As I come to the task of summarizing the inaugural ceremony for the Joslin Diabetes Affiliate at Southeast Texas Medical Associates, I feel more than inadequate. It is impossible to estimate the value of this day without appearing to exaggerate. First, that estimation would address SETMA's staff both in their preparation for the day and in their participation in that day. Three individuals were singled out for special recognition for their contribution but there were dozens who could have just as easily been applauded. The preparations for the day to go smoothly were extensive and required SETMA's full team but the preparations for making the day possible were years in the making.

Proud of our staff for the invaluable character trait of kindness

One of our inauguration guests made the following comment, "It really was a privilege for me personally and NextGen as your partner - by the way all your staff I met and watched were extremely courteous and helpful especially to the diabetic patients who came  Many were somewhat disabled and your staff made them feel at home." My estimation is that, "This comment is the highest possible praise for SETMA." I am reminded that on the 100th anniversary of the birth of Albert Einstein, a remembrance was held, and the consistent comment that his neighbors had of him was, "He was kind."  That was particularly related by a young boy who lived next door to Einstein.  Each afternoon, Einstein would sit and teach him mathematics.  He was in the third grade!!! In his life Einstein said, "The ideals which have lighted my way, and time after time have given me new courage to face life cheerfully, have been Kindness, Beauty, and Truth. The trite subjects of human efforts, possessions, outward success, and luxury have always seemed to me contemptible."

I agree with Einstein (an amusing idea) and I would give an employee a commendation or reward quicker for an act of kindness than for brilliance; and, I would quicker dismiss an employee for rudeness and meanness than I would for a mistake. I offered to SETMA's employees before and I offer to them again my gratitude, "Thank you, ALL, for making us ALL proud of you November 30, 2010.."

It is about you!

It was stated in the ceremony at the very first and it is absolutely true, this day was not really about SETMA or even Joslin but it was about those people who live courageously every day with a complex disease which requires their total dedication in order to live with it successfully. Who of us would not put at the top of this remembrance, Jack and Barbara Isaacson? Seeing Jack wear his Joslin 50 Year Medal - awarded for living 50 years while taking insulin - was as moving and as demonstrative of courageous and bravery as seeing a soldier wearing a Medal of Honor, or a civilian wearing a Medal of Freedom. Those of us who had dinner with Jack on Monday evening, November 29th, and who saw his tears as he related his gratitude for the advances in care and in the tools of that care which he has experienced over the past 50 years of living with diabetes, cannot help but be moved and challenged to renewed and deepened commitment to excellence in the care of those who have diabetes. Noteworthy, Jack did not lament having had diabetes; he did not complain about the health problems he has had. He was grateful. Kindness and gratitude!!! Not a bad formula for a successful life. The Medal and Jack gave us an emotional and spiritual connection with Dr. Elliott P. Joslin, whose work and legacy made our inauguration day possible.

Joslin

Four things continue to challenge me about Joslin Diabetes Center and they are not even Joslin's illustrious place in the care and research of diabetes. Those things are:

1. Their humility in affirming what they know; addressing what they think, and their forthright honesty about what they do not know. Contained within this is their insatiable appetite for learning more and their delight in partnering with those who wish to learn from them with the spirit of, "We want to learn from each other.
2. Their generosity in treating like colleagues those whose distinction, academic credentials and achievements neither match nor approach theirs. The amazing thing is that they want to teach, but they also want to learn from those they teach.
3. Their spontaneity of recognizing the value and potential benefit of those described above and to invite them to join their team in the join commitment to advancing the treatment and care of patients with diabetes.
4. Their optimism. In two, four-and-a-half-hour sessions without a break, our new Joslin colleagues taught me and my SETMA colleagues. The theme of those nine hours of dialogue was the title of one of the sessions, "Everybody is doing better than you think." The idea is that patients with diabetes need to know that they are doing better than most measures indicate they are doing. It is often said that the most common cause of blindness is diabetes, but that statement is NOT true. The truth is, "Diabetes is the cause of.....NOTHING." It is "uncontrolled diabetes" which is the cause of complications but with proper medication and careful attention, patients with diabetes can and do live normal lives.

SETMA is proud of our affiliation with Joslin, even as we are humbled by it. We are confident that in the coming years we will be better because of it. And, we are all committed to the diligence, continual learning and excellence required by it.

