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

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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 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.


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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 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.

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

  1. 5 out of 5

    Lisa

    I realize that I might be the only one interested in reading this book about the discovery of insulin, but if you've ever known or know someone who needs to take insulin to stay alive, this book is fascinating! The authors follow the scientists who discovered how to extract, use and distribute insulin, and also weave the story of a girl with diabetes and an influential mother and father. I often thank God for those who contributed to the discovery of insulin and all the tools that go along with I realize that I might be the only one interested in reading this book about the discovery of insulin, but if you've ever known or know someone who needs to take insulin to stay alive, this book is fascinating! The authors follow the scientists who discovered how to extract, use and distribute insulin, and also weave the story of a girl with diabetes and an influential mother and father. I often thank God for those who contributed to the discovery of insulin and all the tools that go along with managing diabetes, but now I have names for my prayers. Here's an amazing factoid: before the discovery and use of insulin, patients followed a 400 calorie DAILY diet. Only 400 calories!! Even with that, their life was only extended for 1 year. I'm in my 28th year! I don't often do this, but I'm going to share a passage from the book that touched me and made me cry (the heaving kind of messy cry). I hope I don't get in trouble for quoting some of this dialogue. This is a dialogue between the man who created insulin, Dr. Fredrick Banting and Elizabeth Hughes before she receives her first insulin injection: Dr. Banting: "The only question I have is when would you like to start getting better," he said. "Of all the questions of all the doctors I've seen, no one has ever asked me that." (Elizabeth) He stood up and returned the chair to the desk. "How do you feel about shots?" "Will they make me well?" "Yes, I think they will." "Then I'm crazy about them." Banting . . bent to a locked cabinet in the corner of the room and opened the cabinet door. Elizabeth could see now that it was a kind of icebox and that there was nothing inside but two small brown glass vials. She watched him closely. "Is that insulin?" she whispered. "Yes," he whispered back. He swabbed her thigh with alcohol. She watched him fill the syringe. Just before he injected her he asked, "will you promise me one thing, Miss Elizabeth Hughes? Will you promise me that if you get well - when you get well - you will grow up to be whoever and whatever you want to be and you won't let anyone persuade you to do or be something or someone else?" Elizabeth must have sensed what it had cost Banting to become who he was, what it had cost him to carry the idea of insulin against seemingly impossible odds, repeated failure, and constant debt and doubt, all the way to the office in which they sat now. Or perhaps she had caught a glimpse of a profound loneliness behind his eyes. In any case she nodded solemnly, just before the needle pierced her meager hip. She flinched but did not look away as Banting squeezed the plunger, pressing the murky beige extract into her flesh. Neither Banting nor Elizabeth spoke. Then Banting turned away to discard the empty vial. Then Banting turned away to discard the empty vial. "Wait!" Elizabeth's voice broke the silence. "May I keep it?" "The vial?" "Yes." That, too, was a first for Banting. He placed the vial gently in her palm. She closed her fingers around it. (I need a tissue)

  2. 4 out of 5

    Converse

    The low rating I gave to this book is due to the authors use of fictionalized episodes in the text. The authors disclose this practice, so there is no deception, and I believe that it does make the story-telling flow better than admitting that the authors had to hypothesize what had happened. But I think it is a dubious procedure in a non-fiction book and should be avoided. Breakthrough is about the discovery of a practical way of providing diabetics with insulin in the 1920s. Elizabeth Hughes Go The low rating I gave to this book is due to the authors use of fictionalized episodes in the text. The authors disclose this practice, so there is no deception, and I believe that it does make the story-telling flow better than admitting that the authors had to hypothesize what had happened. But I think it is a dubious procedure in a non-fiction book and should be avoided. Breakthrough is about the discovery of a practical way of providing diabetics with insulin in the 1920s. Elizabeth Hughes Gossett, daughter of Supreme Court Justice, New York governor, and Secretary of State Charles Hughes was one of the first patients to recieve this treatment when it first became available. Elizabeth had been diagonised at having diabetes at age 11. Before recieving insulin, Elizabeth had been on a starvation diet (about 500 calories per day) for several years to keep her alive; she survived on this regime for years, much longer than expected. This diet had been developed by Dr. Frederick M. Allen, who ran a sanitarium in New Jersey were Elizabeth receieved some of her treatment. Several medical doctors and scientists in Canada, working at the University of toronto, developed a way of isolating insulin from animal pancreatic tissue. This development was marred by a good deal of conflict among those involved. Frederick Banting, a surgeon, seems to be the member of the Canadian group who thought of a surgical procedure to collect insulin, though he was unaware the idea had been suggested before. Banting, however, got it to work in dogs and also, from his farming background, realized that slaughterhouses for cattle could often provide fetal calves which would be an excellent source of insulin, as the calves would not have been secreting another enzyme that would have destroyed insulin. BJ. J. R. Macleod at the University of Toronto provided support and lab space to the unknown Banting. MacLoed also got an undergraduate in biochemistry, charles Best, to work with Banting on the project; Best made important contributions and from his subsequent career must have been a skillful scientist. Bertram Collip, a professor of biochemistry from the University of Alberta, who was on a fellowship at the University of Toronto at the time, made important contributions in purifying the extract. Banting and Macleod were jointly awarded the Nobel Prize in 1923, but as they were not on speaking terms by then they did not attend the ceremony in Stockholm. The Eli Lilly company in Indianopolis was crucial in scaling up the procedure and commercializing it. Insulin was one of the earlier examples of academic researchers and a pharmaceutical company working together, with all the patent and intellectual property issues that such collaborations bring up. Among the fictionalized episodes was the dramatic nightime removal of Elizabeth, by her mother Antoinette, from the sanitarium run by Dr Allen and subsequent transporation to Ontario for insulin treatment, and the means by which Elizabeth was jumped to the head of the line for insulin treatment when that was still experimental, supplies of insulin were very low, and numerous other parents was clamoring for the same favoritism.

