Life by the Drop
A personal essay of living on the economic edge because of the cost of staying alive with Type 1 diabetes.
My alarm wakes me at six to get ready for class. Before anything else, I test my blood sugar – blearily, groggily, automatically. The meter is a crappy drugstore brand. I miss my old meter, but I can’t afford to use that one anymore – the test strips were $75 a bottle. $375 a month. $15 a bottle for this one.
Slide the strip into the meter and prick my finger. This meter requires more blood than my old one, so the poke has to be deeper, and I squeeze until a gory crimson pearl forms on my fingertip. The dull lancet hurts: you’re supposed to change them out after each use, but I change it out more like once a week, because a box of lancets is $20, and who can afford that?
You can read more on how others afford insulin by reading, “…end of the month, I start skipping meals.”
This is the first of between eight and 20 tests I am supposed to do each day: when I wake up, before and after each meal and snack, before, during, and after exercise, before bed, any time I feel “off”, and maybe a middle-of-the-night check because I’m afraid of dying in my sleep.
Truth be told, I don’t test as much as I am supposed to anymore. I can’t afford that. Once, when I tried to refill the script for my strips a week too early, the pharmacist told me, “You’re testing too much.”
“I’’m Type 1,” I replied, thinking he should recognize the obvious implications.
“You test four times a day. Prescription is for four times a day,” he said.
During a morning class, I feel hazy. The professor gets a bit blurred around the edges. Can’t make out the diagram of a neuron projected on the screen.
My meter beeps quietly when I test, and the bro next to me grunts, “Do you have to do that now?” I crumple and say nothing. Time to calculate a correction.
My entire life is math. I calculate how much insulin I need to correct. I calculate how many grams of carbohydrate are in anything I eat, and how much insulin I’ll need to compensate for them. I subtract for the insulin that’s still in my system. I subtract for any exercise I’ll be doing. I add for lack of sleep. I add for emotions: for anger, for sadness, for fear. I add for hormones: menstrual, cortisol from the stress of school, of working two jobs, and ironically, from the stress of not being able to afford my insulin.
Surreptitiously under my desk, I draw the insulin up into a syringe and jab it into my belly. I don’t swab with alcohol first, because I can’t afford alcohol swabs. The shot hurts despite the needle being a hair’s-thin gauge and only a half-inch long. It is dull from overuse. Insulin syringes are single-use only, but I can’t afford that. I put the biohazard orange cap back on and save the syringe for next time as another bruise forms on my belly. My belly is a constellation of pinpricks and bruises.
I got into the habit of skipping meals to save money. I’d contemplated going low carb, because low carb means less insulin. But the diet itself is expensive, so that evening I start boiling water for plain oatmeal for dinner. Five bucks for the extra large carton.
I remind myself as I stir my soggy beige repast that I am lucky to even have insurance.I am one of the lucky ones, I think, as I roll my vial of insulin gently between my palms to warm it and mix it.
Then the vial slips from my hands and falls to the floor. It shatters on the rust-colored tiles and the reek of the hormone that keeps me alive surrounds me.
The puddle on the floor is a week’s wages.
The puddle on the floor is worth half a month’s rent.
The puddle on the floor is worth two months’ food.
The puddle on the floor is my life.
I sink to the floor next to the puddle and sob.
I walk to the pharmacy. Swollen face and red eyes. The cacophony of traffic and sirens and catcalls blend together into aural soup. The buildings, traffic, people around me blurring together too, unreal and waxy like a swirl of melting crayons. I’m not truly seeing or hearing: What if they won’t refill my prescription early? How much food can I afford when the currency is units of insulin? How long will I last?
The fluorescence of the drugstore rescues me from my mind. I head straight to the pharmacy, and a pharmacist I’ve never met before. She is a woman in her forties with wavy auburn hair. In her white coat, she is the first thing I see with clarity. She is pretty. She has freckles.
I ask for a refill. I tell her I broke my bottle. “You’re not due for a refill for a month,” she says.
“Please?” I say. I don’t have anything else to say.
She consults her computer.
She makes phone calls.
I pace and try not to look at the fitness magazines.
The pretty pharmacist tells me there’s nothing she can do. Insurance won’t fill it for four more weeks.
I don’t cry because I have no tears left, but I don’t know what to do, so I collapse against the wall in desperation, my arms wrapped around me, trying to think and trying not to think.
I don’t know how long I stand against the wall when I feel the hand on my shoulder. I look up at a halo of auburn hair, but I can’t meet the eyes that look at me. She slips a refrigerator-chilled box into my hand, inside, a vial of insulin.
“Don’t tell anyone,” she says, and walks away.
This article has been excerpted, by permission, from a longer essay. To read the full version, go to http://angrygoatgirl.tumblr.com/broken.
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