Nobel Prize: Canada’s Gift to the World

After an overnight visit with his parents in Alliston, Ont., Frederick Banting spent the early morning of Friday, October 26, 1923, driving to Toronto. He arrived at his office at about 9:00 a.m., the morning newspaper folded under his arm, not yet looked at. The phone was ringing as he opened his office door. “Congratulations Fred!” one of his friends exclaimed. “Thank you, but for what?” Banting asked. “The Nobel Prize! You won the Nobel Prize! Haven’t you heard the news?” Banting unfolded the paper and saw the front-page story in The Globe: “Nobel Prize for Medicine Awarded to Doctors Banting and Macleod.” However, instead of smiling at the news, when Banting saw Macleod’s name and picture next to his own, he threw down the paper and rushed out of his office to find Macleod. He was furious.

On the front steps of the University of Toronto Medical Building, Banting ran into Dr. John G. FitzGerald, director of Connaught Laboratories. As Banting later wrote, “He came to meet me and knowing I was furious he took me by the arm. I told him that I would not accept the Prize; that I was going to cable Stockholm that not only would I not accept but that they and the old foggy Krogh could go to hell.” August Krogh had visited Toronto in late November, 1922, stayed with Macleod, and then established insulin production in Denmark. It was known that Krogh, as a Nobel laureate himself, had been involved in the Nobel nominations. “I defied FitzGerald to name one idea that had originated in Macleod’s brain – or to name one experiment he that he had done with his own hands. FitzGerald had no chance to talk.” FitzGerald was soon able to calm Banting down somewhat and suggested he meet with Albert E. Gooderham, chairman of the Insulin Committee of the University of Toronto Board of Governors. Banting saw Gooderham as “one man whose calm and strong personality always reminded me of my father.”

Albert E. Gooderham. City of Toronto Archives, The Dictionary of Canadian Biography.

Gooderham calmly congratulated Banting and advised him to take the first boat to Stockholm to claim the Nobel Prize in person. He also offered to pay his expenses. Banting was nothing if not stubborn, yet, as he later wrote, Gooderham“was one of the few men who knew the whole story and he said words to the effect that he understood my feelings and that he agreed with me but that there were other considerations that must be taken into account. I must think of my country. What would the people of Canada think if the first Canadian to receive this honour were to turn it down? That there was the science to consider. What would the world think of scientists who would because of differences of opinion disagree about a prize? I had not thought of this aspect of the situation. He did not ask me to decide immediately but asked me not to do anything rash & ‘better wait 24 hours.’”

Why was Banting so upset that the Nobel Prize had been awarded to both him and Macleod? To understand his initial reaction to the news, one needs to understand the context of the Nobel Prize itself and the nomination, evaluation and decision-making process. It is also important to appreciate the unique circumstances surrounding the broader recognition that was being given to the discovery of insulin during 1923, particularly to Banting. Also distinctive was the unusual speed with which such recognitions emerged, especially a nomination for the Nobel Prize, so soon after the events surrounding the discovery itself.

Banting was aware that the discovery of insulin was seen as worthy of a Nobel Prize as early as August, 1922. With a special issue of the Journal of Metabolic Research dedicated solely to insulin being planned for publication, George Clowes of Eli Lilly suggested to Banting that once it appeared with the full details, “you would not only get full credit for your work, but it would be the first step toward securing the Nobel Prize in medicine for you and your associates.” At about the same time, there was also an effort among a group of Toronto doctors to organize a Nobel Prize nomination for Banting, although this initiative soon fizzled when it was realized such an effort might be premature. Another similar suggestion came after the visit to Toronto in December, 1922, by Professor Robert Bárány from Uppsala, Sweden. Bárány was at the University of Toronto for meetings of the Federation of American Societies for Experimental Biology. He had won the Nobel Prize in 1914. In early January, 1923, Bárány wrote to Macleod to thank him for his hospitality during the meetings. He also said, “I thought that this discovery is of such importance that it should be awarded the Nobel Prize.”

