"Dear Ms. Joyce,
I appreciated
your support last year on my first letter and the documentation and recap of my
care in Endocrinology as it was briefed to me via email from my doctor. It is been over one year since I have
last communicated through patient administration at Balboa Hospital. This is my second letter and response
to Dr. Douglass’ email, dated March 19, 2013.
I have not
been on the clinic’s scale for my weight on a regular basis, but have been on the
scale at my Command since the beginning of the year, weighing in with my
Command Fitness Leader, who has been carefully tracking my progress. I take issue with the weight gain and
made note of it to the Corpsman, who said they accommodate wearing a full
uniform. As soon as he added an additional
15 pounds to my weight, I immediately told him it was inconsistent and erroneous. I currently weigh 270 pounds. I am in line with Navy BCA standards
and have never failed one PFA or BCA.
It is all documented. It is
difficult however to stay in that standard because of the drugs I am currently taking
so I have worked very hard to maintain and lose weight as required, I feel good
about that.
I understand
that Endocrinology is doing their job and requirements as professional Navy doctors. Why I continue to feel very frustrated and
angry is that I still do not feel adequately cared for or supported as a
diabetic. All I have heard these years in Endocrinology is that more medication
is the way ahead from the turnover of several doctors. My care does not make sense anymore over
these last seven years. The
tendency outside of policy and procedures is to throw more drugs at the medical
condition. I understand doctors
are doing this in an attempt to lower my A1c, I am grateful and I am not
against taking medications. I have
been prescribed drugs in an attempt to make me “worldwide deployable” (and
healthy I hope), yet I hear “How many more years until I retire?” at every
office visit. That comment is
frustrating because it makes patients feel like what about my care and they are
just going to be given the open door to retirement and processed out the Navy. Any doctor can say you need to lose
weight. But this disease is not
just about weight loss; weight loss is a benefit of a healthy life which can
reverse diabetes. Any doctor can
say you need to go on a diet; but with this disease, it is not just about a
diet—it is seeing how I see food and how my individual body responds. For diabetics, optimal health is not
achieved by eating less to lose weight.
Rather, diabetics have to make a big commitment not only to forming
better eating habits but also eating the right foods to help the body heal from
the inside. These changes include
making adjustments in their thinking as well as their diet. I do desire to have a long life
expectancy. No one wants to suffer
needlessly year after year and take more and more medications with side effects
and weight gain and then put on a Medical Board as the solution.
All I have
heard is negative and more negative and not what I am doing well. But no real, specific care with set
goals and measured progress—only treatment for the blood work. I was receiving this with Dr Navarrete. No one in my care has ever said
diabetes can be reversed. No one. I am frustrated because I was encouraged
to put my concerns in writing a year ago, and when I did, I was placed on a PEB
the very next day. That is when
the fiduciary trust with my care in Endocrinology was broken. The timing of the PEB communicated to me
the doctors in Endocrinology are going to do only what the institution requires.
My PEB felt like a retaliatory
response and true concern and reversal have not been a part of my care.
Having been faithful
to all the prescriptions but still not showing significant improvement is a
failure on medicine and critical care to accompany it. Endocrinology at Balboa
has failed me because I never received this support (except for a suggestion of
going to a diabetes support group, which didn’t help me at all). Diabetes has
progressed in me over the years. I
see how the plan I have been on continues to damage my organs and heart. I believe much of my suffering could
have been avoided had I been given more accurate dietary information (other
than eat fewer carbohydrates and reduce your sugar). So I have adopted a healthy high nutritional plant based
diet all on my own. I will reverse this disease not because of medicine
or the care I have received thus far.
If you look
at my numbers since starting my juicing and high nutrient plant based diet 1
FEB to reverse diabetes, you will see change. This may in fact warrant a re-evaluation on the course of
action Endocrinology continues to take.
Unfortunately, in my opinion, treating diabetes with medications and not
the proper diet education gives me and other diabetics a false sense of
security. One can mistakenly think
their somewhat-controlled glucose levels indicate improvement. But this is wrong. Going to doctors and getting every pill
averts the patient’s responsibility.
