You place the navy blue instrument over your middle finger, your other fingers toying with the slider on the rear. You breathe deeply, the warm moisture reaching your hands, only making them clammier. You’ve done this before. Why does it still hurt, though? Will today be the day that your hand is so numb that you won’t feel much, or anything? You can only hope. You’ve hoped a million times and it still seems useless.

You push the slider down and feel the cold needle dig into your skin with a piercing sting.

That is what my best friend Sarah has been doing for eight years, every day, ever since she was four. I’ve seen her do this, prick her fingers for seven years, ever since we were in kindergarten, and I still don’t see clearly why it has to happen. But I have grasped the concept of what she has.

My best friend Sarah has diabetes.

It’s one of those diseases where it’s not contagious, but the hard, tired feeling and straining effect is, at least for me. When a person has diabetes, their pancreas isn’t working right. Most of us don’t consider our pancreas at all, or at least not until we’re studying the human body in science class. But the pancreas is a vital organ because it secretes insulin, which helps us maintain our blood sugar levels and also contains something that helps to stop weight gain.

People die without insulin.

So without insulin, Sarah would die.

Because Sarah’s insulin isn’t there maintaining her blood sugar, she needs to do it manually. So, every time before she eats she has to prick herself and put that blood on a special instrument that tells her what her blood sugar is. And if her blood sugar is high, then she needs to put insulin in her bloodstream. And how she does that is through a pump, which is connected to a needle, which is placed near her stomach. Every three days or so, she needs to take that needle out of her tummy and replace it with a new one. So, wait, why does she put the insulin in again? When?

Well, every time she eats, after checking her blood sugar, Sarah needs to count the amount of carbohydrates in every serving of food that she has. Carbs are converted to sugar and make one’s level high and low. Depending on your intake of carbs, that’s why we get hyper. More carbs make your blood sugar high and none make it low. Insulin makes sure that it’s right in the middle.

When you’re too high, you can die. Sarah has never been at a level where she’s that high, but it’s gotten to the point where she’s so high she goes crazy. She hyperventilates, laughs at everything, and makes non-funny jokes. That’s what it’s like when she’s high.

When you’re too low, you can die. Low blood sugar can result in hospitalization. Sarah has been to the hospital five times herself. Low blood sugar deprives you of energy so much that you just drop. Sarah has fainted in front of me. Twice.

*

*

*


“Sarah,” I said quietly in my innocent first grade voice. “Are you feeling okay?”

I put my tiny palm on her cool forehead. It felt almost too cool, and at the same time it was clammy. I frowned and she smiled, little dimples appearing on her freckled face.

“I’m okay,” she said warily. The smile moved a millimeter. “I’m just a little thirsty. Can we go inside?”

I thought a minute about that. I did not want to go inside. I was a kid and like any kid I worshipped nice days, and today was one of those days. And besides, I wanted to swing.

“Wait a second,” I said quickly and hopped off the green swing, leaving it and Sarah dangling.

I came out with an overflowing glass of water and screamed.

My best friend was on the ground.

I ran over to her. “Mom, Mom, Mom!” I screamed frantically. She was outside in seconds. I was so confused. What had just happened? My mom needed to fix this. Was Sarah alive? I had no idea what was going on.

Instead of screaming like I had, she just ran over and took a sharp intake of breath as she saw Sarah laying there, palms and head facing up. Mom ran to her wrist and let out a long draw of breath. “Thank God,” she whispered.

And then she started yelling at me.

“Go call Sarah’s mom,” she demanded instantly.

“What? Why?” I asked completely confused. My mom was thanking the Lord while my best friend was on the ground. What was going on? I groaned internally.

My mom noticed the pause. “Go! NOW!”

I ran into the house, slipping clumsily on the slick tile floor. I picked myself up and ran to the phone, dialing only the second number I knew by heart.

Sarah’s sister answered.

“Katie,” I said pleading. “Can I please, please, please talk to your mom?”

