Treating My Diabetes Meant Facing My Eating Disorder All Over Again
I posed the question to her, earnestly, seriously: If given the choice, would she rather gain weight or would she rather die?
Diabetic. Type 1. Insulin-dependent. Patient is not presently in a state of ketoacidosis. Patient is conscious. History of Anorexia Nervosa but no concerns at present.
speaking of cupcakes
Oh, honey, you’ll be fine. You’ll just need to be disciplined, count your carbohydrates, and always track what you eat.
I was discharged that evening, needles and insulin and pamphlets full of diet tips in hand. Numb and exhausted, I shakily made my way home to begin my new life with my second disease.
A few weeks later, I stepped onto a scale in my endocrinologist’s office and watched the medical assistant do a double take. Squinting at my chart, she asked if was I sure that my weight had been written down correctly at the hospital. She had me step off, Let’s try again, there must be an error, it would be very unusual to have gained this much weight so quickly. When the number appeared a second time, hot humiliation prickling the corners of my eyes, she wrote it on her clipboard and underlined it three times, saying Wow.
On the drive home, my blood sugar plummeted. I pulled to the side of the road, dizzy and disoriented, reaching for my juice box. As cars sped by me, honking, and my vision began to cloud, I found myself doing something I hadn’t in years: I turned the box over in my hand, searching for the calories.
In January, emerging from the post-diagnosis fog of shock and grief, Will and I decided to get married. He remained steady, kind, calm—making me breakfast every morning, and dinner every evening, and reminding me to check my blood sugar and take my insulin. To eat something, eat something, eat something. In February, bright and icy, we went to buy our wedding rings.
“It should be tight,” the woman behind the jewelry counter kept insisting, “the ring should be nice and tight so it doesn’t ever fall off.” But still I bought my ring a half-size too big, saying it was because my fingers might swell, but knowing it was because the sensation of tightness would be intolerable for me—a waistband’s indentations in the fat of my stomach or an elastic hair tie compressing the flesh of my wrist, unbearable.
To feel, physically, the exact point in space where my growing body met the rest of the world. To be made aware of the exact size and shape of myself—I was running away from this as much as I was running toward anything.
So now, my thin gold wedding band is loose on my finger, sliding precariously up and down between the goalposts of my knuckles whenever my hands are cold or wet. If it does fall off, lost forever in a snowbank or down the drain of our kitchen sink, it would be so that I could feel smaller.
The first Sickness and I, we have been willing to risk everything. We have been telling this lie about my body at all costs.
The oven clock says 3:14. I could wait this out. I could switch off my sensor, rip the tiny needle out of my skin and simply refuse to prick my finger until the morning, if I live through the night. It’s easy to lie about something that’s happening only inside my body. These are all things I have done before, to avoid the negligible calories in a child’s juice box.
I have been standing, paralyzed, at the crossroads of my two diseases, one foot in each kind of death. Where they come up against one another, my monitor screaming URGENT LOW, is where my private struggle plays out over and over again. Where I try and fail, in secret, to drink eight ounces of juice.
When I seek to replicate healthy thinking for myself—meaning honesty and normalcy and freedom from my first kind of Sick—I think of the day I spent weeping in the office of my no-nonsense dietitian. A woman with a severe silver bob and an even more severe lack of patience with me—Patient may struggle with honest self-reporting written neatly under the “Barriers to Meal Plan Compliance” banner on her notepad, angled toward me on her lap. I had come to her panicked and distraught about the outward expansion of my healing body. She finally asked, frustrated, Well, would you rather gain weight or would you rather die?
I nodded tearfully, a pitiful non-answer, hoping that appearing to comprehend the gravity of my situation would be enough to satisfy her, and that the conversation would be over.
Afterward, crossing the parking lot with the friend who had driven me to the appointment, I posed the question to her, earnestly, seriously: If given the choice, would she rather gain weight or would she rather die?
In the years since then, I have forgotten dates and weights and meal plans, but I have never forgotten the look on my friend’s face when I asked her this.
I see it now, alone in my kitchen at 3:16 in the morning. Will sleeps through most alarms, and it would be easy for me to maintain this little fiction for one more night, secretly gambling with my life while pretending compliance.
Patient may struggle with honest self-reporting.
To tell the whole truth about my health entails accepting a gloomier prognosis, of course. The outcomes are frightening for diabetics with active eating disorders—neuropathy, blindness, organ failure, an earlier and more painful death. But telling the whole truth is also the only path to any possible escape from these fates. If I don’t want the secrets and the self-delusions of the first disease to be the end of me, it is time to face the facts of the second disease.
It’s 3:20. The coldness of the juice is a shock to my throat. The sweet-tartness of it braids my mouth into a pucker. I fold forward, resting my forehead against the sloped edge of the counter. I breathe. My heart rate slows.
After a few minutes, I crawl back into bed, kiss the shoulder of my sleeping husband. In the morning, I will be honest about both the frequency and the ambivalence with which I have been touching death. I will speak about my eating disorder in the present tense, and in doing so admit to him that I need help. I will come clean about the juice.
I am two different kinds of Sick, and I hope to someday be only one kind. I can no longer pretend a sickness into the past, but I can start here: I can write this, and I can drink the sugar I need to stay alive for another day.
Hannah Matthews is a librarian, abortion doula, and writer based in Portland, Maine. Her work has appeared in ELLE, Esquire, McSweeney's, SELF, The Lily, BUST, Entropy, and other publications. She tweets at @hannahmsays and cries in public places.