“I wanted to lose weight,” Lacey insisted stubbornly.
“And I had to drag you out for an eating binge.” Terri rolled her eyes. “I’m really sorry.”
“Don’t blame yourself. I had fun that night.”
“Do you have to stick yourself with a needle every day?” Terri wasn’t even trying to mask her wide-eyed curiosity.
“Twice a day. But let’s not talk about it.”
Terri began chattering. “I went to the school library. I looked up diabetes in the encyclopedia. It was pretty interesting. Diabetes is one of the oldest diseases in recorded history. The ancient Greeks wrote about it. Diabetes mellitus means ‘sweet urine.’ The article explained that people who have it can go blind, or lose limbs ’cause of nerve damage, or have kidney failure. I don’t want that to happen to you.”
“It won’t,” Lacey said without much bravado. “I just got a little messed up, but I’ll be back in control and on top of this in no time.”
“I sure hope so.”
“But enough about me,” Lacey insisted. “How’d the play go?”
“After the ambulance left with you on Thursday night, Ms. Kasch told us to go on with the play, but the cast never really got into it.”
Lacey hated hearing that. “So was it a total flop because of me?”
“No … just subdued. It went better Friday and Saturday nights. We struck the set today after school.”
“And—um—the cast party? How’d it go?” Lacey was supposed to have gone with Todd. He’d asked her in his usual offhanded manner one night following a dress rehearsal.
“I didn’t stay very long. But you know me, I’m not much of a party girl.”
Lacey thought it maddening the way Terri wasn’t telling her what she wanted to know. “I guess Todd took Monet,” Lacey said, half hoping Terri would say “no way.”
“Yeah, he brought Monet. I told you he was pond scum.”
“He’s free to date other girls.” Lacey defended him even though she was hurt. Her mother had never mentioned whether he’d even called to check on her. She supposed that he hadn’t.
Terri fiddled with the strap of her purse lying across her lap. “In school today, Monet was bragging that Todd asked her to the prom.”
The news washed fresh waves of humiliation over Lacey. He wasn’t giving Lacey the chance of a comeback; he simply substituted another girl to fill her place. And every person at school who’d seen them together would know the same thing: Lacey had been unceremoniously dumped. “I guess this means I can cancel my dress fitting at Neiman-Marcus,” Lacey said breezily.
Terri smiled ruefully. “I’m glad you’re not letting this get you down. I wasn’t sure how you’d take the news.”
Lacey was upset, but not so much by Todd’s betrayal as by the sense that she was losing something she’d worked hard to have—a feeling of normalcy and belonging. “I hate hearing the news,” she confessed. “But it doesn’t surprise me.”
“I’m sorry you even cared for Todd. You’re more than he deserves.” From the hallway, a voice on the PA system announced that visiting hours were over. Terri rose. “They’re throwing me out.”
“Will you come back?”
“Sure. How long will you be cooped up in here?”
Lacey remembered what her uncle had told her about an extended stay for counseling. “I’m not positive.”
“Well, you won’t miss too much school. Spring break and Easter’s coming.”
Lacey grimaced. “I hate thinking about spending vacation time in this place.”
“I’ll check out the beaches for you. The college crowds have already started bombarding Florida. ’Course, it would be more fun to do this together.” Terri shrugged. “Maybe next time.”
Depression descended on Lacey once more after Terri was gone. They should be out on the beaches together. She should be the one planning on attending the prom with Todd instead of Monet. She should be thinking of having fun instead of facing counselors and dieticians. Diabetes had ruined her life.
When her phone rang, she offered a listless hello.
“Lacey! Is this really you? I’ve been frantic worrying about you!” Katie’s voice exclaimed.
“I’m a loser, Katie. Now everybody at school will know what a loser I am.” Lacey explained her circumstances, venting all her frustration and hostility into Katie’s ear.
“You can’t help it if you’re sick,” Katie said patiently. “Diabetes isn’t exactly the plague, you know. Maybe things won’t be that grim at school. Lots of kids and teachers were sympathetic toward me when they learned about my heart problem.”
