Stephanie was tired, several nights
in a row, despite sleeping well. That was the first symptom. Over the course of
several weeks, she complained that she was almost always feeling tuckered out.
She had cut her hand while slicing
onions in our kitchen. Nothing serious, but it had happened a week earlier, and
the wound still seemed fresh, as if it had only happened yesterday.
She was often thirsty, so she was
drinking more water than usual, but she said she was peeing even more often
than drinking more water might explain.
She made an appointment at UCSF
Medical Center, where she worked, and they ran tests. We'd gotten plugged in to
the internet a few months earlier, so we had already Googled her symptoms, and
all of them suggested diabetes. We had our fingers crossed, hoping for
something else, but when the doctor said it was late-onset diabetes Steph wasn't
surprised. Disappointed, yeah, but not surprised.
This was her first scary diagnosis,
and we were naïve enough to think that it was "the" scary diagnosis.
We didn't know there were more scary diagnoses yet to come.
* *
* * * * * * * *
Diabetes was a word we'd heard all
our lives, of course, but until we started Googling we had only the vaguest
understanding of it. Maybe you're similarly under-informed, so let's explain it
briefly, from a layman's understanding:
It's all about sugar. Also known as
glucose, it powers your muscles and brain cells, and is carried in your
bloodstream by insulin, a hormone produced in the pancreas. Insulin is good. If
you're overweight, though, or not getting enough exercise, or in other ways
less than perfectly healthy, the insulin isn't able to handle the glucose. When
that happens, the glucose doesn't get transported to where it's needed, and
instead you have high levels of sugar floating around in your bloodstream.
Eventually the pancreas can't secrete enough insulin, which is why lots of
diabetics take insulin via shots or pills.
Stephanie wasn't prescribed
insulin, at first, but she was prescribed different pills that were supposed to
help, and probably did. And she was told to cut down on the sugar in her diet,
and the sodium (salt). Way down.
Pasta was forbidden, and of course,
Steph loved pasta. We had six kinds of pasta in the kitchen, and we'd been
having pasta-centric meals 2-3 times weekly. And she was supposed to eat brown
rice instead of white rice. "I hate brown rice." No fruity yogurt,
only plain, which Steph described as "like eating curdled milk, because
that's all it is." No Captain Crunch, her favorite breakfast cereal, and
no other cereal was allowed unless it's bland and flavorless. No soda, except
diet soda, which Steph said "tastes so bad it doesn't count as soda."
No dried fruit, something Stephanie had previously thought was a healthy snack.
No white bread, which was the bread Steph preferred. No ice cream. No candy
bars. No fancy coffees. No pretzels. No fruit juice. No french fries. No, no,
no.
Instead, she'd been instructed to
eat plenty of beans, legumes, and chia seeds. "That's an
exaggeration," Steph said, "but basically, I'm supposed to stop
eating everything I like."
It would've been easier if I'd
gotten diabetes instead of Steph. I'll eat almost anything unless it's visibly
moldy, but Stephanie had higher standards — if a meal wasn't delicious, she'd
barely have a bite or two. Steph was a gourmet, I guess; can't think of a more
accurate word. We were poor and San Francisco is expensive, but she always
prepared affordable, adventurous, and delicious meals for us.
But, following doctor's orders, she
cut everything that tasted good out of her diet, and of course, I did too. Not
that she asked me to — she would never do that, and in fact, not ten minutes
out of the doctor's office, without my even asking, Steph assured me that her
dietary changes wouldn't affect what I ate. "I want you to have a Baby
Ruth bar any time and any place you want," she said, "or a Big Mac
and french fries and a milk shake. This new diet is my punishment, not
yours."
But to heck with that. Her meals
would be my meals, with no complaints. As they say — for better, for worse, for
richer, for poorer, in sickness and health. "If you're eating brown rice
and kale, I'm eating brown rice and kale. I'll just have bigger servings,
because I've always eaten more than you."
And so, she tried. We tried. The
ice cream went from our freezer straight down the drain, and a hundred bucks of
groceries went to charity. For as long as we'd been together, we'd both been in
the habit of bringing each other sweet treats — candy bars mostly, or sometimes
muffins or a piece of store-bought pie — but that habit came to an instant end.
Steph began shopping healthy, and collecting and trying recipes approved by the
American Diabetes Association. Some of those diabetic recipes were reasonably
good, I thought, but Steph thought all of them were icky.
* *
* * * * * * * *
I'm speechless. Taken aback.
Been staring off into space for five minutes or so, because I had completely
forgotten the conversation I'm about to recount. Even after Stephanie's death,
it was forgotten. This happened nearly twenty years ago, and hadn't entered my
mind in at least fifteen years — not until I started typing the last sentence
of the previous paragraph.
* *
* * * * * * * *
Some of those diabetic recipes were
reasonably good, I thought, but Steph thought all of them were icky.
"Tastes like substitute food," she said once, after eating some
watercress and zucchini concoction she'd made, or maybe it was the night we had
low-carb turkey tacos. She didn't say anything more for a bit, and I just
watched her and smiled stupidly.
"It's been two months since
the doctor told me I have diabetes," she said. "And I'm not having
fun with it."
I raised my eyebrows. What could I
say? I wanted to say that the watercress and zucchini hadn't been bad, but
actually, it had been pretty bad.
"Here's what I'm
thinking," she said. "Please tell me if you think I'm wrong."
"Always and of course," I
said.
"I'm a fairly simple woman,
with fairly simple pleasures. I don't want hard drugs. I don't want to climb
mountains. I don't want to go hang-gliding. But I do want dinner. And I want a
better dinner than this."
