Our recycling bin is currently feathered with the torn-up shreds of last week’s New York Times magazine, and the reason is that I’m a freelancer. Since I’m self-employed, I have to buy my own health insurance. My plan’s monthly premium is a staggering $435.70. That still doesn’t cover all of the insulin and continuous glucose monitor supplies I need to survive. When I go to get refills, more frequently than not, the pharmacists balk as they ring me up and ask, “Are you sure? You know this one box costs $400, right?” With warmth, but exasperation, I usually say something like, “Well, I’ll die if I don’t take it, so yeah.” In fact, many people with diabetes do die because they can’t afford their meds, which are criminally expensive. To say that insulin “costs an arm and a leg” is not only a metaphorical idiom.
Anyway, healthcare challenges aside, freelancing is a gift that’s been accessible to me via the privilege of random natural skill and family support and higher education and a whole lot of luck, plus stubborn independence that I have to be careful not to confuse with the rugged individualism ingrained in white supremacy culture. It means I’m always able to work remotely, so the pandemic didn’t change that or render me jobless. In fact, my income was higher for those first few months than it’s ever been before or since, because I took on too many client projects and worked myself to the bone. The great thing about working yourself to the bone is that you don’t have to feel things besides stress and exhaustion, so there was only so much energy I could spend consciously processing my fear of what might happen if I got sick. But I dreamed about COVID a lot. I still dream about COVID. Anxieties about forgotten masks and noncompliant strangers and hospital visits sneak their way into almost every sleep. Here is the actual data: people with Type 1 diabetes, like me, are statistically about three times more likely to die from COVID than those without. The stats are nearly identical for people with Type 2 diabetes, the more common kind (which is, unlike Type 1, reversible, though this also requires privilege and is a subject for another day). Numerous factors have been found to be significantly associated with illness severity; “modifiable factors,” like average blood glucose that can fluctuate in tandem with one’s health habits, have a smaller impact than “static factors,” like race. This, too: a January study found that Black patients with Type 1 diabetes and COVID were four times more likely than white patients to develop ketoacidosis, which is an urgent and life-threatening diabetes complication.
Today, California is beginning to offer COVID vaccine appointments to folks with chronic health conditions. But Type 1 diabetes does not make the cut. Type 2 diabetes does, as long as your A1C (a test that measures a person’s average blood sugar levels over a three-month span) is above a certain number, thus deemed “unhealthy” enough. (An A1C of 7.5 counts, but 7.4 does not. This is the difference of…maybe one slice of toast in that entire three-month span? It’s meaningless, almost arbitrary, in a way that an actual human assessment of a patient’s intersectional risks would not be.) I emailed my endocrinologist — the doctor who costs $435.70 a month to access — to ask if there’s anything she can do or suggest for me, copying and pasting the data I found. She responded in less than 24 hours. She basically said, Nope! Just keep checking the website for updates!
And so — because I can; because I drastically lowered my freelance workload over the course of the pandemic so the stress alone wouldn’t kill me, but not quite enough to qualify for unemployment support; because I ultimately shifted the direction of my freelance projects when lockdown rendered the risks worthwhile for the sake of greater emotional/mental satisfaction, and now I really make my own hours and often find myself alarmingly responsible for my free time — I spent over an hour in the middle of last Tuesday just trying to figure out a vaccination option. And also reading more and more diabetes mortality data. And also thinking about how this country punishes people for taking juuust good enough care of ourselves, or trying to; about how many ways it chooses money over lives; about how more than 500,000 Americans are dead (is it 530,000? 538,000? The exact number doesn’t matter, is meaningless; too many is too many) and we’re just supposed to be grateful.
I scanned the room for something disposable. Contemplated shattering a glass, but grabbed the New York Times magazine instead. Tore it at the seam and ripped it up, scattering the shreds like anti-confetti across the kitchen floor while I sobbed. And then looked at the mess, sobbing harder, lungs heaving. Bent down and crumpled up the magazine bits. Moved them to the recycling bin, handful by handful.
The system doesn’t grieve, doesn’t get angry, doesn’t choose right from wrong. We, the humans, must. The embodiment is our responsibility.