  3. 4 out of 5

    Maureen Mahowald

    As a mother of two Type 1 diabetics this book was a chilling reminder of how recently insulin was discovered. (Less than 100 years ago.) Prior to its discovery the diagnosis of Type 1 diabetes was a death sentence. This book provides an interesting historical narrative of the discovery and the dramatic personalities who, by chance, combined to discover a treatment which continues to save millions of lives every day.

  4. 4 out of 5

    Brandi D'angelo

    “Well, my plan has been to get drunk and stay drunk long enough for an epiphany to bubble up from the subconscious.” – Frederick Banting 1922. This quote kind of sums up the blood, sweat and tears this man, and many others working with him, put into the discovery and production of insulin in Toronto, Canada 1918-1922. Breakthrough is an amazing story… a miraculous story really. It follows two parallel lives, one of Elizabeth Hughes who was diagnosed with diabetes at age 12, which at that time wa “Well, my plan has been to get drunk and stay drunk long enough for an epiphany to bubble up from the subconscious.” – Frederick Banting 1922. This quote kind of sums up the blood, sweat and tears this man, and many others working with him, put into the discovery and production of insulin in Toronto, Canada 1918-1922. Breakthrough is an amazing story… a miraculous story really. It follows two parallel lives, one of Elizabeth Hughes who was diagnosed with diabetes at age 12, which at that time was a death sentence, and that of Frederick Banting, who would discover a treatment that allowed Elizabeth to live to the age of 73. The authors do a fabulous job of describing the relentless tenacity that these researches had to overcome all the odds and obstacles they faced. There were repeated failures, losses and setbacks. You finish the book with a real appreciation for not only the process of discovery, but of all the work it takes from the discovery phase to mass production of a drug or treatment. I leave you with this quote from Banting: “We do not know whence ideas come, but the importance of the idea in medical research cannot be overestimated. From the nature of things ideas do not come from prosperity, affluence and contentment, but rather from the blackness of despair, not in the bright of day, nor the footlights’ glare, but rather in the quiet, undisturbed hours of midnight, or early morning, when one can be alone to think. These are the grandest hours of all, when the progress of research, when the hewn stones of scientific fact are turned over and over, and fitted in so that the mosaic figure of truth, designed by Mother Nature long ago, be formed from the chaos.”

  5. 4 out of 5

    Lucy

    Breakthrough brings to life the human side of one of the most important discoveries in modern medicine, the discovery of insulin. The complete title of the book is BREAKTHROUGH: Elizabeth Hughes, the Discovery of Insulin, and the Making of a Medical Miracle, and to me there are many miracles in this story. First, there's the discovery itself, which took place in a dirty lab in Toronto under the most unlikely summer conditions. Second, there's the unbelievable result that insulin provided to real Breakthrough brings to life the human side of one of the most important discoveries in modern medicine, the discovery of insulin. The complete title of the book is BREAKTHROUGH: Elizabeth Hughes, the Discovery of Insulin, and the Making of a Medical Miracle, and to me there are many miracles in this story. First, there's the discovery itself, which took place in a dirty lab in Toronto under the most unlikely summer conditions. Second, there's the unbelievable result that insulin provided to real-life historic figures who were on death's door, weak and starving, but were rejuvenated due to insulin. Third, there's the ultimate ability to distribute insulin to people with diabetes everywhere, and this part of the story is full of shocks and surprises, difficulties and heartaches, and even fistfights! I never before realized what it takes to turn a new treatment into a product for the masses. Eli Lilly's family is now firmly on a pedestal in my mind.

  6. 4 out of 5

    Shane Phillips

    This was an amazing insight into the discovery, testing, and production of the Insulin. I like the way the writers focused a lot on the researchers but interweaving Elizabeth Hughes story. She survived years on a starvation diet down to 54 lbs before getting Insulin that gave her a real life and she then hid her diabetes history (that is an story in itself). My mom is a 50+ year diabetes survivor and until recently I had never thought to investigate this story. So glad I did.

  7. 5 out of 5

    Megan Beatie

    This story is close to my heart, since I have been insulin dependent for 15 years.

