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Antony Anderson: How an unknown, unimpressive man pioneered Canada’s greatest medical achievement

Commentary

The Hub is pleased to present a weekly column from author and historian Antony Anderson on the week that was in Canadian history.

February 21, 1941: Sir Frederick Banting dies near Musgrave Harbour, Newfoundland. 

He was delirious, rambling, making little sense as he dictated endless streams of instructions, his left arm broken, one of his lungs punctured. Canada’s first Nobel laureate, knighted by the King, the world-famous discoverer of insulin, lay in a bunk of a twin-engine Lockheed Hudson bomber that had crash landed in the wilds of northeast Newfoundland, then another country in the British Empire and Commonwealth. 

The war was on. Banting had been hankering to get over to England to do his duty, as he had done in the Great War as a surgeon. “I am not brave. There is no one who has more abject terror of shells, bombs, bullets and death…But surpassing this fear is the privilege of service to the wounded, those that fight.” There is no way such a distinguished medical pioneer would ever be allowed near a battlefield but perhaps he would find some research role. After all, he had discovered insulin. A chance talk over drinks at a cocktail reception with the senior air force commander led to Banting finding a place on a flight to England departing from distant Gander. Atlantic crossings were still something of a novelty—and in wartime, almost a reckless gamble—but Banting would not be budged. 

Banting was born on the family farm just outside Alliston, Ontario in 1891. He followed a familiar path for his generation crossing from one century into the next, escaping to a bigger world, the University of Toronto, where he turned his back on his parents’ wishes for him to become a Methodist minister and instead chose to study medicine. He did not shine academically. The Great War convulsed his trajectory, but only momentarily as it would prove. He came back to complete his degree and opened a private practice in London, Ontario which limped along the verge of failure. Sinking into a not-so-genteel poverty, he scraped together some income assisting a professor with experiments and instructing anatomy and surgery at the University of Western Ontario. His love life was also a mess. His childhood sweetheart was not thrilled by his dim prospects. 

On the night of October 31, 1920, preparing a lecture on metabolism, Banting happened to read an article about diabetes research that covered a well-trod hypothesis that a mysterious substance in the pancreas might affect the metabolism of sugar. First recognised centuries before, the condition destroyed lives in terrible, painful fashion. Doctors were helpless to stop the ravaging. This article sparked something in the beleaguered, flailing 28-year-old, “It was one of those nights when I was disturbed and could not sleep. I thought about the lecture and about the article and I thought about my miseries and how I would like to get out of debt and away from worry.” That night, Banting wrote down a few notes proposing an experiment in which he would tie off the pancreatic ducts of dogs in order to try and isolate and extract that mysterious pancreatic substance which still hadn’t been conclusively proven to exist. He was an unknown small-town doctor without a stellar academic record or any impressive qualifications let alone any serious research experience. He had never treated a patient with diabetes or shown any interest in the disease. Banting did not let these details derail him. 

He was advised to reach out to John J. R. Macleod, a renowned professor of physiology at U of T.  The master agreed to meet the novice. Insecure and unpolished, Banting was not a comfortable or convincing public speaker. Later Macleod would write, “I found that Doctor Banting had only a superficial text-book knowledge of the work that had been done on the effects of pancreatic extracts in diabetes and that he had very little practical familiarity with the methods by which such a problem could be investigated.”

Despite the dismal first impression, Macleod became intrigued enough by slim possibilities to offer Banting lab space and an assistant, though no salary. Banting agreed to consider the extraordinary offer and returned to London and more drift. 

In the spring of 1921, he wrote to Macleod about starting the experiments, but he was also sniffing out a research post at Oxford, joining the Indian army, and signing on with an expedition to the Northwest Territories, which turned him down. His on and off again engagement was off again. With no other prospects, he headed to Toronto to enter the mysteries of the pancreas, a labyrinth already being explored by other far more experienced medical researchers across North America and Europe. 

