Stephanie was tired, several nights in a row, despite sleeping well. That was the first symptom. Over the course of several weeks, she complained that she was almost always feeling tuckered out.
She had cut her hand while slicing onions in our kitchen. Nothing serious, but it had happened a week earlier, and the wound still seemed fresh, as if it had only happened yesterday.
She was often thirsty, so she was drinking more water than usual, but she said she was peeing even more often than drinking more water might explain.
She made an appointment at UCSF Medical Center, where she worked, and they ran tests. We'd gotten plugged in to the internet a few months earlier, so we had already Googled her symptoms, and all of them suggested diabetes. We had our fingers crossed, hoping for something else, but when the doctor said it was late-onset diabetes Steph wasn't surprised. Disappointed, yeah, but not surprised.
This was her first scary diagnosis, and we were naïve enough to think that it was "the" scary diagnosis. We didn't know there were more scary diagnoses yet to come.
* * * * * * * * * *
Diabetes was a word we'd heard all our lives, of course, but until we started Googling we had only the vaguest understanding of it. Maybe you're similarly under-informed, so let's explain it briefly, from a layman's understanding:
It's all about sugar. Also known as glucose, it powers your muscles and brain cells, and is carried in your bloodstream by insulin, a hormone produced in the pancreas. Insulin is good. If you're overweight, though, or not getting enough exercise, or in other ways less than perfectly healthy, the insulin isn't able to handle the glucose. When that happens, the glucose doesn't get transported to where it's needed, and instead you have high levels of sugar floating around in your bloodstream. Eventually the pancreas can't secrete enough insulin, which is why lots of diabetics take insulin via shots or pills.
Stephanie wasn't prescribed insulin, at first, but she was prescribed different pills that were supposed to help, and probably did. And she was told to cut down on the sugar in her diet, and the sodium (salt). Way down.
Pasta was forbidden, and of course, Steph loved pasta. We had six kinds of pasta in the kitchen, and we'd been having pasta-centric meals 2-3 times weekly. And she was supposed to eat brown rice instead of white rice. "I hate brown rice." No fruity yogurt, only plain, which Steph described as "like eating curdled milk, because that's all it is." No Captain Crunch, her favorite breakfast cereal, and no other cereal was allowed unless it's bland and flavorless. No soda, except diet soda, which Steph said "tastes so bad it doesn't count as soda." No dried fruit, something Stephanie had previously thought was a healthy snack. No white bread, which was the bread Steph preferred. No ice cream. No candy bars. No fancy coffees. No pretzels. No fruit juice. No french fries. No, no, no.
Instead, she'd been instructed to eat plenty of beans, legumes, and chia seeds. "That's an exaggeration," Steph said, "but basically, I'm supposed to stop eating everything I like."
It would've been easier if I'd gotten diabetes instead of Steph. I'll eat almost anything unless it's visibly moldy, but Stephanie had higher standards — if a meal wasn't delicious, she'd barely have a bite or two. Steph was a gourmet, I guess; can't think of a more accurate word. We were poor and San Francisco is expensive, but she always prepared affordable, adventurous, and delicious meals for us.
But, following doctor's orders, she cut everything that tasted good out of her diet, and of course, I did too. Not that she asked me to — she would never do that, and in fact, not ten minutes out of the doctor's office, without my even asking, Steph assured me that her dietary changes wouldn't affect what I ate. "I want you to have a Baby Ruth bar any time and any place you want," she said, "or a Big Mac and french fries and a milk shake. This new diet is my punishment, not yours."
But to heck with that. Her meals would be my meals, with no complaints. As they say — for better, for worse, for richer, for poorer, in sickness and health. "If you're eating brown rice and kale, I'm eating brown rice and kale. I'll just have bigger servings, because I've always eaten more than you."
And so, she tried. We tried. The ice cream went from our freezer straight down the drain, and a hundred bucks of groceries went to charity. For as long as we'd been together, we'd both been in the habit of bringing each other sweet treats — candy bars mostly, or sometimes muffins or a piece of store-bought pie — but that habit came to an instant end. Steph began shopping healthy, and collecting and trying recipes approved by the American Diabetes Association. Some of those diabetic recipes were reasonably good, I thought, but Steph thought all of them were icky.
* * * * * * * * * *
I'm speechless. Taken aback. Been staring off into space for five minutes or so, because I had completely forgotten the conversation I'm about to recount. Even after Stephanie's death, it was forgotten. This happened nearly twenty years ago, and hadn't entered my mind in at least fifteen years — not until I started typing the last sentence of the previous paragraph.
* * * * * * * * * *
Some of those diabetic recipes were reasonably good, I thought, but Steph thought all of them were icky. "Tastes like substitute food," she said once, after eating some watercress and zucchini concoction she'd made, or maybe it was the night we had low-carb turkey tacos. She didn't say anything more for a bit, and I just watched her and smiled stupidly.
"It's been two months since the doctor told me I have diabetes," she said. "And I'm not having fun with it."
I raised my eyebrows. What could I say? I wanted to say that the watercress and zucchini hadn't been bad, but actually, it had been pretty bad.
"Here's what I'm thinking," she said. "Please tell me if you think I'm wrong."
"Always and of course," I said.
"I'm a fairly simple woman, with fairly simple pleasures. I don't want hard drugs. I don't want to climb mountains. I don't want to go hang-gliding. But I do want dinner. And I want a better dinner than this."
