Essays

The Insulin Soldiers

Kristen den Hartog

Just a few years before his famed co-discovery of insulin as a treatment for diabetes, Dr. Frederick Banting was at war, serving in a field ambulance in France, guns thundering in the near distance. A graduate of the University of Toronto’s medical school, his studies had been condensed because of the need for doctors to treat massive numbers of wounded, and in 1917, he went overseas with the Canadian Army Medical Corps. As he amputated limbs and stitched gunshot wounds near the Front, he couldn’t have imagined the turn his work would take once the war ended, nor the effect it would have on a group of veterans under his care. He had little awareness of diabetes, and no idea how widespread it was. The disease affected the body’s ability to control blood sugar, which in turn harmed the organs, blood vessels, and nerves. There was no known cure, though newspaper ads sometimes suggested otherwise. One testimonial claimed, “I’m sure I would be in my grave today, but for Dodd’s Kidney Pills. … [They] have done so much for me that I feel like recommending them to everybody.” In reality, a diagnosis of diabetes was devastating news. In later years Banting wrote that it was “a disease that people did not talk about. … It was usually a family secret known only to the doctor.”

Back in Canada in 1919, he was posted to the Christie Street hospital in west-end Toronto, where the patients had missing limbs or grave facial wounds, gas poisoning or tuberculosis. The building itself was a hastily renovated cash register factory, with extra storeys added to its simple, boxy shape to accommodate some nine hundred men. It was situated along a rail line in what was then an industrial part of town, but it provided a community of sorts, for most of the staff and patients had served overseas and had a shared understanding of war. Together they ate in the huge dining hall in the basement, and gathered in the auditorium for shows by the latest stars. They could also visit the rooftop ward, where patients with spinal tuberculosis basked in the sun as heliotherapy treatment for their illness. The hospital was like a village in a way, and some of its people—staff and patients—would still be there when the next war started, or for the remainder of their lives. Fred Banting’s stay was short, though, and when he was discharged from the army six months on, he probably didn’t think he’d return to the halls of Christie Street. The war was over, and he was finally a young civilian doctor embarking on his career.

He set up a practice in London, Ontario, supplementing his income by lecturing at the university. Teaching was stimulating, since the reading he did to prepare his talks furthered his own truncated education. One of the articles got him contemplating the role of the pancreas in diabetes, and he became fixated on the idea of investigating the possibilities in a laboratory setting. Visiting Toronto for the wedding of a Christie Street nurse, he asked some medical colleagues what they thought of him giving up private practice for research. “They all advised against such a radical move,” he later recalled. But Banting pushed ahead with his plan, and by spring 1921 his famous work with Charles Best had begun at the University of Toronto, and would soon involve patients at the Christie Street hospital.

It was already understood that the pancreas played a role in processing sugars, and that when a person became diabetic, something must be amiss with that organ. The goal was to isolate what researchers suspected was an internal secretion within the pancreas that regulated metabolism, and use it to treat dogs who’d been rendered diabetic by pancreatectomy. In the early experiments by Banting and Best, dogs’ pancreases were removed and ground up to make a serum that hopefully contained the mysterious secretion. Having an adequate supply of dogs was a problem and eventually, the pancreases were obtained from cows and pigs at slaughterhouses.

Walter Campbell, a specialist in diabetes and a colleague of Banting’s, later wrote that “before the First World War, there were only two types of diabetics, those who died quickly and those who stuck around deteriorating for a long time.” Dietary controls were the main form of treatment, but by no means a cure. People slipped into comas or died of starvation—the most effective approach was a liquid diet that starved the patient until sugar disappeared from the urine. The patient could then begin to eat in small but increasing quantities, with all food strictly weighed and recorded, until the sugar reappeared. This determined the patient’s glucose tolerance level, and the diet that would need to be followed.

