-FOUR-
“Well, young lady, welcome back to the real world.” The first thing Rachel saw when she opened her eyes was the face of a man dressed in white. He had perfectly groomed, sandy blond hair and a neatly trimmed beard. He smiled down at her and said, “I’m Dr. Malar. You’re in the hospital and you’ve been a pretty sick girl. But you’re going to be all right.”
“Where are my mom and dad?” she asked weakly.
“Right outside the door,” he assured her. “I’ll get them.”
When her parents entered, Rachel couldn’t believe how tired and worried they looked. Her mother hugged her tightly. Rachel could see that her eyes were brimming with tears. “Hi, honey,” her father said gruffly. “Dr. Malar said you’re going to be fine.”
Rachel felt very confused. Vaguely she remembered strange voices and bright lights and odd smells. “What happened to me?” she asked weakly.
Her parents glanced knowingly at each other. Dr. Malar stepped forward and took hold of her free hand. The other one was pinned to her hospital bed with a tube running out of it.
“The technical term is ketoacidosis. It’s the last stage of the disease diabetes mellitus.”
“What?” Rachel asked. “What are you talking about? Am I going to die?”
“Goodness, no,” Dr. Malar said quickly. “But you’ve got a lot to learn over the next week or so. Right now, get some rest. We can talk more later.”
Questions. She had a hundred questions. But suddenly she was very tired. She did feel better knowing she wasn’t going to die. Yet the look on her parents faces told her they weren’t nearly as convinced as the doctor.
“Two days?” Rachel asked. “You mean I’ve been here two days already?” It was evening, and Dr. Malar sat on her bed flipping through a chart with her name on it.
“That’s right,” he confirmed. “Diabetic acidosis is very serious. It often leads to coma. But we’ve got you stabilized now. In fact, tomorrow morning I’m going to put you on real food instead of just that liquid stuff dripping into your hand.” He motioned toward the IV.
“When can I go home?” she asked.
“Whoa, lady,” he said, smiling. “First things first. You’ve got a lot of things to learn over the next week . . . maybe even ten days.”
“But school . . . a–and my ballet classes—”
“Don’t worry. You’ll be doing all those things soon enough. But first you’ve got to learn how to take care of yourself. You’re going to meet a lot of people during the next few days. A dietician. My associate, Ann Simon. Nurses. Even some other kids with diabetes.”
“But why? You said I was going to be fine.”
“And you are. But diabetes is a life-long condition. You’ve got to learn to manage it. To control it. To take care of yourself. That’s why we keep you here for a while. We want you to feel confident about taking care of yourself when you go home.”
“How will I take care of myself?”
“Proper diet. Blood-sugar testing. Exercise. And naturally, daily insulin injections.”
“Shots?” Rachel asked with a lurch forward. “You mean, I have to take shots every day?”
Dr. Malar nodded. “Twice a day,” he said.
“Oh, but I can’t! I won’t!”
“Yes, you will,” he said sternly. “You’re a type 1 diabetic. That means that your pancreas has stopped manufacturing insulin altogether. And without insulin, all the food you eat can’t be used by your cells. Look,” he explained, “insulin acts like a little key. It opens the door of your cells and allows glucose—that’s another name for sugar—to come in and be used by your cells as food. You don’t make any more insulin. Therefore, all the food you were eating was being turned into glucose, but it had no place to go. So, it built up in your bloodstream. You were thirsty all the time, right?”
“Yes,” she confirmed.
“And you went to the bathroom a lot?”
“Yes.”
“That was your body’s way of trying to flush out the glucose. That’s why you kept losing weight. Your body started breaking down fat and protein for energy. You started building up acetone—you even smelled like the stuff. You know, fingernail polish remover? Finally, the job became too big and your system went into ‘tilt’ or ketoacidosis. You were very sick.”
“But why can’t I just take pills? Why shots?”
“Because pills are for people who make some insulin, but not enough. You don’t make any. Daily injections are the only way to get insulin inside you. Twice-daily injections mean better control.”
