emotional trust—that Gardiner Harris, a veteran reporter of the pharmaceutical industry, dismantles with the methodical, devastating precision of a demolition expert in his monumental work of investigative journalism, No More Tears: The Dark Secrets of Johnson & Johnson. This is not merely a book about corporate malfeasance. It is a biography of a betrayal, an autopsy of a system where the institutions designed to protect us—corporations, regulators, and even the medical establishment—become complicit in a culture of harm. Harris’s account forces us to ask a question far more unsettling than whether a single company lost its way: What is the true cost of our blind faith in the icons of American capitalism, and what happens when the tears they promise to soothe are the very ones they have caused?
The Anatomy of a Myth
To understand the magnitude of the betrayal Harris chronicles, one must first appreciate the architecture of the myth Johnson & Johnson so masterfully constructed. No More Tears is structured not as a simple chronological history, but as a series of deep dives into the case files of the company’s most iconic and, ultimately, most problematic products. Harris begins where the company began its emotional conquest of the American consumer: in the nursery, with Johnson’s Baby Powder. This was not just a product; it was an artifact of love, its scent, Harris reveals through internal company documents, “the most recognized fragrance in the world,” engineered to conjure “the most pleasant memories and associations.” This “Golden Egg,” as the company called it, was the cornerstone of an empire built on “real emotional trust,” a bond so powerful it created a protective halo around every other product bearing the J&J name, from Tylenol to complex prescription drugs and surgical devices.
Harris meticulously traces the company’s origins from three brothers in New Brunswick in the late 19th century, pioneering antiseptic surgical dressings, to a global colossus. He introduces us to the visionary, if autocratic, Robert Wood Johnson II, who in 1943 etched the company’s famed Credo in stone, a document promising that its “first responsibility is to the patients, doctors, nurses, parents and all others who use our products and services.” This Credo is central to the book’s tragedy. It was both a genuine statement of purpose and, as Harris demonstrates, the ultimate camouflage. The book’s narrative tension is built on the ever-widening chasm between the noble words of the Credo and the cynical, profit-driven decisions made in the company’s boardrooms and marketing departments. Harris’s unique perspective, honed over decades covering the pharmaceutical industry for The Wall Street Journal and The New York Times, allows him to see beyond the press releases and carefully managed public image. He approaches J&J not as an outsider lobbing stones, but as a disillusioned believer, someone who, like most Americans, “was the ideal American corporation.” His investigation is fueled by a persistent, haunting question that arose from years of stonewalling and discovering unsettling truths: How could this company, of all companies, have so much to hide?
The Powder and the Poison
The heart of No More Tears beats in its detailed, evidence-laden exploration of the company’s core product lines, and the first pillar of Harris’s argument is the original sin: Johnson’s Baby Powder. It is here that the template for decades of deceit was forged. Harris unearths a history that is nothing short of terrifying. As early as the 1950s, the company was aware that its talc, the primary ingredient in its iconic powder, was contaminated with asbestos, a known and potent carcinogen. Harris writes, “Those impurities, Battelle noted, were ‘less than 1 percent to about 3 percent of contaminants,’ and these were mostly asbestos.”
What follows is a masterclass in corporate cover-up. Through a trove of internal memos, secret grand jury files, and trial transcripts, Harris reveals a multi-decade conspiracy to suppress science, mislead regulators, and betray the public. We learn of scientists like Dr. Arthur Langer at Mount Sinai, who in 1968 found that popular talcum powders, including J&J’s, “were contaminated with asbestos.” We see how the company responded not by fixing the problem, but by launching a campaign to discredit the scientists. In a chilling 1972 memo titled “Antagonistic Personalities in the Talc Story in the U.S.A.,” a J&J executive targeted the very researchers who were uncovering the truth. The company pressured medical school administrators, leading to public retractions that muddied the scientific record for a generation.
Harris details the creation of the “J4-1 method,” a fraudulent testing standard developed by the industry and presented to the FDA. It was, he writes, a standard “designed so that manufacturers wouldn’t find small amounts of asbestos even when they were present.” This act of scientific fraud allowed J&J to publicly and repeatedly claim its product was “asbestos-free” while internal documents and more sensitive tests proved otherwise. The consequences were devastating. Tens of thousands of women who had used the powder for feminine hygiene for decades, trusting the brand implicitly, developed ovarian cancer and mesothelioma. Harris introduces us to their stories through the lens of the landmark Ingham trial, where plaintiffs’ attorney Mark Lanier finally brought the company’s secret history to light. The verdict was a staggering $4.69 billion judgment, an amount an appeals court found warranted because “Plaintiffs proved with convincing clarity that Defendants engaged in outrageous conduct because of an evil motive or reckless indifference.” The Baby Powder saga is not just a story of a contaminated product; it is the story of how the very foundation of J&J’s “emotional trust” was built on a bed of carcinogenic lies.
Miracle-Gro for Tumors and Kingpin of the Crisis
The second pillar of Harris’s devastating critique examines the systemic corruption within J&J’s pharmaceutical and medical device divisions, revealing that the Baby Powder scandal was not an anomaly but a business model. Harris connects the dots across multiple product lines, exposing a recurring pattern of prioritizing blockbuster profits over patient safety through illegal marketing and the suppression of inconvenient data.
