Everyone is young and stupid sometime. It’s a rite of passage from teenagerhood to adulthood usually. I was no different, except that my stupid was far more damaging than that of anyone else I know. My stupid eventually cost me healthy eyes, fully functioning kidneys, and a host of other things. Even now, 24 years after un-stupiding myself, there could be more to come.
Every year I speak to a group of medical school students about this period of my life (and other things) and one of the very few questions each class has asked is what a doctor might have been able to do to bring me out of it. The answer, of course, is nothing. One has to want help in order to be helped. But it got me wondering what I would say to my young-and-stupid self if I could go back 30 years, to that turbulent time.
The first six months were great. I am an overachiever, so I followed everything they told me to do. Part of it was because I was so scared. Everyone who heard “diabetes” reacted like I was doomed. But after six months, things began to change. My providers weren’t listening to me or my concerns – I gained 60 pounds in six months because they wouldn’t take me off a 2,500-calorie diet. I developed body dysmorphia and an eating disorder, and started not following the rules. At about the same time, I began to realize that I might not be doomed. Nothing awful – no strokes or passing out as I had been told were possibilities – had happened since diagnosis, so I began to relax. Fear ebbed and made way for anger. Well, not anger. Rage. An all-consuming, ever-present, block-out-all-rational-thought virago kind of rage. I put a good face on it. There were no “signs” to report. I didn’t lash out at anyone. Except myself.
My parents saw it, of course. How could you live in the same house and not? They did everything they could, but there was nothing they could have done to change me then. I was so angry. I had paid my medical dues already. In spades. My behavior screamed “Danger, Will Robinson” at my providers, but they were not capable of hearing. The more I pushed the boundaries of care with no consequences, the farther I went.
So, what would I – mid-forties with perspective me – say to her – horribly hurting 14-year-old me?
Honestly, not a lot.
First, I would say stop. Just for a minute. Find the eye of the storm and just take a breath. And before you jump in again, understand your own intentions. I think she knew back then that she was trying to destroy that part of herself that was causing her pain. The problem was that she couldn’t separate that part from the whole. I don’t think she really understood that if she burned down that part, the whole house would come down with it.
Second, and last, I would urge her to be kinder to herself. At the end of a relationship I was holding onto, my friend Squirrel asked me whether it was ok if a guy was treating one of my friends like that. When I said no, she asked me, why then was it ok for him to treat me that way? It brought the point home pretty effectively, and I suspect that my younger self would at least give it some thought to the argument if framed in those terms.
That’s it. No threats. No warnings of what was to come. A little elucidation, a little de-escalation, a little bit of thinking and perspective-shifting. I’m not sure it would have helped, but it would have been the only approach that had a shot. It’s always worked best when she comes to things on her own.
Which is what happened ultimately. She slammed face first into the wall that is complications of diabetes. Literally, since retinopathy (eye damage) was one of the first complications she developed. The other one was peripheral neuropathy, otherwise known as “diabetic nerve pain”, which is a woefully inadequate description of the pain of slowly dying nerves in the legs and feet (or other extremities). Fear exploded again and mitigated rage for just long enough for her to realize that her rage had endangered her sight and her mobility. Again. She wasn’t about to lose the ability to walk again. It was way too much effort to get it back. Even the possibility was enough to cool the rage, and holding onto the reality of it was enough to establish a healthier regimen. It took six years, and there was much more damage to come, but it was done.
And so, here I am. Thankfully, no longer young and stupid.