Wednesday, 4 September 2013

Blood Sugar (A Memoir)

Every child has a Christmas they can remember more than the others.
Think about it. That stand-out Christmas where you finally find that big blue bike propped against the door to the hallway, its pedals clean and black. That Christmas Eve when you and your sisters stuffed yourselves full of shiny sweets you smuggled from the Quality Street tin.
I always liked the green ones best. The funny thing is, it’s the sweets that I remember most from that Christmas. The chocolate santas with their jolly round cheeks. The garish packets of gummy bears handed out on the last day of term. A penny toffee from an old lady’s pocket when I visited Peggy in Ty Olwen in that week before she died.
That whole Christmas reeked of hospitals. The tenth door of my advent calendar swung open to reveal me bony and awkward on a starched white bed with a drip in my hand and my father stroking my hair. I hated Peter Rabbit on the walls. I hated the fact the room was yellow and the toys were bright, when all the while behind those curtains nurses would come bearing bright needles and kids would go crazy with screaming. Every time a hand appeared on the curtain, I would ball up to the pillow and curl my hands in, terrified it was another injection.
I guess I didn’t realise it was the start of a future of the things. I don’t think much of it now, slipping 4mm of metal into my stomach at a mealtime. It doesn’t chill me, seeing a tiny red globe of scarlet gleaming on my fingertip. But at eight years old, two weeks before Christmas, memories of my first blood test still have me walking out of the chair the minute the nurse puts a tourniquet on my arm and I see my own veins like a cluster of harebells.
‘Blood tests don’t hurt at all,’ the nurse had said in a soothing voice, gently pushing my sleeve to reveal a thin arm. Behind  her, a dark-haired doctor rustled packets and slid the little coloured bottles into his fingers. ‘We’ll put it in your hand where the magic cream was.’
Magic cream? Don’t fall for it. I kicked. I screamed. And over and over the needle went into my vein, because they were having ‘trouble’. All the while they shushed me, and I howled harder into my Dad’s green fleece, begging him to make the nurses go away, that the needle did hurt and I wanted to go home to my telly and my little sister and my dog Charlie. I’d even go back to school for an extra hour if it made them stop.
‘Ssh now, you’re being silly,’ the fat nurse said, ignoring my cries. I tried to kick her pig-belly. She said it wouldn’t hurt and she lied. They’d already stabbed my finger. What did they need more blood for? And why hadn’t I been allowed breakfast? I was hungry. They’d starved me and bled me and I hated them.
‘You have something we call type-1 diabetes,’ said the doctor, sitting beside me on the bed. I think he was talking more to my parents. He tried to explain it to me in a way I’d understand. I don’t think I did at the time, mainly because my parents seemed sadder than I did. Okay, so this thing called a pancreas didn’t do its job with me. Some small organ near the tummy, about the size of a small bunch of grapes. Insulin? I didn’t know what that was. I didn’t care. I was still thirsty, still dizzy, still feeling my bladder swell uncomfortably far too often. I wanted him to shut up so I could go and have a pee. They knew what was wrong with me now. Perhaps they could give me the medicine. Surely then, I could go home.
And they did give me the medicine, soon after. A smiling nurse with hair like copper wire and a funny laugh came in and sat with me and said she would show me how to take it. When I saw the pen with the sandcastles and the smiling red fish on it, I thought it was a present. A Christmas gift, just like the packet of sweets I still had from my teacher in my schoolbag in the car.
And then she screwed the needle on the top.

