I found the article "Heal Thyself or Die Trying"1 particularly interesting because my father, Richard K. Bernstein, MD, developed blood glucose while self-monitoring for diabetes almost 30 years ago. A Type-1 diabetic from age 12, Dr. Bernstein was beginning to suffer from diabetic complications in his 30's. Using a cumbersome, first-generation blood glucose monitoring device available only to hospital emergency rooms (to distinguish comatose diabetics from drunks), he learned to control his diabetes by appropriately titering his insulin and adjusting his diet. Although successful small-scale trials of his methods were conducted at New York's Rockefeller University, physicians remained reluctant to promote my father's approaches, which included adherence to a high protein/low carbohydrate diet and multiple small doses of insulin daily. Diabetologists feared the possibility of hypoglycemia (low blood sugars) in patients attempting to maintain normal blood sugars.
At age 45, my father left successful careers in biomedical engineering and management to attend medical school, to be able to better help fellow diabetics. He published his first book addressed to Type 1 diabetes while still in medical school. For the past 20 years, he has treated both Type 1 and Type 2 diabetics from across the globe, and he continues to publicize his approaches at medical meetings, in books, and in peer-reviewed articles.
Sadly, it is clear that self-experimentation may be the only option in a medical environment where legal risk to the physician is more important than potential long-term benefit to the patient.
Julie A. Bernstein, PhD
16 Willowbrook Lane
Max von Pettenkofer, the German scientist, a Renaissance personality, one of the founders of contemporary hygiene and epidemiology, cannot be forgotten when it comes to the history of self-testing as the ethical basis of research. On October 7, 1892, Pettenkofer gulped a glass of water containing a diluted culture of vibrio cholera during the epidemic of the disease in Hamburg. He wrote that man, who wants to stand above the animal, "must be willing to sacrifice even life and health for higher, ideal goods."2 The romantic era of science was in the air. Max von Pettenkofer defended with his spectacular experiment not only his erroneous theory of cholera epidemic, but laid the groundwork for the contemporary, endless balancing between an organism and the environment, cause and condition. Unfortunately, neither textbooks of microbiology, nor volumes of pathology and epidemiology books, even mention the Pettenkofer name.
Izak B. Dimenstein, MD, PhD
Loyola University Chicago Medical Center,
1. S. Jaffe, "Heal thyself or die trying," The Scientist, 17 :57, July 14, 2003.
2. W.G. Locher, "Max von Pettenkofer-Life stations of a genius on the 100th anniversary of his death (February 9, 1901)," Int J Hyg Environ Health, 203:379-91, 2001.