Elizabeth Hughes, the Discovery of Insulin, and the Making of a Medical Miracle
by Thea Cooper and Arthur Ainsberg
Copyright © 2010 by St. Martin's Press.
Excerpted with permission of the publisher, St. Martin's Press.
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Chapter 25: Fame and Famine, Summer 1922
Ever since the AAP meeting in May, newspapers around the world heralded insulin as a miracle cure, saying that it would do for diabetics what antitoxin had done for those with diphtheria. The inevitable result was that in July, the Toronto train stations teemed with emaciated children and their distraught families, drawn in by the stories in the press. Best went to Maine for a vacation, and once again Banting found himself alone in Toronto's sweltering summer climate. He was deluged with requests for insulin. A daily pageantry of illness filed up Bloor Street West to the tiny waiting room of his clinical office. Each child's distended stomach and huge staring eyes were more heartrending than the last, but there was no stable, nontoxic insulin. It was an excruciating conflict: He had agreed not to accept any new patients in his private practice once the diabetic ward at Toronto General Hospital was open, but it wasn't open yet. In the meantime, didn't the Hippocratic Oath require him to do what he could to help these children?
That month Antoinette Hughes's letter was one of the dozens of desperate entreaties that arrived at Banting's Bloor Street office, either directly or via Macleod. Some came from family members and others from physicians. A typical exchange, as terse as it was tragic, was this one, via telegram with a doctor in Atlanta:
Dr. J.R. Macleod — Is there any possible chance for you to take Graves Smith the patient about whom Joslin wrote you some weeks ago any time soon[?] His father is anxious to bring him to you if there is any hope of getting him under Banting[.] The boy is in a very serious condition and unless something is done soon will be too late please wire at my expense. — Dr. J.E. Paullin.
Dr. J.E. Paullin — No insulin available at present. Will wire you whenever supply is obtained. — F.G. Banting.
Dr. Morton Ryder, uncle of the twenty-six-pound Teddy, was another whom Banting initially turned away. Trying to offer some hope, Banting suggested that he write to him again in September when there might be some insulin. Ryder replied, "Teddy won't be alive in September."
In 1922 there was a fine line between help and harm. Even laying aside the problem of purity, until they were able to achieve a stable potency in the insulin they produced, it was almost impossible to prescribe the right dosage. At Christie Street, several diabetics had suffered hypoglycemic shock as a result of an overdose and had to be revived with glucose. The lack of supply placed diabetic specialists in both countries in grueling dilemmas about which patients would receive insulin, and these decisions had life-and-death consequences. Most doctors agreed that during the experimental stage, only the most severe diabetics should receive insulin. But others argued that if these cases were so frail that the patient would not survive the experiment, shouldn't they be turned away so that a less desperate case might be given the chance to recover.
Banting turned nearly every case away, yielding only when he was sure that the child was so close to death that the risk of using unstable or impure insulin was justified. He finally accepted three new private patients, three living skeletons from the United States: Myra Blaustein, age eleven, forty pounds; Ruth Whitehill, age seven, forty-three pounds; and Teddy Ryder, age five, twenty-six pounds.
When Mildred Ryder left New York with Teddy for Toronto in early July, a friend helped Mildred with their luggage and waved them off at the station. As the train pulled away, the friend recalled feeling sure that Mildred would never bring Teddy back alive. Mother and son arrived in Toronto on the sleeper on Saturday morning, July 8. They went directly to 160 Bloor Street West. There was no insulin: The last batch had gone inexplicably bad. While Connaught struggled to recover the ability to make effective, nontoxic insulin, the discoverers were dependent upon the Americans for insulin to supply to their own patients. There was nothing to do but wait until Monday when the Lilly shipment would arrive. That Teddy might die within reach of the cure was almost more than Mildred Ryder could bear. To make matters worse, the diabetic clinic at Toronto General Hospital was still a month from opening, and the regular hospital kitchen could not accommodate the diabetic diets; so Mildred Ryder carried poor Teddy through the blistering heat to find a room to rent. She found a suitable situation on Grenville Street, with kitchen privileges so that she could prepare Teddy's exacting meals herself.
On Sunday Banting took delivery of the first new car he had ever owned. He came by Grenville Street and took Teddy and his mother for a drive in it to lift their spirits. On Monday the shipment from Indianapolis arrived, and Teddy's recovery began.
Mildred and Teddy liked Banting right away. He was not at all the intimidating scientific luminary they had expected him to be. He was a plainspoken man who loved children and had struggled with romance. Often, after giving Teddy his injection, he would linger at the Ryder's room to confide his troubles to Mrs. Ryder.
Someone at work asked me for a “fun fact” about myself for an upcoming newsletter highlighting recent accomplishments. Having just had an absolutely hellish day and night of high blood sugars, I thought … Fun Fact: My son’s blood sugar was 525 yesterday. Fun Fact: My son’s blood sugar was so high that he couldn’t take part in his hockey team’s end-of-season party. Fun Fact: It took several...