Breakfast was a challenge. I gazed at my bowl of porridge, my hands the same sickly shade of milk and oats, gripping the spoon until my knuckles became small pearls. Mum sat beside me in her dressing gown, catching Dad’s goodbye kiss on her cheek before he ruffled my hair and left. I lifted my eyes and saw she was combing her hair with her fingers, staring at the bowl. I think she probably needed a cigarette. She was wearing that sort of face.
                ‘You have to eat, Natalie,’ she said, closing her hand around mine so we were holding the spoon together. A figure grew in the frosted glass of the front door and the doorbell sang through the house. ‘The nurse is here. You promised her you’d do this if she let you out of the hospital. You heard her say you have to eat.’
                Frances flounced into the kitchen with bright bags and folders, her copper hair less harsh than it had looked under hospital strip-lights. She took up a seat and beamed. ‘Good morning, Natalie.’ I didn’t know how they did it; kept the smiles fixed on their faces for so long. I tried to smile back but my mouth was still dry and my eyebrows wouldn’t make the effort. Frances gave me a mock-scowl, planting her hands on her hips. ‘Oh dear, we have a sad little girl today, don’t we?’
                I eyed the pen on the table, the horrible little red fish and scribbly spades, aware of the devious needle which would appear like an apparition on top. I wondered why I was supposed to be beaming and full-bellied when I was about to be stung in the leg.
                ‘We did try to get her to eat the porridge,’ my Mum said in a low voice, as though not using my voice stopped me from using my ears. She pointed to the sticky bowl of oats in front of me. ‘She’s refusing to eat anything.’
                 ‘Oh now that’s no fun now, is it?’ Frances leaned over and pinched my cheek. I shrank back, recoiling into my chair like a cat backing from a boisterous toddler. She lifted a spoonful of porridge and let it drop back into the bowl, watching the globs sink back into themselves. ‘It’s all cold now, look. Your poor Mam will have to make another one for you, won’t she? Dear me.’ She laughed that funny laugh that made me like her even though I didn’t want to. I knew she was going to hurt me. She brought out an elephant pen this time, all multi-coloured trunks and tails like worms. I wasn’t going to fall for it again. I knew it wasn’t ink inside the cartridge.
                ‘We need to give it a shake first to mix the two types of insulin,’ she said, as though we were going to have fun. I liked mixing, especially paint. I liked whirling the red into the blue with my brush and sweeping my favourite colour over the paper like a huge violet river. I liked mixing cakes in ceramic bowls but suddenly felt sad about it, picturing the glittering heap of caster sugar. She handed me the pen. ‘Now you try mixing it. Go on. Give it a good shake.’
                I hesitated, then took it in my hand, shyly wiggling it in front of my face.
                ‘Oh, come on! You’re going to have to do better than that.’ Frances was giggling again, and I found the corners of my lips raising very slightly but stopped, reminding myself that it was a trick. She was distracting me. ‘Mix, mix, mix.’
                I did as I was told, but thought seriously about asking to go to the toilet and then dropping the pen so I could flush it away forever. But there was still the sandcastle one on the table. I looked at the garish bags on the table emblazoned with Novo Nordisk and JDRF logos and guessed there were a million of them in there. She knew my game.
                ‘I’m hungry,’ I whimpered, passing the pen back. ‘I want my breakfast now. I want to go and watch cartoons with Emily.’ My sister was under strict instruction to eat crumpets in front of Tom and Jerry, but I know her bright eye was pressed against the living-room door, her chubby cheeks squashed up against it, spying on the red-haired lady.
                ‘And you can have your breakfast,’ said Frances, giving my arm a gentle rub, ‘as soon as you get this all over and done with.’ I sobbed into my hands. Great, gulping sobs that sent fat tears pooling in the corners of my mouth and made my tongue taste salty. I became aware of the bruise on my leg like a tiny squashed violet.
                ‘I don’t want to do this every single day.’ I balled up my fists until they were two little moons and began gnawing at my own knuckles. ‘I don’t want to. It’s not fair.’ Tears dropped like beads in my porridge-bowl. Through blurry eyes I could make out Mum’s dressing-gowned figure stirring a pan of porridge. The out-of-focus milk bottle became a splodged star until I blinked and the tears spilled, transforming it into a white bottle again.
                ‘I know it doesn’t seem fair.’ Frances dropped beside me and took my hand, rubbing it in her own even though mine was all wet and dribbly. ‘But we can do this. Come on.’ She gave me a nudge and winked. ‘Soon it’ll be nothing and you’ll wonder why you were ever scared. It’ll be easy.’
                She screwed a new needle onto the pen and the airshot cleared the air like a thread. She told me it was to get the air bubbles out. I didn’t care much for bubbles unless I was catching them in the kitchen with my sister; Fairy liquid patches where those filmy orbs had burst on the tiles and made us slip and squeal in our socks. It was not the bubbles that had me shaking, every nerve a crackling fibre.
                Frances lifted the nightie to my thigh and gently squeezed a bit of flesh on my leg, though this was difficult; my limbs were still bony. The little needle caught the light and moved like a quick star along the tip. ‘Look away and show Mam how brave you are. What will you be getting for Christmas?’
                I didn’t care what I got for Christmas. I knew the nurses didn’t care what I got for Christmas; they were trying to make me not notice their stabbing hands and pinching fingers.  I didn’t care how brave or how weak I looked. I was no soldier in my nightie, hair cobwebbed to my wet cheek and whimpering as the needle pierced the skin. I wanted Father Christmas to come and take those bad pens away in his toy-sack. I wanted the nurses to stop calling at the door. I wanted to eat whatever I liked, whenever I liked. I wanted to be me again..
                ‘And one…two…three…four…five.’ The needle was lifted from my skin and a drop of blood swelled from the injection site like a tiny ruby. Frances was beaming. ‘Good girl.’
                Mum brought me a fresh bowl of porridge, taking the cold one away and leaned over to kiss my warm forehead. ‘Well done, Nat. See? You can do it. All over and done with. Shall we phone Daddy?’
                Over and done with. I lifted the first spoonful of porridge to my mouth and decided it wasn’t sweet enough. Over and done with until teatime. Over and done with until tomorrow. And the day after. And the day after that. I looked at the blood glucose monitor, knowing my finger would be stabbed in an hour. Then over until the next mealtime.
But never over and done with.

