Podcast Review: Sick — 50 percent different

'I felt like my mom had been raped.' This feeling was brought about because of how some women were treated in the 1980s by their fertility doctors, whom they fully trusted would help them have a baby.

The podcast 'Sick' is a series of eight episodes which explores the story of the Indianapolis fertility doctor, Dr Donald Cline, who impregnated many of his patients with his own sperm in the 1970s and 1980s without their knowledge. In the first episode, '50 Percent Different', the hosts Lauren Bavis and Jake Harper present the personal story of one of the doctor's victims, Liz White and her son, Matt. To my surprise, the emotional story also reveals a bigger underlying problem which is not unique to Dr Cline's patients: in the past, some fertility doctors had the audacity to use their own genetic material on multiple patients to treat their infertility.

The ominous opening music of the episode and Harper's description of the scene around him and Matt, gave a sense of what was to come. The medical building Matt was conceived in no longer brings happy memories to him or his mother but rather reminds them of what happened there years ago. In 2016, Matt found out his biological father was the fertility doctor his mother was visiting, and that he wasn't even Dr Cline's only child. In fact, he is now one of over 50 confirmed siblings.

White always dreamed of having a family with kids. When her husband broke the news that he was infertile, they never spoke about it while trying to get pregnant – the topic of infertility was stigmatised in the early 1980s.

I liked that '50 Percent Different' didn't only tell a story, but also educated the listener about how infertility approaches and the concept of pregnancy have changed throughout the centuries. IVF was not a routine procedure in the early 1980s, so if White and her husband wanted to raise a child, they would have to either adopt or use a sperm donor for artificial insemination.

White eventually decided to use frozen donor sperm but failed to get pregnant. She was then recommended to a fertility specialist who used fresh sperm: Dr Cline.

White's description of the unwelcoming doctor's room and the whole insemination procedure made me feel for her. That the stigma around infertility prevented her from sharing her experience with her friends or her husband was even more tragic to me. Her friends already had kids, they did not have to go to the doctor for years to conceive, and she did not want to disappoint her husband yet again with news of unsuccessful rounds of insemination. I wondered if White's situation was exclusive. Perhaps all of Dr Cline's patients trusted him with their stories because there was no one they could share their thoughts with.

After five years of trying, White finally became pregnant within just five months of visiting Dr Cline. She believed it was his medical expertise that had made her successful. White did not want to know the sperm donor's identity but also did not think that Dr Cline would lie to her.

White's son, Matt had a completely different experience when he found out he could not have a biologically-related child. Nowadays, you can pick your preferred sperm donor, using a catalogue, based on your own height, eye colour or even hobbies, so that the child resembles you. White, on the other hand, was lied to, being told her sperm donor would be a resident in the hospital next door.

The emotional ending revealed how Matt felt on discovering his biological father. He found out by reading a news article about a famous fertility doctor in his local area. He then described his conception as something procedural, not even slightly emotional: Dr Cline 'masturbated and collected his own sample and walked back in that room and put it in my mother.'

The first podcast episode dives into the story of two normal people, a story which normally would not make it to the headlines. Nevertheless, it is intriguing to hear, perhaps even a relief to all of Dr Cline's other victims who were probably treated the same way as White. The episode made me wonder how much infertility treatment had changed in the past 40 years and what is yet to come as science advances. As a society, we also seem to have changed our perspective about assisted reproduction and talk more openly about infertility, not only within the family but in the media, too. The podcast itself exemplifies this change. Although '50 Percent Different' covers just one personal story, in fact it does more than that. It empowers other families to come forward and talk openly about infertility issues because it is not a medical problem one should be ashamed of.

I would be very intrigued to find out the full story of Dr Cline: what was his motivation behind what he did and whether he regrets lying to his patients about the actual sperm donor. Was he consciously playing God by impregnating so many women and spreading his genetic material? Do his victims think Dr Cline should go to prison for what he did?

I could not help wanting to know more about Dr Cline's case. It turns out that fertility doctors at the time were not expressly forbidden to use their own genetic material when treating their patients, and so what Dr Cline did was lawful. He was not prosecuted but nevertheless charged with obstruction of justice for denying the allegations against him (see BioNews 931). Dr Cline subsequently lost his medical license and paid a $500 fine. Because of Dr Cline's actions, the law changed in 2019, although only in Indiana, to make such doctors' actions illegal (see BioNews 998). Similar stories are emerging in other US states and laws are also being passed in other countries to prevent future Dr Cline cases.

Carefully selected questions and a good balance of a personal story and scientific background are the two factors that made me want to press 'play next episode'. I'm looking forward to hearing what Dr Cline has to say in the podcast series!