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Suntans, stories, and Harvey Cushing: in conversation with Randi Hutter Epstein

Yale Medicine Magazine, 2018 - Spring


The quest for the perfect tan gave Yale School of Medicine Writer-in-Residence and lecturer Randi Hutter Epstein, MD ’90, MPH, her first lesson in hormones.

As girls growing up in Yonkers in the 1960s, Epstein and her sister spent summers at their grandmother’s pool club trying to attain that just-right shade of nutty brown, said Epstein, author of the new book Aroused: The History of Hormones and How They Control Just About Everything. The siblings couldn’t understand how their grandmother achieved the coppery skin tone they so desired while staying in the shade all day playing canasta.

“We were mystified,” said Epstein, an accomplished medical journalist and author, in a talk about her book at The Yale Bookstore late September. “We were a bit envious. How did she get so tan hidden from the sun?”

The questions were answered a few years later when Epstein was a teenager and her grandmother was diagnosed with Addison’s disease, which is caused by failure to produce enough of the hormone cortisol and whose symptoms include darkened skin. At first, she didn’t really get the connection between hormones and her grandmother’s illness. “To me, hormones were just boobs and sex and your period,” she said.

Later, Epstein learned that hormones were far more, potent chemicals that control everything from metabolism and sleep, to mood and the immune system. What ultimately inspired her to write a book about hormones was the remarkable story of their discovery in the last century and the many questionable and outright false claims that continue to made about them.

“Consider this,” she said. “When (my grandmother) was born in 1900, the word hormone didn’t exist. By the time, she was diagnosed in the 1970s, scientists had a way to spot her hormone defect down the billionth of a gram.”

Epstein regaled listeners with stories of the often-earthy research—one study involved pregnant goats, another dogs copulating in the fetid basement of the then-Grace-New Haven Hospital—that led to major discoveries. She also told stories of the brilliant, sometimes eccentric doctors and scientists who made the discoveries. She credited one of the world’s first successful neurosurgeons, Yale’s own Harvey Cushing, AB ‘91, with pioneering work on hormones, including connecting the brain’s function with the body’s behavior. His famous brain collection, now on display at the Cushing/Whitney Memorial Medical Library, provided vital raw material for early hormone research, she said.

“He’s one of those infuriating Yalies, that did everything so horribly successfully that it’s annoying,” said Epstein of Cushing, who also drew professional grade drawings of his operations and wrote a Pulitzer Prize-winning biography of his mentor.

In spite of huge and continuing leaps in the understanding of hormones, major gray areas persist, Epstein said. The efficacy of testosterone treatment for aging men, for example, remains fiercely controversial, with opposing sides hurling insults at each other like “hormone-phobes” and “endo-criminologists,” she said.

The unscrupulous, meanwhile, exploit misconceptions for commercial purposes, Epstein said, citing the example of a $48 oxytocin spray. That hormone, secreted at birth, has been shown to affect lactation, birth, and, in tests involving rodents and goats, facilitation of the mother-newborn bond. Makers market it as a kind of aphrodisiac—spray it on yourself or in your vicinity and the hot girl or guy next to you will form an instant bond, Epstein said.

“I would say, buy the guy next to you at the bar a drink,” she said. “That’s a better use of your money rather than spraying him with oxytocin.”

Epstein also talked of several remarkable women who made major discoveries, including one who wanted to enter science, but was advised because of her gender to become a secretary to a scientist, which she did, later earning her PhD and winning a Nobel Prize. Another scientist concluded what she was learning in medical school was wrong and proved it while still a student.

The following day, she was joined in Mary S. Harkness Auditorium by Chelsea Clinton. The two talked about accuracy in science journalism, and the importance of ensuring that research took as many variables into consideration as possible. Clinton and Epstein shed light on the birth of the "anti-vaxxer" movement, while Epstein reminded the audience that incomplete understanding of women's health issues such as menopause was a direct outcome of male-centric scientific inquiry during the 20th century.