  8. 4 out of 5

    Eileen

    I had no idea how the discovery of insulin and how to make it and use it happened. This is an amazing story, what those children had to endure in an effort to survive was pure torture. Elizabeth was stalwart, had a good support network including a private caregiver and plenty of money and she went through so much. I can't imagine what it must have been like for what was probably the majority of children who didn't have her advantages. Some of the descriptions are heart rending. The people involv I had no idea how the discovery of insulin and how to make it and use it happened. This is an amazing story, what those children had to endure in an effort to survive was pure torture. Elizabeth was stalwart, had a good support network including a private caregiver and plenty of money and she went through so much. I can't imagine what it must have been like for what was probably the majority of children who didn't have her advantages. Some of the descriptions are heart rending. The people involved in the events all had, skills, knowledge and dedication to offer and of course some had money but circumstances had to conspire to bring them together and then because they had such difficulty working together it's amazing that anything got done. There is more drama here, especially with Frederick Banting, than in most fiction books. Keep in mind though that some of it is fictionalized in order to tell the story. Something which I dislike in non-fiction. The research for this book was well done and it is evident and documented in the book. I was excited to see that Toronto played a key role since I'll be visiting there soon but it sounds like from the author's notes I won't find much evidence there of this important part of history and the people involved. This discovery earned Canada its first Nobel Prize and wasn't all that long ago but the players and the story have almost been completely forgotten. This story is almost on par with The Immortal Life of Henrietta Lacks by Rebecca Skloot and I say almost because I think Skloot's book was able to take the story to a much more personal level with the family and her journey writing it. However, Elizabeth Hughes made a concentrated effort to erase most of the personal evidence of her illness and any documentation related to it and maintained silence about it for the rest of her life after she left Toronto and unlike Skloot's case, where she could speak to people directly involved, all the players were gone thus making it an incredible challenge to reconstruct the events and bring the characters to life. Cooper and Ainsberg do an admirable job. Today we don't think of Diabetes as an awful illness, a death sentence, and take a lot for granted surrounding the treatment available. To appreciate where you are you need to know where you came from and this book is an eyeopener not just about the research done to discover insulin and other treatments for diabetes but how the whole pharmaceutical industry and research world was changed in the process. It's sometimes so hard to get your mind to wrap around how things happen and what tiny little events can mean in making a miracle. It's like that for me with this story.

  9. 5 out of 5

    Nancy

    An entertaining lay history of the 1922 discovery of insulin through the lives of Elizabeth Hughes (the daughter of politician C. E. Hughes and who, at age 13, was diagnosed with type 1 diabetes) and the doctors, researchers and the pharmaceutical company who saved her and ultimately millions of others. Frederick Allen, the individual responsible for the widely accepted pre-insulin "starving method," Frederick Banting, Charles Best, and James Collip, the ultimate inventors of insulin, their "ment An entertaining lay history of the 1922 discovery of insulin through the lives of Elizabeth Hughes (the daughter of politician C. E. Hughes and who, at age 13, was diagnosed with type 1 diabetes) and the doctors, researchers and the pharmaceutical company who saved her and ultimately millions of others. Frederick Allen, the individual responsible for the widely accepted pre-insulin "starving method," Frederick Banting, Charles Best, and James Collip, the ultimate inventors of insulin, their "mentor" J. R. Mcleod, and the Lilly family, among others, all play big roles in this drama about one of the biggest medical and pharmaceutical successes of the 20th century. With well-researched story lines, authors Cooper/Ainsburg paint a powerful picture of all these players, who had not only their own egos and ideas to manage, but had to deal with an unprecedented North American struggle for bragging rights. Meanwhile, and most importantly, they had to swallow watching their patients dying by the dozens while they were only a few steps away from creating a miracle. The authors don't really answer until the Notes section at the end why we care so much about Elizabeth Hughes, however. She wasn't even remotely the first person to be treated with insulin, nor does her story read as particularly interesting. What they find, however, is that she, like so many others from that generation, chose not to recognize publicly that they had diabetes once/if they reached adulthood, which is where this story ends with her. Once Elizabeth was "cured" by insulin, she never mentioned diabetes out loud again-- Not in her family's biographies, her will, or to the press. What makes her story truly fascinating happens after the fact-- that a woman of such high standing with so much influence, chose to publicly ignore for 50 years that she, a patient of the great Frederick Banting, had a substantial disease until her dying day. Additionally, I don't particularly understand why Cooper/Ainsberg chose to fabricate (as they admit in their Notes) certain scenes and exchanges of dialogue in this complex story. I think it would have been fine (better!) without them. Do we really think Banting said to McLeod "Look, I get you." when requesting funding? ugh, no. These segments never added to the story. Overall, I found this very entertaining. It made me rethink how our our idea of a "cure" is perpetually changing....

