From CNN Jerusalem correspondent Oren Liebermann comes a new type of diabetes book – part travelogue, part chronic disease memoir – that traces his story of low-budget trekking around the world, with a life-changing diagnosis of type 1 diabetes along the way.
Rich and humorous, “The Insulin Express” (just published May 2) resonated with me in a way no other diabetes book has since Jim Hirsch’s 2006 Cheating Destiny -- another smart, witty narrative about a journalist’s “journey of discovery” of life with diabetes.
But Oren’s book is really about what he wanted to do with his life – travel the world – and how diabetes crash-bombed that. (Not to worry, our hero prevails!)
After Oren and his new wife Cassie scour world maps, cobble together a budget, quit their jobs and confront his reluctant family, they’re off and running for a planned full year of travel through Europe, Israel, Southeast Asia, South America and eventually Iceland.
Right from the very first plane boarding, his wry sense of humor pulls you in:
“I had imagined what it would be like to see American soil for the last time as our flight from Philly International arches out over New Jersey and then the Atlantic. I would see the light of the cities—first the City of Brotherly Love, then the Big Apple. I would see the crooked line of the Jersey Shore, inching its way north-northeast...
“That, as it turns out, was a pipe dream. Bereft of both the pipe and the necessary herbal ingredients to place within its hollowed out interior, I have only my view from the middle seat. The window shade to my left, with four people and an aisle between us, has already been closed by an elderly woman who seems to be in complete denial of the fact that she is on an airplane that is about to leave the relatively safe confines of Philadelphia, never mind the fact that you’re almost always safer not being in Philadelphia. The window shade to my right is open, but all I can see past my rotund companion is a section of wing.”
Dr. Gupta and ADA Endorsements
The book's Foreword is provided by famous neurosurgeon and CNN Chief Medical Correspondent Dr. Sanjay Gupta, who wisely mentions that physicians "rarely get a full appreciation of the incredible story and background that brought the patient to us in the first place."
He describes the book as "an anatomy of an illness that leaves (Oren) with the option of possibly dying in a dusty remote Nepalese clinic or coming out the other side stronger and more inspired than before." And he observes: "We will all have challenges in our lives, even the most blessed among us. It is not the challenge upon which we will reflect in our later years, however, but how we behaved in the face of those obstacles. And, for that, Oren has valuable lessons to share with all his readers."
You will also note the American Diabetes Association (ADA) logo on the book's cover. Apparently the author approached the ADA to see if they would be interested in publishing The Insulin Express. They weren't, but someone at the organization put him in touch an agent who helped connect him with Skyhorse Publishing.
Still, ADA remained interested in the supporting the book, so they signed on as "co-sponsors" and added an 8-page information section at the end that covers basics of type 1, carb counting, travel tips, etc.
Half of the proceeds from The Insulin Express will go to the ADA.
When I asked Oren about JDRF involvement, he said he had approached them early on, but never got a response.
Seeing the World
Chapters 1-10 escort the reader through Poland, Kenya, Israel, Thailand and Nepal, with colorful descriptions of the most memorable sites and experiences. Throughout the book, we hear about everything from stargazing in Argentina to celebrating the Songkan festival in Laos (“like a city-wide water fight with alcohol”) to taking a contraband “backstage” tour of the Great Wall of China.
My feeling was that this book could also double as a low-budget food guide, as Oren has a penchant for detailing their cuisine choices in every destination. (Hat tip: Mexican food is not recommended outside of its country of origin or ours.)
Getting to the Diabetes
I have to admit, by this point I was getting a little antsy about the diabetes – which does not make an appearance until Chapter 11 (the irony!)
Along the way, Oren keeps teasing the reader with hints of what’s coming, especially during his and Cassie’s monster hike in the Himalayas. You’re just sure he’s going to keel over and go into DKA at the highest mountain peak, but no… he marches on…
And when the diagnosis finally happens, on Valentine’s Day when he and Cassie are teaching English at a Buddhist monastery, he suddenly recognizes the Denial Factor. Of course he knew something was wrong, but just didn’t want to see the warning signs. So it comes as a shock that rocks him to his core, yet even still embraced with humor:
“I firmly believe that doctors should keep a small but well-trained staff of short people around to kick patients in the nuts before major diagnoses to soften the second blow by focusing on the first.”
By this point he’s lost 45 lbs and is barely able to function. He lands in a local clinic that turns out to be frighteningly incompetent, and is forced to fly to Kathmandu a week later to get decent treatment. Whew! A couple of personal notes:
- As someone also diagnosed with LADA (latent autoimmune diabetes in adults) in my 30s, I can so relate to that feeling that you were “whole” and had a life you enjoyed, and suddenly that’s all being stripped away…
- And yet, for anyone who’s been insulin-dependent for a decade or longer, it’s sometimes hard to endure the naiveté of the newly dx’ed. Yes, it’s T1D. Yes, it can be dangerous. Yes, you are going to be OK.
