A Happy Accident, Not a Filler Mistake

Make No Mistake

Last night I went out to one of those painting bars where an instructor leads you through a canvas painting exercise one stroke at a time between sips of wine. It wasn't long before someone made a light-hearted joke in remembrance of a quote by the popular PBS painting instructor, Bob Ross, "We don't make mistakes, just happy accidents" (Haun, 2019). Mix that sentiment with some reflection on mylatest doctoral learning unit within the Futuring and Innovation course at Colorado Technical University (2022) and I could not help but draw the parallel between art mimicking life in a way that we want to see it. 

The difference you will see is that a number of us view our genetic flaws as mistakes rather than happy accidents on our personal canvas. For some, this could be devastating and a cause of angst and pain. But what if the things we use to correct these mistakes resulted from an accident? To answer that, we would need to make a few substitutions. Trade the painter for the doctor and research practitioner, the paint and brushes for the pharmaceutical compound, and match the luck and creativity needed to convert what may be called a mistake by some to a welcome outcome by all involved.

Seeing Things Straight

The origins of the botulinum toxin can be traced back to a type of food poisoning from poor food storage that acted as a neurotoxin 100 times more deadly than cyanide called botulism (Green, 2022).   While the Department of Defence had hoped to develop it into a chemical weapon during World War II, several prior researchers had proposed using botulism to correct strabismus by relaxing periocular muscles. But it was not until the 1970s that Dr. Alan Scott, an ophthalmologist, would turn the botulinum toxin into a pharmaceutical for severe eye impairments at the Smith-Kettlewell Eye Research Institute (SKERI) in San Francisco, California while looking for a treatment to correct symptoms related to nonaccommodative strabismus ("cross-eyed") without resorting to surgery (Monheit & Pickett, 2017). He demonstrated this successfully during his research in the latter part of the 1960s through the early 1970s through the use of botulinum toxin (BoNT) by weakening the ocular muscles through its injection in his monkey test subjects.  

The final, in 1978, Dr. Scott first injected BoNT into the eye muscles of a patient who had undergone retinal detachment surgery where his eye was tragically left pulled to one side (Green, 2022).   Dr. Scott revealed to Scientific American in a 2016 interview that he didn't know who was more nervous, himself or the patient. The procedure was in part a huge success, and Dr. Scott would go on to change one of the world's deadliest poisons into a life-altering treatment called Oculinum. It would be used to treat those who suffered from conditions where the eyes are misaligned like strabismus. Since that discovery, BoNT has expanded into other therapeutic and aesthetic uses not initially intended by Dr. Scott (Monheit & Pickett, 2017).

Let's Fill You In a Little More

Fast forward to 1987, when Dr. Jean and Dr. Alastair Carruthers accidentally discovered a cosmetic property in BoNT that was eventually branded as Botox, the now billion-dollar industry (Finer, 2018). At the time, the couple shared a Vancouver office where Dr. Alastair Carruthers had a dermatology practice divided between cancerous skin surgeries and other cosmetic procedures. At the same time, his wife, Dr. Jean Carruthers, was a practicing eye doctor treating pediatric disorders and adult conditions. 

One such condition, blepharospasm, an uncontrollable blinking and spasming of the eye and surrounding area, led to this continuation of happy accidents concerning BoNT. That day of reconning, one of Dr. Carruther's patients became irritated that her forehead was not also being injected that session. She noted that it had a side effect of making her wrinkles disappear. This finding was not unlike one mentioned by Pickett (2017), who claims to have heard from colleagues that other patients treated for blepharospasm and hemifacial spasm reported that their wrinkles and migraines had improved after receiving BoNT. In 2013 Dr. Jean Carruther was featured at a TEDx Talks event in Vancouver, where she talked about the origins and challenges she and her husband faced pioneering its cosmetic use. While Botox did not take off as fast and fluidly as expected by the two due to skepticism of injecting a toxin into one's wrinkles, after many clinical trials, it finally took off around 1993 (Finer, 2018).

The Duct Tape of Medicines

In recent years, Botox has had a resurgence in the form of off-label uses (Sifferlin, 2017). According to the National Library of Medicine, doctors now use Botox for temporary smoothing of facial wrinkles to improve appearance, severe underarm sweating, severe neck, and shoulder muscle contractions, uncontrollable blinking, misaligned eyes, chronic migraine, and overactive bladder (MedlinePlus, 2021). However, it should be noted that this is not without controversy as in November of 2016, the FDA held a two-day hearing around off-label uses and if that practice indeed paves the way for scientific progress or is more financially influenced (Sifferlin, 2017). In either case, Botox has given doctors much-needed alternatives for patience with hard-to-treat medical conditions in hopes for more happy accidents. 

References

Colorado Technical University. (2022). Colorado Tech Course Catalog - CTU | SmartCatalog. Retrieved March 13, 2022, from https://coloradotech.smartcatalogiq.com/en/2022/Catalog/Courses/CS-Computer-Science/800/CS-875 

Finer, A. (2018, October 4). The real history behind the birth of botox. Reader's Digest Canada. https://www.readersdigest.ca/health/beauty/birth-botox/

Green, P. (2022, January 20). Alan scott, doctor behind the medical use of botox, dies at 89. The New York Times. https://www.nytimes.com/2022/01/12/health/alan-scott-dead.html 

Haun, S. (2019, May 10). Happy accidents. The Smart Set. https://www.thesmartset.com/we-dont-make-mistakes-just-happy-little-accidents/ 

MedlinePlus. (2021, December 14). Botox. Retrieved March 26, 2022, from https://medlineplus.gov/botox.html

Monheit, G. D., & Pickett, A. (2017). AbobotulinumtoxinA: A 25-Year History. Aesthetic surgery journal, 37(suppl_1), S4–S11. https://doi.org/10.1093/asj/sjw284 

Sifferlin, A. (2017, January 5). Botox: The drug that's treating everything. TIME.Com. https://time.com/magazine/us/4623396/january-16th-2017-vol-189-no-3-u-s/

TEDx Talks. (2013, February 5). Beneath the Surface of Botox: Dr. Jean Carruthers at TEDxVancouver [Video]. YouTube. https://www.youtube.com/watch?v=cuEZ8I_lZe0&feature=youtu.be