Sweet Blood

Pappi Tomas  

In the morning, I think of my father. Perhaps only for a moment, and perhaps it is not so much a thought as an evocation, an impression. But he is there with me in the bathroom-there in the cool bottle of insulin, snug in my hand like an egg in a nest; there in the plastic syringe, thinner than a pencil, orange cap not yet plucked off; and in the bottle of alcohol, which I might twist open, if I do as I am supposed to, if I swab skin and insulin vial as I know I should.

But how often is it that I do as I should? That I check my blood sugar, exercise rigorously, show restraint in the way of food and drink? Not often enough. This morning ritual, for instance. I've brought it to such a casual point that it could be a pill as much as a needle. But just as a pill can stick in the throat, a needle stings occasionally, leaves a drop of blood in its wake, reminding me that yes, it is a needle, and yes, I have a disease, and yes, it might hurt a bit, as doctors always warn. I skip the alcohol swabbing, and I skip drawing back the plunger once the needle is in, a step that would show me, if blood swirls into the syringe, that I'm injecting insulin straight into a vein, not into flesh where it can soak in slowly, and lower my sugar safely. I skip these advised formalities because, while I don't mind injecting, I have, understandably, never come to like it. Nor have I come to like the thoughts of my father that prick me each morning, as if each bottle and syringe contains a thin, ethereal wisp of him, waiting to be injected straight into me, my body, my interior assortment of vessels.

And yet I appreciate this sharp reminder of my father, the way I do a Humphrey Bogart film, suede loafers in a shoe-store window, a backyard garden blinking with ripe tomatoes. Not long ago, when my endocrinologist informed me that I might get by with a simple pill in place of insulin, I decided to stay put, to keep the needles and vials I have grown so used to. But I didn't choose them out of nostalgia. I appreciate the reminder, but unlike tomatoes and loafers and Bogart, these medicinal objects have no warmth, no color. Only the skin they mar, the flesh that receives them, only the body involved can flood the scene with life. My body. And through memory, his.

In the mornings, I would sometimes stop beside the open door of the bathroom, the small square room downstairs with a leaky shower, hard cold carpeting, and plastic curtains made to look like turn-of-the-century newsprint, with pictures of women's corsets and primitive washing machines. And there, half blocking these images, my father would stand, performing his regimen for a disease that science had gone a long way toward solving, but whose crucial secrets remained locked in the future.

I see him assemble the syringe, needle plucked from an old margarine container of alcohol; see him tip the perspiring bottle, pull in the milky liquid, flick the bubbles away, then plunge into his thigh; see him wince, hesitate, then press down with his thumb; see him withdraw the shiny needle, dab the skin with a cotton ball soaked in antiseptic. I watch every gesture, every detail-the way he holds the thigh up, like the women on those curtains fastening their garters, the way he rubs the cotton ball back and forth like a pencil eraser.

His colognes rest like trophies on the window sill. On the shelf of the open medicine cabinet are his shaving cream and after-shave lotion, his hair tonic and crumpled tube of toothpaste, the open container of alcohol, the bottle of amber mouthwash. The smell is a combination of all these. Yet it's the rubbing alcohol I smell most. It stings my nose. And I can taste it-as vividly as I did the morning when, to stop me from sucking my thumb, he doused it in the noxious liquid. I waited for the stuff to evaporate, then went right back to sucking, thanks to him under more sterile conditions.

He sees me standing there. I have long given up the thumb. "You want a shot?" he says, brandishing the needle. "You want some insulin?" I step back, a look of disgust on my face. No, I say. But I can't move, I can't leave. I want him to take apart the syringe, drop the needle back into its tub, pull his trousers back on, fasten his belt. I want the paraphernalia to disappear and my father to turn back into a normal father preparing himself for work. Soon he will start singing, some current popular song of which he remembers only the chorus, and then only a part of it.

I was sixteen when my podiatrist, during a visit for a simple in-grown toenail, made a request for a sample of my blood. Dr. Kaner was an old childhood friend of my father's; they used to play football together, and he knew my father had diabetes. Diabetics, he also knew, are susceptible to lasting infections in their feet, where blood does not circulate as it should, and what was an in-grown nail but a kind of infection? And what was the son of a diabetic but possibly a diabetic himself?

No one, not even my parents, had yet thought to test me for diabetes. If the thought had crossed their minds, either they were putting off the investigation, or denying the need for one. It's odd they would do either, in light of the damage my father had suffered over the years. No doubt the specter of diabetes breathed down their necks the moment my mother learned she was pregnant with me; no doubt it shadowed my crib each time she looked in on me. Or maybe at first they spoke of it only now and again, and then not at all, hoping that I would grow up to be healthy, hoping disease is mostly a matter of attention-ignore it and it will go bother some other family.

