“This is the diabetes book I have been waiting for,” I said to my husband when I was just a few chapters in to After the Diagnosis: Transcending Chronic Illness, by nephrologist Julian Seifter and his wife, editor and writer Betsy Seifter.
“Why?” Jimmy asked.
I flipped through pages of patient stories. I examined phrases and passages of insight I had underlined for re-reading. I reflected on this difference between After the Diagnosis and the many book on diabetes I had read or browsed over the years.
Finally, I answered. “Somehow, this book makes me feel understood. This isn’t advice so much as acceptance and… empathy.”
Not about diabetes only, the subject of the Seifters’ book is more broadly chronic illness. In his practice as one of the country’s leading kidney specialists, Dr. Seifter has treated patients with a variety of conditions in which kidney function was, in some serious way, implicated or affected. He tells stories about people with cancer, kidney diseases (there is more than one that fits under this umbrella), hepatitis, fibromyalgia, chronic alcoholism, and less commonly known conditions such as polyarteritis nodosa (PAN).
He also tells his own story, in fragments and over the course of the book, about his diagnosis as a young doctor with diabetes and his long coming-to-terms with the illness he kept secret. He kept diabetes secret from his colleagues and even, in a way, from himself, by his discomfort with thinking of himself as a patient.
What makes this book special, and why I recommend it to ASweetLife readers, is this dual perspective on the experience of disease. Dr. Seifert knows it from both angles when he writes about paying attention to illness:
The doctor is interested in the level of attention that’s ideal for managing the illness, but the patient seeks the level of attention that’s ideal for managing his or her life. It’s a matter of bargaining. The doctor will never succeed without acknowledging the person who goes home from the office visit to contend with family, work, children, pets, bills, car repairs, plumbing, taxes—not to mention appetites, longings, fears. (72)
The bargaining between doctor and patient parallels the bargaining a person does with himself or herself, and – because of his personal experience with diabetes – Dr. Seifert understands what it feels like to live in that place between the ideal (for example, the attainment of the so-called perfect HbA1C) and the real (the frustratingly high or low blood sugars). Patients and doctors both have “dreams of omnipotence” (165), he acknowledges. I have such dreams, too, and yet still I find comfort in these words:
No health policy or medical Ten Commandments will ever entirely tame the randomness of the universe or control all the variables affecting people’s health. Simply being alive means being vulnerable to time, chance, illness, death. (165)
Even though those of us with diabetes have unusual health challenges to face and manage, there is something about our experience of illness that is simply human. Dr. Seifert shows readers the vulnerable side of himself, too, and how his experience of diabetes has been anything but straightforward and masterful. In fact, at the end of the book, he confesses to the irritation he feels when his wife (also his co-writer) gives him their secret signal that he needs insulin, or conversely some Life Savers (221).
The richness and craft with which the patient stories in this book are told make After the Diagnosis a page-turner, perfect for summer reading. Its honesty and compassion make it deep, reflective, and ultimately therapeutic.
To read an essay by Dr. Julian Seifter, click here.
I also loved this book and you pick up on all the exemplary things Seifter shares through his clinical training and wisdom. If doctors could remember this alone as you quoted: The doctor is interested in the level of attention that’s ideal for managing the illness, but the patient seeks the level of attention that’s ideal for managing his or her life. The doctor will never succeed without acknowledging the person who goes home from the office visit to contend with family, work, children, pets, bills, car repairs, plumbing, taxes—not to mention appetites, longings, fears. (72) – how different the patient/provider… Read more »
This looks very interesting. Thanks for the review!