Diabetes Blog Week 2017 Day 3: The Blame Game

Prompt: The Blame Game - Wednesday 5/17

Having diabetes often makes a visit to the doctor a dreaded experience, as there is invariably bad news of one kind or another.  And sometimes the way the doctor talks to you can leave you feeling like you’re at fault.  Or maybe you have a fantastic healthcare team, but have experienced blame and judgement from someone else in your life – friend, loved one, complete stranger.  Think about a particularly bad instance, how that person talked to you, the words they used and the conversation you had.  Now, the game part.  Let’s turn this around.  If you could turn that person into a puppet, what would you have them say that would leave you feeling empowered and good about yourself?   Let’s help teach people how to support us, rather than blame us!  (Thank you, Brian, for inspiring this topic.)

Honestly, I find the way this prompt is worded pretty disturbing! Maybe I’ve watched too much of Buffy and its ilk, but the thought of turning a person into a puppet makes me shudder. Forced support isn’t support: you’ve built a wall, sure, but it’s the wrong kind. Making someone say the words I want to hear, in its own way, would be just as bad as hearing blame and judgment. 

I’ve talked about this before, but the most memorable comment I’ve ever heard (in a bad way) was when my endocrinologist, frustrated at young adult me, who was academically stellar and in every other way responsible and successful but completely incapable of staying in appropriate blood glucose range, exclaimed dismissively, “I don’t understand why you can’t just DO THIS.” 

Then, as the insensitive cherry on top of the can-you-eat-that sundae, instead of suggesting that the emotional issues surrounding diabetes are intense and highly charged and asking if I’d like to talk to someone, she used the possibility of counseling as a threat - shape up, or I’ll throw you to the psychologists. It was awesome, because it forever cemented a connection between failing and counseling in my head, which meant younger me was never going to talk to a professional ever, not even if she needed it.

The thing is? My endocrinologist does not have diabetes, so no, she doesn’t understand, not really. But there’s a way to use that phrase well, and a way to use it poorly.

“I don’t understand” and “I don’t know” are some of the most powerful tools we have, when used properly. They invite learning, teaching. They ask for help. I don’t understand, but I want to. So show me, and I will try. Those are the words, the connotations, I would like to hear.

As a professor, I have many types of students, but I can classify and divide them into two main categories: those who don’t know something and recognize it’s their responsibility (and privilege) to learn it, and those who don’t know something and think it’s my (or the other person’s) fault that they don’t know it yet. There are a lot of things I don’t know. There are a lot of experiences I’ve never had, and can never have. It is not the person who has had the experience’s responsibility to educate me, though if he or she wants to, I am eager to listen. Most of the time, if that’s truly the case, the other person will be excited to teach.

“I don’t know why you can’t just DO THIS” is not the former type of student, it’s the latter. It says “I don’t understand you and I don’t care to try, because you’re not fitting into the current rubric of success.” It says, “how can you succeed at exams and fail at blood tests?” It says, “it is your responsibility to do better to make me feel more comfortable.”

In schools, they sometimes have educational workshops against drinking and driving. People put on helmets that distort their vision and reflexes, and attempt to walk in a straight line. Special glasses make driving nearly impossible. We need that for everyone who interacts with a person with diabetes (which is essentially everyone). Sometimes CDEs who aren’t diabetic are required to wear a pump for a week with a saline solution. Something like that. Mostly I’d want to make them truly understand; briefly feel what a very high and very low blood sugar feel like. Experience fluctuations throughout a day. The problem is that there’s this unknowable spark, that emotional value that can’t fully come through when you know you can take the machine off and never have to think of it again. But it might be a good start.

How do you make someone come to the chilling realization that this is it, 24/7, for the rest of your life?

I don’t know.

I now have a good relationship with my same endocrinologist, possibly because my A1cs now hover around 7 instead of 10 or 12, but I’m used to people liking me for being good. (I will be fair and say that I genuinely believe she is interested in me as a human being, and often very kind.) What we all need, though, is someone who likes us, supports us, when we’re not good. Who understands that there is much left to learn, and that you can’t categorize failure and success in a simple metric. 

Sometimes success, after all, is as simple as admitting you don’t know.