Seventy-three years. That is how long it takes to learn the exact weight of your own fatigue, how it settles behind your collarbones first thing in the morning like a wet wool blanket before you even put your feet on the cold floorboards. For most of a year I carried that weight around like it belonged to me by right of birth or bad luck, hauling it from the bed to the coffee pot, from the coffee pot to the front porch to check the mail, and then back inside to sit on the edge of the sofa until the room stopped spinning.
I was thirsty in a way that regular water never quite fixed, drinking straight from the kitchen tap with the cold porcelain pressing against my lower lip, then filling the green Mason jar again before I even set the first one down on the Formica counter. My daughter Sarah used to come over on Saturdays with her grocery bags and find three different glasses of water sitting on various end tables around the living room, each one half-empty with a little floating ring of dust or lint on the surface. I told her I was just drying out from the heat of the house, or maybe the furnace was blowing too dry through the metal floor vents. I told her a lot of things because I did not want to admit that my own body was turning into a stranger I could not quite manage anymore.
Back in March, when the dizziness first started getting past a whisper and shouting in my ears whenever I stood up too fast from the kitchen table, I drove my old Buick down to Dr. Evans’s office on Oak Street.
Dr. Evans had been looking down my throat and tapping on my knees for ten solid years, a quiet man with silver hair who smelled faintly of spearmint gum and old paper. He had seen me through my husband Arthur passing away in the back bedroom, and he had seen me through my hip replacement back when the clinic still had those green vinyl chairs in the waiting room. I thought he knew the shape of me. I sat on the examination table with the white paper crinkling under my thighs and told him about the thirst, the way my mouth felt like old cotton batting by two in the afternoon, and how I had to lie down for an hour after folding a single load of towels because my breath felt thin in my chest. He listened with his stethoscope dangling around his neck like a dead snake, nodding that slow, heavy-headed nod that used to make me feel safe when I was younger.
Then he pulled his little silver pen out of his breast pocket and tapped it twice against his knee before looking right over my glasses. He looked at me with that gentle, pitying smile doctors use when they have already decided what drawer to put you in before you finish talking. He said, Doris, that’s seventy-three for you, and told me to drink a little more juice and take a walk around the block when the weather cooled down. I believed him because he was a doctor and I was seventy-three, and who was I to argue with a man who had a sheepskin hanging on the wall with gold lettering and ribbons that had faded to the color of dry mustard over the decades?
I took his advice and walked around the block twice that very Tuesday, my tennis shoes slapping against the cracked sidewalk where the maple roots had pushed the concrete up into little gray ribs.
By the time I made it back to my front steps, my chest was hammering like a trapped bird and I had to sit on the bottom riser for ten minutes waiting for my vision to clear up at the edges. I didn’t go back to Dr. Evans. I just decided that getting old was like wearing a pair of shoes that didn’t fit right anymore, something you just had to grit your teeth and walk through until your feet went numb. But the weight kept coming off, and that was the part that didn’t make any sense even to a stubborn old woman who didn’t know a pancreas from a turnip. I had always been solid, the kind of heavy-set woman who filled out a cotton housedress without needing any help from the seams, but by late summer my collarbones looked like two dry pine knots sticking up out of my skin.
My rings kept spinning around my knuckles until I had to take my wedding band off and put it in the little blue velvet box on my dresser because I was terrified of losing it down the kitchen drain while I was washing the breakfast skillet. The worst part, the part that finally broke my stubbornness wide open, was my mouth. My lower dentures started floating around in my mouth like little plastic boats in a dry pond, clicking against my gums every time I tried to chew a piece of toast or talk to the lady at the post office counter. I had put up with the thirst and the shaking hands and the naps that lasted all afternoon, but a woman can only take so much humiliation when she is trying to eat a soft-boiled egg without her teeth trying to crawl right out the side of her cheek.
