LifeAfterDx--Diabetes Uncensored

A internet journal from one of the first T1 Diabetics to use continuous glucose monitoring. Copyright 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013, 2014, 2015, 2016

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Location: New Mexico, United States

Hi! I’m William “Lee” Dubois (called either Wil or Lee, depending what part of the internet you’re on). I’m a diabetes columnist and the author of four books about diabetes that have collectively won 16 national and international book awards. (Hey, if you can’t brag about yourself on your own blog, where can you??) I have the great good fortune to pen the edgy Dear Abby-style advice column every Saturday at Diabetes Mine; write the Diabetes Simplified column for dLife; and am one of the ShareCare diabetes experts. My work also appears in Diabetic Living and Diabetes Self-Management magazines. In addition to writing, I’ve spent the last half-dozen years running the diabetes education program for a rural non-profit clinic in the mountains of New Mexico. Don’t worry, I’ll get some rest after the cure. LifeAfterDx is my personal home base, where I get to say what and how I feel about diabetes and… you know… life, free from the red pens of editors (all of whom I adore, of course!).

Friday, March 06, 2009

The doctors and me

Doctors don’t like us. Sorry, but it is true.

I go to a lot of medical seminars. And thanks to being a middle-aged white guy, I’m often mistaken for a doctor. No doubt it is my suave good looks and extensive vocabulary. OK, you can stop laughing now. But being mistaken for a doctor lets me hear things that real doctors would not say if they knew there was an undercover diabetic in the room. (Cue the James Bond theme song).

And I’ve noticed over the last few years that many doctors manage to use the word “diabetic” like a curse word. So how can I demonstrate this with the written word so that you can understand the tone, the inflection, that I hear far too often? Harsh. Biting. Like spitting out wine that has turned to vinegar.

Hmmmmmmm….OK, so if someone told you that Dr. X said, “I find these diabetic patients to be very taxing.” Well, now that sounds harmless enough. Maybe even honorably honest.

But it is the way “diabetic” is said that makes the difference.

What is the most vile, disgusting, gross thing you can think of? Yeeeeeewwwww, there’s a bunch of used condoms on the picnic table! Yeeeeeewwwww, there’s a leech crawling up your leg. Yeeeeeewwwww, there’s ….. Well, hopefully you get the idea.

That is how a great many doctors say “diabetic.”

But now, as if I don’t already have enough to do, I’ve been given a chance to do something about this. Not about the used condoms; about the attitudes of doctors.

I was recently drafted by an enlightened doc at a university hospital. His job, among other things, is to train “Residents.” Residents are not people who live at a hospital. Well, actually, come to think of it, they pretty much do. But I’m talking about proto-Doctors in their final phase of training.

Hearing on the grapevine that I was not making enough money in the first place, and am now making even less, he hired me to drive half way across the state two days per month to help him out. The job description was a little vague, but the pay was good.

I figured I’d be working with patients. Wrong. I’m working with the Residents. My first day on the job I was sort of a fifth wheel out-of-place observer. In every way. I work at a clinic where I know everyone by name. All the staff are on first name basis (of course two of them have the same first name: Doctor).

Now I was in a place with hundreds of employees. Maybe even a thousand. It is daunting. Thrilling. Scary. All at the same time.

So what the heck am I supposed to being doing here exactly? I asked my new boss at the end of the day. “You’ll figure it out,” was his response.

It wasn’t until I was driving home the first day that my mission dawned on me. It took a while to sink in. I was replaying the conversations, observations--everything I said, heard, felt, did-- on the way home when it hit me. Suddenly a light came on. Oh crap, I bumped the stupid dome light button!

Then, slowly, a theme emerged. Something I heard three different Residents relate to their preceptor. I’ll paraphrase, as they all pretty much said the same thing: “So the patient hasn’t done anything we asked them to do on the last visit, so I had the complications talk with her.” Picture a self-satisfied smirk. An inquisitor who just lit the bonfire at an old-fashioned witch burning.

I flipped open my cell phone and dialed. You want me to teach the children (his word for the Residents) what makes diabetics tick.


So I guess my next business card will read “Diabetes Ambassador.” My new part-time job is to make the next generation of doctors different from their forbearers. Not to view us as disobedient children; but as complex living organisms who have to exist in an even more complex social environment.

So today, two weeks after my epiphany, on my second day on the job, a young proto doc was complaining that a patient was still eating too many tortillas. After he finished his rant I said out of the blue, I've got a coupon for a free sex change. Would you like to have it?”

Shocked silence.

Awkward laugh. “What??”

Would you like to be a woman instead of a man?

“No…of course not…wha…why…why did you ask that???”

Because it is easier to change your gender than change your diet. You are asking too much. You are using threats and fear to affect change. That might work for a little while, but it is not sustainable. You need to understand your patient. You need to motivate, not intimidate.

Long silence while this set in. “So how do I….?” And we had a great chat. Not diabetic to doctor, or doctor to diabetic, or even peer to peer; but person to person. I love, love, love patient care. But this is a very cool gig.

I really do love Docs. Maybe I’m the right guy to make them love us back. What do you think?


Blogger Christine-Megan said...

Being an RN who is in NP school, yep, we're not liked. It's obvious. I'm not terribly open about my diabetes, at least not til I know people awhile, so I've been privy to these comments as well. "They're so non-compliant." "I don't know why we even bother." "They did this to themselves." "It shouldn't be so hard."

Etc, etc, etc

8:55 AM  
Blogger Scott K. Johnson said...

Wil! I think this is PERFECT for you!!! I hope that you are able to do more of this, because it will make a big difference to many of the people who see those soon-to-be doctors.

I still owe you an e-mail...haven't forgotten, will do it soon, promise.

9:38 AM  
Anonymous Stuart Schaffert said...

It's too bad you can't do this for every new doctor, but you've got to start somewhere. You should write a book! Wait, you already did and it's great! Write one for the up and coming doctors. The should be reading "The Born Again Diabetic" anyway. So should all patients, nurses, and Diabetes Educators. It's that good and targeting Doctors would be even better.

Stuart Schaffert

12:49 PM  
Blogger George said...

Here I am sitting in an exam room and just read this post! I think you are the right guy for the job Wil. I was blown away by how you handled that "child."
And BTW I am LOVING your book!

4:23 PM  
Blogger type1emt said...

Yes-you're totally the right person for the job.I've often wished I had the type of communicative skills to crack the thick(kkkkkkk...)supposedly superior brains of some docs.
Make the world a better place...1 re-educated doc at a time!

1:20 PM  
Blogger Jonah said...

I think the doctors who work mostly with diabetic patients- my endo and all of the people in that office, or the people in the endocrinology wards of the hospitals I've been at- do not have that attitude.
It's the dentist and the ophthamologist who seem to act that way more.
I also think that a lot of type 1s and their parents don't get it.
P.S. But the more people who understand, the better. You might be the best thing to happen to patients of those doctors twenty years down the road.

10:51 PM  
Blogger Sarah S. said...

That is terrific! A gig where you can add so significantly to the understanding of babydocs AND get paid. This sounds like the perfect solution - can you get them to clone you and put you in every resident doctor-training program everywhere?

1:08 PM  

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