Integration,
not Domination:

A Response to “Midnight, Three & Six”


I watched the New York Times Op-doc “Midnight, Three & Six” about the Chamberlain family’s daily struggle with managing Type 1 diabetes published on January 26th, and I was so strongly affected by it that I felt compelled to write a response. As an extremely active professional musician who has lived with Type 1 for 23 years and counting, I know all too well what comes with the territory; the risks of devastating complications, the annoyances which range from the petty to potentially serious, the acute risks of hypoglycemia, the mountain of supplies that are needed to treat the condition, and perhaps most daunting of all: the fact that it never gives one a break even for a moment. Managing Type 1 diabetes is a 24 hour, 7 days a week, 365 days a year job.

All of the above is undeniable, and if one looks at Type 1 only in this way, living with it every day can seem overwhelming if not impossible. I fully acknowledge this, but at the same time I would like to offer an alternative perspective on managing Type 1 diabetes. I was diagnosed with Type 1 in 1992, the month before my 10th birthday. I was already very serious about my musical development and loved nothing more than playing the cello. Indeed, my favorite thing at that time was simply to play music for people in any way, shape, or form. When my diagnosis came, my parents and younger brother were unwavering in their support, for which I am eternally grateful. The year 1992 was a very interesting time to be diagnosed: it was at that time that the DCCT trial results were published, a crucial point for diabetes research. The trial proved definitively that the risk of devastating complications associated with Type 1 (as well as the much more common Type 2 diabetes) could be significantly reduced if not eradicated by achieving as close to normal blood sugars as possible. My doctors were rightfully excited by the results of the trial. They told my family and me in no uncertain terms that as long as I took vigilant care of my blood sugar, I could live a healthy, active, and long life, and that I could be anything I wanted to be.

My family took that advice to heart. At first we had a brief period of adjustment to the daily fingerstick blood sugar testing (8 times a day), insulin injections (6 daily, until I switched to an insulin pump at the age of 16), and we certainly had a lot to learn about nutrition and the way exercise affects blood sugar. My memory is that the adjustment period was a few weeks; I’m sure it was longer for my mother, who assumed almost total responsibility over my daily management of the condition in those first years. However, she and the rest of my family unequivocally impressed upon me the following point: yes, we had to learn how to integrate Type 1 into our lives but we would never allow it to run our lives. I returned to school, practicing the cello, and doing all the things a normal ten year old girl likes to do, including swimming, running, playing, and yes: going to sleepover parties with friends.

I started playing concerts around the USA when I was 14. My family and I made the conscious decision not to tell my new management (ICM Artists at that time, now called Opus 3 Artists) about my Type 1 diabetes, so as not to spook them. There was nothing I hated more than the idea that others might think I couldn’t do something as well as anyone else because of my condition. My manager, who is still my general manager today (and to whom I affectionately refer as my “mother hen”) found out three years later about my diabetes from another source. She was shocked I hadn’t told her about it, but she understood perfectly after I told her why. It is not easy to explain the “integration, not domination” approach to Type 1 diabetes management. It requires acknowledging what is necessary to do to treat the condition and doing it on a daily, constant basis. But it also requires a will, positivity, and energy to not let the condition get in the way of really living.

I am now a professional musician, and I mostly play as a soloist with orchestras around the world as well as in recitals and chamber music. I have had the great privilege of collaborating with some of the greatest musicians living, and am proud to call many of them colleagues and friends. I play upwards of 120 concerts a year on five continents, and I have a longterm recording contract with a major label. I write this letter on a plane to Tokyo. And yes, I have my arsenal of diabetes supplies with me and keep an unwavering eye on my blood sugar control. I continue to fully integrate it into my life, but it does not run my life in any way.