Wednesday, January 31, 2024

Q&A with Eugene M. Helveston




Eugene M. Helveston, M.D., is the author of the new book Death to Beauty: The Transformative History of Botox. It focuses on the work of the late Dr. Alan Scott, a colleague of Helveston's. Helveston is the author or co-author of three ophthalmology textbooks, and he lives in Indianapolis.


Q: What inspired you to write Death to Beauty?


A: As a strabismologist colleague of Alan Scott from the ‘60s, I followed his work with the drug from the beginning, joined his clinical drug trials in the ‘80s, and was an early user of the drug that became Botox.


I realized Scott had had accomplished a monumental feat on his own, but few knew about the man and fewer understood the obstacles he faced.


By 2021 there were few of us who knew Scott and were involved at the beginning. If his remarkable story were to be told it must be done now. To the best of my knowledge nobody had done it, few could, and no one was in the process.


This urgency was validated with Scott’s death in December 2021 at 89. In the six months that he cooperated with the book project we communicated with email, letters, phone, and Zoom conferences. The book contains first-hand accounts from Scott that are available nowhere else.


The immediate acceptance of the book proposal by Indiana University Press in June was the start of the three-year project.


Q: The writer Dana Berkowitz said of the book, “A riveting text that bridges biography, history, and medicine, Death to Beauty is a must-read for anyone interested in the story of how Dr. Alan Scott, working almost independently and with few resources, transformed the world's deadliest toxin into a wonder drug...” What do you think of that description?


A: It does justice to the book.


Q: How did you research the book, and what did you learn that especially surprised you?


A: The opportunity to speak with Alan Scott was the most important research. Next was my own recollections of meeting with Scott in the early ‘80s when I watched him treating patients and subsequently joined the clinical trials that I participated in for seven years.

Later I had a brush with the new owner of the toxin when I was recruited to join a panel overseeing the development by Allergan of a new culture to produce the toxin, but this offer was rescinded.


I spoke with two researchers who dealt with the toxin in their laboratory at the University of Wisconsin and Johns Hopkins Hospitals. I discovered that the father of a colleague made an important discovery of how the toxin worked while in his 20s at the Army Biological Warfare facility at Camp Detrick Maryland in 1945.


The history of the toxin from 1793 is well documented and available. One valuable nugget from Scott was that his mother, who was a biologist, was offered a position working with a key researcher who was solving puzzles about the food processing in California plagued by outbreaks of botulinum poisoning in the 1920s.


Key in the research for this book was the direct route of the botulinum toxin molecule from being embedded in a fatty substance in blood sausage to the diluted, stabilized, and freeze dried powder Scott prepared to perform the first injection of billionths of a gram of the world’s deadliest toxin in a human in 1978.


During this process, the focus of this toxin ever narrowed until Alan Scott was the only “game in town.” There was no race to the wire. Scott was it. If he hadn’t done what he did, the toxin might have simply died out in the lab at the Wisconsin Food Safety Institute.


The final irony is that Scott’s sole interest in Botox (I find it hard to use this name over Scott’s choice, Oculinum) was to treat strabismus. It was as if he invented a needle and thread but only wanted to sew on buttons.


Scott left the myriad of other applications to others and there were dozens. The number is only growing, from calming overactive bladder to drying sweaty palms, to doing something to help migraine and more.


Q: How would you describe Dr. Scott’s legacy today?


A: Alan Scott was a selfless professional who started out “asking questions and seeking answers.” He continued on that path, never wavering. He remained humble and self-effacing as he freely shared what he learned.


He used money to support his research and had no ambitions when it came to lifestyle. “I had all the fun and Allergan made all the money” were Alan Scott’s own words, uttered with a smile and free of rancor.


Q: What are you working on now?


A: I’ll be writing a regular feature on my author’s blog: I have no big project in the works. I just turned 89!


Q: Anything else we should know?


A: Not really, except for this. I started practice in the ‘60s as did Alan Scott. While at Indiana University I conducted clinical practice with a specialty in ophthalmology concentrating on strabismus (eye muscle imbalance) and children’s eye disease.


My work included teaching, and clinical research (of course, not approaching the scale of Alan Scott’s efforts and accomplishments). My life and associations make me the ideal apologist for the greatness of Alan Scott.


Not an attempt at hagiography, Death to Beauty is a sober account of an ordinary man who did something that was amazing, and he deserved to be recognized.


--Interview with Deborah Kalb

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