Choose wisely

 

     I'm not rich. But I understand one often becomes rich by putting money first. You ignore your family, your own health, the marvelous and varied world, and focus on doing the thing that makes you rich.
     But I figure, once wealthy, the whole point is that then you are then freed by those riches. You can do what you like, thumb your nose at convention and authority, act on whims. Like buying a major American newspaper. As vile as Amazon can be, as a company, lining up ambulances to cart away workers who collapsed from heat exhaustion, and forcing them to wear adult diapers because they couldn't take bathroom breaks, I always said, "Well, Jeff Bezos bought the Washington Post." It seemed exculpatory, as the lawyers say. He was forgiven.

Katherine Graham, by Diane Walker (Nat'l Portrait Gallery)

    And now he cravenly spiked the Post's endorsement of Kamala Harris so as to not affect his financial relationship with the perhaps future president. To ensure he can earn even more money. That he doesn't need. The kind of prophylactic groveling that greased the skids toward fascism. Plus, Bezos is a smart man — he must realize what Trump is. How many reputations he's ruined. Elon Musk could cure cancer and establish a thriving colony on Neptune and he'd always be, to me, the imbecile giddly prancing around Trump. You can't unring that bell. 
     Shortly after the shock of Bezos's moment of cowardice — a failure which will haunt him like that of Lord Jim — my pal, two-time Pulitzer Prize winner Gene Weingarten, sent out this week's blog post. I don't want to seize it — you can read the full thing here on his excellent blog. But I believe I can quote two paragraphs without doing him violence. He's talking about Katharine Graham, the publisher of the Post:

     In June 18, 1971, The Washington Post began publishing The Pentagon Papers at a time of extraordinary tension between the media and Richard Nixon’s occultly corrupt government. The decision had been made the day before by the only person with the power to do it: Katharine Graham. Printing the stolen material was possibly a felony. The New York Times had just been enjoined by a court from publishing the documents. It was not unlikely that Nixon’s Justice Department would seek criminal penalties from The Post for breaching that order.
     During a dinner party at the same Georgetown mansion, with the very survival of her newspaper at stake — the government wielded enormous economic power over the media, particularly through licensing of their broadcast affiliates — Mrs. Graham considered a few moments, then gave the order in five two-word bites: “Go ahead. Go ahead. Go ahead. Let’s go. Let’s publish.” When her lawyers warned her that the government might come after the editors with subpoenas for the papers, and they might face prison for refusing to cough them up, she ordered that the documents be delivered to her house, so she and she alone would be the one to defy the subpoena. Let them put an old grandmother in jail, she said.

   Courage is remembered. And cowardice is never forgotten. Choose wisely.

 

Cede fortunae.

   

          "The Death of Seneca," by Jean Guillaume Moitte (Metropolitan Museum of Art)

     Seneca is dead. Needless to say. By his own hand in 54 AD. On order of his former pupil Nero, "some of whose worst misdeeds he did not prevent," in the words of a flap copy writer at the Loeb Classical Library, a phrase that should disturb any one of numerous politicians and billionaire newspaper owners groveling before a more recent tyrant. If only they could, you know, be disturbed by criticisms of their actions.
     But Seneca can spring to life, thanks to his writings. And recent events being what they are, I returned to the conflicted, contradictory epicurean philosopher, starting in on Volume I — Moral Essays.
     As always, I found grist for thought aplenty. In "On Providence," he discusses how the hardships men endure increases in direct proportion to their worth. Quanto plus tormenti tanto plus erit gloriae. "But the greater his torture is, the greater shall be his glory." Uh-huh. Pretty to think so. Spoken like a rich and powerful man who spent his time relaxing in mineral baths at his luxurious country villas. Seneca was a big fan of standing up to abuse — for others, in theory. I don't quite buy it.  
     He does offer an appealing image of fate as a dutiful father. What does a caring parent do for the education of sons? Rouse them from bed painfully early, set them to hard tasks and difficult studies, all for their future betterment. So fate harries and harasses her favorites. "She seeks out the bravest men to match with her ... those that are most stubborn and unbending she assails." In order to shape and improve them. 

