Dr. Dana Hardin is a pediatric endocrinologist and medical director at Eli Lilly and Company in Indianapolis, IN, where she’s been practicing for more than 20 years. She’s also been a pioneer in research on the capabilities of medical alert dogs. In case you ever wonder what gets someone started on a path like this, in Dana’s case it was one very extraordinary grandmother, who had type 1 diabetes back in the ‘dark ages’ of treatment, but nevertheless prevailed…
My grandmother was one of the first patients to take insulin when it was developed by Lilly. Her name was Pearl and she was born in 1907 and raised in Indianapolis. She was diagnosed with type 1 diabetes at age 12. I learned about my grandmother’s experiences by talking with her, listening to stories of family members and reading the family history written by my great grandmother. My grandmother and her experiences have greatly influenced my life.
My earliest memories of my grandmother were of our monthly visits to my grandparents’ cabin in the mountains of northern Arizona. The cabin had three large rooms and a loft. Water came into the cabin from a kitchen pump connected to the spring. Since there was no refrigerator, cold things were kept in bowls in the spring house. I loved these overnight visits. There was no TV; our activities were outside adventure, storytelling, reading books and playing games.
I had been told Grandma had diabetes, but this did not mean anything to me until one specific visit. When I was 5, we were on a typical hike. Grandma had been telling my brother and me about an Indian grave when suddenly she collapsed on the ground and began to jerk her arms and legs. Grandpa ran to her and squirted something in her mouth. After a few minutes, she quit jerking around and woke up. She sat up with Grandpa’s help and ate a candy bar before declaring she was ready to walk back to the cabin.
Later that night, I asked her to tell me what had happened to her on the hike. She said she had a “seizure” because “the sugar in my body got too low” and that “this just happens sometimes, especially when I exercise.” I asked her why she took a chance by hiking and she said, “I love nature and I need to exercise to stay healthy. Low blood sugar is just part of diabetes, but I can’t let it get the better of me.” I asked her if she was ever afraid. She said one of her first doctors had told her she should not move to a remote cabin as it could be dangerous. She said she found another doctor who agreed to work with her to let her live the way she wanted to.
After we talked I wrote down exactly what she said to me in my diary, and her words have influenced me throughout my life.
She said, “Dana, there will always be something to stand in your way if you let it. Diabetes is just one of those things, and you are at risk to get it. Even if you get it, I want you to learn from me not to be afraid to live life the way you want. No matter what happens, you can be and do whatever you want if you are willing to try new things and not be afraid.” I declared that very day I would become a doctor.
As I grew older, I was allowed to stay with my grandparents for one month every summer, as well one weekend per month. Grandma was the major mother figure in my life. I have wonderful memories of her teaching me to cook and letting me style her beautiful silver-white hair. I was especially proud that she let me give her insulin injections. She took them every six hours. I followed a ritual of removing the glass container containing her syringe and attached needle (submerged in alcohol) from the spring. I drew the insulin out of a bottle and used the same needle to give her the shot. I remember by the end of the month, it was quite difficult to pierce her skin with the needle. She said she needed to use the needle for one month before she changed needles due to their expense. She monitored the amount of sugar in her body by collecting urine and dropping in tablets which turned color depending on how high or low was her sugar that morning. She said she wished she had some way to know what the sugar level of her blood was at any given time because she knew it must change over the course of her day.
One special tool Grandma had was her dog, Rocky. Despite no special training, Rocky seemed to know when Grandma’s glucose levels were low. He would bring her a candy bar from a dish sitting on the coffee table, and if she could not eat it, he would run to get my grandpa or one of us kids. After she got Rocky, Grandma said she no longer had seizures as he always seemed to warn her before her sugar dropped low. When she told her doctor about Rocky’s help, the doctor said “maybe that dog is on to something.”
