My Little Brother on Drugs

Suddenly, the growth hormone supply was unlimited, safer and less expensive, opening the door for looser diagnoses, along with higher and more frequent doses. By 1988 what had once been a niche drug prescribed to treat dwarfism was shattering all market expectations, chalking up more than a half billion dollars in annual sales.


At the time, I was 11 years old, and a ripe candidate for growth hormone supplementation. I had been born in the fifth percentile for height, but at age 5 my “growth velocity” started slipping, and by 11, I was hovering below the first percentile. Blood tests revealed that I was only producing “borderline acceptable” levels of growth hormone. “Growth hormone injections may be an option,” Yale pediatric endocrinologist William Tamborlane told my parents. The prospect terrified me. “I don’t care if I’m a midget! It’s what’s inside that counts!” I protested. “I’m not having a shot every day.”



Further testing showed that my thyroid gland was malfunctioning, a definable and common condition called hypothyroidism. Tamborlane prescribed a pill (which I will take every day for the rest of my life), and my growth velocity picked up immediately. Still, I was told that I would never surmount the magical 5-foot threshold.


That’s because most short children can place primary blame for their stature on the genetic lottery. “Want to be taller, Jenny?” I remember Tamborlane asking me as his eyes shifted between my slumping growth chart, my X-rays and my mom and dad. I nodded eagerly. “Well, you should’ve picked different parents.” He chuckled, while I considered the merits of a parentectomy. Today I’m 26 years old and my height has topped off at . . . 5 feet 1, thank you very much.


Fifteen years after I flirted with growth hormone treatment, biotech’s baby has exploded into a $1.5 billion industry that has reached more than 200,000 children and sent many more to the doctor wondering if hGH is for them—including my brother Alex. When my mom called to tell me Alex was growth-hormone-deficient and would soon begin injections, I was skeptical. The prospect of having a shot every day had sent fear through my own little body, and now, as an overprotective big sister, I didn’t want my brother’s carefree childhood to be interrupted by such stress—and such a serious, understudied medical treatment—unless it was entirely necessary. Is being short so horrible that it should be medicalized and treated as an illness?


My thoughts were interrupted by my mom’s voice, bringing me back to reality. “Nurses are coming over next week to show us how to administer the injection,” she said. The decision had been made.

As the 6 train squeals under Manhattan’s Upper East Side, Alex’s Nikes sway three inches above the floor. My brother is a happy kid whose sprite profile doesn’t resemble that of the typical round-faced growth-hormone-deficient cherub. He’s silent now but only because his mouth is full of jellybeans. The train reaches our stop, and Alex places his sticky little hand in mine.


“Excuse me,” he says politely as we jostle our way off.


A surprised middle-aged mom looks up from her book. “My, you are much more polite than my kindergartener,” she says.


It’s been about two weeks since Alex began his nightly injections. Before that, he might have flinched at this well-intentioned under-estimate of his age. But today, he squares himself a bit and responds with a certain pride: “I’m 9 years old,” he says, “and I’m on Humatrope!”

It strikes me, not for the first time, just how important the drug has become to Alex. He yearns to be taller. As the youngest of six, he knows how to get noticed—our family joke is that he swallowed an amplifier—and what he lacks in stature he was dealt in personality. But at school, where tall kids hold the social scepter, his big personality is overlooked.


“Everyone says that it’s what’s inside that counts, and that makes me feel good,” Alex says, “but if I was the tallest instead of the shortest, everything would just be better. People would sit with me at lunch, I’d have more friends, and people in my class wouldn’t make fun of me and call me Little Everett. And I’d be a better soccer goalie. I think 6 feet would be good.”