By Chris Feudtner

One among medicine's such a lot awesome healing triumphs was once the invention of insulin in 1921. The drug produced excellent effects, rescuing kids and adults from the lethal grip of diabetes. yet as Chris Feudtner demonstrates, the next transformation of the illness from a deadly situation right into a persistent affliction is a narrative of good fortune tinged with irony, a revealing saga that illuminates the complicated human results of scientific intervention. Bittersweet chronicles this heritage of diabetes in the course of the compelling views of people that lived with this illness. Drawing on a amazing physique of letters exchanged among sufferers or their mom and dad and Dr. Elliot P. Joslin and the employees of physicians at his famed Boston hospital, Feudtner examines the adventure of residing with diabetes around the 20th century, highlighting alterations in therapy and their profound results on sufferers' lives. even if considering juvenile-onset, or variety 1, diabetes, the topics explored in Bittersweet have implications for our figuring out of adult-onset, or sort 2, diabetes, in addition to a number of alternative ailments that, due to medications or clinical advances, are being remodeled from acute to power stipulations. certainly, the story of diabetes within the post-insulin period offers an incredible chance for exploring the bigger questions of ways medication alterations our lives.

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Extra resources for Bittersweet: Diabetes, Insulin, and the Transformation of Illness

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A few days later, Joslin would mail patients their laboratory findings along with a brief summary of what they had talked about during the visit. He retained this habit of communicating by mail; even after the telephone was no longer a novelty, Joslin continued to write letters. Following the First World War, Joslin started to put carbon copies of his correspondence with patients into their files. He would typically begin his letters by mentioning any particular concerns that the patient had Diabetes History  raised, then he would describe what the physical examination, laboratory tests, electrocardiogram, and X-ray studies had uncovered, and he concluded with a paragraph or two about the treatment plans Joslin and the patient had discussed.

Hardnosed? Authoritative? Compassionate? The letters reveal not only how diabetics wished to be perceived but also their concerns of how they might be perceived—concerns about their public image that shaped their experience with diabetes and their relationships with physicians. At a more matter-of-fact level, the patient letters also provide a unique source of information about the kinds of lives that diabetics lived. They detail the daily rituals of eating and testing and injecting, as they also disclose how these routines did or did not fit into the patient’s family and work life.

30 Despite the drama surrounding the introduction of insulin, the drug’s arrival marked neither the beginning nor the end of astounding change. Joslin, throughout his sixty-year career, rode upon an upward wave of ever-lengthening diabetic life. Evidence of this long-term trend surrounded him. S. population during the twentieth century. ‘‘In North America,’’ he noted presciently in , ‘‘we are to dwell more and more with the old. ’’ This aging, he predicted, would Diabetes History  0 1900 10 20 30 40 50 60 70 80 90 100 1910 1920 Year 1930 1940 1950 Infectious Cardiovascular Cancer Accidents Diabetes All other Education, and Welfare, Vital Statistics , no.

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