Joslin, Best and diabetes. 1963, Length: 00:27:03, Color, Sound. 16 mm to Beta SP [...] [ Music ] [Narrator:] It's rare indeed that these two world-famous men can be brought together in a film. Dr. Joslin died in 1962 at the age of 93. But, fortunately, Dr. Best, who with Dr. Banting discovered insulin, is still with us. When one realizes that there are some 1 and 1/2 million diabetics in United States, and another like amount yet undiscovered, or when at any time you or a member of your family can be afflicted with this disease, then and then only can one comprehend the full value of the contributions of Dr. Joslin, who devoted a lifetime to perfecting the treatment of diabetes, and of Dr. Best the co-discoverer of life-giving insulin. [Dr. Root:] Whether you boys know Dr. Best--Dr. Charles Best, who's coming here today, is the famous doctor who was the co-discoverer with Sir Frederick Banting of insulin 40 years ago. He's coming here to take part and to speak at the Elliott P. Joslin Memorial in Oxford. He was a friend of Dr. Joslin's for many years. [Howey:] Dr. Joslin was my doctor. He was great. I don't know? I know he was an old man and yet, somehow, he wasn't like a lot of other old people. [Dr. Root:] Well, he was 93 when he died.[Scott:] Yes, but he was always asking questions about our diabetes. Why, he even visited us here at camp just the summer before. [ Car horn ] [ Music ] [Dr. Best:] Dr. Garmin, I know that you and I agree on the tremendous importance of teaching these boys good control of their diabetes. As a matter of fact, you should set them a pretty good example; I think. You had diabetes yourself. [Dr. Garmin] Well, there are three things Dr. Best. First, the very close care that my mother gave me when I was a child. And second, the almost imperceptible transfer of responsibility during my adolescence. And finally, the factor common at all times was the close association and friendship with my physician. [Dr. Root:] Dr. Best, I would like to have you meet one of Dr. Joslin's former patients; Scott Currier. [Dr. Best:] Scott. How did you happen to come to this camp? [Scott:] Dr. White. She's at the clinic too.She suggested it to my folks. Dr. Joslin always used to tell me how important it was to take care of my own diabetes. [Howey:] He told everyone that. That's one reason he started the camp: to teach diabetics how to take care of themselves. [Dr. Joslin:] We have had a wonderful group of patients. To all of those who had lived longer with their diabetes and they were expected to live if they didn't have it, Ms. Amelia Peabody made a life expectancy medal. This was given and now we even took two or three thousand patients. And they have cherished it because it showed how faithfully they had lived. But so many of them obtained it that later we had another medal for patients. And this was given to those who after 25 years of the disease; had perfect blood vessels, perfect eyesight, and perfect kidneys, and were generally sound in health. Of these, we have had now some 98 patients. Not one who has obtained this medal of perfection, ever was able to obtain it unless he had followed treatment meticulously just as [inaudible] and Alan prescribed. [Dr. Best:] Scott, what do you mean when you say take care of yourself? [Howey:] Well, I think I can show you better. Come on over to the clinic, we'll show you. Hey, tell Stevie to come here a minute. Steve is the youngest boy in camp who takes his own insulin injection, Dr. Best. He's only seven and already he's learned to take care of himself this way. [Camp staffer:] Okay, boys.[Steve:] What you want? I got to take my shot! [Howey:] Hey, Steve, how about giving Dr. Best a performance? [Steve:] Well, that's that. Me and Art have to go and eat. [Howey:] He's a cute kid but, boy, he can be a pill. Now we'll never hear the end of it: "I shot myself for Dr. Best." [Scott:] Years ago when doctors didn't know what they know now, the kids just didn't get very tall. [Howey:] Sure, I know that. They used to call them diabetic dwarfs. [Scott:] It was because they didn't get enough protein in their diet. Now we know we must take care of our height, our weight, as well as our diet. [Dr. Best:] You mean that you weigh and measure your food and know how to prepare it? [Scott:] Here, let me show you in the diet kitchen. I have a diet of so much fat, protein, and carbohydrate and I use one of these scales to measure it. I check myself about once a week now but I've been doing it for so long, I think my estimates are perfectly all right; at least the doctor and the dietitian think so. [Dr. Best:] Do you find, Scott, that it takes a lot of time to weigh your food and take your insulin shots? Do you find it hard to do? [Scott:] Well, at first it was sort of a hard thing and then I became used to it. And now it's nothing at all. [Howey:] It's really not even as hard as seventh-grade math. [Scott:] Hi, Betty. I was just showing Dr. Best how we weigh and measure our food; the kind of thing that Dr. Joslin used to teach us. [Betty:] He was always interested in the children knowing how to do these things. Howey, where's Beetle. [Howey:] I think he's down by the lake.