In the middle of my interview with Evan Schwartz, the Bethesda 12-year-old started asking me questions. What had I eaten for lunch that day, he asked.
“A turkey sandwich,” I answered.
Evan did a quick calculation in his head. “You probably had around 40,” he said.
Carbohydrate grams, he meant. Evan’s health depends on knowing such things. He has Type 1 diabetes, and to keep his blood sugar within a safe range, the sixth-grader is constantly calculating what he’s eaten, how much he’s exercised, how much insulin the pump he wears is giving him, whether he needs a little extra insulin. . . .
That Evan can do such things — and is responsible for so much of his own care — is a testament to Children’s National, the pediatric hospital he’s been going to since he was 5, when his diabetes was diagnosed. Doctors and nurses at the Washington Nationals Diabetes Care Complex there train patients and their families on how to deal with the treatable but potentially life-threatening condition.
“Our philosophy was to empower Evan with the knowledge to understand how to take care of himself,” his mother, Mimi, said. “When he was 51 / 2 and barely drawing smiley faces, he was giving himself shots in his stomach on his own.”
A little blue zippered bag is never very far from Evan. “Inside is the pricker and some other things,” Evan explained. “There are things called test strips that I put my blood on. And stuff for my pump.”
Evan is so quick at testing his blood — rotating which finger he pricks — that I have to ask him to do it twice. He’s as adept as a magician pulling a card out of thin air, and I missed it the first time.
If he finds it painful, he doesn’t gripe about it.
“We would never acknowledge it,” said Mimi of the shots Evan’s been giving himself for years. She and husband Bob never announced, Okay, Evan, baby, this is going to hurt.
Said Mimi: “We thought the best thing was for him to get used to it. We would just be like, ‘Evan, do your shot.’ The good that’s finally come out of it is you can see he’s impervious to pain.” (But, she said, let him turn his ankle on the sports field and Evan writhes around dramatically like a European soccer player after a questionable tackle. “It’s a very interesting study of the psychology of acknowledging pain or not,” Mimi noted.)
“I was a little worried that my life would be ruined,” Evan said of his diabetes. “But now it’s fine.”
He plays football, lacrosse and basketball at the Landon School, physical activities that are a challenge when it comes to monitoring his blood sugar and insulin.
“He knows what he’s doing. We know what we’re doing,” Mimi said. “And a lot of good mojo in the world is looking out for us. . . . He’s exceptionally well acclimated to his condition. It’s like brushing your teeth or brushing your hair. It’s a habit.”
“I actually probably do my pricks more than I brush my hair,” said the shaggy-haired Evan.
“That is true,” said his mom.
Fran Cogen directs the childhood and adolescent program of the Washington Nationals Diabetes Care Complex at Children’s. It’s the job of Fran and her colleagues to monitor their patients while stressing that their health is in their own hands. They work with the entire family, showing everybody what they need to do. With the right supportive atmosphere, even young kids can grasp the intricacies of living with diabetes.
Maybe even especially young kids.
“Teenagerdom is the bane of my existence,” laughed Fran when I reached her on the phone. “What happens is when they start going through adolescence they have the same struggles that all other children do: separation from family, peer relationships, boyfriends girlfriends, some rebellion. We often see some struggles with diabetes during the period of adolescence.”
Teens being teens, it’s hard for them to imagine life at 30 or 40, when years of non-adherence to their care can have profoundly dangerous effects.
For kids with diabetes, Fran said, “this is the new normal. Giving shots, counting carbs, testing blood sugar: You just have to do it.”
Since 1947, this column — first written by Bill Gold, then Bob Levey — has supported Children’s. When readers donate, the money goes to the hospital’s uncompensated care fund, which is used to pay the medical bills of underinsured families. The idea is that no children will be turned away because they are poor.
To make your tax-deductible donation, visit childrensnational.org/washingtonpost or send a check (payable to “Children’s National”) to Washington Post Giving Campaign, c/o Children’s Hospital Foundation, 801 Roeder Rd., Suite 650, Silver Spring, Md. 20910. Our deadline is Jan. 10.
Your gift today can make a difference in the life of a child.
For previous columns, visit washingtonpost.com/johnkelly.