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BANTING, Sir FREDERICK GRANT, physician, surgeon, army officer, medical researcher, Nobel laureate, and artist; b. 14 Nov. 1891 in Essa Township, Simcoe County, Ont., son of William Thompson Banting and Margaret Grant; m. first 4 June 1924 Marion Wilson Robertson in Toronto, and they had a son; they divorced 2 Dec. 1932; m. secondly there 2 June 1939 Henrietta Elizabeth Ball; they had no children; d. 21 Feb. 1941 near Musgrave Harbour, Nfld.

Fred Banting was a child of agricultural Ontario, the youngest of six born on the family farm near Alliston, northwest of Toronto. A shy, quiet boy who liked athletics and animals, he was encouraged by his family to continue his education beyond the local schools. In 1910 he enrolled in general arts at Victoria College in the University of Toronto, was not able to pass all his subjects, and while repeating the year, dropped out after learning he could enter the faculty of medicine. Medicine had apparently vied with the Methodist ministry as a possible profession.

Banting began his medical course in 1912. He received slightly higher-than-average grades, but otherwise did not stand out. The five-year program in medicine was radically condensed during World War I. He graduated with a bachelor’s degree in December 1916. By his own account, Banting had not been particularly well trained. He had developed an interest in surgery, enlisted in the Canadian Army Medical Corps, and upon graduation began full-time military service. He worked as a surgeon in a Canadian hospital in England for 13 months, was sent to France in June 1918, and as a battalion medical officer, served on the front lines during fierce fighting that summer and autumn. In the attack on Cambrai on 28 September Captain Banting was hit in his right arm by shrapnel and evacuated. He was awarded the Military Cross for his conduct during the action. After several weeks’ anxiety about the condition of his wound, Banting was able to resume duties in England, before being recalled to Canada in 1919.

He had shown interest in improving his medical qualifications and dabbling in research. In 1919–20 he worked under one of his wartime mentors, Clarence Leslie Starr, as a senior house surgeon and registrar at Toronto’s Hospital for Sick Children. He hoped to specialize in orthopaedic surgery. When his appointment was not renewed – the reason is not clear – Banting decided to practise medicine as a general physician and surgeon. In July 1920 he hung out his shingle in the prosperous small city of London, west of Toronto, and waited for patients to come.

When they were discouragingly slow in doing so, Banting took on part-time work as a demonstrator in surgery and anatomy in the small faculty of medicine at the University of Western Ontario. He was deeply worried about his financial affairs, his practice, and his marital prospects, and began wondering if there were better courses to follow. As he prepared to give a talk to Western students about the pancreas, Banting happened, on the night of 31 Oct. 1920, upon an article in the November issue of the journal Surgery, Gynecology and Obstetrics (Chicago) by pathologist Moses Barron entitled “The relation of the islets of Langerhans to diabetes with special reference to cases of pancreatic lithiasis.” Some of Barron’s observations about an unusual but unimportant case of blockage of the pancreatic duct inspired Banting to reflect upon scientists’ search for a substance in the pancreas that might hold the key to preventing the disease known as diabetes mellitus. Late that night he jotted in his notebook a research idea:

Diabetus.
Ligate pancreatic ducts of dog. Keep dogs alive till acini degenerate leaving Islets. Try to isolate the internal secretion of these to relieve glycosurea.

Staff at Western, who lacked both expertise and facilities, advised Banting to discuss his idea with the professor of physiology at the University of Toronto, John James Rickard Macleod*, an internationally recognized expert in carbohydrate metabolism. At a meeting in Toronto on 8 November, Macleod told Banting, who had little knowledge of either diabetes or the pancreas, that his idea could be worth pursuing, but might well lead to the same negative results that had bedevilled many more-experienced researchers. If Banting still wanted to try, Macleod would make facilities and animals available to him.

Banting blew hot and cold about the research idea that winter. He later wrote that his preference would have been to take a job as a medical officer on an expedition searching for oil in the Canadian north. Friends advised him to settle down and make the best of a practice that was actually growing decently. Instead he decided to take advantage of Macleod’s offer and spend the summer of 1921 working in Toronto on his idea. Macleod gave him laboratory space, a supply of research animals, and the services of his student assistants. Charles Herbert Best* won a coin toss with Edward Clark Noble to be the first to work with Banting, and both later agreed that Best would stay on for the summer. Banting and Best began work on 17 May.

