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Dr. Adams looks over the log where Neal has carefully recorded his blood glucose readings on a regular basis for the past week or so since he got out of the hospital. “These look really good, Neal. You figured things out quickly. You’re keeping your numbers perfectly in check.”
“I feel back to normal,” Neal says. “Or even better than normal, now that I know ‘normal’ was really absurdly high blood sugar.”
Dr. Adams smiles. “Glad to hear it.”
“So you’ll sign off on me going back to work, right?”
“No way,” Peter says. Instead of being relegated to the waiting room, for this appointment he’s right by Neal’s side, which is where either he or Elizabeth has been the majority of the time since his diagnosis. And Peter is ready to fight to keep Neal on medical leave from work for as long as possible.
“Why not? You heard the good doctor. Perfectly in check.”
“Yeah, perfectly in check while you’ve been staying in our guest room and doing nothing more than taking Satchmo on casual walks around the neighborhood and doing carbohydrate calculations.”
Neal makes a “tsk” sound. “You’re just mad because Satchmo likes me more than you now.”
Peter rolls his eyes, but Dr. Adams somehow manages to ignore their banter and stay on topic. “What part of Neal returning to work are you concerned about, Agent Burke?”
Peter gives a heavy sigh. It’s not just that he feels responsible for Neal, it’s that he cares about him. And the image of Neal collapsing in the van that day is one he can’t unsee and won’t soon forget. “Well, it’s just that our jobs aren’t exactly boring desk jobs on most days.”
“Right, and Neal can fit a glucose monitor, insulin pen, and glucose tabs all in a suit pocket.”
“My suits have big pockets,” Neal adds. “Multiple. Giant. Like Mary Poppins’ bag, those pockets.”
“Hush,” Peter says, like Neal’s a child begging for a new toy. “It’s not that I’m worried he won’t have the supplies. I’m worried the environment will be less controlled, and we won’t be able to tell if his blood sugar is too high or too low until it’s too late, especially in a serious or dangerous situation.” Peter’s thinking mostly about situations involving guns or explosives, but the doctor probably doesn’t need to know that.
Dr. Adams nods. “That’s valid.” She puts her glasses back on and studies Neal’s blood sugar log again. “You’ve seen what high blood sugar looks like, but Neal, you haven’t experienced a real low yet, have you?”
“No. Not even close.”
“Agent Burke is right that it’s more likely to happen in a less controlled environment, but that doesn’t mean you can’t be prepared for it. Make the unknown known.”
“What do you mean?” Peter asks. “We force Neal into hypoglycemia?”
“Well, when you put it that way, it sounds bad,” she says with a laugh. “Let’s call it practice identifying Neal’s symptoms of hypoglycemia and getting comfortable treating it.” She turns to Neal. “Tonight, when you do your shot before dinner, don’t eat right away. As your sugar drops, I want both of you to pay attention to what symptoms appear and how quickly they progress. You need to check your blood sugar every 10 to 15 minutes, and the second it hits between 55 and 65, you’re drinking juice or regular soda to get your sugar back up. Pay attention to what that looks and feels like, too. I’m not recommending this as a regular occurrence, of course, but I firmly believe people with diabetes can live very normal lives, and if this helps get you back to work, I think the minimal cost is worth the benefit. Do you think that will help, Agent Burke?”
Peter considers. It’s always been the FBI way: train for every variable you can. This is training. “I think it will help me feel better prepared to make sure Neal is okay, yes.”
“And you’re up for it, Neal? It’s probably not going to be…pleasant.”
Neal retrieves his log from where Dr. Adams had placed it on the counter. “I’m mostly just sad that we’re going to ruin the streak I had going here. I mean, did you guys see these numbers?”
Yes, Neal is going to be just fine.
###
“And you’re sure you want to do this?” Elizabeth asks.
Peter feels a fresh stab of guilt at his wife’s doubtfulness at this plan, but Neal answers in the affirmative before Peter can get out a word.
“Yes. I need to know what a low feels like as much as Peter needs to be able to see what it looks like.”
Elizabeth sighs as if she believes him but doesn’t really want to. “Okay. Go ahead, sweetie.”
