CHEATING DESTINY

A character-driven account, written with barely controlled anger, of what diabetes is, what it is like to be diabetic and how and why the medical community is failing to deal effectively with this widespread and as-yet-incurable condition.

Hirsch (Riot and Remembrance, 2002, etc.), a former reporter for the New York Times and the Wall Street Journal, is diabetic and has a young diabetic son. Diabetes is, he says, the most common and costly chronic illness in America and “our most daunting public health threat”—our health-care system, he notes, is designed to treat acute, not chronic, illnesses, especially not those with such physical and emotional complexity. Hirsch distinguishes between insulin-dependent type 1, formerly known as juvenile diabetes, and the more common insulin-resistant type 2, once called adult-onset diabetes. He tells many individual stories: the outreach efforts of a black community-health worker in South Carolina; the economic problems of a doctor trying to provide good care to his diabetic patients; the pros and cons of one physician’s extreme diet regimen. There’s even a chapter of heroic survivor tales. Interwoven in this narrative is Hirsch’s personal experience of diabetes, and most movingly, the story of his young son, Garrett, who was diagnosed at age three, and for whom he battles to obtain the best possible care. Any parent will empathize with the ups and downs of this struggle. Hirsch is not optimistic that a cure will be found any time soon, but he expresses hope that research will find better means of prevention and better therapies. He contends that the burden of diabetic care needs to be shifted from costly physicians who lack both the time and the education to do the job, to nurse specialists, nutritionists, educators, even pharmacists. Given the tools and the training, he insists, most patients can take control of their health and cheat destiny.

A provocative amalgam of staunch advocacy, personal experience and investigative reporting.