The Scar

It could have been my face. If my arm had not raised to blunt my fall, my life, and my appearance, would be very different right now. My sister had the task of cleaning my burnt skin off the radiator before I got home from the hospital; I can only imagine how difficult that must have been. So many things went wrong that night, it's a wonder that my scar is the only physical evidence that remains of what transpired.  That is the nature of type 1 diabetes. It's usually invisible. I learned at too young of an age that the disease I had was referred to as "The Silent Killer." There was not much I could do with that knowledge at the tender age of 12. Surprisingly, when diabetes nearly killed me, it was anything but silent. Rearing its ugly head to demand I take notice, I now wear a constant reminder of my own mortality in the form of a 14-inch burn scar down the back of my left arm from shoulder to elbow. Ten years later, my burn is no longer painful, and the scars on my scalp are invisible under my hair, but the scars I wear inside from this trauma have been far slower to heal.

Type 1 diabetes commandeered my body at age 10, right as I was entering adolescence and becoming aware of the standards of beauty propagated by our media. This brought with it a storm of physical and emotional implications. At the time, I was taking daily insulin injections, and as my dosage needs increased, I began having allergic reactions to the volume of insulin being delivered under my skin by syringe, making the sites swollen, itchy, and painful. To combat this, I began splitting each dose of insulin, taking two injections at a time, multiple times per day. While this helped minimize the welts at my injection sites, it led to an incredible build-up of scar tissue in places deemed unsightly for a teenage girl--like my abdomen. At 14, I switched to an insulin pump, which reduced the problematic volume of insulin I was taking. I could hide the pump under my clothing, but the scar tissue took decades to dissipate, and some of it never did. I didn't want my diabetes to be visible, and I despised that it sometimes was. I was furious that I didn't get a choice in the matter, so I concealed my pump, and I hid the scar tissue build-up under my clothing.

I was in my late twenties and in graduate school when my burn accident occurred. Despite that I was a fit, reasonably attractive young woman, I was obsessed with the areas of my body that had been affected by my injections. This type of self-objectification was painful; rather than being able to focus on the positive, I got eternally hung up on individual physical deficits, reducing a holistic perception of self down to disembodied parts and pieces. Along with this went a compartmentalization of the emotional implications of my disease. Just like I concealed my insulin pump from view, trying to appear 'normal', I also did my best to resemble everyone else behaviorally--engaging in actions that are risky for people with diabetes--like partying and drinking too much. I was not equipped to acknowledge the danger my disease posed, so I rejected it outright in order to cope, creating an even greater threat to my health. I still cannot get over the tragic irony of the outcome of my risky behavior. In the midst of doing everything I possibly could to seem just like everyone else, diabetes delivered a blow that would forever change me, physically marking me with a scar that set me apart even further from the 'normal' I was trying so desperately to achieve.

It was St. Patrick's Day weekend in Boston. I ran a 5K race in the morning with friends, and after, we drank and danced the afternoon away at an Irish dive bar. The problems with my blood sugar began immediately after the race, and it spiked high after I washed down a small sandwich with a couple of beers. As the afternoon progressed I kept testing, and my glucose level remained elevated, despite the large quantities of insulin I was giving via my pump. It was frustrating and not typical. I drank alcohol fairly often, and after an initial spike, my levels would eventually come down and stabilize. I stopped drinking that afternoon because my blood glucose refused to come down, and dumping more sugar into my system in the form of alcohol would make me feel even crummier than I already did. When I left my friends and headed home early that evening, my glucose was finally nearing the normal level. I had an early flight the next morning to visit a friend in Florida, so I finished packing and headed to bed. It was after midnight when the adrenaline rush from hypoglycemia woke me for the first time that night. It was a significant low, and I frantically devoured the granola bars that I kept next to my bed. I remember thinking that I was likely going to rebound and wake up the next morning with high blood sugar, but I was so ravenous and out of my head that I didn't care. Groggy from the low, I quickly fell back asleep, but a few hours later I awoke again, shaking and disoriented, even more hypoglycemic than the first time. It was as if the tremendous amount of carbohydrate I'd consumed had disappeared into the ether. It certainly hadn't raised my blood sugar, so I initiated yet another feeding frenzy--juice, glucose tablets, granola bars, repeat.