“But I just can’t stick myself with a needle!” she whispered.
“Look,” Dr. Malar countered, “there are over eighteen million diabetics in this country. Two hundred thousand of those are kids. And they all get shots. The majority give themselves their own injections. Because without insulin, you will die. It’s as simple as that.”
When her parents came to see her that night, Rachel’s eyes were still red from crying. Why was this happening to her? It was so awful. Two weeks before, she’d been a normal thirteen-year-old girl. Now she was a freak— someone who needed shots and special diets and “managing.”
Her parents looked very worn-out. But she didn’t care. It was happening to her, not to them. How could they possibly understand?
“How did I get this thing?” she asked them. “Did I catch it from someone?”
“No,” her mom began. “I’ve been doing some reading about it. It seems it’s a hereditary illness. I can remember an aunt of mine having it. And Grandmother, too, for about five years before she died. But she was over eighty.”
“The doctors say that there’s a virus involved, too,” her father added. “You have to have the genes for it, but a virus is involved.”
“Well, I hate it!” Rachel cried out.
“Oh, honey, we know. We’re so sorry.”
“Do you know that I have to take insulin shots for the rest of my life?” she sobbed. “That I’m never going to get well?”
“Yes,” her father said. “But Dr. Malar assured us that diabetics can lead normal lives. As long as you take care of yourself, you can do all the things you did before. Dr. Malar is a pediatric endocrinologist. The best in Miami. He’s going to be supervising you and taking care of you.”
“I don’t care,” Rachel said angrily. “I hate it! And it’s all your fault that I have it!”
Rachel sat on the side of the bed and stared at the insulin syringe. The needle was very short, but it looked a foot long to her. Dr. Malar and his assistant, Ann, stood next to her.
Ann had shown her how to draw up the insulin into the syringe. How to thump out the air bubbles and check for accuracy. Ann had even drawn up a syringe of saline solution and injected it into herself.
No doubt to show me “it doesn’t really hurt,” Rachel thought sarcastically. But she asked aloud, “Will it hurt?”
“Yes,” Dr. Malar answered. “Some. Insulin stings a little going in. But you’ll get used to it. Try not to tense up. Take a couple of deep breaths. Relax the muscles in your leg. Exhale. Then inject the syringe.”
With trembling fingers, Rachel pinched up the skin on her leg. She’d wiped it with alcohol three times, but she hadn’t yet gotten up the courage to stab herself. Dr. Malar held the syringe over the spot. Suddenly she took a deep breath, exhaled, and plunged the needle into her leg.
Quickly she pushed down the plunger, pulled it out and pressed the alcohol swab over the site. It had stung. Tears welled up behind her eyes. But secretly she felt pretty pleased with herself.
“Good for you, Rachel!” Ann said.
“Very good,” Dr. Malar confirmed. “I’ll be back this evening before supper to supervise your next one. Believe me, the first one is always the hardest.”
“How would you know?” Rachel said meanly. “It hurt—a lot.”
Dr. Malar paused. Then he reached inside his shirt collar and tugged on a chain. It pulled free and a small metal disc
with a red insignia dangled from his hand.
“This is a Medic Alert medallion. Anyone with any health problems should wear one at all times. Your mother has already ordered one for you. Please read mine.”
He turned it over and held it close for her to see. John L. Malar, Diabetes, it said.
“I know,” he told her. “I know very well, Rachel.”
The dietician had just left. Rachel stared at the pile of papers she had been given. “Recipes for Better Diabetic Diets,” “How to Eat Like a King on a Diabetic Diet,” “Your Exchange Diet Plan—1,500 Calories.” Her head was swimming. “Six saltines equals one bread exchange,” she read aloud. “One medium apple equals one fruit exchange.” It was all so confusing.
The dietician had told her it would be. She had said that she’d spent time with Rachel’s mother, who was also learning all about a diabetic’s diet needs.
No more French fries and Cokes after school! No more midnight ice cream pig-outs. Her life was going to be a nightmare. “This stinks,” Rachel said aloud and flung the diet papers across the room.
