General Articles

LIFESAVER IN A LAB COAT

Dr. Best of the Banting-Best insulin team today leads a crack squad of fighters against the diseases of man

GERALD ANGLIN June 1 1948
General Articles

LIFESAVER IN A LAB COAT

Dr. Best of the Banting-Best insulin team today leads a crack squad of fighters against the diseases of man

GERALD ANGLIN June 1 1948

LIFESAVER IN A LAB COAT

Dr. Best of the Banting-Best insulin team today leads a crack squad of fighters against the diseases of man

GERALD ANGLIN

SOME time after World War II had ended and the last Allied general had made his triumphal tour of liberated Europe, a civilian from Canada was ushered about Britain and the continent to a welcome no less heartfelt if somewhat less tumultuous than that accorded the high brass.

At Oxford, Liege, Louvain and Amsterdam, learned scientists in flapping professorial gowns showered him with honorary doctorates of science

and medicine. At Brussels he received the Medal of Freedom and had tea with the Queen Mother of Belgium. In Norway King Haakon VII decorated him with the Liberty Cross. But it was the enthusiastic audiences of plain Britons, Belgians, Dutch and Norwegians—men, women and surprisingly large numbers of children—that gave the reception to the Canadian visitor its urgent, personal tone. At each point on the tour they crowded the platform to shower bouquets and corsages on his wife, to shake the visitor’s hand and exclaim warmly, “Thank you for saving my life.” These grateful Europeans—and more than two million other sufferers from diabetes throughout the world—owe their lives to daily injections of insulin, a hormone discovered at the University of Toronto 27 years ago. Dr. Charles Herbert Best, the man they honored, was one of the discoverers. He was a 22-year-old graduate student in physiology and biochemistry when in 1921 he teamed up with a 30-year-old physician and surgeon named Frederick Banting. Together they achieved one of the most spectacular advances in the history of medicine.

Today, at 49, Dr. Charles Best is the playing coach of one of the world’s crack medical research teams. He is head of the Department of Physiology in the medical faculty of the University of Toronto and director of the Banting-Best Department of Medical Research. In his field he is famous for his work on insulin and subsequent diabetic research and no less noted for his other accomplishments. His name is closely identified with the isolation

of histamine, a chemical found in the body which, among other things is believed to be the villain in hay fever and other allergical troubles; with the production of a pure form of heparin, which slows the clotting time of blood and saves lives that would be otherwise lost to coronary thrombosis and other diseases of the blood vessels; and with the discovery of choline, a vital factor in diet and an important aid in the treatment of cirrhosis of the liver.

Continued on page 18

Continued from page 17

Appropriately enough for a man who has spent his life waging war on the ills of humanity, Charlie Best is the healthiest-looking individual you ever met. A shade under six feet, he carries his 190 pounds easily and confidently. His pleasantly full face gives out a ruddy glow that has gradually spread over the top of his head, ousting most of his hair. Even when he is just sitting at a desk, talking, he gives a feeling of mental and physical strength kept under an easy control. His manner is relaxed and casual, except for the sharpness of the cornerwise glance he employs to make sure his listener is still with him as he unfolds the simpler medical mysteries.

“For research you must have explorers and developers,” says Dr. Best. “It’s no use hitting a gold mine if you don’t get any gold out. You need some men with novel ideas and others who can get all the possible good out of those ideas.”

There is much of both in Best himself (“You tend to become more of a developer as you grow older,” he confesses) but he is also something else. Research has become a large-scale operation. In his two departments at Toronto, Best has a staff of 100, topped by some 40 able research scientists. These men and women are currently engaged in about 30 different investigations, many of them closely related, and variations of the same projects are being pursued in other centres all over the world. More than 20,000 papers have been written on diabetes alone since insulin was discovered.

Thus has emerged the role of the executive scientist to guide and direct large groups of research workers and this is the role being filled at Toronto by Dr. C. H. Best in the field of physiological science the study of the body’s normal functions. For an executive, however, lie is surprisingly often to be found with his sleeves rolled up, out working in the plant with the boys.

