Managing Diabetes. Jeffrey A. Bennett

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      1

      Critical Conditions

      Besides, I think that the cicadas, who are singing and carrying on conversations with one another in the heat of the day above our heads, are also watching us. And if they saw the two of us avoiding conversation at midday like most people, diverted by their song and, sluggish of mind, nodding off, they would have every right to laugh at us, convinced that a pair of slaves had come to their resting place to sleep like sheep gathering around the spring in the afternoon. But if they see us in conversation, steadfastly navigating around them as if they were Sirens, they will be very pleased and immediately give us the gift from the gods they are able to give to mortals.

      —Socrates, Plato’s Phaedrus, 259A–259E

      As soon as you awake, the familiar pressure is there: Should you write or not? Yes, no, maybe. You heave your body out of bed, prick your finger, and squeeze a drop of blood onto the glucose meter. You shoot insulin into your stomach, eat, go for a walk. You concentrate on your feet touching the ground, on the blue stretch of sky, the roar of crashing waves, the pungent odor of guano. You listen to the environment as Don Juan urged Castaneda to do. Searching for analogies to your budding ideas, you scan cypress trees with twisted trunks, a flock of pelicans flying low over the water, breakers shooting up the cliff walls like geysers.

      —Gloria Anzaldúa, Light in the Dark/Luz en lo Oscuro

      The song of the cicadas murmured through the streets of Bloomington, Indiana in the summer of 2004. After 17 years hibernating underground, the creatures extolled in Plato’s ode to rhetoric, madness, and love trumpeted their return with harmonious fervor. I vividly remember walking past the trees that lined the path from Ballantine Hall to the parking lot behind the Kinsey Institute, distracted by their rapturous hymn. The cicadas’ ubiquitous and ethereal orchestration crescendoed from a subtle whisper to an intense reverberation in a matter of steps. They animated the branches by giving them a pulse, enlivening the atmosphere with an energy that was somehow both electrifying and soothing. The hum from the trees was nothing short of overwhelming, imparting the feeling that at any moment they might conspire to overtake the walkway and whoever happened to be occupying it. Though invisible, they loomed large, effortlessly altering the scene with their euphoric chorus.

      In ancient Greece cicadas represented spiritual ecstasy, rebirth, and immortality. Plato invokes the image of the cicadas in the Phaedrus to symbolize both restraint and honor, narratively crafting a link between personal control and dignity. Plato’s protagonist Socrates tells his companion, the book’s namesake Phaedrus, that they must resist the song of the cicadas, not succumbing to laziness, but practicing restraint against the pleasure-inducing cadence of the insects. Those familiar with the text know that Socrates is obsessing over his libido more than he is lauding some bugs in a plane tree. The storied philosopher reels in his desires for the titillating youthfulness of Phaedrus as he advocates for a disciplining of the passions and the virtue to be cultivated as a result. Socrates hopes that the cicadas will relay to the Muses his moderation and chaste disposition, and that he will be rewarded by Erato, the muse of love, and Calliope, the muse of rhetorical eloquence. Desires constantly encroach on Socrates, and he reproaches these temptations with overt gestures of self-control.

      The relationship between duty and pleasure, what scholars frequently denote as hedonics, is a recurring theme in this book, which is dedicated to the manifestation and circulation of diabetes rhetoric. The tension between earthly desire and the platitudes of well-being is one I learned firsthand when I was diagnosed with type 1 diabetes the same summer the cicadas were resurrected in southern Indiana. Just a few weeks after defending my dissertation (a study about the relationship between blood and politics no less), the droning from the cicadas continued to stir as I was hospitalized suddenly after lower-back pain left me unable to sit, stand, or lay down comfortably. The pain was unlike anything I had experienced up to that point in my life and it still haunts me when I have the slightest backache. Because I was unaware that I had onset diabetes, my blood sugar was unregulated, inciting a condition known as ketoacidosis. In short, my kidneys had begun shutting down. I was immediately admitted to the ICU and spent a dizzying 48 hours immersing myself in a new language, a new routine, and a new way of life.

      There were plenty of signs that trouble was on the horizon in the weeks leading up to my hospitalization, but they were not yet intelligible as something that might signify disease, illness, or however we want to classify diabetes in the medical order of things.1 For starters, I suffered perpetual exhaustion. Having just finished a dissertation, landed a job, and started the emotionally taxing task of finding a new home in a distant city while saying good-bye to my grad school kin, including my partner of just over a year at the time, I wrote off the fatigue as a by-product of stress. I was also terribly moody. Although I am a reliably easygoing person, I found myself regularly irritated. The hormonal changes that accompanied diabetes’s awakening left me undone, conjuring emotions that generally remained dormant in otherwise mundane situations. I had also lost a good bit of weight, but I tended to exercise frequently and was conscious of the scale, so again I attributed the weight loss to stress. When the doctors told me that I weighed a mere 120 pounds as a 5-foot,10-inch-tall man approaching age thirty, I was taken aback. The Greek word for diabetes translates to “siphon,” and the disease was living up to its etymological signifier.

      The weeks and months that followed diagnosis were accompanied by a steep learning curve about diabetes care, but also a newly found appreciation for gauging my body’s response to fluctuating circumstances. Like all people with diabetes, I learned how to count carbohydrates, test my blood sugar, and administer shots. The finger pricks and shots were especially confounding, as I had lived for years with a pronounced phobia of needles. So strong was this aversion that I refused local anesthetics at the dentist’s office before having my teeth drilled for fillings. One of the nurses working with me early in my diagnosis quipped, “A diabetic who doesn’t like needles—how’s that working out for you?” Of all the medical conditions that I could have landed, this one seemed decidedly cruel, as if I was the butt of some cosmic joke. Clearly, the cicadas had delivered bad news to the wrong muse.

      There were other complications that I could not foresee. Early on, my pancreas was still producing trace amounts of insulin (a normal phenomenon for those with type 1 diabetes) and when it interacted with the insulin I was manually injecting, it caused me to have unusual balance problems. I remember on one job interview shortly after diagnosis having a difficult time focusing on a senior scholar’s face as she posed a question. Although I was supposed to be answering her inquiries thoughtfully, I recall struggling to maintain composure and not embarrass myself during a dizzy spell. Driving and public speaking both became precarious endeavors because any mild change in heart rate or nerves left me unsure of whether my sugars were spiking or dropping rapidly. A friend from graduate school warned my partner to monitor me for depression, knowing that the first year after being diagnosed with a disease, chronic or otherwise, can leave a person despondent. I never pursued treatment or clarity about depression, worrying that any trace of flexibility in my concept of self would suggest that I was unable to contend with the multitude of changes I was juggling. Still, that first year I slept more than was normal, I lost time in ways I never had, and I became preoccupied with the life-altering ailments that awaited me. Assurances that “there are worse diseases you could have” or “things aren’t like they used to be” only made matters worse. In the years prior to the Affordable Care Act, I also worried that formal recognition of depression might be used against me in future health insurance matters. I grappled with the fallout of the diagnosis for years, consuming as much information as I could about cures (and some scientist is always curing СКАЧАТЬ