What Goes Around, Comes Around

I had a very interesting phone call with a recent college graduate yesterday. Jennifer, who currently works on writing grant proposals at the Rhode Island chapter of the Arthritis Foundation, is interested in pursuing medical writing and publishing as her career. The president of the R.I. chapter put her in touch with me to get some career advice. Like me, she majored in biology but decided she really enjoys writing about the science. She had questions and I loved sharing my thoughts -- we hit it off well, and her eagerness to explore the same career path I took reinvigorated me.

Her questions made me think about a few things I hadn't focused on in some time:
Did I enjoy my career? Definitely, yes -- love it and love being able to provide people with information they can use to improve their lives.

Any regrets? None, except for the ocassional twinge that maybe I should have gone for that M.D. degree years ago, if only to lend more credibility to what I write. If I had become a doctor, I likely would not have the time, thanks to managed care, to give the advice and information I can provide to people now – and doing that is what makes me happy.

Room for growth? It is what you make it.

Is the field growing? Yes and no – health and science writers are fading away from newspapers but showing up in droves on Web sites, blogs, podcasts and other new forms of media. Like with most careers, there will be job security in the future if you're good at what you do.

Must you be passionate about it? Most certainly. But that applies to any career, too. It makes no sense whatsoever to spend your life devoted to a career you don't truly love and feel passionate about. Otherwise, it's not a career, but just a job that feels like drudgery. No happiness there.

Why do I love it? Hmm. I thought back to something interesting I read years ago explaining the overlap and similarities between the scientific process and the process of researching an article and reporting on the findings. After having gone through scientific training herself, I was sure Jennifer would benefit from the analogy. Like a scientist, a medical journalist must make observations through reading, talking with editors, writers and scientists that lead to questions – the (a-ha moment). Then, a hypothesis is formed. A scientist will come up with questions to be answered through an experiment, whereas a medical journalist will come up with questions for interviews. After the experiment or interview, both the scientist and medical journalist will read through all the data collected and come up with a plan for either writing an article or asking more questions. With a bit of luck and lots of hard work, both the scientist and the medical journalist can get to the hoorah moment – a great study that leads to a Nobel prize or a great article that leads to a Pulitzer prize. The challenges in finding new angles within a slowly building base of scientific knowledge is what makes me love it. When I'm really into a subject, I lose track of time and that feels great. I get the same feeling when I play the flute or piano – getting lost in creating an article feels more like creating art than simply writing a story.

And that brings me around to the "What goes around, comes around" theme today. Twenty years ago I wrote a research paper on vitamin A and cancer. Back then, scientists saw great promise in the carotenoids of vitamin A – through foods like broccoli – being able to reduce the risk of several types of cancer. I remember sitting at a glass-topped table in my parents' home pouring over dozens of books and medical journals I took out of the library. This was back in the dark days before the Internet -- no PubMed, no Google searches, no RSS feeds! I was fully immersed in learning all I could about the topic and figuring out the puzzle. I enjoyed every minute of research, even though I didn't even notice the minutes or hours tick by. Once I got a handle on it all, writing the 20-some page paper flowed easily. Yes, writing about science was what I loved doing. I got an A on the paper and soon after got hired as a bona fide employee of a national health publishing company.

A few years into that job, I found myself writing about vitamin A again. This time, it was a corporate report on the benefits of vitamin A for children in Africa. The vitamin easily could prevent blindness and even death – if only the children in Africa weren't nutritionally deficient in vitamin A. Each year I created the annual report on the company's vitamin A intervention program.

Well, I hadn't thought about all that in years. But as I talked with Jennifer yesterday, I noticed a study printout sitting on my desk about vitamin A possibly being able to fight rheumatoid arthritis. Last week, researchers in California at the La Jolla Institute for Allergy & Immunology found that retinoic acid (derived from vitamin A) could control inflammation by keeping the immune system from attacking tissues. It worked in mice, anyway, and time will tell whether it works similarly in humans and could lead to new treatments for RA and related conditions such as psoriasis or colitis.

In either case, vitamin A research is in the news again. I've been following it for years and haven't tired of it in the least. It's fascinating to see what scientists know and how it evolves over time. Yes, it can be maddening to hear that one day something is helpful and another day to hear that it's harmful. But picking up on those apparent flip-flops means you're observing science (and journalism) as works in progress -- you're part of it all.