Macleod introduced Banting to Charles Best, a fourth-year medical student, and opened up a small, filthy operating room unused for years. The odds of the two neophytes making any headway were, to put it mildly, slim yet they persisted. By the late summer they produced an extract from a dog’s pancreas that lowered the blood sugar in a diabetic dog—a remarkable achievement. They needed help refining their crude extract so it could be administered to a human subject without causing side effects. Banting invited a visiting professor and biochemist from the University of Alberta, James Collip, to take on that challenge, and by January 1922, Collip’s elixir was ready. But Banting insisted his own extract should be the first ever administered. The test subject selected was a fourteen-year-old diabetic, Leonard Thompson: skeletal, listless, doomed. Banting and Best’s extract failed. Collip was then allowed to have his extract administered. It saved young Thompson’s life. The wonder drug was called insulin and wonders it did perform, bringing back countless lives from the brink of death; though insulin was not a cure but rather an essential therapy. 

Sir Frederick Banting is pictured in this undated file photo. The Canadian Press.

In 1923, Banting and Macleod were awarded the Nobel Prize in Medicine, Banting being the first Canadian so honoured. (Macleod was born in Scotland). Banting shared his portion of the prize money with Best, and Macleod did the same with Collip. The four of them never worked together again. The rest is history, or so the general story went for a very long time.

The science in this tangled tale is inspiring. The personal drama is dismaying. The full story was finally uncovered by Professor Michael Bliss in his excellent 1982 best seller, Discovery Of Insulin, which revealed a toxic mix of ego, insecurity, and pettiness, largely emanating from Banting who came to believe that a “grasping, selfish, deceptive, self-seeking” Macleod was trying to steal the idea and glory for himself. At one point, Banting and Collip got into a shouting match that perhaps got physical after Collip said he wouldn’t reveal his extraction process and was going to patent it in his own name. Even though this was the most violent confrontation in the story, Banting eventually reconciled with Collip, conceding his vital contribution. He fell out with Best and never forgave Macleod. Professor Bliss concluded more accurately, “On their own, Banting and Best were not experienced and knowledgeable enough to have carried their work through to a successful conclusion. They badly needed Macleod’s advice.”

Despite his raging anxiety about being cast aside, most of the ensuing glory and fame settled on Banting who was lavished with research funds he spent trying to cure cancer and other plagues, though he was never able to recapture the breakthrough he had ignited with his idle curiosity. The outbreak of the Second World War seemed to offer the canvas for another potential dose of glory.

In 1941, Banting found a spot on the bomber plane with faulty engines because he went to a cocktail party at the last minute. He survived the night of the crash into the following day, in and out of consciousness. When the pilot went off to find help, Banting somehow got up from the bunk and wandered a few metres from the downed plane until he collapsed in the snow. He lay some 10 miles south of Musgrave Harbour, a hamlet untouched by roads or rail, accessible by sea in the summer. Alerted by search planes, locals made the slow trek to the crash site and recovered the bodies of Banting, the radio operator, and the navigator. He was mourned around the world. His former colleagues and those who knew something of the personal squabbles said nothing in public. 

In reply to a sharp critique of Banting and Best’s methodologies and assumptions, a prominent British doctor leaves us with a generous endpoint:

If [the discovery of insulin] proves to have resulted from a stumble into the right road, where it crossed the course laid down by a faulty conception, surely the case is not unique in the history of science. The world could afford to exchange a whole library of criticism for one such productive blunder.

The Weekly Wrap: Trudeau’s legacy is a truly changed Canada

Commentary

The first edition of The Hub’s Weekly Wrap reflects on three of the past week’s biggest stories, including the unfolding ArriveCAN scandal, Steven Guilbeault’s counterproductive comments on roads, and the lasting legacy of Justin Trudeau’s prime ministership.