“Is that what you wanted?” Lacey found the courage to say. “Pity? Not me. I don’t want everybody talking about me behind my back. I was in sixth grade when I was first diagnosed, and I can remember when I came back to school after being in the hospital, a group of kids used to whisper about me. Some of them called me needle freak and junkie. It was awful.”
“That was years ago, Lacey. You’re in high school now. Don’t you think kids might have matured a little since then?”
“No,” Lacey said, sniffing. She told Katie what Terri had revealed about Todd. “So they haven’t matured, Katie,” she finished. “They’ve just figured out ways to be more cruel.”
Katie quietly but firmly answered, “Listen to me, Lacey Duval. You can’t blame Todd’s behavior on your being sick—he’s probably selfish and obnoxious no matter what. He doesn’t sound like much of a loss. Besides, you’ve always told me he never turned you on the way Jeff did anyway.”
“That has nothing to do with it.”
“It has everything to do with it. You can’t blame your diabetes for everything that goes wrong in your life.”
Lacey stiffened. “Well, the last thing I expected from you was a lecture.”
“Well, you need one.” Katie now sounded impatient.
“No, I don’t. I need a friend.”
“I’ve always been your friend, Lacey. Chelsea and Amanda … Jeff too. And let’s not forget Jillian. She liked you, and we had to practically bludgeon you to allow her to visit Mandy’s memorial. Lots of people care about you, Lacey, but you have some stupid idea in your head about what’s ‘real’ and ‘normal.’ Stop feeling sorry for yourself. You drive everybody away who tries to get close to you, and that’s not fair.”
“I’m so glad you told me what my problems are. Thanks for the enlightenment. I’m in the hospital, you know. I have a right to feel sorry for myself.”
“Well, I’d prefer you start taking care of yourself instead of always looking for a way out of it. You’ve got a disease, Lacey. Stop pretending that you don’t.”
“And I’d prefer it if you’d lose my phone number. Permanently. The one thing I don’t need is friends like you.”
Lacey slammed the receiver down so hard that the phone skidded off the table. It lay on the floor in a tangled heap, sending out a mournful dial tone. “Who needs you, Katie O’Roark,” she spat out through clenched teeth. Tears filled her eyes and began to flow. Furiously, she wiped them away. But it was like trying to stop a breech in a dam with a toothpick.
She needed Katie. Desperately. Katie was the best friend Lacey had ever known. And she’d just driven her away. With her mean mouth and hateful words, Lacey had slammed the door on their friendship forever.
She curled up into a ball and tugged the bed covers over her head, but the IV line in her hand prevented her from blocking out all the light in the room. The lights in the hallway dimmed. Lacey felt utterly and completely alone. Her sobs poured out, soaking her pillow.
Her uncle had done her no favor by rushing her to ICU and saving her life. He should have let her die. Dying would be better than this terrible burning pain in her heart. From the floor, the dial tone from the overturned phone turned into an intermittent whine that pierced her eardrums like the wail of a terrified child.
Thirteen
LACEY GAZED UP at the faces of the team of diabetes p
rofessionals surrounding her bed, and although her uncle introduced each member, she barely paid attention. A young woman named Sue, a dietician, said, “You know, learning to eat right doesn’t mean giving up all the things you love and never tasting them again. It simply means planning. You can eat practically anything you want, just so long as you plan for it.”
Of course, Lacey knew that much. “I don’t have much of an appetite now,” she said. “And I’m not interested in gaining back all the weight I lost.”
“You don’t have to gain back most of it,” Sue said. “But when a patient goes DKA, she loses more than unwanted pounds. She loses muscle mass and vital nutrients. We’ve got to put those back, and naturally, weight gain will happen. But it’s a healthy weight gain. We’ll design an exercise program for you.”
“I hate exercise.”
“Me too,” Sue said with a smile. “But everybody needs it. Even people without diabetes. You don’t have to be a jock, but you do need an exercise routine.”
