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 20, 2009

Smarty pants

I guess everyone knows I’m a high school dropout. Well, if everyone didn’t know before, they sure as hell know now.

This has rarely if even been a problem for me. Not that I would recommend it as a course of action (and yes, I did go back and get college degree or two later on).

But I’ve decided lately that too much education is a bad thing. Our new Doc likes to drop articles about diabetes on my desk. Being a knowledge-sucking-sponge I do read everything about diabetes I can get my hands on. Usually, I can understand and absorb pretty much anything I read. But I’ve noticed lately that articles written for Docs by Docs have a unique flavor.

Picture me on at my desk. I’ve had a “no-show” so I have an hour to kill. I’ve unlatched the seat lock so I can lean waaaaaaaaaaaaaaaaay back in my chair, resting my feet on the top of my desk. I have a fine view of the parking lot out my three windows. I’ve got a pen behind my ear and a highlighter clenched in my teeth. I can’t read without making notes… probably why no one will loan me a book. I’ve got my better-than-sex wireless wave key board in my lap, and the latest article on top of the key board.

The only unusual element of this scenario is the key board. This article is giving me trouble and I find myself Googling new words every few paragraphs. My new favorite word not to use in polite company is “armamentarium.”

No shit, I found this word in an article on the emerging intercrin therapy world. Loosely translated it means “the knowledge, tools, and medicine used by medical professionals” to treat illness. Presumably a descendant of the word “arsenal.” Ohhhhhhhhhhhhhhh, silly dropout me. I would have just said “tool kit.”

Well, this is what comes from being too well educated. Don’t get me wrong, you won’t find a bigger fan of the written word than me. Language can be divinely, elegantly precise. In medicine we really do need to be precise in our communication. We do not, however, need to use words like armamentarium when there are perfectly good options that use fewer syllables.

At my new part-time job as the Molder of Future Doctors’ Brains I have noticed that the medical school experience completely destroys student’s ability to communicate with human beings. Take future-Doc Eva. Her heart is totally in the right place. I’m guessing that earlier in her life she must have been pretty interesting: she has a heart tattoo on her left breast. I caught a glimpse of it when she was learning down to pick up a pen she dropped on the floor. Not that I was looking, or anything.

Eva and I were meeting with a delightful upper-middle aged Hispanic lady who was very hard of hearing. That, by itself makes communication….challenging…on top of the fact she’d probably be happier in Spanish; which neither Eva or I speak. But Eva had also forgotten how to speak the common man’s English.

The poor woman had no clue what Eva was trying to say to her. But culture got in the way and Eva had the white coat on. The patient nodded and smiled and never let on.

As we left I told Eva, Call a low down dirty dog a low down dirty dog.


It’s not hypoglycemia. It is a low. There’s also no such thing as a hyperglycemia, it’s just called high blood sugar.

“OK, I’m not sure where you are going with this, but I’ve already learned to hear you out--so explain.”

When you get out in the real world and are practicing medicine on your own you’ll be lucky to have ten minutes with your patient. You can’t afford to fail when it comes to what you want the patient to know. Keep it as simple as possible.

Eva frowned… “Well, diabetics are pretty smart when it comes to their conditions. I don’t want to look dumb. I worry if I keep things to simple they’ll think I don’t know anything and won’t take me seriously.”

Small risk. But you’ve got the white coat. Better you look like a simpleton than have even one patient walk out of a treatment room confused.

“Your vocabulary is pretty high end,” she accused.

Yeah, well I’m at peace with being a hypocrite. I’m a better tour guide than a role model. Besides, I make up for it by swearing a lot. You can’t do that as a doctor.

Boy am I ever glad I dropped out of Grad School recently. Yes, there was much to learn, but possibly, much to lose as well.


Blogger Scott K. Johnson said...

Yeah, there's nothing worse than leaving the docs office more confused than when you arrived. That happens often enough just because of diabetes, never mind having to pretend we understand big technical words. :-)

8:58 AM  
Blogger Jonah said...

I think doctors tend to go to one extreme or the other on this one- they either use small words and get really condescending (no, the Lantus can't peak, it is let out slowly) and usually wrong, or else they get into medicalese and I have to keep asking for them to explain words or at least spell them so I can look them up later, a step I am sure most patients don't do.

Oh, and I am a high school drop out too, and I'm now in college and quite satisfied that I didn't miss anything that would have been useful (other than a diploma). I doubt you did either.

7:35 PM  

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