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August 30, 2016
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Earlier this week, it was announced that the focus of national anger for most of this century had met his Maker, courtesy of the United States military. The TV news showed people reacting by dancing in the streets.


Being one of the many people who were employed in lower Manhattan in September 2001, I should like to believe my thoughts on the matter carry just a tiny bit more weight than those of the average American.While my coworkers and I were displaced from our office for less time than many, we still spent two weeks with no outside communication beyond one Verizon Wireless cellphone, two weeks after that with no Internet access (except for dial-up through that cellphone), and three months of picking our way around scaffolding and safety barriers, inhaling the distinct odors of burning asbestos, concrete, steel, and human remains. Compared to that, the death of an individual half a world away, who never even got his fingers dirty on that day, is little more than a footnote to me.

Reporters tried to cover up the resulting vacuum of hate by warning us of potential retaliation by the decedent's followers. Still, human nature abhors a vacuum, even an emotional one, and the media are hard at work finding ways to replace that loss. This brings me to the one diabetes question for which I never had an answer before: What happens to us after The Cure?

To me, that is one of the most thought-provoking questions among the diabetes community. Sometimes we wonder if, for us as individuals, that cure would be worth the discomfort and displacement -- the cost, physical pain, and recovery time from a transplant, for example, and subsequent dependence upon antirejection drugs that strip the immune system. Some of us question what our health would be like if our pancreatic functions were magic-wand-restored to "normal", but we retained the effects of all of those complications of diabetes that we had already been dealing with. Lurking in the background, there's always the question of how readily that cure would be available to people in "emerging nations" and "lower socioeconomic classes" who had been struggling just to manage some semblance of diabetes care. Finally, some wonder what we will do with the time no longer needed for blood glucose checks and logs, the money no longer needed for diabetes supplies, and (barring other medical conditions) complete freedom of diet.

Once that cure was discovered, tested, and delivered to everyone who needed it, what then would we do with all the time and effort we'd been allocating to diabetes care, advocacy and support? Will we shift our focus to reversing the complications of diabetes? Will we advocate for the cure and reversal of other medical conditions? Will we create the oral histories of diabetes care just in case something similar should pop up again after generations of global diabetes-less-ness?

One thing is certain: just as surely each of us has been changed by the events of September 11, 2001, we have been changed by diabetes in ways that no medical test can distinguish. Diabetes makes us obsessive-compulsive about food, testing, and it makes us prone to the sort of burnout that leads us on "I don't care" binges that lead us into DKA in the short term, and life-threatening complications in the longer term. Freed from the restrictions of diabetes care, how many of us will throw dietary caution to the wind and indulge in megacalories' worth of cheesecakes, fruit juices, breads, cakes, and pastries -- rebounding into the grips of Binge Eating Disorder (and possibly morbid obesity)? How many of us will feel lost without the driving pressure of diabetes care, and fall into a depression other than that concommitant with chronic disease?

Aside from what our government may foist upon us as "safety measures" in the post-Osama fear vacuum, it will be interesting to see easily how Americans settle back into our patterns of "normality", and how quickly he -- though not the events of September 11, 2001 -- will be forgotten. Our CDEs and mental health providers may need to recall those lessons to help us adapt to life after diabetes.

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