Sunday, April 01, 2007

Cheating Destiny (James Hirsch)

"America's biggest epidemic," according to James Hirsch, author of Cheating Destiny, is diabetes.  Hirsch, who is a Washington-Post journalist, has juvenile diabetes himself, as does his famous brother, Irl Hirsch, who works at the University of Washington as diabetes researcher and clinician. And during the course of writing the book, James Hirsch's three-year old son is diagnosed with diabetes as well. Family genetics play an awfully sure role in developing diabetes.

A little over 50 years ago, there wasn't yet insulin. Now there is plenty of insulin but also still plenty of blame. I live with a man who is diabetic, and am familiar with how much responsibility we place on those with diabetes. If they would only be more careful, monitor their diet more, exercise more or in moderation, then they wouldn't have such highs. They wouldn't have such lows.

Hirsch argues that key figures in the history of diabetic care have created our current attitude, to place the "burden" on the diabetic. To shift some of that responsibility to the health care industry would be more accurate and more helpful. Insulin--which is key to control--has seen sky-rocketing costs. Preventative care not profitable enough. Ironic indeed, since diabetic supplies are hugely profitable to pharmaceutical companies, hospitals, health care clinics, and manufacturers. Bigger bucks are made when the diabetic is ill, has heart disease (as many will), loses a limb or goes on kidney dialysis. The list of maladies caused by living with diabetes is long, the bill statement longer.

Hirsch tells this story as his story, making those of us who know little of the disease cognizant of the daily struggle a person with diabetes lives with, that day-by-day recognition that what is done today prevents what might happen tomorrow, or in other words: how to cheat destiny.

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