by Georgia Feuer, BA
Pediatric, Adolescent and Young Adult Section
In 1961, Donna Younger, M.D., began seeing patients at Joslin Diabetes Center under the guidance of none other than Dr. Elliott P. Joslin himself.
Last week, Dr. Younger received an award from the Center for providing patient care here for exactly 50 years.
Here are some of her recollections about how Joslin has changed over time.
The staff and patients of the Joslin Clinic used to form a close-knit community, an “extended family,” as Dr. Younger calls it.
“We communicated more because we would see each other in the hallways,” she says. “There was a staff meeting every morning at 8 a.m., and if you were late to it, Dr. Joslin would page your name throughout the whole building.”
The patients were included in the family. In the Diabetes Treatment Unit, they received individualized coaching at family-style tables from dietitians, nurses and other patients. “Patients had tremendous psychosocial support,” Dr. Younger says. “Everybody used to be together and learn from each other.”
The approaches to diabetes management at the Joslin Clinic were considered radical at the time. The general thinking for diabetes care providers was that “all you had to do was keep the patients out of a coma,” she notes. “Complications were inevitable.” Dr. Joslin was distinctive in his viewpoint that careful management could make a difference in health outcomes.
According to Dr. Younger, this perseverance towards finding ways to improve the quality of life for patients with diabetes is why Joslin Diabetes Center has survived. “People don’t want to hear that you, the care provider, have done all you can do,” she says.
But in the 1960s, care providers faced challenges that don’t exist today. “If a person with diabetes arrived at the emergency room in a coma, we didn’t know if it was hypoglycemia or hyperglycemia,” Dr. Younger remembers. “Depending on how backed up the lab was, it could take two hours to find out if their blood glucose was high or low. We had to diagnose by asking the family members about the symptoms leading up to it. Sometimes we would just give them glucose intravenously and see if they woke up.”
Dr. Joslin himself was “a gentleman of the times,” as she puts it. He always wore a suit, complete with watchcase and chain. When it came to caring for patients, “he worked hard, and he worked us hard.” He insisted the clinic be open six days a week so children could see their doctor on Saturdays and not miss school. Staff members were required to be available by phone 24/7.
Joslin’s founder had great respect for his staff and would refer to his younger physicians for the latest research findings. So great was his confidence in their abilities that when Dr. Joslin himself was hospitalized in 1961 (at the age of 92) he insisted Dr. Younger be his doctor. His explanation was that “any physician good enough for my staff is good enough to be my physician,” she explains.
Dr. Younger proved herself not only “good enough” to be physician to Dr. Joslin, but also dedicated enough to keep helping patients manage their diabetes ever since.