Indiana Jones and the Pharmacy of Doom

     Yeah, I suppose I've been soft-pedaling the emotional aspect of all this. There's a definite "Why me?" component to finding out you have  a disease like diabetes. Or as I put it to a neighbor. "So not drinking red wine for the rest of my life wasn't enough; now I can't have a piece of fucking toast?!?"
     That isn't entirely true. Your blood sugar craters — 58! — you can have something sweet, and twice I've turned to my drug of choice: two pieces of black Kookaburra licorice. But in general, I'm facing a considerably constrained palate, looking down the road. Suddenly a turkey club on wheat toast is as forbidden as a shot of Jack Daniels.
     But my wife stepped up, preparing delicious, low-carb, low sugar meals. And honestly, the struggle to feel well and get my blood in order made the menu a distant consideration. The hardest part is logistics. Finding an endocrinologist — the one I was sent to isn't taking new patients. Or, my God, filling prescriptions. After I got my doctor to put me on insulin, it took six, count 'em, six visits to Walgreens to actually get the stuff.

     The first trip to the drug store, the insulin was supposed to be ready, but actually wasn't. "Come back after 2," I was told. But when I returned, "the shipment didn't show up." It seems the Northbrook Walgreens doesn't stock Lantus insulin, but gets it from another store. The third time they gave me the Lantus. I went home and discovered they hadn't given me needles. The needles are kinda important. So I returned, a fourth time, and found that my doctor hadn't prescribed the needles. I was told I could just buy them — $80 — or contact the doctor and get a prescription. Perhaps it was cheap of me, but I decided to call the doctor and come back. Why pay if I had them coming? I'd been waiting for days; what's another hour?
     The fifth time Walgreens had the needles, but needed an hour to fill the prescription. I asked why they couldn't just walk the needles over to me — I could see the box; they were right there on the shelf — the way they had when they suggested I buy them? The clerk checked with the pharmacist, who said no, they were too busy. 
    I was kinda busy myself, trying to live my life. Or had been, until this ailment showed up and took it over. Now I was going to spend my days standing in line at the Walgreens pharmacy. "Why this is hell," Christopher Marlowe wrote. "Nor am I out of it."
     At least the Walgreens isn't far from my house. Still, a lot of hustling back and forth. One time driving the few blocks, Hozier's "Too Sweet" came on the radio. I cranked it up, and that song segued into "You Can't Always Get What You Want." Now WXRT was providing a soundtrack to my struggles. I took comfort in, "But if you try sometimes, you get what you need."
    Which indeed was the case. "Hell" is overdramatic. It's merely annoying. And if this is a challenge for a moderately bright, relatively energetic, college educated professional journalist skilled at extracting information and pressing institutions, what must it be like for people who are less resourceful? Who don't have insurance — 7.2 percent of Illinoisans have no medical insurance.  There are yawning cracks in the process that are easy to fall into. Several times I found myself imagining: what if Elon Musk had set himself to trying to get everyone the health care they deserve instead of trying to get somebody to Mars? Idiot.

     Meanwhile, I was online, trying to figure out how to give myself injections.
     "This is a very dangerous medication," chirped That Nursing Prof, with a kind of laugh. "Very important you get this double checked by another nurse before you inject."
     Not an option for me, alas. My daily medical care was going to be very much a DIY, amateur effort, aided by Dr. Google.
     And I don't want to leave you with the impression that I blame Walgreens. It's clear they're understaffed and overwhelmed, and I found, when pressed, the pharmacists and clerks could be kind, and go beyond the call of duty. Getting my Crestor, a statin that allows grapefruit (I figure, claw back what regular life can be regained) I had a conversation with the pharmacist, Anish, that bordered on philosophy, as we mused that grapefruit, like life, delivers its sweet deliciousness mingled with bitterness.

     "That's why I'm so attached to grapefruit," I said. "I'm pretty bitter myself." 

