It took me almost a decade after I met Rex to really know him; or perhaps more accurately, I might say I knew Rex for almost a decade before I ever met him. The first ten years I was his endocrinologist, he was not Rex, the confident, outgoing, hard-working, healthy young man successfully juggling college, managing his diabetes, and working several jobs to pay for college; he was Rose, the withdrawn, isolated, depressed teen-aged girl struggling with, among many other things, her diabetes. When Rose came to the diabetes clinic, she would politely and reluctantly indulge me as I instructed her on the importance of taking her insulin, counting her carbohydrates, and checking her blood sugar levels. I would sometimes make it all the way through the lesson before her eyes glazed over, but more often not. I worried about her long-term health and felt that I was failing her as her doctor. I attributed our failure to connect to our vast differences in age, ethnic background, and socioeconomic situation. She connected better, I think, with one of our nurse practitioners, although she continued to struggle with depression, with a lack of motivation, and, of course, with her diabetes … Address correspondence to Stuart A. Weinzimer, MD, Department of Pediatrics, School of Medicine, Yale University, PO Box 208064, New Haven, CT 06520-8064. E-mail: stuart.weinzimer{at}yale.edu