Most people don’t think much about the pancreas. Most of them of course don’t have to think about it at all. But there are a few who, because of events that have occurred outside of their control, must spend a great deal of thought deliberating exactly what it means to act like a pancreas. In drama, when actors do this they may create in themselves the thoughts and emotions of the character they are playing in an effort to develop a lifelike performance. It is called method acting. I like that. I like thinking in terms of practicality, theory and emotion. They are concepts very much suited for nailing the part of the pancreas.
The event that brought about this purpose in us happened last December, or actually sometime before, though we don’t know how long before and anyway it was December when we finally found out about it so there was no casting call, no audition, no understudying. This role was simply and crudely handed over to us. Nor, because of the sudden dismissal of the prior performer, was there any time alloted for rehearsal, though we were given the benefit of learning our part in the relative comfort of our home stage, with only one major exception. Nonetheless, if we are to believe our tutors, our training has gone rather well.
On opening night our hopes were high. The stage was set, our lines committed to memory, and the mood, as the audience was seated, was positively electric.
Lia, a happy, energetic young girl
Dad, a worrisome father
Pancreas, a Patton-esque figure suffering from an identity crisis, but still wants to be in charge.
Setting: Home and Little Friend’s House who is hosting an overnight birthday party. The time is Morning, Noon, and Night.
Breakfast. That morning. Lia is sitting at the kitchen table, in theory testing her blood glucose level, but in reality farting around with paper and magic markers. Dad is at the refrigerator preparing her breakfast.
DAD. Can you please check your blood, sweetheart? (There is no answer from Lia). Lia?
DAD. Can you please check your blood? (Lia puts down the marker and takes up the lancet device and pricks her finger, then touches the test strip to the droplet of blood.) What’s it say?
LIA. (Reading the meter) 276.
DAD. Really? (Lia holds the meter up from him to see for himself. He walks over to the white board and rights the number down. To the right of it he scribbles a calculation, and beneath that he adds up the carbs of her english muffin and banana).
LIA. How much?
DAD. Well, it comes out to 5H, but…
PANCREAS. 5 units is way too high.
DAD. Why’s that?
PANCREAS. It just is.
DAD. Could you be a little more specific?
PANCREAS. (Sighs with exaggerated exasperation.) Well, Mr. Amateur, for starters, she had pasta last night. You know the effect pasta has on her blood sugar.
DAD. Yes, but that was thirteen hours ago.
PANCREAS. (Ignores Dad’s comment.) Secondly, she has a party tonight and that means she’ll be running around, playing, yelling and screaming like her and her young friends do whenever they get together, generally making it hard for anyone else to think much less–
DAD. Can you just skip to the point?
PANCREAS. There’s no reason to get snippy.
DAD. There would be no reason for this conversation at all if you’d just do what you are supposed to.
PANCREAS. It’s not my fault.
DAD. Whose is it then?
PANCREAS. Blame those little white blood-sucking cells. They’re the ones gunking things up.
DAD. Whatever. I still hold you responsible. This is your job and you’re not doing it.
PANCREAS. You can’t talk to me like that.
DAD. I can and I will, now back to her breakfast. Why not a 5H?
PANCREAS. Because, if we want her to be a little high tonight so you don’t lose any beauty sleep worrying your balding head over her suffering a low, then you have to factor in the carbs she’ll use burning up all that energy.
DAD. It won’t matter, I won’t sleep anyway. But okay, what do you suggest?
DAD. (Looking skeptical.) 3H?
PANCREAS. That’s right. That should just about hold her steady at 125. Then this afternoon we can back off a little bit.
DAD. 3H seems low.
PANCREAS. It isn’t.
DAD. Why not 4?
PANCREAS. Because 4 is too much.
LIA. (Holding the insulin pen and looking a little peeved that she isn’t eating now that he made her put away her drawing things.) What’s the dose, Dad?
DAD. (Dad studies the calculations a moment, then looks over at Lia.) 4H.