  10. 5 out of 5

    Leigh

    This is a story that is very close to my heart. On November 23rd 2016 after living with and fighting this disease for 50 years it finally caught up with my mother. Just two weeks shy of her 60th birthday she went in for triple bypass surgery and didn't come out. The culprit was calcified veins a result of having diabetes for so long. Insulin is truly a remarkable discovery. Without it my brother and I would never have been born, my father wouldn't have met and married the love of his life. Countl This is a story that is very close to my heart. On November 23rd 2016 after living with and fighting this disease for 50 years it finally caught up with my mother. Just two weeks shy of her 60th birthday she went in for triple bypass surgery and didn't come out. The culprit was calcified veins a result of having diabetes for so long. Insulin is truly a remarkable discovery. Without it my brother and I would never have been born, my father wouldn't have met and married the love of his life. Countless others would not have been given a chance of life certainly not a long one. Insulin has added years and quality to the lives of diabetics world wide but it is not a cure and only a treatment and many seem to have lost sight of that. To the book. I decided to go middle of the road on this one. The story is an important one and needs to be told. This book doesn't do a great job of that. Lots of fictionalized dialogue and events lots of sections of the book had little to nothing to do with insulin at all. I was bored at times and skimmed pages. I was also disappointed the main focus was Elizabeth Hughes. It would be nice to hear other stories, maybe from people who come from middle class backgrounds just to get a different perspective on the disease and prognosis before there was a treatment. Hughes was unique given her famous father and money and access to doctors one wonders what someone from a background like my own would be up against. However there was some good in this book it was readable and engaging especially for those who enjoy history. For anyone who wants a shorter, more concise and less fictional version of this story I recommend The Fight to Survive by Caroline Cox.

  11. 4 out of 5

    Beth

    I read this book because I just took a job in a diabetes business unit and wanted--as a layman--to learn more about the disease the therapy. Since I enjoy historical fiction, this was an easy book to read because the authors took poetic license here and there to create drama in the story. My biggest take away was that people who do amazing things aren't necessarily the smartest person in their class, the most affluent or attractive and maybe not even an expert in the cause they pursue. But they a I read this book because I just took a job in a diabetes business unit and wanted--as a layman--to learn more about the disease the therapy. Since I enjoy historical fiction, this was an easy book to read because the authors took poetic license here and there to create drama in the story. My biggest take away was that people who do amazing things aren't necessarily the smartest person in their class, the most affluent or attractive and maybe not even an expert in the cause they pursue. But they are somehow consumed by a passion and never get deterred--not by naysayers, lack of funding and even lack of decent food and shelter. These are extraordinary people who are fascinating to read about. And to whom we owe a huge debt of gratitude.

  12. 4 out of 5

    Whitney

    I know that not everyone will be interested in the discovery of insulin but this is a great book for those who are. It is written like a novel so very easy to read. Profiles several fascinating historical figures, including Charles Evans Hughes -- famous New York lawyer who was governor of New York, ran for President and sat on the Supreme Court, and who's daughter had Type 1 diabetes. Treatment of diabetics before insulin also very interesting -- including near-starvation diet that actually kep I know that not everyone will be interested in the discovery of insulin but this is a great book for those who are. It is written like a novel so very easy to read. Profiles several fascinating historical figures, including Charles Evans Hughes -- famous New York lawyer who was governor of New York, ran for President and sat on the Supreme Court, and who's daughter had Type 1 diabetes. Treatment of diabetics before insulin also very interesting -- including near-starvation diet that actually kept many alive long enough for cure.

  13. 4 out of 5

    Melanie

    Heard about this on WFYI publc radio show "Sound Medicine." Fascinating story with several prominent early 20th c. people involved and an Indianapolis connection through Eli Lilly. It would have been more compelling if Elizabeth Hughes had not destroyed most of the record of her childhood diabetes--apparently she was determined to be "normal"--she lived to 72-- and only her closest relatives knew she was diabetic. Heard about this on WFYI publc radio show "Sound Medicine." Fascinating story with several prominent early 20th c. people involved and an Indianapolis connection through Eli Lilly. It would have been more compelling if Elizabeth Hughes had not destroyed most of the record of her childhood diabetes--apparently she was determined to be "normal"--she lived to 72-- and only her closest relatives knew she was diabetic.

  14. 5 out of 5

    Amy

    Excellent, moving history of how insulin was discovered and became available to diabetics. Obviously, this is a a story that I find particularly meaningful. I'm so thankful for God's gift of modern medicine! Excellent, moving history of how insulin was discovered and became available to diabetics. Obviously, this is a a story that I find particularly meaningful. I'm so thankful for God's gift of modern medicine!

  15. 5 out of 5

    Sarah Beth

    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 pr 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. 3.5 stars

