Eleven years of averages

For eleven years Rosa Nakamura’s care was organised around a single number reported four times a year. It is a useful number. It is also, as her clinician puts it, a photograph of a film.

The programme front-loads almost nothing. The first phase changes two things and no more, which most people find insulting for about three weeks and survivable after that.

The first twelve weeks

There was a plateau from about week twenty. Nothing was going wrong; the body had simply arrived somewhere and wanted to stay there for a while.

An average can look excellent and hide a week of chaos inside it.

Dr. Amara Oyelaran, endocrinology

What changed at review

Medication was reviewed twice, and on both occasions the change was a reduction. That is not the usual direction of travel and nobody in the room pretended otherwise.

“I was managing something I couldn’t see,” she says. “Now I can see it. That’s most of what changed.”