The Nobel Prize

The Nobel Prizes have been widely viewed as the world’s most prestigious awards bestowed for intellectual achievement. The prizes originated from the 1895 will of Alfred Nobel, a Swedish chemist, engineer and industrialist, and were to be awarded “to those who, during the preceding year, have conferred the greatest benefit to humankind.” There were originally five separate prizes in the fields of Physics, Chemistry, Physiology or Medicine, Literature, and Peace. Alfred Nobel was most famous in his lifetime for the invention of dynamite. With his death in 1896, Nobel bequeathed all of his remaining assets to establish the five prizes, the first of which was awarded in 1901. The Nobel Foundation was set up to carry out the provisions of the will and administer Nobel’s funds, but four different institutions (three in Sweden and one in Norway) would award the prizes. The Karolinska Institute in Stockholm was given responsibility for conferring the prize in physiology or medicine.

Alfred Nobel.

The special prestige associated with the Nobel has largely stemmed from the considerable research dedicated to the selection of prizewinners. While the winners have traditionally been announced in October and November, the selection process begins in the early fall of the preceding year, when each of the prize-awarding institutions invites nominations from a broad list of nominators drawn from each field: Nobel laureates, members of the prize-awarding institutions, active scholars in each field, and officials and members of diverse universities and learned academies. Each nomination must include a written proposal that details the worthiness of candidate, and self-nomination is not allowed. The deadline for Prize proposals has always been on or before January 31st of the award year.

Nominating Insulin

While Banting, Best and Macleod were focused on the practical matters associated with insulin production in their meetings with August Krogh, they did not appreciate the significance of another aspect of his Toronto visit in November, 1922. As a Nobel laureate for the 1921 prize for Physiology or Medicine, Krogh was among the select list of people invited to submit nominations for the 1923 award. While Krogh was Macleod’s houseguest, and they had previously met, Banting and Best were less familiar with him. According to Best, Banting was somewhat in awe of Krogh during his Toronto visit. Banting introduced Krogh to several diabetic patients restored by insulin, including Elizabeth Hughes. Banting and Krogh were also at a meeting on November 25th in Toronto of a group of the leading North American diabetes specialists gathered for a special clinical conference on the use of insulin.

Krogh’s Toronto visit was a detour near the end of an extensive lecture tour in the U.S. after he won the 1921 Nobel. During the tour, news of insulin and its development and clinical use became increasingly prominent, and was of special interest to Krogh’s wife Marie, who had been recently diagnosed with diabetes. His travels also brought him to Cleveland and Washington, D.C., where he met with Dr. George Washington Crile, professor of surgery at Western Reserve University, Cleveland, Dr. George N. Stewart, also of Western Reserve, and Dr. Francis G. Benedict of the Carnegie Institution of Washington D.C., all of whom, like Krogh, were also among the selected list of Nobel Prize nominators. Crile and Stewart had a connection with Macleod from his days as chair of physiology at Western Reserve from 1903 to 1918 (before he joined U of T), although neither had any experience with insulin. Crile and Benedict would decide to nominate Banting for the Nobel Prize, Stewart nominated Macleod. Among the four nominations associated with the discovery of insulin received by the Nobel Institute, Krogh’s was the fourth and the only one to nominate both Banting and Macleod, “for the discovery of insulin and their exploration of its clinical and physiological characteristics.”

Krogh struggled with apportioning credit for the insulin work among Banting, Best, Macleod and also Collip. His difficulty stemmed from his more direct personal contact with the Toronto team (except for Collip), and also due to the constraint that the prize could not be given to four people. After much soul searching, Krogh reasoned that Best, whom he regarded as a young student assistant, had played a minor role in the discovery and was not worthy of nominating.

In his January 23, 1923, letter to the Nobel Committee, Krogh emphasized Banting’s primary role but noted that he could not have done it alone. As Krogh understood the events, Banting was directed at all stages by Macleod. Krogh was also aware of others who collaborated with Banting and Macleod, but Collip was most significant for his very important contributions to the method of producing insulin in a practical way based on adult animal pancreas. Yet Krogh felt this contribution was insufficient grounds for including Collip in the nomination. Krogh was also aware of Macleod’s experimental work locating insulin in the pancreas of several species of fish (although it had not yet been fully published) as well as his physiological research focused on exploring insulin’s action on carbohydrate metabolism.

Part of the second page of a four-page letter from August Krogh to Göran Liljestrand (the secretary of the Nobel Committee) dated 20 January 1923. “[TRANSLATION] As you understand from my discourse it is my opinion that the discovery of insulin is of extraordinary both theoretical and practical importance and it will hardly surprise you that I intend to submit a nomination that the Nobel Prize be awarded to Dr. Banting and Professor Macleod.” The Nobel Prize.