Banting believed that by ligating the pancreatic ducts of living animals, he could cause the cells that produced the organ’s external secretion (digestive enzymes) to degenerate. They would no longer interfere with or neutralize the pancreas’s mysterious internal secretion, which could then perhaps be isolated in an active form. Evidence from his notebook and later suggests that Banting first hoped to use his surgical skills to transplant portions of pancreas from duct-ligated dogs to diabetic dogs to see if he could improve their condition by reducing the sugar in their urine or blood. The research proceeded slowly and fitfully through the hot summer of 1921, with heavy loss of animals and various setbacks, frustrations, and transient frictions between Banting and his assistant. After the first month, during which he gave advice and instructions to Banting, Macleod had gone to Scotland for the rest of the summer.

By the end of July, Banting and Best, in lieu of transplants, were able to begin injecting extracts from the pancreas of duct-ligated dogs into the veins of depancreatized, diabetic dogs. The dogs’ blood sugars appeared to drop dramatically, suggesting that the extracts were restoring the metabolic function. In some cases the animals were perkier and lived a little longer than would normally be expected with untreated diabetes. When he returned from Scotland in September, Macleod urged an enthusiastic Banting to build his evidence by repeating and refining his experiments. Unfortunately, Banting and Macleod, the one untrained and a bluntly impulsive personality, the other a cautious and quiet scientist, disagreed sharply about the priority that Banting’s work should have. A serious breach was narrowly avoided, and the work continued through the autumn.

Banting found that he could bypass his cumbersome duct-ligation procedure by making extracts from fresh fetal calf pancreas. Then he found that chilled extracts of whole dog or beef pancreas could also be effective. As the pace of the research increased – from the beginning Banting’s goal was to be able to treat “diabetus” in humans – he suggested that the team be strengthened by the addition of James Bertram Collip*, an experienced biochemist who was working with Macleod in Toronto while on leave from the University of Alberta. Collip joined the group in December, quickly began making improvements in Banting and Best’s crude extract, and added substantially to knowledge of its properties. Still, the first formal presentation of the Toronto group’s findings, at the annual conference of the American Physiological Society in New Haven, Conn., on 30 December, was far from triumphant, as there was considerable doubt that the team had gone further with pancreatic extracts than several previous investigators.

Even as the research then advanced to another level, it was hampered by Banting’s deep insecurity and mounting suspicion that Macleod and perhaps others were appropriating credit for his findings. He resented the extent to which Macleod publicly identified himself with the work and became deeply alarmed when Collip was given the responsibility of purifying the extract for use in clinical trials. Macleod granted Banting’s demand that his and Best’s extract be the one first used formally on a human diabetic (Banting earlier had tried it on himself and on a diabetic classmate with meaningless results). The initial test was made on 11 Jan. 1922 on a 13-year-old boy, Leonard Thompson, in the Toronto General Hospital. Banting was not present; lacking experience with diabetes, he had been denied privileges at the university’s teaching hospital.

Banting and Best’s extract had only minor effects on Thompson’s condition, and a sterile abscess formed at the site of injection. The clinicians decided to discontinue the experiment. Twelve days later, on 23 January, they resumed administration, but with an extract that had been purified by Collip. When Collip told Banting of the favourable results of his extract and then refused to reveal details about his method of making it, the two scientists came to blows in the lab and Best had to separate them.

On 25 January the four researchers signed an agreement to work together, under Macleod’s general direction and in cooperation with the University of Toronto’s Connaught Antitoxin Laboratories [see John Gerald FitzGerald*], to develop the extract. Collip would be in charge of production. It was separately agreed that the names on publications would be in alphabetical order.

Harmony was never fully restored to the research team, even as the first clinical trials began to yield truly exciting results. The purified extract, soon to be named insulin after the cells in the pancreas known as the islets of Langerhans, where the group assumed it originated, had dramatic effects in eliminating the symptoms of diabetes mellitus and restoring its victims to nearly normal physical health. A very great discovery was emerging from the University of Toronto. Who had made it?

Banting believed that he was the discoverer of insulin, first as the man whose idea led to the discovery, secondly as the conductor of the animal experiments which he believed had proved the presence of the substance. His claim was highly vulnerable, however, because of inadequate controls and inconsistent results in his research, the failure of his extract in the first Thompson trial, and the inconclusive result of a longevity experiment on one of the dogs (whose pancreas Banting had failed to remove completely). At the time there was a prima facie case that Collip’s work had made the great leap forward in Toronto. Later analysis has supported this view, exposing numerous factual and interpretive errors in Banting and Best’s first paper, Banting’s mistaken assumptions about the physiological consequences of duct ligation and pancreatic degeneration, and the possibility that faulty technique made their experiments almost meaningless. As well, Macleod had given Banting more advice than the latter acknowledged. As early as December 1922 the British Medical Journal (London) published a devastating critique of Banting and Best’s research, which concluded that “the production of insulin originated in a wrongly conceived, wrongly conducted, and wrongly interpreted series of experiments.”

