Rivalries, Starvation Wards, and Salvation: The Human Drama Behind the Discovery of Insulin

Before 1922, a diagnosis of Type 1 diabetes was a death sentence. It meant watching a child, or a young adult, waste away to skin and bones in a hospital ward, on a diet of near-starvation that could only delay the inevitable by a few months. These were called "starvation wards." The only known treatment was a diet of maybe four hundred calories a day. It was a slow, agonizing process. And in the summer of 1921, a struggling Canadian surgeon named Frederick Banting became obsessed with finding a way to stop it. He wasn't a top-tier researcher. He was a general practitioner whose practice was failing. What gave him the idea that he could solve something the world's best scientists couldn't?

It was a hunch that woke him up in the middle of the night. He'd read an article about the pancreas and its digestive juices. He theorized that if he could stop the pancreas from producing those juices, he could isolate the other thing it made—a mysterious internal secretion that regulated blood sugar. So he takes this idea to J.J.R. Macleod, a prominent professor at the University of Toronto. And Macleod is deeply unimpressed. Banting is an amateur, his idea is crude. But he reluctantly gives him lab space, ten dogs for experiments, and a student assistant named Charles Best. Then Macleod leaves for his summer holiday in Scotland, probably assuming he'd never hear from them again.

He basically gives them the keys to a back room and says, "Don't burn the place down." Exactly. And what follows is this frantic, desperate summer. Banting and Best are working in a sweltering lab. They’re performing surgery on dogs to tie off the pancreatic duct, then waiting weeks, then removing the shriveled pancreas. They grind it up into this brownish, murky fluid… And inject that sludge into other dogs they've made diabetic. It sounds brutal. It was. Some dogs died from infections. Others from the surgery itself. But they got a flicker of success. Then another. Eventually, one diabetic dog, Marjorie, was kept alive for seventy days with their daily injections.

They knew they were onto something. But their extract was too impure for a human. It caused terrible abscesses. This is where the story shifts. It’s not just two guys in a lab anymore. No. Macleod comes back from his vacation, sees their data, and his skepticism vanishes. He realizes this is real. And he takes over. He assigns a brilliant biochemist, James Collip, to the crucial task of purifying the extract. I can't imagine Banting was happy about that. He felt this was his discovery. He was furious. He saw it as a hostile takeover. There were shouting matches. Banting and Best had the vision, but Collip had the chemical skill they lacked.

The rivalry was so intense, they almost came to physical blows in the lab. But they have to test it on a person eventually. January 11th, 1922. A fourteen-year-old boy named Leonard Thompson is dying in a Toronto hospital bed. He weighs just sixty-five pounds. They give him the first injection of the Banting-Best extract. And it fails. Oh no. He develops a sterile abscess. His blood sugar barely budges. It's a disaster. But Collip—the biochemist—he locks himself away for twelve straight days and nights, refining the process. He returns with a new, pure, alcohol-based extract. On January 23rd, they try again with Leonard. And…?

And it works. His blood sugar plummets. His symptoms vanish. Within weeks, parents are bringing their comatose children to the lab, and the team is literally pulling them back from the brink of death. So the team that was at each other's throats ends up succeeding. But the story doesn't end there, right? The Nobel Prize gets awarded the next year. It does. To Banting and Macleod. They left out Best and Collip. Banting was so enraged he almost refused it. Instead, he publicly announced he was splitting his prize money with Charles Best. In response, Macleod announced he was splitting his share with James Collip. A final act of competitive collaboration.

It's a pattern of rivalry and partnership forced by necessity. It is. But the most important decision they made had nothing to do with prizes. They sold the patent for insulin to the University of Toronto for one dollar each. They believed this discovery belonged to the world. Their gift created a global pharmaceutical industry whose modern pricing stands in shocking contrast to that first, defining act of grace.