Krogh summarized his nomination by writing, “With the information which I personally have obtained in Toronto, and which also, although less clearly so, emerges from the published works, one may conclude that the credit for the idea behind the work which led to the discovery, undoubtedly goes to Banting, who is a young and apparently very talented man. However, he would definitely not have been able to carry out the investigations, which from the start and during all stages, have been supervised by Professor Macleod.”

Recognition for the Insulin Team

While the Nobel Prize jurors were embarking on their first round of consideration in Sweden, Canadian public and political recognition about the discovery of insulin grew in intensity during 1923. On February 13th, the Ottawa Branch of the University of Toronto Alumni Association held its annual dinner at the Chateau Laurier, with Banting and Best as guests of honour. The next day, Banting and Best, along with University of Toronto President Falconer, had lunch with Governor General Julian Byng. Following Banting and Best’s Ottawa visit, a Toronto area MP, Thomas L. Church of the opposition Conservatives, raised in the House of Commons the idea of an annuity for Banting and Best to support their further research. On February 27th, Church suggested, “I think something like $7,500 annually should be provided in the Supplementary Estimates or some substantial financial aid be given to men like Dr. Banting and Mr. Best.” (When Macleod heard about this idea, he wrote to Collip in Edmonton to say that he was doing all in his power, although quietly, “to place things in their proper perspective” and to see that Collip’s part was given full recognition.)

There was then a flurry of activity in Toronto to honour the discovery of insulin and especially Banting and Best. On March 23rd, the Toronto Academy of Medicine gave enthusiastic acclaim to the work of Banting and Best, and on March 27th, Sir William Mulock, the chief justice of Ontario, sent a letter to Prime Minister William Lyon Mackenzie King, suggesting that Banting, as discoverer of insulin, be given a Dominion grant. Mulock had a personal connection with King. In 1900, when Mulock was serving as Canada’s minister of labour, he had appointed King as his deputy, which was King’s first position in the public service. In Mulock’s first letter to King, he emphasized the significance of this Canadian discovery. In a second letter to King, Mulock emphasized that while Best was born in the U.S., his father had been born in Nova Scotia and Best was never naturalized in the U.S. On April 6th, King replied to affirm his support for an annuity of $5,000 to $10,000 for Banting. He had also secured support from Conservative opposition leader, Arthur Meighen, as well as from philanthropist John D. Rockefeller, of New York City. There were also other letters of support for such an annuity from leading U.S. diabetes specialists.

In the meantime, Banting had written to Ontario premier E.C. Drury to discuss the formation of a Banting and Best Department of Medical Research at the University of Toronto, and also to suggest other potential provincial supports for medical research. One such initiative was realized on May 4th, with the passing in the legislature of the Banting and Best Medical Research Act, which established an annual provincial grant to the University of Toronto to promote medical research.

In Ottawa, MPs approved the resolution for an annuity on June 27th, but it did not mention Best. When FitzGerald heard this news, in his capacity as secretary of the University of Toronto Insulin Committee, he immediately sent a telegram to King to underscore Best’s major role. However, in his reply, King said only one person could be named for such a national recognition and based on a general consensus of professional and scientific opinion, that one person was clearly Banting. Frustrated, Banting sent a telegram to Best, wishing he had also been given federal recognition. As Best told Banting, “it’s an old story now.” He seemed resigned to being overlooked. Nevertheless, Banting assured Best, he would be looked after in some way, perhaps through Connaught Labs.

A further honour came in late August when Banting and Best formally opened the Canadian National Exhibition in Toronto. Connaught’s newly expanded insulin production facility was a key feature in a highly popular exhibit in the CNE’s Government Building. As was described in The Globe on August 27th, “A huge sign in the Government Building, bearing in large letters the legend ‘Insulin,’ and proclaiming it was discovered in the Department of Physiology of the University of Toronto and is prepared in the Connaught Laboratories, is a beacon to all who may be interested.” The display featured a large vacuum still, “which permits of the evaporation of the alcohol from the insulin mash at a low temperature,” along with samples arranged on a board, illustrating the various stages in the production process. Large crowds flocked to the exhibit. Public interest in insulin was so great that “already more than 3,000 of the bulletins prepared by Best on the subject have been disposed of.”

Sir Frederick Banting Opening The Canadian National Exhibition in 1923. CNE Heritage.

Yet for Banting, especially, by the end of the summer of 1923, he was very tired and wanted to be left alone to focus on his work. Indeed, he was quite sick of everything pertaining to insulin.

