By Arne Vainio, MD
He looked so much older since Donnie died. A year earlier I saw them together hauling wood and they were drinking coffee and smoking cigarettes in the cab of Brian’s old pickup truck. We never talked about happiness. They swore at each other, and they swore at their chain saws, and they smoked even as they were cutting wood.
Donnie was in his mid-twenties and Brian had been taking care of him since Cecelia died when Donnie was five. Donnie barely remembered her and the only parent he ever knew was Brian. Brian was rough and always had a couple days of gray whiskers, and they lived in an old motorhome that quit running years ago. They built a porch on it and just stayed with the motorhome.
They went through a lot of firewood in the winter and were always looking for more. They sold parts from old junk cars that just seemed to find them and when all the useable parts were gone, they hauled the car bodies to one of the bigger junkyards and they got between forty and fifty dollars if they were having a good day. The driveway was lined with old cars, bathtubs, windows and anything else they could collect. I first met them when I put an ad in the paper looking for some old tractor parts and they were the only ones who called. I drove my rusty old truck there and pulled up next to the porch. Brian told Donnie to pull the starter I needed from an old tractor and we leaned against my truck as Brian smoked and drank coffee, and we watched Donnie bringing his tools out to the tractor.
He got the starter off with a minimum of swearing and set it in the back of my truck. The starter was covered in grease and he wiped a clean spot with his sleeve and hooked a battery to it. It spun freely and he looked up and said, “Forty dollars. A new one is over a hundred if you can even find one.”
I pulled two twenties out of my wallet and we shook hands and I left. The starter worked fine and I ended up going back off and on to get other parts for the tractor. One time I brought them an old lawn tractor that needed too much work to be worth fixing and they unloaded it from my pickup and parked it almost reverently next to an old Buick. “You’re sure you don’t want nothing for it, then? It looks like it still has lots of good parts.”
One day I went there and they were clearly arguing. Donnie was taking the fenders off an old car and he was banging tools around and Brian finally yelled at him, “That’s not going to help! You know you have to take that stuff or you’re going to get sick again!”
Brian looked at me and he shook his head. “He was real sick a couple of weeks ago and I finally had to take him to the hospital. He was in there for four days and they told him he has sugar diabetes and he has to take insulin shots or he’ll die. He doesn’t want to take them and it’s been hell around here ever since.”
Donnie came walking over to visit and he was still settling down. I asked him, “What kind of diabetes did they say you have?”
“I don’t know. The worst kind, they said. I can’t take pills for it and I have to give myself these damn shots every time I eat something. I don’t know what they’re trying to tell me and I don’t know when this is going to go away.”
“It sounds to me like you have Type 1 diabetes. That means your body doesn’t make insulin at all and you need the insulin to get sugar into your cells for energy. If you don’t have insulin and the sugar in your blood can’t get into your cells, then the blood sugar keeps going higher and higher and that’s why you were so sick when you went into the hospital.”
“How would you know that?”
“I’m a doctor.”
They were both looking at me like I said I was the governor. “Really?”
“Then why do you drive that old truck?”
“I don’t know, I just like old trucks. You do need to take your insulin and this is going to be lifelong. People are always either afraid or mad at the things they don’t understand and that’s just human nature. Checking your blood sugars isn’t that hard and the needles for the insulin are small. Once people get used to it, it isn’t a big deal at all, it’s just something you need to do. Do you have any questions?”
“They said I could get kidney problems if my sugars are high.”
“That’s right. You can also get eye problems and heart disease and be at risk for amputations if your sugars are too high.”
“I didn’t want this.”
“Nobody does, but you need to keep it under control to avoid complications.”
They had lots of questions after that and we leaned against my truck and I answered question after question.
I stopped in briefly every few months and for the most part, Donnie was trying hard and he was mostly good about taking his insulin.
I saw his obituary in a Sunday paper that was almost a year-old. I had it wrapped around an old carburetor and his name caught my eye and I felt terrible for finding out so late. I drove out to the old motorhome on the edge of the swamp and Brian came out when he heard my truck.
“Donnie drove way out in the woods to cut some firewood and he didn’t tell me where he was going. He didn’t take his insulin with him and his truck slid off the road and he was stuck there. He must have been confused, because he left his phone in the truck and he was walking in the wrong direction. They found him a couple miles from his truck and they figure he died the day before. God, I hope he didn’t suffer. He was a good kid, wasn’t he Dr. Vainio?”
“He was, Brian. I’m going to miss him and I’m really sorry I found out so late. What are you going to do?”
“I’ll just stay here. I can still cut wood and I’ll be alright.” I could see the hurt in his eyes and I could hear the empty space in his voice. I took out my pocket tool and I held it out to him and said, “I’ve given away over two hundred of these things, Brian. They’re good tools and I use them all the time and I always give the one I’m carrying. They might have nicks and scratches and they might have been sharpened, but I want this tool that was in my hands to be in yours and I want you to use it and I want you to think of respect when you do. I’m always grateful for the goodness of the people surrounding me and I want us all to be connected. I want you to know you’re respected and I want you to know you did the best you could.”
“I remember the day we found out you were a doctor. We were both real happy you ever wanted to come and see us and Donnie really liked that you drive that old truck when you could have a brand new one. Most don’t give us a second look and they want to be done talking to us as soon as they start. They don’t think we have feelings just like everybody else, but we do. When his mother died, we didn’t have anybody else and I didn’t want someone to come and take him away. He went to school every single day and he was respectful to his teachers. I should have told him I loved him, but those words don’t come easy to an old man with a hard life. I thought I had more time. Ain’t nobody supposed to bury their own kid, Dr. Vainio.”
He put the pocket tool into his pocket and went into the motorhome and came back out with two cups of strong black coffee.
We leaned against the truck and watched the sunset in silence.
Arne Vainio, M.D. is an enrolled member of the Mille Lacs Band of Ojibwe and is a family practice physician on the Fond du Lac reservation in Cloquet, Minnesota. He can be contacted at email@example.com.