Sugar Blues

By William Dufty, 1975

Chapter 6: From the Nipple to the Needle

It’s high noon on a hot July day in Manhattan. A man reels dizzily down the stairs to the subway, clutching the handrail, lunging for the candy vending machines. No candy. No Pepsi-Cola. Only gum. He’s sweating. His speech is slurred. He looks like a sloppy drunk, bracing himself against a steel column until the BMT express pulls in. He lunges into the train, gripping the center pole with one hand. Sweat pours through his shirt. Clumsily he removes his jacket, one hand, then the other, clutching the pole. When his jacket slips to the floor he can’t pick it up. The train screeches to a halt. He hangs onto the center rail, trying to keep from slumping to the floor. Two passengers grab him, a well-dressed matron and a burly laborer. Two seated passengers arise so he can sprawl on the seats. They loosen his tie.

Do you have heart trouble? the matron asks. Do you have nitroglycerin or something you should swallow? The desperately ill man sighs but cannot speak. The laborer smacks him twice in the face, once on each side.

The shock forces his eye open. In thick-tongued fashion, he stammers he is a diabetic about to pass out unless someone feeds him sweets. The word spreads through the car. Two kids open their picnic lunches, extracting cans of orange soda pop. The motorman radios for an ambulance. A fat woman across the aisle gives him a gooey cupcake. Gradually, he recovers his metabolic balance and gets off the train at Times Square. He is a top political reporter from The New York Times, a diabetic for 23 years, who forgot his regular packet of melt in your mouth, not in your hand candies. He suffered from insulin shock. Too much insulin. Hypoglycemic reaction. Low level of glucose in the blood. Sugar blues.

A few months later on March 6, 1974, he died of diabetic complications. The March 25 issue of New York Magazine published his story of the subway incident posthumously. Contrary to all the stories about unfeeling New Yorkers, said the magazine, [he] was well treated by the people around him. This episode is an example of one more urban myth exploded.

One myth down and another to go. And on and on.

When a junkie dies, known or unknown, is it ever from metabolic complications? Of course not. Heroin is a killer. Junkies die of junk. Even when a drunk dies, he dies of his sins. But when a person dies of sugar blues, the mourners often serve sugar at the wake. Sugar-poisoning is a word wedding that rarely appears in print.

The same double standard is evident in the world of art and entertainment. Junkies die like flies every hour of every day on television. Many of these consoling sagas are brought to you by those wonderful people who push sugar and other products laced with sugar at every commercial break.

Camille suffers from TB. Audiences weep when the heroine of Love Story drifts into leukemia. Psychos clutter our stages and screens. Heart attacks abound when plots need unthickening. The snake pits, the prisons, and the psychiatric couches have been heard from. Autobiographical confessions and television dramas galore flow from alcoholics and opium eaters. But where are the Lost Weekends of the sugar addicts?

In modern literature, the significant thing may be what’s missing. Have you ever read a book or seen a play, movie, or TV program which took into account the sugar plague of the twentieth century? Who has spoken to us from the depths of sugar blues and been publicly heard or produced?

Two exceptions prove the rule. The first occurred on Merv Griffin’s syndicated talk show in late 1973. Griffin disclosed his own belated discovery that he was a victim of low blood glucose or hypoglycemia. He had wrestled with an overweight problem and gone through alcoholic binges. His exemplary reaction to the discovery that he had hypoglycemia was to devote several of his shows to enlightened panel discussions on the problems of refined sugar in our diets — how it poisons people and how simple it is to follow a curative diet. The second exception can be found in The Philosophy of Andy Warhol (which was published in 1975). Warhol frankly admits that all he ever really wants is sugar. You can’t take a princess to dinner and order a cookie for starters, no matter how much you crave one. People expect you to eat protein and you do so they won’t talk. He goes on to explain that after being alive, the next hardest work is having sex. I have found that it’s too much work.