The doctor Joseph Gilchrist, a friend and classmate of Fred Banting’s during medical school, would have understood his prognosis better than the average patient when he was diagnosed with diabetes in 1917. By then he was part of the Canadian Army Medical Corps, having reported for duty, like Fred and the rest of their class, immediately after graduation. His yearbook entry states that he “plodded through the darkness of Arts into the light of Medicine, where he will bask when the war is o’er.” But he never made it overseas with his fellow young doctors. Around the time that Fred set sail, in March 1917, Joe experienced his first symptoms: extreme thirst, frequent, abundant urination, a craving for sweets, weakness, and weight loss. Tests showed sugar in the urine, and though his symptoms cleared up when carbohydrates were removed from his diet, they came raging back when he returned to eating normally. “Immediately after eating even a slice of bread,” one doctor noted in his record, “he shows 2% sugar in the urine.” The recommended treatment was rest, fresh air, exercise and an “anti-diabetes diet” that quickly turned him gaunt and rangy.

Postwar, Joe Gilchrist continued following these principles, his health slowly worsening until October 1921, when he contracted severe influenza that shattered his glucose tolerance. The pounds began to fall away. He was thirsty and hungry; sugar was always present in his urine samples, and sometimes his breath smelled of acetone—a sharp, acrid, rotting fruit scent and a clear sign of dangerously increased acidity in the blood and a poorly functioning metabolism.

At first he had no idea his illness coincided with his old classmate’s obsession, but shortly after his bout with influenza, news of Banting and Best’s research began traveling in medical circles. They gave a talk at the University of Toronto in November and another at Toronto General Hospital in December, and somewhere around this time, Joe approached Fred and asked to try the serum. Even if he hadn’t been diabetic, he would have thought the work exciting, but his own medical history added a profound layer to his interest in the research, and he was eager to be what he called a “human rabbit” for the cause. He was given an oral dose, probably because the extract hadn’t been tried on humans yet, and injection was considered too risky. But the outcome was disappointing. Fred wrote in his notes, “Dec 20. Phoned Joe Gilchrist – gave him extract that we knew to be potent. – by mouth. empty stomach. Dec 21 – no beneficial result.”

Within a month, though, the extract was given by injection to a teenage boy at Toronto General Hospital. Weighing 65 lb. on admission, Leonard Thompson was considered so near death that even the wildest experiment gave him more of a chance than doing nothing. The boy reacted badly to the first shot, but there was major progress when the extract—tinkered with and vastly improved by a biochemist named James Collip—was tried again. To see a body so utterly transformed was astonishing. It was as though a magic potion had brought him back to life. As the serum was tried on more patients in more places, the amazement spread, and pressure mounted to mzake the medicine widely available. American diabetes specialist Elliott Joslin likened the serum’s effect to “near resurrections,” and had high hopes for his own patients, who were wasting away on starvation diets in a diabetic clinic in Boston.

These were thrilling times for people involved in the development and production of insulin. The sense of urgency around the affair sparked plenty of collaboration, infighting, selflessness and ego as the work evolved and various doctors and scientists helped perfect, produce and deliver the treatment. A hundred years later, the spotlight still shines brightest on Fred Banting, though he was far from the lone player: along with doctors, academics, and pharmaceutical companies, the drama enfolded nurses, orderlies, dietitians, patients, and patients’ families—and also veterans newly returned from World War I.

By spring 1922, a clinical trial at Christie Street had been arranged, and diabetic soldiers were being recruited. Joe Gilchrist was a supervising doctor as well as a patient participant. Medicare was still years off, so the patients were lucky their illness had surfaced in wartime, for those who’d fallen ill during service were entitled to free healthcare, which in this case meant a treatment that had taken on the qualities of a miracle. As soldiers, they knew what it was like to be hungry, cold and tired, and then to have that discomfort compounded by illness. And yet, knowing the treatment was experimental may also have made them wary. Each patient signed a declaration stating that the treatment had been thoroughly explained to him, and that he understood it hadn’t yet reached “a stage of finality”—the work involved an element of risk, and “it is not yet fully known just what the treatment will do.” But for the most part the men at the Christie Street clinic were severe diabetics with bleak futures. One man was already in a coma when admitted, and another weighed a frightening 76 lb.

