Frederick Banting

Frederick Banting: The Surgeon Who Read One Article

On the night of 30 October 1920, a failing country doctor in London, Ontario sat up preparing a lecture on the pancreas he did not want to give. He read a paper by Moses Barron on what happens when the pancreatic duct is closed off, and scribbled down an idea for an experiment. Fourteen months later a fourteen-year-old boy dying in a Toronto ward was walking again. Frederick Banting had no research training, no biochemistry, and a practice so thin he taught part-time to eat.

The Farm Boy Who Failed First Year

Banting was the youngest of five children born on 14 November 1891 in Essa, Ontario, to a farmer, William Thompson Banting, and Margaret Grant. He remembered a lonely childhood among older siblings who "could not be bothered with me for the most part," and school in Alliston was worse: shy, bullied, hopeless at spelling, which he blamed on an inferiority complex. He passed his matriculation examinations in July 1910 only after repeated attempts, announcing an ambition to teach while privately wanting medicine.

At Victoria College, University of Toronto, he failed his first year of General Arts outright. He repeated it, entered the medical faculty in February 1912, and proved an ordinary but diligent student — roughly a B average, a serious rugby player, summers on the farm. Nothing in the record suggests brilliance. It suggests stubbornness.

Cambrai

Canada declared war in August 1914 and Banting tried twice to enlist, rejected both times for poor eyesight. In 1915 he got in as a private in the Royal Canadian Army Medical Corps. His class was accelerated through a compressed summer 1916 curriculum heavy on surgery and trauma, and he took his M.B. on 9 December 1916. He sailed from Halifax in March 1917 and spent thirteen months as assistant to the orthopaedist Clarence Starr at the Granville Canadian Special Hospital in Ramsgate, running 125 patients. France came in June 1918. He was at Amiens on 8 August, working on the wounded for days. At Cambrai a German soldier walked into his aid post and Banting was saved by one of his own patients — a sergeant, an amputee, who shot the man. Shrapnel from a shell ended his frontline service before he was willing to stop, and in 1919 he received the Military Cross for "exceptional bravery while attending the wounded under fire."

The Attic Laboratory

Back in Canada he could not get a hospital appointment. After a year as resident surgeon at the Hospital for Sick Children he moved to London, Ontario in July 1920, opened a private practice that barely functioned, and lectured part-time at the University of Western Ontario. That was the lecture on the pancreas.

The theory was already in place: diabetes came from a failure of the islets of Langerhans to secrete a hormone Sharpey-Schafer had named insulin. Every attempt to extract it failed, because the pancreas's own digestive enzymes destroyed the hormone in the process. Barron's paper suggested the way out: tie off the duct, let the trypsin-secreting tissue die, leave the islets alive, then extract. Banting took the idea to John Macleod, professor of physiology at Toronto, who was sceptical of its soundness but gave him bench space, dogs, and one student assistant — Charles Best, a fresh physiology graduate — from May 1921.

That summer the two of them ligated ducts and removed pancreases from living dogs and found that their extract dropped blood sugar in diabetic animals. In November 1921 Banting had a second idea that mattered nearly as much as the first: fetal calf pancreas, from the William Davies slaughterhouse, was just as potent and vastly more available. By December he was extracting from adult pancreas too. The biochemist James Collip joined to purify the material, and cracked it by precipitating the active ingredient with alcohol at slightly over 90 per cent concentration.

On 11 January 1922, Leonard Thompson, fourteen, received the first insulin injection at Toronto General Hospital. On 3 May 1922 insulin was announced to the medical world, and by 1923 it was in commercial production.

The Quarrel

The team detested one another almost immediately. When the findings were presented at Yale on 30 December 1921 the reception was poor, Macleod intervened, and Banting concluded he was trying to steal the credit. Collip refused to give his purification method to anyone but Macleod, and Banting nearly came to blows with him over it. The 1923 Nobel Prize in Physiology or Medicine went to Banting and Macleod alone. Banting, thirty-two and the youngest laureate in the category, immediately split his money with Best. Macleod split his with Collip. It was a graceful settlement of an ungraceful fight.

The Long Second Act

Parliament voted him a lifetime annuity of $7,500 in 1923; the Ontario Legislature endowed the Banting and Best Chair of Medical Research, from which he directed work on silicosis, cancer and the mechanism of drowning. George V knighted him KBE in 1934 and the Royal Society elected him a Fellow in May 1935.

He also painted — seriously, starting on cardboard shirt packaging, then in oils on birch panels alongside A.Y. Jackson and Lawren Harris of the Group of Seven. On a 1927 Arctic sketching trip with Jackson he watched influenza travel down the Mackenzie on Hudson's Bay Company boats, and said so publicly: for over $100,000 of fox skins, he estimated, "the Eskimos had not received $5,000 worth of goods." The HBC called this slanderous and summoned him to retract. He refused.

From 1938 he headed the RCAF's No. 1 Clinical Investigation Unit on the old Eglinton Hunt Club grounds, studying pilot blackout and working with Wilbur Franks on the anti-gravity suit. He tested mustard gas burn treatments on his own skin. In February 1941 the Hudson carrying him to England for operational tests of the Franks suit lost both engines after leaving Gander; Banting died of his injuries the next day near Musgrave Harbour, Newfoundland.

Why Frederick Is Called a Genius

The honest answer is that the label sits awkwardly. Banting failed his first university year, had no biochemistry, and was by the record a mediocre student with an inferiority complex. He did not purify insulin — Collip did. He did not supply the physiological framework or the institutional judgment — Macleod did. He did not do the bench work alone — Best was beside him all summer. The Nobel committee's decision to name him and Macleod, and to omit Best and Collip, has been contested for a century, and any account presenting insulin as one man's brainwave is wrong.

What Banting had was a specific and rare cognitive move: he read a clinical observation about duct obstruction and immediately saw it as a laboratory technique for a completely different problem. Trained researchers had read the same literature without making that jump. He then had the quality that matters as much and is praised less — he would not let go. He talked his way into a lab where the professor thought he was probably wrong, spent a brutal summer on dogs with a student assistant, and when dog pancreases ran short he found fetal calves. Sharp idea, ferocious persistence, surgical hands to execute it. That is a real and unusual combination, and it is not the same thing as raw intellectual power. Canada's insistence on him as a national genius has always been partly about the farm boy and the Military Cross, not only the science.

Legacy

He entered the Canadian Medical Hall of Fame in 1994 and the National Inventors Hall of Fame in 2004, and finished fourth in the CBC's 2004 "Greatest Canadian" vote. Since 1991 his birthday, 14 November, has been World Diabetes Day. At Sir Frederick Banting Square in London, Ontario a Flame of Hope, lit by Queen Elizabeth the Queen Mother in 1989, is meant to burn until diabetes is cured. But the plainest measure is this: before 1922 a diagnosis of type 1 diabetes was a death sentence, and after it, it was not.

Achievements

• Nobel Prize in Physiology or Medicine — 1923
• Knight Commander of the Order of the British Empire — 1935
• National Inventors Hall of Fame — 2004
• Affiliated with Hospital for Sick Children, University of Toronto and University of Western Ontario
• Educated at University of Toronto
• Worked as physician, pharmacologist and researcher