All the Days of Her Life (14 page)

Lacey explained to Jeff that islet cells were responsible for insulin production within the pancreas.

Gary added, “In the diabetic, the islets stop doing their job. And without insulin the body can’t convert food into glucose. In essence, the diabetic can be eating like a horse and still starving to death.”

“So why can’t you put these islet cells back inside me?” Lacey asked.

“That’s what we’re trying to do. Scientists affiliated with the DRI have been working on this for over twenty years, but it’s a complex task. In the seventies we transplanted insulin-producing islet cells into diabetic rats. In the eighties we did the same thing with dogs. Both experiments worked. In 1985 we tried it on humans. One patient had a very acceptable response.”

“You mean you cured her diabetes? Then why aren’t you doing this for me?”

Gary shook his head. “Believe me, if it were that easy,
I’d
have been transplanted by now. Eventually, the graft of new islets failed in the patient. But doctors
think it was because we didn’t transplant enough into her. We gave her approximately eighty thousand cells. Now we realize a person needs closer to eight hundred thousand to a million islet cells in order to function normally.”

“That’s a lot of cells,” Jeff said.

“And that vast a number is part of our problem.”

“How do you mean?”

“Where do we get them?”

Lacey pondered the question. She remembered Katie and Chelsea and their donor organs. “From donors?” she asked Gary.

“True, but preserving a donor pancreas outside the body is difficult. So first our scientists had to solve that problem. Then they had to isolate the islet cells. Remember, the pancreas does more in the body than just produce insulin.

“They discovered a new enzyme to improve the isolation process. They designed a machine to help isolate and purify the yield of cells from a single pancreas. Then, of course, they have to deal with transplantation’s major nemesis—rejection.”

Lacey recalled the medications Katie took to impede rejection of her transplanted heart. “But has anybody really been cured for always?”

“There is an islet transplant recipient in Kentucky who’d had her pancreas removed for other medical reasons, and she’s been implanted. Actually the liver is a good host for new islet cells—and guess what? They’ve been working fine for three years.”

“Then why can’t you and I get these new islet
cells?” Lacey’s curiosity had turned into genuine, hope-filled interest.

“That’s our next step and the primary focus of new research.” Gary punched the elevator button to take them down to the ground floor. “We know that diabetes is caused by a combination of factors. A genetic predisposition, a virus, and a person’s own immune system.” Gary ticked the causes off on his fingers.

“So even if we transplant healthy islets into a patient, we don’t know if diabetes will occur again. And if we transplant a patient, he must take immunosuppressant drugs to avoid rejection. As a person who’s been taking these drugs for my kidney transplant, I can tell you, they aren’t without their long-term side effects. Brittle bones and excessive hair growth to name a couple.” He rubbed the top of his head which was partially bald. “Except on the head. Why can’t I grow hair up here?”

Lacey and Jeff laughed, which broke some of the intensity of the discussion. “I don’t care if I grow hair out of my feet,” Lacey declared. “It would be worth it to get rid of all the shots.”

“I’ve read stuff about cloning,” Jeff said as the elevator opened on the ground floor. “Why can’t you grow islet cells like in a lab or something? You know, on an islet farm.”

Lacey gave him a patronizing look and asked, “Like in Old MacDonald’s islet farm, eee-aye-eee-aye-oh?”

“That is precisely what we’re trying to do,” Gary said. “Actually, trying to come up with close to a
million cells for every diabetic in the world is impossible to do with donor organs. And if we can grow them, we can avoid the rejection problem because they won’t be genetically preprogrammed.”

Lacey interrupted. “Let me guess. It’s hard to grow them.”

“Bingo!” Gary said. “Someday we may be able to grow them in abundance in petri dishes, but we’re not even close to that technology today. So now we’re experimenting with using pigs as surrogate hosts.”

“Pigs?” Lacey and Jeff asked in unison.