     I'm trying not to be. Yes, there is often the Indiana Jones, escape-from-the-giant-rolling-stone-ball-and-come-face-to-face-with-the-tribesman-and-their-blowguns aspect. When I tried to refill the Lantus pen prescription, Wednesday insurance sent me a text message that it was too soon, based on the minimum doses and not what I was actually taking. Then, after calls to the doctor, Walgreens wanted four days to fill it. I appealed in person, and a pharmacist found the pens — at a different location, but just down the road. But when I went there to claim my pens, I was told they were ready in theory, but not in reality, and had to wait a half hour. I took a seat, and a workman walked over and began drilling into sheet metal a few feet away.
     The beauty of all this is, there really isn't a choice. You can ignore it, and develop one of the hideous side effects — blindness, neuropathy, amputation, death. Not a lot of toast when you're dead, discounting the possibility of hell. Plus, as I keep telling myself, "Nine-year-olds manage to cope with this..."
     I promise I won't write about diabetes forever. It may seem that way. But for the moment, it's the only show in town. If it seems all-encompassing and oppressive, well, welcome to my world. Generally I go about my business, forget about this for 10 or 20 minutes at a time. Work of course is a comfort ("Work," as Noel Coward once remarked, later in life, "is more fun than fun.")
     There have even been moments of happiness. Early on, I had hurried to Sunset Foods to stock up on stuff I could eat. I rode my trusty Schwinn Cruiser, and was coming out of Sunset with its black metal basket full of spinach and chicken and pork chops, and some sashimi for lunch. A gorgeous sunny day: 68 degrees. And I could feel my brain reboot, like I had gotten my mojo back, and for the first time in days was myself again. I went home, laid lunch out nicely, tried to be festive about it, breaking out my new blue whale chopsticks holder. Yes, this is a struggle, but as Hemingway said, the world is a fine place, and worth the fighting for.

Diabetes 'a huge public health problem'

     You know what's a great motivator for dieting? The prospect of going blind. Or having your fingers become permanently numb. Focuses the mind wonderfully.
     Or maybe that's just me. I immediately snapped to the idea that diabetes (which I wrote about contracting on Monday) means your body isn't processing insulin properly, causing sugar to overload your bloodstream and rot your plumbing. I leapt to get my blood tested, see a doctor, do whatever I'm told: take drugs, banish sugar and carbohydrates from my diet.
     But maybe that's just me. Maybe I'm an exception. How many diabetes patients receive their diagnosis and then do what they're supposed to do?

Dr. Anthony Pick

   "The minority," said Dr. Anthony J. Pick, an endocrinologist at Northwestern Medicine. "There's a lot of inertia, people who go years with poorly controlled diabetes. Because it's a chronic disease, and it's a lifestyle, a lot of patients struggle."
     With nearly half the country overweight, diabetes has skyrocketed — a third of American adults are prediabetic; 10% have the disease.
     "It's probably getting worse," Dr. Pick said. "It's fairly depressing when you look at the level of diabetes care. It's a huge public health problem."
     Especially given the silly stuff we do obsess over — shark attacks, asteroid strikes — diabetes doesn't get the attention it deserves.
     "There's a lack of awareness," agreed Dr. Pick. "Diabetes is the tip of the spear of chronic poor lifestyle disease: fatty liver, sleep apnea. The No. 1 killer is cardiovascular disease, and diabetes feeds right into that."
     Diabetes runs in certain populations: Blacks, Latinos, Asian Americans get more than their share.
     "Pima Indians have a 90% incidence of diabetes," said Dr. Pick. "In certain populations, the numbers are staggering."
     The jury is still out, but it seems that I didn't get mine from poor lifestyle habits — being obese, not exercising, smoking, etc. (Type 2) — but from my body attacking my pancreas (Type 1). A genetic alarm clock went off, perhaps nudged by other factors medicine hasn't yet pinpointed. Dr. Pick said perhaps even COVID might play a role.

