Diabetic Me by Sean Stiny

Summers growing up I would swim in the Governor’s Mansion pool in those oppressively hot Sacramento evenings. My father, a museum curator, had the keys to this palace in the mundane heart of the Golden State. He’d hush us quiet so not to be heard over the tall hedges and stucco fence running parallel to H Street in midtown.

It was a fine childhood, unmarred by want or pain nor household angst. My life was linear, organized, as it often is to a child. At eighteen, just as the embers of adolescence were cooling, disease planted its flag in the duration of my life.

When I walked into the Kaiser hospital in May of 2003, it was a buzzing Friday afternoon. Geriatrics were shuffling in line and mothers were cooing to newborns. In the endocrinology wing a sign on the wall read, ‘You don’t have to lose your leg to diabetes.’ I wasn’t losing my leg that day, but rather a life free of needles plunging the depths beneath my skin. The truth of morbidity and an organic existence declared itself with that first needle into my abdomen.

I must’ve stabbed myself twenty thousand times by now. My dagger, a 31 gauge syringe into my pin cushion belly. The clear liquid that fills the plunger smells like a Band -Aid. One of those flesh colored ones.

Juvenile diabetes struck me hardly as a juvenile. At eighteen, my pancreas went kaput and tethered me to a regimen of self dosing. Type 1 Diabetes. Diabetes Mellitus. This was my gateway to adulthood.

The back of my refrigerator sits labeled the box of swine insulin that keeps me slowly alive. It’s behind the lettuce and lunch meat. Insulin not synthesized in a lab, but grown in a pale bulging stinking pig.

Twenty thousand injections. Each one a vestige.

At present, it looks like a have a plum beneath my skin southwest my naval. The end of my needle burst a blood vessel some weeks ago. The pigment is slowly returning to this blood-addled fruit. My wife sees glimpses of it. Any disgust she keeps in silence.

My mother had a handwritten chart of all the foods I frequented and their corresponding carbohydrate count. Campbell’s minestrone soup, 26 carbs. Peanut butter sandwich (bread turns to glucose), 32 carbs. Beef jerky, 4 carbs. A handful of cashews, 8 carbs. 4 saltine crackers, 23 carbs. 1 popsicle, 22 carbs. I was told to count these carbs and calculate the correct units of insulin using my doctor-instructed equation. 2 units insulin to 15 carbs. It rarely works that seamlessly. Some foods are unmistakably harder. Pancakes, and their glut of carbs, really do me in.

Most diabetics prick a finger to read their blood glucose. I prick my forearm. It’s much less painful and annoying to me than the acceptable finger prick. My doctor admonished, “Do what works for you, blood is blood” soon after diagnosis, so I did and still do.

It took three months to reimagine the remainder of my life post-diagnosis. One full summer. What is there to gain through fifteen years of illness? Through an eventual lifetime.

The balance between food and insulin is the delineating difficulty of Type 1 Diabetes. I’m not supposed to figure out this equation, my failed pancreas is. My brain has to assume this role. It is woefully miscast.

The insulin I inject unlocks my cells and allows the energy-producing glucose to enter and do its job. Without that key, the glucose (sugar) floats around in my blood and meanders through my kidneys. In essence, the engine is circulating sludgy oil.

The pendulum of diabetes swings by injecting the right amount of pig insulin to cover the food I consume. And my diabetes has an insatiable appetite. A sandwich feeds it. A cookie really gets it excited. A soda, euphoric.

Too little insulin, my blood becomes stagnant with sugar (high blood glucose). This subsides in time. Too much though and it quickly reduces the glucose in my blood to a level of concern. In this state my blood carries not enough sustenance to my brain. The feeling of low blood glucose is fogginess. I quickly become disoriented, unfocused, sweaty, irritable. It feels like my mind is seized and fading away. Low blood glucose in the extreme can render me comatose. I’ve come close, but half a can of soda cures this in haste.

I read late into the night. Midnight, 1 o’clock. My mouth starts tasting of sour metal long after my wife has fallen asleep, I know my blood is rich with sugar. The taste is bitter and dry and rotten. The sugar flowing freely through my veins turns my blood to silt that needs dredging. The taste is proof that my dose was lacking.

To be frustratingly clear as well, Type 1 Diabetes is a much different disease with a much different cause than the oft heard Type 2 Diabetes. Type 2 comes from a sedentary lifestyle mixed with a sluggish diet. It’s often a family trait because families propagate a similar lifestyle. It’s nurtured.