“What’s wrong, honey?” her mother asked as she came into the room.
“I’ve got diabetes,” Rachel shot back.
“Now, honey. . . you’re going to be all right. And besides, I’ve got some good news for you. Jenny and Ben have been calling daily. They want to come up and see you during visiting hours tonight. Dr. Malar said it would be fine.”
“What!” Rachel squealed. “I don’t want to see anybody! Do you hear, not anybody! I don’t want anyone to know ever about my shots and diet. I’m a freak!”
“Rachel! Stop that! Your friends are concerned about you. They don’t know much about diabetes. But they do care about you. And,” Mrs. Deering took a deep breath, “Madame Pershoff wants to come see you, too.”
Ballet. Her first love. “How can I even think about ever dancing again?” she asked her mother. “Oh, Mom, all I ever wanted to do was dance. But how can I now?” She began to cry.
“Oh, honey,” Mrs. Deering put her arms around her daughter. “I know it will all work out. Dr. Malar says that regular exercise is part of good diabetic control. And dancing is good exercise. Don’t cry, Rachel. We’ll work something out. I promise. Now won’t you please let me call your friends and tell them it’s all right to come for a visit? I know it will make you feel better. Please?”
“Okay,” she said. “I guess I have to face them sooner or later. But I don’t want to see Madame Pershoff. Not yet, please.”
“Boy, breakfast in bed . . . your own TV. . . people waiting on you hand and foot...not too bad, Rachel.” Jenny flitted around the room pushing buttons and making funny faces. Ben stood off to one side looking uncomfortable.
“Sure, Jen,” Rachel answered. “It’s a regular hotel. Care to join me?”
“And miss out on a week of Matthews’ history class? I couldn’t stand that,” Jenny said with a laugh.
Her mother had been right. It was good to see her friends again. And it made Rachel want to get out of the hospital, too. For the first time, she really began to long to go back home.
They talked on and on, sharing school stories and jokes. Finally the call came over the speaker system for visitors to leave. Jenny patted Rachel’s hand good-bye. Ben barely brushed her fingers.
“Got to run,” Jenny said and shot Ben a mean glance.
That’s odd, Rachel thought. It’s like they’re afraid to touch me.
It wasn’t until they had left the room that Rachel got an inkling of what was wrong. She could hear Jenny’s voice outside the door. “For heaven’s sake, Ben. You treated her like she had leprosy. Her mother told us that you can’t ‘catch’ diabetes from Rachel like a cold. Honestly, you can be so insensitive.”
-FIVE-
“Hi, there. You Rachel Deering?” She looked up from her history book to see a tall boy standing in her hospital room doorway. He had dark red hair, a deep golden tan, and bright blue eyes. He was really cute.
Rachel self-consciously tugged the covers higher. “Yes,” she answered.
“I’m Shawn McLaughlin. Dr. Malar sent me.”
He eased into the room and pulled up a chair next to her bed. “He told me you were pretty. He’s right.”
Rachel blushed and looked away from his steady gaze. “What do you want?”
“Just thought I’d like to meet you. Thought you might like to meet someone who lives with diabetes every day.”
“You have it, too?” She examined him openly. He seemed so . . . well. So healthy.
“Sure. Since I was three. I’m fourteen now. That’s eleven years.”
“Really?”
“Yep. And I hate having it as much as you do. But I’ve learned to live with it . . . around it . . . in spite of it,” he said as he grinned broadly at her.
His smile was infectious. She smiled back.
“In a way,” he continued, “I’m luckier than you. It happened to me when I was so young that I don’t ever remember not having it. I’ve had two shots a day for forever, it seems. Let’s see, three hundred sixty five times two . . . that’s seven hundred thirty. . . . times eleven . . . that’s eight thousand thirty. . . I forgot to count leap years in that. Yep, you could say ‘I have it, too.’”
Rachel stared wide-eyed. “You talk about it so—so casually. Doesn’t it bother you?”
“Sometimes. But I don’t let it interfere with everything I want to do. I play soccer.”
“You do?”