LIA. (Lia sets the dose and gives herself the shot in the stomach.) Can I eat now?
DAD. Go ahead. (He walks over to the sink and stares out the window at the garden.)
PANCREAS. You’re welcome, but I think you’re making a mis–
DAD. Shut up.
Lunch. Lia is sitting at the kitchen table before a plate of graham crackers, yogurt and a cheese quesadilla. In her hand she holds the blood glucose meter, which reads 89. Dad is standing over her looking perplexed.
PANCREAS. Told you so.
DAD. Spare me the attitude.
PANCREAS. Well, maybe you’ll listen to me next time.
DAD. Maybe I’ll have you replaced with one that works.
PANCREAS. Good luck with that.
LIA. I’m hungry, Dad. Can I eat?
DAD. (He looks at Lia.) Not yet. (He studies the white board where all the data has been collected.) What do you think? (Pancreas doesn’t answer. Dad sighs.) All right, I’m sorry. Yes, I should have listened to you.
PANCREAS. There, that wasn’t too much to ask, was it? My theory is we cut her bolus by half a unit and give a 2H.
DAD. Half a unit?
PANCREAS. You’re already factoring in her low sugar level. You don’t need to go overboard cutting the dose to match the carbs. This is lunchtime, remember. Her body converts energy differently than at other times of the day, but she still needs insulin.
DAD. Yeah, but cutting only half a unit doesn’t make sense, not with her sitting at 89.
PANCREAS. It will when you see the result.
DAD. And if not? This isn’t some lab rat were testing your half-baked theories on, this is my daughter.
PANCREAS. I know who it is, and my theories are not half-baked. They are based on millions of years of complex, fine tuning. Listen, just trust me, trust yourself. Together we’ll get her through this.
In the truck, on the drive over to Little Friend’s house. Lia is sitting with her diabetes kit open in her lap and waiting for the meter to give her the blood glucose reading. After it beeps, she reads it and looks at him.
DAD. What time did we eat lunch?
LIA. I don’t know. Twelve o’clock.
DAD. (They come to a stop sign. Dad waves a pickup through the intersection. Lia is occupied putting her kit away.) What’s that all about?
PANCREAS. What’s what all about?
PANCREAS. Could be anything. Leftover carbs from lunch, excitement at going to the party. Could be the little cold she’s been fighting, or she’s growing, or–
DAD. Or maybe the dose wasn’t enough.
PANCREAS. It wasn’t the bolus.
DAD. Then what is it?
PANCREAS. I don’t know.
DAD. You’re a lot of help, you know that.
PANCREAS. Be patient. You’ll see.
Dad is home working on the computer when the phone rings. He answers it.
LIA. Hi Dad, my number is 122.
DAD. 122, really?
LIA. Yeah, and I’m having two pieces of pizza and ice cream with Oreo cookies.
DAD. I can do the pizza, but is it ice cream and a cookie, or Oreo cookie ice cream?
LIA. (Talking to someone in the background.) How much is 21 grams of ice cream, Dad?
DAD. (Dad walks over to the freezer and pulls out a container of ice cream and reads the nutrition information.) 21 grams is half a cup. That’s about two scoops, honey.
LIA. Okay. (Dad holds the phone in the crook of his neck and walks over to the white board to work over the figures.)
PANCREAS. What’s that?
DAD. I didn’t say anything.
PANCREAS. Oh, I thought I heard you say something.
DAD. I didn’t say anything because I don’t want her at 122. I want her at the higher end of her range like 170 or 180 before she goes to bed.
PANCREAS. Is she going to bed now?
PANCREAS. Then back off.
DAD. All right, smart ass. What should I dose to get her to 180?
PANCREAS. How many carbs?
DAD. 58 grams.
PANCREAS. 1 unit.
DAD (Talking into the phone.) 1H, honey.
LIA. All right, Daddy. See you later.
PANCREAS. Just like that? No argument?