“Why?” she answered and then sighed. Even in third grade she was bratty. Why couldn’t she just hand the receiver over without a stalling session?

I stated the obvious in a short kitten-trying-to-be-tiger kind of yell. “Because I need to talk to her!”

“Fine,” she mumbled and then passed the phone over with a wave of static sounding in the background.

“Hello,” said Mrs. Johnson’s voice. “What can I do for you?”

I took a deep breath and then let it spill. “You’ve got to come over here because Sarah and I were swinging and then I went to get her a drink and then when I came out she was not swinging anymore and she is not awake and I’m not even sure if she’s alive!”

I was crying. Was Sarah alive. No, no, no! She had to be! She was my best friend, this couldn’t happen! What had happened? I didn’t know. I had no IDEA! If I didn’t know anything that had caused this awful scene, how had my words come across that I had?

I heard Mrs. J make a little gasping noise. And then all I heard was the dial tone beep-beep-beeping away and I gasped too.

The endless question replayed again.

What was going on?

It replayed itself again and again, like my brain was a broken tape recorder that wouldn’t shut up! I banged my head against the table trying to make it stop, or at least put it on pause somehow. I couldn’t face the not knowing!

I sighed and pressed my fingertips gently against my temple and felt the blood there pulsing underneath the thin layer of skin. I sighed again and turned around.

I walked back outside through the garage door and sniffed the air, a putrid gassy smell tickling my nose. I sneezed and then looked up. Mrs. Johnson’s white van sat in an awkward, crooked position on the driveway.

Running over to the play set that sat in between the driveway and fence, I took in the scene before me. My mom and Sarah’s mom were bending over a now foaming at the mouth Sarah.

“It’s okay,” Mrs. Johnson was saying. “Everything will be okay.” She gripped Sarah’s hand more tightly and then turned to my mom. “She’s okay, just low. She’ll need to go to the hospital. We’ll be back soon.”

My mom nodded and then Mrs. Johnson took my best friend up to her van and drove off with a rush of putrid gassy air slapping me in the face.

*

*

*


That was only the first time. Sarah was low, but she was alive. It was the first time I really understood what having diabetes meant- how serious it was. And then there was the second time.

We were in fourth grade at the park- ironic, huh? Sarah was pacing and going crazy and that’s all I thought it was. Just her messing around, as if she hadn’t done that before. But it ended up being more serious. We had to meet Sarah’s mom at Culvers with an ambulance where my mom had to steal a cake so that Sarah could get sugar in her bloodstream I can still see all the pictures so vividly, the sound of the sirens pumping through my ears.

But despite all her diabetes issues, Sarah and I have stayed best friends since kindergarten. We’ve been through a lot, and it’s hard to explain to someone who doesn’t know. She’s the silliest, most fun, enjoyable girl on the planet and I couldn’t have asked for a better friend.

I don’t know who I would be without her. If I couldn’t read a goofy text from her every day or see her goofy laugh in my head every time I laugh. Honestly, almost every joke I make is one of hers. (Not that I’m even funny myself.)

And that’s who I admire and truly look up to- all those people who make it through the day without a complaint while we’re whining away about how we have to actually sing in chorus or pass the football in gym. Gasp! People like Sarah have to go through so much more every day than we do in a year, or our whole lives. Pricking her fingers is just the start. It’s the worrying that makes you truly crazy. Everyday she must think, Am I going to die today?

But those people do get through the day. They make it a great day. They make every day a great day. You ask Sarah if what’s up. She just says she’s been in the hospital. There’s no whining from her. It’s just one of those things that happen and she takes it like that. It’s not a tragedy to her. Despite everything, every misfortune that has so unluckily played upon her life, she can still say, “Wow, that was a great day.”

Sarah is a sister, a daughter, a building block, an Illinoisan, a computer whiz, a comedian, a smarty-pants student, a musical genius, a survivor of diabetes, and my best friend.