When he was a child, his mother used to give him a Hershey bar every time I finished a page in my coloring book.

When insulin was new, Sidney Kingsley wrote the Broadway hit Men In White; it became a Clark Gable movie. In this story, two doctors have conflict at the bedside of a young girl who is desperately ill. The young doctor diagnoses (correctly) that the patient is in insulin shock (needing glucose), while the senior doctor insists that it is a diabetic coma (needing insulin).

Fortunately, the doctor making the right diagnosis prevails: The child recovers and smiles up at him. Cut.

That stage portrayal of the medical profession’s division and confusion was forty years ago. Today, there are millions of autobiographies of personal catastrophes caused by sugar. The patients are fumbling and stumbling around us every day and this drama happens in real life not in books and magazines. Backstage at the theater, not out in front. On the movie and TV sets, never on the screen.

Bottle babies often end up loving the bottle and hating their Mamas, according to Elijah Muhammed, the Black Muslim prophet He could have been talking about George who’s tall, white, and handsome. He was a bottle baby. He got his first sugar through a rubber nipple. After his teeth appeared, he had sugar with his Cheerios and orange juice, and ketchup with his morning eggs. Probably his parents, and millions like them, didn’t even realize ketchup contained sugar. (Even in the 1970s, few consumers realize that ingredients are listed on labels in order of decreasing predominance by weight. Different names for man-refined sugar also confuse the issue — ketchup that is labeled tomatoes, sugar, dextrose, vinegar, salt, onions, and spices has two varieties of man-refined sugar — dextrose is the hidden sugar.) Meat and potatoes were served for dinner every night with frozen peas; then came home-made pie, heavy with sugar, or canned peaches in a sugared syrup. When he was a good boy, he was rewarded with a Hershey bar or a bottle of 7-Up and chocolate fudge before bed. His teeth had cavities the first time anybody looked. He had strep throats continually, so his tonsils were yanked out when he was five. He went through all the typical childhood diseases like measles and mumps, plus exotic attacks of allergies that kept him in bed with hot compresses for half the summer of ’54.

Grandmother’s house (she was Polish) always had an aroma of sauerkraut and ham hocks, carbolic laundry soap, lilacs, and bay rum. Grandma talked a lot about her special diet, but she seemed to have her hand in the chocolate donuts as often as anyone else. George remembers Grandma hiking up the skirt of her flowered frock to stick a needle in her thigh. He didn’t think too much about it. Maybe all old women of fifty-two have this thing they call diabetes. When the little boy found a hypodermic needle in the alley one day, he brought it in to Grandma so she’d have a spare. When George was thirteen and Grandma was fifty-nine, she died. She couldn’t handle sugar and died trying. None of the family seemed to learn anything from her suffering. When George went to church later with his aunt, they sat in the choir loft and ate rock candy. His mother had inherited Grandma’s compulsion for sweets. He could always count on her for candy — so long as he was a good boy.

Three years after Grandma died, the family had another diabetic — little George. He had just won his high school varsity letter in tennis. On that first day out in his deep blue sweater, tradition entitled any senior letterman to grab him and twist the orange letter on his chest. Social status in high school was determined by this ritual. He got into a few fights. By lunchtime, he was so knotted up inside that he could hardly eat his hamburger and Boston cream pie. After class, he ran for the water fountain to drink his fill. Within an hour he was in the lavatory letting go.

His weight dropped from 165 to 140 pounds in a very short period of time. His mother knew what it meant. She and Dad drove him to the doctor. Two minutes after George had supplied the urine sample, they had the news: he could lead a normal life by shooting insulin in his leg every day like Grandma. Nervous, breathing heavy, swooning from the alcohol fumes, he wondered: How long? Sweet, sickening Jesus, how long? From sweet sixteen until when? That night, the condemned boy’s mother let him have a last Hershey almond bar. Why couldn’t it have happened to me? she sobbed.

