Abstract
Raymond is a lean and weather-beaten 75-year-old, with the slow movements and deliberate conversation of a man who has spent his life among cows. He was in his work clothes when I visited the farm, and the pale scar left by an aortic valve replacement showed beneath his shirt. His exercise stress test had been normal, however, and I struggled to keep up as we headed across the pasture to inspect his beloved dairy herd. Raymond developed diabetes 58 years ago. The surgeons found healthy coronary arteries when they did his valve replacement in 2004, and he has no proteinuria or retinopathy. Like all farmers, he complains of his back. As we walked among the herd and he instructed me in the finer points of bovine anatomy, I thought of all the young people who developed diabetes in 1950 and are now in their graves. We stooped to examine a mysterious swelling on one of the animals, but I could only wonder: Why you?
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