That was how I ended up pulling my Buick into the gravel lot behind the plaza dental office last Thursday morning, right between a faded red pickup truck and a delivery van for the local bakery. The plaza was one of those strip-mall places with a flickering green neon sign over the dry cleaners and a window display of orthopedic shoes that had been sitting behind dirty glass since the Carter administration. The dental office was clean, though, smelling of peppermint mouthwash and hot sterilization trays the second you pushed open the heavy glass door. The girl at the front desk had dark hair pulled back into a tight bun and a nametag that said Kelly, and she didn’t even look up from her computer when I walked in and told her I was the ten o’clock for a denture adjustment. She just handed me a plastic clipboard with a yellow pencil that had been chewed down to a stub by six people before me.
I sat down in one of those orange plastic shell chairs that tilt you backward if you lean too hard, and I tried to fill out the medical history form with a hand that wouldn’t stop doing a little fine jitter against the paper. When Kelly called my name twenty minutes later, I walked down the narrow linoleum hallway past three closed doors until I smelled that sharp, sour odor of old tooth decay mixed with bleach that always makes the back of my throat tighten up.
The young hygienist didn’t look like she was a day over twenty-four, with clear brown skin and bright, round eyes behind a pair of wire-rimmed glasses that kept sliding down her nose. Her nametag said Chloe, and she had a little gold star sticker stuck to the corner of it that must have belonged to her niece or something. She didn’t talk much while she got her tray ready, just laid out those little metal picks and the small curved mirror that looks like a tiny spoon for a doll. I opened my mouth and let her poke around, my jaw aching from the way the bone had shrunk away from the acrylic plate over the last few months. She worked quietly for a long time, scraping away a little tartar behind my bottom molars where the toothbrush never quite reached anymore, but then she stopped. She didn’t pull her hands back, but the little mirror stayed right there against the inside of my cheek, her fingers holding it steady while she looked closer at the pale, yellowish tissue underneath my tongue.
I watched her eyes shift behind those wire-rimmed glasses, moving from my gums to the chart she had clipped to the wall mount, and then back to my gums again. She didn’t say anything for a second, and honestly that felt worse than if she had shouted. She just reached up with one gloved finger and pulled her mask down under her chin, her face going very still and serious in that bright halogen light.
She asked me how long my gums had looked like that, all pale and puffy around the edges with those little white spots that looked like salt grains pressed into the meat of the tissue. I told her I hadn’t looked inside my own mouth with a flashlight in twenty years, and that my teeth were just loose because I had lost some weight. She kept her eyes right on mine, not blinking once, and asked me a question that didn’t sound like anything a dental person had any business asking. She asked whether anyone had ever checked my blood sugar. I told her no, of course not, because Dr. Evans checked my urine every year at my physical and said everything looked fine down the line, just a little old age and a lazy bladder. Chloe didn’t smile. She just pulled off her blue latex gloves with a sharp snap that echoed off the white tile walls and laid them carefully on the edge of the silver tray.
She didn’t even pick up her pen. She just looked at me with those big, steady eyes and said, “I’ll be right back, Mrs. Miller. Don’t go anywhere.” She walked out of that little room and left me sitting there with my mouth half open and the metal tray staring at me like a set of small, cold teeth.
I didn’t have to wait five minutes before the door swung back open, but it wasn’t Chloe who came through it. It was Dr. Arthur, the dentist who owned the place, a tall man with graying temples and sleeves rolled up to his elbows over thick, freckled forearms. He didn’t look at my teeth at all, which struck me as strange since I was paying one hundred and forty dollars just for him to look at them. He walked straight past the sink, picked up my paper chart from the wall rack with one hand, and flipped the yellow pages back until he found the page Chloe had been staring at. His face looked like he had just bitten into a green persimmon, all pinched around the corners of his mouth and his eyebrows drawn down until they nearly met over the bridge of his nose. He didn’t say hello or ask how my morning was going.
He just stood there under that glaring overhead light and looked down at me with an expression that was half-angry and half-pitying, the kind of look you give someone who has just walked out into a thunderstorm without an umbrella. He laid the chart down on my knee and tapped the corner of it with his middle finger twice, hard enough to make the paper rustle. He said, “I want you at the ER tonight. Your body has been trying to tell us…” and then he stopped himself, took a long breath through his nose, and told me that my blood sugar was likely sitting somewhere up near five or six hundred, cooking my organs from the inside out while I sat around waiting for my dentures to settle. He told me that my gums weren’t just shrinking from weight loss, they were dying from lack of circulation because my blood had turned into something resembling warm syrup over the last twelve months.
