Insulin Stories: How a New York Peep Show Saved a Young Writer

by james s. hirsch

Everyone with type 1 diabetes has an insulin story. What happens when your insulin pen is accidentally flushed down an Amtrak toilet? How do you administer an injection while traveling 65 m.p.h. on the back seat of a Harley-Davidson motorcycle? How, exactly, do you wear your insulin pump while at your favorite nudist beach?

I collect insulin stories like others collect rocks or stamps, and I’ve spoken to people who’ve had to surmount all of these challenges; regarding the nudist beach – the insulin pump hangs from a belt, which, if nothing else, makes for an interesting conversation piece.

I admire the creativity and improvisation of all patients who, at some point, find themselves on an awkward “insulin precipice” but find their way to safety. Perhaps I’m fascinated by these accounts because one of the most bizarre stories is, well, mine.

My first job out of graduate school was in New York. I had only been to Manhattan once, briefly, and had spent most of my life in the Midwest. So the day before I began my job (as a copy boy at The New York Times), I figured I would walk Manhattan. Like a foreign explorer in some exotic land, I would start at 125th Street and walk south on Broadway until I reached the southern tip of the island. It was a warm June day and I was 23 years old. What did I know?

In 1986, my diabetic regimen consisted of two injections a day, mixing NPH and Regular insulin. That was considered progressive care back then. I carried my syringes, vials of insulin, and alcohol swabs in a white plastic case, which I kept in my pocket. I had a glucose meter, but it was too bulky to carry.

I don’t recall when I started my journey through Manhattan, but when it was time to eat dinner, I found myself in Times Square. This was not the gentrified Times Square of today, overrun by Disney. Twenty years ago, it was the center of the adult theater and pornography industry. Standing on 42nd Street, I had already walked 83 blocks, and I needed to eat. In those day, before basal insulins or widely used insulin pens or pumps, you were supposed to give your insulin and eat your meals at pre-determined times. You were taught that your schedule was sacred, and any deviation risked chaos.

Finding food in Times Square wasn’t a problem. Street vendors were everywhere, which appealed to me because, frankly, I hardly had any money and couldn’t afford a restaurant. But I needed some place private to draw up my insulin and give my injection. I wouldn’t give an injection in public anywhere, but if I did one in New York, in that neighborhood, I’d be marked as a drug user, and who knows what would follow.

My best bet, I figured, was to find a restaurant and use its rest room. At first I couldn’t find one. When I finally did, I asked where the men’s room was. Big mistake. I was told that the facilities were only for patrons. (They were probably trying to keep out the drug users.) So I was back on the street, searching for privacy, knowing that I needed to eat, knowing that I needed to take my insulin, looking around, searching, wondering. And then it hit me. I’d go to a peep show.

I don’t recall what exactly the billboard sign said, but I assume the word “Booth” must have been in it. As it happens, the New York Times building was located in Times Square, on 43rd Street, so I walked through the porn district every day for three years and became quite knowledgeable about the verbiage; and, truth be told, I don’t believe they invested a lot of time in creative movie titles. I developed, however, a grudging respect for “Sex in the Candy Rack,” only because it was visually complicated.

At any rate, I realized, in my moment of need for insulin, what I had to do. I went inside this peep club and entered a private booth, with a naked woman dancing through the hole. I took out my white plastic kit, set up my insulin vials, swabbed the rubber heads, rolled my NPH, drew up the syringe, bunched up my skin, injected, plunged, withdrew. Perfect.

I packed up, I pretended like nothing unusual had happened, and I even left the woman a tip. It was cheaper than a restaurant.

I can look back at that experience, some 23 years later, with some amusement. But to be honest, it wasn’t funny at the time. I would have rather been caught dead than have been seen giving my shot in public – whether they thought I was a heroin addict or a diabetic, either would have been devastating. I just remember that feeling of desperation: I may not have been hypoglycemic, but I was famished, yet I couldn’t eat without taking my shot, and everything around me was just strange and out of synch. If it’s possible to have gratitude for a peep booth, I had it that day.

I got my dinner from a hot dog vendor and continued my walk. My blood sugar level was fine for the rest of the evening. It was a nice night, I was young, and this was New York.