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"Riding that storm runnin' through my veins"

 

Luke Combs

     Music is medicine. Not that it literally heals you. Unfortunately. Rather it inspires, bolsters the will, injects courage to push forward and do what must be done. 
     For me anyway. I've always listened to music, especially when I exercise. It's almost impossible for me to work out in silence. Music helps pass the time and encourages me to do better. Particularly on the stationary bike, when I not only listen, but sometimes watch videos. I've watched Andra Day's "Rise Up" — the version using video from the 2012 London Olympics — 50 times if I've watch it once. Always gets the blood going.
    If you read Monday's column, you know I was diagnosed with diabetes at the end of September. It's been a slog. I'm going to write about it again in the paper Wednesday and maybe Friday, "I don't know," to quote Indiana Jones. "I'm making this up as I go."
     I don't want to write about it too much. Nothing is more dreary than to hear some sick person complain. On the other hand, it is new, a body of knowledge I have to master. As any Dante fan knows, if you go to hell, take notes. Not that this is hell. Far from it. I keep reminding myself that his is Affliction Lite. Some people have it much, much worse. I'm blessed to have health insurance, a skilled, compassionate doctor, and a knowledgeable diabetes educator. Still, it does suck; writing about it makes it suck less.
     It helps to have a song. When I was in recovery — well, you're always in recovery — when I was in rehab, music was key. Someday when I take a week off I plan to write a weeklong series, "Songs about Sobriety" highlighting some essential tunes. "Fallen" by Sarah McLachlan or "Mr. Hurricane" by Beast. "Can you imagine even one more day, with a beast right up in your face?"
     When I got drop-kicked into DiabetesLand, I found myself turning more to country music. It has a passion, a raw human emotion, and an honesty that I've been drawn to more anyway, but is extra valuable in a time of distress. Hard not to relate to a song like Jelly Roll's "I Am Not Okay" when you are, you know, not okay.
     A little too dire to be useful, though, as a shovel to dig out of this mess, however. For that, I've settled on Luke Combs' "Ain't No Love in Oklahoma" from the "Twisters" soundtrack as my Official Diabetes Theme Song. An infectious opening guitar riff, then: 

I keep chasing that same old devil
Down the same old dead end highway
Riding that storm runnin' through my veins
Like a shot down, tail spun airplane
Scared of nothin' and I'm scared to death
I can't breathe and I catch my breath

    No shit, Luke. Storm running through my veins indeed — it couldn't be more spot on if it mentioned glucose levels and epipens.  I listen to it every single day, sometimes more than once a day. 

    Enough. My gut tells me I might be straying into oversharing territory. Maybe you can make me feel less exposed by mentioning music you turn to for comfort and inspiration.

     Readers have been very creative when it comes to suggesting songs, and since I wrote this, I've development my "Kick Diabetes' Ass" mix, which I'll share below, in case anybody wants to poach from it.

       

The algorithm will see you now

     People are troublesome. And expensive. We've seen the steady exile of problematic, costly wetware, replaced with vastly more efficient — and a whole lot cheaper — computer programs. Out with telephone operators, in with phone loops. Out with cashiers, in with self-checkout kiosks.
     I get that. And go along, grudgingly. If I pulled into a gas station, and one way went to self-service pumps and the other to an attendant in a freshly starched uniform and peaked cap hustling out to pump the gas, wash my windows and give me a stick of Doublemint gum, I'd certainly opt for him. A few times. But if his gas cost 25 cents a gallon more, it wouldn't be long before I'd find myself guiltily edging into the self-service line, avoiding the attendant's gaze.
     How reluctant I was to use those self-checkouts, at first. As if it were stealing from the cashiers. Which of course it is. Then the grip loosens, and tradition tumbles into the abyss. Technology wins.
     Still, each time you encounter the shift anew, it's jarring. The past month I've been going through ... let's call it a medical crisis, for now. In September, I lost 10 pounds without trying. Then I was thirsty at night. Really thirsty. Up every hour, tongue glued to the roof of my mouth. My eyes were dry. I'd gulp a few Dixie cups of water, put in eyedrops, go back to bed.
     After the second night of this, my wife urged me to get a blood test. So I went to a Quest Diagnostics, the McDonald's of blood testing. I found myself in a crowded waiting room, but no attendant. People lined up in front of a computer terminal and entered their information, then sat down.
     This struck me as something new, the unattended waiting room — the next step with AI and Zoom medical exams. Someday you'll get your full checkup, be poked and prodded and weighed by robots, without ever seeing a living person. There was one at Quest: Every so often, a woman would open a door and bark someone's name. At least machines don't yell at you. Yet.
     Turns out my test wasn't in their system. My doctor's office was a few steps away — I hadn't gone there first due to an insurance conundrum impossible to express in words. So I walked over, planning to get my blood work order and return. But once in the comforting office of a doctor I've been seeing for 20 years, I decided to just get my blood drawn there.
     That evening I received a brisk email titled, "Test result available on Portal." Half the time I can't even log into these things but somehow managed. Checking your results can be fraught — I'm not a doctor, and interpreting raw data can be confusing and scary. I began on my "Comp Metabolic Panel" and didn't have to get far. Front and center, the first item was: "GLUCOSE 318" while the "REFERENCE RANGE" was "60 - 99 (mg/dL)."
     That was all too clear: My blood sugar was triple what it should be. Part of the advice Dr. Google gave was to proceed to a hospital immediately. "Do not delay."

