My D Team: Me, Myself and I

The only player on the D mgt court!

The other day somebody innocently tweeted that diabetes management was a team effort.That got me thinking and although it’s dangerous to push metaphors too far I don’t believe thinking of diabetes management in terms of a team is appropriate or helpful.

The team analogy implies that everyone has a role to play at all times and most importantly that everyone shares the joys of victory or the bitterness of defeat. This is simply not true. It is me and me alone who feels the hypos, the highs, the fear and reality of complications.  Every finger prick, every needle, every blood test, dilated pupil exam or pump site change is felt by me alone. It is me who savours the ‘victory’ of a straight line on the Libre after eating pasta or the relief of a ‘clear’ complication screening.  The closest I come to sharing this is the empathy  in the diabetes community when rejoicing or commiserating with those of us who know exactly what it’s like.

That’s not to say that there’s not a vital role for support and that a multidisciplinary care team isn’t essential-it is! It’s just that their role needs to be acknowledged, they’re not on the field, they have no skin in the game, they’re supporters.  I believe the better analogy is that of a singles tennis player.  Think about somebody like Serena Williams, she has a huge team of family and professional supporters behind her. Coaches, managers, doctors, physios, masseurs and psychologists as well as her significant others who support her as she travels the pro tennis circuit. The thing is though, when Serena’s out there on centre court, it is her and her alone who makes the decisions and is responsible for the match result. It is Serena ‘s own self discipline and determination that drives her to spend hours on the practice court and at the gym. Nobody else can take over for a while, nobody is behind her to hit the shots she misses or to put their hand over hers as she hits a groundstroke.

Nope, diabetes management is not a team effort, it is an individual effort supported by a team of occasional consultants/advisers.

While I’m at it, I’ll stretch the metaphor to add that most of us engaged in managing diabetes don’t have the kind of team that Serena Williams can muster either. No, it’s more like the team I had playing Northern Suburbs, 2nd Division Juniors. We had the odd coaching session, somebody organised a draw and when we were injured Mum gave us a bandaid and an icepack, unless of course there was a sprain or broken bone or something in which case the GP was consulted.  That’s a bit like the team effort most of us have with diabetes. It’s hard and it’s up to us, keep going for the aces and the smashes, sometimes they’re winners and sometimes we swing and miss, that’s okay as long as we’re still on the court. (OK I’m finished torturing the metaphor now).

Whilst discussing this on Twitter, Jane Speight of the ACBDR* made this excellent point

You can bet that professional athletes put a lot of effort and research into building the team that’s going to make them the best they can be. It might be helpful to think about our healthcare teams in this way, if somebody isn’t helpful perhaps it’s time to fire them and find somebody who can help you manage diabetes in the way you want to. It’s your life and you want to enjoy that ‘court time’ as much as possible, find the right team of supporters/consultants to help you do it.

*Jane Speight is a Chartered Psychologist; Foundation Director, The Australian Centre for Behavioural Research in Diabetes. T:@janespeight

2 thoughts on “My D Team: Me, Myself and I

  1. Melinda, I’m so glad you posted a link to this excellent June article recently on Twitter. It’s especially perfect in light of your recent online “discussion” (I use that word charitably to describe a brief Tweetchat between you and a diabetes researcher who clearly took offense by your use of the term “skin in the game”. Personally, I found his odd reaction to your use of this very reasonable term to be puzzling. OF COURSE you have “skin in the game” and he does not! Instead, he retaliated by accusing you of not understanding what it’s like to be an academic trying to make the world a better place.

    He also accused you of “personally attacking” a scientist presenting at a medical conference, and called your comments “not helpful” and “inappropriate” because you had the temerity to question a practice (not a person!) that in your informed opinion did not represent good patient care.

    Yours is an educated viewpoint, as you continue to accurately prove. As one of my Heart Sisters blog readers once reminded a physician who had told her he did not “approve” of his heart patients turning to Dr. Google for information. Her immediate retort: “I really am not here to gain your ‘approval’. This is your career, but it’s MY LIFE.”

    I’d offer that same pithy response to any academic/physician/researcher who doubts for even one nanosecond that a patient’s lived experience with a chronic illness isn’t what “skin in the game” means.

    Keep up the great work you do on behalf of patients…

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