[Betty:] Well, when you see him, would you give this to him? [Howey:] Wow! Sure! This is for Beetle Daws. He's bugs about bugs.[Scott:] You know, the camp is for fun too. We do everything they do at any camp. You don't have to feel you're sitting on a bench if you're diabetic. [ Music and clapping ] [Dr. Best:] You know boys with all this activity around the camp, makes me think of another one of Dr. Joslin's great interests. He was always trying to find out the influence of exercise on diabetes. [Dr. Joslin:] Now, [inaudible] found this. And this puzzled him and embarrassed him. He found that the patients to whom he gave a diet--the same diet that he had in the hospital--and sent them home, that they did better when they were away from him at home on their farms than when he had them in a hospital. And it finally dawned upon him that exercise was the reason for it.[Dr. Best:] Thank you, Scott. Thank you, too, for acting as the host at the camp for us today. [Howey:] There's a girls' camp, the Clara Barton camp, that has a program just like ours. Boy, won't they flip when they find out that you've been here and not there. [Dr. Best:] Well, as matter of fact, I'm going over to the Clara Barton camp tomorrow after the dedication. Are you boys going to be at the dedication?[Scott:] You bet! I wouldn't miss that for anything. [Howey:] Me too. [ Music ] [Dr. Root:] We are meant today to celebrate the 250th anniversary of the founding of Oxford, Massachusetts. In this city were born two persons who achieved distinction by their service to humanity. Clara Barton. Born in Oxford in 1821. She brought about the formation of the United States branch of the International Red Cross. Dr. Elliott P. Joslin, born here in 1869, became a professor of medicine, a distinguished physician and known the world over for his teachings in diabetes. But my real privilege today is the introduction of Dr. Charles H. Best. [Dr. Best:] Thank you Dr. Root. I enjoyed every time I ever met Dr. Elliott P. Joslin. And I'm delighted to have this opportunity to pay a tribute to his memory. [ Music ] [Susie:] Dr. Best, many of us knew Dr. Joslin rather well too. And your speech at Oxford really meant a lot to us. Some of the things you said were just the way we felt about him. [Dr. Best:] Thank you, Susie. Dr. Joslin knew how to say things wonderfully well.I've enjoyed having the tour of the Clara Barton camp with you three girls. And I'm amazed at how many things you've learned to do well. [Cathy:] We've been wondering just what did happen to the children in the days before insulin? What was it like? [Dr. Best:] Well, Cathy, there were thousands of years after diabetes was discovered when there wasn't much you could do for children. You fed them as little as possible and they lived for a time. Then in 1921 and 22, when we had insulin, the first children did very well. But we didn't have much insulin. And with one or two of the children, we ran out of insulin and we lost a little girl. One little girl and one boy. [Susie:] You know, Dr. Best, that Dr. Joslin took care of my mother? [Dr. Best:] Yeah.[Susie:] In fact he warned her that I had a good chance of becoming a diabetic.[Dr. Best:] Yes, we know Susie that diabetes does run in families and it's passed down from the mother or the father to some of the children. Linda, someone told me that you've been in the camp here for seven summers. You'd come for seven summers. [Linda:] Yes, I've been coming to Clara Barton for seven summers now. [Dr. Best:] And what are your parents think about your coming? Do you think that they're very pleased? Have you learned something that gives them satisfaction? [Linda:] Yes. They're pleased that I've come to camp. Because by coming to camp, I've learned to take care of myself by adjusting my diet and my insulin. Taking the right amount of exercise so I can control my diabetes by myself.[Dr. Best:] Yeah. [Linda:] Which puts them at ease. Because when I go away from home, they won't have to worry about me. [Dr. Best:] Well, I think you're right, Linda. This is a wonderful camp. I've been to a lot of other camps. And after thinking about them, I feel that they do a great deal not only for the children but for the parents. Well, girls, Dr. Joslin was very much interested in these diabetic camps too. He used to talk about them when I saw him in Boston. And I remember he mentioned them when came to Toronto to see the opening of our research institute. Dr. Joslin was interested in investigation, you know, research. And he was interested in the camps. And he told us at that time that he hoped someday he'd have a wonderful clinic where he could do all or many things that he had in his mind to do for diabetics. Well, as you know, that clinic really has come into being and I hope to go there again tomorrow. [Dr. Joslin:] To predict the future diabetic: we hope