Tuesday, January 22, 2013

Antifragility is Unwelcome But Necessary

Two days, three instances of diabetes near-breakdowns. One had life-threatening potential; one was an unfortunate mishap; the last, simply sad.

No matter how much work we do, diabetes defeats us, at turns random and unpredictable. And sometimes, another force--call it God, or maybe parental instinct--rallies to save the day.

Yesterday, I went online for hot lunch carb counts. The numbers there are highly exact--12.2g for low-fat white milk, etc, and though I know there's a margin of error when it comes down to the lunch lady spooning out the one-third cup of peas, I trust in this higher math. Yesterday, though, a count felt wrong to me. 53.6 grams of carbs seemed high for breadsticks at the school, though not, say, at Olive Garden--the school's portions tend to be smaller. Yet I trusted in the math, calculated Theo's lunch shot, wrote it on a slip of paper for the secretaries and sent it, carefully folded, in his pocket.

Late morning, my gut told me to do some investigating. First, I scrolled through previous months' lunch counts to find the same menu option; no luck. Next I googled the name of the brand I thought the school used, with some success--two seven-inch breadsticks would add up to the right number. And yet: four-inch breadsticks existed.

A call to the school determined that indeed, that brand's smaller breadsticks were used. The note in his pocket, then, added up to approximately two more units of insulin than was required. Two units are smaller than a single teardrop, but they are everything. Theo's been quite low before, but this could have sent him unconscious.

Instinct, God, dumb luck: thank you. All of you.

Today, the principal gave Theo his lunch shot. How wonderful that the man has trained to help out in this way when the office is busy. Today, something told him to look at the insulin pen after the shot, at which time he noticed that a portion of the dose was still in the pen. But because we weren't sure what had happened, we had to wait two hours to learn that yes, he received too small a dose, and yes, his blood sugar was 413.

Earlier in the day, a random email I sent unearthed the detail that pizza would be served in Theo's classroom tomorrow. He is not a kid who would sneak food, and even if he was, his classmates would probably call him on it. But he would have been left out. Everyone eating pizza and Theo watching. Sad. Not dangerous, but sad.

In Antifragile, Nassim Nicholas Taleb writes that "we can almost always detect antifragility (and fragility) using a simple test of asymmetry: anything that has more upside than downside from random events (or certain shocks) is antifragile; the reverse is fragile."

Taleb is careful to distinguish antifragile from resilient, an adjective meaning "able to withstand difficult conditions"; antifragile not only endures but grows stronger and better as a result of difficulty.

Right now I am feeling at the mercy of the random, not strong and not antifragile. And yet we've come this far.

Sunday, January 20, 2013


Right at this minute, unless you just ate or awoke, your blood sugar is most likely right around 100. That's normal. So when Theo's blood sugar registers around there, say, at 104, it's a cause for celebration. The diabetic, is, for this moment, normal.

But just for a moment. Were you to prick his finger a few seconds later, the number might show at twenty points higher. Still good for a diabetic, but no longer nearing normal. There's no landing there, just skimming near and around, with numbers good, bad, and ugly.

A friend told me her husband's recent bone marrow test was good. He's been in remission for two years. "But you're only clear 'til the next test," she said.

There's no rest, then. How are we to celebrate the good when change, we know, is ahead? And when we know that we won't always know: the twinkies that were abundant on the shelves are now nowhere, without warning. People die. They leave us. We didn't know.

If there is no struggle, the reward is easy and cheap. The struggle for the perfect renders each bite all the sweeter, until every bite is gone.