Two science journalists examine the fascinating history of medical science’s flawed attempts to manipulate height and the ethics involved. In the first section, set primarily in the 1950s and 1960s, they discuss middle-class families who were urged to try to reduce their daughters’ height before it was too late for them to be “successful adults.” The tall girls were given estrogens to send them prematurely into puberty and force their growth plates to close. In the second half, the authors focus on the use of human-growth hormone to increase the height of naturally short children. Before synthetic-growth hormone was developed, there was a painstaking procedure for extracting it from cadaver pituitary glands. This defective process led to the spread of neurological diseases as horrible as Creutzfeldt-Jakob disease (the human version of mad cow). Interestingly, neither the growth hormone nor the estrogen resulted in systematically proven results. This startling look at medical ethics and history has implications for the future of “human improvement” therapies; recommended for large academic and public libraries.
Sobering story of what parents, and doctors, will do to help short and tall children become “normal.”
In the 1930s and ’40s, popular magazines and newspaper columnists warned that tallness could be a handicap for a girl and shortness could turn boys into sissies or young Napoleons who faced bias in the job market. Such societal views prompted parents of children outside the height norms to turn to the controversial therapies detailed in this information-packed book. Medical journalists Cohen and Cosgrove begin with the FDA’s approval in 1941 of diethylstilbestrol (DES), a synthetic form of estrogen administered at Massachusetts General and other medical centers to inhibit growth in tall girls. The drug encouraged early puberty and had many side effects; its use to “treat” an inherited trait (height) was immediately controversial. Nonetheless, DES in large doses slowed growth and quelled parental anxieties, which later dissipated as tallness in females became more socially acceptable, and fewer girls received estrogen treatment. In the ’50s, Yale chemist Alfred Wilhelmi and others began using anabolic steroids, which include synthetic testosterone, to spur growth in short boys. Through the stories of patients and scientists in the United States and abroad, the authors examine the rise of the vast growth-hormone industry, which skyrocketed in the ’80s when Genentech developed a biosynthetic hormone. By the ’90s, many children whose bodies produced growth hormones were receiving still more by prescription, despite the fact that the long- term safety and effectiveness of the drugs remained uncertain. Meanwhile, complications continued to surface in women who took DES years ago. The authors question the motives of all the key playersùparents, doctors, drug companiesùand note that there have been many more incentives to encourage treatment with hormones than to study the drugs’ long-term effects. “Once a treatment exists, its existence becomes a reason to use it,” they lament.
Solid reporting on the reckless use of medical technology for socially dubious ends.
ù Kirkus Reviews
Part 1. drug turns young amazons into beauties
Chapter 1. “Tallness Can Be a Real Handicap for a Girl”
Chapter 2. Playing God with Hormones
Chapter 3. Two Girls, Two Continents
Part 2. helping the dwarfed children
Chapter 4. “A Gland Lost Is a Gland Wasted”
Chapter 5. “No Patient Seems to Have Caught Anything”
Chapter 6. “Soon. Very Soon. . .”
Part 3. to market, to market. . .
Chapter 7. “Only Genentech Is Not in Mourning”
Chapter 8. Dear Parent. . .
Chapter 9. “Never Before in the History of Medicine”
Part 4. reckonings
Chapter 10. Absence of Evidence Is Not Evidence of Absence
Chapter 11. Friendly Fire
Part 5. $35,000 an inch—and growing
Chapter 12. A Disease Is Born
Chapter 13. Now What?
Conclusion: A New Normal?