Scientist at Work

Professor Best does his directing from an office on the top floor of the Banting Institute on Toronto's College St. It is a severe, businesslike room, its austerity lightened by large windows and several small oil paintings of his own creation (academic and lots of color). The walls are lined with tables, bookcases, his desk and a red leather chesterfield where weary young men in wrinkled lab coats occasionally sneak 40 winks.

The dominant feature of this crowded room is the large central table which functions as the composite brain box of the Best laboratories. Here the Chief and any two or three of his associates may regularly be found in sessions of mental ping-pong concerning the various studies in which they are engaged. These range from a proposed method for finding the insulin content of blood to the way nerve endings control the muscles; from thrombosis to cirrhosis of the liver; from cancer to the bugs which crawl around in your mouth when you get pyorrhea.

These huddles are deceptively informal. Newcomers soon learn that an apparently casual suggestion from the big, quiet-spoken man at the head of the table is an assignment to start work on a new problem—something he has probably been mulling over ever since that conference last month in Chicago. Then, before they know it, he injects them with a large dose of his own intense if untrumpeted enthusiasm and soon there’s another red-eyed victim for the red chesterfield during the long scientific watches of the night.

Best’s explorers and developers come from all over Canada, from the United States, Denmark, pre-Hitler Germany, Australia and India. There are eager young fellows fresh out of medical school, working for nothing or on $100a-month fellowships; and there are brilliant scientists (physiologists, biochemists, histologists, atomic physicists) on the full-time staff making $3,500 to $5,500 a year.

Many of Best’s investigators could command much better pay across the border (he has turned down numerous offers himself) yet Americans are among those who come to Toronto to work with him at low pay.

“They like it here,” says Best, “because it’s exciting. They never know when they’ll strike a gold mine.”

The prospectors themselves say they like it because of the close personal interest their director takes in their work and his instinct for deciding which of several possible approaches to a given problem will bring results, often saving months of fruitless chasing after fool’s gold.

His Ruthless Timetable

“The chief wants you to bring him a fact you can hang something on,” one of his ardent seekers said recently. “I don’t think he’d be too upset if you wandered from the problem he put you at, providing you tracked down a new and useful bit of knowledge.

“But I think he’d be mad if he learned that a group somewhere else had beaten us to something we were also seeking. He’d take it as evidence that we weren’t on our toes and he wants his team to play right up there in the world league.”

Best’s stern habit of saying what he thinks of any piece of research may have done less than endear him to an occasional brother scientist, but his many friends are warm and loyal. Conscious that no man of Charles Best’s pre-eminence in any field can escape rivalry and jealousies (infections which often thrive in university circles), they close in about him like a personal bodyguard, defying anyone to discount their praise.

One thing on which colleagues both younger and older agree is that no matter how much they share their director’s enthusiasm they can’t stand his exhausting pace. During a busy mid-term month like January, for instance, he gave nine lectures to student groups, showed up regularly at the weekly sessions of the U. of T. physiological society and took part in 13 faculty meetings, office confabs and more formal conferences. Some of the last involved trips to New York and Cleveland to keep posted on what other groups were up to and in turn he entertained visiting professional gentry come on similar scouting missions to Toronto.

Sandwiched in among all these were daily bouts with a heavy correspondence and other administrative annoyances, yet he also found time for 11 sessions of experiment and general lab work and four periods of work on medical manuscripts. He is the author, or joint author, of some 220 papers on medical research, not to mention an 1,100-page physiology text written in collaboration with Prof. N. B. Taylor of Toronto. The book has gone into several editions over the past 10 years and has sold upward of 140,000 copies— at $10 a tome. On this the two professors split royalties of approximately 10% , out of which they have to pay an artist for extensive illustrations and other expenses. Professor Taylor, who has done the major share of the writing chore in the later editions, draws the greater portion of the net proceeds.