Lacey thought of Katie, athletic to the core. The memory of their fight the night before caused fresh pain. She flashed Sue a hostile look. The woman was young and tall, slim and fit. Her hair was dark brown and hung in a French braid, her eyes brown and lively. “And I suppose you’re on the hospital’s softball team, bowling team, golf team, and every other team they have. How would you know what it’s like to have to stop in the middle of everything that’s happening and give yourself a stupid insulin shot? I’ve always had to sneak off at sleepovers and play rehearsals and measure out my insulin. What fun.”
“I know what you mean because I’ve done it for years,” Sue said. “I’ve been a diabetic since I was fifteen.”
The news stopped Lacey’s sarcastic tirade cold.
Uncle Nelson intervened. “You’ll see everybody again this afternoon. Along with a private session with Dr. Rosenberg. But for right now, I want to take you for a little ride.” He pulled a wheelchair to the side of Lacey’s bed.
“I’m not going anywhere in that thing.”
“Yes, you are,” Uncle Nelson said firmly. “While you’re here, I’m in charge, and besides, I’m bigger than you, so get into the chair and don’t give me any lip.” He softened his tough talk with a broad smile and a wink.
Grudgingly, she got into the chair and waited while her insulin pump and IV pole were adjusted to travel with her. It was humiliating being wheeled down the hall followed by the apparatus of her condition. She still didn’t feel good physically and wondered if she ever would feel good again. How could things have gone so wrong over the past few months? And when would she be able to resume a normal life?
Her uncle rode down with her in the elevator, wheeled her down a hall with signs reading RENAL UNIT, and into a room with several machines that stood beside chairs that resembled recliners. A person sat in each chair while lines from the machines snaked down his or her body and disappeared into a tube protruded from arms. One person was calmly reading, another was dozing, and one woman was busy knitting. The clack of her needles could be heard above the hum of the machines.
“Am I supposed to be impressed?” Lacey asked, feeling a coldness form inside her.
“This is the dialysis unit.” Her uncle ignored her bad temper. “These people come in three times a week for four or five hours a day and have their blood shuttled through these machines to cleanse it of toxins and impurities. Their kidneys don’t work, and without dialysis, they’d die.”
“So what’s your point?”
Uncle Nelson crouched in front of her chair and looked her in the eye. “Forty to fifty percent of all type-one diabetics—that’s the type of diabetes you have—suffer from kidney disease. It may take fifteen or twenty years to develop, but nevertheless, once a diabetic’s kidneys fail, he has only two options: dialysis or transplantation.”
She listened to him, all the while watching the patients in the room. The machines looked grotesque to her, like giant birds of prey hulking beside beds, with gauges for eyes and tubes for beaks. Hours had to be spent hooked up to them. Hours of everyday life that should have been spent doing other things, fun things.
Uncle Nelson gestured toward the room. “This unit is for hemodialysis—it cleans the bloodstream. Often, diabetics do better on CAPD, continuous ambulatory peritineal dialysis.
“You do this kind at home. You have a catheter inserted into your abdominal cavity”—he touched her stomach area—“and then dialysis fluid is put in through the catheter’s opening, where it sits for six hours attracting toxins and then is drained and replaced with fresh fluid.”
She thought the procedure so horrific that she could barely imagine it. She’d be attached to an IV line for a quarter of the day, 365 days a year while the fluid did the job of failed kidneys. “If you’re trying to scare me, you are,” Lacey said, holding his gaze with hers.
“I want to scare you, Lacey. I want you to understand the reality of your disease. You’re my niece and I love you. I don’t want this to be your future. It saves many lives and is extremely important, but I hope you won’t have to use the machines to save your life.”
“I don’t want it either.”
“That’s why it’s important that you take care of yourself.”
“But it could happen anyway, couldn’t it? Fifty percent is a high number. There aren’t any guarantees.” Her hands were shaking, so she kept them folded tightly in her lap.
“No guarantees,” he said. “But studies do show that the more tightly you control your blood sugar, the better able you can manage and postpone the side effects.”