Banting, who had risked his career, his livelihood, his reputation, and perhaps the possibility of marital happiness on the research, had nearly broken down in the early months of 1922. He seldom appeared in the lab and, by his own account, used alcohol, sometimes stolen from the lab, to get to sleep. Friends thought he might be suicidal. He returned to work, however, at Best’s urging after Collip found that he had lost the ability to produce effective insulin, a not-uncommon problem in pioneering biochemical extraction. A desperate struggle by the team in the spring to rediscover the technique resulted in Banting and Best recovering an element of leadership: Banting suddenly found himself with the major supply of usable insulin – apparently made by Best – and both his morale and his determination revived. He felt deeply indebted to Best for having come to his aid when he most needed it, and he launched into private practice in Toronto as the clinician who could treat diabetes and was also permitted to care for diabetic patients at the Christie Street military hospital.

A tense, confusing situation was gradually resolved as Banting received an appointment at the Toronto General Hospital to work with other clinicians on its diabetes ward. The process of isolating insulin was patented in the names of Banting, Best, and Collip and the patent then transferred to the University of Toronto’s board of governors. A joint venture between the university and Eli Lilly and Company of Indiana resulted by the summer of 1922 in a constantly growing supply of effective insulin, which began to be used in informal clinical trials in several centres. Collip returned to the University of Alberta. Macleod concentrated on researching the physiological properties of insulin. The Connaught Laboratories gradually assumed control of Canadian insulin production.

By the end of 1922 it was clear that insulin’s impact in the treatment of diabetes was dazzling, and the discovery was almost universally hailed as a triumph of modern medicine. With important help from politically astute friends and admirers such as his former teacher Dr George William Ross, Banting quickly developed a reputation as the key man in the insulin story, a rough-hewn Canadian genius who had taken his idea to wonderful success under the most difficult conditions, with some assistance from Best. An organized campaign to honour Banting led to the government of Ontario in 1923 appointing him to a Banting and Best chair of medical research at the University of Toronto, the first purely research professorship at a Canadian university. Parliament granted him an annuity “sufficient to permit Dr. Banting to devote his life to medical research.” And in the autumn of 1923 it was announced that Banting and J. J. R. Macleod would share that year’s Nobel Prize in Physiology or Medicine for the discovery of insulin. It was the fastest honouring of a discovery in the history of the Nobel prizes; Banting, at the age of 31, was the youngest laureate and the first Canadian. For the rest of his life he would head lists of prominent Canadians, and he would be showered with honorary degrees, prizes, and fellowships.

He remained embittered at almost everything to do with Macleod’s role in the research, briefly considered rejecting the Nobel, and then declared that he would share his prize money with Best. Macleod said that he would divide his with Collip. For many years there was general curiosity about what had happened in Toronto to cause such a strange and controversial situation – two prize winners, four equal sharers in the money. At the University of Toronto’s celebratory banquet on 26 November, Dr Llewellys Franklin Barker tactfully summarized the controversy with the comment “There is in insulin glory enough for all.”

The two Nobel laureates went separate ways at the university and were said not to speak. In 1928 Macleod returned to his native Scotland, and Best, who had left Toronto to finish his education in Britain, was appointed to Macleod’s chair in physiology the following year. Banting had resumed research in facilities separate from the department. An adoring public and media wondered what diseases the Canadian genius would next conquer. To help him, his admirers in 1925 raised $500,000 to endow Canada’s first medical research fund, the recently created Banting Research Foundation. Banting at first worked mainly in solitude, assisted by Sadie Gairns, who had done an ma with Macleod. His aura and the funding he could command gradually attracted other researchers, his chair evolved into the Banting and Best department of medical research, and by the 1930s it had become one of the largest university research establishments in North America.

Banting saw himself as an idea-driven man, not a clinician or a diabetes specialist. He deeply wanted to make further discoveries on his own to show that the doubts about his competence in the insulin work were wrong. It was unfortunately true that his training had been inadequate and his later research ideas and techniques were crude, simplistic, and unproductive. A quest to produce a universal antitoxin, initially billed as something better than insulin, from the secretions of the adrenal cortex was a dismal failure. Banting then took up cancer research, devoting years of fruitless experimentation to the problem of Rous sarcoma in chickens. His obsession with ideas that might lead to the catching of another brass ring, somewhat on the model of tinkering inventors, led to investigations of infant stools, royal jelly, the physiology of drowning, and other unproductive initiatives.

