what can i say?
i think some people like to pretend they are living under rocks. was he just being plain insulting to the 'rest of' the world? was he just assuming that because a particular group does something differently than what he would define as a 'goal' it is therefore not a goal?
my point here is to comment on how vitally important it is to collaborate in anthropology, as collaboration is key to life!
when we feel that there is a problem that needs to be solved, we go out to find a solution, no? no one likes to merely be 'told what to do.' i can tell you from community health work in africa that people want you to work with them. no one likes to be viewed as some little person in great distress that is being saved, eh? i don't care if you're dying of AIDS, you want to be treated with dignity and respect, with your major issues viewed as target areas of the greatest need. help me help you, right?
i'm talking about this because diabetes (both type 1 and 2) are a prime example of how important collaborative healthcare is. providers must work with each patient as a different individual with a different diabetes than the next person.
because in reality, not everyone can or wants to be a member of Team Type 1.
and so, yes, i think everyone 'has a goal.' we all live for something, even if it's you filling your emotional void with donuts or cocaine.
ethnic, cultural, socioeconomic, and gender (!) differences all play a role in how people feel, think, act, react, respond, and live with their disease processes.
from a medico-cultural anthropology standpoint, this could get overly intellectual and academic. but let's just try being human:
accept others and try to understand their worldview perspective and life situation. work with that person for who they are. you get a lot further in helping them to define their own idea of wellness if you try to start from a sense of collaborative and holistic health. then all the straightforward 'this is what your disease is and this is what you must absolutely do to stay alive' stuff will easily follow.