"I can do that," I say, almost certain that I can't do that.
"You'll have to call me at home tonight between 10 and 11."
"Okay," I answer, "if I need you, I'll call." She scrunches her brow. "I don't think you understand—if I don't hear from you, I'll be up worrying the entire night. You have to call."
Then she presents me with a secret weapon in my brand-new war. "This is Leigh Siegel-Czarkowski—you'll be spending a lot of time together."
I recognize her from my bloodletting.
"I'll walk you through the injection and blood test now, and then we can go over it again tonight," says Leigh, a 30-something nurse practitioner and diabetes educator, as she hands me her phone number. I leave the office at around 6:30 with a glucose meter, insulin pen, test strip, needle, lancet, and splitting headache. Only later do I learn that the office closes at 5.
That night I lay everything in front of me and phone Leigh.
"I don't think I can handle this," I say, attaching the needle to the insulin pen.
"That's how I used to feel," she says, and instructs me to pinch my thigh.
"Since I'm 15."
"Isn't there some horrible disease I can get that involves ointment?"
"Of course there is," she assures me, "but right now you've got this."
I sink the needle into flesh, push the button on the pen, force myself to count slowly to five until the drug is completely released, and pull the needle from my leg.
"I'm right here."
We listen to each other breathe for a while and finally she says, "Let's stick your finger now so you can call Dr. Goland and say goodnight."
First thing the next morning, I'm back in Leigh's office—a place I'll be hanging out in every day for hours over the next three weeks. We'll also talk at least twice daily on weekends. After conferring with Dr. Goland, it is decided that I'll prick my finger to check my blood seven times a day and control my sugar with five injections of insulin a day. Needless to say, I am not part of the decision-making process.
I'm sent to an obstetrician a few doors down who, via sonogram, locates my baby's heartbeat and then reviews the long list of potential problems for a baby who's been marinating in sugar. Her definitive answer is that she won't know anything definitive for some time. Back at the center, I'm sent to nutritionist Kira Almeida for an eating plan tailored to my needs. I'm sent to Dr. Daniel Casper for the most thorough eye exam I've ever had. I'm sent to social worker Kari Plotsky for a head exam. Actually, Kari just wants to see if I feel like talking. I tell her I really don't, then proceed to talk for the next hour and a half.
A couple of weeks go by. I know everyone and they know me. Needles, carb counting, weighing and recording every bite of the three small meals and three small snacks that I consume at roughly the same time each day still don't come naturally, nor does willing myself to believe that I'll have a healthy baby—but I do it nonetheless. Dr. Goland checks my blood pressure, and in the peppy cheerleader style I've come to cling to pronounces me "completely amazing."
"Completely amazing people don't let themselves become diabetic," I say.
Dr. Goland shoots me the have-I-taught-you-nothing? look and pulls up a chair. "This is not your fault, Lisa."
"C'mon," I say. "I've stopped going to the gym, I've put on weight, I've—"
"Time out," she says. "Diabetes is a genetic disease. And as for being overweight, that's one of the most inheritable conditions we know of. Almost as much as having blue eyes."
"Okay," I reply, "but you've gotta admit that there's an environmental component to all this."
Next: How genes play a role in diabetes