Grandma never failed to encourage my interest in medicine. She bought me books about medicine and helped me gain self-confidence, despite my rough home life (I grew up without a mom and we were quite poor). One special influence was her taking me with her when she saw her endocrinologist. Dr. Wasco was one of only a few females to graduate from her medical school class. I remember Dr. Wasco asking Grandma about her activity and her meals, but most importantly about her life. She seemed to really care whether or not Grandma was happy. Dr. Wasco never failed to ask me about my school work and my grades and always encouraged me to become a doctor.
One visit especially stands out because Dr. Wasco told Grandma about a new insulin which lasted longer and would allow her to take fewer shots each day. Grandma listened intently, and as was her habit, asked a lot of questions and wrote down the answers in the little red book where she kept her medical information. On the long drive back to Prescott, Grandma told Grandpa about the insulin then said “I am not going to take it!” She then turned to me in the back seat and said, “You mark my words Dana Sue, someday they will find out that taking more shots is better than taking fewer shots.” For the remainder of her life, she continued to take regular insulin every six hours. However, she was thrilled to use a glucometer instead of urine tests later in her life.
As my interest in medicine developed, I interviewed Grandma and any family member who knew her about what they observed or had been told about her life with diabetes.
Diagnosed Before Insulin
My great grandmother (“Mamo”) described her daughter’s childhood and diagnosis, and said when Pearl was young, “she was smart as a whip, but could never sit still.” She said Pearl was a “tomboy” who “played too rough for the girls, and was always coming in with scraped knees and other injuries.” Mamo said that in 1920, when Pearl turned 12, “all that changed” as she became “noticeably thin and lost all her energy.” Despite loving school, she did not want to get up some mornings and she never wanted to go out and play. One morning, Pearl simply “could not be awakened and there was a smell of rotten fruit in the room.” The doctor was called. As he drove Pearl and Mamo to the hospital, he told Mamo that he felt certain her daughter had “sugar diabetes and will surely die as there is no treatment.”
Mamo was determined her daughter would not die, and stayed with her morning through night until she was well enough to go home. During the hospitalization, Mamo learned that the most promising treatment was a raw liver and calorie-restricted diet. She put her daughter on this treatment and rarely let her go out of the house so she could monitor her well-being. She even had Pearl’s older sister bring home daily school work so that she could continue in school, but Pearl refused. About Mamo, Grandma said “she was very strict and I hated her for it and I hated my life.” She said on two occasions when her mother had to leave overnight, she “made and ate a whole pan of fudge. I was sick for days, but oh did it taste good.”
In 1923, when Pearl was 15, Mamo read about a new drug being studied for the treatment of diabetes. That drug was insulin and the company was Eli Lilly and Company “right in the same city where we lived!” By that time, Pearl had lost her will to live and refused to leave her house due to lack of energy. According to Mamo’s journal, Pearl weighed 82 pounds and “looked like a little girl instead of a young woman.”
Mamo took her to the doctor who was using insulin to treat patients. Pearl agreed to try the new medicine even though it was given as shots. However, she told me “I decided if the shots did not work I would find a way to end to end my life.” Thankfully, the insulin worked! Grandma said she felt better within two days, and by two months, had gained 15 pounds. She had missed so much school, she decided not to go back, and instead became a clerk at a department store. She developed a passion for dancing, and became so good that she won a state contest for dancing the Charleston.
My grandmother met my grandfather, an American Indian, at a dance. He was a handsome man, but uneducated, and was not what Mamo had in mind as a suitable husband for her youngest daughter.The story is that Mamo offered him money to move away. Instead, he and Pearl eloped. The riff widened when Pearl became pregnant. Mamo was certain her daughter would die during delivery and accused my grandfather of “murdering my child.” My grandmother did not die, but the delivery was hard. “A surgery was done to deliver the 9-plus pound baby girl, and Pearl was left with internal injuries which would not allow her to every have another child.”
After my mother was born, my grandparents decided to move to Arizona and live a more native life. Grandma packed her medicines and off they went. They ran a rock shop and sold Indian jewelry in a shop on Prescott’s town square. The rest, as they say, is history. Despite her rather unusual life, Grandma lived to be 68 and only during her last month of life did she have diabetes complications.
Her “can do” attitude clearly led to a rich life of activity and influence.