Diabetes

A week or so ago, while Chris and I washed and dried the dinner dishes, I made the following comment:  "Can you imagine?  My grandmother is forty-one years older than me."  All at once, the realization that I'm fifty years old, and that my maternal grandmother in Kelowna has lived fully forty-one years more than I have hit me in a way it hadn't before.  I couldn't imagine living as long as I have already and an additional forty-one years on top of it.  At the time, that seemed like an incredibly long span, although, if you asked my grandmother, who's never had a serious illness and who's never spent a day in a hospital except to give birth to her two daughters, she might say it's not long at all, that it passes in an instant.  

I looked at Chris then, and I asked jokingly, "Can you imagine spending another forty-one years with me?"  Of course, the question was intended to provoke him to make yet another comment about how tough it's been for him to live with me for the past seventeen years, let alone another forty-one.  Instead, he surprised me by saying he probably wouldn't be around that long.  He said that he'd be eighty-two in forty-one years, an age most people with type 1 diabetes don't live to.  Then he said that, in the unlikely event he did see it, he'd probably be blind, or have kidney or heart disease, or have some combination of his hands, arms, feet, or legs amputated.

What?

Chris and I have talked about the long-term effects of diabetes before; in fact, the subject's come up several times over the years.  But I guess it seemed like such a long time before anything awful could happen, as though we were talking about some dim possibility far into the future.  Only, we've both gotten older since then, and, more than ever, the future feels like it's right now.  

Where I used to be happy with how age manifested itself in my face and body--mostly, to a large degree, because it didn't, and because people used to say consistently that I looked as many as ten years younger than I really was--I'm now in tune with aging more than I've ever been before, and the reality has sunk in that my youth is long gone, that I'm less and less able to defy looking my age, and that I really will die some day, whether I believe it or not (oh, I believe it, more than ever).  And with that comes concern for Chris too, as we both grow older together, and as there's the very real possibility that we'll have to work through how diabetes may affect him, and us.

Feeling myself getting increasingly upset over what Chris had said, I thought for a moment and knew I had to say something, if only to try to make myself, and him, feel better.  "What do you mean?" I asked.  "You take care of yourself.  You're conscientious about your diabetes.  I thought if you managed your blood sugar levels with insulin over a lifetime, preventing the highs and lows, you could stop all those bad things from happening to you."  I needed reassurance from him that I was right about diabetics taking care of themselves and staving off the horrible and unthinkable consequences that we hear about happening to those in denial of their disease and of the need to take care of themselves in ways they never have before.  

"It's not that easy," he said, in that same matter-of-fact tone he uses when he talks about most serious things in life--like it's going to happen anyway, and there's little you can do about it.  The effects are cumulative, he told me.  It doesn't matter how conscientious you are about managing your diabetes, keeping your blood sugar levels within the normal range over time.  In the end, your body breaks down regardless.  All the fluctuations in sugar levels over a lifetime have an effect on the body, impact the organs, cause poor circulation.  Then, to soften the blow perhaps, he told me the same thing could happen to me too, as my own body grows older.  It was less likely to happen because I'm not a diabetic, he admitted, but it still could.  One never knows how age will affect one's body.

I must have been more sensitive than usual.  I'd heard all the words before, although maybe not these exact ones, but I hadn't really heard them. I knew how diabetes could affect the body over time, if it hadn't been managed properly.  I'd heard stories of people not taking care of themselves, eating whatever they'd wanted to, not getting proper exercise, not taking their pills or insulin with every meal to help in the processing of sugar in the blood.  And how they'd lost their eyesight, or went into kidney failure, or suffered heart attacks, or had parts of their bodies removed.

But I always thought that, if you were like Chris, and you worked hard to keep your diabetes under control, which he's done diligently since I've known him, you could prevent the long-term effects of the disease.  I always thought because of how conscientious he is, Chris would be one of the few fortunate diabetics to reap the benefits of his efforts, and that he'd be rewarded with a long and happy life, essentially unimpeded by the ravages of the disease, giving us many, many good years together as we both got much older.

That night, I learned what I'd assumed was wrong, that what I'd thought didn't guarantee anything; all the hard work involved in taking care of diabetes didn't mean you'd avoid any or all of the insidious aspects of the disease.  In fact, despite all the hard work, many of the more tragic consequences of having such a disease for the majority of your life couldn't be avoided.  It was perhaps just a matter of time before it started to manifest itself in some form in the body, necessitating drastic medical attention, and starting the downward slide to even more tragic consequences.