The men ranged in age from twenty-five to fifty-three. Following a physical and the establishment of individual diet and insulin levels, they were monitored by doctors and nurses, and also Christie’s trio of dietitians: female university graduates whose profession was just coming into public awareness. Ideally, the men received their injections three times a day, though at this early stage, producing enough of the extract and obtaining a pure, effective product was difficult. When they could get their shots, many patients developed large, excruciating abscesses at the injection site. A strong extract caused more severe side effects, but a weaker one required large doses that were more painful to receive. As the doctor-patient, Joe Gilchrist took the first sample of each batch, according to Banting, and followed up with regular blood sugar tests. “I doubt if there is a person in the world who has had his veins punctured so many times. He had abscesses at the site of injection on very many occasions, but he took his injections regularly and persistently.” The pain and the inconsistency of the treatment made men reluctant to join the study as it inched forward. “But then an event occurred,” wrote Banting, “which surprised and encouraged everyone… One of the faithful lads asked for leave. This was a most unusual request. He also wanted insulin to take with him. He was intelligent and could look after himself & his requests were granted. On the following Monday morning he returned all smiles. ‘For the first time in three years I am a man again,’ he told everyone. Severe untreated diabetics lose all sex desire. With insulin the desire and power returned. By night every diabetic in the hospital was asking for insulin.”

Jim Ostrom was one of the younger patients. After the Battle of Vimy Ridge in April 1917, he came down with an illness that doctors couldn’t pinpoint. He was nervous and tired—not surprising considering his placement at the Front and his rank of signaller. Signallers kept the communication flowing to and from the front lines, laying cables in the trenches and repairing them when they were blown apart by shellfire or broken by soldiers’ boots. Signallers also encoded and decoded messages, or carried them in person, travelling through the trenches when the technology failed. For defensive purposes, trenches were dug in a zigzag pattern, making short distances much longer. Sometimes these missions took a soldier into the wide open, where he risked sniper fire or burial by a shell explosion; or he travelled further afield, crossing territory he didn’t know and memorizing the landscape for the return trip. A man had to have stamina and good instincts for such potentially dangerous missions.

Fit and healthy when he’d enlisted, now Jim experienced palpitations, vertigo, and “air hunger,” meaning he gasped for breath on the slightest exertion. He was invalided to England and diagnosed with “disordered action of the heart,” also called “soldier’s heart,” an ailment thought to be caused by stress and exhaustion rather than organic disease. He was moved to a convalescent home in Bushy Park, which neighboured the splendid Hampton Court Palace on the outskirts of London. If he felt well enough to enjoy it, this was surely a wonderful place to be, with a river that fed cascading pools and a waterfall, deer roaming beneath chestnut trees, and birds chirping in the woodlands.

The hospital specialized in heart cases, who mostly responded well to treatment that involved convalescing on the verandah and engaging in physical therapy. But after forty days at Bushy, Jim hadn’t improved. “General condition not good. He has not reacted well to exercises.” He returned to Canada, and back in Toronto an examination revealed “man cannot walk one mile without resting at intervals.” Running for a streetcar set his heart racing and his lungs heaving for air. A family story says that he was a young, fit man when he went to war, that he was buried in a shell explosion, and that his rapid decline made it seem that war had caused his illness.