I am not
asking Dr Douglass to shirk his responsibilities as he stated in his email, but
the doctor-patient relationship and bedside manner I have experienced is
disappointing and needs improvement. Care means so much more than prescribing medications and
prescribing further medications to treat the side effects to include a Medical
Board. Care means not treating
patients as a number (me) but treating them with respect as an individual and
to truly care for their well-being and their outcome and partnering with them
for the way ahead to be found fit for service and heal. I need this and doctors who will
partner with me; I understand that I see care differently. I was making progress with my civilian
doctor Dr Navarrete and was hoping to continue. This course of action was terminated not at my request.
Listening to
what patients need to say extends to other aspects of communication and doctor
care as well. It troubles me to
see military medicine, plans, models and operational memoranda that refer to
communication as some sort of weapon that can be fired downrange. Navy medicine should not be in a business
rather it is people and care for those people in the military that is the
hallmark of our Navy. Rather, it
is an obligation to explain ourselves, to put into context what you are doing
and why and then partner with the patient; not just quoting notes, telling the
patient what you did with surprise and quoting policy and procedures. I see it as Endocrinology has made
decisions without keeping me informed and partnering with me. I see it as the department is not
taking any ownership to the breakdown of the fiduciary trust and care in the
doctor oath of office and with me.
We live in a participatory
culture, a post-audience world. People
don't want just access to information or be told information anymore. They want
access to conversation. They want to be heard. I do not feel heard or cared for. To take part in that conversation doctor and guide it, at
times, requires a humility that we don't always possess. It requires us to
listen as well as speak, to solicit as well as inform, to admit our
shortcomings and accept sometimes brutally frank feedback such as what your are
receiving right now. I know my
credibility, and that of the Navy, is enhanced when I join in a discussion
rather than merely lead it. It gives us a better sense of the mood and attitude
in which our words and actions land. It helps us communicate more comfortably
across the spectrum of caring for people and that is what we both do in our
respective professions in the Navy.
I feel very
capable as a Navy Chaplain and world wide deployable. I have served at sea and with special operations commands as
a diabetic over the last seven years.
I would just take the meds I needed which had no impact on my ability to
serve as an active duty Navy Chaplain deployed operationally. I still desire to serve on active duty
and believe I am called to be a Navy Chaplain. I do in fact feel discriminated against because of my care to
date in Endocrinology and take issue with the way I have been treated. It is stereotypical to think that a
person with diabetes is going to have more medical issues while deployed or
unsupported. I have deployed as a
diabetic at sea and with our Navy SEALs.
I do believe by October, I will be worldwide deployable and able to go
to sea. I would like to believe
that a military member is judged on the unique skills they bring and not their
diagnosis. Diabetes does not have
to interfere with the ability to do a job, and most of the time is
doesn’t. I would have enjoyed some
more optimism and encouragement and I have never received that from
Endocrinology. I do appreciate Dr.
Douglass’ kind words in his email about assisting me as I improve and what I
bring as a professional as my A1c improves. I just feel like what I am getting is more socialized
institutionalized medicine. I will
show that more medication is not the solution, but a healthy life and reversal
should be the focus.
With my
progress, I do not believe a Medical Board was the necessary next step in my
care plan and has been forced upon me.
This Medical Board can effect my ability to be promoted. I am going to continue this high-nutrient
and plant-based diet for 180 days.
I will continue to give blood so my medications can be adjusted as
needed. My goal is to be off all
my medications by October 2013. I
still need the partnership with
doctors. Thank you in advance Dr
Douglass in your assistance in stating that my condition does not interfere
with my ability to perform the duties required of me as a Navy Chaplain. I disagree that it excludes me from
worldwide deployment and sea duty.
I believe I can complete the mission as a Chaplain, that I am physically
fit, mentally tough, morally courageous, and spiritually connected to God to serve
my country as I have these last eighteen years."
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