Macleod, meanwhile, had been given his own honours. He was elected to the Royal Society (originally the Royal Society of London) in recognition of his position as a well-established member of the scientific community. In addition, in the spring, Macleod was awarded the prestigious Cameron Prize from the University of Edinburgh for distinction for therapeutics. When he heard the news about the Prize, Macleod wrote, “The work on insulin, as you know, has been the outcome of a joint effort by several of us and I feel a little embarrassed at accepting this prize on that account. However, I suppose the award was made after full consideration of these facts and with full knowledge of them and on that account, I will feel that I am justified in accepting it.”

Macleod then spent the summer on his home soil of Scotland among friends and colleagues who perceived the discovery of insulin by the Toronto team as the crowning achievement in his many years of carbohydrate metabolism research. Macleod felt especially at home at the Eleventh International Physiology Congress in Edinburgh in late July. He delivered the keynote address about insulin, which was quite exhaustive in its detail. Banting was also at the conference and in the audience for Macleod’s keynote. In his talk, Banting noted, Macleod had been “very fair, but not at all unselfish.” Later in the conference, Banting and Macleod each gave papers in a session on insulin, although Banting was less charitable in how he viewed Macleod’s paper. “Macleod had showed lantern slides of ‘his’ work which was mostly negative results but voluminous. He has a diarrhoea of words and experiments & constipation of ideas and results.”

Awarding the Nobel Prize

As of April, 1923, the Nobel nominees in physiology or medicine had been narrowed to a short list of nine, counting Banting and Macleod as one. At this point, those on the short list would receive special investigation and appraisal. Two of the appraisers, John Sjöquist and J.C. Jacobaeus, focused on insulin’s physiological importance and its practical application, respectively. In addition, the Nobel Committee secretary, Goran Liljestrand, wrote a special report after attending the Edinburgh Physiology Congress. The investigators also read very widely and visited several parts of Europe where insulin had been in use to assess its effectiveness, although it was almost impossible to make such an evaluation so soon after its initial use. Nevertheless, the investigators’ reports concluded that the discovery of insulin was worthy of a Nobel Prize. Sjöquist further accepted the suggestion of dividing the prize between Banting and Macleod, concurring with Krogh. Jacobaeus had more difficulty assessing Macleod’s role, yet reached the same conclusion about giving the award to Banting and Macleod.

By October 11, when the Nobel Assembly met to decide the award winners, questions remained about the Banting-Macleod recommendation and Macleod’s role. However, on October 18th, a further reassessment of Krogh’s original nomination and his direct experience in Toronto, as well as re-evaluation of the original publications, along with review of Macleod’s Edinburgh Congress lecture about insulin, led to a reaffirmation that Banting and Macleod jointly deserved the Prize. It was also apparent that one of the Nobel Committee members who questioned Macleod’s qualifications had been trying to advance the case for another nominee. Finally, on October 25, 1923, the 19 assembled professors from the Karolinska Institute held a secret ballot, the results of which awarded the Nobel Prize in Physiology or Medicine to Banting and Macleod.

On October 26th, after Banting had first heard the news and expressed his anger about sharing the award with Macleod, he suddenly realized he did not need to wait 24 hours before responding. He knew exactly what he had to do. Banting grabbed a notepad and hurriedly wrote a telegram to Best: “Nobel trustees have conferred prize on Macleod and me. You are with me in my share always.”

Best was in Boston, where he had been invited to give a lecture at the Harvard Medical School and would be with Dr. Elliot Joslin, one of the leading diabetes specialists. Banting addressed the telegram to Best in care of Joslin. Best’s lecture was to an overfilled room, after which Joslin read Banting’s telegram. The final version declared, “I assign to Best equal share discovery Insulin. Hurt that Nobel Trustees did not so acknowledge him. Will share with him. Please read this telegram at any dinner or meeting. Banting.”

Banting was quick to also notify the press of his decision, releasing a statement on October 27th.. “I am extremely gratified that the Nobel award should come to Canada and to the university. I desire to share my portion of the award with Mr. Best, with whom I have been so intimately associated and who has contributed so much towards insulin, in order that he may have the recognition that is due. The award will be devoted to scientific research to be carried on in the University of Toronto.”

