Hypoglycemia occurs when your blood sugar gets too low. For a diabetic, it’s called diabetic shock and it’s no joke, if you’ve ever experienced it. As someone with hemochromatosis that has caused diabetes, I’ve been in that battle ground on several occasions. Two years ago, I published a crime novel, Tito’s Dead. One of the characters is a diabetic journalist who gets kidnapped by a gangster anxious to elicit some information from him. The character’s name is Garvan Deare and this is his experience.
Heels pulled into the wire and concrete fenced yard of the disused dockland warehouse, flush with confidence. As he swung the sleek Mercedes into a corner parking spot, he ran through his triumphant arrival in his mind’s eye.
He’d give it loads of ‘it’s-all-in-a-night’s-work, boss’ as he dropped his human booty at the feet of Joe Connolly. He couldn’t suppress the strut as he sprang from the big car’s cockpit and strode, keys jangling loudly, to the car’s trunk.
Deare will be a pushover, he thought, after a few slaps he’ll be singing and the boss’ll soon have this mess behind him.. And it would all be on account of him. Once more, he thought, he delivered for the boss and he’d be well rewarded for it.
But as he swung open the trunk door and peered at the curled body of the unconscious journalist something about the inert figure gave him cause for alarm.
Garvan Deare felt the first flush of diabetic disorientation while he was sitting in Madigan’s with Sandy Nelson.
It was a routine feeling and it came with the same familiar baggage: first, his peripheral vision began to play tricks as though what went on outside his sight line was happening at a different pace. The skin on the back of his hands gave him a pins and needles sensation that spread to his lips, tongue and mouth.
The third stage was unpredictable. It could come half an hour after the first began or might tumble straight after it or worse still, all three stages could happen simultaneously. All he could ever rely on were the first signs and that’s when swift action was needed. In the third stage he would lose control of his motor functions, stagger and gibber.
Deare left the pub with the intention of going straight home to gorge on a feed of brown bread, hummus and fresh fruit. The combination had always worked the trick for him, a combination of simple and complex carbohydrates. But all that was academic now.
He hadn’t made it home. Instead he woke in the dark, smelly confines of a car boot with a splitting headache and the realization that holding onto a coherent thought had become as tricky as picking up raindrops from a petal. The terror induced by his circumstances, the pain in his blood caked face and the hypoglycemic symptoms he displayed, were accelerating him towards a full blown diabetic turn. He could neither see to think nor think to see.
He lost horizontal and vertical control as his thoughts flew by like waste in a sewer. On top of that he could feel the approaching dim, envelop him, like a concrete waistcoat. He was only aware of the door opening because of the faint waft of fresh air. His eyesight was clouding, failing.
Garvan Deare stands in a crowded room of faceless people. It’s a long, wide room, with white walls. The ceiling is very close although from a distance it appears lofty and cavernous, distorting shapes and perspective. People shift about like a shoal of sardines. Deare tries to focus but he can’t see their faces. He thinks his sight’s failing, or the dull light is playing tricks. Occasionally, in the corner of his eye, he can make out a set of recognisable features, so he scrunches his eyes together and concentrates. Now he notices that for all this movement, he hears nothing. He tries to speak. He tries to reach out and touch someone. Nothing happens. He shuts his eyes and waits. When he opens them again the room is an empty blur.
Light from a street lamp filters through the grime of the skylight window in the ceiling. He’s sitting on a swivel desk chair with curved, padded arms that has seen better days. The padding on one arm has burst and someone has idly stripped it back to its wooden base. He tries to apply pressure to his foot, in an effort to move the chair, but soon realizes it has no legs and the heavy metal casters have long since seized with rust. His arms hang, like a discarded puppet, off the sides of the chair. The knuckles of his left hand touch the ground.
The bare walls are painted an institutional, snot green, colour. The desk in front of him is painted two shades of gunmetal grey. It has a smooth, modern top of veneered chipboard.
Occasionally his mind slips into a giddy distraction, flitting about like the reflection of a shiny moving object on a ceiling. He knows the blow to the head has left him groggy but the dizziness comes from hypoglacaemia. He has no means to deal with it. He needs a quick sugar fix, a simple carbohydrate like a finger scoop of sweet jam, a Mars bar or an apple.
Sometimes, when these were not available he devises other means of maintaining his equilibrium and consciousness. One of these is minimal activity and slow but concentrated observation. So he studies the ripped and worn lino floor and notes the upside down coat hook on the back of the office door.
Then he hears a metallic click. He feels a slight breeze on his cheek but doesn’t move. He can barely contain his excitement as he feels the recovery of his senses, sensation and sound. Someone’s moving about nearby. He dares not open his eyes again. The sound is faint and distant, receding footsteps. He holds his breath.
When there’s no further sound and he can feel nothing else apart from that fleeting cold breath of moments earlier, he lets his eyes relax so the light seeps through his eyelids. He can see the room has changed. Or was this the room of his dream? Concentrate. Breathe. He’s slumped on a chair in a tiny empty office. The cavern has gone and so have the faceless people.
He doesn’t move. He waits while his mind reacquaints him with his body. He’s drained and exhausted but relieved he can still wiggle his toes in his shoes. His fingers send him contact signals. He can feel the trail of black, sticky blood on his face and the searing ache where his head has been struck, not once, he thought, but several times.
Disoriented, sore and tired, he sits motionless, struggling to gather his scattered thoughts amid the debris. Gradually, his thoughts return. He remembers walking home and stumbling into a car that appeared from nowhere. He remembers the bumping darkness in the car’s boot before he lost consciousness. Every thought struggles to hold a grip as he feels the cold fog descend again.
Everyone’s experience of hypoglycemia is different and everyone who does experience it, must learn to recognize the signs to counteract the effects as swiftly as possible. I was playing football on a beach in Minorca once. It was mid-summer, midday and very hot. After the game, my girlfriend noticed I was a little unsteady on my feet. She knew the signs and steered me in to a local, beachside taverna, grabbed a handful of pasta from a customer’s plate and stuffed it in my face. There was uproar but she saved my life, again. We apologised to the staff and the manager, paid for the surprised couple’s meal and left.
Everybody knows a diabetic, although they may not know it. Some diabetics don’t like to draw attention to themselves. But when the fog of hypoglycemia descends, anything can happen. Find out about it, ask your friend because when everyone knows what’s happening, there’s a better chance of a quick response and a good result.