Customer Reviews

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

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When I was a mere eleven years old, my parents noticed my brother attempting to smuggle a pitcher of water up to his bedroom. He admitted that he had been drinking a lot of late, and my parents became alarmed. Rushing him off to the hospital he was quickly diagnosed with type 1 diabetes. It was a strange and frightening time for the whole family, and I read everything I could on the disease to get an understanding of what was happening to my brother.

This book, takes the reader back in time to that amazing transitional time in 1922 when the diagnosis of diabetes changed from being a sentence of death, when the discovery of insulin gave so many people world-wide back their lives. It looks at the victims of the disease, focusing primarily on Elizabeth Hughes, daughter of the Secretary of State of the United States, and looks at the researchers whose activities resulted in the most important breakthrough in the treatment of the disease.

First off, I must agree that this book does take the barebones story of what happened in 1922 and before, fleshes it out with a good deal of "imagined" detail. Therefore this book is probably not terribly useful to someone who wants a reliable and scholarly history.

What this book is is more of what I would call a "popular history," that is, a book written to tell the story of the discovery of insulin, but in an entertaining and engaging manner. I for one found this to be a very informative and entertaining book. The early part that dealt with what families went through before the discovery of insulin was quite literally heartbreaking. And I must admit that when I got to the part where peoples lives were being returned to them (as opposed to living in a concentration camp-like sanitarium), I quite literally got tears in my eyes.

Yes, I really enjoyed this book, and am very glad that I read it. As someone at least somewhat knowledgeable about diabetes, I was interested to learn about what diabetes was like before there was insulin, and how much better things are today. I don't hesitate to recommend this book.

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.

Up until about 1922, anyone diagnosed with Type I diabetes was destined to live a short life. From the time of diagnosis until death from the disease was measured in months, not years.

This book tells the story of the first patient to receive insulin therapy and the circumstances of how it all happened. That first patient was a young girl named Elizabeth Hughes, who died in 1981 at the age of 73.

It is a story of parents trying to come to terms with the inevitable death of their daughter and their decision to allow the experimental use of insulin on her.

A remarkable story, and a testament to the dedication and persistence of a Doctor striving for a life-saving treatment for diabetes.

Recommended!

This is a wonderful true story of the serendipity and inspiration of this medical discovery. It also follows the courageous struggle of a child to survive until medical help becomes available. It is a great book for any age from 7th grade up and would be a terrific addition to nearly any science or humanities syllabus. The true personalities in the book are fascinating as well.

This book exceeded my expectations by being far from the dry history I thought it might be. The discovery of insulin is balanced between the macrocosm of Post World War I geopolitics and the microcosm of one little girl's diagnosis of diabetes. Elizabeth Hughes beat the odds to live a long and full life after becoming one of the first patients to receive the new insulin treatment. This was a miracle in many ways, as the book reveals. Egos and personalities of the researchers threatened progress at almost every turn. The serendipitous location of the Eli Lilly pharmaceutical company near plentiful livestock slaughtering is another example. I was impressed with Ainsberg's research that went into this book. I also enjoyed Cooper's touch that brought the historical era alive and made the book a surprising page turner. I highly recommend this book.

Breakthrough tells an engrossing and important story in a clear and entertaining manner. Both the scientific endeavors -- as a team of scientists protective of their own reputations struggled to find a way to control a killer disease -- and the personal stories -- as young children struggled through near starvation to survive, and as parents struggled through emotional pain to keep their dying children alive -- are thrillingly described. Although some dialogue is fabricated, the authors provide full disclosure of their use of artistic license, and the book remains an excellent factual expose. I highly recommend it!

This book is amazing! It is fascinating to learn about the conditions under which the scientists had to work and it is heart wrenching to think that parents in those days were dealing with a death sentence when a child was diagnosed with Type 1 Diabetes. This book brings these stories to light to tell us what life was like for the families dealing with loved ones diagnosed with diabetes. Thank goodness the scientists persevered in their quest towards the discovery of insulin. Thank you for writing this book so that these stories could be shared with us.

Unfortunately, in telling a wonderful and exciting story, the authors resorted to made-up dialogue - which is fairly common - and made-up situations and actions, which is not acceptable in an historical account. Without a shred of evidence other than their intuition (which is probably accurate), they infer certain things and only reveal this in their discussion of sources at the end of the book - a section of the book that very few people read. This is truly unfortunate; they could have made their book just as exciting and it could have been reliable as well without this dishonest gimmick. Shame on them.

(Seriously, my dumb dog chewed on this book...)

What I really enjoyed about Breakthrough was how well it conveyed not just the history of the discovery and development of insulin treatments, but also how the writing really gave me the feeling of being transported back in time to the early twentieth century when the events took place. The history itself is fascinating. It's so easy to forget in this age of pocket-size glucose meters, sugar substitutes and disposable needles that it wasn't so long ago that a diagnosis of diabetes was a death sentence. And I found the description of the earliest treatments (which primarily involved starvation) very illuminating. It's obvious that the authors went to great lengths to research the events and the characters (there's an exhaustive bibliography and sources section at the end, with a lot of emphasis on memoirs and personal letters), which one would expect in a historical book, but the quality of the authors' narrative really brings this research to life in a way that makes it hard to put the book down. It's sort of like the TV show House if it was set in the 1920's - including crazy substance-abusing doctors challenging the staid medical establishment - and all well documented. The story of Elizabeth Hughes and her family is also fascinating, because unlike today, parents just weren't expected to involve themselves in their children's medical care the way they are now, so there are some incidents of what we might today consider *questionable* parenting. It's a great read and I would recommend it to anyone.

I was expecting a history of insulin-how it was discovered, the details of purifying and testing it, and the problems of large scale production. Cooper and Ainsberg touch on these subjects, but it was far from a detailed description of these events. Instead the book meanders through the lives of several famous Americans a couple Canadians and the odd Scotsman.

The High Points:

>The book was eminently readable, and written in a pleasant tone. I ended up reading it in two sittings, and enjoyed the narrative.

>The history of insulin is presented through the eyes of patients and doctors involved. There were some surprising details about the early treatments for diabetes, which make injections seem mild in comparison.

>There is a smattering of the history and motivations of the medical men behind the discovery, and a peek into the rivals of the academic and research environments.

The Low Points:

>The book goes down a number of blind allies that really do not add to the story, even as background information. Further, the book often skips around from subplot to subplot, which made me impatient to get back to the story.

>The actual discovery and trials of insulin are almost an afterthought to the book. Instead the narrative concentrates on the biographies of the Hughes family, and their political and medical history. Interesting material, but not what I was expecting.

>There were entire "discussions" in the text which appear to be more fabricated than actual history. While it helps the readability, it does diminish from the factual content-especially as some of the relationships were full of conflict.

Summary:

The book is an enjoyable read, but I found it a far more comprehensive review of the Hughes family and the early treatments of diabetes than a history of insulin. it was a disappointment, because the parts of the insulin story that were included hinted at a much richer and more robust story line.

I would recommend it as a general history read, but found it disappointing as a history of science genre. It simply glossed over too many of the details of insulin, and had far too much history and politics, to be considered a science history.