Monday, August 19, 2013

Breaking Point

There is no use crying over spilled milk. Or spilled Lantus. But that doesn't stop anyone.

 Every once in a while, a frantic call comes in via the emergency pager about this very thing. More often than not, the call comes in the night the patient was first discharged from the hospital. The night we nudged the entire family from the nest, with the parents feeling like the flailing baby birds.

They are so very green - only 3-4 hours into unsupervised life with diabetes. Lantus is the last hurdle of the day, but it's a high one. Do you remember the first time you held a vial and syringe? The first time you tried to hold both with one hand while pulling back the plunger with another? It seems so fluid now - having done it a countless number of times - but it wasn't always so mindless.

Sure, they spend lots of time practicing while in the hospital. But nurse and doctor supervision is a warm, comforting blanket that got left behind. Doubt and fear quickly creep in, chilling parents to the bone, and they panic. They tremble. They drop things.

The insulin spills everywhere, permeating everything. But so does the fear, sadness, frustration, and anger that has been building and building and building since the first news of the diagnosis. Having not had diabetes long enough to build up a stash of supplies, they have no recourse but to contact the on-call doctor.

Those emotions come spilling through the phone line, too powerful to stop. I've heard parents at their most panicked, rambling incoherently over my attempts to soothe. I've heard husbands and wives carry out screaming matches that I am forced to awkwardly sit through, unable to mediate because no one is able to hear me. I've had parents take out their frustration on me, yelling that I should have prescribed two bottles instead of one.

I can easily call in a prescription to remedy the insulin shortage. But when that first bottle hits the ground and shatters into a million tiny pieces, it always manages to crack their spirit, too.

And there is no prescription I can write to remedy that.


  1. Beautifully written, so true.

  2. The best prescription is a doctor who understands and has a heart to care. You do have that to give and I am so glad that you do.

  3. I love your writing... Makes me wish you were Elise's doc!

    I'll never forget the day we were discharged, my husband flew to NYC for business two hours after we left the hospital. When it was time for Elise's dinner shot, I realized I hadn't diluted the insulin and had lost the diluting instructions. I was in a panic when I called the endo, but of course it was after hours and the on-call doc had no idea what I was talking about.

    I sure could have used someone like you answering my call that day!

  4. We were home a few days when we made our first panicked call to the on call doctor ... Neither my husband or I could remember whether we had given our son his nightly lantus shot! I remember that night vividly ... The doctor we spoke to was so kind ... Thank god for all the caring doctors out there, just like you!

  5. Aww, I agree-this is a beautifully written post.

  6. I sorta wish those parents, years down the road, could go back and listen to themselves at the beginning. Or, magically do the opposite. It would give them so much confidence. Thanks for being a great endo.