SWEET DREAMS | Moshe Gordon
I have diabetes, but I am not fat. That wouldn’t be a thing to assume about anyone. Recently, I went to the hospital, super anxious, thinking I was having a heart attack. They asked me about my medical conditions.
“Diabetes —” I started to say. “Hypoglycemic then, fits with anxiety.” I heard the medical student in the corner mutter to her classmate. “Insipidus,” I finished, looking straight at her, watching for that flicker of confusion.
***
My twin sister, Angelica, also has diabetes. She has Type 1 Diabetes Mellitus. I remember the morning when Mom realized something was wrong. We shared a room back then when we were about seven. Angelica woke me with her vomiting, her deep panting breaths, her cries for water. I remember being annoyed that she had woken me up, jealous that she would not have to go to school. As Angelica was bundled off to the doctor, I reluctantly got dressed, Mom threatening severe consequences if I didn’t get myself to the bus on time.
We both wet the bed often in those years. The room was permeated with a fruity, sweet smell.
***
That morning was the first of many years of similar mornings. Mom would come in early to wake Angelica, to take her downstairs, to plan her day, pack her lunch, discuss every bite of carbs she would eat, and when and how and with what dose of insulin before and after, and what to do if something went wrong.
I would wander down half an hour later to pack my lunch, plopping my foul, damp sheets in the washing machine on the way.
So I was healthier than Angelica. And more independent: from my Mom, from insulin and from getting up to use the toilet in the middle of the night.
***
I suppose I wanted to be independent from gravity too. What a burdensome nuisance to be shackled, eternally in one place or circumstance. So I biked off the top of the Big Stairs near the park, heaving on the handlebars, asserting my control over this scrappy metal contraption.
I busted up my brain — the hypothalamus part of it.
“The doctors are saying you now have diabetes,” Mom started to explain. I felt a strange twang of emotion.
“Insipidus,” she continued, and I felt another, but different.
***
Insipidus, it turns out, means flavorless, unlike mellitus which means sweet. Angelica has the sweet diabetes, an auto-immune disorder, her poor body attacking its own pancreas leaving her without insulin and too much sugar in her blood. Sometimes, when she doesn't take enough insulin and her body can’t feed on the heaps of sugar in her blood, it starts to use her fat for energy. This somehow makes her blood full of acetone, which comes out in her pee, smelling sweet.
I have flavorless diabetes. My stupid daredevil stunt broke my brain’s ability to secrete ADH, a hormone that reduces urine volume, so now I’m always peeing too much, not just at night.
But it's plain smelling urine. Even her pee is sweeter than mine.
***
Years later, Angelica was reminiscing to me, filling in memories about that day which apparently had been knocked out of my brain along with my hypothalamus. She said I had biked ahead of the rest of the family who had all stopped to check her sugar levels. Angelica had thrown a fit about not wanting to use the finger stick, since she was wearing white and was afraid it would get stained, but this was all a ploy - she just didn’t want the sharp, biting pain of the cut, and the ugly band-aid to follow.
I had biked ahead, impatient. Angelica remembered looking up at me, seeing the red flash of light glint off my plummeting Mongoose, as I shouted, “Mom, look!”
***
Once, at a roadside diner, Angelica said she was thirsty. That was a whole fuss. Maybe she took too much insulin? Maybe too little? What had the doctor said again? Where are those notes I took?
Mom, I’m thirsty too. All the time.
***
That was all years ago now, and I don’t think about any of it. Until last night, when the power went out, and I baked in the stifling summer heat, waking in a disgusting, damp tangle of sticky sweaty sheets. I’m middle-aged now, I live alone and work alone. But these warm, wet sheets, so viscerally familiar —
I felt like I was dying. So I went to the hospital.
***
The med student in the corner does not look confused as I had anticipated. I think she is trying to conceal delight. After they reassure me I am not having a heart attack and have me sign papers saying I’m refusing further care, they let the med student loose.
She says she wants to interview me. She tells me about the practice of asking about — and learning — a patient's story, of understanding the totality of their health experience. She tells me about an ad in the subway that — alongside an image of a broken train track — says:
Don’t let diabetes de-rail your life. Control your blood sugar.
She finds this triggering because — Oh, haha — I have diabetes insipidus too, she tells me, starting to look a bit uncomfortable, not knowing what to say next. Anyway, I want to hear your story. I really want to know everything about your experience. Her eyes, shining pools of water, reflect genuine, focused interest.
And I am so excited, I might just pee my pants.
Moshe Gordon is a second-year medical student at Albert Einstein College of Medicine.