During my practice of medicine in the hood, my family and I lived above my office. They participated in helping me to give service to my neighbors and patients. My wife was my sidekick and kept things on an even keel. My children cleaned and kept the office in top-notch condition. I hired many high school students to serve as secretaries in the office. By being a neighborhood doctor I was on call 24/7 for 365 days. As long as my car was in the driveway, folks knew where to find me and they did. I recall how one time during a heavy snowstorm I received a call from a patient’s family. I told them that because of the heavy snow, I could not get my car out of the driveway. They responded by saying that they would pick me up and bring me back, which they did.
This introduction leads me to a story that happened on a cold, snowy winter night when I was called to see a patient who was dying at home. When I got to the house, after slipping and sliding in the snow, I was welcomed into a warm home. The relative who called me told me that her sister, who had relocated from Washington, was terribly ill and had come to live with her for her last days. She further told me that her sister had severe diabetes, which could not be controlled with medications prescribed by her physician. She then led me into a room where her sister lay on a spotless white bed with candles at the head and foot. The patient was pale and motionless. After examining her and getting a medical history, I decided that this patient with poorly controlled diabetes may be a victim of hyperthyroidism. When this condition accompanies diabetes, it is often difficult to control the blood glucose. Because her sister did not want her to be hospitalized or even to call an ambulance, I had to make a decision on the basis of her medical history and examination that I would treat her at home with a medication that is used to treat hyperthyroidism. Over a period of several days, she began to take on a new life. She started sitting up and taking nourishment. Her sister was so elated to see this resurrection that she praised God for the healing.
As the snow melted and spring returned, this lovely lady who had come to die was blossoming like a daffodil. She ultimately felt so well that she was able to return to her home in Washington and resume her previous lifestyle.
I tell this story only to relay the importance of getting a good history and performing an adequate examination. This medical story also reveals how important it is to look for other medical conditions that can affect poorly controlled diabetes. If the thyroid is overactive, which is a medical condition known as hyperthyroidism, it may complicate the control of diabetes.
After several weeks, I received a letter from this patient, who is now under the care of her family physician and ready to revisit her sister, who has planned a cruise for both of them.