Continued on page 38

Lifesaver in a Lab Coat

Continued from page 18

In addition to his Toronto responsibilities Dr. Best is a special consultant to the Rockefeller Foundation and the U. S. Public Health Service, as well as being a member of Canada’s National Research Council and Defense Research Board. Each of these posts adds several more out-of-town trips every year to an already bustling schedule, and he is constantly in demand as a lecturer at professional gatherings on this continent and abroad.

Canadian From Maine

All of the foregoing takes no account of the additional hours of work he puts in on almost every “free” night when no meetings are on the docket. Although he has slept on his share of lab tables in the past when no chesterfield was available, he now does his night work and what still must be little more than incidental sleeping at home.

The role of executive scientist is of recent development and in the case of Dr. Best the man developed with the job. Though born in West Pembroke, Maine, he has never considered himself anything but a Canadian since his physician father and his mother were King’s County folks from Nova Scotia. Driving about with his father on calls (and according to some stories lending a hand with the anaesthetics and other chores) he acquired a first-hand interest in medicine. He was sent to live with his aunt in Toronto in time to complete his high schooling at Harbord Collegiate and he entered Toronto University in 1916 when he was 17 years old. As soon as he was 18 he joined the artillery and went overseas as a sergeant driver, but was still in England when the Great War ended.

On discharge he resumed his studies, fell in love with a co-ed from St. Andrews, N.B., named Margaret Mahon, and spent one summer swinging pick and shovel with a golf-course construction crew. In the spring of 1921 he finished his premed course as a B.A. in physiology and biochemistry. The day after his last exams he started to work with Dr. Banting, who had conceived an idea for combating the curse of the faulty pancreas—diabetes.

At that time diabetic sufferers gave an advance glimpse of the horrors of Dachau and Belsen—they were gaunt and weak, wasting away under a nearstarvation diet treatment and the inability of their bodies to turn the sugar of the bloodstream into energy. If the blood sugar level rose too high they went inio diabetic coma and died. Some failure of the pancreas was known to be at the root of the trouble, but just what was largely conjecture. The pancreas produces ferments which are important to digestion; perhaps it also produced some substance necessary to carbohydrate metabolism, without which a person would become diabetic. Actual existence of the “substance” could only be proved by extracting some from the pancreas and showing it had a beneficial effect on sufferers of the disease.

Dr. Best has told on numerous occasions of how he and Frederick Banting worked night and day during the summer of 1921, two young men who had been given one small lab room, 10 dogs and 10 weeks in which to isolate “an effective antidiabetic hormone.” The trick was to extract the mysterious hormone in pure form from animal pancreas and learn how much of the stuff to give to diabetic dogs (whose pancreas had been removed) to keep the blood sugar level under control and the dogs alive.

They repeated their tests again and again, taking sugar counts at hourly intervals on their experimental animals, then rattling off in Banting’s old car to an all-night restaurant for a bite to eat. “We knew every restaurant which remained open during the night within several miles of the laboratory,” Best has said, “but really preferred the products of our own Bunsen burners.”

The lab-cooked meals had another advantage; they were cheap. The pair were on nobody’s payroll; Best was still living on his veteran’s allowances and finally Banting sold his car to support them both.

The 10 weeks grew to 20 because in summer there was no one in the medical faculty to tell them to stop. The whole building was deserted and they raided every other lab for needed equipment. They made new extracts, injected the stuff in more diabetic dogs and knit their brows over those blood-sugar entries in the logbooks.

It took them exactly four months— May 16 to Sept. 16—to obtain the first certain experimental results that put insulin, the university and themselves on the medical map. Then one day Charlie Best went off to a Toronto abattoir, selected a likely looking steer, and with all the sterile caution of a full-dress operation removed the pancreas from which was made the insulin first used on a human diabetic in Toronto General Hospital. Before giving it to the patient, Banting gravely injected some of the sample in his own arm and then in Best’s.

Athletic Guinea Pigs

It was Best, too, who did another summer of night-and-day work with Dr. D. A. Scott the following year, trying desperately to produce sufficient insulin to keep life in those few diabetics among whom the limited supply was being carefully rationed. The effect on the disease’s victims was miraculous. It plucked them from diabetic coma, the last stage before death, and within a few weeks returned them to almost normal health, supplying the missing hormone their own bodies could not produce.