The Ceremony

Everyone agrees that beyond Jack Isaacson's Medal Award, the highlight of the ceremony was the keynote address of Dr. Martin Abrahamson, Chief Medical Officer and Senior Executive Vice President of Joslin Diabetes Center. The superlatives which have been used to describe his contribution to the event are so magnanimous as to defy belief, but they are all true. We are all delighted that the event was professionally videotaped and that DVDs will be available soon. We will transcribe and publish his address on our website. Thank you, Dr. Abrahamson, for giving your time and friendship to SETMA. It will always be a moment of pride in SETMA's history that you attended this event and that you shared Joslin's vision with our community.

Ms. Carole' Mensing presentation of a copy of the book, Elliott P. Joslin, MD: A Centennial Portrait by Donald M. Barnett, MD, was both a gift and a challenge. The inscription states, "Dr. Holly and Team - To a Champion in the cause of Diabetes," signed by The Joslin Team - November, 2010." This book will go into SETMA's archives with the memories of other seminal moments in our history. Two quotations from this book will always guide our steps; they are:

"How can we measure the success or failure of a diabetic career? Any standard has its deficiencies, but if a diabetic with his disease can live longer than his neighbor of the same age without it, I consider that he has attained a distinction, and should be recognized as outstanding." Elliott P. Joslin - 1930." (page 84)

"In 1962, in the last week before he died, apart from seeing about 15 patients and dictating 20 letters a day...Elliott Joslin never gave up. He seemed to be forever pursuing his mission. In his last textbook he had said:

"'With a missionary zeal, one must convert not only the patient's mind and soul, but also his doctor to the realization that it is worth the effort to control the disease as shown by the sugar-free urine, normal blood sugar and cholesterol.'

"A framed picture belonging to Dr. Joslin was discovered several years ago stored in the hall closet of his son's...home. It was a large portrait of the 17th century "English preacher, John Wesley. Their similarities are many. Wesley and Joslin were both missionaries. By train, ship and later by plane, Joslin and his disciples traveled with a set of 'Scriptures.' -- Joslin's revised Manual and textbooks. They preached Dr. Joslin's gospel: 'Right living with attention to daily detail of exercise and a sparse diet control the threat of many diabetic complications.' Or, as he would also say: 'control of diabetes pay.'

"Ironically, it was exactly one century later (1993) from the time that Dr. Joslin present his first paper on diabetes as a medical student, that the bitter controversy over controlling type 1 diabetes was settled. That year the Diabetes Control and Complications Trial (DCCT) was published. It proved beyond a doubt that intensive diabetic treatment blocked or delayed complications; depending at what stage the disease was studied.

"Perhaps the next century will have as effective an educator as Dr. Joslin - one who 'rides' the Internet or travels as incessantly for that common purpose, as EPJ stated it: 'To study diabetes and care for persons with the condition.' And perhaps that person will expand Dr. Joslin's dream and find a cure.

"The words of Wesley state correctly the essential ingredients of EJP's long career:

"Do all the good you can,
"By all means you can,
"In all the ways you can,
"In all the places you can,
"At all the times you can,
"To all the people you can,
"As long as ever you can.

"John Wesley's rule" (pages 85-86)

Few things enrich our lives as reading, and, in our own way emulating the lives of great men and women; whose lives are always marked by one thing: selflessly serving others.

The inauguration ceremony was really a three-day event for SETMA and Joslin. Drs. Richard Jackson, Director, Medical Affairs, Strategic Initiatives, and Kenneth Snow, Director, Medical Programs Strategic Initiatives, along with Joslin leaders Ms. Carole' Mensing, Manager for Clinical and Education Programs Strategic Initiatives, and Loren McLean, Operations Manager Affiliated Programs, in addition to making meaningful contributions to the formal ceremony conducted the last steps in the process for all SETMA providers becoming Certified Joslin Primary Care Providers. It would have been my desire if all of SETMA's staff and all of our community had had opportunity to sit in, to visit with and to learn from these exceptional people.

Ted Carpenter and TexanPlus

Mr. Ted Carpenter's, President Medicare Advantage TexanPlus HMO, kind words about SETMA and the presentation of Universal American's $150,000 contribution to the SETMA Foundation was one of the high points of the occasion. The confidence in SETMA and the approval of our mission represented by this gift, in addition to the potential benefit to our patients, made all of SETMA very proud. TexanPlus' subsequent publication of congratulatory, full page ads in The Examiner and in the Beaumont Enterprise was a special treat and surprise.

We are grateful for all who came to celebrate with us and particularly thank Mayor Becky Ames for participating.

The Future

More will be said about this event and about its aftermath but these preliminary thoughts are an attempt to say, "Thank You," to so many and to pledge SETMA's future to the achievement of the promise and hope of this day and to pledge our best effort to be worthy of the designation as an Elliott P. Joslin affiliate.