When I read EG Shields' essay "Blink Once" (Spring 2025 Intima), I found myself holding my breath. Her mother, silenced by ALS, communicates through eye movements—blink once for yes, shake for no. Hospital staff raise their voices as if volume solves everything. They don't take time to learn her language.

I know that exhaustion.

For fifty-eight years, I've lived with Type 1 Diabetes. My body speaks in tremors, in metallic tastes, in sudden collapses that look like laziness to people who don't know better. Like Shields' mother, I've spent decades translating myself for others—apologizing for leaving early, for needing to sit, for being tired when I looked fine.

Shields, an Appalachian-born writer and graphic memoirist, writes that her mother "hasn't been able to speak for years now, but I never think about how much she actually says." That line stopped me. Because I've said so much through my silences too. Every time I drove home from a party with the radio off, hands shaking on the wheel. Every time I apologized for not helping with dishes while my wife found me gray-faced on the couch. I was speaking, but no one had learned to listen.

What strikes me most about Shields' piece is the labor of communication under constraint. Her mother types painstakingly with her eyes, letter by letter, while technology fails and caregivers lose patience. I've done that labor too—explaining hypoglycemia to kids who thought I was faking, translating my body's demands to employers who only saw absence.

Both essays are about the same thing: the exhausting work of being understood when your body speaks a language the world refuses to learn and acknowledge.

Shields became her mother's interpreter. I became my own. The day I stopped apologizing—"I'm too tired today"—was the day I finally translated myself without shame.

Her mother blinks once for yes. I've learned to say yes to myself: yes to rest, yes to limits, yes to the truth that surviving what killed my friends deserves respect, not apology.

Shields writes about waiting for surgeons in the ICU, afraid to leave her mother alone. I've waited too—in emergency rooms, at the edges of parties, in the space between blood sugar swings—afraid that if I leave, no one will understand what my body is saying.

Now I speak for both of us.

Mark E. Paull was diagnosed with Type 1 diabetes in 1967 at age eleven. He has lived through nearly six decades of diabetes care evolution, from boiled glass syringes to modern technology. In the early 1980s, he worked as a diabetes educator, helping patients and families navigate chronic illness management. Paull has completed CME-accredited training in Type 1 Diabetes care and reviews manuscripts for Diabetes Care, and works as an educator and coach. His work has appeared in The New York Times, The Globe and Mail, Folklife, CHADD's Attention Magazine, The Good Men Project, Breakthrough T1D Canada, and The Times of Israel.

He is the author of “The Day I Stopped Apologizing for Being Tired” in the Fall/Winter 2025 issue of Intima: A Journal of Narrative Medicine.