Glucose Gladiator

“Nobody believed in me. That was their first mistake,” read the sticker slapped diagonally across the top of her computer. It was sandwiched between the neon comic-sticker “Only good vibes” and a wiener dog driving a pickle with the slogan “In a pickle.” They were the only things holding Kelsey together as she tapped the shift key repeatedly to meticulously align the table indented .5 inches beneath the first letter of the title on slide eight. After two rounds in front of St. Elmo's Hospital, PMR Consulting needed to close the deal, or they would be dead in the water.

That wasn’t the only reason Kelsey fretted over this trip. Fourteen years ago, Kelsey sat in the ICU of St. Elmo’s in a medically induced coma with the one thought, “I hope I walk out of here.”

The muffled voice of a desk agent gargled overhead. Kelsey tuned them out. Now a seasoned traveler, she knew like clockwork Chuck would be deboarding from Chicago any minute now.

Scrunched in a folding chair, she flipped through each slide. Her mouth mimed her opening phrases in the packed airport terminal. A stopwatch whizzed through numbers, timing the pace of her delivery. She only had twenty minutes to convince them. Her laptop balanced on her knees. The Celtics and Patriots championship banners flapped overhead. The years of success bore down on her with the expectation of excellence. A typo caught her eye in the fine print on slide ten.

“Ready?” Chuck threw his tie over his shoulder as he adjusted the strap of his bag. As senior consultant, he’d step in if Kelsey’s presentation won them over or she bombed. His blond hair cowlicked in the front, resembling a young Brendan Fraser. Passengers weaved between them.

“Yup. Just some final touches.” She slapped the computer closed. Only a thirty-minute drive stood between them and her pitch of a lifetime.

“Let’s do this, Terminator.” He shot her his winning, bleached-white smile. When it came to Kelsey, Chuck always resorted to robotic pep talks.

Kelsey lowered her voice in an attempt to impersonate Arnold. The words came out sounding slightly French, with a heavy emphasis on the ts, that sounded like zs, and ending in an e rather than a y. "Hasza la visza, babé."

He strode towards the signs marked "Ground Transportation." His voice lowered. “No pressure, but I heard Deloitte pitched something yesterday.”

Kelsey quickened her pace. Sarcasm dripped from her lips with a sag in her tone. “Thanks, Chuck, just what I needed.”

Conveyor belts, escalators, and elevators forced them up and down floors and across hallways like a game of Pac-Man. Her luggage clicked over the tile like a metronome. A black sedan pulled up in spot twelve. Kelsey switched out her flats for the two-inch Valentinos with the leopard-print heel. They offered her a subtle, fierce energy. Her suede skirt fought with her slip as she stepped into the car. The GPS predicted twenty-two minutes until drop-off. Kelsey pulled the bag with the slogan, “Pretty Shit,” from her suitcase and prepped.

Her favorite cheery pink lip oil from Elf glided across her lips. She dabbed a dot of concealer under each eye. War paint to cover the dark circles of sleepless nights. One fake eyelash fluttered to her lap. She fanned the remaining extensions to keep her voluminous look. She liked the dramatics of the thick black lashes against her olive skin. Her honey eyes popped with the dash of eyeliner under her neatly threaded brows.

Chuck tossed two Tic-Tacs in his mouth. “The numbers are solid, right? You know they’re going to ask about EBT margins.”

Kelsey tried to cross one leg over the other, but her hem cut into her thigh. “I’ve got it, Chuck.”

The GPS displayed Twelve minutes until drop-off on the car's dashboard. She pulled her black hair into a clip. Hair spray moistened the air as she sprayed a few puffs around her head. Her fingers glided over her hairline to ensure every flyaway was plastered to her scalp.

The car pulled into the front entrance. An ambulance blared past them. Kelsey checked her phone. Her thumb hovered over the small square app with a green slanted teardrop. She silently prayed for 165. It clicked open to show a perfect 100 with a flat arrow pointing right. She unzipped her purse, one Juicebox, a bag of gummy bears, and a pulverized granola bar crammed in with her wallet and keys.

Patients filed through the revolving doors. Kelsey and Chuck hustled past toward the administrative suites. Checkered tile transformed to plush blue carpet before they reached the large double oak doors.

He gave her a wink, “We got this R2D2.” A nickname she coined as an intern when her pump alarm went off during her final round of interviews.

She chuckled and then, as if on cue, her phone chimed.

Chuck shot his elbow out towards her purse. “You okay?” His brow raised in concern.

“You know I’ve got this.” She twirled the small tube protruding from her pocket. It snaked under her blouse. Before the doors could open, she felt it coming. The battle she never signed up for, every so often, forced her into the ring like a gladiator. Her bag chimed again. Kelsey smiled. “Let’s do this.” Confidently, she pushed past Chuck. Her hand shook slightly.