“Believe it or not, the little oinkers are frighteningly close to humans in their genetic makeup.”

Lacey shot Jeff a sideways glance. “I’m not surprised.”

“Is that a rude comment about my gender?” he asked.

“Did I say anything?” She blinked innocently, then turned back to Gary. “So how will pigs help the cause?”

“We hope they can be used as hosts to grow the cells, which can be extracted and transplanted into diabetics. At least that’s the theory. More testing has to be done to see if it’s a practical solution.”

Lacey’s head swam with information. Every time something gave her hope, another piece of information came along to dash it. “So you’re still a long way off from curing
my
diabetes,” she said.

“A lot closer than we were,” Gary told her. “The institute’s main purpose is to put itself out of business.
How many other organizations can claim as much?”

“And how about artificial pancreases?” Jeff asked. “Can’t they make a machine for you to use?”

“Machines aren’t living tissue,” Gary said. “Who wants to be hooked to a machine? Or even have one implanted inside your body? Even if we could make it small enough, which we can’t, remember the pancreas is a multifunctional organ. And islet cells are very interesting little pieces of protoplasm. For instance, they come in all different shapes and sizes. Is this important? And they not only produce insulin, they also regulate the flow of insulin into the body.” He shook his head. “There’s simply a lot we don’t know yet.”

The three of them stood in the nearly completed lobby, their mood subdued. Finally Lacey said, “I don’t know if I should be excited or not. A cure seems impossible because there’s so much more to be learned.”

Gary squeezed her arm. “We’ll lick it eventually. I’m hopeful because the human body is ‘fearfully and wonderfully made.’ For every dilemma we come up against, there’s a solution. Time and money for research is what we need. You’re young, Lacey. You’ll reap the benefits of our research one of these days. In the meantime, take good care of yourself and stay in as tight a control of your blood sugar as possible to hold off the side effects.”

She thought of all the damage she’d allowed to happen to her body already by mismanaging her disease. In spite of his tour and explanations, she
felt depressed. “Maybe your hope will be contagious.”

He smiled, and she recognized understanding in his eyes. “Two years ago I married. And last year I had a son. Every day I look at him, I find hope for the next day. As long as I’m alive, I’ll hang on to that hope.”

She felt Jeff ease his arm around her waist and knew he was feeling sympathy for her. She eased out of his embrace because she didn’t want his sympathy. She wanted his love.

Lacey thanked Gary for his time, then asked Jeff to please drive her home. They left the concrete and glass monument to diabetes research and headed for the parking garage under the blazing Miami sun. Lacey knew someone like Todd would never have been caring enough to listen to Gary, and even ask questions. A person didn’t have to be sick to understand, but it still made Lacey uneasy to call herself sick.

L
ACEY HELD HER
head high as she walked down the hall at school, her gaze focused straight ahead. She avoided eye contact with everyone because she was certain that everybody in the school was discussing her. And her diabetes.

“It’s a big school,” Jeff had reminded her the night before as he’d said good night. “I don’t think you should be worried about being the main topic of conversation.”

She’d slept fitfully, nervous about returning and facing the kids in her circle who had never known about her disease.

“Wait up!” Terri called. Lacey stopped and waited until Terri came alongside her. “I need you to come with me to the auditorium after school,” Terri said, slightly out of breath.

“Why? I was going straight home after school.”

“You can’t spare me fifteen minutes?”

“I don’t want to hang around.”

“Just come with me.” Before Lacey could beg off, the bell rang and Terri dashed away. She called over her shoulder, “See you at three.”

At three Lacey went to the auditorium only because Terri had been a good friend to her during her ordeal. She pushed the heavy door open and saw that the vast room was empty. Onstage, the curtain had been pulled open and there was a single chair lit with a spotlight. Curious, Lacey hugged her books closer and walked down the sloping floor to the stage. She climbed the steps, crossed to the chair, and saw a sign taped to the seat. She read:
SIT HERE
.

