Breakthrough: Elizabeth Hughes, the Discovery of Insulin, and the Making of a Medical Miracle

Summary (from the publisher): It is 1919 and Elizabeth Hughes, the eleven-year-old daughter of America's most-distinguished jurist and politician, Charles Evans Hughes, has been diagnosed with juvenile diabetes. It is essentially a death sentence. The only accepted form of treatment - starvation - whittles her down to forty-five pounds skin and bones. Miles away, Canadian researchers Frederick Banting and Charles Best manage to identify and purify insulin from animal pancreases - a miracle soon marred by scientific jealousy, intense business competition and fistfights. In a race against time and a ravaging disease, Elizabeth becomes one of the first diabetics to receive insulin injections - all while its discoverers and a little known pharmaceutical company struggle to make it available to the rest of the world.

Relive the heartwarming true story of the discovery of insulin as it's never been told before. Written with authentic detail and suspense, and featuring walk-ons by William Howard Taft, Woodrow Wilson, and Eli Lilly himself, among many others.

Review: This work of non-fiction follows the true story of eleven-year-old Elizabeth Hughes, who was diagnosed with juvenile diabetes in 1919. Elizabeth was the daughter of one of the most well known politicians of the time, Charles Evans Hughes. Hughes was a one time presidential candidate, a Supreme Court justice, a governor of New York, and during Elizabeth's illness became Secretary of State. At the time, diabetes was a death sentence with the only treatment being starvation, which only served to prolong a child's life. But Elizabeth was lucky because while she starved, Canadian researchers managed to identify insulin and Elizabeth, thanks in part to her father's political connections, became one of the first diabetics to receive injections of insulin. 

Although the reader knows from the outset of this book that Elizabeth did survive to adulthood, the authors do a good job of building the arc of this story to detail how precarious Elizabeth's health truly was and pacing that part of the book with the race to find a cure. At its worst, Elizabeth, although a teenager, dropped below fifty pounds and barely had the energy to walk. Chapters about Elizabeth and her starvation treatment are interspersed with chapters following the research undertaken by Banting and Best in Canada in their attempts to identify insulin from dog pancreases. Furthermore, the Hughes family, with their central place in American politics of the day, provided a fascinating focal point for the story. Although one of the most well known names of the day, Charles Evans Hughes has almost no name recognition today, which is surprising given all the many roles he held during his lifetime. 

Although it was a necessary evil of medical research of the time period and did ultimately lead to thousands of lives being spared, I had a difficult time reading the chapters that focus on the research carried out on dogs. Hundreds of dogs lost their lives in the pursuit of researchers pinpointing what would eventually be called insulin and it was heartbreaking to read about scientists who had built relationships with the lab dogs only to eventually have to sacrifice them. It was very hard to read about all the botched attempts that resulted in dogs dying left and right in the lab. Again, I understand that this was an unfortunate reality to the research, but still a possible trigger warning for any animal lovers interested in this book. 

My one true issue with this book, however, deals with the inclusion of fictional scenes, where the authors imagine how different conversations might have gone and include this imaginary dialogue in the text. Although the notes section at the end of the text does reveal this, practice I did not like the inclusion of not only imagined dialogue but the authors' imagined 'depictions' to help illustrate characters' emotional states. For example, the author's include a midnight flight to Elizabeth's sick bed by her mother to rush her off to receive insulin. The authors include in the notes that this is all imagined on their part and they don't have any real idea of when or how Elizabeth was removed from her starvation treatment site. Although, this practice did give this book a novel-like sense of drama and urgency, I found this practice disconcerting and misleading, particularly since the authors wait until the conclusion of the book to specify which scenes are fictional. 

Finally, I found the authors' condemnation of Elizabeth's choice to move on from her childhood disease unnecessarily harsh. After her illness, Elizabeth seems to have chosen to obscure this part of her life, never revealing to outsiders that she had diabetes and moving fully on with her life. The authors seem to see this as a masterful, calculating move on Elizabeth's part and call her out on this choice, including the fact that she didn't give money to diabetes research or treatment later in life. However, I don't think due emphasis was given to the stigma of such a disease at the time, let alone  Elizabeth's feelings on how much of her life she had already sacrificed to the disease. I don't think she should be blamed for not wanting to become a champion or poster child for diabetes when it seems ardently clear that she just wanted to resume living a normal life. 

Stars: 3.5