The timing of his diabetes diagnosis isn’t certain, but by 1921 he was living just west of the Christie Street hospital, working as a mail clerk. His health was poor and his thirst was insatiable. He’d fill a big glass milk bottle with water before bed, and by morning he’d have drunk it all. Despite his illness, the period must have been joyful, for he’d fallen in love with a woman named Grace, who lived nearby and worked at Eaton’s department store. Jim’s descendants suspect Grace’s family didn’t approve of the match, perhaps because Jim was unwell and his future in question. But you wouldn’t guess at his frailty on seeing a 1920 photo of Jim and Grace: Jim wears a flat cap and civvies, his sleeves rolled up; he’s lifted Grace to one shoulder, and she perches there, smiling and leaning into him, hands folded at his collarbone. They married a week after the emaciated boy, Leonard Thompson, received his transformative injection of insulin, and in the following months they must have felt hopeful that what the press was calling “one of the most important discoveries in modern medical research” would make a difference in their lives. As medicine for a debilitating disease, insulin seemed miraculous, and many believed it might be a permanent cure—that with enough injections, the body might relearn the ability to regulate blood sugar.

The dose was hard to get right, especially at that time, when the qualities of insulin being produced were variable. Around Christmas in 1922, Joe Gilchrist delivered a lecture describing a case of hypoglycemia brought on by the administration of too large a dose. The man—Jim Ostrom—had received his injection in the late afternoon, then gone down to the hospital dining room and eaten a hearty meal, “but by 8 o’clock he evinced a strong desire to climb up the walls of the ward.” Gilchrist described the first sign of a hypoglycemic reaction as a mixed feeling of anxiety, restlessness, and dread. After that, the patient would start to sweat and crave food—lots of anything would do. Then the trembling would begin; the skin blanched, the pulse raced, the pupils dilated. As the blood pressure dropped, the patient would feel faint and lose the ability to concentrate and call up names and ordinary words. Without the ingestion of glucose to relieve the symptoms—which Jim quickly received at Christie—convulsions and coma could follow.

Some of this was known because of experiments on animals. When the Toronto Daily Star reported on Gilchrist’s lecture, it also detailed experiments done on rabbits that had been intentionally sent into convulsions with overdoses of insulin. They grew so hungry they devoured wood shavings; their eyes bulged; they panted and jerked themselves around; they stiffened and lost consciousness. The experiments confirmed that sugar was an effective antidote. When news of the story reached an animal rights’ activist, she contacted the local Great War Veterans’ Association and urged them to join the antivivisectionist fight and protest the inhumane treatment of soldiers at the hospital, which in turn prompted the Star to investigate.

Joe Gilchrist invited the reporter to visit the Christie Street clinic and meet the patients himself, nine of them at that time. One—a man named Doherty—claimed he’d been close to comatose when he’d entered the hospital, and “almost literally a mass of skin and bones.” The doctors thought he’d die within a few days, but since then he’d gained 25 lb., and his skin, once “dry and brown like that of a mummy,” was now fresh and pink. “His eyes sparkle, and he declares that he is fit for anything.” All of the men spoke of weight gain and renewed energy, but also a sense of hope. Said one man: “It’s given me a chance for my life.”

Jim Ostrom had been discharged from Christie Street by this time, but the Star reporter went along to his home to ask about the overdose that had sent him climbing the walls of the ward. “Mr. Ostrom admitted having had certain pronounced reactions, but added: ‘I would be willing to climb the CPR building if I could get the benefit that I got from the treatment.’”

The cash-register-factory-turned-hospital had become a centre of innovation in its few short years of existence, with X-ray and electric therapy departments, the rooftop ward for heliotherapy, and a team of specialists devoted to the new field of plastic surgery, rebuilding chins and noses. Now, in a specially equipped laboratory, the men of the diabetic ward learned how to test their own blood and urine for sugar levels, check the strength of the insulin, and administer their own doses. They knew to always carry a bit of candy, and to carefully monitor their diet. Men who’d struggled to climb a flight of stairs could soon walk two or three miles a day with no trouble. With other patients at Christie Street, they took field trips to sprawling High Park, or travelled by streetcar and ferry to the Toronto Islands. They had renewed energy but also enthusiasm, and joined in the hospital’s beading or basketry workshops, trying to outdo each other with their creations. The effect of the insulin was so noticeable that strangers who visited the ward—medical experts from other cities and countries—said they could tell at a glance who had begun receiving injections and who hadn’t started their treatment.

