Cheating Destiny, Living with Diabetes, America’s Biggest Epidemic

Review By: Doris J. Dickson

Type 1 Mentor

Jim Hirsch, a resident of Needham, Massachusetts, a former New York Times and Wall Street Journal reporter and best selling author is also a type 1 diabetic. "Cheating Destiny" speaks from both his experience as a diabetic as well as from that of a parent of a young, newly diagnosed, juvenile-onset diabetic. The book begins with a prologue describing the day his three-year-old son Garrett was diagnosed. Hirsch revisits his son’s progress several times during the year or so he spent writing the book.

With the diabetes epidemic so often featured in a detached and minimalist fashion by the non-diabetic media, I thought it would be refreshing to read a book that, from its title, “Cheating Destiny” would be a story of just that  –  how to cheat the destiny that has been laid out for so many diabetics. I thought it would be a story in the life, a chronicle of how to beat the odds we have all been told we are destined for. It is not.

The book is, however, historic and story telling in nature. After the prologue describing Garrett’s diagnosis, the first chapter describes an American Diabetes Association (ADA) convention in Orlando, Florida, diabetes products and sales pitches that I found distressing to say the least. Apparently, we will buy whatever manufacturers produce even if it has nothing to do with healthy control of any version of the disease. My personal dislike of the ADA did not improve from Hirsch’s historic and current accounts of the organizations, founders and mission. Those sections of the book are quite eye opening and honestly, infuriating coming from a tightly-controlled patient's perspective.

There is a chapter in direct opposition to the ADA methodology on Elliot Joslin, which I found highly informative. His ideology continues, in part, in the current clinical guidelines of the Joslin Clinic. The theme – this disease is up to the patient to control. A corresponding chapter is dedicated to Dr. Richard Bernstein, a type 1 diabetic and controversial physician but whose philosophy is strikingly similar to that of Dr. Joslin. Hirsch, however, finds his ideals require “too much time and finesse” and are too “Spartan.”

For those committed to a cure, there are two chapters on current research and two researchers who have dedicated their lives and careers towards that end: Dr. Douglas Melton of Harvard University and Dr. Denise Faustman at Massachusetts General Hospital. Dr. Melton has focused on stem cell research while Dr. Faustman has focused on the immune system.

There are also chapters on survivors. Hirsch tells the story of one of the first young women treated with insulin – Elizabeth Evans Hughes, daughter of New York Governor, Charles Evan Hughes. He also tells of Eva Saxl born in 1921 Czechoslovakia and diagnosed with diabetes during wartime while living in a Jewish ghetto in Shanghai, China. He also shares the story of current day “Diabetes Queen” and diabetes advocate, Florene Linnen of Georgetown County, South Carolina.

The epilogue describes a Hirsch family trip back to Orlando for an Annual Friends for Life Conference and expo sponsored by the Children with Diabetes foundation. Hirsch also discusses a mistake he made sending Garrett to a day camp without proper medical instruction and the low blood sugar that occurred as a result. He does end the book on a positive note stating that though “diabetes has no happy ending” Garrett is still “laughing with his Friend for Life, knowing that he is not alone, bounding off the bus and heading for the Magic Kingdom, a little boy at play.”