The Wilderness Guide, the Diabetes Educator and Guerrilla Warfare – part one

She came to me exasperated, “Sam, our referral system is down, and I can’t find Jack’s details… I don’t know what to do with him, coz he doesn’t have a booked appointment with anyone!” Sally (our receptionist) was already under the pump when Jack walked into the clinic and told her that he needed to check his numbers with someone. 

“It’s OK Sal, I’ll see him.”

Jack looks to be in his 70s, he’s wearing oversized pants and a polyester knit that needs a wash. His hair is faded, greying and long. His beard differs only in its distinctive pungent nicotine stains. He’s carrying a shopping bag full of clothes and is eagerly presenting his blood glucose diary to me. 

I gesture to the seat for him to sit. He sits, still clutching his diary. I pop myself next to him and we have a chat.

Turns out Jack usually lives out bush. A couple of months ago he was told his sore throat was an aggressive neck cancer. Since then he’s been living in town in the hospital accommodation, receiving daily radiotherapy to shrink the mass. He points to his neck and tilts his head to the left presenting a thickened swelling beneath his skin running from his earlobe to his collarbone.

He’s not able to swallow solid food, he says.

“I stopped taking me insulin five days ago… is that ok?” Jack is still gripping the handles of his Coles shopping bag and pressing his diary towards me with the other hand. I take the diary and sit it on the table. “Let’s take at look then Jack” I say, holding his gaze for a moment.

I do the usual stuff – check out the diary he’s been busting to show me, read notes, look at discharge plans, correspondences and treatment goals. I see that Jack has followed the plan to the letter. “Jack, since you stopped taking the medication that made you need insulin, it appears you don’t need insulin. You were spot on to stop giving the insulin. You don’t need it at the moment.” Jack seems pleased with this. We agree that he should keep testing and come and see us if his levels start creeping up again.

Jack and I spend about 20 minutes together planning and reinforcing goals. We talk a little about how town is hectic and the peace of the bush. We’re both pretty pleased that he’s able to go home for the weekend.

Being a Diabetes Educator requires me to be nothing more than what a person needs. Jack needed me to run through some of the decisions he’d made and I was happy to support him. Don’t get me wrong, there are years of training and experience informing my chat with Jack… For both of us. 

But what I give, is what is asked for. I just need to show up and be present.

After Jack leaves, I start thinking about what my job is like. How would I explain it to a person who has never needed a Diabetes Educator and doesn’t know what I do. I watched some YouTube videos about Diabetes Education for inspiration.

I don’t recommend it. 

I got bored and wanted to quit my job. 

Look, while what they say is true: “diabetes-educators-support-the-person-living-with-diabetes-and-teach-about-diabetes-self-management-of-diabetes-oh-and-the-role-of-a-diabetes-educators-has-excellent-opportunities-in-diabetes-health-and-by-the-way-I’m-in-demand-it’s-profitable” … yawn, I’m bored again, and a little nauseated.

It’s not riveting viewing. It makes it sound boring. Worse it makes me sound boring! And it’s not. I’m not. Anything I watch online doesn’t capture the magic that happens in situations when someone like Jack walks in to your clinic. The online diabetes educator voice kills the essence of what we do in guiding and walking with a person to their best health.

For the diabetes educator, everything starts and ends with the person living with diabetes. I see us as guides for the person wanting to get somewhere. It’s like if you want to walk the Mt Anne Curcuit. You don’t just take off in shorts and your thongs. When you decide you want to go exploring dense forests, craggy mountains and wild alpine valleys with no experience, you’re probably going to get a guide who’s hiked and camped and knows how to survive such perils.

However, and maybe most importantly, just because you’re experienced and passionate hiking guide favours a cracking pace on that steep and rocky incline and sleeping rough in a swag because they love the bracing alpine nights, doesn’t mean you want that, right? A great guide finds out what you enjoy and want. They take the time to get you prepared to achieve that goal. A great guide doesn’t make you feel like garbage because at the moment it hurts walking up the stairs at work.

In the end a great guide will get you there and back, and have you jumping on their website (as soon as get home and safely on your couch) rating the hell out of their service. Not because they’re great, but because you got where you wanted to go and lived to tell how stoked you feel.

But what if you’re trekking in a war zone? What if your sweet hiking guide Brodie doesn’t know how to get you safely through the No Man’s Land that is your current health experience. What if the terrain becomes a place of ambush and injury?

That’s when your Diabetes Educator needs to turn to you and ask permission to unleash their Che Guevara.