By James S. Hirsch; 307 pages. From the cover: "Cheating Destiny offers revealing views of the diabetic subculture, the urge toward secrecy that many diabetics feel, the glycemic rollercoaster they constantly ride, and the remarkable perseverance -- even heroism -- required for survival."
There are books by parents of children with special needs, by adults dealing with disabilities, and by professionals explaining what the first two are doing wrong. Cheating Destiny blends the perspectives of parent and patient to challenge those "authorities" to stop blaming victims and find a real cure.
- Offers both a patient's and a parent's perspective on diabetes
- Mix of memoir and investigation makes for an absorbing read
- Gives overview of current diabetes history, research and politics
- Challenges notion that diabetics can be wholly responsible for their own care
- Questions system that places treatment of complications over maintaining good health
- Criticism of doctors, researchers, and advocacy organizations may rile some readers
- Writes favorably of research that others have found controversial
- Makes diabetes look scarier and less manageable than you may have been led to believe
- Chapter 1: Diabetic Utopia
Chapter 2: Insulin's Poster Girl - Chapter 3: The Burden of Control
Chapter 4: The Diabetes Queen - Chapter 5: Rewarding Failure, Punishing Excellence
- Chapter 6: You Have to Be Brave, Or Else It Hurts
- Chapter 7: New Lows
Chapter 8: Dr. Bernstein's Solution - Chapter 9: High-tech Tradeoffs
- Chapter 10: Pushing Back the Horizon
- Chapter 11: The Magical Beta Cell
- Chapter 12: The Trials of a Maverick Scientist
- Chapter 13: The Price of Survival
Chapter 14: Survivor Tales
Epilogue
While reading this forthright account of the difficulty of living with diabetes, I was reminded of a passage in another book about the disease written by a doctor on fire about diabetics' perceived refusal to take their health seriously. As I recall, the doctor was pressuring a young woman to start exercising. The woman protested that it was unsafe to walk in her neighborhood, and she couldn't afford a gym. The doctor insisted, the woman started walking ... and was shot to death. Rather than cause the doctor a moment's reflection about how proper diabetes management can be legitimately difficult for people living in the real world, she continued to insist that the exercise had been necessary, and the rest was just too bad.
Which is not wrong, exactly -- just indicative of an attitude that James Hirsch decries in Cheating Destiny, the belief that diabetes is a manageable disease and any complications that occur reflect on the moral fortitude and strength of character of the patient. Writing as a journalist, a person with diabetes, and the parent of a diabetic child, Hirsch lashes out at insurance companies that pay more for treating complications than for maintaining good health; organizations that are too invested in the maintenance business to really pursue a cure; researchers whose competitive instincts get in the way of meaningful progress; and the notion that the availability of insulin means diabetes is not that big of a deal anymore.
It's strong stuff, and a lot of conventional wisdom gets overturned in its wake. Your comfort level with the book may be related to how invested in that wisdom you happen to be. I was fascinated by the mix of research and memoir and opinion, and found the frustration with making medical care the patient's responsibility relevant to all to many special needs in these HMO-heavy times.