DAD. Do you want one? Cause you and I got plenty of other things still to talk about. (There is no response from the pancreas.)
Dad is standing outside Little Friend’s house. It’s 8:30 at night. He rings the bell and Little Friend’s mother answers and leads him inside. He finds Lia sitting on the sofa with Little Friend and a group of other young girls. A movie is just starting to play on the television.
LIA. Daddy! (Lia jumps up and runs over and hugs him. She has changed into pajamas. Dad picks her up and holds her in his arms.)
DAD. How’s the party?
LIA. Great. Can I have popcorn with the movie?
DAD. Of course. (Dad sets her on the floor and finds her diabetes bag leaning against the wall in the corner and picks it up and takes it over to where Lia has settled back on the couch.)
DAD. Do you want to do this here? (Lia nods and jumps up and takes charge of testing her blood.)
LIA. Everybody watch. (The other girls follow her movements as she pricks her big toe and squeezes the blood a little too hard. She takes what she needs for the test strip and then pulls the foot to her mouth and licks the big toe clean.)
LIA. (Shrugs.) What?
DAD. Nothing. Where do you want your Lantus? (Lia pulls up her sleeve. The meter beeps and they read it together. Dad stands then and fixes her bedtime dose and gives her the shot in the arm but winces as he pulls the needle out. A small dot of insulin appears on the surface of her skin. Lia winces too but she looks at her friends watching her and the look quickly disappears. Dad hugs her and whispers something in her ear. The scene then cuts to him back in the truck driving away.)
PANCREAS. What did you say to her back there? (Dad doesn’t say anything.) You don’t have to tell me, I was just wondering.
DAD. (Finally answers after a minute passes.) I told her she was the bravest little girl in this entire world.
Dad is sitting alone on the sofa with his feet propped up and a glass of red wine on the table beside him. The computer is on his lap and the television on. The phone rings and he answers it right away.
DAD. Hi Sweetheart!
LIA. Hi Daddy.
DAD. You getting ready for bed?
DAD. You sound tired.
LIA. I’m not. We’re going to go to bed but we’re going to talk some.
DAD. That sounds fun. What’s your number?
DAD. That’s great, honey.
LIA. Ok. Goodnight Daddy.
DAD. Goodnight sweetheart. I love you. Call me in the morning. (Dad hangs up the phone. He looks out into the room at nothing in particular with a contented look on his face.)
PANCREAS. You did it. 180, just like you wanted. (Dad sits quietly.) You should feel good about that.
DAD. I’ll feel good when this night is over and she’s back home.
Dad is sleeping in bed beneath the covers, breathing heavily. The room is dark. Something startles him and he wakes suddenly. He leans over and reaches for the phone.
PANCREAS. What is it?
DAD. Was that the phone?
PANCREAS. I don’t think so.
DAD. (He listens but no one is there, just a dial tone. He sets it back down.) I thought I heard it ring.
PANCREAS. I didn’t hear anything.
DAD. Just a minute. (He gets up out of the bed and turns on the light and looks at the display on the phone, then he sets it back in the cradle and goes down the stairs and turns on the light in his office and picks up that phone and reads the display there and then sets it back down too. He runs a hand along the back of his head and walks slowly back upstairs and lays back down in the bed.)
PANCREAS. Everything okay?
DAD. I thought I heard the phone.
PANCREAS. She’s fine. We did everything just right.
DAD. I know.
PANCREAS. What time is it?
PANCREAS. You told her to call when she gets up?
PANCREAS. Then go back to sleep.
DAD. (Closing his eyes, whispering to himself.) She’s fine. She’s fine. She’s fine. She’s fine.
Dad, looking tired and still dressed in his pajamas, is sitting at his desk looking at pictures posted online of his wife’s trip to France. Every now and then he glances at the telephone sitting on the desk, or at the clock in the corner of the monitor screen, or out the window. He is on his third cup of coffee when the telephone rings. He looks at the caller ID and smiles and brings the handset up to his ear.