I was angry because I couldn't imagine any of the awful things Chris mentioned happening to him.  I looked at him standing in front of the kitchen sink, his hands immersed in the water, swishing a dishcloth around, washing one of the pots we'd used to make rice that night.  I looked at his right profile, the greying hairs on his temple, his short, trimmed sideburn, the four-days growth of beard on his cheek, and I saw the kid he was when we first met, when I was thirty-two and he was just twenty-three.  I saw the man he'd become, that I've spent a third of my life with, the man I want to grow old with, with whom I want to spend the rest of my life.

The more I thought about it, the angrier I became.  It seemed unfathomable that this disease he's had to deal with since just before we met could eventually take his eyesight.  That it could stop the functioning of his kidneys or lead to heart failure.  That it could necessitate the removal of a part of his body that he now counts on to do such mundane things as stand and walk, shower and shave himself, eat and, yes, wash dinner dishes.

For a moment, I imagined myself having to take care of him, which we've joked about over the years--who will have to take care of who first?--and which there could be no question I would do.  But, in that moment, standing in front of the kitchen sink, both of us still relatively young, healthy, and vital, I couldn't see him as anything less than he is now--didn't want to see him as anything less than he is now--without being filled with so much sadness and so much anger and so much pity that the tears would come, and keep coming, because I wouldn't be able to stop them.

I couldn't imagine this man that I love as fully and as deeply as life itself in a position of being dependent on me in any way.  I couldn't imagine our lives any different than they are now, despite the two of us getting older and having to work through the effects of aging on our minds and bodies.  I couldn't imagine that he would be diminished in any way, and I never wanted to see that happen.  I wouldn't know what to do with myself if I ever did.

"Mary Tyler Moore is a type 1 diabetic," I said to Chris then, grasping defensively at what I could, "and, as far as I know, she hasn't faced any of the consequences of the disease that you mentioned."  Of course, I couldn't say that for sure.  The last time I saw her was on the "Oprah" show, maybe a year and a half ago, when Oprah did a "The Mary Tyler Moore Show" reunion, and she looked good, particularly for seventy-two, and seemed to be in good health.  But how could I know for sure what she was going through as an older woman who had battled diabetes for most of her life?  And she was seventy-two, not eighty-two, which Chris had mentioned, referring to himself.  I prayed the comment I made in haste was right.  "Do all diabetics suffer awful consequences?"

"Not all," Chris conceded.  "But most do.  It's life."

His comment was too cavalier, too thoughtless, really.  Why wasn't he angry, I wondered, as angry as I was?  Why did I seem to be more upset about him suffering long-term effects from diabetes than he was?  That didn't seem right.  Surely he didn't want to get sick and lose his quality of life.  Surely he didn't want the life we share together now to be affected by this disease he has no business having in the first place.  Surely he knows how devastating it would be if any one of the dreadful things he'd talked about happened to him, let alone several of them.  Why can't things stay the way they are now, I wanted to yell out at God?  Why do we have to get old and sick and die?  Why does Chris, the most patient and sweet and wonderful human being I know, and the man I love so much, have to have diabetes?  He doesn't deserve it.  Nobody deserves it, really.  

For now, all I have is what all of us have when it comes to the long litany of horrible things that can happen to us during this human experience on earth:  Hope.  Hope, in Chris's case, that he will die many, many years from now, of something completely unrelated to diabetes, that he'll be one of the fortunate few spared from its devastation.  None of us know our fate in life.  And I can't help but think that's a very good thing.  Which one of us wants to know that we'll get cancer when we're sixty-one and die three years later from it?  Which one of us wants to know we'll die of a heart attack this weekend when we're at Save-On Foods buying our grocery items for next week?  Which one of us wants to know we'll have a stroke when we're eighty-one and be paralyzed for the next five years, suffering several more strokes until we're mercifully taken?  We're blessed not to know how we'll die because, otherwise, I can't help but think we'd live our lives differently, constantly worried about that end time and what it'll be like.  

Life is strange.  I worry about what will happen to Chris, but, in fact, something could happen to me first.  After all, I'm nine years older.  I try to take care of myself, but you never know when something you inherited genetically will do you in.  You never know when you'll be involved in some freak accident.  In short, you never know when your time is up.  All any of us really have is today, and, if today, you find yourself in good health, and the person you love is in good health, too, and you're both able to enjoy each other's company and take advantage of your usual quality of life, you need to make the most of it right now.  Because no one knows if what we take for granted today will be irrevocably changed by something that happens tomorrow.