Even before Shara Bialo, 29, was diagnosed with type 1 diabetes as a child, she had her eye on a career in healthcare. Today, twenty years later, she is a pediatric endocrinologist. As a teenager, Bialo was so determined not to let diabetes define her, she kept it a secret and it took a long time for her to come to terms with diabetes. Now, however, she believes that diabetes helped shape her into the happy person she is today. Her own life experiences have also influenced the way she treats her patients – not just by offering medical options, but also offering them sensitivity and support, with mindfulness about the emotional stress that may come along with diabetes. (You can read more about how stress may affect diabetes here.)
Why did you choose to go into endocrinology? And why pediatric endocrinology?
When I started my pediatric rotation, I knew I was home! Working with sick children can be very difficult, but is infinitely rewarding. I was not decided on endocrinology when I entered my pediatric residency, but I was undoubtedly drawn to it because of my own experience.
How do you take care of yourself while taking care of others? Do you have any precautions in place before you do rounds or see patients in your office?
There is nothing more frustrating than having to take a “time-out” at work to treat a low, and my productivity is hampered with very high blood glucose numbers because they make me feel exhausted. My continuous glucose monitor has helped me avoid these situations.
Even though we have plenty of diabetes supplies at work, I keep a stash of my own supplies in my desk drawer. Despite it all, there have been several instances where I had to grab some juice at the nurse’s station or borrow some test strips from the supply closet.
Do you tell your young patients that you have diabetes, too?
I do, but not always. I feel out each situation and only divulge that I have diabetes if I think it could benefit the patient or their family in some way. The appointment is about the patient, not me.
Giving a child a diabetes diagnosis – and telling the parents about it – must be one of the hardest parts of your job. How do you do it?
I hoped that it would become easier over time, but it has not. I still get that knot-in-your-throat feeling for every patient. I am consumed by the thought that their lives have irreversibly changed forever.
I take a few minutes to pull myself together before I introduce myself and the concept of diabetes. I tell them that it can be treated and emphasize that it will not hold them back from living life to the fullest.
How do you manage your diabetes?
Do you ever find it difficult to practice what you preach?
Actually, treating patients with diabetes has influenced me to take better care of myself. That being said, there are several things that I tell patients to do that I hardly ever do – but I try to be honest about those things, even struggles with blood glucose checks.
What’s your best advice for living a healthy life with diabetes?
I am a strong believer that you cannot have a healthy body without a healthy mind. If patients are feeling down about their diabetes, I try to pick up on it early in order to refer them to counseling services.
If you could go back to the day of your diagnosis, is there anything you would change?
I do not remember too much about those first few days, but I know my parents remember every word. Despite the tears, they came away loving the endocrinologist who diagnosed me. My mother still carries his business card in her wallet twenty years later. I keep this in mind every time I have to diagnose a new patient, and it fills me with a deep responsibility to handle the situation with as much grace as possible.
Jessica Apple is the co-founder and editor-in-chief of the online diabetes lifestyle magazine A Sweet Life. Her writing has appeared in many publications, including The New York Times Magazine, The Financial Times Magazine, The Southern Review, The Bellevue Literary Review, and Tablet Magazine. Apple is a paid contributor for The DX. All opinions contained in this article reflect those of the contributor and interviewee, and not of Sanofi US, its employees, agencies, or affiliates.
© 2013 The DX: The Diabetes Experience