Not long ago, I attended the American Diabetes Association's Diabetes Expo here in New York City. Personally, I didn't expect to get much out of the event because I knew that the Diabetes Expo (and ADA as a whole) is skewed toward the predominant type 2 diabetes population. But still, I wanted to bring along a friend who's been struggling with her diabetes, and I wanted to say hello to a few other friends who were also attending.
So we went, and the experience of watching some food presentations on healthy eating by people who don't look like they're necessarily following their own advice got me thinking about an issue that's been on my mind through the years: judging the diabetes "experts."
It began with Charles Maddox, actor-cum-chef, nephew of Bob Marley and type 2 PWD (person with diabetes) who's dubbed himself "The Poor Chef." He presented about healthy cooking on a budget, which was particularly relevant to my friend and I since we're both young and broke. While he demonstrated a cilantro salad with olives, sunflower seeds, garbanzo beans and feta (it was delicious!), he asked a woman next to him to explain a bit about what garbanzo beans are. I had assumed she was his simply his assistant, but Charles introduced her as being a Registered Dietician.
This is where the rubber meets the road -- the part that's difficult to admit and even a little embarrassing. But this is important to talk about, since it's actually an issue that I've seen come up repeatedly over the years.
Once this registered dietician came out from behind the stage, I could see that she was overweight -- an overweight dietician talking to a group of type 2 diabetics about healthy eating. Even though I battled thinking it, I would have guessed she was a type 2 PWD.
I know, I know! So judgmental of me, right? All those stereotypes that we wage war against were clouding my own head! But I couldn't help it. The RD, who was espousing healthy eating information, didn't appear to be following her own advice. That got me thinking about how many other people I know who judge their healthcare professionals by how they look...
This conversation came up many years ago with a friend who mentioned he couldn't stand appointments with his dietician because she was so overweight. Who was she to tell him what to do and how to eat? And that dietician isn't alone in the world of healthcare providers. I've attended two annual American Association of Diabetes Educators (AADE) meetings, and let me tell you the truth: they are not all athletic Mediterranean Diet-eating educators. Many appeared to be a "healthy" size, but many were also overweight and some were downright obese. So I know that this isn't an isolated incident.
If it's so tough for these educators and docs to practice what they preach, then what right do they have lecturing us on what we're supposed to be doing? Or presenting it under the guise of "Well if you just did this, this and this, everything would be fine"? As if it were all so easy!
Makes you wonder.
For me, the most guilt-inducing part of this whole situation was that just days earlier, I had read a wonderful post by fellow type 1 Abby Bayer, who's a registered nurse and fellow D-blogger. She talked about why PWDs aren't as qualified in health matters as CDEs. She noted in her post that sometimes, she doesn't even mention to her patients that she has diabetes. In the comments, she elaborated that this is because she doesn't want to risk having her patients judge her, or have outrageously high expectations that she'll be the "perfect diabetic" -- because we all know that's impossible.
Here's the Catch-22: do we have unrealistic expectations that our healthcare professionals will be perfect, while simultaneously expecting them to let us off the hook because being a "perfect diabetic" is so damn difficult?
What I saw myself doing at that ADA Expo was judging this RD based on the highest of standards because she is standing before us as an expert. She's supposedly the role model for all these patients. So, shouldn't she be setting an example? This is something I am trying to do, actually. I often think about how I want to be healthier so that I can be a better role model for my future patients once I finally become a diabetes educator. If I can show them that I lost all this weight (I'm about 50 lbs. overweight, FYI) and got my A1C into the 6s all while going to nursing school, then I'll be more deserving of respect. Right? Maybe they will look up to me and I'll be a better teacher because I can show them just how it's done.
But really, I'm doing a disservice in thinking this way. I am essentially discrediting the more practical mantra of striving to simply "do better" in small steps, and instead seem to be putting this imagined perfection on a pedestal, where neither I will nor my future patients will ever reach it.
So I have to change my thinking and face the music. Hey, I am not a "perfect diabetic," nor will I ever be. And there's nothing wrong with that! I'm doing the best I can — I test my blood sugar regularly, eat mostly healthy foods and get regular exercise. Bad habits take a long time to break, and just because someone outwardly appears to be overweight doesn't mean they aren't trying to be better. And we can't see how many times a day they are testing or exercising, so it's not fair to judge them without knowing those details.
At the ADA Postgraduate Course that I also attended in late February, the AADE's past president Sandra Burke acknowledged this point about diabetes educators, saying: "We are the most knowledgeable people about diabetes, and we don't necessarily do what we need to do. It's hard to do what you need to do."
While I find it debatable as to whether or not CDEs are the most knowledgeable about diabetes, I do agree that it's very hard to do what you need to do. So maybe while we're cutting ourselves some slack over not being perfect, we need to cut the educators and dieticians some slack too? Maybe so.
All of this was a great wake-up call for me. This observation and self-reflection made me realize that, despite my best efforts, I still have a double-standard for people who are in the medical field versus those of us who are "regular patients." We are all educated in how to be healthy, but sometimes the knowledge is more difficult to put into practice than we think. Sometimes despite our best efforts, obstacles get in our way.
At the end of the day, what I've gained from this experience is that I need to be more understanding of others' situations, just as I struggle to be understanding of my own. No one is perfect. Not even the "experts."