Four bald white men sat in a semicircle near the front by the podium. Seated in a row, they resembled the audition room of the Blue Man Group, sans the dye. Kelsey slid her computer out of its pouch. Her eyes skimmed the sticker: “Nobody believed in me. That was their first mistake.” She rubbed Winny the wiener dog in his pickle for good luck. Stealthily, she snuck five gummy bears into the palm of her hands. Like a pack of pills, she shoved them in her mouth, barely chewing them as they slid down her throat.

“Can we start in five?” Asked one of the bald spectators three seats in.

Kelsey gave them a thumbs up. The lights dimmed slightly. She felt a thin trail of sweat trickle down her spine. The green app on her phone now blared at her, with a red bar showing the number “56” and a trending-down arrow.

The hole in the juice box deflected the straw's jab, bending the plastic joust at an awkward angle. Kelsey stabbed it twice until liquid squirted out the top. She sucked it down with vigor.

In her mind, she rehearsed slide one. “Let your data guide you rather than gate you.” A second alarm growled, forcing her bag to vibrate.

Kelsey tore the side of the granola bar open. Crumbs dribbled down her chin and into the folds of her blouse.

The eldest of the bald vulturous group raised a finger. “We’re good to start.”

Chuck plugged in the computer. He gave Kelsey a weary look. She mouthed back, “I got this.”

Her trembling hand brushed the crumbs off her chest. She breathed. A thin dark line bled through her silk white blouse. She casually pulled a blazer from her suitcase. The black polyester clashed with the soft suede but would cover the marks.

The slides she’d spent the last five weeks scrutinizing flashed across the massive screen behind them. PMR Consulting’s logo drifted across the screen, stopping in the far-right bottom corner. Kelsey balanced her phone behind the podium. She flashed on the glucose trend screen. Her latest reading was 65, and both arrows pointed slightly up. She counted silently to ten. Her hands flipped through the small note cards.

Chuck whispered in her ear. “Ready?”

The presentation jumped to the next slide. The four men sat back.

Kelsey stepped out behind the podium. “St. Elmo's is the third-largest hospital in New England, and yet profit margins from the last three years continue to drop by 3 percent; let’s change that.” She shot a finger at a trend graph on cue.

The fluorescent light above projected a soft golden circle on the floor in front of Kelsey. She stepped into the ring. Bar charts fluctuated behind her as she spoke. “Let us reshape emergency room trends with real-time data.” She flashed a pie chart with a monochromatic color scheme. “Our machine learning models can predict what will drive the longest admissions.”

Her eyes flitted to the phone screen. Her pancreas-killing opponent changed tactics, forcing a spike. One hundred and forty-eight blinked on the screen with two arrows pointing straight up. Her audience hurled a question at her mid-sentence. “This isn’t unique to us; how is your plan different from the others?”

Kelsey reached into her pocket for her weapon. Like defusing a bomb, her thumbs dialed in the insulin units as she spoke. Her words flowed like the steady stream of translucent liquid into the small subcutaneous site taped to her stomach.

Another spontaneous attack. “I question your approach given the current capitation rates.”

Chuck stepped in to answer. Kelsey raised her voice. “Let me jump to a further slide to help visualize our approach.”

Her stomach churned. A dryness crept up the back of her throat, dusting her words.

Her glycemic villain fought back. A new chime hummed from her phone. The number read 220. Kelsey turned it face down. The hands of a numberless clock shadowed three fifteen. By three thirty she’d know if she defeated the high.

A voice piped up in front of her. “Can you give us an idea of the impact on EBT?”

Kelsey stepped into the ring further. The light glinted off her patent leather pointed-toe shoes. “In fact, I can.” The screen flipped to a new slide. The one with the table at a .5 margin indent right under the title. “Let me walk you through these numbers.” Her quick mental math felt like pulling a rabbit out of a hat in front of children. Years of carb counting trained her for this moment.

Hands clapped. Chuck squeezed Kelsey’s shoulder. She unplugged the computer. Track lights flipped on. Several new faces filtered into the room for the next meeting. Chuck shook hands. Kelsey flipped her phone over. The screen read 135. She breathed.

She closed her computer. Three stickers cheered her on. Fatigue clashed with the adrenaline flooding her veins. One of the suited C-suite attendees gave her a wide grin. “Excellent presentation.”

The room buzzed with discussions of next steps. Kelsey reveled in her win. She pulled out the small black sack from her suitcase. Lancets tumbled into her hands. The glucometer hummed on with a gaping frown. She slipped a new test strip into the machine's mouth.

Click

A crimson bubble sat on the tip of her ring finger. The strip absorbed it. 135. Victory.

It was fourteen years since Kelsey sat in St. Elmo’s inpatient unit attached to an IV with a chart that read Type 1 Diabetic. It felt good walking out of that revolving door again.

***I wrote this story for my chronically ill companinions who manage a daily disease while still hitting major milestones in life.