In those early months, however, Best, Scott and an assistant operated the world's only insulin plant in the basement of the medical building. Life was revived in more than one diabetic, only to be snuffed out when the last available dose of insulin was exhausted. But Best and Scott together devised the methods which, with further work in commercial laboratories in the United States, gradually made mass production of insulin possible.

Continued on page 41

Continued from page 38

Today world insulin sales total $50 millions a year and, had they wished, the men who discovered and perfected it could have been more than wealthy. Instead, patent papers were turned over to the University of Toronto with the stipulation that no royalties should be charged for the manufacture of insulin anywhere. Even in recent years of steadily rising prices, diabetics have paid progressively less for insulin.

Dr. Best’s capacity for work has seemed only to increase since those exhausting summers of’21 and ’22. He was made head of the insulin division of the Connaught Laboratories, where all Canadian insulin is produced and all American-made insulin carefully tested, and at the same time plunged into the completion of his medical course. After receiving his M.D. in 1925, he left the Connaught Labs to spend three years in Britain, where he obtained his doctorate of science from the University of London in 1928.

This was also the year of the Amsterdam Olympics, which gave Best a chance to do a side-line bit of research in sports. Marathon runners at Amsterdam were led, still gasping, from the finish line to a temporary Best lab where they were unkindly jabbed in the ear and relieved of a sample of blood. The Canadian doctor wanted to know what a 26-mile run had done to their blood sugar level and he found, as he suspected, that such exertion played hob with it. He further noted that the wily Japanese runners had been tippling on lemonade, spiked with sucrose, during the race—variations of which stunt are now common practice.

Percy Williams, Guinea Pig

An eager quarter-miler himself while at college, Best had thrilled with the other Olympic fans as Vancouver’s Percy Williams sprinted home with the 100-metre and 200-metre championships. Watching Williams gave him an idea for another bit of athletic research, this time into the friction of muscle fibres as they stretch and contract in action. As soon as they were both back home he put Percy on his staff for two months and set him to sprinting madly down a special track in the Toronto Coliseum.

With nobody on hand to cheer except Dr. Bestand his co-experimenter, Mrs. Barrett Partridge, Williams did sprint after sprint with small magnets strapped to his chest. These caused electric coils, lining the course, to register impulses on a graph which accurately clocked his efforts.

The technical findings of the otherwise unheralded Coliseum track meet were subsequently presented in a paper before Britain's august Royal Society. However, although he today recalls enthusiastically that Williams hit a consistent, top speed of 26 miles an hour, Best brushes off the scientific accomplishment as pretty crude stuff. “You can show the same thing now with a bit of muscle fibre in a test tube,” he says.

The Banting-Best Department of Medical Research had been created by an act of the Ontario legislature in 1923, with Sir Frederick as director and Best as a research associate. On his return from London Best also soon found himself heading two other departments, physiology and physiological hygiene. There followed a period of tremendous research activity at Toronto, shared by all medical departments, which kept the visiting savants constantly queuing up at the door of the new Banting Institute. All this was shattered by the outbreak of the Second World War.

Both Best and Banting had seen war coming and realized the part medical investigation would play in helping the fighting services. Banting was keenly interested in the aviation end and it was for an aviation research job that he was flying to Britain when he lost hie life in a Newfoundland crash two years later.

For his part, Best’s first reaction to Canada’s declaration of war was to turn almost his entire staff loose on the problem of developing a method for turning human blood into dried blood serum which could be kept indefinitely and shipped to any front. This was in 1939, before the first bombs had started to fall and it seemed impossible to awaken interest in any of the authorities who should have been most concerned. Best went right ahead and opened a pilot-plant hlood donors’ clinic on the varsity campus. Toronto college students thus became the willing guinea pigs for an organization that, when later taken over by the Canadian Red Cross, relieved Canadians of some 2,300,000 blood donations and considerable home-front frustration. The serum was all processed in the Connaught Labs and saved thousands of lives, both civilian and military, once hostilities got under way in blitz-earnest. This work earned Best a C.B.E.