Neal had just finished doing his pre-dinner blood-sugar check – a very respectable 104 – and preparing everything for his insulin injection. Now, he lifts his shirt, pinches a spot to the left of his belly button with his left hand, inserts the needle without even a flinch, pushes down on the dose knob with his right thumb, and holds it there for a count of five before pulling it out and capping the needle.
Peter offers the sharps container to Neal, who removes the capped needle from the pen and tosses it in.
“Now we wait,” Neal says.
“Correction.” Peter glances at his watch, carefully noting the time fifteen minutes from now when they’ll first need to check his blood sugar again. Then he stands and grabs a deck of cards out of a junk drawer. “Now we play Go Fish.”
El snorts. “Go Fish?”
“We can’t just sit here. Sitting still isn’t an accurate way to notice symptoms. We need to be talking. Doing something.”
Neal nods. “And I guess we can’t play poker with three people. But what about blackjack?”
Peter shuffles the cards and lifts them into a bridge. “I don’t know, do you count cards?”
“No,” Neal says, but it sounds a lot like “yes” to Peter.
“Uh huh. Go Fish it is.”
“I don’t even remember how to play this game,” Neal says.
Peter starts dealing the cards. “It’s not one that’s played in prison?”
“Strangely enough, it’s not.”
All three pick up their cards. “I’ll teach you,” El says. “Neal, do you have any fives in your hand? And you have to tell me the truth.”
“Oh, now I get why we didn’t play it in prison. But no, I do not.”
“Okay, then I have to draw from the pool.” She picks up a card and adds it to her hand. “Now it’s your turn, sweetie.”
“Hmm.” Neal studies his hand, then turns back to El. “El, do you have any sevens?”
“Nope, sorry. Go Fish.”
Neal picks up a card, puts it in his hand, and nods to Peter. “You’re up.”
Peter smiles. “Neal, do you happen to have any sevens?”
Neal’s jaw drops. “Rude! You know I have sevens!”
“I do. And now you have to give them to me.” He gives the same double fingers he gives at the office.
Neal hands over his two fives in a less-than-gentle fashion, and Peter places them face up on the table with the two he already had in his hand. Then he turns his attention to El. “El, my queen, do you have any queens?”
“Go Fish,” El says.
“Boom,” Neal adds.
“Hey, this isn’t ‘gang up on Peter’ night. Wait until El steals from you for the first time. She only looks innocent.”
They laugh and play until it’s time for Neal’s first blood sugar check. He usually waits about 15 to 20 minutes after his injection to eat, so they’re not expecting much. Sure enough, it’s only at 99. They mark it down on Neal’s log.
“Feeling okay?” Peter asks.
“Feeling great. Feeling like you better have a freaking two in that hand.”
Peter groans and hands over the last card Neal needs to win the game. Neal whoops and cheers loud enough to make Satchmo bark.
“Beginner’s luck,” El mutters to her husband.
“Yeah, yeah,” Peter says, wondering if it’s possible to count cards in order to win Go Fish.
After their second game, which El manages to win, Neal’s second blood sugar check is at 82. It’s definitely trending downwards, but still above the hypoglycemia level of 70.
“It’s happening more slowly than I thought,” El says. “That’s good, right? It means if you’re a few minutes late on a meal, it’s not an emergency right away.”
She is right, but Peter also can no longer imagine a world in which Neal injects insulin and Peter fails to ensure that there is a sandwich in his hand in longer than fifteen minutes, barring some apocalyptic disaster.
“How do you feel?” Peter asks.
“Hungry, but that might just be because it’s dinner time. Another game?” Neal asks. “It’s gotta be your turn to win now, right?”
“Exactly.” But of course, when Neal deals the cards, Peter ends up without even one pair of cards that are the same.
They’re barely a few hands into the game when Neal says, “Peter, look.”
Neal’s studying his cards, but not as much the numbers as the fact that they’re trembling in his hands.
“Shaking?”
“Yeah.” He sets down his cards and gives his hands a shake, but the trembling doesn’t stop. “Just started.”
Peter files that information away and prays Dr. Adams was right about this being worth the risk.
“Feeling anything else, sweetie?” El asks.
“Feels like my heart is pounding.”