  16. 4 out of 5

    Chris

    An enjoyable fictionalized account of the discovery of insulin and Elizabeth Hughes' experience as a diabetes patient in the pre- and post-insulin periods. Cooper and Ainsberg clearly did a ton of research and usually did a good job of working it in organically (every so often there was an irrelevant fact or digression). I was also impressed that two people could have such a coherent shared writing "voice." Some reviewers have objected to the "fictionalized" nature of this book, but it's not any An enjoyable fictionalized account of the discovery of insulin and Elizabeth Hughes' experience as a diabetes patient in the pre- and post-insulin periods. Cooper and Ainsberg clearly did a ton of research and usually did a good job of working it in organically (every so often there was an irrelevant fact or digression). I was also impressed that two people could have such a coherent shared writing "voice." Some reviewers have objected to the "fictionalized" nature of this book, but it's not any different than what authors like Candice Millard and Erik Larson do. I don't mind literary nonfiction, especially when the authors tell you where their sources ended and their extrapolation began, as Cooper and Ainsberg do in their postscript. If you want the hard-core history version of these events, read Bliss's "The Discovery of Insulin." Oh--and definitely read this one instead of Cox's "The Fight to Survive." Cooper and Ainsberg's info about type 1 diabetes was usually accurate, but in the postscript they weren't as careful. For example, the language about how many people today have diabetes and don't know it pertains more to people with type 2 diabetes; type 1s don't experience "pre-diabetes" in the same way. --------------------------------------------------- Read as part of the Diabetes Memoir Project, in which I am reading my way through 8 commercially published (i.e., not self-published) biographies/memoirs of people with type 1 diabetes (i.e., not parents of children with type 1 diabetes) treated with injections/insulin pump (i.e., not a transplant), in chronological order by the person’s date of diagnosis. The titles are: - Breakthrough: Elizabeth Hughes, the Discovery of Insulin, and the Making of a Medical Miracle by Thea Cooper and Arthur Ainsberg (Elizabeth was diagnosed in 1918 at age 11) - Borrowing Time: Growing Up with Juvenile Diabetes by Pat Covelli (diagnosed in 1964 at age 10) - Growing Up Again: Life, Loves, and Oh Yeah, Diabetes by Mary Tyler Moore (diagnosed in 1969 at age 33) - Sweet Invisible Body: Reflections on a Life with Diabetes by Lisa Roney (diagnosed in 1972 at age 11) - Needles: A Memoir of Growing Up with Diabetes by Andie Dominick (diagnosed in 1980 at age 9) - Not Dead Yet: My Race Against Disease: From Diagnosis to Dominance by Phil Southerland (diagnosed in 1982 at age 7 months) - The Sugarless Plum: A Ballerina’s Triumph Over Diabetes by Zippora Karz (diagnosed in 1987 at age 21) - The Insulin Express: One Backpack, Five Continents, and the Diabetes Diagnosis that Changed Everything by Oren Liebermann (diagnosed in 2014 at age 31)

  17. 5 out of 5

    Asma

    The book tells the story of the discovery of insulin and everyone that has been instrumental to it in a very attractive way. While this book is essentially nonfiction. It tells the events that went down during the discovery, the feuds that went down between the original team of discoverers, the greatly debated Nobel prize and the story of Elizabeth Hughes. You'll notice that there's a lot of touch ups that the autohors felt necessary to fill in gaps. The story has been "augmented" for narrative The book tells the story of the discovery of insulin and everyone that has been instrumental to it in a very attractive way. While this book is essentially nonfiction. It tells the events that went down during the discovery, the feuds that went down between the original team of discoverers, the greatly debated Nobel prize and the story of Elizabeth Hughes. You'll notice that there's a lot of touch ups that the autohors felt necessary to fill in gaps. The story has been "augmented" for narrative purposes. We certainly have no way of knowing what exactly went through Banting's head as this or that happened. I felt like I was being cheated. It may have made the story more appealing to others but that was at the expense of its integrity. Now I have read The Discovery of Insulin by Micheal G. Bliss. An excellent book if you're looking for an impartial recount. Highly recommended. Yes, lots of jargon, research talk and numbers but at lest you're getting the real deal. So for the most part I already knew everything there is to know. But there were some worthy details that I'm glad I didn't miss out on. Like Teddy Ryder's birthday story where Banting comes in dressed in a pink dress. And I liked the focus on Elizabeth Hughes. Her struggle is kind of an inspiration. Basically this is what happens when you turn a book into a movie (or another book in this case). Details like "the sun that dappled upon heads of the family members, the knot between the eyebrows, the apprehension felt at a paricular moment" have no place in a nonfiction. If the discovery of insulin wad turned into a movie, this would be its script. A touch of fiction can't hurt anyone right? Except for the integrity of the story. At some points I'd stop and think did that really happen or was this another postulation by the authors. Ideally I'd have given it a 5 but I'm inclined to mark it down after the authors' of fictionalization of medical history. I enjoyed it nonetheless.

  18. 5 out of 5

    J.S.

    Elizabeth Hughes was the eleven year-old daughter of a prominent and popular American politician when she was diagnosed as a diabetic. There was no cure and few survived more than a year. The only treatment was a carefully monitored starvation developed by Dr. Frederick Allen. By gradually decreasing the caloric intake to control blood-glucose levels, he managed to keep patients alive longer in the belief that a cure was imminent. Elizabeth's weight eventually dropped below 50 lbs, and many wond Elizabeth Hughes was the eleven year-old daughter of a prominent and popular American politician when she was diagnosed as a diabetic. There was no cure and few survived more than a year. The only treatment was a carefully monitored starvation developed by Dr. Frederick Allen. By gradually decreasing the caloric intake to control blood-glucose levels, he managed to keep patients alive longer in the belief that a cure was imminent. Elizabeth's weight eventually dropped below 50 lbs, and many wondered if the treatment wasn't worse than the disease. In Toronto, the volatile Dr. Frederick Banting, an army surgeon during WWI, had had an inspiration while researching the disease on behalf of a friend who had recently been diagnosed. Although not a researcher, and having questionable medical skills beyond amputation, he convinced Dr. J. J. R. Macleod to fund the research which led to the refinement of insulin from animal pancreases. The story of the discovery and development of insulin is an exciting and compelling read - I couldn't put it down at times. It doesn't just read like a novel, though; it sounds like a movie. The authors have written with plenty of cinematic flourishes that bring the story to life in a way that I could see it in my mind (and the way it's told, this is a story that could easily be made into a movie). Unfortunately, for me that was also the greatest negative. The book is filled with invented dialog and situations where emotions and thoughts are presented. I found myself frequently thumbing to the notes in the back to see if there was any justification for such vivid descriptions - entries in someone's journal, etc. - but found nothing. Those who don't read history as often will probably not be annoyed at this, however, and with the scarcity of information (most of the principal figures in this drama won't even be found on Wikipedia) perhaps necessitates such liberty. In spite of that, it's a fascinating story.