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It isn't ALL lies....

Roman toy shop

     Credit where due.
     Donald Trump is a very honest liar. 
     Hear me out. Yes, he vomits forth an endless spew of self-aggrandizing untruths. I can't begin to allude to them specifically, there are literally tens of thousands. A recent favorite: he is "the father of IVF."  WTF? It instills a sense of near wonder. For its pure daftness. He can't believe it himself, can he? Delusion or lie? An interesting question, but also a distinction without a difference.
     Yet through the cracks between the lies shines candor. Trump sometimes says exactly what he will do, pointed truths even more shocking than the lies.  He avows his unwavering support for despots in general and Vladimir Putin in particular. He outlines his intention to use the government to harass enemies, squash the media, subvert elections so his followers never have to vote again.  His passion to expel immigrants, even legal immigrants. 

     He could shoot someone in the middle of 5th Avenue and not lose a vote. He said it. And it's true. At this point, he could go to 5th Avenue and shoot someone, to illustrate his point. How shocked would we be and for how long? Not much on either account.
     Said it almost a decade ago. Compare that to Saturday night's calling Kamala Harris a "shit vice president." Which pales next to his truly bizarre ramble about golfer Arnold Palmer's manhood. This is the past and perhaps future president. Someone with a coin toss's chance of being re-elected in a little more than two weeks. 

       None of this is new. Facebook served up a comment of mine from 2016:

So let's review, shall we?

Donald Trump refuses to accept the basic mechanism of our democracy, the orderly transition of power after an election, citing imaginary voter fraud. He closes his eyes to Russian manipulation of our election, denying the evidence endorsed by 17 government agencies. He calls his opponent, stolidly accepting his blather and insults, "a nasty woman." Yet millions are voting for him. I just don't get it.

     Sound familiar? 
     Lately I've seen friends online marveling what the appeal of Trump could possibly be. Really? You haven't figured it out yet. C'mon. Get with the program: his followers are grievance junkies. Their lives are the fault of dark forces beyond their ken. Period. In their view, they are not responsible for their setbacks and wrongs. Others are. If they can't find a job, it's because some Venezuelan who walked across the Darien Gap and can't speak English and is a criminal in a gang nevertheless managed to show up and take it. 
    Even the "can't find a job" trope is generous. Giving others the benefit of the doubt is murdering democracy. A lot of Trump supporters aren't suffering unfortunates, but the gilded upper 1 percent, trying to maximize their advantage. Elon Musk, richest man in the world, prancing around Trump like a cast member from "Godspell." I reviled him before. But the sun will go out and be a cold ember and Musk's infamy for his daft Trump push will still be fresh in my mind.
    Trump might win. If he does, the nation will go to the dark place his backers occupy and the United States of America will certainly fail, or slide closer to failure. For a very long time. The future is dim. When was the last time you saw something made in Russia? They  don't even lead the world in the production of vodka.  
    There is hope Trump won't win. That's as far as I'll go. Trump might lose, both the election and his clown coup that will come afterward. I hate that the media says it "might" happen or he "seems" to be laying the groundwork. It will happen. Take it to the frickin' bank. Strap in. It's going to be a wild ride. Another wild ride.