Why Dr. Kaner himself had never inquired before into my health is a mystery to me; too focused on feet perhaps; though I'm glad my infected toe gave him reason to be curious that day. "Just to be on the safe side," he'd said.

On our next visit my mother cried when she heard the news. "I didn't want you to have to live with this," she said. The test had shown my glucose to be over three hundred. Such a number was unequivocal, they said, no fluke. I was a diabetic now.

I didn't feel any different. But when my mother lamented the fact that I would have to "live with this," I thought right away of my father's life.

I had watched him fumble, and heard him falter, in ways that seemed beyond his control. Part of me resented these signs of weakness. He was my father; he was not supposed to be fallible-not in that way. It was expected that he would force me to hand over wrenches while he fiddled with a power brake, or cranked away at a sink pipe, but not that he should have to stop for a bite to eat and rest. It wasn't so much the idea of stopping for lunch that bothered me as it was the necessity of stopping. And no son, at any age, wants to hear his father wretch, violently guttural, down in the small bathroom with the door shut, pipes echoing. Nor does he want to see him wear a cotton patch over one eye, hear him cry because the stitches from a recent operation are scratching, poking; or see him pace and pace and then pick up his daughter's petite rocking chair and hurl it into the ceiling, bits of wood and plaster littering the floor, a pupil-black hole in the drywall. He would rather his father not play baseball with cousins at family reunions, because though he can hit the ball well enough-a teenage baseball star, after all-he runs with a short, careful step, shoulders hunched, as if the ground might give way. He is embarrassed by his father at such moments, embarrassed for him.

Then, hard on the heels of these images, it was words, the language of my father's disease, that flashed before my mind's eye-gastritis, neuritis, insulin, needles, alcohol-a general impression of discomfort, agitation, and pain. I felt taken by surprise. And because of this, because my mother gave the impression that she had feared this day all along, I also felt betrayed, as if some very important detail of my personal life had been kept from me these many years, as if, like an adopted child who had never been told the truth, I was not the child they had led me to believe I was. And yet to me I was the same child, the same sixteen-year-old boy I had been before my big toe swelled up and festered. I would limp for a while, and have to shower with a plastic bag over my foot. But I would walk smoothly again. Routine operation. No cause for worry.

But I was worried. In my adolescent willfulness, I tended not to take my parents seriously. But something in the tone of their voice told me that I should be concerned, too.

So my father and I, one brisk morning, drove off to the hospital to find out more about my new disease. Our destination was a cramped, dingy-white waiting room with a tall reception counter and low Formica tables piled with magazines. Along two walls were armless vinyl chairs in blue, yellow, green, and red. Besides this bit of color, the bare, stiff appearance of the room did nothing to soften the prospect of my spending four hours there, dreading the arrival of each half hour, when a sample of blood would be drawn from my arm.

If I learned anything about diabetes that day and in coming years, it was that in this disease blood figures prominently. I had heard of symptoms-nausea, dizziness, loss of appetite, excessive urination-but I myself had experienced none of them. The only way, then, to prove I had the disease at all was to take a bit of me and subject it to science: in this case, a glucose tolerance test. First I drank a small bottle of sweet black molassesy goo. Then, each half hour for the next four hours, I offered up a tube's worth of my blood to be tested. Eight needles in all, four on each arm, staggered to prevent bruising. The nurse gave me Band-Aids decorated in cartoon characters, which I was still young enough to enjoy.

In the waiting room people came and went. A television high up on the wall played the news, a few soap operas. After the third or fourth blood sample, each drawn quicker than I imagined blood could flow, I felt like a hardened pro. My father was impressed, too. "You okay?" he inquired the first few times I returned to my seat. Eventually, though, he patted my knee, inspected the bandaged crooks of my arms, and encouraged me to agree with him that there was nothing to it. No, I told him, nothing to it at all. He smiled and went back to reading his Sports Illustrated, drinking vending-machine coffee from a Styrofoam cup.

We didn't talk much those four hours, my father and I, but the morning spent sitting beside each other in the waiting room, waiting for another bit of me to be drained away and inspected, was perhaps the most important time I had ever shared with him. Sure, he had been my soccer coach, and gone camping with me and the Boy Scouts, but never had we shared this much time alone, with no one else to weaken the intimacy. He had taken off work to spend these few hours with me, and why shouldn't he, the diabetic father who had passed on his disease, his legacy, to his first-born son? I had not become a good baseball player, had never enjoyed tinkering under the hood of a car. But I had accepted his disease without a hitch. He had not had to foist it upon me; instead it had snuck into my body. Of course he was not pleased to have given me such a gift, nor was I glad to receive it. But here we were, sharing the event anyway, the ceremony. Blood brothers.

