A Pilgrimage to Peace With Diabetes

| Jul 6, 2007

Each year, one hundred thousand peregrinos, or pilgrims, set out for Santiago De Compostela in northwestern Spain to visit the bones of St. James buried beneath the cathedral. Called El Camino de Santiago, it's one of the world's largest Christian pilgrimages.

Twenty years old and flat broke, I had an itch to see the world from the seat of my bicycle. When I learned that the pilgrimage could be done on a bike, I was hooked.

If I had seriously considered the enormous challenges of the trip, I probably would have cancelled my plane reservation. Instead, I bought a travel insurance policy and dove into a mad rush of filling prescriptions, ordering and purchasing supplies, tuning my bike, reassuring my parents, and convincing a friend to come along.

At the time, I was on multiple daily injections of Humalog and Lantus, and there was not enough room in my bicycle packs for all the syringes I would need. My doctor advised me to take two insulin pens instead of syringes because the needles and vials for a pen are much smaller.

To keep the insulin cool I bought a product called Frio, a crystal-filled pouch that comes in several sizes. When submerged for five minutes in cold water, its crystals turn to gel and keep the pouch at an insulin-friendly temperature.

I packed twice as many supplies as I expected to need, as well as two blood sugar meters, a glucagon kit, and extra prescriptions for my medicines. I obtained a doctor's letter for customs, airport security, and anyone else who might be alarmed by all those needles. In no time at all, my friend and I had boarded our plane and were on our way to Spain.

Diabetes makes adjusting to new time zones especially difficult, so we spent three days in Barcelona recovering from jet lag before driving to Pamplona. There we ambled down cobblestone streets to the church where we applied for our credencial del peregrino, a document proving our status as pilgrims. Smiling at my garbled Spanish, the priest questioned us about our intentions, then handed us our pilgrim's passports and wished us well. We were off.

For just one or two euro a night, we stayed in churches, abandoned schools, and converted homes, all official albergues and refugios provided for the pilgrims by the Catholic Church. I slept on the floor or on a thin pad, face to face or face to foot with other exhausted and malodorous wanderers. Each morning we rose at dawn, ate a breakfast of bread and café con leche, and bought food and water for the day's ride.

My insulin needs dropped dramatically, and I had to eat and check my blood sugar constantly while riding. No matter how isolated the countryside, there was always at least one gas station along the way where I could restock my portable pantry and bottles of water and juice.

Through trial and error, I eventually determined the correct dose of Lantus and found that I had to give myself boluses of Humalog only for large meals eaten while resting. Heaps of pasta, paella, and tapas at the end of the day gave me energy for the fifty- to-ninety-mile-ride I faced each morning.

Out on the open road I sank into a steady rhythm, talking myself through brutal moments of fatigue. It's one thing to climb a fifteen percent grade with nothing on your bike, but it's another thing entirely to do it with forty pounds of gear. My leg muscles morphed into iron fists. When I was not dazzled by the scenery or coaching myself to push harder, I thought about the past and tried to figure out what had motivated me to take this pilgrimage.

I was diagnosed with type 1 diabetes when I was twelve years old. It was my introduction to the randomness and unfairness of life. One day I was an avid soccer player and one of the fastest runners in my school, and the next I was on a strict meal plan and couldn't eat sweets. Everything that went into my mouth had to be measured and its carbohydrates calculated. Suddenly my world shrank, my freedom disappeared, and an early fog of adulthood crept in.

When people asked about my condition, I chose my words very carefully. I was not diabetic; instead, I had diabetes. The distinction was important because I did not want to be identified by the one part of myself that was sick. I distanced myself from the illness as much as I could.

Begrudgingly, I went through the motions of checking my sugar levels and giving myself injections, but my heart wasn't in it. The only way that I could deal with such an overwhelming challenge was to pretend that it didn't exist. If I let myself think about the risk of complications, I cried and felt sorry for myself. My own body had betrayed me, and I could not forgive it. Why should I take care of it? After all, what had my body ever done for me?

One of the most challenging passages of El Camino is between Ponferrada and O'Cebreiro, a medieval stone village on top of a mountain. During that ascent, the reality of my refusal to face diabetes finally hit home. The hill ceased to be merely a hill and became a metaphor for the challenge of living with an imperfect and treacherous body. My legs throbbed, but I would not quit. To get off my bike would be to admit that I was fundamentally weak. The important thing was to not give up.

While climbing that endless hill, I realized that after my diagnosis of diabetes, I quit. I gave up on my adventurous dreams and fantasies. I gave up on the idea of being healthy and living a long life, and I gave up on ever having good control of my disease. Tears flew from my eyes and down my cheeks and I began to talk aloud, encouraging myself to continue, assuring myself that I could do it.

I demanded that I prove my strength. Finally, in utter exhaustion, I fell off my bike and lay by the side of the road. I had not reached the summit, but I had given it every atom of muscle and willpower that I possessed. I was unashamedly proud as I sat by the side of that road smiling to myself. If my legs had not been jelly, I would have danced a victory jig. Instead, I dragged myself back onto my bike and tackled the remaining few miles.

When my friend and I at last arrived in Santiago with thousands of other pilgrims, I rested my bike in the shadow of the great cathedral and let the tears fill my eyes again. My pilgrimage had re-ignited a part of myself that my diagnosis had extinguished. It had been a journey to recover my lost faith in myself, a pilgrimage to my own strength and resilience. My wholehearted, whole-body, whole-mind effort had restored the health of my spirit.

By the end of El Camino de Santiago, I'd shown myself that I could still rely on my body. I was stronger and healthier than most people without a chronic illness. I'd climbed mountains and fallen from my bike in exhaustion rather than give up. The pilgrimage was indeed un camino, a path or way, that led to a new understanding of my diabetes and myself. There will always be challenges to this disease, but I learned along El Camino that I am stronger than I think and I can trust myself. Buen Camino, as the pilgrims say. Good Journey.

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