The troubling implications of a shocking scandal 

This week’s auditor general’s report on the ArriveCan scandal is genuinely shocking. Even if one is prepared to grant the government considerable slack in light of the unique pandemic context, it doesn’t excuse such a fundamental governmental failure. 

The basic details are now well-known. The government outsourced the development of the mobile application to GC Strategies without evidence that the two-person company had much capacity or expertise or even requiring that it first submit a proposal. It then itself outsourced app development to various sub-contractors to actually perform the work. The eventual cost ballooned to as much as $60 million. GC Strategies received $19 million for its role. 

It mustn’t be forgotten that the app which was used for roughly two years didn’t function well either. It was the subject of 177 updates (which amounted to one every five days) including one in June 2022 that caused 10,000 travelers to be wrongly instructed to quarantine. 

The upshot: we paid far too much to companies who were unqualified to develop a mobile application, and they predictably produced a poor-quality one that caused a lot of problems for the government and Canadians. 

Yet, as much as we know from the auditor general’s report, there’s a lot that we still don’t know—namely, how did something like this happen?

I previously worked in Ottawa for more than five years, including in the Prime Minister’s Office and the Department of Finance. My experience was marked by the typical frustrations of working in the government, including multiple layers of signoffs, various stages of approvals, and ongoing Treasury Board scrutiny. We were often told that these laborious processes were an annoying yet necessary insurance cost against such spectacular failures. 

In light of those various bureaucratic checks, it’s hard to understand how something that so self-evidently failed the principle of “value for money” and quite likely crossed into the realm of outright criminality could have gotten through the system. It should have been killed at various stages of review and approval. 

The RCMP’s own investigation may determine why that didn’t happen. But the present facts don’t indicate that sophisticated corruption was a key factor here. The only people who seemingly got rich off the scandal are the two principals at GC Strategies. The real story seems both less salacious and satisfying than one might expect. It mostly appears to be a story of low-grade incompetence. The implications for the government are in some ways worse than if corruption had been the cause. 

Conservatives are often criticized for having a more restrained vision of the state on the grounds that it signals an indifference to our economic and social challenges or the limits of market forces to solve them. As I’ve written elsewhere, however, it’s not sufficient to declare that a certain problem represents a market failure. The nature and scope of a market failure need to be weighed against a realistic view of a potential government response rather than an idealized one. Market failure, in other words, must be assessed against the rather high possibility that a government intervention will produce its own failures that could be bigger and more damaging than the problem that it’s trying to solve. The ArriveCan app is a case in point. 

The main lesson of the week therefore ought to be a hit of reality for those inclined to an idealized view of government action. Unless, of course, you work for GC Strategies.  

Guilbeault’s counterproductive radicalism 

Steven Guilbeault’s comments this week that the federal government will no longer fund provincial and local road projects has precipitated pretty widespread condemnation and a feeble attempt on his part to clarify his statement. 

It must be said that there is a world in which his comments are actually defensible. The federal government’s involvement in funding local infrastructure isn’t the historic norm. For most of Canadian history, it was understood that provinces and municipalities were responsible for financing their own infrastructure. The federal role was mostly limited to interprovincial or trade infrastructure like railways, highways, border crossings, and ports. 

Starting in the early 2000s, successive federal governments have entangled themselves further and further in the direct financing of provincial and local infrastructure. We’re now collectivizing national tax dollars to fund residential roads in local communities. There’s a strong argument that this policy trend represents a misreading of the Canadian Constitution. 

If therefore Guilbeault’s point was that Ottawa is getting out of the business of local road construction in favour of dedicating federal resources to national projects, it would have been a principled correction to the growing nationalization of public infrastructure financing in Canada. 

But of course that wasn’t his motive. Guilbeault seems to live in another virtual realm in which motor vehicles—including hybrid or electric ones—aren’t going to be a key part of Canada’s transportation future. 

