True Confessions (On Diabetes)
by Lois Jovanovic, M.D.
This Excerpt is from the book The Diabetic Woman: All Your Questions Answered by Lois Jovanovic, M.D. June Biermann and Barbara Toohey, 1996 and is reprinted with permission of the author.
My father had Type I Diabetes. by the time he had children, he was already riddled with problems. I remember his morning ritual of testing his urine--a tablet, which I now know was Clinitest. The test tube became very hot, and the contents then turned an ugly brown or orange. Now I realize that he never, never was in good control. He took his insulin with a glass syringe, which mother boiled. Every afternoon he had an insulin reaction (insulin shock caused by extremely low blood sugar), and if we didn't rush home from school to give him dinner, he was in a diabetic coma.
From my earliest memories, Daddy was bedridden and blind. At the time of his death, I was twelve; he was fifty, with twenty years of diabetes. I promised at his graveside that I would devote my life to curing diabetes.
At almost the exact age at which my father got his diabetes, I developed mine. I had completed medical school and medical residency and was in the middle of my endocrine/metabolism fellowship when it happened to me.
I completely denied the symptoms. I attributed my weight loss, irritability and insomnia (which was caused by my constant need to urinate during the night) to the stress of my career.
Then, during the middle of an experiment, I donated my blood as a normal control. When it came back sky high--more than three times the normal range--I thought the assay was wrong. When my blood was used to calibrate the biostator (a kind of giant mechanical pancreas used in the hospitals), I did not think that the 400 blood sugar could be mine, but instead screamed at the technician for not calibrating the machine correctly.
After three months of deteriorating health, I was forced by a dear friend and colleague to accept the truth. I refused, however, to admit that I needed insulin. I was sure that I could manage my "mild diabetes" with diet (in essence starvation), exercise, and if necessary, oral agents. In less than a week I was in a ketoacidotic coma, that advanced state of out-of-control diabetes that can lead to death if insulin is not given.
Denial was certainly the major component in the on-set of my diabetes. The next stages were all in accordance with the classic stages described in Elisabeth Kubler-Ross's book On Death and Dying. I went through the phases of anger and depression and finally arrived at recovery and acceptance. This process took me a year. Now I know that a year of grief is normal when a chronic disease is diagnosed.
I didn't really change my career
plans, but I refused to "come our of the closet." The truth was difficult
to admit publicly. I thought my credibility as a physician and a scientist
would be harmed. I only revealed my diabetes five years ago, when I went
on a b.i.d. [twice a day], insulin pump. Then I couldn't deny my "affliction"!
Surprisingly, I found out that my diabetes actually enhanced my credibility. Not only were physicians more respectful, but in addition patients became more willing to follow my advice, since they knew I was following it myself.
Perhaps my acceptance took too long--but then again, I saw my father crippled by the disease, and thus it was terrifying to me. And it did serve to make me understanding of denial in other diabetic people and to allow me to better able to help them work through theirs.
I haven't cured diabetes, not has anyone else--yet. I have all faith, that someone will find a cure in the not-too-distant future. In the meantime, your goal should be to stay healthy and to keep your blood sugar normal so that you'll be ready to enjoy the benefits of that cure. Your other goal should be to lead a wonderful life. What, after all, is the good of being a perfect diabetic woman if it means sacrificing all the joys of human existence?
I know from my own personal experience,
as June [Biermann] knows from hers, that these two goals--good control
and a wonderful life--are not incompatible. They can be achieved. My goal
is to help you achieve them.