The total value of the prize was $40,000, to be divided evenly between Banting and Macleod. Banting’s offer to split his half with Best left each with $10,000. As was reported on November 1st, Banting pledged to direct his full share of the award towards the establishment of the “Banting Medical Research Foundation,” upon which a North America-wide effort would aim to raise an endowment of at least $1 million. Among early supporters were Canada’s Governor-General and U.S. Secretary of State Hughes, father of Elizabeth Hughes, Banting’s star diabetic patient.

Macleod first heard the Nobel news on a steamship on his way back to Canada from his summer in Scotland. On November 2nd, when he arrived in Montreal, he was asked by a Toronto Star reporter if he had heard about Banting splitting his award with Best. “I have made absolutely no decision as to the disposal of my Nobel prize award. You may be sure, however, that my decision will in no way be influenced by the action of others.” After being shown Banting’s statement, Macleod said, “Yes, I have seen that. Well, I am a Scotchman and I never make up my mind in a hurry. I want to consider this from every angle.” When asked for a comment about Banting’s contribution of his $10,000 award to a new endowment fund to further the work of young scientists, Macleod said, with a twinkle in his eye, “Well, I think there should be something for the work of old scientists.”

Over the next few days, Macleod decided to share his half of the award with Collip. As he said in a statement to the press on November 7th, “It would be invidious and quite unnecessary to try to dissect or divide up the work on insulin among the various men who were engaged on it. The University of Toronto has been given a great deal of credit for this discovery, and I would like to emphasize that it is team play that did it. We found that we were engaged on a work that appeared to have in it a great benefit to mankind and our aim was to hurry it along as fast as we could to completion. Other work was dropped while this was proceeded with. It was on this basis of understanding that Dr. Collip, who was on leave of absence from Alberta University, came into the work with us.” When Macleod was then asked about his own share in the work, he laughed and said, “Oh. I was only the impresario – the managing director.”

The Nobel Committee’s decision was certainly controversial even beyond Banting’s initial anger. Macleod’s inclusion in the award was problematic for a prominent diabetes specialist, Dr. Rawle Geyelin of New York City. He was a great friend of Banting and had helped facilitate an urgent donation of $10,000 towards new insulin production equipment for Connaught. On November 10th, Geyelin asked Banting if he should send a tersely written letter to the press, attacking the Nobel trustees as being either ignorant or woefully misinformed about who was responsible for the discovery. By this time, however, Banting had calmed down and felt there was no point in further public discussion, particularly as it could discredit the University of Toronto and science in general. Nor would it change anything as the Nobel Committee’s prize decisions were final.

There was actually little awareness among the Nobel Committee about the controversies over the prize in Toronto and beyond. However, the Nobel Committee did receive letters of protest from other scientists, such as Georg Zuelzer in Berlin and Nicolas Paulesco in Romania, who had experimented with pancreatic extractions for diabetes treatment prior to Banting and Macleod. Their protests fell on deaf ears.

On October 26th, as soon as the news broke, Robert Falconer, the University of Toronto’s president, stated publicly his “profound satisfaction that two such men as Dr. Banting and Dr. MacLeod should be at work in our laboratories. Dr. Banting’s modesty and quiet bearing have won the appreciation of everyone, and it must be a source of satisfaction to him and to his friends that he has been privileged to confer such a great boon on humanity.” Falconer promptly suggested to the board of governors “that in the near future a dinner may be arranged to do honor to these to distinguished gentlemen.” The banquet would take place on November 26th at the Great Hall of Hart House. Some 325 invitations were issued, although at least 400 people attended the event, representing governments, universities, scientists and the medical profession from across North America. “Never before had the academic splendor of the great hall of Hart House witnessed such an event,” the Toronto Star reported the next day, “an event which will remain as one of the milestones in the annals of the University.”

While Banting stressed Best’s major role, and Macleod lauded Collip, the importance of teamwork was emphasized in the dinner speeches, perhaps most eloquently by Dr. Lewellys F. Barker of Johns Hopkins University. A U of T graduate, Barker was among the first in the U.S. to talk about an important discovery in Toronto. According to the Toronto Star report on the banquet, Barker said, “Great discoveries are rare. Insulin is no exception. Many paved the way, but the genial idea must occur. The discoverer must devise a technique and have the will power to persevere. Imagination, technique and will, these are the three ingredients of success.” He further characterized the discovery “as a happy instance of the success of teamwork. In research it was as in games, star players by themselves could not win victory. There was in insulin glory enough for all.”