Is Every Child Your Child? A Tale of Courage and Determination

Is every child my child? Does ideology end at the bedside of a sick child? I ponder those questions every day when I watch the bravest person I know – my granddaughter. Consider this:

A healthy, happy little boy was suddenly insatiably thirsty. He began urinating a lot and often and feeling increasingly tired. His skin became thin and dry. No matter how much he ate, he continued to lose weight. A few months later he was weak, gray, and skeletal. His eyesight weakened and then his retinas detached rendering him blind. Within nine months, the now bedridden child gasped for air. Less than a year after falling sick, he slipped into a coma and, mercifully, died.

The sad part to this tragic tale is that it was not rare. Ancient Egyptians, Greeks, Chinese, and Indians saw children and adults die in this horrible, mysterious fashion. A first-century Greek researcher, Arataeus of Cappadocia, described the disease as “the melting down of flesh and limbs into urine.” He used the Greek word for “passing through” or “siphon” to name it: diabetes.

For hundreds of years, researchers were stymied. It was suggested that diabetics eat things that the body would have to fight to turn to urine such as almonds and broken bits of coral. It didn’t work. Seventeenth-century Scottish researchers developed a diet treatment in which patients ate nothing but blood puddings, fat, and rancid meat. It didn’t work. In the 1800s, doctors bled diabetics; every day for a week or so, a vein would be opened and pints of supposedly bad blood was drained. It didn’t work. In the early 1900s, diabetic children were hospitalized and fed only 450 calories a day. They were starved to death. German scientists found that eating carbohydrates was linked to symptoms and so they locked up diabetic children and force fed them oatmeal. Nothing worked.

An import step came when German researchers used autopsy studies to link diabetes to the pancreas. The pancreas is a small seahorse-shaped gland that lies between the stomach and spine. You can locate it by pressing your right thumb and little finger together, keeping your other fingers straight and together, and then placing your thumb at the centre of your stomach, even with your lowest rib. Your three extended fingers now approximate the location and size of your pancreas.

German researcher Paul Langerhans advanced learning by postulating that the pancreas produces two types of cells. One is secreted into the small intestine and aids with digestion. He called them external cells. The other is secreted into the bloodstream to regulate glucose levels. He dubbed them internal (later the islets of Langerhans).  It was postulated that without the internal clusters of cells, sugars could not be metabolized from food and so suger entered the blood stream and gathered in increasingly high levels as the body could no longer clean and flush it out. Then the awful symptoms began.

It was a breakthrough but for decades afterward, researchers tried but failed to find a way to utilize the new understanding by artificially doing what a dead pancreas could not – extracting cells from a healthy a pancreas and injecting them into a diabetic patient. People continued to die.

blood-sugar-research-and-hope

Photo: Queen’s University

Frederick Banting grew up on a small Ontario farm. He undertook medical training at the University of Toronto. After service as part of Canada’s First World War Army Medical Corps, and becoming both wounded and decorated, he became a surgeon in Toronto. He later opened a small practice in London, Ontario. The 29-year-old was barely eking out a living.

In the middle of a sleepless night, he was reading a medical journal about diabetes research when he experienced a eureka moment. It appeared clear to him that when extracting secretions from the pancreas, researchers were missing the possibility that external secretions were damaging the internal secretions. The two had to be separated, he thought, and then a serum could be developed using only the internal secretions.

The next weekend, he arrived without an appointment at the office of the University of Toronto’s professor of physiology, J. J. R. Macleod, who was famous for his work on the metabolism of carbohydrates. McLeod listened patiently but was unimpressed by the young man with little knowledge of current diabetes research, without a Ph.D., and with no clinical research experience. After several more visits, Banting was about to give up when he saw the professor lean back and close his eyes. But then, McLeod leaned forward, smiled, and said the idea just might work.

In April 1921, Banting arrived at McLeod’s small lab. He met fourth-year student Charles Best who would assist. They used dogs. Banting removed the pancreas of some to induce diabetes. He removed part of the panaceas from others and then, with blood vessels still in place, sewed the severed portion just below the skin of the abdomen. He then tied off, ligated, the grafted portion and waited for the external cells to die. Internal cell clusters were then extracted, purified and processed using water at first and, as they learned more, alcohol. They then injected the extraction into depancreatized dogs. Some showed slightly positive reactions but most didn’t. Many died. The determined Banting and Best slaved away in the smelly, sweltering lab, painstakingly honing the process of removing impurities from the extracts.

In July, after a number of revisions and failed experiments, they injected a depancreatized white terrier with duct-ligated extract. Blood sugar levels dropped from dangerous highs to near normal levels. With their extract in its body, the dog was metabolizing sugar as if its pancreas was still there. Unable to estimate the amount of extract necessary, the dog died. They learned. They injected another dog that had fallen into a diabetic coma with new extract and marveled as the dog awoke, wobbled to its feet, and then walked about the room. Banting and Best were ecstatic. They called their extract Isletin.

