Kersten T. Hall, Insulin – The Crooked Timber: A History from Thick Brown Muck to Wall Street Gold (Oxford: Oxford University Press, 2022) 480 pp. £31.49 Hb. ISBN: 9780192855381
Out of the crooked timber of humanity, no straight thing was ever made. — Immanuel Kant
Whether you interpret Kant’s famous quote in a moral sense, or simply as being about the limits of human reason, it rings truer than ever. Not as a pessimistic outlook on humanity, but as a brutally honest view of scientific advancement for what it is – a combination of virtue and vice. This is the message biologist-turned-science writer Kersten T. Hall conveys in his intriguingly titled book, Insulin – The Crooked Timber: A History from Thick Brown Muck to Wall Street Gold. If the title is not alluring enough to make you want to read, the contents page, with chapter titles like ‘The Vision of Ezekiel’, ‘A Greek Tragedy’, and ‘The Prophet in the Labyrinth’ will convince you otherwise. And true to Kant’s timeless quote, the essence of Hall’s story is a reminder to fight the temptation to oversimplify history and to ‘tell a story of lone geniuses’ (xvii) as saviours of humanity. As much as Hall is appreciative of lifesaving medical innovations, he is equally wary of the path to glory. Using humanity’s journey to insulin therapy as an example, he emphasises the importance of recounting history as is, of not painting a conveniently simplistic picture to romanticise people or events.
The introduction and first chapters acquaint the reader with the disease that is central to the book – diabetes – its history and reputation as the incurable ‘pissing evil’ (5). Here we are introduced to the first part of the journey from Thick Brown Muck to Wall Street Gold. The first attempts at curing the disease are using ‘thick brown muck’ – the extracts of pancreatic tissue. Liberally peppered with quotes, the first chapter, ‘The Pissing Evil’, is articulate, with concepts flowing nicely into each other. The evolution of the understanding of diabetes is discussed briefly. A good amount of suspense is built with sentences like ‘while the award certainly brought Banting fame, …it would ultimately prove to be a blessing, and curse, for him’ (15). The next chapter, ‘Thick Brown Muck’ reads a bit gossipy, fanning the flames of a professional rivalry between two scientists whose names are perhaps most famously associated with the discovery of insulin – Canadian pharmacologist Frederick Banting, and Scottish biochemist John J. R. Macleod. The pharmaceutical company, Eli Lilly and Company is introduced in this early chapter of the book, hinting at the potential to convert ‘Thick Brown Muck’ to ‘Wall Street Gold’. Hall then reveals the first hints of the ‘crooked timber’ of humanity, with the subsequent chapters four to nine abuzz with stories of rivalry, jealousy, and ambition in the pursuit of glory, of the desire to be recognized as the first to deliver humanity from diabetes.
The book adopts an anthropocentric view of science and innovation. For while innovations may be new, human nature at its core remains the same. The author highlights the behind-the-scenes frustrations of being a researcher – of not getting credit where credit is due, of jealousy, and of professional greed. It would seem not much has changed in academia over the years, if academic twitter is to be trusted. Some of the middle chapters are quite verbose, and while the extensive research is commendable, many parts are tangential to the main story and could have been skimmed over.
Insulin – The Crooked Timber is less a popular science book, and more a social commentary on the nature of humankind. It is less about science, more about society’s reactions to it. It is less about the cure itself, and more about the race to get there. Chapters 12 and 13 of the book finally arrive at the promised ‘Wall Street Gold’ part of the journey. In these final chapters, two seemingly separate worlds are merged when science meets the world of finance, as insulin makes stock market history. Venture capitalist Robert ‘Bob’ Swanson and biotechnologist Herbert Boyer find a way to pull breakthrough science from inside the walls of universities into the brave new corporate world, when their company, Genentech, offers stock in an initial public offering (IPO) on Wall Street. The runaway success of this listing is portrayed as a clever combination of business skills – the identification of insulin as the ideal commodity due to its high demand and established market, and of scientific skills – the use of artificial, and not human DNA, made possible by the synthesis of the complete DNA sequence of a gene. In a time where there were heavy restrictions on the use of human DNA due to ethical concerns, these chapters capture the kind of innovative thinking that has since been at the heart of enterprises funded by private corporations. The silicon valley today is reminiscent of this. Where chapter 12 praises the genius of unshackling minds from the constraints of academia, and the bold idea of funding science through startups, chapter 13 serves as a warning against the proverbial evils of capitalism. It touches upon issues of corporate greed and market monopolies: ‘the market price of insulin did always not reflect its production costs but was instead inflated by the costs of marketing and promotional campaigns. Furthermore, … control of production was in the hands of only three companies’ (346) eloquently captures the problems associated with the entry of private companies into healthcare.
The book, published during the COVID-19 pandemic, was meant to serve as a warning, as the world waited for vaccines against SARS-CoV-2. As welcome as vaccines are and will continue to be in the future, we will do well to utilise them not as ‘silver bullets’ (349), the author advises, but as a ‘welcome walking stick thanks to which societies can take cautious steps out of lockdowns’ (349).
In painstakingly researching the advent of insulin, Kersten T. Hall has shown that the literature associated with the history of science can help serve as a reminder that breakthroughs are often achieved ‘not by standing on the shoulders of giants, but by being hewn from the crooked timber of humanity’ (xvii).
Ashitha B. Arun, National Centre for Biological Sciences, Tata Institute of Fundamental Research