to erect in Boston a hospital teaching clinic in which ambulatory diabetics can return at much less than regular hospital costs--fully a third less--receive instruction, encouragement, and such development of character that life and health hither to unrecorded for diabetics will be obtained. [ Music ] [Dr. Best:] It's nearly 10 years ago now since Dr. Joslin came to Toronto to take part in the opening of the institute which they named after me. Two years later, the cornerstone of this Joslin clinic was laid. and here we are now in the completed clinic which Dr. Joslin had so much desired. [Dr. Root:] Yes, Dr. Best. This clinic has fulfilled not only the ideals which he expressed there in founding your institute, but also the hopes which you know he had as long ago as 1922 when you first came to Boston. And here are the opportunities for training patients an adequate and proper diet is more important today in the treatment of diabetes than ever before. And here we emphasize the doctors teaching patients how to measure and evaluate food. When a child develops diabetes, it helps tremendously if the child and her mother can together in the same room be treated and the mother learn firsthand the best methods for the care of that child. Perhaps the most important single thing for a diabetic patient to learn is how to test the urine for sugar and when to do it. One important aspect of our program is the doctors' teaching of patients. Mrs. Cohan. You have known the teaching and training in diabetes over many years which Dr. Joslin inculcated. May I ask you how you feel about it?[Mrs. Cohan:] When I first came here 25 years ago with my daughter, who was then a child diabetic and myself; I was worried, alarmed, tortured how I was going to care for both herself and myself. After being a week at the clinic in the teaching unit, I learned how to take care of us. I learned all about diet and food, exercise, the care of the infant to such a great degree that I was completely in confidence. I had the absolute confidence that I can go home and take care of all my problems. My fears were gone, and I felt that I could do all that was necessary for the best for both of us. [Woman speaker 1:] Can you have diabetes without having any apparent symptoms? [Dr. Krall:] Why, yes, of course. Very early in diabetes sometimes there are no symptoms and you have to find elevated blood sugars or urine sugars.[Male speaker 1:] Is necessary to keep insulin in the refrigerator?[Dr. Krall:] The insulin you are storing should be kept in the refrigerator. But the insulin that you're using can be kept at room temperature. [Woman speaker 2:] If one member of the family has diabetes, should the other members of the same family be checked? [Dr. Krall:] Why, certainly. Diabetes has hereditary tendencies and other members of family should be checked particularly those who are overweight; if any.[Male speaker 2:] These pills sound exciting. Can all diabetics use these pills?[Dr. Krall:] No, I'm afraid not. While many of the diabetics who are milder get by with pills perfectly well, most diabetics and certainly more severe ones still require insulin. [Dr. Best:] We all agree that one of the most important things in looking after diabetics is to teach them. I know that this has done extremely well in the clinic here. I've seen Dr. Joslin, Hugh Howard and many others giving a great deal of their time to patient education. Dr. Root, I know that Dr. Joslin has been interested for many, many years in training physicians in the various aspects of diabetes.And that they've come to him from all over the world. [Dr. Root:] Yes. And today we have a group of doctors from many countries in various types of training. In fact, they have a number of questions to ask you, Dr. Best. [Doctor 1:] I've always wondered, Dr. Best, how you happen to find insulin and many other researchers have failed? [Dr. Best:] I suppose there's an element of good fortune and all successful research. We had several assets really. We had good surgery. Fred Banting was an excellent surgeon. And then we had the micro methods for doing blood sugar which all our predecessors had lacked. And then we had youth. We weren't too much concerned about what happened before we started. [Doctor 2:] Dr. Best, you have a long-range picture of the diabetes mellitus problem. Could you tell us what advances you hope will be made for the diabetic patient in the next 10 years?