Prejudiced Against Ourselves?

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Do people ever treat you as if diabetes makes you a second-class citizen, or makes you damaged goods? Do people blame you for diabetes? Such prejudice is sometimes called “healthism,” referring to the belief that healthier people are superior to people who are less well.

As many commenters posted in the “Type 1 vs. Type 2” discussion, the public is often told that Type 2 is the fault of those who have it. They’re doing it to themselves. Readers with Type 1 expressed anger, because they often get painted with that same brush.

That kind of blame is totally unwarranted, of course. Both Type 1 and Type 2 are environmental illnesses with strong genetic factors. But even when they’re not blaming, people can still find ways to put you down for being sick.

I see this nearly every day from my wheelchair. People are anxious to help. But they tend to treat me like a child, as if I don’t have the ability to take care of myself, or I don’t have anything worth saying. One day recently, I was out in the neighborhood with my wife, and a neighbor smiled at her and said, “Oh, good. You’re getting him out.” I felt like slapping her, but somehow I held back.

It’s a little different with diabetes, because it doesn’t show as much. But don’t people tell you what to eat, or that you need to exercise more? Or give you some “valuable” information they heard on TV, like you’ve never learned anything about diabetes before?

Healthism is always annoying, but it can be damaging if employers, landlords, or government officials believe it. People are refused leases, drivers’ licenses, and jobs based on health prejudice every day, and it can be very hard to redress.

Health-care providers sometimes have the worst healthism. They act as if we’re sick because we don’t follow their orders, rather than seeing the environmental, social, and genetic burdens we’re carrying. They label us with names like “noncompliant,” “in denial,” or “nonadherent.”

We can even be healthist towards ourselves. A reader named Joan wrote me that she was afraid to pursue a love relationship because she didn’t want to be a burden to a potential partner. She was judging herself before other people got a chance to judge her. I see this all the time in the multiple sclerosis (MS) community. People hide themselves away because of illness, while other people who could love them are left lonely.

I know when I have a bad health day, I always think it must be my fault. If my MS seems to be progressing, like if I’m having more trouble walking, I think it must be something I did. Am I eating the wrong things? Am I stressing too much? Am I keeping myself too cold or too warm, or too something? I can keep myself up nights worrying about whether a new writing project will be good or bad for my health, or asking myself some other question I can’t answer.

Likewise, when people’s blood glucose is up, or when they have a new diabetes complication, they’re likely to blame themselves. Of course, many times what you eat can cause high numbers. But there are many other causes, and not all of them are easily traced. A blood glucose number is not a value judgment. It says absolutely nothing about how good a person you are.

It makes sense for you and me to try and figure out what we can do better. But we should also accept that we are doing the best we can. We are good people making, for the most part, good decisions in tough situations.

It’s worth trying to live a healthy life. Feeling powerless is the most stressful feeling there is, so in general, so it makes sense to do things that help us feel in control. But we have to acknowledge that we don’t have total control. We have to accept ourselves as we are, at whatever level of health.

Maybe we should treat health as more of a gift, and less of a responsibility. Maybe the person living the best life is not necessarily the one with the lowest A1C. Agreed?

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