"You keep making the diabetic
recipes, and you'll find some that you like."
"No, I won't. I've made us
fifty diabetic dinners. Fifty. Yeah, I've been keeping count. That doesn't
include all the healthy breakfasts and low-carb lunches that I haven't really
liked — they're inedible, but at least they're not much trouble. But I want a
good dinner. I put some time and effort into making this crap, and it's just
wasted time and effort. Fifty diabetic dinners, and not a one of them was any
good."
"I liked some of them. The
BLTs last week were pretty good."
"B is for bacon, but those
sandwiches had turkey-bacon — fake bacon. The bread was grainy bread, which I
don't care for — fake bread, if you ask me. The mayonnaise was reduced-fat —
fake mayo, and it tasted gross. The lettuce and tomato were real, but the
sandwiches were fake."
Didn't know what to say, so I used
my standard line for whenever I was flummoxed. "I love you, Steph."
"And I love you, but Doug,
you're easy to please with food. I'm not so easy to please. And I am not
pleased." She gave a long sigh, and then continued. "After fifty
dinners, I've decided that this just isn't working."
"Well, what do you think we
should do?," I asked.
"I'm going to eat what I want
to eat. That's what I'm going to do."
"Like what?" I cocked my
head like a confused puppy. "Do you want to go back to the meals that made
you sleepy, and thirsty, and made your cuts slow to heal?"
"Yup," she said, and then
she said the words I'd somehow forgotten through all the years since this
happened. "Here's the choice. I can eat crappy meals like tonight, and
maybe live a longer and healthier life. Or I can eat food that tastes good, and
maybe have a shorter life with worse health. And of course, even if I eat
flavorless awful food that makes me perfectly healthy, I still might get run
over by a truck — there are no guarantees. But if eating good food cuts my life
short, well, I think I'd rather have a short, happy life than a long, boring
life."
Obviously, this was big stuff. I
tried to choose my words carefully. "Well, you said I should tell you if I
think you're wrong, so I gotta say … I think you're wrong. Diabetes is serious,
and I'd say — keep trying different diabetic foods until you find some that you
like."
"Doug, you're not listening. I
know that diabetes is serious. I've read all the pamphlets they gave me at the doctor's
office. I work at a medical center, and I've spent a lot of my lunch breaks
lately in their library reading about diabetes. It's serious and I'm taking it
seriously, but — I can't live like this. Food matters to me. I mean it
when I say, I don't want a long life without decent food."
"Can we tweak the
diabetic-approved recipes? Maybe make them diabetic-compromise recipes? Maybe
BLTs with real bacon instead of fake-bacon, but only one slice instead of
two?"
"Sure — that's a good idea.
That's reasonable. And I'm not going back to candy bars as my go-to
snack. I'm not going to eat a bag of dried fruit for breakfast. I'm not
going to make us pasta 2-3 nights every week, like I used to. I have diabetes,
and that's serious, and I'm not going to ignore it. But I'm also not
living the rest of my life, or the rest of the week, without pasta. In fact,
I've hardly touched this watercress mess and I'm very hungry. I want pasta for
dinner tonight."
"We don't have any pasta. We
gave it all to the food bank."
"I'm going to the corner
grocery down the street, and buying some spaghetti and Ragu. With ten minutes
in the kitchen, and I can add enough spices and olives and onions and a little
bit of red wine and convert the Ragu into an edible spaghetti sauce."
"I worry," I said as she
slipped into her windbreaker and walked toward the door.
"Well," she said, "I
worry too. But, trust me. This isn't a snap decision; it's something I've been
thinking about since around Lousy Dinner #35." And with that she was out
the door. Half an hour later we were eating spaghetti, and it was much better
than the watercress and zucchini. We did not have ice cream for dessert, or any
dessert at all, and Stephanie was happy.
* *
* * * * * * * *
She began modifying the
diabetes-approved recipes, making them taste better but also making them not so
diabetic-approved. She altered some of her standard recipes to make them more
diabetes-friendly. She cut way back on sugar and salt, white bread and Captain
Crunch. She rarely ate candy bars, and when she allowed herself one as a
special treat, it was bite-sized, not full-sized.
She worked at controlling her blood
sugars, and she brought those numbers down by quite a lot — but rarely as far
down as her "target numbers." Years later, a rude doctor told her
that she'd let her diabetes rage out of control, and that's unfair and untrue.
It is fair to say, however, that Stephanie could have done better at managing
the disease.
Steph and I talked about her
diabetes, often. We strategized almost everything together, and we had decided
together that she would decide how she handled her diabetes. I wouldn't
say that I agreed with her decision to stop making diabetic-approved dinners,
and also wouldn't say that I disagreed. Let's just say that I understood and
respected that she was a tough lady making a tough decision. It troubled me and
worried me, and of course, it troubled and worried Stephanie, too.
Toward the end she developed
cardiovascular troubles, and vision problems caused by injuries to blood
vessels in the retina, and bacterial and fungus infections, and circulation
issues in her feet (leading to amputation of several toes), and nerve damage in
her legs (leading to amputation of her left leg). All of these are known to be
long-term complications caused by diabetes.
Still, Stephanie lived for almost
twenty years after the diabetes was diagnosed, and she told me many times that
they were happy years, for the most part. That's what matters, in my opinion.
That's what matters more than anything.
She said, "I'd rather have a
short, happy life than a long, boring life." She decided to make a
trade-off — spaghetti instead of watercress. So far as I know, she never
second-guessed or regretted that decision. I'm not second-guessing it, even
today.