Diagnosis

Richard
Diagnosis
June 29, 2007, Starbucks

I was twenty-three when I learned I was a type 1 diabetic, and this is the way it happened. The material in this section was generated from several prompts. As memories surfaced, I saw that my relationship to diabetes and to the English class system were oddly entwined. They both asked for compliance, and I rebelled against them, at least inside. It wasn’t until I began to write that I saw the correspondence.

While shaving, I cut myself below my bottom lip, and it turns into an ugly bump that bleeds on and off for a week. It’s 1973, and I’m in the waiting room of Leeds University Student Health Center in the north of England. Around me are women in their late teens and early twenties. We fidget before our names are called, seated on steel chairs which make a horrible scrapping sound on the linoleum. It’s the first week of the autumn term, and most here are signing up for the Pill. The Center is the place for free birth control.

My girlfriend, Kay, has urged me to get the cut checked. I’m reluctant and self-conscious. The Center is located in a row of imposing Victorian houses. This one, staid-looking from the outside, is a maze of jutting staircases and corridors inside, and although the walls are painted a clinical cream, the environment still shouts upper-middle class home. I’m jittery in this typically English palimpsest of old breaking through new—where the values of sexual liberation and expanded opportunities for children of the lower classes, like me, are serviced in signifiers of establishment wealth and power. The mixture confines as it liberates, and no sooner do I enter a place like this than the issue of compliance rears up in me like a sleeping snake made irritable, even as it remains curled in its basket.

The English class system, like bacteria and fear of death, is amorphous and everywhere. Education is the only way through it—or the door out of it—for kids like me and Kay. We are part of the Labour Party’s postwar leap of change, whereby offspring from every class can go to university free. The government pays our expenses, so we can study without having to work. But my place in the class system is slippery. My father is a tailor—a bespoke tailor—and his shop is in our house, but our house has a back garden, and all these factors weigh in to your place in the pecking order. Depending on where you come from, as well as your accent and skin color, you navigate the class system the way Alice does Wonderland, in one context taking up all the space in a room, in another becoming the ball in a croquet match. Alice in Wonderland is a brilliant meditation on ways we feel small or large. It’s a parable about how children experience their place among adults. It also describes the feelings of people in a class-bound culture and of those diagnosed with an illness living amid the able-bodied and well. Class, education, and diabetes swirl inside me, one aspect of my condition moving me up in rank, another threatening my stability.

In time I’m called to see the doctor, a route that involves Kafkaesque wanderings up and down stairs. Dr. Cameron—big and beefy and with a ruddy complexion—speaks in a broad Scottish accent and wears a tweed jacket with leather patches on the elbows. He waves me to sit down, and it feels condescending. With a very firm hand-shake—perhaps in the manner of the doctor who might once have practiced here with his family and servants bustling in adjoining rooms—he asks what I’m studying. “Philosophy,” I say, and there is no reply.

Here is the doctor, a repository of established authority, and I want him to say something affirming about my class-vaulting choice. In the past few months, he’s probably asked a thousand students the same perfunctory question, and many, like me, have come trailing cultural aspirations he’s unable to address—perhaps even notice. He gets down to examining my cut and asks about my general health. He directs me to step behind a curtain and pee into a cup. I don’t ask why. A doctor directs, and you comply. That’s how I was raised, and that’s what I do. Afterward, he tells me to return to the waiting room where I sit long enough for a whole new crop of students to enter and leave. My lip throbs.

Eventually, a nurse calls me to the counter. She’s wearing a bright pink jumper like ones my grandmother knits for herself, and I’m disposed to trust her. She says I must taxi immediately to St. James Hospital on the other side of the city. The Center will pay the fare.

“Why the rush?”

“They’ll explain when you get there, dear, but your urine contains high amounts of sugar.“

Nothing registers, although the signs of diabetes are blaring. I’m playing my part as passive patient to the hilt.

“Can someone bring you pajamas and a toothbrush? It’s a Friday and you’ll probably have to stay a few days.”

On the ride across town, my thoughts are absorbed with class, not the possibility of serious illness. What awaits? Clearly, I’m too unimportant to have things explained. Leeds, despite housing the country’s largest urban university, still wears a grim, working-class aspect for the most part. We speed through labyrinthine streets of back-to-back terraced housing. Washing flaps on lines strung across side streets. Neighbors chat to each other from door steps. Pubs are the main life of the community, and there is one on every other street, interspersed by fish-and-chips shops and corner stores that sell sundries such as single fags for those too poor to afford a pack. Here and there soot blackened churches are becoming Sikh temples and Muslim mosques.

The hospital, a red-brick structure built in the ‘60’s, is part of Leeds’ urban renewal effort. I’m installed on a ward with five other men. One is a hemophiliac, about my age and from a village like the one where I grew up. He paces the corridors until he’s informed he needs an operation. Immediately. His chances of surviving are only fifty-fifty. Everyone hears. It’s horrifying, and I’m stunned by his reaction, which is no reaction. He says okay, his eyes cast down, his chest curving inward. I want to say: “Speak up for yourself. Ask questions. Are there other hospitals that specialize in my condition? Do I need a second opinion? What is the track record of the surgeons on my case?” I say nothing. What would I do in his place? Am I in his place?

In another bed, a bus driver past fifty who’s recovering from a heart attack is so frustrated by the lateness of his meal he smashes a plastic plane he’s spent the day gluing together. I want to smash something, too. It’s evening, and I still don’t know why I’m there. Kay arrives with my things and demands answers from the nurses, but they are tight lipped. “Wait until doctors’ rounds,” they say without informing us the doctors aren’t coming until Monday.

I remain in the dark until Saturday night when an orderly asks me to pee into a bed pan. Under his impatient scrutiny, I manage a trickle. I am handing over the pee when I notice, written along the side of the container: “Richard Toon—diabetic.”

“Does this mean I’m diabetic?”

“Yes,” he says, striding away with my pee.

On Sunday a nurse wearing a bright blue uniform briskly demonstrates how to inject insulin into an orange and then into my upper arm. It’s simple to impale the orange but something else when I’m expected to plunge a needle into my own flesh. “Go on,” she urges and after taking a moment to notice light glinting off the steel spike, I slip it into the fat layer above my right biceps. There’s a dull ache. I repeat the procedure in the other arm with the same hesitation followed by pain. I don’t complain or wince. I want her to commend me for getting the job done—for not gumming up the works.