Breakthrough

🚀 The Book in 3 Sentences

This book is about the discovery of insulin.

🎨 Impressions

I read this book cause I worked for novo-nordisk back in the day.

I got sad cause the dogs who suffered and died. They died but got a lot of love, and their sacrifice saved a lot of lives.

✍️ My Top Quotes

• Symptoms of diabetes were described on Egyptian papyrus as early as 1550 b.c. The recommended Egyptian treatment was to eat a boiled assortment of bones, wheat, grain, and earth for four days, a diet perhaps no more satisfying than that prescribed for the disease in 1918.

• Aretaeus of Cappadocia, a celebrated Greek physician, coined the term “diabetes” after the Greek word for “sieve” because the symptomatic incessant thirst and urination made the body act as a sieve.

• In 1918, despite thousands of years of medical scrutiny, physicians could only watch helplessly as diabetic children like Elizabeth died.

• There are two major types of diabetes: Type 1 diabetes is defined by the body’s failure to produce insulin; type 2 diabetes is defined by the body’s resistance to or insufficient production of insulin. Type 1 diabetes is also called insulin-dependent diabetes, or juvenile diabetes, because it affects mostly children, teenagers, and young adults.

• Great Britain and its empire lost over 1 million soldiers; France, 1.3 million; Russia, 1.7 million; Germany and its allies, 3.5 million.

• To replenish its devastating losses, Britain passed five versions of the conscription act, each one broader than the previous one until the last, when they were calling up all men, married or unmarried, of any profession, from the ages of seventeen to fifty-one.

• One thing I learned is that I’d rather save lives than win arguments.”

• While Wilson was incapacitated, he was sequestered from even his vice president and cabinet members. Edith Galt Wilson, Wilson’s second wife, spoke for the president during the remainder of his term, thus earning her the title “American’s first woman president.”

• At that time, it was widely accepted that the interests of medical research and the pharmaceutical business were utterly and irreconcilably incompatible. Researchers were primarily concerned with contributing to a body of research by writing, presenting, and publishing scientific papers. Pharmaceutical firms were primarily concerned with making money by means of manufacturing and selling products.

• As Eli Lilly saw it, he faced two hurdles in creating a creditable new internal research group, and they were two sides of the same coin. The first hurdle was to persuade the company’s board of directors to invest in a fundamental research department. The second hurdle was to persuade a research scientist to climb down from the ivory tower to work in the world of commercial enterprise.

• In 400 B.C., Hippocrates used the powdered bark and leaves of the willow tree to help relieve pain and fever. By 1829, scientists had identified willow’s beneficial compound as salicin. Then French chemist Henri Leroux improved the extraction process and Italian chemist Raffaele Piria refined salicin, isolating salicylic acid. Salicylic acid is highly effective but it irritates the stomach. In 1853 another French chemist, Charles Gerhardt, succeeded in buffering salicylic acid without diminishing its efficacy. Like a true academic, Gerhardt published a paper to document his results and thought no more about it. It wasn’t until 1897—forty-four years after Gerhardt’s discovery—that a chemist named Felix Hoffman at Germany’s Friedrich Bayer & Co. began working with the compound in order to alleviate his father’s arthritis pain. By 1899 Bayer aspirin was selling around the world.

• On the evening of March 31, Best broke. He visited Banting’s boarding- house room and let loose his fury and frustration as he had never dare to before. He attacked Banting for allowing himself to languish in morbid self-pity when so many around him were working hard toward a solution. Banting drank stolen alcohol from a beaker and listened impassively. “You said we’d do whatever it takes!” Charley howled. Banting shrugged. “Changed my mind.” “It’s too late to change your mind. You sold your house. You sold your car. We stole dogs!” “It takes a brave man to know when to surrender.”

• Banting raised his glass and drank to bravery while Charley watched in disbelief. “Col- lip’s process worked. Ours didn’t. Here’s to the continued success and glory of James Bertram Collip! I salute you—you prig bastard.” “So he won the purification round. So what. We still have to find a way to make large quantities. Aren’t you the one who’s always reminding everyone that this is about the diabetics?” “To the diabetics!” Banting raised the beaker, drained it, and threw it across the room. It shattered against the wall.

• In August 1922, the quality, quantity, and potency of each batch were utterly unpredictable, and deterioration and sensitization reactions continued to present problems for clinical use. Clinical data from all of the participating physicians accrued and was analyzed in Toronto: There was a frustrating mixture of miraculous recoveries and baffling failures.

• “But the problem is one of shortage, is it not? If so, then if Elizabeth receives insulin it may be at the cost of another child’s life.”

• “If you are asking me to do this, I will consider it.” He held her gaze for a long time, watching her carefully. “Are you asking?” “I am asking,” she said in a barely audible voice. And then she went to bed.

• “Excuse us.” Antoinette interrupted the doctor as she guided Elizabeth toward the door. “We’ve a long trip ahead and no time to spare.” Antoinette now stood nose to nose with Allen. “This is my institute!” he snapped. “This is my daughter!” she rejoined. “Do you think that being Mrs. Charles Evans Hughes gives you any authority in my hospital?” “I am her mother! Now please, step aside!”

• Before 1922, hyperglycemic coma, induced by total lack of or insufficient insulin, accounted for 86 percent of the mortality of diabetic children; after insulin, from 1922 to 1936 the mortality rate of diabetic children from hyperglycemic coma declined, but was still 56 percent. The first diabetic “resurrected” from a hyperglycemic coma by the injection of insulin was eleven-year-old Elsie Needham, at the Hospital for Sick Children in Toronto in October 1922.

• As Frederick Allen said, insulin improved but did not simplify the treatment of diabetes.

• Charles now understood something that Elizabeth had learned through her years of trial—that the purpose of living is not to preserve life but to lose it. Living is by necessity a process of continuous loss. As we live we lose time, we lose innocence, we lose family and friends, we lose memories, and the longer we live, the more we lose. Ultimately, we lose the process of losing itself. Accepting this, Charles was free. He was no longer a standard-bearer; he was a man.

• Frequently less than one dollar per week and seldom more than two dollars. (Consider that this was just two years after the initial announcement in New Haven and one year after Elizabeth left Toronto to begin a new and normal life.

• The Banting Research Foundation played a major role in supporting the development of the first anti-gravity or G-suit, designed to prevent pilots from blacking out when subjected to extreme acceleration. These suits were used during World War II, and all G-suits worn by pilots, astronauts, and cosmonauts are based on this original design.

• IN LATE 1922 Dr. August Krogh returned to Denmark with the insulin formula, courtesy of Macleod. In the spring of 1923, Dr. Krogh and Professor H. C. Hagedorn founded the Nordisk Insulin Laboratorium, which began to manufacture the first Scandinavian insulin. Two years later, Novo Terapeutisk Laboratorium was founded and started producing insulin and a special syringe for injecting it.

• The initial work that led to this new type of insulin took place in Denmark, where Dr. Hagedorn discovered that protamine, derived from fish sperm, when combined with insulin, slowed its action. The new protamine insulin allowed many diabetics to reduce their daily injections by half.

• Novo Nordisk—originally Nordisk Insulin Laboratorium—is also a world leader in diabetes care, with international production facilities in seven countries and more than 29,000 employees (as of December 2009).