Operation Beautiful

The next day I watch as Emmaleigh learns how to inject an orange and then herself, I take notes on the different types of insulin, practice how to fill up a syringe and how to inject myself, since Emma was too scared to do it alone at first. That part is probably the most nerve-wracking for everyone. Mrs. Hansen tried first but stopped at the last minute, saying her hands were shaky. Then I tried, and I don’t know what was harder: telling myself I was going to have to puncture my own stomach, or watching Emmaleigh’s trembling hand as she bit her lip and grabbed a pinch of her own flesh in preparation. That was the day they released her.

Mr. Hansen had managed to get hold of Emmaleigh’s parents the day he came home, so their arrival coincided with her release. I ended up at the Watsons’ house that night, since I knew more about their daughter’s condition than they did. We’ve fallen into a routine of things. We all get up to watch Emma check her blood sugar (which we’ve jokingly abbreviated as BS) late at night and we all know how much an injection of insulin will bring her down.

It’s Sunday now: two days after Emmaleigh’s release. I’m sitting in the library with Jessica, the two of us poring over books on diabetes. Emmaleigh and her parents are at some day-long seminar where they teach young diagnosees how to care for their new condition.

“How did I not notice?” Jessica groans, shaking a book in my direction. “She was obviously losing weight, she drank water like a horse, she was waking up to go to the bathroom constantly, she was always craving sugary stuff like cookies and pudding, she randomly started eating more. Why didn’t I notice?!”

“It’s not your fault,” I say. “I barely noticed anything, especially weight loss.”

“You’re a guy,” Jessica says angrily. “I’m supposed to be her effing best friend.”

“Are you just looking at the symptoms?” I ask. She’s just getting started with a little pamphlet from the hospital.

“Yeah. Why do these things happen?” she asks.

“Well,” I begin, putting down a copy of Think Like a Pancreas. “Your pancreas makes insulin, right?”

“I know that,” Jessica says with a sigh. “Insulin is what makes your cells take sugar from the blood. And diabetes is when your pancreas can’t make insulin anymore.”

“Right. Well, Emma has type one diabetes. Which means for some odd reason, her immune system just up and started attacking the parts of her pancreas that make insulin and killed them off.”

“They don’t know why?” Jessica asks, looking up at me.

“No.”

“Wait-” Jessica squints a bit. “Since when do you call her Emma?”

“Just...since...” I trail off, not sure of my answer.

“Whatever,” she says with a sigh. “It doesn’t matter. Just keep explaining.”

“Okay,” I take a breath and start to explain. “Well, when you don’t have insulin hanging around, the cells don’t absorb sugar. Sugar gives them energy. So, essentially, Emmaleigh’s cells were starving.”

Jessica’s eyes widen. “So that’s why she was so hungry all the time?”

“Exactly. She was eating, but none of the sugar she was eating actually went into her cells like they were supposed to. So her body kept asking for more sugar.”

“I see...” Jessica says, her voice trailing off.

“And because she had all this sugar in her blood but none in her cells, the water kept flowing out of her cells and into her blood.”

“Which is why she was so thirsty!” Jessica exclaims.

“Yup. Plus the body was trying to get rid of the sugar through her urine, which made her feel thirsty and need to go to the bathroom a lot.”

“Wow...” Jessica leans back. “Okay, why was she losing so much weight?”

That was probably the creepiest thing. When it came down to it, we found out that Emmaleigh had lost fifteen pounds over the span of a week. I’m still kicking myself for not noticing.

“Her body needed energy, so it started breaking down fat and muscle.”

“Oh.”

“We’re lucky we caught it in time,” I say, looking down at the book on the desk. “When your body’s in this state for too long, there are these things called ‘keytones’ that form and end up in your urine and blood. They’re by-products of breaking down the fat. Keytones are really bad for you. You can die because of them.”

“Die?”

I start at the fear in her voice and hastily backtrack. “Only if it goes on for a very long time. Emmaleigh was nowhere near that point.”

“Don’t scare me like that,” Jessica snaps. She looks back down at the booklet and starts reading again.