Prologue
“Ironically, a cure for diabetes couldn’t have been farther from the mind of the man who would be at the center of its discovery.”
Chapter 6: Describing Fredrick Banting on his breakthrough discovery:
“It would be one of many experiences in Banting’s life where he succeeded by persistence through repeated failures and against compelling evidence and poor odds.”
Reminds me of a concept outlined in Loonshots by Safi Bahcall called the “False Fail”. A False Fail happens when an innovative idea or project is abandoned because early attempts didn’t succeed, even though those failures were due to controllable factors, like poor execution or external conditions, not because the idea itself was fundamentally flawed.
People often dismiss these ideas (like extracting insulin from the pancreas) too quickly, assuming that the failures prove the concept doesn’t work, when in reality, success might have been achievable if they had persisted or adjusted their approach. Bahcall uses examples like radar and statins (cholesterol-lowering drugs), where initial failures almost derailed breakthroughs that went on to change the world.
Chapter 10: On where ideas come from (intuitive mind)
Banting was preparing for a lecture on a topic that was adjacently interesting to him. He fell asleep while digesting what he had just read when:
“He was awakened by the force of an idea. He took the small black notebook from the bedside table and scribbled twenty-five words in barely legible, sometimes misspelled, loopy, half-awake hand. These twenty-five words scrawled at two o’clock in the morning on October 31, 1920, would eventually lead to the solution of a medical mystery that had persisted for thousands of years. The notation was: ‘Diabetus [sic] Ligate pancreatic ducts of dog. Keep dogs alive till acini degenerate leave Islets. Try to isolate the internal secretion of these to relieve glycosurea.’”
This was not a new idea, Banting didn’t know that Lydia de Witt described the same idea as early as 1906, however de Witt suffered the false fail.
“Banting’s initial idea was neither original nor successful, but he persisted in it, and his persistence led to a solution that was both original and successful.”
This seems eerily similar to the situation I currently find myself in (minus the success), attempting to go where Posner’s group tried and found limited success.
“He would later say that if he had been more familiar with the literature on the subject and had known about the previous attempts, he would have not pursued his idea at all. Fortunately… he knew close to nothing.”
Lol, same.
Chapter 11:
“Whenever doubt crept in, he asked himself, ‘why not me?’ Hadn’t Einstein been a lowly patent clerk when he had his epiphany about relativity? Hadn’t he struggled to find a job after graduation, just as Banting had? Hadn’t he claimed that imagination was more important than knowledge? Science failed when it neglected to ask the bold questions when it dared not challenge the historical record.”
I really need to finish Isaacson’s Einstein Bio.
Chapter 19:
“Eli Lilly… thought that the future hinged on patenting fundamentally new ideas, not improvement of old ideas. Had not George Westinghouse and Thomas Edison proved that cooperation between inventors and industry could catalyze the development process and improve the product? An internal research and development division would enable the company to develop and patent entirely new proprietary drugs. He held that the future of pharmaceutical manufacturing was in fundamental biological research. It was a radical idea”
A noble statement, however seems easy to say when Eli Lilly had an effective monopoly on insulin. This pharma soon-to-be giant would drift away from this philosophy when trying to not get left out of the golden age on antibiotics down the road (stay tuned for notes from Gerald Posner’s Pharma)
Chapter 29:
“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.”
Chapter 31: Banting on the model of sudden inspiration and insight that lead to the discovery of insulin
“We do not know whence ideas come, but the importance of the idea in medical research cannot be overestimated. From the nature of things ideas do not come from prosperity, affluence and contentment, but rather from the blackness of despair not in the bright light of day, nor the footlights’ glare, but rather in the quiet, undisturbed hours of midnight, or early morning, when one can be alone to think. These are the grandest hours of all, when the progress of research, when the hewn stones of scientific fact are turned over and over, and fitted in so that the mosaic figure of truth, designed by Mother Nature long ago, be formed from the chaos.”
Highlights the importance of undistracted thinking, something that is getting harder and harder to come by as our attention gets harvested for profit. Would Banting and Best been able to figure this out if they had TikTok?
Postscript: A note on the times
“The initial development of insulin took just under two years… Another way to look at it is that insulin became available for general distribution one year and four months after Lilly signed the indenture with Toronto. Today a new drug takes ten to fifteen years to wend its way through clinical development and regulatory review. Toronto’s cost in developing insulin was $1,400 ($14,000 in today’s dollars) and Eli Lilly’s initial investment was $250,000 ($2.5 million in today’s dollars). Today the cost of developing a new biotechnology product often exceeds $1 billion.
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