LIFE CAN TURN ON a dime. One minute you’re in your lawyer’s office discussing the possibility of adoption, the next you’re standing in your bathroom staring at a little stick that—against all odds—has somehow managed to register two skinny pink lines. Anyway, that’s my story. I was forty-one years old, I was pregnant, I was cautiously euphoric. And then the world turned upside down.
It was September 24, 2002. Nearly three weeks after declaring me pregnant, the obstetrician sent a letter saying my glucose appeared “slightly elevated” she suggested a glucose tolerance test “at my earliest convenience.” Fed up with never once being able to get her on the phone, I called a colleague’s husband, a highly respected obstetriciangynecologist, and read him the results of the test. There was a pause—I remember that—and then I think he said something like “Uh-huh, okay, hold on a minute while I make a call.” After a very long minute, he got back on the line with what struck me as an absurd question. “Are you wearing shoes?” he asked. “Yep, I’m in my sensible pregnant-girl flats,” I answered. “Good,” he said. “I want you to grab your bag and get into a taxi. You’ll be going to 168th Street and Saint Nicholas Avenue. Take the elevator to the…” It was going way too fast. “Listen,” I said. “I’m pretty beat, but maybe tomorrow.” And then he cut to the chase: “You’re diabetic,” he said, “and this baby can’t wait until tomorrow.” He explained that my soon-to-be-former doctor had taken much too long to diagnose me, and that, at nine weeks along, my baby’s organs were being formed in an environment of uncontrolled sugar. He said other things, but it was all a blur. Thirty-five minutes later, I found myself at the place that would become my second home: Columbia University’s Naomi Berrie Diabetes Center in New York City.
I have endured great pain in my day. A large woman named Helga waxes my bikini line every May, and I had a roommate who once listened to Enya for nine straight hours—so believe me when I tell you I understand human suffering, and I realize that in the grand scheme of things a little finger jab or an occasional shot in the arm doesn’t really hurt all that much. But needles freak me out. It’s irrational, it’s phobic, it’s not changing anytime soon. Before I could meet the doctor, I was to be given a hemoglobin A1C test—a simple finger stick that determines your average blood sugar for the past three months. “Not that hand, this one,” I sobbed. “Wait, this finger. Use this finger. Hold it; I’m not ready,” I pleaded as I breathed in the nauseating smell of rubbing alcohol on cotton. The little girl in the next chair rolled her eyes. A slightly more sympathetic preschooler assured me that “they’re quite good here.” It is not pretty when you’re seated with two people under the age of seven and the only one who wants her mommy is you. Just then I felt a hand on my shoulder. “Hi, I’m Dr. Robin Goland. We’ll sit down and talk in a couple of minutes,” and in a futile effort to further reassure me, she added, “I promise you’re not the first woman in history ever to be diabetic and pregnant.” But I was pretty sure she was wrong. “Actually, Dr. Goland, I believe I’m the first woman in history ever to be pregnant.”
Holding my newly pricked finger as if I’d been bayoneted, I settled in for a chat with Dr. Goland. She was a combo platter, equal parts wry, compassionate, and no-nonsense, a slim powerhouse in her late forties who I imagined cheerfully defusing a midlevel nuclear device while forging a permanent peace in the Middle East and harnessing solar energy. Over time I found out that she had absolutely no grasp of pop culture and once forgot her child at an ice rink, but this was only our first date. That day I needed her to be clear, kind, heroic—and that’s exactly what she was.
To my total shock, the result of my hemoglobin A1C test indicated that my diabetes was not gestational. It proved that I was walking around with undiagnosed diabetes before ever becoming pregnant. Dr. Goland asked me about my family history (cancer galore). She asked me if I smoked (never). She asked me about my diet and fitness routine (used to see my trainer three times a week, currently see my refrigerator three times a night). Then it was my turn to ask the questions.
“What exactly happens if your blood sugar is too high?”
“Blindness, loss of limb, kidney failure, heart attack, stroke.”
With each word I shifted deeper into catatonic noodle mode.
“But,” she added, brightening, “every one of these things can be delayed or prevented. Because we didn’t used to know how to keep blood sugar normal and how to prevent the complications, a lot of people are under the misconception that first you get the disease, then you get the problems, and that’s that. The truth is, if you work to control it—and it is work—none of this is inevitable. You can be a healthy person with diabetes—you may never experience any of these complications.”
My eyes scanned the room as I tried to take all of this in. There was a Harvard diploma hanging on the wall, pictures of three tanned tourist kids in front of some Greek ruins, a tiara-wearing teddy bear resting on the windowsill. I massaged my ever-expanding stomach and finally asked the million–dollar question: “Is my baby okay?”
Dr. Goland said it was too soon to tell. She wanted to send me to a lab so they could run more tests, and I started a fresh round of sobbing. Directing me to the nearest box of tissues, she stepped out of the room and returned followed by a band of angels. “You know what, Lisa, you don’t need to get yourself to another lab. We’re going to take some blood right now.” Two nurses, Dr. Goland, and one vampire/ medical assistant named Berenise (“She’s the best”) brought me into an examination room and started rolling up my sleeves in search of a good vein. It’s a remarkable tribute to peer pressure and vanity that I ever allowed my ears to be pierced, and I explained how that procedure actually made me pass out. They had me lie down, and the process began.
