A pediatrician expert in infectious diseases, Offit is particularly focused on vulnerable children, who do not have the agency to make choices for themselves. In such instances, deluded parents can prevent a child with a potentially curable malignancy from receiving proven therapies, while pursuing remedies that are not only nonsensical but also noxious. Early in the book we are introduced to Joey Hofbauer, a seven-year-old who, in 1977, developed a lump in his neck. He soon received a diagnosis of Hodgkin’s disease; his prognosis was excellent, with a 95 percent chance of complete remission: “Joey could live a long and fruitful life. But for Joey Hofbauer, the road to recovery wasn’t going to be easy.” The barriers in his path were not a lack of insurance or of access to expert oncologists. Rather, his parents, John and Mary Hofbauer, believed that there must be a more “natural” way to cure their son than toxic chemotherapy and radiation. They decamped to the Fairfield Medical Center in Montego Bay, Jamaica, to receive laetrile, a touted cancer “cure” extracted from apricot pits.

The state of New York tried to take custody of Joey, and a legal battle ensued. While the dispute raged, John Hofbauer secretly gave Joey several doses of laetrile. To the dismay of the state’s Child Services, Judge Loren N. Brown of the Saratoga Family Court agreed to allow the Hofbauers to treat Joey with laetrile for six months, so long as they identified a licensed physician willing to administer it. The parents found Michael Schachter, a psychiatrist from Nyack, New York. As Offit recounts, Schachter had them sign a consent form releasing him of all responsibilities, and it included the statement that he was not a cancer specialist and had no direct experience with orthodox cancer-therapy modalities of chemotherapy, radiation, or surgery, and was not in a position to advise the Hofbauers about the benefits and risks of treatments for the malignancy. But despite these limitations, Schachter was not averse to assuming care and providing laetrile—along with “raw milk, raw liver juice, cod liver oil, soft-boiled eggs, Staphylococcus phage lysate (staph bacteria infected with a virus), pancreatic enzyme enemas (which partially dissolve the lining of the colon), massive doses of vitamin A (which cause blurred vision, bone pain, and dizziness), a vaccine to prevent ‘Progenitor cyrptocides’ (a bacterium believed by a physician named Virginia Livingston to cause all cancers), a vegetarian diet, daily coffee enemas made by adding three heaping tablespoons of regular coffee to one quart of water (coffee enemas had already caused two deaths), seven injections of an ‘autogenous vaccine’ (made from bacteria in Joey’s urine), and Wobe-Mugos enzymes (a combination of several pancreatic enzymes obtained from pigs).”…

The Saratoga County Department of Social Services appealed to higher courts but failed to have the decision about Joey Hofbauer reversed. In July 1980, at the age of ten, the boy died of Hodgkin’s disease, his body riddled with the lymphoma. Four months later, the actor Steve McQueen died of an aggressive type of lung cancer, called mesothelioma; he had left Cedars-Sinai Hospital in Los Angeles and gone to receive laetrile in a clinic in Mexico. A year later Charles Moertel, an oncologist at the Mayo Clinic, led a multi-center clinical trial of 178 patients with advanced cancer, testing laetrile and high doses of vitamins. There was no sign of benefit, and several of the patients suffered symptoms of cyanide poisoning from the treatment. In 1987, the FDA banned the sale of laetrile.