Beating the Numbers Racket

Thuy D. Bui

“What’s my number?” shouted Betsy as I entered the examination room one day last fall.

“Oh, you mean your A1C? It’s nine-point-four!” I answered. A sentence sped through my mind: “The hemoglobin A1C number tells how well a patient’s diabetes is controlled–seven or less is good.” In my seven years as Betsy’s primary-care doctor, I’ve repeated this information at visits and included it in appointment reminders as well.

Betsy is a pale, stocky woman in her sixties, with short, neatly cropped hair. Her rather tentative smile, to me, always seemed a bit forced, as if covering up for underlying pain. And she’s had plenty of pain in her life.