Exasperating?

I saw a patient of the kind that exasperates physicians. She has diabetes, but is has been in denial of it, doesn't take her insulin, doesn't exercise, eats all the wrong things, and then is surprised when her doctors express frustration.

It looks like she got a wake-up call this time though. As part of the interview, she was asked how she'd been doing recently, and she casually mentioned that she had been brought to the hospital last weekend. "Oh really?" was pretty much the most disinterested reply managable at that point. "Yeah," she replied, "I passed out and in the ER they said my blood sugar was 800."

As a bit of a side note, your blood sugar should be between 70 and 100 (in milligrams per deciliter) all the time, with only minor variations. Diabetics get a bit of leeway, and they usually try to keep it under 120, though lower is better. 800, though, is like having Karo syrup in your veins. I was honestly floored that such a level was even possible. The Zen Master, almost imperturbable, said that this was a new record in his practice.

Back to the story though, this might actually be the wake-up call the patient needs. She's a grandmother, and with some stern exhortations that if she wanted to see her grandchildren get too many years older, and remember their grandmother as someone who could see and had all of her fingers, toes, feet, and/or legs, she would have to get her sugar levels under control. It may sound a bit heartless, and perhaps it will be when I'm an older, more prone to be jaded physician. But for now, I was just excited that she seemed to want to change, and her motivation seemed so good. It was said with genuine conern for her quality of life. I don't want to lose that concern.