Peter stands and puts two fingers against the pulse point in Neal’s neck. Neal tips his head, allowing it. Peter monitors the second hand on his watch, counts, and does the mental math. “Yeah. It’s about 120. Hanging in there? We’ll check your blood sugar again in a few minutes.”
“Hanging in there,” Neal confirms.
The cards go untouched as they wait and watch. “Any blurry or double vision?” Peter asks, thinking back to the list of symptoms of hypoglycemia he read. But it’s one thing to read a list of possible symptoms and another thing to see how they’ll happen in real life.
“Not yet.”
“Good. Ready to check your blood sugar again?”
Neal nods and turns the monitor back on. It takes him three tries to get a test strip into the machine with his shaking hands, but he does it. He’s running out of fingertips after this many pokes, so he has to take the lancet to his pinky. Thankfully, the drop of blood appears right away, and Neal’s able to get it onto the test strip without too much trouble, where it’s wicked away into the machine.
“68. That’s close enough, Neal. We can be done now.”
“No,” Neal says quickly, looking up at Peter with those intense blue eyes. “I’m okay.” Then softly, more slowly, “I want to be okay. I need to be okay. I need you to see that I’m going to be okay.”
Every fiber of Peter’s being is screaming at him that this is wrong, that Neal is not okay and it’s okay to not be okay, but that’s not what Neal wants or needs. Not now. Not yet. So he gives a tight nod. “A few more minutes. After the next check.”
El stands. “I’ll get some juice ready. Orange juice okay, sweetie?”
“Yeah. Thanks, El.” Then Neal rests his head down on the table.
“Dizzy?” Peter asks.
“A little.”
“Nauseous?”
“No.”
“Good.”
El returns with a glass of juice and gives Neal a sympathetic look. She pulls her chair up closer to his and brushes his hair from his forehead. “He’s sweaty,” she says softly to Peter before starting to gently rub up and down Neal’s back.
Peter frowns and cards his own fingers through Neal’s hair, feeling the cold sweat there, adding that to his catalog of signs and symptoms. He almost calls the whole thing off one more time when Neal makes a little moaning sound that Peter isn’t sure Neal even realizes he makes. But then they’re at ten minutes since the last check.
“Okay, bud. Time’s up. Let’s see where you’re at.”
Neal makes no move towards the glucose monitor, but Peter’s seen it done enough times by now to know exactly what to do: Monitor on, test strip in, lancet ready. He tries to find the fingertip that looks least sore, but he isn’t sure it matters, since Neal doesn’t flinch at the poke or acknowledge Peter’s whispered apology. Neal is still conscious, eyes open, tracking Peter’s movements, just letting him take control. Peter gets the blood onto the test strip, and they wait. Again. Until finally, it beeps. 58.
“Low enough,” Peter says with a firm nod. “Let’s see how quickly we can turn it around.”
El springs into action, wrapping an arm around Neal’s shoulders and pulling him into a seated position, holding the glass up to his lips. “Small, slow sips, okay?”
He does. At first, nothing changes. He just slumps against El instead of against the table so that he can continue to sip. Five minutes. Ten. Peter is starting to doubt Dr. Adams and every single one of her credentials.
But then Neal is able to sit up a little on his own.
“Your color’s coming back,” Elizabeth says.
“Less dizzy?” Peter asks.
“The room is no longer spinning.”
Peter breathes a sigh of relief. As Neal continues to sip the juice, the sweating and trembling go away. Peter checks his pulse and finds it much closer to a normal resting heart rate.
“Well, I think we definitely know what to watch out for,” Elizabeth says.
“I don’t know what you two were so worried about. I was totally fine.”
El scoffs and nudges the blood sugar monitor in his direction. “Check that one more time. Make sure we didn’t overcorrect with the orange juice. See if you get to have any carbs with dinner.”
As El heads into the kitchen and Neal prepares the monitor yet again, he says, “So, did I pass? Do I get to go back to work?”
It’s only now that Peter realizes this wasn’t as much about him as he thought it was. “It’s up to you. You feel ready? Even after all of that?”
“Why wouldn’t I? You have my back.”
That, Peter has to admit, he does.