All the Days of Her Life (10 page)

L
ACEY GAZED UP
at the faces of the team of diabetes professionals surrounding her bed, and although her uncle introduced each member, she barely paid attention. A young woman named Sue, a dietician, said, “You know, learning to eat right doesn’t mean giving up all the things you love and never tasting them again. It simply means planning. You can eat practically anything you want, just so long as you plan for it.”

Of course, Lacey knew that much. “I don’t have much of an appetite now,” she said. “And I’m not interested in gaining back all the weight I lost.”

“You don’t have to gain back most of it,” Sue said. “But when a patient goes DKA, she loses more than unwanted pounds. She loses muscle mass and vital nutrients. We’ve got to put those back, and
naturally, weight gain will happen. But it’s a healthy weight gain. We’ll design an exercise program for you.”

“I hate exercise.”

“Me too,” Sue said with a smile. “But everybody needs it. Even people without diabetes. You don’t have to be a jock, but you do need an exercise routine.”

Lacey thought of Katie, athletic to the core. The memory of their fight the night before caused fresh pain. She flashed Sue a hostile look. The woman was young and tall, slim and fit. Her hair was dark brown and hung in a French braid, her eyes brown and lively. “And I suppose you’re on the hospital’s softball team, bowling team, golf team, and every other team they have. How would you know what it’s like to have to stop in the middle of everything that’s happening and give yourself a stupid insulin shot? I’ve always had to sneak off at sleepovers and play rehearsals and measure out my insulin. What fun.”

“I know what you mean because I’ve done it for years,” Sue said. “I’ve been a diabetic since I was fifteen.”

The news stopped Lacey’s sarcastic tirade cold.

Uncle Nelson intervened. “You’ll see everybody again this afternoon. Along with a private session with Dr. Rosenberg. But for right now, I want to take you for a little ride.” He pulled a wheelchair to the side of Lacey’s bed.

“I’m not going anywhere in that thing.”

“Yes, you are,” Uncle Nelson said firmly. “While
you’re here, I’m in charge, and besides, I’m bigger than you, so get into the chair and don’t give me any lip.” He softened his tough talk with a broad smile and a wink.

Grudgingly, she got into the chair and waited while her insulin pump and IV pole were adjusted to travel with her. It was humiliating being wheeled down the hall followed by the apparatus of her condition. She still didn’t feel good physically and wondered if she ever would feel good again. How could things have gone so wrong over the past few months? And when would she be able to resume a normal life?

Her uncle rode down with her in the elevator, wheeled her down a hall with signs reading
RENAL UNIT
, and into a room with several machines that stood beside chairs that resembled recliners. A person sat in each chair while lines from the machines snaked down his or her body and disappeared into a tube protruded from arms. One person was calmly reading, another was dozing, and one woman was busy knitting. The clack of her needles could be heard above the hum of the machines.

“Am I supposed to be impressed?” Lacey asked, feeling a coldness form inside her.

“This is the dialysis unit.” Her uncle ignored her bad temper. “These people come in three times a week for four or five hours a day and have their blood shuttled through these machines to cleanse it of toxins and impurities. Their kidneys don’t work, and without dialysis, they’d die.”

“So what’s your point?”

Uncle Nelson crouched in front of her chair and looked her in the eye. “Forty to fifty percent of all type-one diabetics—that’s the type of diabetes you have—suffer from kidney disease. It may take fifteen or twenty years to develop, but nevertheless, once a diabetic’s kidneys fail, he has only two options: dialysis or transplantation.”

She listened to him, all the while watching the patients in the room. The machines looked grotesque to her, like giant birds of prey hulking beside beds, with gauges for eyes and tubes for beaks. Hours had to be spent hooked up to them. Hours of everyday life that should have been spent doing other things, fun things.

Uncle Nelson gestured toward the room. “This unit is for hemodialysis—it cleans the bloodstream. Often, diabetics do better on CAPD, continuous ambulatory peritineal dialysis.

“You do this kind at home. You have a catheter inserted into your abdominal cavity”—he touched her stomach area—“and then dialysis fluid is put in through the catheter’s opening, where it sits for six hours attracting toxins and then is drained and replaced with fresh fluid.”

She thought the procedure so horrific that she could barely imagine it. She’d be attached to an IV line for a quarter of the day, 365 days a year while the fluid did the job of failed kidneys. “If you’re trying to scare me, you are,” Lacey said, holding his gaze with hers.

“I want to scare you, Lacey. I want you to understand the reality of your disease. You’re my niece
and I love you. I don’t want this to be your future. It saves many lives and is extremely important, but I hope you won’t have to use the machines to save your life.”

“I don’t want it either.”

“That’s why it’s important that you take care of yourself.”

“But it could happen anyway, couldn’t it? Fifty percent is a high number. There aren’t any guarantees.” Her hands were shaking, so she kept them folded tightly in her lap.

“No guarantees,” he said. “But studies do show that the more tightly you control your blood sugar, the better able you can manage and postpone the side effects.”

She edged her gaze away from his. “I take care of myself.”

He took her by the arms. “Lacey, you were brought into the emergency room in DKA. That couldn’t have happened unless there was something else going on in your body, like a massive infection or other illness.” He paused. “Or if you’d stopped your insulin shots.”

“I was taking my shots,” she said stubbornly.

