I’ll admit it: I judged him a little the minute I saw him. He was skinny in an unhealthy way, pale Portland skin with a neck tattoo creeping out above his purple polo shirt collar. His wallet chain dangled from his pocket and swayed as he walked over with my stack of copies. It was early evening and I’d stopped at my local FedEx to get some clinical studies printed up. He looked at me and asked if I wanted them collated, and I told him no thanks, I’ll do that at home myself.
“Ok that’s good, I wasn’t sure my diabetic hands would be able to get the job done anyways.”
I cocked my head to the side and asked in a somewhat annoyed tone “Did you say that because those are a bunch of studies about diabetes?”
He looked at me with genuine surprise. “Oh no, I didn’t see what the copies were about. I have diabetes.”
I softened. “Me too.” I said.
I looked at him a little closer. He was much younger than I had thought at first. He looked worn out and tired in the way that a hard life can do to people. His eyes seemed flat. His voice was timid. Defeated somehow.
He continued, more quietly. “Yeah I have peripheral neuropathy in my hands and feet and it’s really hard for me to separate the pages and get them collated sometimes because I can’t feel the paper very well.”
“How long have you had diabetes?” I asked.
“Well they misdiagnosed me. They think now I had pre-diabetes as a teenager but they missed it. So I’ve had it about 10 years I guess.”
I looked him over again. He looked…frail. Pained maybe? “Are you a Type 1 or a Type 2?” I asked.
“Type 1,” he responded.
“So, um, sorry to ask,” I ventured further, “but are you on insulin?”
“Yeah I take one shot of insulin a day and then also glimepiride.”
I cringed. His clothes engulfed him. His black Dickies work pants, anchored by his belt, barely clung to his tiny waist. His wrists were bird-like, and his tattooed neck protruded from the sizes-too-big FedEx polo shirt. He was Type 1 alright, and his body had been starved for nutrients for a very long time. He was on a Type 2 diabetes medication regimen that left his cells famished and him thinking this is what it meant to live with diabetes. That peripheral neuropathy in both hands and feet was normal after 10 years with this disease.
“Ok,” I said slowly. “I work in the diabetes industry, and I’ve had diabetes for 21 years. It’s none of my business, but from one person with diabetes to another, I think there’s an insulin you’re missing. I think you might feel better if you took that long acting insulin and a short-acting one to cover you food intake. Has anyone ever talked to you about that?”
“Hmmm, no not really,” he said. “But I was really poor growing up. I didn’t get to the doctor much, so I think they missed this for a while. But I just read an article recently that said pretty much everything we know about diabetes is wrong. Have you heard that too?”
I nodded. “Sure. That’s one way to look at it.” I paused, then started again. “Do you have a good doctor? An endocrinologist that you see?”
“Um no, I didn’t have insurance for a while. So I just saw this one guy up north for a while. But I have new insurance now. I really need to find one down here in Portland now that I live here.”
“Do you have a piece of paper and pen I can use?” I ask him. He hands me a scrap of paper. I scribble down the two names.
“These are two of the best endos in Portland. You need to see a new doctor. You’re not getting the right medication for your diabetes, and I think you could feel so much better.” I write down my own name too. “That’s my name. You can tell them I sent you. Both of these doctors know me.”
He takes the paper and smiles, “Great! I’ve been wanting to see an endocrinologist. Thanks!”
“Thank you,” I respond. I take my copies. “Take care.”
“Yeah, you too!” he says, with a wide smile.
We are both part of the club. The crappy club that no one wants to be a member of but we are anyways because we don’t get a choice in the matter. The only difference is that I grew up in a house where we had insurance, access to good medical care, and education. I was guided through high school to get good grades, apply to college, graduate and get a good job with good insurance. Someone did a C-peptide when I was diagnosed. My doctors explained in no uncertain terms what my condition was but that I would thrive with diabetes if I just took care of myself. And he didn’t get any of that.
That’s the only difference between he and I. Diabetes does not care if you have insurance, education, or a good doctor. It will not affect us all equally or in correlation to our efforts. It will make no sense to even to the most educated person on the planet. But we can all try to look out for one another in this little crummy club of ours. So at least we know that we are not alone.