Nevertheless, there were losses. Some of the men were so unwell when they arrived that there was just no saving them. They had weakened hearts or tuberculosis, or other complications that persisted even when the insulin worked. The deaths must have been a blow to both the caregivers and the fellow “rabbits,” who would have worried about their own chances for survival.

Ogden Besserer was twenty-eight when he was conscripted in 1917. He’d been managing the fur department of a popular shop in Ottawa; he wasn’t married, and he was young and seemed relatively fit, according to his medical examination. On his paternal side, he was of German ancestry, but his family, mixed with French-Canadians, had been in Canada for generations, and his grandfather had owned great swaths of land in Ottawa, and had named streets after family members. By WWI, the area that had once been Besserer property was a bustling neighbourhood called Sandy Hill. When his younger brother Theodore voluntarily enlisted in 1915, Ogden kept on with his job, perhaps because he knew his health was fragile. At age twenty-two, just before the war began, another brother had died in a diabetic coma, and a family history of diabetes was noted in Theodore’s service record. The first great loss had happened in Ogden’s childhood, when his mother, also a diabetic, died at thirty-two.

Ogden travelled overseas early in 1918. He was a driver, charged with delivering ammunition to the front line, and though he made it through the war unscathed, just before Christmas—when he was still in France—he complained of double vision. The problem had come on suddenly and persisted. In medical terms, it was called “diplopia,” and while it was sometimes noted in shell shock cases, it can also be a symptom of diabetes, when damage to circulation causes a palsy in the muscles that control eye movement. The muscles of one eye stop working, so the two can’t align together to send a cohesive message to the brain. If Ogden was still working as a driver at this time, the symptoms would have been especially dangerous and frightening. But “with treatment”—probably rest and a patch over the eye—the vision problems subsided during the next six weeks, and Ogden returned to Canada. It’s impossible to know if he suspected diabetes, but it seems likely. During his time in the army, he requested a portion of his earnings—separation pay usually reserved for wives and family—go to a woman named Laura Blake, listed only as “friend” in his record. Laura was a single woman who worked as a government stenographer. Did they hesitate to marry because of Ogden’s illness?

After his discharge from the army, he returned to his old job at the furrier’s, where he’d begun at the age of fourteen. But over the next year, he developed sores on his chin and the back of his neck, and he grew weak and thin. Doctors diagnosed diabetes, and he was hospitalized in Ottawa as his disease quickly progressed. At one point he received less than four hundred calories a day, “obviously way below his body requirements,” but necessary, the doctors thought, to control his metabolism. He suffered recurring attacks of diarrhea and edema, a swelling in his face, legs and ankles. His symptoms were so persistent that one doctor wondered if someone was sneaking in food for him, since “the mathematics of diabetic feeding” just didn’t add up. The doctor added that “the man’s morale is badly shaken and this idea should not militate against him.” The Ottawa doctors felt they couldn’t offer him the specialized care he needed, nor monitor his condition closely enough, but there was little improvement after a stay in Elliott Joslin’s Boston clinic. Joslin would go on to become a world leader in the treatment of diabetes, but at this time he, too, implemented the starvation treatment, training patients to manage their condition by diet. The work was heartbreaking, and he followed news of encouraging developments in Toronto from the earliest days. “Naturally if there is a grain of hopefulness in these experiments which I can give to patients,” he wrote in a 1921 letter to Banting’s supervisor, “… it would afford much comfort, not only to them, but to me as well, because I see so many pathetic cases.”

By spring 1922, Ogden Besserer was “markedly undernourished” and weighed 110 lb., 40 lb. less than when he’d left the army a few years earlier. News of the insulin trials must have offered a welcome spark of hope. “Arrangements are being made,” states his record, “to have this man admitted to Christie Street hospital, Toronto, so that Dr. Banting’s treatment may be tried.”