The next memory I have is seeing something in front of my face that I didn't recognize, fading in and out of view as my vision alternately blurred and cleared. I could not make out where I was, just that I was on the ground. I tried to move, but my arms and legs responded only with exaggerated jerks, far exceeding the range of movement I intended. I could not bring myself to a sitting position, so I pulled myself convulsively along the ground. It was futile. I had no motor control. It was at that point that I realized that I was bare-chested, naked except for my underwear, and a sense of terror spread through me, as the notion that I had been assaulted and left for dead took hold. I frantically tried to search my memory for a clue as to what had transpired and where I was, but no clear thoughts would come. All I knew is that something very bad had happened; I was in trouble. A dull but persistent stinging at the back of my left arm filtered in and out of my perception. I opened my mouth to cry for help, but I could not form words. My voice came out as a moan, guttural, that of a dying animal. I tried again, louder, with the same results. Over and over, I thrashed with limbs that would not move and cried and screamed with a mouth incapable of speech.

I don't know how long this went on before my sister heard me and came in my room. I can't remember a tremendous amount, only that she was bending over me, and she too was screaming. I was a prisoner in my own body, rendered absolutely incapable of saving myself. When Amy entered, a glimmer of relief shone through my twisted perception as I realized I was lying on the floor of my bedroom next to my wooden platform bed rather than in some dark alley. She squeezed dextrose gel into my mouth, rubbing it on my gums and I frantically flailed my arms trying to assist her, getting the sticky gel all over my hands, too uncoordinated to grasp it. I could not swallow, and I gasped, trying not to choke. The next thing I remember is feeling embarrassed by my nakedness as male firefighters and paramedics flooded my room. They seemed to be talking about my arm as they administered another dextrose gel and loaded me into a chair-like stretcher to take me down the five flights of stairs and out of my building. One of the paramedics told me I had been badly burned. I did not understand what he meant at first but as the dextrose slowly entered my system, my brain began to associate this statement with the incessant stinging of my arm.

I was not able to speak until the paramedic administered a dose of IV glucose in the back of the ambulance. "I'm supposed to fly to Florida today," I said, my speech returning the instant the glucose hit my blood stream. He told me I had been burned and was going to the hospital, and I finally comprehended what had happened. "Mother fucker," was all I could say as he pushed the next plunger of liquid into my IV, and the ceiling of the ambulance swirled with the heat of a morphine-induced head rush.

The next eight hours were spent in the ER. After being stabilized and having a head CT to ensure I wasn't concussed, I was moved up to the burn unit. With my blood sugar having been brought up to normal, I understood that the third time that night that I went low, I had likely gotten out of bed to treat my hypoglycemia and passed out, falling backwards and landing on the metal forced-hot-water radiator that stood next to my bed. Unfortunately for me, it was a cold morning, and the unit was filled with blistering hot steam at the time I fell. I landed with my left arm stretched up towards the ceiling, hitting the back of my head on the way down. It seared my skin instantaneously, as I had apparently ripped my shirt off after soaking it in the cold sweat that accompanied the adrenaline rush of the low. I can't have been on the radiator very long, but it was long enough to give me second and third degree burns that put me in the burn unit at Massachusetts General Hospital for two weeks and required multiple surgeries for burn grafting.

Recovery was long and uncomfortable, and like I have done so many times before, I put away the emotion of the episode and quickly shifted into "everything is fine" mode. It is only now, more than ten years later, that I'm finally accessing some of the pain and trauma. It has been a process. Sharing my writing is a vehicle that is helping me do so. I wrote the majority of this entry over a week ago, but have been reluctant to dive back in to edit and post; it was just too raw, and I needed a break. There is a lot more to tell about my accident, and I will, but for now, I need to put this down for a bit.

Me--and my scar--pictured here at the Lincoln Woods Trailhead;
on our way to do a 19 miler up to Owls Head.
July 2019