Katsura tree

     No matter how many times I visit the Chicago Botanic Garden, I always notice something new. Friday afternoon — sunny, mild, in the mid-60s — it was this katsura tree, caught by the afternoon light in full autumnal splendor.  I'd swear I've never seen it before. One of only two members of its family, cercidiphyllaceae, so named because the leaves, apricot-colored in fall, look like those of a redbud, cercis, though the two are not related.
     The katsura hails from Asia. An ancient Chinese legend places a katsura tree on the moon. As the "katsura man" prunes it, the moon wanes (I haven't found an explanation of what happens when the moon waxes — maybe the leaves grow back). 
    Though Asian cultures tend not to put men on the moon, in the Western fashion, but rabbits. As to why the rabbits don't trim the tree, since they're there, well, nobody says these myths must be consistent. 
     Wood from the katsura tree is used to make Go and chess boards, for its warm hue and beautiful grain, like ripples from a pebble thrown into a pond. 

     Tree experts praise the katsura for being interesting to look at in all four seasons, even in winter, due to "handsome winter branch architecture." I'll have to make sure to circle back and confirm that. The scent of the leaves in autumn is also said to smell like caramel, or cotton candy, or "freshly baked muffins." I photographed the leaves up close, but didn't know enough to come in close and take a whiff. Now I do; good reason to go back to the Botanic Garden soon, as if another reason were needed.

Books on the nightstand: The Whore of Akron

     Really? It's been seven years since I offered up a new installment of "Books on the Nightstand"? Negligent of me — or of you. You're supposed to keep me on my toes, chide me about such things. "Hey Neil! Aren't you reading anymore? Spending all your time watching clips of 'Young Sheldon' on Instagram, are ya?"

     No. Still reading, still researching. Which is how I stumbled upon Scott Raab's "The Whore of Akron: One Man's Search for the Soul of LeBron James." Published in 2011, the book is an example of that once common, now rare literary form: a philippic, a screed against an individual, an ad hominem attack, in this case keelhauling LeBron James, NBA superstar and the titular whore, roundly damned him for abandoning his Cleveland Cavaliers and flouncing off to Miami in search of championship rings.
     Not the sort of book you'd imagine me reading; me, who nearly asked Michael Jordan who he was when I met him. But I am working on something related to our mutual hometown, came across the book, and figured it would fill holes in my knowledge base.

     Boy, has it ever.
     Frankly, I was a little surprised I hadn't heard of Raab previously. We share at least half a dozen common characteristics, being both: 1) from Cleveland; 2) Jewish; 3) alcoholics in recovery; 4) prone to fatness; 5) associated with Esquire; 6) experience drinking with Wright Thompson, the ESPN scribe. It's a big world, I suppose; you can't keep track of everything. 
     Though Raab far surpasses me in #4 (topping out at 388, while I never weighed more than 225) and #5 (he started as a writer-at-large for Esquire in 1997, while I wrote one profile and contributed a few items to the "Dubious Achievement Awards.")
     What makes "The Whore of Akron" well worth seeking out is Raab's voice. I sincerely couldn't give a shit about LeBron James or his championship hopes in the first decade of the 21st century. But Raab performs the same magic trick that Robert Caro does — taking someone you'd otherwise care nothing about and turning him into a font of fascination, though the book is about Raab far more than LeBron. The author is virtuosic at plumbing the queasy mix of pride and resignation that afflicts all who harbor a little patch of Cleveland in their hearts, starting with his Lost Eden, the 1964 Cleveland Browns championship, which he had the misfortune — in my view — of attending as a 12-year-old.