George spent a week in the hospital learning to shoot up, practicing first on an orange before he began sticking himself in the leg. He was taught to watch his diet. No more sugar. Everything else was rationed. A whopping 4,000 calories a day to be balanced off with 45 units of Eli Lilly NPH U-80 insulin. Calories were emphasized, Every food had a number, even beer. Quality didn’t count. Nobody mentioned it. Only calories. Natural whole carbohydrates like stone-ground, whole grain bread counted the same as spongy, supermarket foam made of refined flour and sugar. He was supposed to avoid sugar but nobody told his mother how to avoid the sugar added to supermarket food. Nobody told Mom how to get around that one. Maybe the Doctor’s wife did the shopping, says George. There was no sign he’d ever looked at a label or knew what was going on. But neither did I.

George was equipped with certain baggage: Syringes, needles, alcohol, pads, Clinistix, insulin, and sugar cubes. Any junkie traveled lighter than that. Each time he urinated, he waved the Clinistix through the stream. If it turned red, he had too much glucose in his blood. Quick, more insulin. The Clinistix was no help at all when he had too little glucose in his blood. That meant he had taken too much insulin, overworked, or missed a meal; he could go into shock. An overdose of insulin can be as dangerous as an overdose of heroin. George depended on his glucose-starved brain to send him that message. Quick, the sugar cubes. Teeter-totter all the way. The Medicalert pendant around his neck had a telephone number in case he was discovered passed out. The card in his wallet read: I am a diabetic. 1 am not intoxicated. If I am unconscious or my behavior is peculiar, please refer to emergency instructions on reverse side of this card. The flip side said: Emergency treatment: If unable to swallow, give sugar in some form — orange juice, Coca-Cola or other sweet beverages, candy, syrup, etc. — and call a doctor.

He would prepare for a basketball game by taking less insulin. Sometimes, after exertion, he would feel his nose become wet and cold, his arms and legs tingle, the back of his brain go empty and light. That meant the onset of insulin shock. More sugar cubes and he’d be OK.

When working in a supermarket one day, his plastic box of sugar cubes tumbled out on the floor. As he picked them up an old man passed by and said: Diabetic, huh? It takes one to tell one. The secret brotherhood. George felt like a derelict soul imprisoned in the body of a youth.

One day after a game, his buddies stopped off to have ice cream — a no-no for him. He knew he needed something else to eat but didn’t want to call attention to his affliction, so he braved it out. The rest of the afternoon was a blank. He remembers the car stopping in front of his house and someone handing him his basketball. He took one step into the yard and woke up in the hospital with glucose pouring into his arm from a tube. At the age of 16, he had started with 45 units of insulin daily. By the time he graduated from high school, this was up to 55.

In his second year of college, marijuana or grass was a big deal. Grass and Vietnam. If you got busted for one, you missed out on the other. George was marked 4F as a diabetic. He missed the army anguish but checked out the grass. As a college junior in 1967, he took his first LSD trip. As a college senior, he had taken a dozen LSD trips and smoked grass every day; he maintained passing grades by writing mystical term papers. Richard Alpert visited the campus to lecture on hallucinogenic drugs and announced that grass lowers the body’s glucose level while LSD raised it. This was a blinding revelation to George. His brain might not have acknowledged it but he knew in his veins it was true.

Whenever he got stoned on grass, gnawing hunger drove him to gorge on sweets, apples smeared with peanut butter, bread with saccharin jelly. LSD had the opposite effect. During an acid trip, he would urinate furiously and needed extra insulin when it was over. He prepared for new eventualities with more baggage. When the acid heads began to discover Eastern religions, George tagged along. A classmate found a Japanese book which claimed that diabetes could be controlled and prevented by eating natural whole carbohydrates such as brown rice, azuki beans, and pumpkin. This was totally incomprehensible to George. Doctors had convinced him that a carbohydrate was a carbohydrate was a carbohydrate. According to Western medical religion, rice was a carbohydrate and totally taboo for him. Now his mind was being opened on the subject of food. It began to penetrate that what you put in your face has something to do with what goes on in your head, whether it’s smoking grass, tripping on LSD, or eating rice. George began dabbling with chopsticks and natural foods. He switched from hamburger to fish and from Rice-A-Roni to whole brown rice, adding a little Japanese seaweed and some green salad. But he kept on taking 55 units of insulin — 45 in the morning and 10 more at night.