Hopefully Jennifer is excited to start tracking subjects that interest her now; over time a few will pop up as her favorites, and she'll find herself losing hours to delving deep into some topics. Speaking of vitamin A and spending hours of research time again ... be sure to look at what I found regarding vitamins in the upcoming Sept-Oct issue of Arthritis Today. In that issue will be our 2007 Vitamin Guide with background information on the vitamins and minerals your body needs, as well as whether research showing any benefit for arthritis and related conditions exists. If you can't wait until then, you'll find nutrition information on our new and improved Web site: www.arthritis.org/ArthritisToday.

Keep reading... I'll (happily) keep writing!

Stuck

It's been a few weeks now since I've had to start dealing with gestational diabetes along with RA, pregnancy and autoimmune thyroid disease, but you know what? There's always somebody who's worse off. Unfortunately, it's my next-door neighbor – a little 3-year-old girl named Rebecca.

The day my obstetrician said I'd have to start tracking my glucose levels and meet with a nutritionist to get started on the strict low-carb, low-sugar diet, little Rebecca was in the hospital unbeknownst to me. She had been at a regular check-up with her pediatrician when something clued her doctor in to a possible high glucose level. They tested her blood right there at the pediatrician's office and found her glucose level was in the astonishing range of 400. (Normal is between 80 and 100 or 120 two hours after a meal). Immediately, they sent Rebecca to the hospital.

Sure enough, Rebecca was diagnosed with type 1 diabetes, or juvenile diabetes – an autoimmune disease, just like my rheumatoid arthritis and thyroiditis. For the rest of her life, she'll be on medication. She's now suddenly at a high risk of kidney problems, blindness and future amputation. And, like me, she needs to get stuck four or more times a day to have her blood glucose level tested. I don't mind needles and I can handle getting shots or an IV line. I've done it before, and I'm a big girl now. I can handle pain. But after several weeks of testing my blood sugar four times a day, my fingertips are sore. They have little black dots where the blood has clotted recently. The skin is cracking where I've hit the same spot more than once too many times. It's uncomfortable, but I'm 41 and can deal with it.

My first thought, upon Rebecca's return home from the hospital and hearing about her diagnosis was, "How is her mom going to hold her down to prick her tiny fingers or give her a shot of insulin?" But guess what. Rebecca is as big and brave as I am. The second day she was home – after an excrutiatingly long day where she and her parents were educated about her condition and what it would take to manage it – she ran over to my husband and said, "Want to see me test my blood?"

Amazing. Even at three years old, she knew that she has to endure this to take good care of herself. She knows the medicine makes her feel better. And, when her blood sugar is too low, she knows that sometimes she has to have a snack – even if she doesn't want to stop playing to eat it. She's out riding her little bike and running around the yard every day, and her parents are out there doing it with her. Their lives have changed forever, too. Rebecca's mom has changed what she cooks, and they've become stringent about the times that they eat. It's probably been harder on the parents than on Rebecca, as they learn to gauge what foods have the best effect and how much to balance the insulin and food to keep her steady.

They're doing what needs to be done because it's crucially important to take necessary steps – just as anyone dealing with a chronic illness must. The disease, like RA, will never go away, and if good care isn't taken, the toll on health will be great. As I thought about the coincidence between the timing of both Rebecca and I having to deal with diabetes, albeit on greatly different levels, I also thought about the children with RA I met at last year's AJAO conference here in Atlanta. Like children with juvenile diabetes, those with juvenile arthritis often need to endure needles daily. And they do. Like Rebecca, they know it makes them feel better. They know it lets them function better, which means play better or be "normal" at school. They adapt quickly and generally take it in stride.

As my pregnancy winds down, this year's AJAO conference will be gearing up. In two weeks, kids, parents and volunteers will be descending upon Hershey, Pennsylvania (one of the best-smelling towns on Earth!). They'll share their stories, find solace in people like them who can understand what they endure every day, and they'll renew their hope for the future. (Learn more about the AJAO conference by going to www.arthritis.org.) Above all, they'll have fun – and function – thanks to the medications that make them feel better. It's tough work, but it's worth it.

I'll continue to stick myself, watch what I eat closely and make sure I get out and walk and swim. And I'll think of all the courageous kids I've met each time I do.