Type 1 is purely genetic. Bad luck. Natured.

My wedding night I couldn’t get my blood sugar to go down. Too much wine and cake and merriment.

I do a two-insulin regime all days. One to simulate the release of insulin at mealtime, and another to simulate the slow drip of insulin throughout the day. The pancreas is a mostly forgotten organ until it thoroughly fails like mine, or is under cancerous attack.

It’s been fifteen earnest years of this. My disease is a teenager now. It breaks curfew, hangs out, puffs a cigarette, slams the bedroom door, rebels against my every effort. But we’re still close. We understand each other. One day it will outgrow me, go off to college, fall in love, leave me behind. It’s the natural order. I’ll give it everything and expect nothing in return.

Diabetes means siphon in Greek. Mellitus means sweet. Insula, island in Latin. My sweet little island. Alone on it I toil, an explorer lost at sea. Insulin is my gimbal, but it never quite steadies. Alone on my island, I brandish my red badge of courage until rescued, however that may be.

Insulin was discovered in 1921.[1] Long before that, it was noticed the urine of diabetics was particularly sweet. It would attract ants. Ancient Egyptians make note of it in papyrus manuscripts. In 2019 it comes in a glass vial, harvested in swine.

I make birdhouses in my spare time. In my attic. It’s a finished attic, large enough to walk around on the sheets of plywood nailed to the ceiling joists. Large enough to have a small woodshop and scatter a layer of dust over our storage boxes and Christmas decorations. The joints and angles cut by the blades are a small respite from corporate work and personal anxiety, from inquisitive needles and daily bloodletting. My mind is silent.

The miters I cut on the birdhouses produce an addictive pine fragrance. If it were a cologne, it’d be called Eau de Birdhouse.

I used to volunteer at various charity events for juvenile diabetes. Walkathons, week long camps (I was a camp counselor), black tie events for the JDRF (Juvenile Diabetes Research Foundation). Money was raised, hearts were lightened, hope was given. Diabetics sit around and trade diabetic stories, compare glucometers, tell tall-tales of uncontrolled blood sugars.

But my infirmity is a quiet one. It’s my tempest to take shelter. I bear a scarlet D that few can see. My family has some notion of it. My in-laws even less. The solitude of malignancy runs deep, like the cool brown Colorado River beneath the jagged sedimentary walls it has carved.

My wife and I would like to have a child. A happy bouncing baby to make our lives runeth over. Will she or he have my eyes, my nose, my thinning hair. My disease. Will I have to stick her or his soft little skin.

I lost my wedding band to a gurgling creek in big skied Montana. A small bend in the clear creek veiled a muddy bottom. I sunk waist deep in the mud and flailed the band right off my finger. It was loose anyway. I had surrendered a smidgen of weight after losing my job and bringing disquiet to my young marriage. I lost my ring and I cried. Right there, on that shore. In front of my brother.

That blessed metal is fused with the bed of that cold stream for the duration of time. Back to the earthen volcanic rocks from which it came. O’Dell Spring Creek near Ennis, Montana. It will wear thin the symbol of our union for the next thousand years.

What is there to gain through fifteen years of illness. Through an eventual lifetime.

I had eighteen years before I acquired this disease. In a few scant years I’ll have had this longer than not. The memories free of it are starting to yellow in the corners.

I used to think diabetes dissipates with love and understanding. Giving it space and recognition lessons its importance. That was wrong. I now know it dissipates with life. The ease of crisp air and blue sky, warm rain and breathless sun.

What is there to gain through countless years, an eventual lifetime, of illness?

Resiliency. Unexpected, surprising resiliency.

When my blood sugar rises it’s a high tide lapping the shore, eroding a little further each time. I could lie down and perish at any unintended moment. The quiet murmur of life is all I have. To impede that is inscrutable. Illness dampers that murmur not in the slightest. Rather, it deepens this journey which I have been thrust. I am resilient.

Life is ineffable and to divert its path, even disease, is careless.

What choice am I left. I’m thirty four. I’m thoughtful and sensitive and ambitious. Though, long before diabetes I bore these virtues. I am the emperor of all I behold.

I too am the emperor of my malady.

[1] http://www.diabetesincontrol.com/history-of-type-1-diabetes-treatments/

Sean Stiny, a Northern California native, studied English Literature at the University of California, Davis. He’s a writer and a woodworker and escapes outdoors regularly. He labors in marketing and lives with his wife, a third grade teacher, in Sonoma County. His work has appeared in Catamaran Literary Reader.