  19. 5 out of 5

    Tina Carstens

    I debated if this was worth 4 or 5 stars... It was hard to start and keep going on but once I had some dedicated time to read I couldn't put it down. This book. Phew. It tells a story of the discovery of insulin and the fight to make it available for all. In the 1920's, people diagnosed with diabetes were sentenced to death. They essentially starved to death. It was a terrible death. There were two doctors though that changed everything. One developed a strict diet plan to keep diabetics alive f I debated if this was worth 4 or 5 stars... It was hard to start and keep going on but once I had some dedicated time to read I couldn't put it down. This book. Phew. It tells a story of the discovery of insulin and the fight to make it available for all. In the 1920's, people diagnosed with diabetes were sentenced to death. They essentially starved to death. It was a terrible death. There were two doctors though that changed everything. One developed a strict diet plan to keep diabetics alive for as long as he could. They patients would lose weight and only consume small amounts of calories but they would find the balance between life and death in hope that a cure would be found. The other doctor worked to develop insulin and make it safe for use. Those first patients went from skin and bones to healthy, happy people in a matter of days. Amazing. As a parent of a child with Type 1 Diabetes, we are forever grateful to Dr Banting and others that discovered this life saving medicine. The insulin we use today is nearly identical to what they developed in 1922! The story telling was ok. Not the most awesome writing but the weaving of different stories like that of Elizabeth Hughes was very interesting. For much of the book I was bothered by how the authors make up dialogue and story arks that they didn't have the information for... But as I read the after notes I think they did actually make good assumptions and ones that needed to be made to tell the whole story. And they didn't change the full impact of this important medical history!

  20. 4 out of 5

    Meg

    I thought that this book was a fascinating read. The authors did a great job personifying the patients and scientists involved in discovering insulin. As a story, the plot and characters were well-drawn and flowed nicely. However, I worried that the documentation was inadequate for certain scenes, particularly those related to Elizabeth Hughes's involvement in early insulin trials in Toronto. In the afterword, the authors note that there is no evidence that Charles Hughes intervened to get Elizab I thought that this book was a fascinating read. The authors did a great job personifying the patients and scientists involved in discovering insulin. As a story, the plot and characters were well-drawn and flowed nicely. However, I worried that the documentation was inadequate for certain scenes, particularly those related to Elizabeth Hughes's involvement in early insulin trials in Toronto. In the afterword, the authors note that there is no evidence that Charles Hughes intervened to get Elizabeth into the trials. Similarly, there is not evidence that there was a middle-of-the-night departure from Allen's sanitarium. They note that this would have been in character for Elizabeth's mother, but this does not help explain how a nonfiction book can take such extreme liberties with dialogue and plot. In some ways, the fact that this is a nonfiction book makes the liberties taken more egregious since it impacts the way that future researchers, historians, and the general public will view the lives of actual human beings. On the basis of relatively slim information, entire lives were constructed and the resulting story was neatened. This makes for an excellent book, but less excellent history.

  21. 4 out of 5

    Alicia

    Such an amazing story about the history of insulin and those who created and refined the formula. Definitely deserving of the Noble Prize. It was nice to get kind of a "wrap up" in the last few pages of how everyone in the book ended out. The most surprising thing is that the the "heroine" of the story, Elizabeth Hughes, never wanted anyone to know she had diabetes. The book thinks this is because of the way that she went about getting the cure (I won't spoil it for you, it's kind of heart pacing Such an amazing story about the history of insulin and those who created and refined the formula. Definitely deserving of the Noble Prize. It was nice to get kind of a "wrap up" in the last few pages of how everyone in the book ended out. The most surprising thing is that the the "heroine" of the story, Elizabeth Hughes, never wanted anyone to know she had diabetes. The book thinks this is because of the way that she went about getting the cure (I won't spoil it for you, it's kind of heart pacing how it happens) but I wonder if there is another reason behind it. Who knows. She's not talking, and she never told anyone. Oh, and if you are a member of PETA, don't read this book. Because you will say that medicine didn't need to kill all those dogs to find the cure. But I think about the pictures of some of the kids in the middle of the book and I want to tell those PETA wackos to shut your mouth. If I were a mother during that time and had to watch my child go through that, I would shoot every dog in NYC to get them better. Harrowing. Heartbreaking. Stunning to think that the best way to treat diabetics during this time was to starve them (max 500 calories a day diet). This story is a page-turner. If you aren't into non-fiction, this one will suck you in.

