Accepting the Fact of Mortality
by Gabrielle Kaplan-Mayer
When I was 10 years old, my pancreas stopped working.
During the weeks leading up to my Type 1 diabetes diagnosis, I exhibited unquenchable thirst and woke up multiple times in the middle of the night to pee out the excess sugar that was building up in my body.
We went to see my pediatrician and he had me pee on a little strip. The test results sent us right from his office to the hospital and changed my life forever. At a blood glucose reading of 450 mg/dl, internal organs can begin to shut down. My reading read over 500 mg/dl.
I was injected with insulin and told those daily injections would keep me alive. I’d also have to test my blood glucose every few hours. Unregulated high blood sugar leads to kidney failure, neuropathy, heart attack, blindness and stroke over time. Blood sugar that drops too low can quickly become life threatening.
That first afternoon, a nurse brought an orange, a needle and a vial of saline to me. She showed me how to draw up the right dosage, pinch the orange like it was my own skin, then push the needle in and plunge the syringe. That’s it! Good girl. Thatta way. Her praise was the only anchor that I had.
When it was time for my second dosage later in the day, she brought the same syringe but with a real vial of insulin. Go ahead, she told me. Pinch your thigh there. I looked her in the eyes. She nodded. I shoved the needle into my flesh and plunged the syringe. I dared not cry.
“No one around me spoke about the scary parts of Type 1 diabetes, like the children whose blood sugars dropped overnight and who never woke up in the morning.”
When I left the hospital, I adapted OK to my new responsibilities. No one around me spoke about the scary parts of Type 1 diabetes, like the children whose blood sugars dropped overnight and who never woke up in the morning. That part of my illness was left to loom around in the shadows, to come whispering in my nightmares and growing anxiety.
The truth was: I could sense the shadows of what was not spoken about. They became part of me.
On the bus ride to school, I used to sit by myself and read or just look out the window. One morning in sixth grade, I was watching the houses go by–the same houses that we passed by every morning. The sun was hitting them in a way that mesmerized me. As I watched them, I heard something.
You are here to see this amazing sunlight because someone invented insulin. If you don't take your injections, you will die. You wouldn’t be here to see this light. But you are alive. You are alive.
That voice wasn’t audible, but I heard it–felt it like an electric current. A numinous understanding: life and death were not separated. They were dancing partners; my insulin shot was the music that animated their tango.
From then on, I recognized that existence is both a mystery and miracle.
But midway through my teenage years, I lost my motivation to do what managing a defunct pancreas required.
Hormones raged, wreaking havoc with my diabetes control no matter what I did. I snuck around with friends, drinking as much stolen beer as they did.
I landed in a college scene where hedonism was normalized. Every weekend became a choice between life and death for me. Somehow my survival instinct kicked in, even though I desperately wanted to escape into the edge of careless abandon with everyone around me. When I packed my little purse before heading to some unknown party, I made sure I had blocks of glucose tabs in case I got low. I wanted to escape, but I stayed reasonably responsible. I was not ready to die.
In my mid-20s, I knew that something was wrong with me. I lost my will to keep up with my injections and intensive diabetes care routine. I was beyond burnt out.
I heard about a new holistic health center and made an appointment with its founding doctor. I begged him to help me stay alive. He was the one who must have supplements or acupuncture, something to help me manage Type 1 diabetes, things that traditional Western medicine had overlooked.
“I talked openly about living on the close precipice between death and life and how that felt in my body.”
That doctor did save my life, though not in the way I had imagined. He prescribed antidepressants for me and got me started seeing a cognitive therapist on his staff. It was the medicine that I needed then. That therapist helped me to bring the full shadow of my diabetes into consciousness.
I talked openly about living on the close precipice between death and life and how that felt in my body. I wept from fear that I’d held inside for years. I felt both more grounded and lighter at the same time.
All of us humans are in the same situation–living with the reality that death is our only certainty. Many folks keep that truth at a distance, but since age 10, I haven’t had that choice.
Coming out of depression led to positive, lasting changes in my life. When I hit 30, I married a loving life partner and felt healthy and confident enough to become a mother. I gave birth to two children through carefully monitored pregnancies. I was firmly rooted on the side of the living and looked forward to my years ahead.
At age 37, though, when my children were ages six and three, I found a lump in my right breast that turned out to be stage two breast cancer. Though I had lived with a chronic illness for 27 years at that point, I was not prepared for how a cancer diagnosis would rock me. If mortality had poked at me before, now it came right up in my face.
“This collection of health-related experiences have led me to understand that I shouldn't waste my time here. Now, I tune in more deeply to my creative energy.”
I was fortunate for an early diagnosis, for great treatment, for an excellent prognosis, for love and support from family and friends. After surgery, chemo and radiation, life felt even deeper and more sacred. With each milestone I reached–five years, 10 years–my gratitude for life grew.
This collection of health-related experiences have led me to understand that I shouldn't waste my time here. Now, I tune in more deeply to my creative energy. I do things out of love, not obligation. I rest when I’m tired. I am comfortable disappointing people when I need to set boundaries. I laugh a lot. I love hard. I am healthy, vibrant and vital.
When I faced a recurrence of breast cancer in March 2020 and when we all were entering pandemic lockdown and the intensifying fear of COVID-19, I was prepared. I was grateful for the accumulated wisdom from my cancer experiences and living with a chronic illness for so many years.
Each of us knows our birth date, but not our death date. I wonder whether facing that knowledge could help us to be more tender–to each other and to ourselves.
Gabrielle Kaplan-Mayer is a writer and educator based in Philadelphia. She teaches online workshops at the intersection of writing and spiritual growth and shares a weekly Substack called Journey With The Seasons. She is working on a memoir about tapping into the wisdom of her ancestors.