Sometime later, he woke up in the night thrashing like a dying fish. His roommate called the ambulance which rushed him off to the college infirmary. The doctor there told him 55 units was too much insulin, he was cut back to 45. Maybe the Oriental guru was onto something! A few weeks of rice and seaweed had changed his direction. To celebrate, he threw away his Medic-alert pendant.

After graduation, he headed for San Francisco to join a hippie commune. One afternoon, while sitting on the floor smoking grass, he fell asleep and woke up in the hospital with glucose pouring into his veins. Hospitals always pumped him so full of glucose he had to take more insulin as soon as they let him go. Glucose balance is a tricky thing, as George was learning. The next day, when it happened again, a psychiatrist dropped by to ask if George was attempting suicide.

George loathed being dependent on insulin and being obliged to count the hours exactly between meals. He loathed being a diabetic. If he wasn’t a diabetic, what the hell was he? He had no better identity at the moment. Invalidism was a tempting way out, a built-in excuse for failure. With insulin, grass, LSD, you choose your dependency. But what if Eli Lilly went out of business?

Late that summer at a rock concert, George was desperately hungry for something sweet. He had his sugar lumps with him, but he wanted something mild like orange juice. He headed for the refreshment stand. The long line moved like molasses. George began to stagger a bit; eventually, he wove an unsteady path to the shelter of a hedge that bordered the sidewalk; he lay on the ground there, fumbling with the rubber band around his box of sugar. Magazines of the early 1970s would have one believe that every other sugar cube in California was soaked with LSD. Here was George acting like an addict. However, he wasn’t trying to evade the police, on the contrary, he was seeking aid. Help!!! he cackled to a passing stranger. The stranger was hip enough to know an acid freak when he spotted one. He ran the other way. George collapsed. A friend heard him screaming, found him, and started feeding him sugar. Killing him softly, pulling him out deeper.

Next, George got a job on a California ranch where Mokelumne Indians came over with a peace pipe full of hashish the first day. But that was the only dope he had during his entire stay there except that Lilly white insulin. He ate whole wheat bread, oatmeal, cheese, apples from the trees, watercress from a stream, and raspberries from a patch. He rode a horse, killed a snake, chopped wood. On hard working days, he reduced his insulin to 25 units. When that was still too much and he felt the gathering storm of insulin shock, he’d eat some honey and go back to work. Too much glucose in the blood was worse in the long run. In the short run, one always remained conscious, in control. Too little glucose in the blood, or what they call hypoglycemia, can leave you an inert mass out there somewhere on the forest floor. A diabetic learns the hard way about the ultimate terrors of the sugar blues.

Mornings after he had eaten too much, he would wake up with a swollen bladder, wave a Clinistix through his urine and angrily watch it turn red. He would stand there looking out at that beautiful dawn, hating his mother for having made him a cripple. We can’t forgive others sometimes because we know we ourselves are in the wrong. George knew it was his own fault for eating too much. Why blame himself for being fearful of hypoglycemia, or insulin shock? When he needed someone to blame, George absolved himself and screamed at his mother two thousand miles away. Blaming her for putting him on the rubber nipple which connected with the steel needle. From nipple to needle, the story of his life!

Next, he returned to Berkeley and LSD. He had learned that careful eating could help, and he knew he would have to kick grass as well as insulin. Although living on whole grains and vegetables as the Japanese prophet suggested was great, George wasn’t a good cook and didn’t want to learn. He wanted Mama to cook for him; she had got him into this, now let her cook his way out.

