Message to Champions

By Dr. Anne L. Peters, Physician to Gary Hall, Jr.,
Olympic Champion with Type I Diabetes

Gary Hall, Jr.
Photo credit: Allsport

It is late in the evening.  I am standing on the observation platform for the warm up pool at the Olympic Natatorium in Sydney, Australia.  The air is damp, warm and chlorine-scented.  I am with nine other people, the family of Gary Hall, Jr.  We are waiting with expectant impatience.  Then we see him coming towards us.  Tall, tousled still wet hair, moving as though physically exhausted but with a grin that explodes across his face in joy and relief.  We encircle him, one by one embracing him.  From his pants pocket he unobtrusively pulls out a gold medal.  We take turns holding it.  We are crying.

How did I get to this point?  Me, who has rarely opened the sports section or watched a sporting event on television.  I got to the Olympics by being a doctor, which has been my lifelong obsession.  I decided early, at age 5, that I wanted to be a physician because I loved science, math and people.  Diabetes is the field I chose because in no other area of medicine are the three so closely linked.  And I became increasingly passionate about treating the disease as I learned how great the need for improvement was.

As I have practice medicine, one of the things I have learned is that one heals people by learning how to apply technology and love in equal measure.  The traditional “godlike” physicians no longer holds much sway in this world of managed care contracting and Internet-based information access.  Moreover, the more patients question, the more they learn and become involved in their own health.  And as every mother knows, the hardest, most important part of love is figuring out the fine balance between giving appropriate independence while at the same time maintaining clear limits and boundaries.  This also applies to a doctor.  Many physicians don’t succeed at diabetes because the regiments they create are too rigid.  My goal is to adjust the diabetes treatment to the patient’s lifestyle, not the other way around.

Gary Hall, Jr. exemplifies this approach.  Halfway between the Atlanta and Sydney Olympics he developed Type I diabetes.  He had won two gold and two silver medals in Atlanta and his chances looked good for Sydney.  But after he was diagnosed with diabetes, three doctors in Phoenix told him he could never swim competitively again.  I can understand why.  Diabetes is, in part, a disease of muscle fuel metabolism.  At the Olympic level, races are won and lost by a hundredth of a second.  No one with diabetes had ever competed in such an aerobic sport at such a high level.  To say yes meant risking losing.  It was easier to counsel Gary to change his dreams.

But I tend to be a bit of a rebel and fight hard when I am told something isn’t possible, especially if it is something I want to do.  When Gary and his fiancée, Elizabeth, came to see me in Los Angeles they arrived for their appointment 2 hours late.  I had to go to  the San Fernando Valley to give a talk, so I crammed them (both over 6 feet tall) into my little red VW Beetle and drove them across town with me.  I think I disarmed them by being, unintentionally, so different.  After spending several hours with Gary I knew he could do anything he wanted.  I still wasn’t quite sure about winning the Olympics because I knew nothing about competitive swimming, but I told him I would help him.  I told him he could try.

To learn about swimming, I flew to Berkeley, where Gary was training, to sit by the pool and check his blood sugars, to learn about his nutritional needs, to meet his coach, to be sure I didn’t think he would drown from hypoglycemia during a workout.  After spending the day with him, I knew he could make it to the Olympics, if that was what he chose to do.  And choose to do it he did.

I was with Gary at his swimming meets where we cheered him on to make the cutoffs to qualify of the Olympic trials.  I was in Indianapolis, screaming encouragement as he beat the competition and won a spot on the US Olympic team.  And I was with him in Sydney where he won two gold medals, a silver and a bronze.  It is hard to imagine being more proud of anyone than I am of Gary.  But the path was not easy.  Swimming competitively with Type I diabetes is not simple.  Yet, it IS possible.  And I also had to learn to let go with Gary.  He did his best with my support but not necessarily with too much specific advice.  He is very smart.  He knows his body very well.  I could teach him theory but the application was up to him.

Part of the reason I fought so hard for Gary is because of his willingness to take on the task of role model for others with diabetes.  He will increasingly be serving as a spokesperson for people with diabetes.  He will do what I cannot – show people by example how to cope with this disease.  And as amazing as Gary is, his story is one that many of us live, that of overcoming challenges, of following one’s dreams, of caring for other people.  Treating diabetes is a partnership, between health care provider and patient, between mother and child, husband and wife.  Although it takes a great effort to treat, there are many benefits that come from the process.

Every child, every adult who has diabetes or takes care of someone who does, deserves a gold medal for trying.  And until we find a cure, I will be on the sidelines, cheering as hard as I can.

Anne L. Peters, MD is a Professor of Medicine at the Keck School of Medicine, University of Southern California.  She is the Director of the Clinical Diabetes Program at USC and at LA County, where she is designing and running a large outpatient diabetes program for the poor in Los Angeles.  She also heads a center for diabetes treatment and clinical research, funded by a newly established diabetes foundation.