Several of the workers around Banting were better trained and began making significant contributions. In the 1930s his department, administered by Gairns and with quarters in a larger building misleadingly named the Banting Institute, was a major pioneer in developing a state-of-the-art preventive approach to silicosis. Banting’s self-effacing position on research – he gradually recognized and accepted his limitations – made him popular with his young associates. As the great discover of insulin, he slipped naturally, if a bit awkwardly, into a broader role as national spokesman for medical research. In 1937 he was asked to join the National Research Council, chaired by former army chief of staff Andrew George Latta McNaughton*, and the next year he became head of its new Associate Committee on Medical Research, the first body charged with national responsibility for coordinating work in Canada.

Banting’s tribulations as a researcher were paralleled by a less-than-happy personal life. In the turmoil of the insulin years a relationship with his Alliston sweetheart had collapsed. The marriage in 1924 of Canada’s most eligible bachelor with an outgoing doctor’s daughter, Marion Robertson, proved an ill-considered joint imprisonment in solitudes, loneliness, and deep unhappiness. It formally ended in 1932 in a sensational divorce, with charges and countercharges of adultery and abuse. Accused publicly by his father-in-law of beating his wife, Banting struck back with private threats to deny the paternity of their son. During these years he found refuge in painting, developing through Toronto’s Arts and Letters Club friendships with Alexander Young Jackson* and several other members of the Group of Seven, whose techniques he competently absorbed. He went on several sketching trips with Jackson, including a lengthy visit to the Arctic in 1927. In the subjects of his art, in his attitudes to women, and in his musings about the stresses of his fame, Banting often expressed nostalgia for the simpler life and mores of rural Canada.

In 1934 he was one of the last group of Canadians who received titles from the monarch. He hoped his knighthood was exoneration of his tarnished standing as a divorcé, but otherwise thought it ludicrous for people to address him as “Sir.” His friends appreciated him as just one of the gang, an amiable storyteller, especially late in the night while killing a bottle of rye in a smoke-filled room. It was often remarked, sometimes by Banting himself, that he would have been happiest in medicine as a general practitioner in a small town. Still hoping to find contentment in marriage and to father a flock of children, in 1939 he married Henrietta Ball, who had been working as a technician in his department.

He had become well travelled and a frequent diarist, who recorded strong opinions on the state of the world, the problems of his fame, and the conundrums of life in Canada. In 1935 he attended a physiological congress in the Soviet Union, toured widely, and came home with the enthusiasms of a typical fellow-traveller who thought he had seen the future, at least with regard to socialism’s recognition of science. As the world drifted towards another war, Banting tried to alert the British government to the need for serious initiatives to prepare for bacterial and chemical warfare against Adolf Hitler. In 1939 he converted his department’s research focus to problems in aviation medicine, while also re-enlisting in the Canadian army.

Banting spent several months in Britain during the winter of 1939–40 trying to assess research needs. At home he threw himself into war work at every level, from useful advances in aviation medicine through quixotic studies of bacterial warfare and self-wounding with mustard gas to test an antidote. As the Battle of Britain developed, he longed to be able to resume the simple role of a medical officer with his old battalion, or at least to get back to England in its time of crisis. His relationship with Charles Best, who had been forging a parallel career at the University of Toronto and in medical-research circles, had become cool and testy (in marked contrast to the friendship Banting developed with J. B. Collip). When Best said that he could not go to Britain on the next research liaison mission, Banting decided to go instead. To reduce travel time he took up a casual offer of a ride on a bomber being ferried across the North Atlantic.

He left Gander, Nfld, on a two-engine Hudson with a crew of three during the night of 20 Feb. 1941. Shortly after take-off the pilot reported that an engine had failed and he was turning back. When the second engine failed, the plane crash-landed by a pond near Musgrave Harbour, on the east coast of Newfoundland. Two of the crew were killed instantly. The pilot survived. Banting was mortally injured and died before outside help arrived.

Major Sir Frederick Banting’s body was returned to Toronto, where he was given a hero’s and a warrior’s funeral. There is no truth in propaganda stories that he had been on a secret mission to Britain of the highest importance, or in persistent rumours that his plane had somehow been sabotaged by Nazi agents. He left a modest estate to his widow and the son of his first marriage.

Over the years Banting’s fame remained undiminished, as the myth persisted that insulin had been discovered through the genius of Banting and Best, working without significant help. In fact he had been the curious and lucky doctor who had started a ball rolling, had stayed with it through the mobilization of expert help in an excellent facility, and then had spent the rest of his life coping with the consequences of having achieved a scientist’s fondest dream – saving lives, winning the Nobel Prize, becoming an immortal.

Michael Bliss