John Brinkley bought his medical degree from the Eclectic Medical University of Kansas City, a diploma mill, and in 1917 set up practice in Milford, Kansas, a town of two hundred people.
His procedure was to implant slivers of goat testicle into the scrotum or abdomen of men complaining of impotence, low energy or infertility. The tissue did nothing — xenografts of this kind are rejected within days — but the surgery was real, unsterile, and killed a number of patients.
His patients reported improvement in large numbers, and this is the part that requires explanation rather than mockery.
Three effects, all of which were understood only later and none of which were understood by Brinkley's critics at the time in a form they could use.
Placebo response, which is substantial in exactly this domain. Sexual function is heavily influenced by expectation and anxiety, and the intervention here was maximally dramatic: surgery, a fee, an operation with a memorable and virile-sounding component, and a doctor who was certain.
Regression to the mean. Complaints like these fluctuate. Patients present at their worst — that is what makes them seek treatment — and the subsequent measurement, whatever intervened, tends to be closer to their average. Any treatment administered at a trough will appear to work.
And selection in the reporting. Satisfied patients wrote in. Dissatisfied ones did not, and the dead ones could not.
Randomized controlled trials exist precisely to strip these out, and they did not become standard until the 1940s.
What made Brinkley extraordinary was the second business, which is why he is in this guide rather than a history of quackery. In 1923 he built KFKB, one of the first radio stations in Kansas, and used it to broadcast a program in which he answered listeners' medical letters on air, diagnosing conditions he had not examined and prescribing numbered preparations available from a network of affiliated pharmacies that paid him a commission.
Radio gave him something no previous quack had possessed: a parasocial relationship at scale. The voice in the kitchen, present daily, speaking directly and warmly, produces the sense of a known and trusted person. That is the authority heuristic of chapter 7 combined with the mere-exposure familiarity of chapter 24, delivered to hundreds of thousands of homes.
Morris Fishbein of the American Medical Association campaigned against him for years. Kansas revoked his medical license in 1930 and the Federal Radio Commission refused to renew KFKB's license. Brinkley ran for governor of Kansas as a write-in candidate and very nearly won, then moved to Del Rio, Texas, and built XER across the border in Mexico — a border blaster eventually running a million watts, audible across North America, beyond the reach of American regulation.
He died in 1942, bankrupt, facing fraud charges and wrongful death suits.