Book Review: Let There Be Life

From its grandiose biblical tile (Let There Be Life) to the mixed metaphors and patriarchal presumptions of its final paragraph, this self-published “intimate portrait” of British embryologist, IVF pioneer, and Nobel prize-winner Robert Edwards is an unfortunate hagiography. The author, Roger Gosden, is a physiologist who worked in the 1970s with Edwards at his Cambridge clinic, Bourn Hall, and had a long career in reproductive medicine in the UK, Canada, and the US. He is an unapologetic booster of both his subject and the field he helped pioneer.  Throughout the text, Gosden elevates Edwards while failing to address adequately the many ethical ramifications of the work that helped usher in the age of reproductive medicine. 

Edwards and Patrick Steptoe, his physician partner who pioneered gynecological laparoscopy, co-authored a version of their exploits in the 1980 A Matter of Life. Their book gives a fairly unvarnished account of their actions and motivations. Each time they had vague ethical qualms, they quashed them or came up with a rationale for moving forward. In general, they dismissed criticism from scientists and non-scientists alike, driven by the conviction that their work would enable infertile women to fulfill dreams of having a baby.

A Matter of Life includes a number of unintentionally embarrassing scenes involving both co-authors. Edwards is described masturbating into a sterile vessel to obtain sperm for an experiment in fertilizing a human egg in the lab, championing “eugenic techniques providing healthy births,” and arguing for unfettered embryological research at conferences in the US and UK. A set piece of Steptoe has him in full Telly Savalas mode, greeting Lesley Brown with, “Who loves ya, baby,” the day before she underwent a caesarean section and the world’s first “test tube” infant, Louise Joy, was heralded into the world.

Gosden rehashes the same ground as Edwards and Steptoe did, extending his narrative to the years after Louise’s birth in 1978, when Bourn Hall became a flourishing fertility center. (Before Edwards’ death in 2013, it was bought by the then Italian-owned pharmaceutical company Serano, manufacturer of the human menopausal gonadotropin drug Pergonal from the urine of menopausal nuns.) He also provides a snapshot of Edwards’ role in founding the European Society of Human Reproduction and Embryology and its now influential journal, Human Reproduction, as well as his launch of the online Reproductive Medicine Online. The epilogue includes a description of the 2010 Nobel ceremony at which Ruth Fowler, Edwards’ wife, accepted the Physiology or Medicine prize on his behalf due to his physical infirmity.

But Gosden’s additions to the Edwards-Steptoe book seem mostly ornamental. It is littered with assumptions and asides that give it a somewhat Victorian patina. It frequently alludes to the British class system (“Clubbable when it suited, [Edwards] was always his own man even as a youngster”). The character and nature of women in Edwards’ life, including his mother, his wife, and various female colleagues is assessed in stereotypical ways (“[Ruth] was a hidden woman in the story, an energetic multitasker like her husband, the lioness who raised their five daughters, managed the farm, and was an accomplished scientist in her own right…. [S]he would never receive the glittering accolades heaped on her husband. She was his best prize”). And there are frequent asides regarding the unreliability of the press (“[T]he journalist ignored the medical benefit to publish an inflammatory story about trivial reasons for choosing sex. It caused a public rumpus”).

Gosden retells Edwards’ early years from his birth to his doctoral studies at the University of Edinburgh, always against the background of his humble origins. Edwards’ father was a disabled World War I veteran who had worked as a miner and then as a rail tunnel inspector; his mother oversaw the household. Here, the book often reads like a travelogue in its descriptions of the Yorkshire dales, northern Wales, and Edinburgh (“a city of gracious architecture steeped in culture, science, and history that was worthy of the name ‘Athens of the North’”). 

Gosden also fleshes out many of Edwards’ peers and colleagues, giving thumbnail portraits of researchers at Edinburgh, Caltech—where Edwards worked fruitlessly on a contraceptive vaccine—and in the UK at the National Institute of Medical Research, the University of Glasgow, and Churchill College, Cambridge. Gosden is at his best describing Edwards’ embryology research, which followed a winding path that eventually led to his unconventional collaboration with Steptoe (“Bob was chalk to Steptoe’s cheese”). He is at pains to paint Edwards as the lonely genius, seeing his habit of juggling multiple projects as a sign of his ever-probing intellect and casting his motivation as altruistic, owed purely to his desire to “benefit families around the world.” 

While the book does deal with the pushback Edwards received from fellow scientists, ethicists, and religious leaders internationally at multiple points during his pursuit of in vitro fertilization, Gosden sides with Edwards in seeing all such challenges as unwarranted. In only one paragraph, on page 303, does Gosden admit that, “It would be dishonest to ignore side-effects of IVF treatment, its costs, frequent failures, and the rare mix-up in labs.” That item addressed, the author seems to feel he has guaranteed his status as a truth-teller and moves on. 

Throughout, Gosden glosses over the way in which Steptoe and Edwards carried out much of their work under less than transparent consent conditions. Lesley Brown did not even know that the procedure she underwent in an effort to become pregnant had never resulted in a successful birth.

Perhaps most disquieting is that Gosden makes no mention whatsoever of Edwards’ eugenical views. Edwards was a long-time member and trustee of the UK’s Eugenics Society and then, under its new name, the Galton Society, as Osagie Obasogie detailed in Scientific American in 2013. In a December 1970 article in the same publication, Edwards and Fowler foresaw and embraced the possibility that IVF would enable the selection of embryos according to their genetic characteristics, including “choosing male or female blastocysts.” They also envisioned other manipulations of embryos, writing that while such experiments would present “challenges to a number of established social and ethical concepts,” they would bring great rewards. Edwards implicitly acknowledged the eugenical implications of his work in 1999 when he said, “Soon it will be a sin of parents to have a child that carries the heavy burden of genetic disease. We are entering a world where we have to consider the quality of our children.” 

Let There Be Life was published by Gosden’s own publishing house, Jamestowne Bookworks. He explains that an independent press affords “greater freedom for authors. A life story can be crafted as they think fit, without steering the content and style to surf a popular wave.” This book would have profited from a rigorous editorial review. 

As it is, we can appreciate Gosden’s generosity toward his old colleague, but find little added value or merit in what is finally a nostalgic exercise.