Lacey glanced around for Terri. All at once, from backstage, a throng of kids surged forward, Terri leading the pack. In unison they yelled, “Surprise!”

Lacey stood immobile as the cast and crew of the play swarmed around her. “Did we surprise you?” Maria asked.

“Did you suspect anything?” Terri wanted to know.

Lacey shot Terri a glance that could kill. “I’m surprised, all right,” she said.

“Good.” Terri ignored her expression and grabbed her arm. “Come backstage. We have a party all set up.”

Farther back and to one side there was a table heaped with vegetable trays, diet sodas, and a magnificent fruit platter decorated with a sign reading:
WELCOME BACK, LACEY
. Ms. Kasch hugged Lacey warmly. “It’s wonderful to have you back in school. We’ve been concerned, but Terri has kept us well informed. I called the hospital switchboard all through spring break to check on you personally. You gave us quite a fright on opening night.”

Others came forward and hugged Lacey too. Two of the group told her about a friend and a parent who had diabetes. “If you’d ever had a reaction, I’d have known exactly what to do,” a girl named Gloria assured her.

Lacey felt overwhelmed by the attention and concern. She had expected shunning, not understanding. “I’m sorry I loused up opening night,” Lacey told them.

“The show went on,” Ms. Kasch said. “But we sure missed you.”

“We missed your makeup,” Gordon called out. “I did my own and I looked more like Freddy Krueger than the character I was playing.”

Laughter rippled through the group.

“Let’s eat,” someone suggested, and kids scattered toward the food table.

At first Lacey felt uncomfortable with everyone restricted to eating the foods best for her. But no one appeared to care as they piled paper plates high with raw vegetables, dips, crackers, and fruit. She also realized that even if the table had been overflowing with sweets and goodies, she could have taken a taste of whatever she wanted without feeling guilty. Tastes were okay. Pigging out wasn’t.

Lacey turned when the side stage door swung
open and sunlight spilled inside. “Are we late?” Todd asked as he sauntered in, his arm around Monet’s waist.

“Yes, you’re late,” Ms. Kasch said. Her look of disapproval caused Todd to release his hold on Monet.

Lacey felt herself tense, but she pointedly ignored Todd and walked over to Terri, who was busily rummaging for paper napkins in a grocery sack.

“Sorry about him,” Terri said as she pulled out the package of napkins. “But Ms. Kasch insisted all the kids come to your party. I didn’t actually invite him, but of course, word got around.”

“No problem,” Lacey said. “I’m completely over him.” She watched Todd make the rounds of the different groups, noticing how he constantly vied for the attention of the others and how his manners bordered on rudeness. She thought about Jeff and recalled the way he’d held her, letting her cry, talking to her, and making her feel special. She wondered how she could have ever been so stupid as to want to date a guy like Todd.

He came toward her. She lifted her head and gave him her frostiest stare. “I’m glad to see you,” he said. “I was going to visit you in the hospital, but I went skiing with my folks in Aspen. I was out of town while you were sick.”

“I had plenty to keep me busy,” she said.

“So you aren’t mad?”

“I’m not mad,” she said, meaning it. “Being mad implies I care. And I don’t care.” She watched the expression on his face shift as her words sank in.
But before he could say anything, she added, “Have a good life, Todd,” and turned away.

“Good putdown,” Terri told her.

“I meant every word,” Lacey said. She went with Terri to the food table and chose an assortment of vegetables and fruit.

She looked up to see Monet standing on the opposite side of the table. Their gazes clashed. Dark half circles rimmed Monet’s eyes, and her skin didn’t radiate a healthy glow. To any other observer, Monet was still quite pretty, but Lacey knew Monet’s secret. Suddenly, Lacey felt sorry for the girl.

Monet said, “I was sorry to hear you’re sick.”

“I’m not sick,” Lacey told her. “I have diabetes. And at least I’m on top of
my
problem.”