“Sure. At first, my folks started me playing to help control my blood sugar. But pretty soon I loved the game so much that I played in spite of my diabetes. I’m on the select team now. Really competitive play. We get to travel and play in championship matches. How about you? Do anything special? Besides studying?” He glanced at her open book.
“No . . . I–I mean, I used to dance. Ballet. But now I don’t know if I will again.”
“Why?”
Just then she hated his intense eyes, like they could see right through her. It wasn’t any of his business anyway.
He sensed her instant hostility. “Listen,” he said as he got up and turned toward the door. “I’m not prying, believe me. I really just wanted you to know there are a lot of us diabetics out there. In fact, a group of about fifteen of us meet twice a month with Malar to talk. Share our problems. We have a pretty good time. Sometimes we have bowling parties or go swimming. It’s good to get with other kids with the same problems. Maybe you’d like to meet with us sometime?”
She felt very uncomfortable under his gaze. Why did he have to be so cute? “No,” she said quickly, “I don’t think so.”
“Well, if you change your mind, let Malar know. He’s a pretty regular guy. For a doctor,” Shawn said with a grin.
“I don’t want to be reminded about my diabetes,” Rachel explained. “Why would I want to sit around and talk about it with a bunch of strangers?”
“It’s kind of like Alcoholics Anonymous for diabetics. Believe me, Rachel . . . it does help.”
“Well, thanks anyway.” She resented his intrusion into her life.
He smiled broadly. “I’ll keep in touch.” Then he was gone.
Darn Dr. Malar anyway! Who did he think he was? Shoving people down her throat. Well, maybe she did have diabetes, and maybe there was nothing she could do about it, but she was not going to accept it. Never! She would hate diabetes every single minute for the rest of her life!
“So you didn’t think too much of Shawn?” Dr. Malar leaned back in the chair next to her bed.
Rachel had just finished giving herself her evening injection. “Oh, no. He was very nice—” she started.
“But you don’t like to be reminded of the realities of your life,” the doctor finished.
“I know I have diabetes,” she said, defending herself.
“That’s right, Rachel. You do. And you’ve been having quite a pity party over it.”
“What?”
“You heard me.
You’re angry. Mad at your parents. They passed on the lousy genes. You’re mad at me. ‘How dare I change your life!’ You’re even mad at God. ‘How dare He do this to you.’”
She avoided his eyes. He was right.
“Rachel, I can’t make it go away. If it’s any help, there are tremendous strides being made in research to find a cure. But for right now, it’s daily injections, diet control, and urine and blood-sugar testing.”
“Yes, I–I know. I’m doing my urine tests. I even did a Chemstrip today and found out that my blood sugar was about one hundred eighty.”
“Good. Because controlling your blood sugar is the name of the game. I want you to feel good. I’ll be regulating your insulin dose for a while. But pretty soon, you’ll be able to decide if you need a little more insulin—like when you get sick. Or a little less—like when you exercise heavily.”
“I want to go home. But I’m scared,” she told him.
“I know. It’s a lot to learn. But I want you to resume your normal life. School, dancing, dating. That won’t change. But there will be adjustments. The important thing is to keep you feeling good, to keep you out of insulin reactions.”
“Reactions?” she asked, surprised. “What’s that?”
After he told her, Rachel was sorry she’d asked.
“As long as you take your insulin and follow the rules, you should never have to face acidosis again. But insulin reactions—they’re part of diabetes.”
“I don’t understand.”
“Well, sometimes you’ll exercise more heavily than usual. You’ll use up a lot of food at once. But your insulin level is still the same. With insulin floating around and nothing for it to react with, you’ll experience a reaction. You may feel lightheaded. Or dizzy. You turn pale and shaky. Sometimes you might be nauseous or headachy. The first thing to do is reach for a fast-acting sugar—orange juice, candy, or sugar cubes. Always carry something sweet with you, just in case. Take it the minute you feel the symptoms coming on. Then eat something. Crackers, cheese, milk. You’ll be fine in about ten minutes.”
Last Dance Page 3