She edged her gaze away from his. “I take care of myself.”
He took her by the arms. “Lacey, you were brought into the emergency room in DKA. That couldn’t have happened unless there was something else going on in your body, like a massive infection or other illness.” He paused. “Or if you’d stopped your insulin shots.”
“I was taking my shots,” she said stubbornly.
He scrutinized her carefully. “When I examined you, I saw that your throat and upper esophagus looked irritated, consistent with a patient who’d been vomiting. That’s why I ran tests to determine if you had food poisoning or a stomach bacterial disorder. You didn’t.”
Her heart began to pound. He was getting close to something she didn’t want discovered. Her purging shouldn’t have had anything to do with her problem. She had been careful to not do it after every meal, only just when she’d eaten too much of the wrong things. “I don’t know what you want me to say,” she said. “I was giving myself my shots.”
He ducked his head and took a deep breath, then stood. “If you won’t be honest with me, please come clean with Dr. Rosenberg. We’ve got to get to the bottom of this, and I won’t let you go home until we do.”
Lacey slept in her room until it was time to meet with Dr. Rosenberg. One of the nurses took her to his office in the wheelchair, chattering all the way and singing the doctor’s praises. Still, she was prepared to dislike him. She didn’t want to talk to a shrink and she didn’t want to have him digging around inside her head for details about her psyche. She realized now that she’d made a mistake in trying to diet by juggling her insulin and purging. Why couldn’t she simply put the past behind her and start all over?
Dr. Rosenberg was a short man with round features and jovial eyes. He reminded her more of a department store Santa Claus than a doctor. His office had an unkempt quality with stacks of papers and books on every surface, including the floor. “Sorry about the mess,” he said after introductions. “I’m moving into the new wing of the Diabetes Research Institute, and housecleaning is a chore.”
“My uncle’s told me about the institute. It’s just for diabetes research, isn’t it?”
Dr. Rosenberg raised the blinds on the window, and she could see a glass and concrete building rising in the near distance, windows gleaming in the bright Miami sun. “It’s the culmination of years of work and fund-raising,” Dr. Rosenberg said. “The o
nly one of its kind actually. A facility dedicated to finding a cure for diabetes while treating patients with the latest and best therapies available.
“If you want, I’ll take you on a tour. We’re dedicating the building in a big ceremony this fall. But some of us will be setting up shop before then. The finishing touches are being put on the place now.”
“I don’t think so,” Lacey said. “I’m not much interested in buildings or diabetes.”
He lowered the blinds and rolled his office chair in front of her, where he sat and offered a smile. “But you’ve had diabetes for several years. Don’t you want to know what we’re doing to cure it?”
“I just want out of here.”
“I’ve met your parents,” Dr. Rosenberg said, changing the subject.
“Then that explains the real reason your office is such a mess. Did they start throwing things?”
Dr. Rosenberg smiled knowingly. “They may not like each other, Lacey, but they love you very much.”
“Sure. I’m the glue that held them together, all right.”
“Do you blame yourself for their divorce?”
“Do we have to talk about this?”
“You should talk about it with someone. Your health is in jeopardy.”
“Well, I don’t feel responsible for my parents’ divorce and right now I’m tired and I want to go back to my room.” Her voice had risen as she spoke.
“Very well.” Dr. Rosenberg rang for a nurse. “But will you come back tomorrow? I’m seeing your mother, then your father, in two separate meetings. I’d like to see you again too.”
Of course she didn’t want to, but she knew her uncle was expecting it. And she also felt that if she focused on talking about her family, then maybe she wouldn’t have to fess up to her gross mismanagement of her diabetes. “I’ll come,” she told Dr. Rosenberg.
She was tired and drained, but back in her room she couldn’t sleep. TV was boring and her vision kept blurring when she tried to read. Terri was in school. Katie wasn’t talking to her. Todd was a lost cause. Lacey felt alone and cut off. Then she thought of the one person in the world whom she wanted to see and talk to.