  22. 5 out of 5

    Cyndi

    This book attempts to examine individuals who were instrumental in the breakthrough to mass produce insulin. There was a number of years where scientists knew that sugar and the pancreas was involved but attempts to reliably produce insulin and replicate results were disheartening. I did not know that the method of dealing with those who were diabetic was to basically put them on a starvation diet. There were a few pictures that showed the children before they were given insulin and then after. This book attempts to examine individuals who were instrumental in the breakthrough to mass produce insulin. There was a number of years where scientists knew that sugar and the pancreas was involved but attempts to reliably produce insulin and replicate results were disheartening. I did not know that the method of dealing with those who were diabetic was to basically put them on a starvation diet. There were a few pictures that showed the children before they were given insulin and then after. They were basically skeletons and then you wouldn't know what they had suffered through. It is miraculous. Dr. Allen worked with these children and while some said it was wrong to prolong their lives by subjecting them to starvation, he did keep many of them alive to receive treatment. A big part of the book has to do with how egos came into play and how people tried to claim credit with being the first. Much of it was interesting but I wanted to reach through the book and tell these men to see what was at stake. Those who received the Nobel Peace Prize and had their names on the patents received lots of fame and fortune but the child who could live a normal life should mean more than either of these.

  23. 5 out of 5

    Marnie

    This book takes us back to a time when children lived only a matter of months, after being diagnosed with diabetes. The only treatment available was a near starvation diet of a few hundred strictly chosen calories a day. Parents had to make the painful choice to watch their child waste away on the starvation diet, hoping a cure would come along, or let the child live normally and die within weeks. It's an unimaginable choice to have to make and the odds were terrible. This book covers the time j This book takes us back to a time when children lived only a matter of months, after being diagnosed with diabetes. The only treatment available was a near starvation diet of a few hundred strictly chosen calories a day. Parents had to make the painful choice to watch their child waste away on the starvation diet, hoping a cure would come along, or let the child live normally and die within weeks. It's an unimaginable choice to have to make and the odds were terrible. This book covers the time just before and during the discovery of a stable form of a pancreatic extract (insulin) that would treat diabetes, and tells the stories of the individuals involved. As with The Immortal Life of Henrietta Lacks, this is a medical history book and biography all in one. While the history of medicine, on its own, is fascinating and enlightening, it's the stories of the people involved that help you appreciate the advancements all the more.

  24. 5 out of 5

    Erin

    I DNFed this half way through. I only recommend this to people who like biographies and American politics after the first World War. I am very disappointed to say that I really, REALLY dislike this book. The writing wasn't bad, and actually flowed quite well, but this isn't about insulin as much as I thought it would be. I thought this would be more of a book about the science, the clinical trials, and the push for production of insulin. There is information about Diabetes and the standard treat I DNFed this half way through. I only recommend this to people who like biographies and American politics after the first World War. I am very disappointed to say that I really, REALLY dislike this book. The writing wasn't bad, and actually flowed quite well, but this isn't about insulin as much as I thought it would be. I thought this would be more of a book about the science, the clinical trials, and the push for production of insulin. There is information about Diabetes and the standard treatments back before the discovery of insulin, but this book talks more about the biography of the men and various other people involved with the discovery and the production. This also goes over the politics in America during that time, which isn't something I think is relevant to the discovery of insulin. There was also a lot of speculative conversations between various people, which really bothered me since I didn't really understand the point of it. This book was such a bummer for me personally. Read 129/247 pages.

  25. 4 out of 5

    Michelle

    This book details the development of insulin as a therapy for diabetes. The keystone for the book is Elizabeth Hughes, a young girl diagnosed with diabetes, and daughter of the politician and jurist, Charles Evan Hughes. The book describes the early pioneer in the U.S. of severe dietary restriction to keep diabetics alive, Frederick Allen, and then moves forward to the research efforts to understand diabetes in animal models, primarily through the work of Frederick Banting and Charles Best in th This book details the development of insulin as a therapy for diabetes. The keystone for the book is Elizabeth Hughes, a young girl diagnosed with diabetes, and daughter of the politician and jurist, Charles Evan Hughes. The book describes the early pioneer in the U.S. of severe dietary restriction to keep diabetics alive, Frederick Allen, and then moves forward to the research efforts to understand diabetes in animal models, primarily through the work of Frederick Banting and Charles Best in the laboratory of MacLeod. The University of Toronto was key for the initial development, but without the intervention of the pharmaceutical company, Lilly, the preparation of sufficient quantities of drug to supply those in need would not have occurred. Understanding the sheer mass of of pancreas needed to purify insulin is stunning; more than 2 tons are needed to purify 8 ounces of insulin. The book chronicles the successes and failures along the way, and does a brief summary of the revolution provided by Genentech’s creation of a recombinant form of insulin.

