By the Early 1920s, Bermuda was establishing herself as a favourite and fashionable winter destination for rich Americans from the eastern seaboard. The glory days of Island tourism had arrived. Boatloads of genteel tourists arriving for weeks or months of leisure in the December-to-April high season wrote to their friends on the snowbound U.S. east coast, gloating over the sea, flowers and sky. Fourteen-year-old Elizabeth Evans Hughes, visiting Bermuda with her companion Blanche Burgess between December 1921 and June 1922, was no exception. Writing from Honeymoon Cottage, her little rented cottage in Fairylands to “Dearest Mumsey” and “Pa” back in wintry Washington, she depicted her Bermuda days as a seemingly flawless idyll of picnicking, sailing, bird-watching and sightseeing by horse and carriage.
Elizabeth’s first letter home in January described for her parents a picnic on what was then called Elba Beach: “The most heavenly time imaginable roaming around that lovely beach and staring [at] the bluest green[est] ocean and breakers dashing on the rocks that you ever saw.” One fine day, the Plimptons, other well-to-do American visitors, rowed her around Hamilton Harbour, where Elizabeth collected shells and fantasized about the caves in the coral, speculating that Bermuda was “one big cave underneath.” In the breathless style of a young girl, Elizabeth exclaimed to her mother: “Such a day as it was, blue, blue, oh, dear, don’t get me started on these colours down here, for I’ll never stop, but how I did enjoy it…” Elizabeth kept telling her parents how grateful she was for her Bermuda winter– “this wonderful opportunity which will remain with me during my whole life.”
Elizabeth also eagerly looked forward to a visit from her parents, Antoinette and Charles Evans Hughes. Longing for her family to join her, she counted on these seasoned Bermuda travellers to help her decide whether she loved the views of the North or the South Shore the best. The elder Hughes were regular visitors to such elegant establishments as Paget’s fashionable Pomander Gate Guesthouse, and were exactly the sort of prominent visitors that Bermuda courted in its heyday as a winter resort.
In fact, Charles Evans Hughes was an internationally known statesman and jurist. Elizabeth addressed her letters home to “The State Department, Washington, D.C.” because her beloved “Pa” was, in public life, U.S. Secretary of State in the administration of President Warren Harding. In 1916, Hughes himself had been the Republican candidate for president, having resigned from the U.S. Supreme Court to run for office. When Elizabeth Evans Hughes was born in 1907, it had been the Governor’s mansion in Albany, New York during her father’s term of office. Accordingly, brown haired, fine-boned boned Elizabeth, with her heart-shaped face and dark almond eyes was a child of privilege– but she was also dutiful, intelligent and sensitive, a lover of nature. As bluebirds and cardinals flocked to feed at the hollowed-out calabashes filled with seeds she had hung beside her cottage door, she assured her parents that she had “simply gone clean crazy over the place and would like to make my home here forever.”
Elizabeth had been sent to Bermuda without her parents, who could not escape the round of conferences and official entertainment that her father’s high office exacted from both her parents. But the Hughes were making time for a visit– albeit one of only 10 days or so, a short visit by the standards of the time. Elizabeth tantalised her parents with her little adventures as she eagerly awaited their arrival. One day, she told them, on the way back to her cottage after her favourite outing out to Natural Arches and Pink Beach, the horse pulling her rented carriage had slipped in a rut on the white coral roads; fortunately, both passengers and beast were unhurt. Playing the guide, she told her parents in March 1922 that the Tucker’s Town golf course had just opened and “the club-house is all finished and extremely attractive looking.” She cautioned her mother to bring all her woollens for “everyone lives in sweaters and scarves down here” and urged her father to book Stateroom 19 on the Fort Hamilton for their voyage from New York City because, located in the centre of the vessel, it was “steady being in the middle.”
It is easy to be envious of the Hughes family, outwardly so rich and secure, and to imagine a flawless, untroubled holiday with their winsome daughter on the islands of sunshine. But reading Elizabeth’s letters was bittersweet torture for her parents, and they hurried down the gangplank in Bermuda to greet their daughter at the end of February sick at heart. For Elizabeth was dying– slowly, inexorably wasting away.