I sat there in that orange chair and told him he must have made a mistake, that Dr. Evans had checked me over just last spring and told me I was fine for seventy-three. Dr. Arthur didn’t yell, but his voice had that hard, flat edge to it that doesn’t leave room for arguing with a stubborn old woman. He told me that dentists see what regular doctors miss because the mouth is the first place the body gives up when the chemistry goes bad, and he told me that if I went home and went to sleep instead of driving straight to St. Jude’s emergency room on the south side of town, I might not wake up to see the sun come up over my porch the next morning. He didn’t let me leave until he had walked me out to the front desk himself, stood right there while Kelly called the hospital intake desk, and handed me a sealed manila envelope with my dental x-rays and Chloe’s notes tucked inside like a death warrant written in blue ink.
I didn’t argue with him anymore. My knees felt hollow, and the room had that funny tilt to it that tells you your blood pressure has dropped right down into your boots. I walked out to my Buick in the plaza parking lot and sat behind the steering wheel for ten minutes with the engine idling, watching the bakery delivery van back out of its space while my hands shook so hard I couldn’t get the key into the ignition on the first try.
The emergency room at St. Jude’s smelled like floor wax and old panic, that particular kind of hospital clean that makes your stomach turn over before you even reach the glass doors. I walked up to the triage counter and handed the nurse Dr. Arthur’s manila envelope without saying a word, and within five minutes I was sitting in a wheelchair with a plastic identification band snapped around my left wrist so tight it pinched the thin skin over my veins. They didn’t put me in a waiting room with the people coughing and holding their arms. They rolled me straight back past the heavy double doors into a little curtained bay where three nurses descended on me all at once like hens on a June bug. They stuck a needle into the back of my right hand before I could even tell them I bruise like a peach, and within half an hour a young doctor with dark circles under his eyes came in and told me my blood glucose was reading at 584, which he said was like running an engine with no oil until the pistons weld themselves right into the block.
They hooked me up to an IV bag of clear saline that felt icy cold as it hit my elbow, and they started drawing blood every two hours through a little rubber port on the back of my hand until my arm looked like it had been in a grease fire.
By midnight Sarah had arrived, her coat half-buttoned and her hair sticking out on one side where she must have jumped out of bed the second she got my message from the hospital desk. She didn’t cry, because we aren’t criers in our family, but she stood at the foot of my hospital bed with her arms crossed over her chest and her face looking like thunder while the young doctor explained what was happening to my kidneys. He told us that my body had been burning its own muscle and fat for months to keep the engine going, which explained the twelve pounds I’d dropped without trying, and that the constant thirst was just my kidneys trying to flush out all that extra sugar the way a garden hose washes mud off a driveway. He said if I had waited another week, or maybe even another weekend, I would have slipped into a diabetic coma and probably wouldn’t have come back out of it.
Sarah looked at me across the metal bed rail, her eyes wide and dark in the dim light of the ward, and she didn’t say anything about Dr. Evans right then, but I could see the gears turning in her head. She knew as well as I did that I had been sitting in Dr. Evans’s office every six months like clockwork, telling him about the exhaustion and the thirst and the way my clothes were hanging off my ribs, and he had patted my hand and told me that seventy-three was just a hard number to carry around.
They kept me in that hospital bed for four days, pumping me full of insulin through a little machine that beeped every time I bent my wrist too far and teaching me how to prick the side of my finger with a little spring-loaded clicker to test my own blood before every meal. It hurt the first few times, a sharp little pinch like a fire ant bite, but after a while you get used to the rhythm of it, the drop of dark blood on the little white strip and the digital numbers blinking back at you like a small green eye telling you the truth whether you want to hear it or not. By the third day my head had cleared up for the first time in a year, that heavy gray fog lifting away from my ears until I could actually hear the nurses talking down the hallway without it sounding like it was coming from underwater.
