Managing Diabetes. Jeffrey A. Bennett
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the work appears to be directed at a universal audience, encouraging patrons to deepen their understandings of the disease, even if it is done through identification with the fictitious Diana Betes and her quandaries. “Good Morning” is not as easily processed as “Routine,” as it calls upon viewers to evaluate myriad factors: time, space, consumption, caution, and calculation. Time is a noteworthy theme across Jacobs’s work, illustrating repeatedly that people with diabetes are persistently focused on the time of day, the times they need insulin, and the time they have left in this world. Diabetes is, after all, a chronic disease, structured around the gradations of the calendar and the gradualism of the clock. In this way, Jacobs’s work is astoundingly rhetorical—being concerned with the contingencies of situations as much as they are the universal qualities usually privileged in art.
Figure 1.4. Jen Jacobs, “Every Time I Eat.” Used by permission of Jen Jacobs (diabetesart.com).
Figure 1.5. Jen Jacobs, “Can You Eat That?” Used by permission of Jen Jacobs (diabetesart.com).
Being public is a captivating idea in Jacobs’s work, giving primacy to the ways diabetes is made relationally intelligible, not simply in the confines of one’s home or in the space of the clinic. Both “Can You Eat That?” and “Downtown” highlight the extremes of insulin use, one preoccupying itself with the prospects of hyperglycemia and the other with hypoglycemia. “Can You Eat That?” focuses on a singular object: a large sundae that shimmers on the canvas. Jacobs has noted that her work is sometimes satirical in its impulse. She incorporates humor to deal with the pressures of diabetes, as so many living with the disease do. This painting fits the bill, as any person with diabetes recognizes the absurd exchange this situation immediately invites. The ice cream has multiple layers—hot fudge, caramel, whipped topping, and the proverbial cherry on top. The glass holding the dessert is transparent, but crystalized, representing the very warning that is denoted in the painting’s name. The visual material might otherwise be mundane until one realizes that the title is a query directed at a person with diabetes. This is not mere decadence, but also a moment of judgment that is interpretively polysemous. The painting could be depicting an instance of disciplining the diabetic body. It could betoken resistance to other, wiser food choices. It could reveal anxieties shared among both actors in the interaction—the person posing the question who has no knowledge of what happens next if the person with diabetes elects to eat the ice cream and the burden of being surveyed for the interlocutor with diabetes. The work depicts a moral question as much as it does a medical one, an account that reflects the fleeting but ominous structures that organize the life of someone who is insulin-dependent.
Figure 1.6. Jen Jacobs, “Downtown.” Used by permission of Jen Jacobs (diabetesart.com), and the owner, Claude Piche.
“Downtown” is, to my mind, Jacobs’s most compelling painting if only because its abstraction reflects the difficulty of capturing the experience of hypoglycemia. Jacobs’s work concocts a memory of her blood sugar descending rapidly at a farmer’s market. Like Socrates and Anzaldúa, Jacobs is walking, performing the most ordinary of tasks in an otherwise unremarkable setting, when the hypoglycemia strikes. The feeling of dangerously low blood sugar is experienced differently among people and can have varying effects on the body. For some, hypoglycemia is disorienting. Others may become obstinate. Still others may become tired, weak, giddy, or despondent. Jacobs’s painting captures the disorientation created by hypoglycemia, noting the distortions, panic, and anxiety that can materialize if one is in public and others are unaware of the condition. Are you alone? Do you have food or drink that can amplify your blood sugar? How quickly are your levels dropping? The numbers on the board at the bottom left of the painting indicate a quick fall from mild hypoglycemia (the number 72 is low, but still relatively safe) to the number 31, which signifies a dangerous state that can render a person unconscious. The numerals visually slide off of the sign, literally hitting the floor, indicating what is to come if action is not taken immediately. We might expect that Jacobs is one of the figures in the painting (presumably the person next to the numbers) or the entire occurrence might be understood from her perspective. The scene and agent blur into one configuration, where the danger of low blood sugar is both internally and externally present. The shadows on the abstractions stretch in different directions, the buildings are distorted, and the lines discernably not straight. While there is food and drink all around her, confusion persists.
Jacobs’s art grants an opportunity to explore diabetes in ways not typically seen in academic literature.68 Each of these paintings is a snapshot of her life with diabetes that resides outside the realm of the clinic, shining a spotlight on the complications and contradictions of management, the boldness of proclamations about routine, and the nuances that must be addressed to truly apprehend and sympathize with her particular needs and problems. One composition relays the looming desire for sugary food and the self-monitoring it instigates. Another ponders the isolation of disease in the most public of settings. The artist’s visual narratives are themselves an important part of life with diabetes for, as Mol tells us, in “the logic of care exchanging stories is a moral activity in and of itself.”69 Jacobs calls attention to balance, temptation, desire, and discipline. The song of the cicadas could be the soundtrack to her gallery.
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The remainder of this book explores a variety of case studies to provide an overview of diabetes’s public personifications. The archive of this volume purposefully works outside strict biomedical renderings of diabetes that limit the scope of how the condition is made intelligible, surveying artifacts as diverse as everyday speech and public health controversies, to ascertain diabetes’s amorphous persona. The objects of study in the following chapters are part of a public archive, one composed of media representations, political posturing, and seemingly banal communicative exchanges. The content for each chapter is often mined from news reports but is also composed of congressional testimony, law reviews, and interviews with public health officials. This is not to say that medicine is absent in my archive. Any mention of diabetes carries the rhetorical remainder of that history and I often engage medical reports directly. Following the work of scholars like Berlant, I find that such a prosaic archive exhibits an ordinariness that “requires an intensified critical engagement with what had been undramatically explicit.”70 This archive is itself a form of rhetorical stitching, and I am conscious of the ways my own perspective shapes and narrows management’s conceptualization. Like all forms of knowledge creation, my own academic expertise helps to structure the materials being explored here: Two of the chapters are deeply dependent on queer theory and LGBT studies, one on feminist investigations of intersectionality, and all are informed by disability studies in some form.
The chapters are loosely organized around two dialogical pairs that accentuate how diabetes is publicly represented. The first binary situates diabetes as easily managed on the one hand and lethal on the other. The second dyad focuses on the necessity of the individual to overcome the disease, which often stands apart from discourses that call for heightened systemic intervention. These four tropes: effortlessness, fatalism, individual transcendence, and institutional regard, all act as major organizing devices for the next four chapters. I contend in the book’s conclusion that these four heuristics blur in discussions of diabetes technologies, elucidating political and cultural obstacles that necessitate contemplation in the decades ahead. As is often the case with academic segmentation, the individual concepts in each chapter bleed into one another as much as they stand apart. The case studies are isolated for the purposes of analytical clarity, aspiring to detail an assortment of themes and figures that constitute diabetes management and the cultural contexts people navigate to make sense of their lives.
As a critic indebted to rhetorical and cultural studies, I have selected the case studies that follow because each elucidates unique qualities about the constitution of diabetes management. Humanities scholars have long utilized particular situations in order to theorize larger cultural trends and social impulses, recognizing that all knowledge creation is inherently contextual and contingent.