Elizabeth Hughes was one of those visitors of old whose experiences on the Island modifies and deepens our picture of tourism in Old Bermuda. Her story reminds us that for a significant minority of visitors in bygone days, the Bermudas were first and foremost ‘The Isles of Rest.’ where health seekers’ sought to regain or preserve their health in the days before antibiotics and other wonder drugs. During those winters early in the century, Bermuda was largely free of the epidemics and bouts of influenza, colds and pneumonia that dogged “nerve-straining Gotham”– the snow-bound, smog-filled cities of the American seaboard.
For a time in the 19th Century, even tubercular patients came to Bermuda to seek a cure before medicine decreed that cold mountain air in fact offered the best hope of recovery. Moreover, even in balmy Bermuda, health seekers often failed to flourish. One hopes that in her rambles in Paget, Elizabeth Hughes did not see the gravestone for one female visitor from Halifax who had come to Bermuda 75 years before for her health and, in the words of her epitaph in St. Paul’s churchyard, “found only a grave.”
But what afflicted Elizabeth? Why was this 14-year-old girl sequestered in Bermuda, or as one American newspaper put it, “virtually an exile from her family … [in] the salubrious climate of Bermuda … deemed best suited to her unfortunate condition.” Elizabeth Hughes had diabetes.
The diagnosis had fallen upon her parents’ ears like the stroke of doom. In the days before drugs were developed to control the condition, diabetics, plagued by a loss of pancreatic function, were unable to absorb sufficient nutrients carbohydrates, fats and proteins- -to enable them to survive.
Juvenile diabetics like Elizabeth, whose diabetes had been diagnosed in April 1919, often survived less than a year. As the sugar their body could not absorb overwhelmed their system, diabetics were tormented by acute hunger and thirst. They ultimately lapsed into coma and died, their sickrooms tainted by the characteristic sickly-sweet apple smell of the last stages of their disease.
Elizabeth was still alive to delight in the oleanders and lilies of Bermuda in the spring of 1922, but it was at terrible cost. Blanche Burgess, her companion, was in reality a specially trained nurse who oversaw a grim regimen. In the words of Dr. Frederick Allen, Elizabeth’s physician and the leading diabetologist in the U.S., she had been placed on the only possible treatment available in 1922-an ‘undernutrition’ diet. Without drugs to help the body absorb nutrients to compensate for the malfunctioning pancreas, Dr. Allen could offer his patients only a special diet to prolong life by about two years.
But ‘undernutrition’ really meant slow starvation. Elizabeth could only tolerate small and ever diminishing quantities of food without her blood sugar shooting up to dangerous levels. Amid the lush vegetation of Bermuda, therefore, Elizabeth herself was wasting away. When she was diagnosed with diabetes in 1919 at the age of 12, her five-foot-tall frame had weighed in at 75 pounds. But after three years of Dr. Allen’s diet, Elizabeth was dwindling away as the amount of calories she was allowed fell inexorably from about 1,200 calories a day to 750 calories a day far less than her growing body needed. Breakfast was only five grams of oatmeal topped with 20 milligrams of cream. She had not tasted bread for years. Dinner was a tiny omelet with 20 grams-less than an ounce of lettuce and a half-cup of cocoa and two days a week she had to fast even to be able to maintain this pitifully meagre diet.
Elizabeth’s weight had fallen to 48 pounds, and beneath her lace-trimmed dresses and pretty Trimingham’s hats wreathed with forget-me-nots, she was, as one doctor put it, a “walking skeleton” with protruding ribs and a stomach swollen with famine. Most diabetics, particularly children, lacked the willpower to follow such a devastating diet, and succumbed to hunger pangs or to diseases which carried them off in their weakened state.
But Elizabeth was a remarkable girl. She had stuck to her diet, and had survived earlier bouts of tonsillitis. Her parents had sent her to Bermuda– as Elizabeth put it “down here away from all epidemics and cold”– to protect her weakened constitution as best they could. But the gift Antoinette Hughes brought her daughter during her brief Bermuda visit was a hammock, for her daughter was so weakened by hunger that she had to rest long hours each day.
