Tuesday, November 19, 2013

The Secret Life of D's

I carry my diabetes with me throughout the work day, sometimes sharing it with patients and sometimes not. I pick and choose based upon whether or not I feel it will be beneficial.

As a physician still in the final leg of training to be an independent pediatric endocrinologist, everything I do has to be signed off by my superiors. I follow many patients that I consider "my own" and often pick up others that "belong" to my bosses.

Last week there was a particularly busy diabetes clinic, and I picked up a patient that I had not previously seen. I rushed from the patient before him and quickly scanned his medical chart for the pertinent information about his diabetes history. He was 6 years old, on Lantus and Humalog, and still honeymooning from his diagnosis only 6 months prior. It was noted in his chart that he has had a hard time coping with the diagnosis, which struck me as sad yet impressively mature for a child his age.

I swept into the room all smiles in an attempt to start the appointment on a positive note. I said hello to him, then to his mother and father sitting to either side of him. I introduced myself and my role, and assured them that their usual doctor would also be seeing them after me. His parents were polite but clearly exhausted, the stress of the previous 6 months weighing heavy on them. His mother was very attentive, his father just nodded without taking his eyes off of his cell phone. With my focus on the boy again, I asked him how he was doing. Not the diabetes, just him.

"But everything is diabetes," he said with sadness and an understanding that was beyond his years. "I don't really want to do it anymore." My heart ached at the sentiment, and I decided that this was an appropriate time to share my own.

"I understand that feeling. I wish you did not have to do it anymore, either. I feel that way sometimes, too, because I also have diabetes," I carefully explained.

His eyes widened in disbelief. He stayed quiet for a few moments and then shouted in disbelief "You have diabetes like me?!"

He studied me carefully, almost looking to see if there was something on me that he missed. Something that would have declared me as diabetic had he looked closer the first time.

He then pointed to his father and said, "My dad has diabetes, too! My mom is the only one here who doesn't!" His smile widened bigger than his amazed eyes.

Now it was my turn to be surprised. I turned to his father and our eyes met as he looked up from his cell phone. I smiled at him and looked back down at the chart. It was listed there: father with longstanding Type 1 Diabetes, with diabetic retinopathy and nephropathy. I caught myself thinking that I would have never guessed he had Type 1 despite knowing firsthand that diabetes is an invisible disease.

"Guess we're all in the D-Club together, huh?" I said to the boy.

"Haha, yeah! It's like a secret club!" he said with a giggle.

More insightful words from a very insightful little boy.

Tuesday, November 12, 2013

Diabetes Awareness Month

I have never been more acutely aware of diabetes than this particular month. And all I want to do right now is ignore diabetes completely.

I know that designating November as Diabetes Awareness Month was not meant for making the patients themselves aware, but for the public. For the masses that don't know anything about Type 1 or Type 2 or any other type and for those that think diabetes is not as big a deal as breast cancer and heart disease. I appreciate that. I just can't bring myself to join the movement at this moment in time.

I got bad news at the ophthalmologist at the start of this month regarding my recently diagnosed retinopathy. It is news that will be more eloquently fleshed out in a future post, when I have the strength to chip this mountain of emotion down into words and sentences.

For now, I just want to bury it. All of it. The tears, the guilt, the frustration, the anger, the shame, the fear, the regret. The massive regret. I can't face it all head-on right now. I want to walk away from diabetes.

But diabetes is holding me hostage. As much as I want to ignore it for even a few hours, knowing that ignoring it is what gave me this complication in the first place forces me to pay closer attention. Test, bolus, repeat. I am shackled by the guilt of it and fear of doing even more damage. The ball and chain has always been attached, it's just never felt so heavy before.

Work has been busier than ever, but I have been slower to get out of bed. I drag myself there and put on a happy face. I encourage patients to keep doing their best. I diagnose kids with new-onset Type 1 and tell them that they can live a perfectly healthy, normal life free of complications. This is the truth. It isn't my truth, but I keep that to myself. And I constantly feel like a hypocrite behind my cheerful facade.

My very situation is why Diabetes Awareness Month needs to exist. We need to get the word out to fund the research that improves and eventually eradicates this illness so no one else has to feel what I feel right now. I am grateful that the diabetes community has been so involved in getting the word out and wish I was a more vocal participant, but my rally cries have been overcome by a different kind of cry.