"You keep making the diabetic recipes, and you'll find some that you like."
"No, I won't. I've made us fifty diabetic dinners. Fifty. Yeah, I've been keeping count. That doesn't include all the healthy breakfasts and low-carb lunches that I haven't really liked — they're inedible, but at least they're not much trouble. But I want a good dinner. I put some time and effort into making this crap, and it's just wasted time and effort. Fifty diabetic dinners, and not a one of them was any good."
"I liked some of them. The BLTs last week were pretty good."
"B is for bacon, but those sandwiches had turkey-bacon — fake bacon. The bread was grainy bread, which I don't care for — fake bread, if you ask me. The mayonnaise was reduced-fat — fake mayo, and it tasted gross. The lettuce and tomato were real, but the sandwiches were fake."
Didn't know what to say, so I used my standard line for whenever I was flummoxed. "I love you, Steph."
"And I love you, but Doug, you're easy to please with food. I'm not so easy to please. And I am not pleased." She gave a long sigh, and then continued. "After fifty dinners, I've decided that this just isn't working."
"Well, what do you think we should do?," I asked.
"I'm going to eat what I want to eat. That's what I'm going to do."
"Like what?" I cocked my head like a confused puppy. "Do you want to go back to the meals that made you sleepy, and thirsty, and made your cuts slow to heal?"
"Yup," she said, and then she said the words I'd somehow forgotten through all the years since this happened. "Here's the choice. I can eat crappy meals like tonight, and maybe live a longer and healthier life. Or I can eat food that tastes good, and maybe have a shorter life with worse health. And of course, even if I eat flavorless awful food that makes me perfectly healthy, I still might get run over by a truck — there are no guarantees. But if eating good food cuts my life short, well, I think I'd rather have a short, happy life than a long, boring life."
Obviously, this was big stuff. I tried to choose my words carefully. "Well, you said I should tell you if I think you're wrong, so I gotta say … I think you're wrong. Diabetes is serious, and I'd say — keep trying different diabetic foods until you find some that you like."
"Doug, you're not listening. I know that diabetes is serious. I've read all the pamphlets they gave me at the doctor's office. I work at a medical center, and I've spent a lot of my lunch breaks lately in their library reading about diabetes. It's serious and I'm taking it seriously, but — I can't live like this. Food matters to me. I mean it when I say, I don't want a long life without decent food."
"Can we tweak the diabetic-approved recipes? Maybe make them diabetic-compromise recipes? Maybe BLTs with real bacon instead of fake-bacon, but only one slice instead of two?"
"Sure — that's a good idea. That's reasonable. And I'm not going back to candy bars as my go-to snack. I'm not going to eat a bag of dried fruit for breakfast. I'm not going to make us pasta 2-3 nights every week, like I used to. I have diabetes, and that's serious, and I'm not going to ignore it. But I'm also not living the rest of my life, or the rest of the week, without pasta. In fact, I've hardly touched this watercress mess and I'm very hungry. I want pasta for dinner tonight."
"We don't have any pasta. We gave it all to the food bank."
"I'm going to the corner grocery down the street, and buying some spaghetti and Ragu. With ten minutes in the kitchen, and I can add enough spices and olives and onions and a little bit of red wine and convert the Ragu into an edible spaghetti sauce."
"I worry," I said as she slipped into her windbreaker and walked toward the door.
"Well," she said, "I worry too. But, trust me. This isn't a snap decision; it's something I've been thinking about since around Lousy Dinner #35." And with that she was out the door. Half an hour later we were eating spaghetti, and it was much better than the watercress and zucchini. We did not have ice cream for dessert, or any dessert at all, and Stephanie was happy.
* * * * * * * * * *
She began modifying the diabetes-approved recipes, making them taste better but also making them not so diabetic-approved. She altered some of her standard recipes to make them more diabetes-friendly. She cut way back on sugar and salt, white bread and Captain Crunch. She rarely ate candy bars, and when she allowed herself one as a special treat, it was bite-sized, not full-sized.
She worked at controlling her blood sugars, and she brought those numbers down by quite a lot — but rarely as far down as her "target numbers." Years later, a rude doctor told her that she'd let her diabetes rage out of control, and that's unfair and untrue. It is fair to say, however, that Stephanie could have done better at managing the disease.
Steph and I talked about her diabetes, often. We strategized almost everything together, and we had decided together that she would decide how she handled her diabetes. I wouldn't say that I agreed with her decision to stop making diabetic-approved dinners, and also wouldn't say that I disagreed. Let's just say that I understood and respected that she was a tough lady making a tough decision. It troubled me and worried me, and of course, it troubled and worried Stephanie, too.
Toward the end she developed cardiovascular troubles, and vision problems caused by injuries to blood vessels in the retina, and bacterial and fungus infections, and circulation issues in her feet (leading to amputation of several toes), and nerve damage in her legs (leading to amputation of her left leg). All of these are known to be long-term complications caused by diabetes.
Still, Stephanie lived for almost twenty years after the diabetes was diagnosed, and she told me many times that they were happy years, for the most part. That's what matters, in my opinion. That's what matters more than anything.
She said, "I'd rather have a short, happy life than a long, boring life." She decided to make a trade-off — spaghetti instead of watercress. So far as I know, she never second-guessed or regretted that decision. I'm not second-guessing it, even today.