My Life With Diabetes

A play in four acts

Ann Williams' grandmother

Ann Williams’ diabetes education began with the death of her grandmother. Photo courtesy of Ann Williams

Act I

It’s a warm summer day. I am five years old, standing in my back yard near some tomato plants, when my mother approaches me.

"I have something sad to tell you," she says. "Grandma died today."

Tears fill my eyes. I ask, "Why?"

"It was diabetes."

This sickness called "diabetes" seems mysterious to me. It’s the reason my grandmother had only one leg, and now it has taken her away forever.

My small hand closes around a tomato leaf, crushing it, and the pungent smell fills the air. I think, "When I grow up, I will do something so people don’t have to die from diabetes."

For the rest of my life, the smell of tomato leaves will bring back my grief from the moment I heard of my grandmother’s death, but in the capriciousness of youth, I quickly forget my promise.

Act II

I am a 40-year-old with a job as a nurse diabetes educator. I notice that I have some diabetes symptoms—fatigue, insatiable hunger, thirst, and copious urine. I check my blood glucose, which is high. I have self-diagnosed my diabetes.

Many of my aunts and uncles have diabetes, so I knew about my risk. I now feel somewhat relieved. Now I don’t have to remain vigilant, wondering whether—or when—it will come.

It’s already here.

Act III

Eight years after my diagnosis, I am presenting testimony to Ohio’s Senate Health Committee about a bill that would require health insurance to cover the diabetes self-management education and supplies necessary to prevent complications.

I list statistical facts, such as prevalence rates and costs of complications. I tell stories about a few of the hundreds of people with diabetes complications I have known – a middle-aged woman who had to stop working when she developed disabling foot complications; a young man who was working as a police officer when he lost his eyesight; a woman in her early 20s who died of heart complications.

I tell the senators, "The financial cost of these complications is high, much higher than the cost of preventing complications. And the human cost of diabetes complications is immeasurable."

The bill is not passed during this session. In fact, as of this writing, even though 46 other states have already passed similar laws, the Ohio legislature has allowed this bill to die in committee every single legislative session since 1994.

Act IV

In 2008, after 21 years of practicing as a nurse diabetes educator, I have completed my Ph.D. I now work as a nurse scientist, researching diabetes self-management and finding effective ways to teach people how to self-manage diabetes and stay healthy.

It is a warm summer day, and I am walking outdoors, deep in thought about my research. I pass by a small garden and brush against a tomato plant. The smell of crushed tomato leaf fills my nostrils. For a brief moment I am a small child losing my grandmother; then, I am once again an adult.

"I kept my promise, Grandma," I whisper in my heart. "I’m doing something so people don’t have to die from diabetes."

Ann S. Williams, Ph.D., R.N., is a postdoctoral fellow at Case Western Reserve University’s Frances Payne Bolton School of Nursing and a three-time alumna of the university.