He stayed off meat but grass forced him to gorge on sticky, sweet food. Even with occasional bingeing, he cut his insulin down to 25 units. He managed to avoid severe shocks to his system but suffered little ones.

He remembers the ultimate last tango in Sacramento. He attempted a seduction and found the female ready and willing … and himself disabled. At the first sign of stress, his penis began to shrink — another telltale sign of approaching insulin shock. His young companion watched in amazement as George pulled a honey candy bar out of its wrapper and chomped it down.

That episode clinched matters. It drove him to drastic, foolish things in search of manhood. He tried kicking insulin cold turkey in favor of whole rice, azuki beans, and pumpkin. This was where he came in. He was back to sweet sixteen, drinking quarts of water and passing quarts of colorless urine. So he gave in and took a shot. Then he tried eating nothing at all. Another failure. He went from one extreme to another. He wanted an instant cure. He couldn’t find the patience to continue weaning himself slowly and gradually off insulin onto a steady regime of whole grains and vegetables. Maybe because I was never weaned from my mother’s breast? he asks. I don’t know.

In the summer of 1969, he took about 40 LSD trips. Trying to kill myself, he admits. His old self, that is. He wandered through the student riots in Berkeley smoking grass and more grass until one day he walked into a bathroom.

I saw a tall rather pretty girl standing there. I thought I’d seen her somewhere before. Then he noticed he was gazing into a mirror, staring at himself. He got off the psychedelic bus and went for a haircut. He stopped taking LSD and grass. Then he found out what kind of a monster his metabolism had made of him. All he wanted was sugar. He craved sugar like a wino craves muscatel. He ran from one store to another buying candy bars. He discovered he was not alone. This usually happens when one withdraws from LSD. But no doctor ever told him. They don’t teach them about LSD in medical schools.

Not yet. Or about hypoglycemia either. Although Seale Harris broke the news in 1924.

I was a nymphomaniac for fudge, George recalls. Rewarding myself with suicide. After the binges, he had to crank up his insulin dose to a new high of 60 units a day. Between raids on the candy counter, he decided to head back East and study Oriental medicine whose teachings he had been flirting with for so long. He felt this was the end of the line for him. I was hopeless, medically and spiritually.

He moved into a commune near Boston where good cooks prepared traditional Oriental food — whole rice, vegetables, a little fish, salads, beans, sea vegetables, traditional soy sauce, tofu (white soybean cheese), miso (a paste of soybeans, wheat, and salt), and occasional seasonal fruit. Slowly, gradually, his balance returned. He reached that point where sugar-free food tasted sweet to him. His crazy longing for sugar fell away. He lost his craving for milk, yogurt, cheese, even ice cream.

In two years, George was able to reduce his insulin dosage from 60 to 15 units a day. His weight stabilized at 150 pounds. He doesn’t carry around sugar cubes anymore. If he feels a small insulin shock coming on, he doesn’t even need the honey anymore. He takes a piece of whole-grain bread or a mouthful of whole rice. When he chews it well, by the numbers, sometimes up to fifty times, it breaks down into glucose right in his mouth. It’s just as effective at balancing his metabolism as the sugar cubes — without what he calls that runaway Drano impact on my digestive system.

Every week he gets needled by a Hasidic acupuncturist, a fellow he has known since college. Acupuncture has taught me patience, he says. My friend tells me my liver was overloaded — maybe from repressed anger and tons of sugar when I was a kid. According to acupuncture theory, if the liver is overactive, it has a destructive effect on the pancreas, where insulin comes from.

On a plane one day, George was seated next to a youngster. He could tell the way the kid’s mother was hovering over his airline dinner, counting out the calories, that the lad was diabetic, hooked on insulin.

It had taken George ten tortuous years to find his way. Today the Lilly company is getting them younger and younger. He couldn’t resist asking the boy’s age, the lad was. only nine years old. How long had this boy been hooked already? George was scared to ask.