Two science-based reasons to love “The Danish Girl”

A couple of nights ago I finally managed to watch The Danish Girl. The movie had got my attention since I first saw the trailer on YouTube, during one of my binge trailer-watching session in frantic search of interesting novelties. Then Alicia Vikander won the Oscar for the Best Performance by an Actress in a Supporting Role, and I was even more curious. One month and a half later here I am, finally managing to write about it.

Let me begin by saying that I really enjoyed the movie. The characters were very well cast, the performances were stunning, the scenery was beautiful and the story very emotional and touching. But being a science nerd, I also found two more nerdy reasons to like it, and I’ll share them with you.

1) Lili’s orange lipstick

Portrait of Lili Elbe. Watercolour, c. 1928, Wellcome Images

Let’s start with the more trivial of the two: I visually loved every scene in which Lili wore that lipstick. That orangey-rusty-reddish tone just stole my heart.

Did you know that the first lipstick was probably invented between 2500 BC and 1000 BC? Ancient Mesopotamian men and women (hello gender!) used crushed gemstones to decorate their lips. Then came the Egyptians, who were real innovators and made lipstick from carmine beetles, the ones that we still use to produce paints, crimson ink, rouge, and other cosmetics.

But how did they fare, lipstick wise, in the 1920s when our story is set? In the movie we only see Lili applying lipstick from drawing paint with a paint brush, but solid commercial lipstick was already available and rocking. In 1884 the French cosmetic company Guerlain started to produce lipsticks made from deer tallow, castor oil and beeswax. In the first decade of the twentieth century we can also find the earliest evidence of metal ‘lipstick’ containers, from newspaper advertisements. While it is still unclear if the first lipstick that was sold in cylinder metal containers was invented by Maurice Levy in 1915, it seems accepted that in 1923 a cylinder swivel-up tube was patented by James Bruce Mason Jr. in Nashville, Tennessee.

All in all, Lili could have worn a commercially available lipstick, but probably the shade range at the time would not be as exhaustive as we are used to nowadays (just google “MAC lipsticks” if you do not believe me, and see for yourselves). Probably the custom made colour option at the time was still the best way to beautifully complement one’s colour complexion.

2) Lili’s courage, a.k.a. surgery without antibiotics and anti-rejection drugs

The first antibiotic, Pennicillin, was discovered in 1928 by Alexander Fleming, when he suggested that the Pennicillium mould could secrete a substance that could kill bacteria. But we need to wait untill 1961 to effectively see antibiotics used as surgical prophylaxis. The original study was conducted on pigs and it led to the use of antibiotics to prevent infections at the surgical site. Since then antibiotics prophylaxis has become the standard of care for most surgeries.

Anti-rejection drugs, also called immunosuppressant, are instead drugs that help to suppress our immune system rejection of a new organ. The immune system is very smart in recognising what is self and what is non-self, meaning that it will effectively attack and try to eliminate everything that does not belong to our body. This feature, so useful against bacteria and viruses, unfortunately is very dangerous in case of organ transplant, when we need to substitute an entire organ that does not belong to us.

The first identified immunosuppressant drug was cortisone. Discovered by the American chemists E.C. Kendall and H.L. Manson, cortisone was produced commercially for the first time in 1949. Unfortunately its wide range side-effects significantly limited its use. In 1959 a second and more specific drug was discovered and named azathioprine, but we need to wait until 1970 and the discovery of cyclosporine to see an improvement of organ rejection and the expansion of transplantation surgery from kidney to liver, lung, pancreas and heart.

According to the movie and to history, Lili Elbe attempted four consecutive surgeries, first to change her sex and then to have a uterus implantation. This last surgery was the one that costed her life. All her surgeries were performed without antibiotics and without anti-rejection drugs. Of course she would not even know the names of these useful drugs, but she did know that the procedures she attempted were experimental, extremely dangerous and very likely could lead her to death.

But she did not care. She had the courage and the strength to go through it. One could think that she was crazy, but she was not. She was desperate, and determined. And I loved the way Eddie Redmayne portrayed this profound drama and resolution in the movie.

Lili Elbe died on the 13th of September 1931, three months after her last surgery, due to cardiac arrest caused by the rejection of the uterus by her immune system and the resulting infection, both of which could nowadays be treated by antibiotics and anti-rejection drugs.

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