     "That flag still flies in my soul," he writes. "The roar still echoes in my ears. The vision — of Cleveland triumphant, of Cleveland fans in communal thrall to a joy beyond all words, of a Cleveland team lifting the town's immortal heart to heaven — still fills my eyes."

     Me, I'd observe that success is an addiction too, like anything else, and if you find yourself wanting something too much, and chasing it too relentlessly over the years, maybe it's time to forswear it and find satisfaction elsewhere.  But I am not a sports fan. A guy who has written every day for 11 years plus shouldn't lecture anybody on abandoning oneself to pointless pursuits.
      Raab is a searing, fearless writer. I thought I was candid, having written a frank book about sailing with my father. Raab writes about trying to kill his grandfather: "Once, my brother David and I tried to kill the old man. While he was at shul, we wedged the front and side doors tight, waited on the upstairs back porch until he came around the back door,and then fired every knife in the house down at himi the hope of poleaxing his yarmulked skull with one of them."
      I deploy my cute little metaphors like paper boats in a bathtub. Raab rakes his cheeks with his fingernails and scrawls his thoughts in blood on a white wall. Reading Raab, I felt an emotion that I can't recall ever feeling reading another writer: shame. I felt kinda ashamed, of myself, and my own weak tea craft, compared to the high-octane heat he brings to cavailing James as a loser and headcase. My favorite passage, the one I read out loud to my wife, is:

"I'm calling my wife now. As ever, I get rolled into voicemail. I try the landline. Hope. I try her cell again. Nada. Landline. Cell. Landline. Cell. Landline. Cell. She is unavailable. Unreachable. I miss her. I want her to be there for me every time I want her to be there for me. I want to whisper in the small pink shell of her ear that as our years together have unfolded, the mystery of our love grows ever more unfathomable, especially the mystery of where the fuck she is or why the fuck she doesn't answer her fucking cell phone."

     That last sentence, the pivot it makes, is brilliant. Though speaking of his wife, the book does have a notable flaw — in my view. And to give you an idea of the gap between us, I can hardly articulate the sin he commits. But here goes. His beloved, respected, wife makes her first appearance in the book when he calls her over for a handjob, an act which is almost a leitmotif in the book. That doesn't seem respectful. While I'd never judge another man's relationship with his wife, I do know that if I presented my wife in that fashion in a book of mine, she would rip my heart out and taunt me with it as I died. So if you do read the book, and you should, know that's waiting in there.
     Otherwise, it's all pain and Cleveland fandom, set out in Hunter S. Thompson level prose that snaps between Los Angeles and Miami and Cleveland. There are descriptions of basketball games, but not too many. A book should create a world, and as someone who only vaguely knew that James eventually won a few of those championships — I think, I'll have to check (four; quite a lot, really) — it's a joy to see him portrayed as a quitter and a crybaby. 

     Yes, I wish Raab could put some distance between himself and the salmon-to-spawn desire for a championship that so animates sports fans, step back, and explore why the self-worth of an individual — many individuals — can rise and fall on the record of a team whose efforts, really, have nothing to do with them. To him, it's a given.

     "I truly believe that Cleveland's collective soul will be redeemed on that great and glorious day," he writes. "Nothing less." 

      Trust me, as someone associated with a city whose baseball teams have won a World Series apiece in the past 20 years: redemption is elusive.

     Plus I wish he could have considered how a guy supposedly in recovery can take that much Valium and Vicodin. 
     But those are quibbles. October hasn't been the best month, and "The Whore of Akron" is one of those books I opened with gratitude and read with pleasure, an escape from grim reality hanging all around like fog. I've already picked up his second book, "You're Welcome Cleveland" and will turn to that next.
     Sometimes, when someone accuses me of being successful, I point out that I'm not even the most successful writer living in Northbrook — that would be Bob Kurson, author of best-selling "Shadow Divers" and other wildly-popular volumes. Now, with the discovery of Scott Raab, I can say I'm not even the most successful alcoholic Jewish writer from Cleveland with a troublesome family. Still, given what Scott Raab has gone through, and how excellent he is at conveying it, I do not begrudge him the title one bit. Okay, well, maybe a little.