With the hlood clinics gurgling along j efficiently, Best joined the Navy as director of medical research and univer| sity authorities loaned the IlCN the i full facilities of Best’s labs and staff, many of whom also donned uniform.

Soon old salts on the bridges of almost every Canadian, British and American warship found themselves peering at red-lit instrument panels because tests by the medical physicists among Toronto researchers had showed j red light was easier on the eyes. Aek! ack gunners were issued goggles with filter lenses so they could follow their tracer shots even directly into the sun. Torpedoed tars bobbed about in new I life jackets and protective clothing, meanwhile munching on special ernergI eney rations, all originated by the Toronto medical brain trusters.

The most famous idea dreamed up by the seagoing version of Best & Co. was the RCN’s seasick pill, which was heralded with 21-gun salutes by the Navy public relations people and as loudly pooh-poohed in other quarters. Certainly, it was one of the Naval Research squad’s most exhaustive studies, perhaps not uninfluenced by the fact that Captain Best had himself become deathly ill on his first jaunt in a bouncing corvette and consequently took a very dim view of mai de mer.

Scientist at Play

Ex-Captain Best still loyally defends the seasick pill as the best prescription yet devised. He undoubtedly feels, moreover, that you shouldn’t expect too much of any findings based on tests using undependable humans as guinea pigs. He has the true scientist’s passion for a cageful of white mice in a nice quiet laboratory as the only practical medium for proving anything.

Discharged from the Navy, Charlie Best has been back in his Toronto laboratories for three years, comfortably surrounded by the quiet peeping of rats and mice and the soothing tinkle of beaker and test tube. He is if anything busier than ever but the colleague who said he couldn’t imagine his chief ever taking time out to relax was somewhat in error. Despite the fact that his professional life has been steadily encroaching on the 24 hours to which he is regrettably limited in a day, he manages to work equally hard at being a family man.

He married the girl from St. Andrews, N.B., whom he fell in love with at college, and she still has his ardent love letters written the summer of 1921—ardent on the subject of pancreaetomies and blood sugar levels in a kennelful of dogs. They have two sons, Henry, 13, and Sandy, whoat 1 6 has completed his first year at Trinity College, U. of '1'.

The Bests have a farm near Georgetown, Ont., about 35 miles from Toronto, which the whole family uses as a hideaway for skiing, riding and gardening. They also have a summer place called Schooner Cove Farm on the Maine Coast, near Best’s old home, where on annual vacations they go on cod-fishing excursions. These usually feature a picnic feast of fresh fish chowder, enthusiastically prepared by Best and Sons.

So Much To Do

The doctor was a keen athlete as a young fellow, playing football and baseball as well as doing some running. Today he plays golf, though not as much as he used to, and his below-90 game shows no hang-over from his first days on a golf course with pick and shovel.

“Charlie plays just as hard as he works,” one of his old friends declared recently. “I’ve seen the sweat pouring off his forehead as he operated on a dog in the lab. hut no more so than when we’re out playing golf.”

Though still at an extremely hale and hearty age, Charlie Best confesses to a sense of urgency in all his professional activities, a feeling that so much remains to be done with so little time to do it in. He should have every chance to make the most of his time, for the University of Toronto has announced plans for a new building, to be known as the Charles H. Best Institute, which will provide a considerably enlarged home for the two departments under his direction.

When this project was mentioned in a speech by the president of the American Diabetes Association, contributions promptly started coming in from grateful insulin addicts in the United States. Thankful as they are to be alive and healthy, diabetics sometimes get a little tired of jabbing themselves with a needle from once to three times daily. Some day the insulin treatment may he supplanted by a cure and diabetics everywhere suspect that if a cure can he found those fellows in Toronto will probably hit it first.

'Their faith has high professional backing. Dr. Elliot P. Joslin of Boston, dean of diabetes specialists in the United States, has declared: “If

asked where capital could he invested most wisely in the furtherance of the diabetic problem, 1 should place first of all the laboratory of Professor Charles H. Best in Toronto.” ★