I wasn’t thirsty anymore. The water in the plastic pitcher on my bedside table stayed cold and untouched for hours because my body finally knew what to do with what I gave it. When they discharged me on Monday morning, Sarah drove me home in her own car with a brown paper bag full of insulin pens, alcohol wipes, and a brand-new digital meter that beeped when it was ready for the strip. But we didn’t go straight back to my house on Elm Street. We stopped three blocks short of Dr. Evans’s clinic on Oak Street, right in front of the brick building with the white pillars and the brass sign that said Richard Evans, M.D., Internal Medicine.
I didn’t call ahead for an appointment because I knew if I gave myself twenty minutes to think about it, I would lose my nerve and let Sarah drive me home to my own front porch. I walked through those heavy glass doors with my hospital discharge papers tucked inside my large leather purse right next to my new blood sugar logbook, my head held higher than it had been in twelve months. The girl at the front desk looked up from her computer and started to give me that little professional smile they practice in school, but when she saw my face she stopped dead with her mouth half open. I didn’t wait for her to ask me if I had an insurance card. I told her I wanted to see Dr. Evans right now, and when she started to tell me he was booked up with appointments until three o’clock, I laid my hospital discharge summary right down on the counter on top of her neat little stack of appointment cards.
I didn’t shout. I didn’t make a scene where the other patients could hear me, because a lady doesn’t need to holler when she has got five hundred and eighty-four milligrams of unassailable proof sitting right there in black and white on government-issue hospital stationery. I told her to go back and tell Dr. Evans that Doris Miller was in the waiting room with her lab results from St. Jude’s, and that she wanted to know why seventy-three looked a lot like diabetic ketoacidosis to the folks down at the plaza dental clinic.
It took less than three minutes before the side door swung open and Dr. Evans stepped out into the hallway, his silver hair looking a little more ruffled than usual and his white coat unbuttoned at the bottom. He looked at me standing there by the reception desk, and for a second his eyes flicked down to the hospital papers spread out on the counter like a summons. He tried to put that old, gentle grandfather smile back on his face, the one that had fooled me for a decade, and he took a step forward with his hand half-raised as if he was going to take my elbow and lead me back to the quiet room with the paper table. He said, “Doris, I hear you’ve had a bit of a scare at the hospital, let’s go back to my office and we can talk about getting you referred to a specialist.” I didn’t move an inch.
I kept my feet planted right there on the linoleum floor, my fingers resting on top of my leather purse where I could feel the hard plastic edge of my new blood sugar meter. I looked right into his eyes, right past the gold-rimmed glasses and the spearmint smell that didn’t hide anything anymore, and I told him he didn’t need to refer me to anybody because I was already done being his patient. I told him about the twelve pounds I’d lost while he sat there tapping his little silver pen against his knee, and I told him about my gums rotting away while he blamed my age for a pancreas that had quit working six months ago. He tried to say something about how complicated older bodies were, how symptoms overlap when you reach seventy-three, but his voice trailed off into nothing because he could see the look in my eyes and he knew as well as I did that he had simply been too lazy to look under the hood.
I didn’t wait for him to finish his sentence. I picked my hospital papers back up, tucked them into my purse, and turned around and walked out of that office without looking back once.
That was three weeks ago, and my new doctor is a woman over at the medical center on the north side named Dr. Sterling, who doesn’t smile quite as much as Dr. Evans used to, but who listens every time I tell her my feet feel a little cold or my morning numbers are running higher than they ought to. My dentures fit right again now that my weight has started to crawl back up toward where it belongs, and I don’t carry four different glasses of water around the living room anymore because one green Mason jar by the kitchen sink is plenty for a woman who knows what she’s drinking. This morning the sun was coming through the screen door early, throwing long stripes of light across the linoleum floor while the kettle was just starting to make that soft, humming sound on the burner. I sat down at my kitchen table with my new leather-bound logbook open to today’s date, poked the side of my finger with the little clicker until a small dark bead of blood came up, and touched it to the white strip on the end of my meter.
The green numbers blinked up at me from the little gray screen, steady and clear as church bells on a Sunday morning, right where they were supposed to be. I wrote down the number with my black ballpoint pen, closed the book with a quiet little snap, and reached out to take a slow, unhurried sip of fresh water from the glass sitting right beside my hand.
