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[IPk] Hope, The Understated Gift

I recently read this article in Countdown, the magazine of the Juvenile
Diabetes Research Foundation <http://www.jdrf.org> It's by Paul Andrews,
and American in his early 30s who was diagnosed with Type 1 diabetes in


The nights are hot and dry and close at Kate's mother's house outside
Boston during the week before Christmas. It's hard to get to sleep because
we're still on Californian time. My blood sugar level is seesawing
unpredictably, and even though I'm keeping detailed notes and searching for
patterns, it's impossible to untangle all the variables: irregular exercise
during forays into the city, restaurant dinners of uncertain carbohydrate
content, stress, the new long acting insulin I switched to shortly before
the trip. I'm making adjustments at least once every night, and as I creep
around the small creaking house I have a familiar feeling. I know I am
already reacting to my blood sugars, rather than acting, already losing
control by small increments.

Whenever I lose my fragile sense of balance, things tend to get quickly
worse until causes and effects are confused. I wake parched, dragging off
my shirt, reaching for the bedside lamp, the glucometer, the water glass,
the insulin for a couple extra units of humalog to bring my sugar down. Or
I over-compensate, my sugars fall dangerously low, and I struggle from
tell-tale nightmares soaked in cold sweat. I don't need to waste a test
strip to know I'm close to passing out: thoughts form slowly, it's hard to
breathe, my heart is racing, and darkness is starting to nibble at the
edges of my vision as I gobble glucose tabs while Kate sleeps oblivious
beside me.

So most mornings on this holiday, my eyes are bloodshot and my wits are
dulled, my feelings blunted and subterranean. I keep my growing sense of
failure to myself and try to stay sociable and cheerful. It's all worth it
I tell myself: we're seeing old friends and family, visiting familiar
places that feed our souls. But the fact is, a vacation is too often a time
when I must be more vigilant than ever, when my secret self with diabetes
claims more and more attention, growing jealous and vengeful that I've
dared imagine even the smallest escape. Several times it occurs to me that
the only real hope for regaining control would be to lock myself in a room
with my glucometer, a schedule written in stone, a pile of Powerbars, and a
Stairmaster - and refuse to emerge until we fly back to San Francisco.

On Christmas day Kate's Aunt Lena and Lena's husband, Mike, arrive for
dinner. I know that Mike - a quiet autobody specialist in his mid-50s - has
had Type 1 diabetes most of his life, but he's always been reserved around
Kate's talkative family, and we've never spoken of the subject. After
dinner all 10 or so of us head out for a walk in the cold before dessert.
We straggle past houses with packed driveways and warm lights glowing in
the windows, and then meander along the fairway of a nearby golf course.
Kate's mother tells me the grass is still bright green because of a weirdly
warm autumn, and I think to myself that the global climate seems as out of
balance as the sugar in my bloodstream.

As we approach the house, Mike falls into step with me at the rear of the
group, and when the others file back inside he hangs back and I follow his
lead. We remain standing alone like conspirators in the empty suburban lane
as dusk thickens under a heavy gray sky. Then he asks me how my diabetes is

He's had diabetes far longer than I, and if he thinks it best to handle it
discretely, then perhaps he knows best. In answer to Mike's question, I
tell him my diabetes sometimes takes a lot of effort but I really can't
complain. I want to trust in his curiosity, but I'm used to keeping my
struggles to myself and I'm careful what I say. Mike tells me he guesses
his diabetes is okay, too. I want to ask: Does he have any complications
like kidney or heart disease or retinopathy or nerve damage after all these
years? But I don't. If he says he's doing fine, then perhaps he really is.
Even with other people's diabetes, I'm never quite sure what constitutes
honesty: the subject's huge and complex, and each of us has a personal
relationship to it, a series of private stories we tell ourselves without
ever quite knowing if they'd make sense to anybody else.

So we stand there muttering back and forth, like two souls on the edge of
an ocean of experience, unable to put out to sea. But at least - in out
stilted masculine way -- we're talking about it, which is more than I have
done all week except with Kate. Mike pats his stomach and says he needs to
lose some weight, and I jokingly suggest he get a dog so he'll be forced to
take more walks. He chuckles quietly.

I know we're delaying the start of dessert, and I wonder what the others
are thinking as we stand together out in the cold. But for some reason I
want to keep talking, so I tell Mike about I've been doing a lot of
research online lately into the search for a cure and it seems like real
progress is being made. In response, Mike tells me a brief story: When he
was diagnosed more then 40 years ago, he went to the Joslin Diabetes Center
in Boston, and there he met the famous founder, Eliot Joslin, who was then
a very old man. Joslin told Mike that all he had to do was hang on and
never give up, because there would certainly be a cure within his lifetime.

"So," Mike now says with another of his quiet laughs, "I'm still hoping." I
know Mike is a New England stoic, a person accustomed to keeping his
feelings to himself, but I can tell he really means what he says. He is
still hoping, and as we go inside, I'm grateful for his understated gift,
and curious about the other things he could have said.

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