He scrutinized her carefully. “When I examined you, I saw that your throat and upper esophagus looked irritated, consistent with a patient who’d been vomiting. That’s why I ran tests to determine if you had food poisoning or a stomach bacterial disorder. You didn’t.”

Her heart began to pound. He was getting close to something she didn’t want discovered. Her purging
shouldn’t have had anything to do with her problem. She had been careful to not do it after every meal, only just when she’d eaten too much of the wrong things. “I don’t know what you want me to say,” she said. “I was giving myself my shots.”

He ducked his head and took a deep breath, then stood. “If you won’t be honest with me, please come clean with Dr. Rosenberg. We’ve got to get to the bottom of this, and I won’t let you go home until we do.”

Lacey slept in her room until it was time to meet with Dr. Rosenberg. One of the nurses took her to his office in the wheelchair, chattering all the way and singing the doctor’s praises. Still, she was prepared to dislike him. She didn’t want to talk to a shrink and she didn’t want to have him digging around inside her head for details about her psyche. She realized now that she’d made a mistake in trying to diet by juggling her insulin and purging. Why couldn’t she simply put the past behind her and start all over?

Dr. Rosenberg was a short man with round features and jovial eyes. He reminded her more of a department store Santa Claus than a doctor. His office had an unkempt quality with stacks of papers and books on every surface, including the floor. “Sorry about the mess,” he said after introductions. “I’m moving into the new wing of the Diabetes Research Institute, and housecleaning is a chore.”

“My uncle’s told me about the institute. It’s just for diabetes research, isn’t it?”

Dr. Rosenberg raised the blinds on the window, and she could see a glass and concrete building rising in the near distance, windows gleaming in the bright Miami sun. “It’s the culmination of years of work and fund-raising,” Dr. Rosenberg said. “The only one of its kind actually. A facility dedicated to finding a cure for diabetes while treating patients with the latest and best therapies available.

“If you want, I’ll take you on a tour. We’re dedicating the building in a big ceremony this fall. But some of us will be setting up shop before then. The finishing touches are being put on the place now.”

“I don’t think so,” Lacey said. “I’m not much interested in buildings or diabetes.”

He lowered the blinds and rolled his office chair in front of her, where he sat and offered a smile. “But you’ve had diabetes for several years. Don’t you want to know what we’re doing to cure it?”

“I just want out of here.”

“I’ve met your parents,” Dr. Rosenberg said, changing the subject.

“Then that explains the real reason your office is such a mess. Did they start throwing things?”

Dr. Rosenberg smiled knowingly. “They may not like each other, Lacey, but they love you very much.”

“Sure. I’m the glue that held them together, all right.”

“Do you blame yourself for their divorce?”

“Do we have to talk about this?”

“You should talk about it with someone. Your health is in jeopardy.”

“Well, I don’t feel responsible for my parents’ divorce and right now I’m tired and I want to go back to my room.” Her voice had risen as she spoke.

“Very well.” Dr. Rosenberg rang for a nurse. “But will you come back tomorrow? I’m seeing your mother, then your father, in two separate meetings. I’d like to see you again too.”

Of course she didn’t want to, but she knew her uncle was expecting it. And she also felt that if she focused on talking about her family, then maybe she wouldn’t have to fess up to her gross mismanagement of her diabetes. “I’ll come,” she told Dr. Rosenberg.

She was tired and drained, but back in her room she couldn’t sleep. TV was boring and her vision kept blurring when she tried to read. Terri was in school. Katie wasn’t talking to her. Todd was a lost cause. Lacey felt alone and cut off. Then she thought of the one person in the world whom she wanted to see and talk to.

With trembling fingers, Lacey picked up the phone and asked information to look up Jeff McKensie’s phone number for her.

“A
RE YOU SURE
you’re all right?”

The anxious expression on Jeff’s face as he asked his question stirred Lacey’s heart. She’d caught him between classes at his apartment when she’d called and he’d come within the hour. He looked wonderful, so familiar and caring that all she wanted to do was throw her arms around his neck and hold tight. But she didn’t because she knew how mean she’d treated him in the past. He probably didn’t want anything to do with her and had come only out of pity.

“I’m not all right,” she told him, admitting for the first time how bad the week had been for her. “I’m feeling sick and I don’t have any energy. And I hate being attached to these things.” She raised her
arms. The lines from the IV and insulin pump dangled.

Jeff eased himself onto the bed, carefully pushed the plastic tubing aside, and slipped his arms around her. She felt his hands against the soft cotton of her gown, and a tingle shot through her. She slid her arms as best she could around him and laid her cheek against his chest. Enveloped in his arms, snuggled against his warm, broad chest, Lacey closed her eyes and gave in to the swelling dam of tears clogging her throat.

He let her cry, all the while stroking her long hair and rocking her tenderly. “It’s okay, baby,” he murmured into her ear. “Everything’s going to be fine … I’m here now.”

“I’ve made a mess of my life, Jeff,” she sobbed. “I’ve gone and screwed things up really bad.”

“The doctors will straighten you out—”

She interrupted. “It’s not just my health. It’s everything. I—I had a terrible fight with Katie. And everybody at school knows about me now. And Todd … well, he’s never even called once to check on me.”

At the mention of Todd’s name, she felt Jeff stiffen. She hugged him all the tighter. She heard him ask, “Is that why you called me? To mourn your boyfriend?”