Elizabeth’s letters to her parents, however, testify to her spirit and to Bermuda’s true charm- the ability of islanders to cherish and charm a sick young girl. Overseen as she was by Colonel Swalm of the U.S. Consulate, she became Bermuda’s celebrity invalid that winter of 1922. She was spoiled by Bermuda residents both rich and poor. Moniz, the gardener at Honeymoon Cottage, took her out fishing one day with his son, and one Bermuda carriage driver regaled her with a long poem about Bermuda that he himself had composed. When Charles and Antoinette Hughes arrived to visit her at the end of February, the Hamilton Hotel offered them their best suite free of charge.
For their part, the Trade Development Board, which oversaw tourism, invited his daughter to select her choice of tinted Stuart Hayward photographs of Bermuda, a choice souvenir of the day, which she proudly arranged on the mantle of Honeymoon Cottage. Since Elizabeth was not strong enough to attend school, she was invited to join the Girl Guide troop at the Bermuda High School for Girls, and sewed camisoles and enamelled tin boxes to sell at the annual Guide bazaar that spring. She was thus able to invite other young guides, like Bermudian Caroline Cooper and Gwenny Simmons, daughter of a major at Prospect Military Camp, to tea. The British Admiral stationed on Bermuda invited her for a gala visit aboard his flagship and even detailed a handsome young midshipman to assist her around the cruiser.
Perhaps Elizabeth’s sincerest and most exalted admirer was Governor Willcocks, a former British army general who had seen distinguished service in Africa and India. Soon after her arrival on the Island, Elizabeth wrote her family that she was “overcome” when the Governor– whom in Yankee fashion she mistakenly called “the Governor-General” but rightly dubbed “a peach” — “blew in on us for a few moments just to see how we were getting along.” Willcocks made good on his promises to invite Elizabeth up to Government House On Mount Langton to watch him compete in games of “tent-pegging,” an equestrian substitute for polo, which involved flailing away at pegs with mallets while on horseback, and to show her his trophies of the Empire. Elizabeth was thrilled to be shown “chairs with seats of the original black native skins (which I had to sit down in) and which were very tough and strong.”
But the Governor’s finest moment came one afternoon at Tom Moore’s Tavern, when both he and Elizabeth were invited to a fashionable concert and tea held at Walsingham. As Elizabeth, unable to eat, wistfully watched the guests devour plates of fancy tea sandwiches, strawberries, ice cream and four kinds of layer cake, the Governor, to keep Elizabeth company, refused everything but a cup of clear tea– all the emaciated girl was permitted to have.
After tea, he and Elizabeth autographed and exchanged the special place cards designed for the occasion by the Tucker sisters. No wonder Elizabeth told her mother that the Governor was a “great old sport and I simply adore him and his sweet wife.” When the Governor came over to greet her after Easter church service, Elizabeth sighed that he was “very natty in his white dress suit, with his red, white and blue sash and medals.”
Confined as she was to bed, hammock and carriage much of the time, Elizabeth devoured the children’s magazines of the day such as the popular St. Nicholas Magazine and Everyland, a missionary magazine for children. She even contributed stories to these magazines and both her reading and her writing show her longing for health and activity. The story she sent to St. Nicholas Magazine that year was called Our North American Indian and she devoured the popular classics of the day like Green Mansions and A Girl of the Limberlost, fantasising about the freedom to roam in nature that diabetes had stolen from her. When she and her nurse read aloud to each other, what she loved to hear best were Zane Gray novels, with their rugged “Western tales of ranch, lumber and cow-boy life.” Meanwhile, she had to watch her nurses and friends swim and bicycle, pleasures denied her. But she was stoic. Like Pollyanna, heroine of another popular girl’s story of the day, she played “the glad game” and rejoiced in what she had rather than what she was denied.
When high sugar levels forced her meagre intake to be decreased, even by a fraction of an ounce, she was upbeat in her letters. “I am getting along beautifully now on this diet and am not feeling the change any in strength at all. In fact I really feel better than when I was on a higher caloric diet and showing traces [of excess sugar in the blood] all the time.