They’d had the same ragged rope of tinsel wrapped around the Disney mural every year. The same line of mothers huddled like hens and dangled car keys in their hands, keeping the other hand free to rifle through leaflets that gave them the same bullshit. Mint-green chairs. Whimpering kids in school uniforms. The same overweight nurses strutting with medical files and rubber gloves, their arms like great pink hams. These same nurses preaching the importance of healthy eating, passing custard creams over their computers.
‘Have you even written your blood sugars down for me to see?’ The doctor stretched his limbs like an oversized cat, shooing a nurse with a lazy flick of his hand. I gazed at my nails.
‘No. They’re saved on my blood glucose monitor.’
‘Well it’s not as easy for me to see them on there.’
‘I lost the record book.’
Dr Evans sighed and uncurled his fists on the table. ‘Well it’s not my job to go looking through them. I’m busy. That’s your responsibility.’ I felt my jaw tighten. ‘You’re not a baby, you’ve got to do these things yourself.’
‘I already have to remember insulin doses and glucose tablets and study. I can’t always remember.’ I hated him. I’d always hated him. I knew the minute I creaked open his door and saw the pompous bastard tapping his fingers and swinging on that stupid leather chair that I was going to have to sit there, tongue clamped between my molars, sucking away on the expletives that formed on my tongue like pear drops. A nurse came in quietly, head bowed and cradling a mug of tea, her brow furrowed and lips pulled into a tight line. He barely glanced at her as she placed it before him, drumming his fingers upon his sleeve. I swear he was humming.
‘Do you take your insulin like you’re supposed to?’ he asked as the nurse clicked the door shut, her pixelated shadow lifting from the square of glass and shrinking away out of sight. I looked at him, gently pressuring my wrists with my nails.
‘Yeah, of course.’ Fucking idiot. He raised an eyebrow and I swore I saw the ghost of a smirk run along his lip.
‘I can see some high sugars here,’ he said through a yawn, pressing the button on the monitor. ‘You’re not skipping doses because you can’t be bothered?’
‘No. I’m not stupid.’ My nails pushed harder until my wrists were braceleted with little white crescents that rushed pink when I lifted my fingers.
‘Your parents can’t make you do things now but that doesn’t mean you should be lazy with your diabetes control. You should be past the adolescent angst by now, Natalie. You’re a young lady.’
His mug of tea blurred to a smudge of white and brown on the wobbling beech table. Lazy. Angsty. What did he know? He knew the row of medical textbooks on the shelf. He knew diagrams and science exams and words on a page. He didn’t know how to deal with those numbers of glucose readings himself when they’re going crazy in your blood. He didn’t know how those numbers crush you when you realise you’re failing to have control; injecting and bleeding, injecting and bleeding as exam dates loom closer and the head gets too fuzzy to focus. He didn’t have to stop, think and calculate carbohydrates and insulin units over a birthday meal with friends. No polite headshake when the sugary cocktails arrived, sparkling. No nights spent awake drinking water and having to piss six times an hour.
For all his textbooks, his doctorate, his huge balding head, the man was fucking clueless.


The corridor is calmer today. They’ve painted over Peter Rabbit. In long glass windows, I see my slim shape move against the cream walls, a quiet ghost passing the familiar names on doors and the endlessness of chairs. Frances stands with her foot in the doorway talking to another nurse, her red hair peppered with silver. As always, her face is rung with smiles.
‘Well hello, you,’ she says, turning her bright head towards me over her shoulder. ‘I like your hat.’
‘Thank you.’ I offer her a smile and take a seat. I pick up a leaflet, but know I’ve read the same thing over and over. A cartoon boy on rollerskates beams on the front page, an apple in his hand and his thumbs up. Showing me it’s easy-peasy.
His grin doesn’t bother me so much today.
The blood forms rustle in my handbag as the nurses pass like peacocks in a flash of blue and green, hollering names into waiting-rooms. The kneeling children eye them auspiciously from behind Lego towers, barely noticing the whoop of cartoons on a TV screen as they wait to be fetched by gloved hands. A boy my own age yawns, pressing the ridge of his veins.
I still don’t like blood tests. My stomach still turns at the pull of a tourniquet around my arm, the dull conversation they try out on me as though they care what degree I am studying and whether I’ve been watching The X Factor. No I haven’t been watching The X Factor, thank you for asking. I can slip slim needles into my own flesh, no problem. But there’s something about the fragility of veins, the gentle impression beneath the skin and the sucking coloured bottles that makes my knees soften in the chair and the room ripple in all its sickly yellow. I still don’t trust a beaming face if it’s smiling above a syringe.
‘Natalie?’ A small, dark-skinned nurse appears in the doorway with green plastic covering her uniform. The smell of bleach suddenly slides down my throat and I realise my tongue has become a dry slab. Shaking, I make to get up on feet that feel like sponges. Beside me, a small girl also gets onto her feet and nibbles on her nails, wide-eyed and skinny. Her hands are shivering as the nurse looks between us and gives a little laugh.
‘Oh dear, two Natalies! I meant the little one.’ She offers her hand to the young girl, but she doesn’t take it, slipping her hand instead in the pocket of her father’s coat. I hear the nurse reassure her in a voice fading away down the corridor. Oh no, this won’t hurt a bit sweetheart.

I noticed the square of ‘magic cream’ plastered on her hand before it got swallowed in her father’s coat pocket. I almost feel sad she believes it.

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