He takes us deep into the story of Procrit, a drug to boost red blood cells in anemic patients. J&J saw a massive market in cancer patients weakened by chemotherapy. Yet, from the outset, there was evidence that the drug could act as a growth factor for tumors. A Harvard researcher funded by J&J presented findings that EPO, the drug’s active ingredient, seemed to stimulate cancer growth. The researcher recalled a J&J executive saying, “We have to kill this work.” They did. For years, the company concealed studies showing increased mortality and tumor progression, all while marketing Procrit through its “Strength for Living” campaign. Dr. Otis Brawley, then chief medical officer of the American Cancer Society, would later ask the damning question that defines the scandal: “What data do you have to assure me that this is not Miracle-Gro for cancer?”
This pattern of deceit is repeated with even more tragic consequences with the antipsychotic Risperdal. Initially approved only for schizophrenia in adults, J&J saw enormous, untapped markets in children with behavioral issues and elderly patients with dementia. Harris reveals the creation of a dedicated “ElderCare” sales force and marketing schemes like “ice cream and popcorn parties” for child psychiatrists, all designed to promote these illegal, “off-label” uses. This was done even after the company’s own studies showed that Risperdal was deadly in the elderly, significantly increasing the risk of strokes. An internal analysis found a “statistically significant association between Risperdal use and strokes, heart attacks, and death.” For children, the drug caused massive weight gain and, in a horrifying side effect known as gynecomastia, caused boys to grow female breasts. Harris uncovers how J&J manipulated and ghostwrote studies to hide this fact.
Perhaps most damning is Harris’s reframing of the opioid crisis. While the Sackler family and Purdue Pharma have become the public face of the epidemic, Harris convincingly argues that J&J was the quiet “kingpin.” Through its subsidiaries in Tasmania, J&J developed a high-yield “Norman” poppy and became the largest supplier of the raw narcotic ingredients for the entire American market, including Purdue. Furthermore, it aggressively marketed its own fentanyl patch, Duragesic, by falsely claiming it was “less prone to abuse” than OxyContin, a lie it perpetuated by exploiting a known flaw in the government’s drug abuse tracking system. A McKinsey & Company report commissioned by J&J even recommended the company “Target high abuse-risk patients (e.g., males under 40).” As one expert told Harris, “The Sacklers are pikers compared to Johnson & Johnson.”
The Empty Throne of the Watchdog
The third and perhaps most crucial pillar of Harris’s analysis is the systemic failure of the one institution that should have stood as a bulwark against this corporate malfeasance: the U.S. Food and Drug Administration (FDA). Throughout No More Tears, the FDA is not portrayed as a tough cop on the beat, but as an underfunded, outmaneuvered, and ultimately captive agency—a watchdog that has been defanged and leashed by the very industry it is meant to regulate.
Harris argues this “regulatory capture” is not a bug but a feature of the modern system. Beginning in the 1990s, the FDA became financially dependent on “user fees” paid by pharmaceutical companies to fund its drug review process. This created a fundamental conflict of interest, turning the industry into the agency’s primary client. The results, as detailed in the book, are catastrophic. We see it in the Tylenol poisoning crisis of 1982. The public narrative, which J&J masterfully shaped, is one of corporate heroism. Harris reveals a more complicated truth: J&J resisted a nationwide recall until a copycat case forced its hand, and the investigation was deeply flawed, likely missing the true perpetrator, a disgruntled warehouse worker with access to J&J’s distribution system. The FDA, led at the time by a commissioner who would later take money from the industry, quickly and publicly exonerated the company, solidifying a myth of corporate blamelessness.
This pattern of deference repeats itself with horrifying regularity. In the case of medical devices, Harris exposes the gaping 510(k) loophole, a regulatory pathway intended for minor modifications that has been exploited for decades to bring high-risk devices to market with no human clinical trials. J&J’s Pinnacle metal-on-metal hip implants—a revival of a disastrous 1960s technology—were brought to market through this loophole. The implants failed at catastrophic rates, shedding toxic metal debris into patients’ bodies. Harris unearths emails showing engineers warning of design flaws days before the FDA submission, yet the company proceeded, submitting an application with false specifications. Similarly, the Prolift vaginal mesh, a device that caused life-altering pain and injury to hundreds of thousands of women, was sold for years without any FDA approval at all. The company simply decided the device was “substantially equivalent” to an older product and put it on the market. When the FDA finally ordered studies, the results were so horrific the trials were halted. As Harris chillingly concludes, “Johnson & Johnson was a criminal enterprise. Indeed, mafia families get a large share of their income from strictly legal activities. But no mafia outfit ever consistently targeted the kind of vulnerable people that J&J exploited.”