Still, Antoinette Hughes must have winced as her daughter’s letters from Bermuda described growth and health that they were powerless to give her. Elizabeth had adopted a kitten, dubbed Daisy, whom she told her mother was “a big enormous cat… growing like everything.” Elizabeth was sure rounded by “fields and fields of beautiful, blooming Easter lilies and budding oleanders.” but her mother knew there was no bloom in her daughter’s cheeks. In early May, even Bermuda failed her, and she was laid low by an attack of diarrhoea, prompting Nurse Burgess to write gravely to the Hughes that “I hope we can avoid any more such upsets for she has so little reserve strength.” As Elizabeth prepared to leave Bermuda at the end of June, she felt that she had to tell her mother not to be alarmed when she saw her, as she could not now climb stairs, or rise from a chair without help, and could only walk short distances. She had to confess to her mother that when she ordered a new dress, she was so thin that she had the dressmaker add an extra wide piece of lace on the collar so as to make it look softer and broader on me. “The other way it made me too much like myself, narrow and scrimpy…”
Frail as she was Elizabeth knew that her beautiful Bermuda had helped her survive the winter and on June 7, in her last letter, she told her parents– with ironic imagery that she was “so happy when I think of coming here again next year, and having Honeymoon and all, that I’m nearly dying.”
She rejoiced in “the dark, green, grotesquely shaped cedars, the white, white houses [and] gardens of the most exquisite flowers, a riot of colouring…” Still hoping to be a writer someday, she commissioned an island cabinet-maker to make her a cedar desk set “to remind her of dear old Bermuda.” Vowing to return, she walked up the gangplank to board the ship to New York on June 27, 1922, barely upright but unassisted, vowing to return next winter to the balmiest isle of sunshine.” No one who saw her off believed that they would ever see the dying girl again. Elizabeth did return to Bermuda–thanks to a miracle. Over the summer, her parents heard of Dr. Frederick Banting, a gruff Canadian physician who had helped develop insulin, a new ‘wonder drug which was helping diabetics to metabolise food and live normal lives. Meanwhile, Elizabeth moved nearer to death over the summer, and when her mother brought her to Toronto in mid-August, Banting’s medical notes provided a grim picture of one of the first patients to receive insulin. She was, he noted, “weak … emaciated, scarcely able to walk, hair brittle, skin dry and scaly … [with a] feeling of weakness and sleeplessness.” But thanks to the new drug, Elizabeth improved as the weather of the Canadian fall deteriorated. Able to eat adequately for the first time in three years, she gained 31 pounds in three months, and grew half an inch in one month alone. By October, Nurse Burgess wrote jubilantly to Mrs. Hughes: “You will see a great change in Elizabeth. Her whole body is filling out and she is much stronger.” Elizabeth herself described insulin as “too wonderful for words.” To the chagrin of the reticent Elizabeth, her remarkable recovery was widely covered in the newspapers, but the Hughes family were all delighted when Frederick Banting and the research team at the University of Toronto received the Nobel Prize for Medicine in 1923.
Elizabeth Hughes kept in touch with her Toronto doctor, and by March 1925, she wrote that she had grown two and a half inches and weighed 124 pounds and was hiking, horseback riding and playing tennis– a far cry from the feeble wraith of her Bermuda sojourn. Elizabeth kept her love for Bermuda, however, returning to spend three months on the Island with her family in the spring of 1925. In 1930, having just graduated from Barnard College, she married a promising young lawyer William T. Gossett, with whom she would have three children. And where did they honeymoon? Why, Bermuda, of course. It is wonderful to record that she lived until 1981, returning regularly to the ‘Isles of Rest.’
Elizabeth Hughes’ Bermuda letters and the medical records of the period she spent as one of the first group of people to receive insulin-she took over 40,000 injections by the end of her long, active life–can be found at the Fisher Library, University of Toronto. For telling me about these remarkable letters from Bermuda, my thanks to Canadian historian Professor Michael Bliss, whose book The Story of Insulin chronicles the discovery of insulin and the early patients who benefited from it.