Outside of the country’s major cities, the idea that public transportation can become a significant or even the dominant mode of transportation is an ideological fantasy. It’s similarly fantastical to think that we can somehow fully substitute the 77 percent of the volume of goods that are shipped across the country by truck. These faulty assumptions reflect a fundamental misunderstanding of the interaction between basic economics and Canada’s unique geography. They’re such radical ideas, in fact, that they bring into question Guilbeault’s entire understanding of climate policy in the Canadian context. 

Minister of Environment and Climate Change Steven Guilbeault makes as a funding announcement at the Fletcher Wildlife Garden in Ottawa on Wednesday, Feb. 14, 2024. Patrick Doyle/The Canadian Press.

They also involve a high degree of cognitive dissonance. His government has mandated the transition to electric vehicles by 2035. It has also already spent billions of dollars to subsidize production in Canada. Is the plan to regulate and subsidize the creation of an electric vehicle industry into existence and then refuse to fund the roads on which Canadians will drive them? 

It’s the sort of unserious thinking that actually does harm to the practicalities of a durable and successful climate change agenda. It also exposes the inherent problems of appointing a hard-core ideologue to lead the file in the first place. 

Progress on climate change, as we discussed with David Frum this week, will come from pragmatism, not dogmatism. Guilbeault’s controversial tenure as federal environment minister is dispositive proof. His radicalism may resonate with his fellow activists but, as we’ve seen in recent days, it’s ultimately counterproductive for his own cause.  

Trudeau’s legacy is a truly changed Canada

This week’s poll that only 3 percent of Canadians believe that Justin Trudeau’s ongoing leadership of the Liberal Party is in the party’s interest is a virtually unprecedented public indictment of a sitting party leader. At this point, only some combination of delusion and ego would cause the prime minister and party members to not seriously consider replacing him before the next federal election. 

As devasting as the poll is however it’s wrong to interpret it as a sign of failure of Trudeau’s prime ministership. Yes, of course, he’ll leave office with levels of unpopularity that are matched by only the least popular prime ministers in Canada’s history. But public standing is only one means to evaluate a political leader’s record. Another is the extent to which Trudeau has made durable changes to Canada’s overall public policy direction and its political culture more broadly. On this front, he must be understood as a highly influential prime minister. 

Take Canada’s fiscal policy direction. Trudeau’s large-scale spending on child care, climate change, health care, housing, and other files has reshaped the federal government’s fiscal trajectory by effectively locking his successors into dedicating scarce resources to his progressive priorities and in turn narrowing the options for tax cuts or other conservative policy preferences. Unless he’s prepared to assume great political risk, a Pierre Poilievre-led government will preside over a fiscal framework established by Justin Trudeau. The net result: Ottawa will be permanently bigger than it was before the latter became prime minister. 

The same goes for the broader political culture. Although causality and correlation are hard to judge, it’s clear that Trudeau has presided over the flowering of identity politics in our major institutions including big business, universities, the news media, and the government itself. Gender pronouns, race-based hiring and promotion, and culture wars over questions of human sexuality weren’t really part of the pre-2015 mainstream debate. They are today. 

Even if Trudeau didn’t originate these trends, he certainly helped to precipitate them. One might even (somewhat facetiously) argue that one of the biggest exports during his time in office is Jordan Peterson who first rose to prominence based on his opposition to Bill C-17 (tabled in May 2016 and passed in June 2017) which added gender identity and expression as protected grounds under the Canadian Human Rights Act

It’s hard to imagine that Trudeau’s eventual departure will cause these types of divisive issues to recede. They’re now not only ensconced in the public consciousness but there are various individuals and institutions whose interests are firmly rooted in the perpetuation of these ideas and norms. The future will be marked by greater contestation concerning culture, identity, and sexuality. This is a big part of Prime Minister Trudeau’s personal legacy too.

The key point here is that Trudeau has overseen a transformation of Canadian public policy, governance, and culture. The country has changed under his prime ministership and an electoral defeat (even if a significant one) won’t change that.