A frustrating joy

 Mr. R. is a 69 y/o male with poorly controlled diabetes.

He has fired or been fired by two endocrinologists, as well as three different diabetic educators.

The most upset I have ever seen him was after seeing the last diabetic educator.

He reported the person (it was a male) was so rude he "just wanted to reach across the desk and punch him!"

I have been his primary care physician for the last 8 years.

The entire time, his A1C has been greater than 10 (for non-medical folks this means very poor diabetic control).

He's very well read.

Despite multiple long conversations about diabetes, the pancreas, insulin production, gluconeogenesis, the need to take oral medications and insulin, etc., he continues to have his own strongly seated beliefs about how he wants to take care of his diabetes.

His most recent A1C was 14.2.

Amazingly, he does not have retinopathy, his blood pressure is well controlled, his renal function is normal, he does not have proteinuria and has no symptoms of neuropathy.

It's a frustration to have his as my patient.

He's also evangelical, spirit filled, loves life, walks two miles twice a day, doesn't drink or smoke, always verbalizes his thanks to the LORD for his health and always ends visits by thanking me for being his doctor and asking for an update on my family.

It's a joy to have him as my patient.

He's a frustrating joy.