Diabetes and Portrayal in the Entertainment Industry: Realistic or Not?
I admit it! I watch television and go to the movies as a means of relaxation and to immerse myself in other people's problems. I have always been intrigued with how medical personnel and their lives are portrayed in the media. My first experience with diabetes in the media was the movie Steel Magnolias with Sally Field playing the mother, and Julia Roberts as the adult nurse with long-standing diabetes. This movie showed a relatively realistic documentation of diabetes as it was treated in the late 1980s. One of the first scenes showed an accurate rendition of an "insulin reaction" where the audience (except me) had no idea what was happening. I remember audibly yelling "give her glucose," much to the annoyance of the audience (until they realized what was happening).
Recently, I have noted an increase in roles that involve either adults or children with type 1 diabetes. The Panic Room (2002) with Jody Foster depicted a scary situation involving a child with diabetes. Most notably, the child was wearing a watch that could determine blood glucose levels. Many thought that the watch was actually the glucowatch, which was on the market at the time. However, the watch looked like a typical wristwatch and had no resemblance to the real glucowatch (much bigger and bulkier). After the movie was released, our team got multiple phone calls from parents wanting us to prescribe this precursor of the continuous blood glucose monitor. Unfortunately, though the technology (ionopheresis) was promising, the process of wearing the watch was painful - causing a stinging sensation on the inside of the wrist every time the watch measured glucose, and was unreliable. In addition, after I wore it for only 24 hours (to see if it would record my normal blood sugars), I was left with a visible rash on my inner wrist that took six weeks to disappear. Not a realistic portrayal of diabetes technology! (Good acting, though!)
Recently, television has portrayed children and adults with diabetes as regular people. One of the best representations of how diabetes presents in children was on a 2006 episode of Brothers and Sisters in which Sara's (Rachel Griffiths) daughter, Paige, presented with new onset diabetes. Symptoms included the traditional ones like increased drinking, increased urination, irritability, etc., which were missed by Sara. Finally, Kitty (Calista Flockhart), Sara's sister (and the child's aunt), realized something was amiss after spending an evening alone with Sara's children. Eventually, Paige became lethargic and went to the Emergency Department where the diagnosis was finally made. What followed was a realistic storyline of hospitalization followed by diabetes education and treatment, in a very moving and well-directed episode. I suspect that a family member of the Brothers and Sisters production team must have type 1 diabetes to have produced such an excellent and appropriate dramatization of diabetes diagnosis and initial treatment. As a result of this realistic discussion of diabetes, I actually began watching the program regularly. Additional episodes of Brothers and Sisters have occasionally commented on Paige's need to take insulin injections; but there has been no further development of this storyline.
The latest portrayal of a child with type 1 diabetes was on television's Private Practice. In this episode involving the pediatrician in the practice, a child was noted to have a malfunctioning insulin pump with hyperglycemia along with an infection of the tissue around the infusion site. The catheter was realistic with appropriate inflammation around the site. A complicated storyline noted that the father was unable to obtain appropriate supplies, which explained the inflammation and need for antibiotics. The child was hospitalized and it was never made clear that the infusion set was subcutaneous and, thus, did not require a surgical procedure for changing out sites. The pump, itself, was an amalgamation of the different insulin pumps on the market and therefore did not serve as an advertisement for one of the different brands of pumps. I was appalled, however, that no mention was made about using insulin injections to mimic the functioning of the insulin pump until a new pump could be obtained. I suspect this was to further the plot at the expense of realistic management.
I am interested to hear about other portrayals of children with diabetes in the entertainment industry, as this is an excellent venue for diabetes education. With appropriate and accurate information delivered on television and in the movies, we, as diabetes educators, are assured a vast audience! On the other hand, with inappropriate and medically suspect diabetes information presented, we are doing a great disservice to our families and the surrounding communities. We need to take advantage of all opportunities in the media to provide accurate medical and realistic portrayals of our children and families in the diabetes world.