My father escorted me from doctor to pharmacist to dietitian, but never discussed with me his own experience of having diabetes. Now and then he asked me how I felt, but what I learned from him came more from watching than from listening, and watching sidelong at that, curious but wary. It was my mother, oddly enough, the less animated parent, who did most of the talking about my father's disease. It was she who recited the folklore.

It was a day in late autumn and he was sixteen years old. At a field close to home my father and his friends were playing football, and all was fine-the air bracing, redolent of sweat and torn grass and cold November dirt-except that he had begun to feel dizzy, light-headed. In mid-play, the ball zinging past his head and into the hands of another, he felt his legs give way, his head fill with blackness. He didn't feel the ground as his body fell to meet it; he didn't know what had hit him.

Later, perhaps that evening, or the next morning, he was taken to the hospital. There they looked him over, asked a few questions-have you felt strange lately? noticed anything out of the ordinary?-and then drew some blood. In answer, the blood told them that indeed something strange was going on. It told them a sweet, sticky story, a story with many plot complications, one that imposed rules and discipline and ongoing vigilance. And they, in turn, repeated the story to the parents of the boy, whose mother had heard the story already, knew it as her own. And as the boy listened and tried to understand what it meant, he searched the dreamy flow of doctor-spoke words-mellitus, complications, glucose management-for a simple, clear symbol that would make sense of his predicament. Then he heard it, the word he had been waiting for without knowing he had been waiting for it. Pill, someone said. And from a long dark tunnel of needles and blood, he emerged into a wide verdant valley of cool flowing waters, the word pill suspended above, lighting the sky, the hills, like a glowing sun, a warming disc of soft orange light.

He took his pill, promised to stay away from sugar as best he could, though who knows indeed what his best was. He turned twenty-smart, handsome, headed for optometry school. He had a pretty girlfriend, just out of high school, who loved him and whom he loved in return. The next year, they married, then moved to the city. Four years after that, degree in hand, a son on the way, they were ready to move back home, as if to take up their life where they had left it.

By this time he had lived with his disease-that of his own mother-for almost ten years, and all that had been required of him was that one small pill be taken once every morning. After which he forgot his disease until the following morning, so that most of the time it seemed to him he had no disease at all. The pill was magic, each day healing anew.

Now he was a doctor, a father, a breadwinner. He looked with pride and pleasure at his wife, still pretty to him, who was now a mother. But the story inside him continued. Despite the pills he took, despite how healthy he felt most of the time, this disease was taking its toll. What was worse, his prescription had run out and the laws had changed. For years he had not seen a doctor, had not thought it necessary. Now they were telling him it was necessary, if he wanted more of his medicine. But he was afraid, and stubborn, and no doubt felt a little invincible. They say I have a disease, he thought, but I don't feel diseased, I don't feel sick. For weeks I have been without those pills, and what has happened to me? Nothing. So he cursed the pharmacies, for they were trying to curse his life, and he cursed the doctors, who he was sure would bring him down. He threw the empty bottle away.

The following years were full of trouble. At the office where he examined eyes there was a soda machine, and each day he drank bottles of cola, sweet and fizzy, cold and uplifting; he looked forward to each one, to the cap pried off, the glass touching his lips. He had forgotten his disease, forgotten his pill. He was free now, working, eating, loving, sleeping. He lived as any man might who had everything in life he had ever thought he would need.

At first his stomach revolted, bubbling over like those dark bottled soft drinks. Then his nerve endings grew sensitive, pricking him at the touch of any but the softest fabric. At night his legs and arms felt cold, so that he could fall asleep only in stockinged feet and full-length pajamas, which had to be silk. The world was becoming hostile to his senses, and as if to shrink from it, he ate less, lost weight, lay in bed longer and longer. His wife pleaded with him to call his doctor, ask about more pills, but he would not, not until he was too ill to do otherwise.

When he did call a doctor, who put him straight into the hospital, it was too late for magic. He had been too long without it, too long unprotected and unconcerned. He had no choice but to pierce his skin with needles, as if it were a punishment. And the needles, like the pills had done, healed him, though a part of him would always be ill. This time he would not be allowed to forget. Each day would reveal the next page of the story within him, and he would be obliged to read.

