Dancing With Many Different Ghosts

Treatment of youth with type 2 diabetes

My training in the treatment of type 2 diabetes in children began when my father recounted stories of his experience in northern Canada as a fur trader with the Hudson’s Bay Company (HBC) in the 1930s. The Cree people lived in tents in the winter months and took them down in the summer and fall to go out on the land to hunt. The HBC store traded fur pelts for flour, lard, and saccharine (sugar was much too expensive). Later, in the 1970s, as a medical student on an elective in northern communities, the itinerant dentist talked of the frustration at having to do so many dental extractions in young children with rotten teeth. My early “diabetes” training was continuing with the stories told by the pregnant women who sat for hours together carving soapstone behind the hospital. The women had “come out” from their communities to wait until after delivery before returning home. They talked of their hardships and sorrows, their children and families, and living off the land.

I’ve also learned from our northern outreach clinics. We fly in small planes to small communities surrounded by rock, lakes, rivers, and boreal forest. After our afternoon clinics, we walk to the store along the frozen barren roads in winter or the potholed, dust-covered roads shared with pickup trucks in spring. Several youth from our clinic show up. We walk around the aisles together as a group—the teens, doctor, dietitian, nurse, and social worker. We read labels of snack foods and compare prices of fresh, frozen, and canned products. Elders express their concern about diabetes in their community and especially about the fate of the children. We scrutinize the checkout counter to see how many cartons of soda pop and chips are going through. We learn that two of the …