     Seneca says that kind of thing a lot — what's the point of being a good, strong person if you never get the chance to show off what you've got? Affliction is a celestial compliment. Gee thanks.
     That is page 21. But on page 233 I came upon something more persuasive, or at least more useful to my current mode of thought: cede fortunae. "Submit to fortune." You have to — what choice is there? Denying fortune doesn't really do much good. Some things can't be changed. Why rail at the inevitable?

    Cede fortunae. Looking at the Latin, it reminds me of one of my favorite lines in the classics, Virgil's tu ne cede malis. "Yield not to evils." Book VI of the Aeneid. Which leads to the essential dilemma: is this fortune's will, to be accepted, or a wrong to be battled? 
     Hmm...good question. How to tell? It's really a restatement of the Serenity Prayer: "God grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference."

    That can be a tough call. Sometimes something can seem bad but ultimately be good — I use the example of anti-Semitism in Poland in the 1920s. Bad for the people there, generally; good for my grandfather, specifically, since it set him on the road to the United States, so that when Holocaust took place, he was dandling my mother on his knee in Cleveland. Luckily he went where fate blew him.
     I try to keep that dynamic in mind when seemingly bad things occur. A certain development appears bad now. But might it not yield up something good, if I respond in the right way? Might it be, not a setback, but a benefit? A journey? You don't always want to go somewhere, particularly when forced: here's your staff, your hat, get going. But having no choice, you set out on the road, and suddenly you're seeing things you would not have seen nodding at home by the fire. Maybe the setback is really an adventure in disguise. Let's hope so.

Prayers, menu tips: Advice to a new diabetic from Sun-Times readers

     Keep a water bottle by your bedside. Resize your wedding ring so it doesn't fall off. Take berberine, turmeric and cinnamon.
     Readers flooded me with advice after my columns earlier this week about diabetes. Thank you everybody, both for the practical tips and the warm sentiments. I truly felt embraced.
     Some shared huge amounts of information: web pages and podcasts, books and lists. They overflowed with culinary suggestions. 

Smithsonian Institution

   "Now I buy bread with 1-2 carbs (easily found at grocery stores) and eat french toast, grilled cheese etc." wrote Jane R. "Creamy salad dressings are better than 'healthy.' Peanut butter puffs cereal is better than organic 'health' cereals. Dark chocolate coated almonds are low carb and sweet. It's a whole new way of thinking but it works. Go check out the labels!"
     Others were delightfully concise.
     "Have to cut down on bread," was the entirety of Virginia M.'s email. (I decided to use just the last initial of readers' last names to spare them any online blowback).
     Some were spiritual, offering prayers and good wishes. They shared stories of personal tragedy.
     "Our 28-year-old daughter died from complications of diabetes," wrote Robert N. "Our daughter never wanted to accept. She was diagnosed at a very young age and it was an effort to keep her healthy. So many doctors, so many hospital visits. Wore all of us out … and finally her body just gave up."
     Several wrote about their young children. Now when I begin wallowing in self-pity, I rebuke myself: "Show some spine; there are 4-year-olds coping with this."
    The fight brings some families closer together. Mary Lou O. wrote that her 19-year-old granddaughter was diagnosed earlier this year and it has been a bonding experience for them:
     "Our [physician] gave her an order to attend educational meetings with two very helpful diabetic RN/Dietitian/Nutritionist ladies. I attended those meetings with my granddaughter and we both learned a lot about necessary lifestyle food changes. "
     She sent me the nutritionists' business cards — there's a lot of networking, trying to navigate the system.
     A positive tone ran through my emails. Some were more enthusiastic, frankly, than I am quite ready to accept.
     "Welcome to Club Diabetes!" wrote Royal B. Which made me shudder, a little, for its Tod Browning "One of us! One of us!" quality.
     Email gets a bad name, but I found readers, perhaps because they take a moment to gather their thoughts, responded better than some of my actual friends in the real world.
     "That's horrible," a colleague exclaimed when I gave him the news, really getting his back into that second word. He then proceeded to tell me about Ron Santo having his legs amputated — several people shared the experience of the heroic Cubs Hall of Famer, never pausing to consider whether it perhaps is not the story I want to hear right now. There was a bit of that.

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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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