In June, Ogden joined the rest of the men on the diabetic ward. He was in rough shape upon admission, with clusters of boils, skin infections and abscessed gums. Though emaciated, the swelling in his legs and face persisted. To add to his discomfort, the hospital’s proximity to a railway meant that the building shook when trains shunted past. He didn’t sleep well, and sometimes suffered night sweats that soaked his pyjamas and made him cold and clammy. Despite his placement in a pioneering trial, he continued to falter. Joe Gilchrist jotted down that Ogden’s muscle mass had diminished, and that he experienced “loss of memory, loss of interest in things generally.” Doses of the extract seemed to help some days but not others, and by September he was so unwell that injections were stopped, and he was moved to a private ward. He ached all over. His vision blurred. He was unable to distinguish between people he knew, though the record doesn’t specify if family or the friend named Laura were among his visitors. By the time of his death at age thirty-three—around the age his mother had died—he weighed 96 lb. The secrecy around the illness, which Banting wrote about in later years, shows in the obituary that appeared in the Ottawa Citizen: Ogden had been undergoing “special treatment” at the Christie Street hospital, the piece said, but “died as the result of illness contracted by over-exposure at the front during the war.” The word diabetes was not mentioned.

Ogden was the last of four diabetics to die at Christie that month. Of the earlier deaths, two were recent admissions to the hospital; the third, a brewer’s labourer, left behind a wife and five children living in poverty. Following a sweltering city summer with major problems in insulin production, these losses must have demoralized the whole diabetic team. That first summer during the clinical trials at Christie Street, Banting wrote to Best that “worse than the heat as a disturbance is that diabetics swarm around from all over and think that we can conjure the extract from the ground.” Desperate souls even showed up at the lab, hoping to get insulin, though at that time the sporadically available doses were all going to the veterans. Soon the trials expanded further, to Toronto General Hospital and the Hospital for Sick Children, and the work continued at Christie Street, with Joe Gilchrist in charge and Banting and Best in high demand elsewhere.

By the summer of 1923, insulin was being used in the United States, England, the Netherlands, China and Australia. There were articles raving about patients being “brought back from the very threshold of death,” so it was not surprising when, later that year, Banting and John Macleod, his supervisor at the University of Toronto, received the Nobel Prize in Medicine, and in turn shared the award with Charles Best and James Collip. The discovery made the men famous, and could have made them rich, too, but rather than profit personally, the team sold the patent to the University of Toronto for one dollar, and the university set up committees that would oversee its use internationally, avoiding monopolization and ensuring the drug was affordable and widely available. The system remained in place until the 1950s. Today, even in Canada, many diabetics can’t afford the full cost of their treatment, and ration their use of insulin.

Banting didn’t live to see the changes. In 1941, he died in a plane crash, making headlines once again as a hero and a “great benefactor of mankind.” In 1934, he’d been knighted for his accomplishments—a doctor, a Sir and a Nobel laureate all at once. One wonders how Joe Gilchrist felt during Banting’s glory days, remaining in the shadows, yet having played such an integral part in the development of a medicine that would save so many lives worldwide. “It was on him,” Banting himself had written shortly before his death, “that we tried not only new batches of insulin … but also many experiments that had to be carried out, for example, the time in relation to meals, the distribution of dosage, the treatment for overdose.”

In 1951, Joe was admitted to Sunnybrook Hospital, originally a veterans’ hospital built to replace the old cash register factory on Christie Street. Never a purpose-built facility, Christie had become overcrowded when WWII soldiers began arriving, and though described in the press as “the best of its kind on the continent” and “a Mecca for doctors who rejoice in modern scientific improvements,” by 1945 it was labelled a disgrace, and a group of Toronto women took it upon themselves to push for new accommodations. “[Christie Street] is old, cockroach-infested and rat-ridden,” one woman wrote to the pensions minister, “and sick and wounded men are suffering there needlessly.”

