Words are such intriguing little creatures.
One word can hold all kinds of meaning and connotation for one person that it doesn't for someone else, and I've always been fascinated by the interpretative nature of language. That's a big reason why I enjoy the legal system so much, and during my years as a legal reporter loved reading court rulings to see how words and sentences were regarded in the eyes of the law.
For example, who knew the courts could base entire decisions on the word "shall," delving into dictionaries and historical documents to find out what constitutional scholars from 200 years ago might have meant by that term back when they chose it, and how the meaning may have evolved into something differently now?
It's all quite fascinating to me.
We have some of the same kind of wordplay issues right here in our own Diabetes Community, particularly when it comes to the use of the word "diabetic" to describe someone who lives with this disease. This has been a controversy for quite some time, and many have adopted what they view as a more politically correct term, "person with diabetes."
And earlier this month, U.S. News & World Report picked up on the issue, in a Dec. 10 story with the headline, "Why 'Diabetic' is a Dirty Word."
In the first graph, the writer sets the tone of the story:
What do you call someone who has diabetes — a diabetic or a person with diabetes? The distinction may not sound like a big deal to you, but to those with the condition, it's the difference between living with the disease and letting the disease control their life.
And then it goes into quoting some D-peeps about how they feel the term 'diabetic' is hurtful -- a negative label that overshadows whatever else they may be in life.
As we in the Diabetes Community know, whether the 'D-word' is really offensive has been hotly debated over the years. with some folks coming out strongly with the argument that you wouldn't call a person with cancer a 'canceratic,' and so on. There was even an interesting discussion last year among diabetes educators online over at the AADE blog.
All the arguments against the term seem to be derivatives of these main points:
- I am more than my diabetes; this disease doesn't define me
- Other health conditions aren't called cancer-atics, ALSics... so why should only D-folk have such a label?
- The label implies guilt -- that the person somehow brought the disease on themselves
Just like everything, opinions vary.
Our own AmyT, editor of the 'Mine, wrote back in 2007:
"A writer, a mother, a brunette, a diabetic — all these terms describe me. And I don't take offense to any of them, because to me, none of them are derogatory. I realize that the diabetes community is pretty much split down the middle on whether to insist on being called a 'person with diabetes' rather than 'a diabetic.' But there are so many terms and labels bouncing around the diabetes arena, my personal take is that we ought to seek some clarity and stop getting insulted (i.e. agree on definitions and get over the emotional baggage)."
I happen to agree. I personally don't care what someone calls me when it comes to diabetes (except if we're talking about that medical lingo "non-compliant," which opens up a whole different world of opinion for me...) But the term "diabetic" doesn't bother me one bit. I actually prefer it, because it's easier to say than "person with diabetes." It's how I have been talking about my diabetes for the most part since being diagnosed as a young kid back in 1984.
No, in my mind that word doesn't trump everything else about me -- I'm also a husband, friend, journalist, history-lover, genealogist, cynic, realist, beer and coffee appreciator, TV fan, and so on. Yep, I'd even add academic, critic, insulin addict, and glucose strip-aholic to the list of labels that apply to me.
Like our friend and fellow blogger Kerri Sparling who personifies bullet point No. 1 above with her signature line, "Diabetes doesn't define me, but it helps explain me," I feel that I get to choose when and how I'm going to wear any of those designations on my sleeve, or not (although in reality, diabetes does interfere with life in unwanted ways!).
So is this "label game" a topic worthy of national attention, calling for advocacy? That's debatable too.
I was curious how the U.S. News story came to be (a niche topic for such a general media audience) so reached out to health reporter Amir Khan to ask how it came across his radar. He doesn't have any personal D-connection, but says the issue came up in November when reporting on an earlier story about online support for diabetes. So he ran with it for this recent piece -- one that I think really captures the debate well, and is fair and balanced on both sides.
It's certainly gotten folks talking again in our community -- including the new CEO of JDRF Derek Rapp, tweeting about the story:
Insightful article by @AKhanMedia. As a Dad w a son w #T1D, it's a key distinction. #Diabetes doesn't define anyone. http://t.co/tpqFs8hp84
— Derek Rapp (@JDRFceo) December 11, 2014
There are lots of important issues that I think call for advocacy efforts in this day and age: healthcare being fair, Medicare covering CGMs, better designs for diabetes devices, whether A1C is the end-point of how we're viewed by medical professionals, how our diabetes research money and efforts are being handled, and getting access to our data in ways that fit our lives best. But this PWD vs. Diabetic thing just doesn't rise to that same level, IMHO.
Still, there's the important issue of protecting us against discrimination at work, or being judged by society at large as being at fault for our disease...
So perhaps it makes a difference if the term in question comes from one of us, or from "outsiders" who aren't also pancreatically-challenged? And then does it matter whether someone has Type 1 or Type 2, or another lesser-discussed form of diabetes?
Some folks are very prickly about these issues. And they aren't wrong, because that's just how they feel. It ruffles their feathers to feel defined, labeled, restricted, and so on. I get that.
We at the 'Mine have long been sensitive to this, therefore we standardized on "person with diabetes" or "PWD" a while back. Ironically, we get some blow-back on that, because some people find the term silly, or an exaggeration of the trend towards political correctness.
Whatever the accepted label, those of us with diabetes are all people first, disease second. That's a message we've been championing amongst the medical community for a long time: that we're not just textbook examples, and that each person's D-management should be tailored to what works best for them as an individual.
So yes, 'diabetic' does seem to be a word that we're collectively phasing out, gradually. Whether it's ever stamped out entirely, we probably won't be around to see. Instead, future medical writer and the D-Community of future centuries will look back on this issue and have to ponder it just as judges and lawyers now wonder why certain words were ever used the way they once were.