Cheating Destiny: Living with Diabetes, America's Biggest Epidemic

#51Title: Cheating Destiny: Living with Diabetes, America's Biggest EpidemicAuthor: James S. Hirsch
Publisher: Houghton Mifflin
Year: 2006
Genre: Memoir/Medical History
307 pages

Hirsch, who has a brother and son with Type I diabetes, as well as having it himself, is well-situated to write this memoir/medical history of the disorder. He moves swiftly and easily through the early history of medical treatment for diabetes, with numerous interesting biographies and anecdotes. These are interwoven with his contemporary experiences and impressions related to his son's diagnosis and care as contrasted with his own. Hirsch holds my interest until Chapter 12, then bogs down in a fairly detailed and less-interestingly told account of Denise Faustman's research and political travails; he hits his stride again in Chapter 14, though he retells some pieces of his family story that he's already told.

I enjoyed encountering William Beaumont's observations of a young Canadian man with a shotgun wound in his gut. I first read about this in a science book that used to belong to my mother or aunt (it also featured a chapter on transplanting a piece of a rhesus monkey's uterine lining to its eye and observing that it bled in synchrony with the monkey's estrus, which was how I first learned about menstruation, so I must have been 9 or 10).

Hirsch seems a bit vague on the findings on Type II diabetes, particularly on the reflexive relationship between weight and insulin resistance. His book focuses on Type I, which is fine, but in some places contributes to the general confusion about the similarities and differences between the two types.

Hirsch provides a lot of useful information about the history of Blue Cross/Blue Shield and other health delivery systems, along with an informed analysis of ways in which diabetes management profits those systems. I would recommend this book for people who are somewhat familiar with Type I diabetes; I would not recommend it for a newly diagnosed person or her family as Hirsch's ambivalence about the medical system is less-well mediated than the rest of the book; in addition, he seems angry on his son's behalf, but not his own, in a way that sometimes makes his tone an odd mixture of flat and over-emphatic.