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Learning From The Movies

Both groups struggled with the same problem. How to extract and purify a chemical that is part of a complex mixture? For researchers led by Dr. Frederick Banting at the University of Toronto in 1921 that chemical was insulin, while in the late 1930s at Oxford University for Drs. Howard Florey and Ernst Chain the target was penicillin.

Both groups struggled with the same problem. How to extract and purify a chemical that is part of a complex mixture? For researchers led by Dr. Frederick Banting at the University of Toronto in 1921 that chemical was insulin, while in the late 1930s at Oxford University for Drs. Howard Florey and Ernst Chain the target was penicillin. Both teams eventually solved the problem, but the paths leading to success were anything but smooth, as can be seen by anyone willing to delve into the extensive popular and scientific literature describing the discoveries. However, if that is too challenging, two films, while not flawless, tell the stories remarkably well. The CBC’s “Glory Enough for All” and the BBC’s “Breaking the Mould” do justice to both the thorny science and complex personal relationships involved in bringing insulin and penicillin to market.   

“Glory Enough for All” introduces us to Dr. Frederick Banting as he is administering to wounded soldiers on the front in 1918. After the war, unable to secure a hospital position, he sets up a private practice in London, Ontario. With patients being scarce, Banting somewhat reluctantly accepts a part-time teaching post at the University of Western Ontario where in one of his classes he has to discuss the pancreas. As he researches the subject, his interest is piqued by papers describing the role of pancreatic secretions in preventing diabetes and the failed attempts to extract the active ingredient, putatively been named “insulin” by the British physiologist Edward Sharpey-Schafer.   

The film erroneously attributes the coining of the term insulin to J.R. Macleod, Professor of Physiology at the University of Toronto whom Banting approaches with an idea about tying off the pancreatic duct in a dog. He believes this will force the organ to produce more insulin for extraction. While the movie does acknowledge that Banting was aware of previous research, it fails to divulge just how extensive that research was. More than 400 scientists had already investigated pancreatic secretions in the treatment of diabetes, and while in some cases sugar levels dropped, the work was stymied by the serious side effects. Romanian physician Nicolae Paulescu in particular had published a paper five months before Banting’s landmark publication in which he described the isolation of what he called “pancreine” and its effective use in diabetic dogs. However, Paulescu was unable to scale up his production and did not publish any use of pancreine in humans. Paulescu later argued that he should have been awarded the Nobel Prize for penicillin, but he did not get much support from the scientific community, partly because he was an ultranationalist and flagrant anti-Semite who claimed that Jews are degenerate because their brains weigh much less than "Arian" brains. 

Dr. Macleod is skeptical about Banting’s proposal to ligate the pancreatic duct, but is intrigued enough to offer a small laboratory and a bright medical student, Charles Best, to assist with the research. The film accurately portrays the pair’s work in the stifling heat of the summer 1921 and the unfortunate deaths of a number of dogs before, with the help of young biochemist James Collip, they manage to purify the pancreatic extract. The key here, seemingly too complicated for the film, is the elimination of trypsinogen produced by the pancreas. This is the precursor to trypsin, an enzyme that breaks down proteins such as insulin.   

Banting, Best and Collip do not always see eye to eye, and their arguments, sometimes close to fisticuffs, are accurately portrayed, as is Banting’s failed romantic relationship. The most significant conflict is between Banting and Macleod, with the former being irritated with what he sees as Macleod taking credit for work in which he was not involved. That is also historically accurate, as Macleod was actually not in Toronto the summer of 1921 and was not a great supporter of the research until a pure form of insulin was successfully used to treat Leonard Thompson, a 14-year-old diabetic. Curiously, the film does not highlight this epic moment, but rather focuses on Banting’s compassionate use of insulin on Elizabeth Hughes, daughter of U.S. Secretary of State Charles Evans Hughes. Perhaps this makes for a more compelling storyline. In any case, Elizabeth’s story allows for an accurate description of the severe restriction of calories that she had to endure, the common treatment for diabetes at the time. 

All in all, “Glory Enough for All” is a first-rate production and correctly portrays the trials and tribulations leading up to the awarding of the 1923 Nobel Prize to Banting and Macleod and does leave the viewer with an appreciation of the criticism that has been leveled at the Nobel committee for recognizing Macleod instead of Best.  

Personal relationships and conflicts are also woven into the story of penicillin as depicted in “Breaking the Mould,” although sometimes with questionable accuracy. The film begins in 1938 at Oxford University with Professor Howard Florey and chemist Ernst Chain, who had fled Nazi Germany because of his Jewish background, working on lysozyme, an antibacterial substance found in saliva and tears. In pursuit of this research, they come across a paper written ten years earlier by Alexander Fleming in which he noted bacteria being killed around a mould that had accidentally infiltrated his bacterial culture. Fleming had been unable to isolate the active ingredient produced by the mould and had gone on to other research.  

With war looming and infections becoming a growing concern, Florey and Chain take up the challenge of trying to isolate the active ingredient in Penicillium notatum. They have a great deal of difficulty until biochemist Norman Heatley figures out a way to grow the mould on a large scale in bedpans. The research team also includes Florey’s wife, with whom, as the film makes clear, he has a bumpy relationship. But the reason, Florey’s dalliance with his technician Margaret Jennings, is barely hinted at. While the first use of penicillin on a policeman who had developed a terrible infection after being scratched by a rose thorn is properly described, the extraction of unabsorbed penicillin from his urine to boost dwindling supplies, an interesting facet of the treatment, is not mentioned.   

Chain’s repeated urging of Florey to patent penicillin, and the latter’s refusal to do so because “patenting puts science on a par with colonialism,” is factual, as is the portrayal of the experiments with mice that prove penicillin’s efficacy. However, the depiction of Fleming as a scientist who was just blessed with good luck and then tried to snatch credit from the Oxford trio is not backed by contemporary accounts. Indeed, Fleming referred to his own public elevation as the "Fleming Myth" and graciously shared credit with Florey and Chain when the three received the Nobel Prize in 1945.   

Both of these films are great examples of how there is so much more to scientific discovery than is conveyed by the simplification that “Fleming discovered penicillin” and “Banting and Best discovered insulin.”


@JoeSchwarcz

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