“So,” said Dr. Goland, who seemed to believe in the power of distraction, “what’s Rosie really like?” Through clenched teeth, I told her that I worked for Oprah and that though I’d never really said this to anyone before, “I guess the thing that makes Oprah so special to me”—they all leaned forward—“is that SHE’S NEVER STABBED ME IN THE ARM WITH A SHARP NEEDLE.”
Dr. Goland decided I should be hospitalized till I got the hang of everything. I begged her to let me go home. “You’ll have to test your own blood tonight and give yourself a shot of insulin,” she said.
“I can do that,” I said, almost certain that I couldn’t do that.
“You’ll have to call me at home tonight between ten and eleven.”
“Okay,” I answered, “if I need you, I’ll call.” She scrunched her brow. “I don’t think you understand—if I don’t hear from you, I’ll be up worrying the entire night. You have to call.”
Then she presented me with a secret weapon in my brand-new war. “This is Leigh Siegel-Czarkowski—you’ll be spending a lot of time together.”
I recognized her from my bloodletting.
“I’ll walk you through the injection and blood test now, and then we can go over it again tonight,” said Leigh, a thirty-something nurse-practitioner and diabetes educator, as she handed me her home phone number. I left the office at around 6:30 with a glucose meter, insulin pen, test strip, needle, lancet, and splitting headache. Only later did I learn that the office closes at 5:00.
That night I laid everything in front of me and phoned Leigh.
“I don’t think I can handle this,” I said, attaching the needle to the insulin pen.
“That’s how I used to feel,” she said, and instructed me to pinch my thigh.
“You’re diabetic?”
“Since I’m fifteen.”
“Leigh?”
“Hmmm.”
“Isn’t there some horrible disease I can get that involves ointment?”
“Of course there is,” she assured me, “but right now you’ve got this.”
I sank the needle into flesh, pushed the button on the pen, forced myself to count slowly to five until the drug was completely released, and pulled the needle from my leg.
“Leigh?”
“I’m right here.”
We listened to each other breathe for a while and finally she said, “Let’s stick your finger now so you can call Dr. Goland and say good night.”
First thing the next morning, I was back in Leigh’s office—a place I’d be hanging out in every day for hours over the next three weeks. We’d also talk at least twice daily on weekends. After conferring with Dr. Goland, it was decided that I would prick my finger to check my blood seven times a day and control my sugar with five daily injections of insulin. Needless to say, I was not part of the decision-making process.
A couple of weeks went by. I knew everyone and they knew me. Needles, carb counting, weighing and recording every bite of the three small meals and three small snacks that I consumed at roughly the same time each day still didn’t come naturally, nor did willing myself to believe that I’d have a healthy baby—but I did it nonetheless. Dr. Goland checked my blood pressure, and in the peppy cheerleader style I’d come to cling to pronounced me “completely amazing.”
“Completely amazing people don’t let themselves become diabetic,” I said.
Dr. Goland shot me the have-I-taught-you-nothing? look and pulled up a chair. “This is not your fault, Lisa.”
“C’mon,” I said. “I’ve stopped going to the gym, I’ve put on weight, I’ve—”
“Time out,” she interrupted. “Diabetes is a genetic disease. And as for being overweight, that’s one of the most inheritable conditions we know of. Almost as much as having blue eyes.”
“Okay,” I replied, “but you’ve gotta admit that there’s an environmental component to all this.”
“Clearly there is. But in most cases, without the genes you don’t become diabetic. You could weigh four hundred pounds, but if you don’t have the genes, chances are your blood sugar would be normal.”
My eyes remained glued to the scale across the tiny room.
“I think it’s a little unfortunate that we believe eating is completely an issue of free will. It’s not. Food intake is carefully regulated. It has to do with survival of the species. There are important circuits in the brain that are hardwired to direct how much we eat and when we feel satiated, and it’s increasingly clear that there’s a derangement, probably an inherited derangement, in the circuits of a person who struggles with weight.”
And here I thought it was my needle phobia and constant weeping that would convince her I was deranged. “Now,” she continued, “this isn’t to say you couldn’t go on a diet and lose weight after the baby is born—you could. It’s just extremely hard to keep it off when the circuits are altered and your body is telling you you’re hungry. It’s also much easier for some people to gain weight. And again, that’s their genes talking. The thing is, if you really pay attention and you’re willing to be a little hungry and exercise regularly, your genes are not your destiny.”
I vowed then and there never to touch spaghetti carbonara again.
“People who struggle with diabetes still have to live in the real world. It’s unrealistic to tell someone they can never have the good stuff. If there’s something you love to eat, I want to make sure you can still eat it from time to time. It’s impossible to always be perfect. You have to learn what your blood sugar levels are supposed to be and keep them within those limits eighty percent of the time—shoot for a solid B; the other twenty percent is a quality of life issue.”
And so, eight years later, I continue to eat a lot of vegetables, some protein, and an occasional dish of spaghetti. I walk home from the office at a fairly brisk pace two or three evenings a week, but the secret to my fitness program involves chasing around a funny little kid with a voracious curiosity and a mind-boggling level of energy. It took a village, but Julia Claire Labusch was born perfect and pink, healthy and happy—the most delicious sugar substitute I’ve ever come across.