Making an impact?
I’m at a bulk car dealership on a busy Saturday morning, and it’s needless to say that I don’t really want to be there. It’s swarmed with annoyed people and screaming children, and I just want to get in and out quickly. A smiling face with a blue polo shirt pops up, cheerfully offering his services. Before I know it, they’ve whisked my vehicle off for inspection and I’m left with Mr. Smiley to shoot the breeze for 45 minutes while my car is reviewed.
“So, what do you do for a living?” he asks.
“I’m a sales representative for a pharmaceutical company, they make diabetes drugs and I have diabetes, so it’s very close to my heart,” I explain.
“Oh wow, Type 1?” he queries.
“Yes, I’ve had it for 17 years. That’s amazing that you know what types there are. Most people don’t know that part,” I tell him, impressed at his knowledge.
He looks down, hands folded in his lap. “Oh, well my wife. She has Type 2. But she’s really bad about it, she never takes her medication. It’s so bad.”
I size him up before responding. He couldn’t be more than 30 years old, and assuming his wife was around his age, she was still reasonably young to be dealing with Type 2 diabetes already.
“Why doesn’t she take her medication? Is she on insulin and scared of the injection or something?” I ask.
“Oh no, it’s not that bad yet, she’s just on pills but she never takes them.”
“Metformin?” I ask, already knowing.
“Yeah, metformin. My mom has the shots already though. I don’t want my wife to have to do that” he says.
“Well she might not have to, but it’s really important that she takes her medication now to stay healthy, and stays on top of her diet and exercise while that’s an option - you know?”
“Yeah I know, but she doesn’t listen to me.”
“Well I’ve had it for as long as I can remember, and I have the kind of diabetes where I have to take shots and check my sugar all the time to live, which is a lot more than taking one pill, and your wife needs to know that having diabetes never has to hold her back, but she has to manage it so it doesn’t manage her. I know it’s easier said that done, but it’s so important to stay on top of the disease at the beginning, you know?”
I want to keep going. I want to tell him that his wife needs to take this early diagnosis as a wake up call. That she needs to take her meds, get to the gym, and watch her diet. But would she change, even if she heard it from a person with the “bad” kind of diabetes? Would what I say here and now, on a Saturday at this car dealership matter to her in 5 minutes? Would she understand that taking that pill every day might prevent her from having tough complications down the road? Or maybe something else is going on? Maybe they live in an unsafe neighborhood and a walk around the block is out of the question. Maybe her diet is dictated by a specific religious belief - who knows? So many patients have so many different barriers to good control and good health - whether it be them self or things out of their control.
But that’s just the thing that can make so many of those conversations seem so futile. There are so many barriers to good diabetes control, how do we ever reach the masses? How do we convince a society that thrives off of instant gratification that steady, healthy, habits over a lifetime will let you live a long and healthy life. Although I do try to make a difference one conversation at time, it’s so tough to know that person is one of 300 million people worldwide living with diabetes every day. It’s an awful lot of conversations to have.
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And as Oprah demonstrated, there are very wrong ways to have these conversations.