The second war was over by the time patients were moved into Sunnybrook, so the building—a “palace of healing” according to Maclean’s—was only a few years old when Joe Gilchrist was admitted, this time just a patient and not a doctor in charge. He was in his late fifties, his legs, arms and buttocks scarred from years of insulin injections. His pension record states that he’d controlled his diabetes well on his own until shortly before his admission, when he started having chest pain and shortness of breath that caused him to speak “in gasps.” The record also notes a separation from his wife, and an ongoing battle with mental illness following his years at Christie Street. “Since the early 30s, he has been over active mentally and physically having an obsessive-compulsive behaviour with grandiose ideas. … He is very talkative and keeps on referring about his research he did back in the early 30s. He has the true mental activity of a manic depressive. His thought processes are disjointed and mixed with delusions of importance and influence with occasional paranoidal ideas.” Joe rallied for a time and was discharged, but returned to Sunnybrook that same year, “in gross cardiac failure.” He died soon after, of heart disease caused by diabetes. A Globe and Mail obituary acknowledged that he’d been “the first walking diabetic patient to receive the insulin treatment,” and also “a personal friend of Sir Frederick Banting and Dr. C.H. Best.” There was no mention, though, of the clinic he’d run at Christie Street, and his vital role as both patient and doctor.

Unlike Joe Gilchrist, Ogden Besserer, and so many other diabetics the world over, Jim Ostrom lived a long life, raising two sons with Grace in a pleasant neighbourhood in Toronto. He continued to work as a postal clerk, and took excellent care of his health, eating well and rising early each morning to boil his single insulin needle. His now ninety-five-year-old son Ron recalls that his father always carried butterscotch candies when they went on drives, and that he had his own mini-laboratory in the basement of their home: as taught at Christie Street, he’d pee into a test tube, heat the urine and a chemical reagent over a Bunsen burner, and measure his glucose level by the colour the solution turned, which told him how much insulin he needed. Despite scrupulous self-care, he sometimes went into diabetic shock: as the family sat at the dinner table, “the knife and fork would start rattling,” Ron recalls, and Grace would have to get Jim to the floor and “get the OJ into him.” Half an orange usually sufficed when he had an insulin reaction, but occasionally he worsened and slipped into a coma and had to be rushed to hospital.

And yet, Jim outlived Grace, who suffered two massive strokes and died in her fifties. He stayed on alone in their home for a while, but once, in the throes of an insulin reaction, he started hammering on the wall shared with his neighbour, who phoned Jim’s son Lloyd in a panic. After that, Jim had a live-in caregiver for a time, but eventually moved into Sunnybrook, where he remained until his death at almost eighty years old.

Coincidentally, the son, Lloyd, worked at the Christie Street hospital site when it became a city-owned long-term care facility after the veterans’ departure. For many years, he was a bookkeeper there, managing financial accounts for the residents. Every year, he’d take his children to the corner of Christie and Dupont to watch the Santa Claus Parade go by, and then the family would go for hot chocolate in the cafeteria where Jim and the other patients had once taken their meals.

Jim’s granddaughter Anne—the daughter of Lloyd—remembers her grandfather well, and says that like most veterans, he didn’t really talk about the war. But perhaps he did at Sunnybrook, where he lived with others who’d been soldiers and his memories had a different context. Every Saturday Lloyd would travel out to Sunnybrook, pick up Jim and bring him home for a roast beef dinner and a game of cribbage. “I think of him whenever I smell a cigar or have an Orange Crush,” says Anne. And when asked if she knew of Jim’s early involvement with insulin, she answers yes: “I would not be alive if not for the discovery.”

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Kristen den Hartog

Kristen den Hartog is a novelist and non-fiction writer whose most recent book, The Cowkeeper’s Wish, was co-authored with her sister Tracy Kasaboski. She lives in Toronto.

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