[Dr. Best:] Well, of course, no one can be completely certain about any research problem--about the solution of any research problem until it's actually accomplish. But I think the indications are that we will have synthetic insulin.It won't be any different perhaps in potency than the natural insulin. But we're going to need some day more insulin than you can make from natural sources. [Doctor 3] I think we all like to be interested, Dr. Best, to know how you went about getting the first insulin and also getting enough of it? [Dr. Best:] Well, our first insulin was made from dog pancreas. It was very good material, but of course you can't collect a lot of pancreas from dogs. Then we went to beef pancreas. And this proved to be an excellent source. We had to change the technique of extraction a bit, use different strengths of alcohol and acid, and so on. But the main problem at that time was to get into large-scale production. We did some of the preliminary work in the University of Toronto, but we were fortunate to have the cooperation of one of the great family companies in the United States the Eli Lily company. And their engineers were expert in doing the sort of thing that needed to be done. I remember that I went there nine times in the first year to try to tell them what I knew. And they taught us a very great deal. And I think the insulin committee of the University of Toronto was very happy that we selected the Eli Lily company to work with us for the first preliminary difficult year in the large-scale production of insulin. [Doctor 4:] Dr. Best, in your travel around the world, do you find the society of free people developing programs in the field of diabetes? [Dr. Best:] Well, Dr. Joslin and I had the honor of being the first honorary presidents of the International Diabetes Federation. And over the years, I've been in a great many countries where societies devoted to the interest of diabetics have been formed. In some countries, these societies are doing a wonderful work. And in others, of course, it's slow. But the idea of the International Diabetes Federation is to use the knowledge gained in the more active countries and to apply this in the effort to help those countries which are not so fortunate. Dr. Lozano, you're finishing your two years here in the clinic and you're going back to Mexico. Do you feel that you will be able to apply a lot of the new information which you gained while you were here? [Dr. Lozano:] Yes, I do. I will work in the Hospital of Nutrition Disease where, like many other places in Mexico, we have a high standard of medicine. Of course, there are areas in Latin America as in other parts of the world where getting enough food for the children is a special problem. [Dr. Root:] And finally, now, his best hope: his deepest hope: a new laboratory for research. One of Dr. Joslin's most absorbing interest in the last 20 years has been the study and prevention of blood vessel disease. Dr. Reese, you are conducting research in this field. Tell us about it.[Dr. Reese:] Our research has been directed at the relationship between the control of diabetes and the progression of small blood vessel disease. Studies today clearly indicate that good control retards the progression of small blood vessel disease in diabetes. Another aspect of our research focuses upon the blood vessels of children who have a high index or chance of developing diabetes. With this camera, we can pick up abnormalities a blood vessel before there's any evidence of diabetes by the usual clinical criteria. [Dr. Best:] I suppose, Dr. Root, that this clinic has a very special meaning for you personally. You are Dr. Joslin's first associate, and I believe that you gave the first dose of insulin that was administered in New England. [Dr. Root:] Yes, Charlie. But let me say this...eEven before the discovery of insulin, Dr. Joslin had demonstrated that devotion to the care of the patient. That keen interest in learning and in teaching. When we learned that you and Dr. Banting had each given yourselves a dose of insulin, although neither of you had diabetes [Dr. Best:] Right.[Dr. Root:] I should not have been so terrified as I was on that day on August 7, 1922 when there stood before me this frail nurse. The diabetes which had reduced her weight from 135 pounds to 65 pounds. How much insulin should I give her? [Dr. Best:] How much did you actually give her?[Dr. Root:] I have to admit, Charlie, I gave her one unit and my heart beat. [Dr. Best:] Yeah. [Dr. Root:] And there, there she is. The nurse who learned to give insulin. She was then the lovely Ms. Peterson. And now Mrs. Simons. Mrs. Simons, what do you remember of that period in 1922? [Mrs. Simons:] I remember particularly the children because they started to grow and thrive and live happily. [Dr. Root:] And in those next months, she was the nurse first instructed to teach the administration of insulin among the nurses [Dr. Best:] Yes.[Dr. Root:] of the Deacons Hospital. [Dr. Best:] Dr. Elliott Proctor Joslin was one of the greatest men whom I've ever known. I heard his name when I was seven years old. I met him in Toronto in 1922 and I was in very close touch with him throughout the rest of his life. I'm sure that I speak for everyone who's taken a part in making this record. We all feel highly honored. [Narrator:] And so, since 1922, with the discovery of insulin by doctors Banting and Best and the leadership of Dr. Elliott P Joslin in development of a program of patient care, there has evolved a new life; a normal life for millions of diabetics and their families. [ All singing ]