B. C. and his wife came in for his diabetes follow-up the other day. His blood pressure and blood sugar have been out of control for over six months now, but he has refused to try new blood pressure medications and he won’t consider insulin. He even hates pricking his fingers, so he had ordered a glucometer that uses blood samples from the forearm.

“I feel good”, he always says.

Even though we have seemed to be at a medical standstill, I have enjoyed our visits together. He has told me many things about the wildlife around here and he has helped me understand our male dog’s reactions to the wolves and coyotes that surround us.

“Here, this is for you”, he said as he handed me an oblong envelope. Inside was a Christmas card with a picture of the two of them – she in a long dress, he in a colorful costume with a bearskin draping his back and the bear’s head on top of his.

“That’s me in full regalia”, he said proudly.

His face in the picture was quite pale.

“How’d your face get that that white?” I asked, wondering if he was starting to feel poorly some of the time.

“Grease paint.”

I thanked them for the Christmas card and got down to business.

“Have you checked any blood sugars after meals?” I asked.

“No, my new machine hasn’t come yet, so I’ve only checked a few times, but my sugars are down”, he smiled.

The three readings he remembered were actually in a good range.

“Are you eating differently?”

He shook his head. “I eat about the same.”

“No, we got rid of all the junk food”, his wife corrected him. I noticed he had lost a few pounds.

“I went to he herb woman”, he said, “and she gave me a mixture of thirty-two herbs that I’m supposed to take with each meal. It tastes like salt, but there’s no salt in it. I’ve also been taking my cinnamon.

“And I’ve been reminding you about your pills”, his wife interjected.

He ignored her comment.

“Between that and the fenugreek my blood sugars have really come down and I feel great; I have so much more energy.”

“Well, I’ve got to hand it to you. I don’t know exactly how the stuff lowered your blood sugar, but it sounds like you should keep taking it.”

He grinned proudly and gave his wife a triumphant glance.

“But, just to be safe, I hope you’ll keep taking your regular pills, too. And watch the junk food, okay?”

“I will”, he said, rising from his chair.

“Merry Christmas my friend”, he said, offering his big hand in a firm shake.

“You too”, I said, “both of you.”

His wife, now standing behind him, looked into my eyes and silently formed the words with her mouth:

“Thank you.”

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Osler said “Listen to your patient, he is telling you the diagnosis”. Duvefelt says “Listen to your patient, he is telling you what kind of doctor he needs you to be”.


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