A month later, shortly after MacLeod’s return from an extended absence overseas, Banting stormed into the professor’s office with a list of demands including a salary, more assistance, and changes to the lab. A young man was hired to tend to the dogs, biochemistry professor James Bertram Collip joined the research team, a bigger lab was found, back pay for Banting and Best was paid, and a university lecturing job was found for Banting who at that point was just a few dollars from destitution.

Research moved more quickly when Banting began using the pancreas of unborn calves that he procured from local abattoirs. The diabetic dogs began responding better and living longer. Finally, it was time

His name was Leonard Thompson. He was 14 years old. He was from a poor family and so was a public ward patient at the Toronto General Hospital. His diabetes had been diagnosed nearly two years before. He was emaciated and near death. He weighed only 65 pounds. His skin was gray, he could no longer walk, and had trouble focussing and even staying conscious. Banting explained the extract trial to Thompson’s father who quickly consented.

On January 11, 1922, two doses of isletin extract were injected into young Thompson’s backside. Thompson was too ill to even flinch. The sugar in his blood and urine dropped by 25%. It was good but not great. The disappointing results were deemed the result of impurities in the extract and so they went back to work with Collip whipping up batches like a chef trying new recipes.

Two weeks later they walked back across the street to Toronto General Hospital’s H Ward. Leonard’s condition had worsened. He was now fading in and out of a coma. The boy was given two injections that afternoon and one the next morning. It worked. Miraculously, he sat up. He smiled. The fog that had haunted his eyes for so long suddenly cleared. He asked for food. Leonard was Lazareth.

Banting opposed patenting what they were now calling insulin. He insisted that medical advances belonged to all and were for the good of mankind. A patent was eventually applied for in the names of Best and Collip and with the direction that it would be assigned to the University of Toronto. It was written so anyone could use their process to manufacture insulin but that no one else could patent the process. It thereby deprived anyone from stopping anyone else from manufacturing insulin. American legalities later led to Banting’s name being added to the patent.

True to Banting’s principles, the Indiana-based Eli Lilly and Company was afforded an exclusive deal to manufacture insulin in the United States but for the first year it had to be distributed free of charge. Toronto’s Connaught Laboratories manufactured and distributed free insulin in Canada. It was also agreed that the university would happily send the formula to any researcher in the world for free, in return for a promise that insulin would not be produced for sale.

By the end of 1923, diabetes patients in Canada, the United States, and parts of Europe were receiving insulin injections. Each represented an inspiring and heartrending story of recovery as they stepped back from death’s door. The 1923 Nobel Prize for Physiology or Medicine was awarded to Banting and McLeod. McLeod shared his prize money with Collip and Banting shared his with Best.

Among the millions of lives that have been saved by the work of Banting and his Toronto colleagues, and those upon whose shoulders they stood, is my granddaughter. She’s eight years old. For three years now she has pricked her thumb to draw then test blood six to ten times a day. It hurts every time. Trust me, I’ve done it, and it hurts. She now injects herself with insulin six or more times a day. She watches what she eats and her Mom counts every carbohydrate consumed to adjust insulin dosages. It’s an awful disease but it doesn’t define her. Before the work of Banting, Best, and the others, though, it would have killed her.

We know now that type two diabetes is mostly contracted by adults and mostly due to lifestyle choices. But type one attacks children. No one knows why. For some reason, a virus that gives some kids a cold kills the pancreas of others. Today, over 420 million people around the world and about 10% of Canadians have diabetes. Most have type two. About 26,000 Canadian children have type one.

And so we are back to our initial question. God bless the determined researchers who are working in labs every day, uncelebrated, and often underfunded and underpaid. And God bless those who support the idea that our circle of community involves devoting charitable giving and a sliver of our tax money for research. We are helping people we’ll never meet. We are making all children ours. We are saying where ideological arguments should die so that fewer children will; at the bedside of a sick child.

Someday the cure for type one diabetes will be found. Banting and Best will be remembered. And on that day, I will stand with my granddaughter, and we will cheer.

If you enjoyed this column, please share it with others, consider leaving a comment, and checking out my other columns at http://www.johnboyko.com

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Africville: Racism and Redemption

The bulldozers came in the morning. For days they roared like monsters demolishing houses and streets and even the church. They tore down what remained of Canada’s moral authority to say anything about race other than, “We were wrong.”

Africville was created in 1842 with land grants to African American families escaping slavery and discrimination for the hope of better lives. The original sixteen single-acre lots overlooked the Bedford Basin and were separated from Halifax, Nova Scotia by a thick woods and impassable road. The community was called Campbell Road. As Black families left the racism of Halifax and elsewhere seeking solace among friends it was dubbed ‘Africville’. The name stuck.

