This book details the discovery of insulin and how that discovery affected the lives of Elizabeth Hughes and her family. Cooper, a playwright, and Ainsberg, an author, put together this book as a collaborative project. The book juxtaposes the details of the discovery and development of insulin as a therapy for diabetes with the diagnosis and subsequent health decline of Elizabeth Hughes, daughter of Charles Evans Hughes. Elizabeth Hughes was first diagnosed with diabetes in April 1919 at the age of 12. At that time, the best therapy for diabetes was Allen's starvation treatment, in which patients were put on a strict dietary regime which kept them on a knife's edge between sugar poisoning and outright starvation; indeed, as Cooper and Ainsberg note in this book, many of Allen's patients succumbed to starvation. Allen's severe dietary restrictions were no cure for diabetes, but merely a stopgap measure, with the hope that it would enable patients to survive long enough for a diabetes cure to be found. Elizabeth Hughes was one of the Allen's most famous patients, and one of the first for whom the starvation gamble paid off when insulin treatments began to be tested on human patients in 1922.
This book delves into the gritty details of the discovery and development of insulin, how a young doctor named Frederick Banting with no research experience but a unique idea was able to persuade veteran Toronto researcher Charles Best to let him try a summer project in his lab. Cooper and Ainsberg relate the details of Banting and Best's subsequent strife-filled collaboration. They also discuss the family background of Elizabeth Hughes and her well-known father, Charles Evans Hughes. They consider the ethical questions of Elizabeth's treatments with Allen and Banting, and conjecture some of the ethical questions that Charles Evans Hughes may have been faced with when making decisions concerning his daughter's treatments.
The book provides informative details about the bleak situation for diabetes patients before 1920, and a glimpse into the difficulties faced by many collaborative research efforts. I found the focus on Elizabeth Hughes a bit misleading though; rather than being the first patient successfully treated with insulin injections, she was more a famous exemplar rather than a pioneer. The book is rife with descriptions of conversations and mental states; in looking for references to describe how the authors may have been able to uncover such intimate material, I found instead that they had made it up. Indeed, one of the book's most important scenes depicts an ethical quandary faced by Charles Evans Hughes, yet in the sources, the authors write "The phone call from Charles Evans Hughes to President Falconer at the University of Toronto is imagined, as is Antoinette's urging him to it." If such details were invented for dramatic emphasis, then this book must be approached as a work of fiction, not of medical history.
