Treatment of Type 1 Diabetes

“Endocrinologist is My Co-Pilot.”

“Maybe we should switch places,” my patient laughed when I confirmed that his self-diagnosis was likely correct.

After a beat, I said, “That’s actually a pretty good idea.”

I had been having a long day at my endocrinology practice, and he did have a rather cool job as a mechanic at a nearby auto dealership. It would be nice if we could switch jobs for a day to get a new perspective, sort of like that Freaky Friday movie from back in the day. After a few brief seconds of deliberation, though, I decided that it probably wasn’t worth the amount of paperwork which we would have to send in to the medical licensing board to become an endocrinologist. And my white coat likely wouldn’t fit him.

There are times that I fantasize that I am practicing back in the day when patients would have to come to my office to pick up a pamphlet called “Getting to Know Your Diabetes.” Those days ended years ago, and WebMD and Wikipedia picked up where the pamphlets left off. Now almost all medical information is at everyone’s fingertips, including erroneous information and information that’s difficult for those without a medical degree to understand.

There are pluses and minuses to practicing medicine in this era. In all, I am grateful when patients are knowledgeable about their conditions. While I expect my mechanic to help me make the right decisions and fix parts as they break down, I am ultimately the one who has to drive the car. Likewise, I am here to help my patients navigate their paths, but it is ultimately they who have to take care of their diabetes, day in and day out. And the more they know and the better prepared they are, the better I believe that I can help them with their journeys.

Of course, I am happy to take the wheel when necessary or offer up my own directions when they start to veer off course. (Incidentally, it can be difficult when I’ve got a back seat driver for a patient, one who criticizes my decisions while not taking ownership of the journey him/herself.) What I like most is when my patients and I can take the trip together. There is no one clear roadmap to managing Type 1 diabetes, and both patient and doctor need to keep their eyes on the winding road ahead.

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Dr. Aaron Chidakel earned his medical degree from Jefferson Medical College in Philadelphia, Pennsylvania. He completed his Internship and Residency in Internal Medicine at Beth Israel Medical Center in New York, New York and did his Fellowship in Clinical Endocrinology and Metabolism at the National Institutes of Health in Bethesda, Maryland. He is currently working as a clinical endocrinologist in the Washington D.C. metropolitan area.

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