  26. 5 out of 5

    Ngaio

    I found this to be an engaging read on a topic that I didn't know much about, but which turned out to be fascinating. I vaguely realized that before insulin diabetes was fatal, but I hadn't really put too much thought into it. The fact that it was so prevalent and that it led so immediately to death with almost no option for treatment was startling. The authors were very good at portraying the human side of the science. I would have liked to hear more stories of other families that were struggli I found this to be an engaging read on a topic that I didn't know much about, but which turned out to be fascinating. I vaguely realized that before insulin diabetes was fatal, but I hadn't really put too much thought into it. The fact that it was so prevalent and that it led so immediately to death with almost no option for treatment was startling. The authors were very good at portraying the human side of the science. I would have liked to hear more stories of other families that were struggling with this rather than just the one, but the Hughes were interesting in their own way. I didn't like that the authors chose to fictionalize so much of the story (inventing episodes and whole sequences of events as well as dialogue). It's one thing to guess at how a historical conversation went: it's another to fabricate people's actions. It was a very interesting read, but I would hesitate to use it as a source and would recommend it be supplementary rather than primary material.

  27. 4 out of 5

    Leslie Zampetti

    Breakthrough is a fascinating exploration of the history and people involved in the discovery of insulin. Prior to this development, most people with diabetes died within a year or less - especially children diagnosed with Type 1 diabetes. Cooper and her co-author have researched this history minutely; however, they've chosen to frame their subject in narrative nonfiction, creating a story as gripping as any thriller. Focusing on Elizabeth Hughes Gossett, daughter of Charles Evans Hughes, a noted Breakthrough is a fascinating exploration of the history and people involved in the discovery of insulin. Prior to this development, most people with diabetes died within a year or less - especially children diagnosed with Type 1 diabetes. Cooper and her co-author have researched this history minutely; however, they've chosen to frame their subject in narrative nonfiction, creating a story as gripping as any thriller. Focusing on Elizabeth Hughes Gossett, daughter of Charles Evans Hughes, a noted lawyer, jurist, and politician of his day, Breakthrough uses Elizabeth's story to put a human face to all of the victims of the disease, as much as it traces the discovery's path through the lives and work of the scientists involved. A subplot highlights the efforts of the Lilly company in creating today's model of pharmaceutical research as it fought to bring insulin to market. Well worth reading!

  28. 4 out of 5

    Brian

    Breakthrough provides an excellent look at the business, political, scientific and human side of the race to find insulin. From the starvation of patients under Dr. Allen who hoped to only keep them alive until a cure could be found to the testing of pancreas glands of various animals in Canada that led to the development of insulin this book shows how it all came together. It covers the fights (including fistfights) of the development team in Canada and the mass production that would make Eli L Breakthrough provides an excellent look at the business, political, scientific and human side of the race to find insulin. From the starvation of patients under Dr. Allen who hoped to only keep them alive until a cure could be found to the testing of pancreas glands of various animals in Canada that led to the development of insulin this book shows how it all came together. It covers the fights (including fistfights) of the development team in Canada and the mass production that would make Eli Lily into the powerhouse that it is today. It is a heart wrenching story of a race against the clock where death was a constant specter for those who suffered from diabetes. The only option was starvation of sometimes as little as 400 calories a day while waiting for a cure to be developed. As testing occurred around the world it would be Canada who discovered the cure and lead to the first Nobel Prize for that country. Very easy to read and well worth the time.

  29. 4 out of 5

    Jen

    I had this book on my "to read" list for quite awhile, but was afraid it might be boring. I'm generally not a non-fiction fan, and although I love science and work in the pharma industry, I wasn't sure I wanted to read a book about this subject. But somewhat surprisingly, I loved this book and could hardly put it down. I'm a bit embarrassed, as a scientist and proud Canadian, to realize how woefully little I knew about Banting and the discovery of insulin. I didn't know anything about the horrif I had this book on my "to read" list for quite awhile, but was afraid it might be boring. I'm generally not a non-fiction fan, and although I love science and work in the pharma industry, I wasn't sure I wanted to read a book about this subject. But somewhat surprisingly, I loved this book and could hardly put it down. I'm a bit embarrassed, as a scientist and proud Canadian, to realize how woefully little I knew about Banting and the discovery of insulin. I didn't know anything about the horrific diabetes treatments used in the early 20th century, and also didn't realize the pivotal role this discovery played in the creation of the modern pharmaceutical industry. The characters are almost too interesting to be believed; it's amazing that so many high-profile people were involved. Overall a great read, and I learned even more than I expected to.

  30. 4 out of 5

    Heather Ivy

    The writing style of this book is not my favorite. It was informative and interesting, but I'd rather have more of the facts, not recreated thoughts and actions (possibly based on letters?). It felt like the basic story was padded out to make enough pages for a book. The one example that comes to mind is when Dr. Allen is walking to the house of Elizabeth Hughes, to give her parents the bad news that she had diabetes and how long she had to live. The author describes the doctor's thinking along t The writing style of this book is not my favorite. It was informative and interesting, but I'd rather have more of the facts, not recreated thoughts and actions (possibly based on letters?). It felt like the basic story was padded out to make enough pages for a book. The one example that comes to mind is when Dr. Allen is walking to the house of Elizabeth Hughes, to give her parents the bad news that she had diabetes and how long she had to live. The author describes the doctor's thinking along the way, his decision to not hail a cab and a moment described in detail of the doctor stopping to look at his expression in a clothing shop window. It just all seemed so contrived and unnecessary. Maybe in some letter, Dr. Allen described this event in great detail, so it could be authentic, but my impression was that is was just fluff added by the author.

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