The Credo as Camouflage: The Banality of Corporate Evil
What emerges from Gardiner Harris’s exhaustive investigation is a thesis more profound and disturbing than a simple exposé of a rogue corporation. The central, provocative argument of No More Tears is that Johnson & Johnson’s most powerful weapon was not any single product, but its own meticulously crafted myth of ethical supremacy, embodied by “Our Credo.” This document, displayed in every office and recited at every major meeting, was not, Harris contends, a genuine guide for moral action. It was the ultimate instrument of corporate gaslighting, a moral camouflage that allowed the organization to commit profound harm while simultaneously believing in its own inherent goodness.
This is what makes the evil Harris documents so banal, and so terrifying. The villains of this story are not cackling caricatures from a corporate thriller. They are men like Alex Gorsky, the West Point-educated CEO who rose through the ranks by overseeing the illegal marketing of Risperdal and Duragesic, a man who, Harris reports, once told an interviewer he “felt like Thomas Jefferson” while co-authoring a statement on corporate purpose. The decision-makers at J&J were not, for the most part, sadists. They were ambitious, performance-driven executives operating within a system that richly rewarded the external performance of virtue while incentivizing the internal normalization of deviance.
The Credo provided the perfect psychological shield. By constantly invoking their responsibility to “patients, doctors, nurses, [and] parents,” the company created a powerful cognitive dissonance. Employees could engage in activities—bribing doctors, hiding fatal side effects, designing fraudulent scientific studies—and frame them as necessary evils in service of a greater good, or simply as the “cost of doing business,” as one executive admitted regarding infant deaths from Tylenol. The language of care and responsibility became a tool to sanitize a culture of ruthless profit-seeking. Harris shows how this dynamic played out in meeting after meeting. When confronted with data showing Risperdal was deadly to the elderly, the marketing team’s ethical analysis concluded that stopping the illegal marketing would be a moral failure because it would “relinquish obligation to patients, caregivers & providers.” This is the logic of an organization so lost in its own mythology that it can no longer distinguish between helping patients and exploiting them. No More Tears thus becomes a case study in Hannah Arendt’s “banality of evil,” demonstrating how immense harm can be perpetrated not through monstrous intent, but through bureaucratic indifference, a diffusion of responsibility, and the powerful, self-justifying language of a corporate mission statement.
An American Story, A Modern Malaise
Gardiner Harris has written a book for our times, a harrowing account that resonates far beyond the misdeeds of a single company. No More Tears lands in a contemporary landscape scarred by a profound erosion of trust in our most foundational institutions. The patterns of behavior Harris uncovers—the elevation of branding over science, the dissemination of corporate misinformation to shape public opinion, the capture of regulatory agencies by powerful financial interests, the complicity of experts—are the very pathologies that define our modern malaise. Reading about J&J’s decades-long campaign to sow doubt about the link between talc and cancer, one cannot help but think of the fossil fuel industry’s campaign to deny climate science. Reading about the company’s funding of front groups and co-opting of medical societies to push opioids, one sees the playbook for countless other influence campaigns that place profit over public welfare.
This book is a vital, urgent read for any citizen who feels a creeping sense of unease about the unseen forces shaping their health and society. It is for anyone who has ever wondered why their prescription drug costs are so high, or why a medical device was approved, or who is truly funding the patient advocacy group they support. The ideal reader is not a cynic, but a concerned citizen who still believes in the possibility of accountability. Harris defines J&J as “a quintessentially American company,” and its story is indeed a dark mirror of the American dream. It embodies the nation’s genius for innovation, marketing, and global dominance, but also its capacity for boundless greed and its systemic failure to protect the vulnerable from the powerful. The book is not a recommendation to buy or boycott, but a call to vigilance. It is a demand that we look past the comforting logos and heartfelt mission statements and scrutinize the evidence, for as Harris so powerfully demonstrates, the gap between a company’s promise and its practice can be a chasm in which lives are lost.
Beyond the “No More Tears” Promise
In the end, No More Tears is a work of immense journalistic courage and staggering detail. Gardiner Harris has not just written a book; he has compiled an indictment. He synthesizes decades of complex litigation, scientific studies, and internal documents into a narrative that is both rigorously academic and deeply human. We feel the heartbreak of parents whose children were disfigured by Risperdal, the agony of women whose lives were destroyed by Prolift mesh, and the quiet fury of scientists whose work was suppressed. The book’s ultimate value lies not just in its exposure of Johnson & Johnson’s sins, but in its meticulous dissection of the system that made those sins possible—and profitable. It is a definitive account of corporate sociopathy operating under the guise of public service.
In 2023, facing an avalanche of lawsuits, Johnson & Johnson spun off its consumer products division into a new company, Kenvue. The iconic brands—Tylenol, Band-Aid, and yes, the now talc-free Baby Powder—are no longer part of J&J. The symbolic severing of the company from its past is a fitting, if cynical, end to the story Harris tells. The “Golden Egg” had become too toxic to hold. Yet, as Harris notes, the core pharmaceutical and device company remains a global powerhouse, its influence undiminished. The mythology may be tarnished, but the machine remains. The enduring legacy of No More Tears is its permanent demolition of one of America’s most cherished corporate myths. It forces us to confront the painful truth that the promise of “No More Tears” was never a guarantee of our comfort, but a prerequisite for the company’s profit. The tears that followed were simply the cost of our trust.