- I want a Cassie! If Oren’s descriptions of his wife are unexaggerated, she represents the absolute model “Type 3” supporter made in heaven! Other than D-parents, I’ve never heard of a loved one being so integrally involved in every carb count and calculation of a PWD. She’s a keeper, my Friend!
The second bullet point above not withstanding, I truly appreciate Oren’s descriptions of his feelings of devastation and how he sobbed uncontrollably at some points – not always easy for men to admit.
I believe this sends an important message about the psychosocial impact of diagnosis with a chronic illness – one of the HUGE challenges no one ever talked about until recent years. I hope anyone in the medical profession reading this book doesn’t brush Oren off as a softie, but rather sees someone hitting a perfectly normal and incredibly common mental wall, and just being brutally honest about it.
“While the body recovers, so, too, must the soul,” he writes.
Did I mention the author talks a lot about his loud, meddling Jewish family that he clearly loves dearly? This is some of the most entertaining stuff in the book, IMHO.
My personal fave is the part when he first calls home (pre-diagnosis) to say he isn’t feeling well, and he and his parents get into a shouting match (yes, actually SHOUTING) about who is more remiss in taking care of themselves. They are convinced that’s he’s gravely ill, and he’s angry that they’ve become inactive and overweight.
Later, he’s the one who has to eat crow, sending an email about his T1D diagnosis:
Subject: I have never been more wrong
I apologize to all of you for the massive attitude I gave you. I will apologize in person when I see you again. But we’re Liebermanns—arguments are what we do.
So bittersweetly funny! (Waving to my own Jewish mom ;) )
The good thing about journalists writing books about diabetes is that they do it so well.
There are some snippets here describing key disease constructs that are well worth copying off or emailing to interested friends and family. In particular, look for:
- “A bit of history about the Big D” in Chapter 13
- “The millimolar” in Chapter 18
- His description of the A1C in Chapter 24
Eff You, Diabetes
Oren describes world travel and hiking as the loves of his life (besides Cassie of course). And like many before him, he has an iron resolve not to let diabetes get in the way.
And that he surely does not. It was impressive to hear that when they broke off their trip to fly to the U.S. after diagnosis, they actually only stayed home for a month. Yep, 31 days respite, a little diabetes education, a whole load of supplies, and they’re back on the move again!
So by Chapter 13 we’re back to a travel log, taking us through Laos, Cambodia, Viet Nam, Hong Kong and later Iceland.
As Oren tells it, deciding whether it was OK to travel with newly diagnosed diabetes wasn’t the hard part. The hard part was convincing his family, which went something like this:
“You can’t leave yet. You’re not ready! Traveling with diabetes is different, and you don’t know how to do it!”
“Of course it’s different! It will always be different! I will never learn how to travel with diabetes while staying at home not traveling with diabetes.”
He’s just not stopping and that’s that.
At one point he quips: “To my pancreas: I’ll see you in hell. Quitter.”
“Coming to Terms with My Disease”
Oren admits that pre-diagnosis, he ate way too much candy and drank a whole lot of chocolate milk. Changing those habits is never fun. He also realizes that returning from travel means pressure to find a job with excellent health benefits (that works out unexpectedly well when he lands at CNN).
And in the epilogue, he shares that he and Cassie welcomed a beautiful healthy daughter, Noa Lillian, on June 2, 2016. He worries that she will have an increased risk of developing diabetes, and blames himself for that. Not your fault Oren, none of us asked for this!
They say the day you become a parent is your last worry-free day, but that counts for diabetes x2, does it not?
I appreciate how Oren writes about the nonstop nature of T1D and how he’s “slowly learning each day.”
“Yet none of that—none of the injections and blood sugar checks—keeps me from enjoying every moment of every day. It will take a bit more time, but I am coming to terms with my disease,” he writes.
That’s a journey we all can relate to. Thanks to Oren for sharing his witty and insightful POV in this compelling new book.
The Insulin Express is currently available on Amazon in hard cover for $15.84 and on Kindle for just over $14.
But before you buy, want to win a free copy from us?
A DMBooks Giveaway
1. Post your comment below, including the codeword "DMBooks" to let us know you'd like to enter. Or you can email us at firstname.lastname@example.org with the subject header, "Insulin Express."
2. You have until next Friday, May 12, 2017, at 5 p.m. PST to enter.
3. Winners will be chosen using Random.org.
4. Winners will be announced on Facebook and Twitter, so make sure you're following us! And please be sure to keep tabs on your email and/or Facebook inbox, as that's how we contact our winners. (If winners don't respond within a week, we select alternates.)
We'll update this post to let you all know who the lucky winners are.
Good luck, D-Travel Fans!
This contest is now closed. Congrats to our three winners, chosen by Random.org -- Carole East, Kelly Wright and Lisa Felsky!