Links between Halifax and Africville grew over the years as kids were bussed to school and most of their parents worked in the city. Throughout the 1940s and 1950s a number of famous people visited, including retired boxing champion Joe Louis, and Duke Ellington who married an Africville woman named Mildred Dixon. Folks were thrilled with the celebrities but understood that their hospitality was essential because while Louis and Ellington were feted in Halifax during the day they were unable to find lodging in the segregated city at night.

In that way, Halifax was no different than most other cities and towns. The Queen may have been Canada’s head of state but Jim Crow was boss. African Canadians grew used to restaurants where they could not eat, churches in which they could not pray, houses they could not buy, business licenses for which they could not apply, and schools their children could not attend.

Africvillephoto credit: Halifax.com

By the 1950s Halifax had grown to encircle Africville. The city council embarked on a determined campaign to rid itself of the Black community that had become part of their city. Despite the fact that Africville’s people were Halifax citizens and paid municipal taxes, the road to and through the community was unpaved and in the winter it seldom saw a plow. There were no streetlights. There were no sewers. Families drew water from a central well that the city had dug as a “temporary measure” in 1852.

Police seldom patrolled and ignored most calls. In 1947, seven houses were destroyed by fire because, although the fire department had been called, like usual, it had not responded. Insurance companies refused to sell home and property policies, so banks issued neither mortgages or home improvement loans.

Africville churchphoto credit: Halifax.com

Everything distasteful and dirty went to Africville. With no consultation with Africville’s citizens, and in defiance of petitions and presentations, Halifax council located in or adjacent to the community a pungent slaughterhouse, oil refinery, and tar factory, a deafeningly loud stone crushing plant, and a hospital for infectious diseases. A railway company was allowed to build a line through the community and landowners were only partially compensated for expropriated land. The city dump was relocated 350 yards from west end Africville homes and then a smoke-belching incinerator was constructed nearby.

The disgraceful treatment of the community and the racism faced by those working in Halifax took its toll. Africville got tough. The “Mainline” portion of town was home to middle-class people who worked hard and did their best. The “Big Town” area, however, knew every crime and vice imaginable. The only white people who saw Africville came to Big Town for dirty old times after Halifax bars closed.

University of Toronto’s Gordon Stephenson wrote a report that echoed 1950s urban renewal practices. He recommended relocating Africville’s people and razing their homes. A 1962 Halifax Development Department report stated that the majority of Africville’s people did not want to leave; they just wanted the services that other Halifax citizens – White Halifax citizens – had enjoyed for decades. The report concluded, however, that the people should be ignored and the professor obeyed.

Concerned Africville citizens met at the heart of their community, the Seaview Church. Over a hundred people vowed to save their homes. Peter Edwards made an impassioned plea to city council on October 24, 1962. He spoke of Africville’s history and spirit. He spoke of the racist policies and treatment endured over the years and in the current process. “If they were a majority group,” he said, “you would have heard their impressions first.”

City council responded by hiring University of Toronto’s Albert Rose to study the situation. No one was fooled. Rose had written Regent Park: A Study for Slum Clearance. They knew what he would say. In no time at all he said it. Africville was doomed.

Residents received an average of $500 for their homes. It was later discovered that additional assistance had been available but only 30% of the people were told about it and then only 15% of applicants were approved. People who had been self-sufficient homeowners were forced into a subsidized housing project and then forced to move again when told that even before they had been crammed into the ramshackle apartments, the complex had been scheduled for demolition.

By 1969, Africville was gone. The city had said it needed the land for industrial expansion but it never happened. It said it needed the land to construct a bridge but ended up using a sliver of the property.

In 1985, a monument was erected to the people of Africville in what had become the Seaview Memorial Park. The names of the original families were engraved into a stone. Family reunions began finding their way home with grandchildren being told the old stories. A former resident recalls, “Out home, we didn’t have a lot of money but we had each other. After the relocation, we didn’t have a lot of money – but we didn’t have each other.”

Africville lives. It lives as a symbol of the more than three hundred years of systemic racism that African Canadians endured and against which they struggled. In 2010, the Halifax City Council apologized to the people of Africville for all they did to, and all they did not do for the community. It apologized for Africville’s destruction.

A hectare of land was set aside and money allocated to rebuild the Seaview United Baptist Church. It will serve as a historical interpretive centre in a park renamed Africville. There, stories will be told of a time when racism coursed through Canadian veins and of a hope that someday, racism will be relegated to the dustbin of history. Someday.

If you enjoyed this column, please share it with others, consider commenting or following my blog, or even buying my book entitled Last Steps to Freedom: The Evolution of Canadian Racism, that addresses the history of racism in Canada. (Find it at Amazon or here at Chapters online: http://www.chapters.indigo.ca/en-ca/home/contributor/author/john-boyko/