After my father died, eyesight faltering, kidneys failing, blood pressure refusing to stay put, I was certain, at nineteen, that our stories were nearly identical. I would die young too, if not at forty-five, then not long after. Even now I am struck by how similar my story is to my father's. From the age of my diagnosis, to the pills I took for several years thereafter, to the cavalier attitude I have often assumed toward the seriousness of diabetes. We diverged, however, somewhere in our twenties, when his attitude degenerated into gross neglect, his body along with it, and mine acquired enough sober confrontation to keep me seeing doctors, taking pills, monitoring the ups and downs of my unreliable blood sugar.

Why, I ask myself, was my father so careless with his disease? Why did he not at least see a doctor when he needed one, renew his prescription, keep abreast of his body? And why, at times, have I been so careless with mine?

For my part, I have always been too spoiled. My parents, in their zeal to provide, to prosper, gave me nearly everything I wanted, more than what I needed, and outside of homework and acne, they made all my important decisions. So when I found myself, a teenager, seated before a dietitian-a cheerful young woman with ruddy good looks, glowing with health as a dietitian should-I was cheerful myself, and cooperative, but not that serious. It boiled down to this: my half box of vanilla wafers munched in front of the television was now twelve starch exchanges and six fat; my bottle of Coke was four apples' worth of sugary fruit; the butter slathered on one slice of bread was enough, in theory, for my entire supper; and the formidable mound of broccoli, which I could hardly force down as it was, could stand to grow five-fold. And regular exercise? And I had to break this pill in two and swallow one jagged half every morning? Were they kidding?

In answer, I had only to recall Larry, my wrestling partner in seventh-grade gym class, who had died of diabetic complications. I felt guilty still, recalling that I had never let him pin me to the mat, his light body, his belly soft and lumpy, he had said, from years of needles. And I had only to think of my father, whose eyes had already begun to hemorrhage, his vision now and then impaired by squiggly ink marks, like jellyfish silhouettes. He discussed little with me, but the grave cast to his expression, which I noticed between his shenanigans, told me what I needed to know.

Yes, I believe he must have spent a part of each day wearing that pensive face, brooding over his body. He was concerned. But also angry. Diabetes angered him. Painful, slow-to-rise mornings; dizzy, famished insulin reactions; early-evening exhaustion; and the prohibitions-none of this, less of that, no drinking, no smoking (and he did smoke well into his late thirties). All this made him irritable, and angry. It was this mixture, I believe, of fear on the one hand, and anger on the other, that resulted in a kind of two-faced defiance, now casually dismissive, now belligerent and stubborn.     

He'd let go of the beer of his college days, and eventually the cigarettes. But as far as I could tell growing up, he'd never given up sweets. My mother baked him special low-sugar cookies, but he supplied himself with bags of small candies poured into bowls, disguised as treats for the kids, and ate plenty of ice-cream, which we ate along with him. My mother chided him, but succeeded only in raising his Italian temper. "Would you lay off," he'd say. "I'll eat what I want." Only then did he resemble a kind of over-pampered child, petulant and greedy, resentful of being deprived.

Mostly my mother did leave him alone; it was her disposition to let him do as he pleased. Later, after he had pleased himself to death, I blamed her for her permissive attitude. Why did she not fight him with gusto to match his own? Why did she not fight to save him? In her place, wouldn't I have done more, been more tough on my father? But as I turn a critical eye on myself, I realize that I, too, could have tried to influence him. I was his son after all, his oldest. And yet it came as such a shock to me the morning my brother called at my university dormitory to break the news, and with it much of the faith I'd had in my future.

A shock? How could that have been? I'd known how sick he was. Hadn't we all? "I didn't think he would leave us this soon," my mother said that morning, soon after I had arrived to a dim house already filled with relatives and neighbors, the gloomy sounds of crying all around me. He had left his warm place in bed beside her that morning, early; had settled into a soft living room chair by the front door; and at some point had stopped living. But not this soon, my mother said, draping her arms limply around my neck. Meaning what? That she had expected him to last, say, at least another year, another five years? He was forty-five; most would agree his departure was premature. But in my mother's shaky words there was more than recognition of a fact so trivial. I did not think it then, but her voice recalled the day Dr. Kaner told us I had diabetes. "I didn't want you to have to live with this," she had said. Then as now, she had been fearing the day of reckoning, and if not fully expecting it, then awaiting it with a dread perhaps half-hidden from herself, and fully hidden from me. Yes, she had given my father much thought. And me? That morning, before the phone rang, I had been shaving, rubbing the bathroom mirror free of steam to see my face. I had been looking at my face, but not thinking of my father, the person I most resemble. No, he had been nowhere in my thoughts.