When personal emergencies strike

Smack dab in the middle of May, I found myself driving late at night from Chicago to St. Louis. My mom lives in St. Louis and she was rushed to the hospital after having been found unconscious. I made it to Springfield and spent the night with family, and managed to get to the hospital the following morning.

There are two ways that a diabetic can loose consciousness due to blood glucose. One way is hypoglycemia, in which blood glucose levels that are too low. This happens when they’ve taken too much insulin before a meal, for example. Another way for a diabetic to loose consciousness is a syndrome called diabetic ketoacidosis, which is triggered when blood glucose levels are too high. Most non-diabetics have blood glucose levels that vary between roughly 80 and 120 mg/dL. When a diabetic’s insulin isn’t working and their blood glucose levels go over 350 mg/dL, the cells in the body transition from metabolizing glucose to metabolizing fat. Ketones are one of the byproducts of metabolizing fat. They are acidic, which means that the blood pH begins to drop with the onset of diabetic ketoacidosis. The body works hard to prevent the blood pH from dropping very far, but it can only do so much and eventually the body shuts down. At this point, the body has been stressed both by the overly acidic blood and by the metabolic shifts that the body employs in response to that acidity. This is what happened to my mom.

Thankfully, restoring the body to normal function after an episode of DKA is usually straight-forward and this was the case with my mom’s recovery. There are potential complications but my mom did not suffer any. Rather than write about my mom, I wish to write about how my responses make it obvious that I am a scientist.

I quickly learned that family members and friends want lots of updates when somebody is in the hospital, and this brought out the science-writer in me. My sisters, of course, wanted to know what was going on, but so too did my mom’s cousins and her friends from church. Within hours, I found myself writing emails explaining my mom’s condition. When somebody in the hospital is recovering, doctors and nurses always explain the state their recovery by reporting the levels of various chemicals in the blood. Obviously I cannot just pass those numbers along to my family: they won’t know what to expect. I also felt that it wasn’t much help saying “mom’s getting better” without explaining why. So, I wrote emails with details of the various chemicals that were being measured, what they meant, what might cause them to be high or low, what a normal person’s levels might be, and what my mom’s levels were doing. (I was greatly helped by having two doctors in the family who were able to explain the physiology behind many of these readings; otherwise I would have spent much more time on WebMD trying to understand what was going on. Even when I arrived, nearly all of mom’s levels were healthy or trending that way.) By giving the full context of these numbers, everybody could feel relieved that mom was indeed recovering. In the process, I discovered that I really enjoy science writing for a “popular” audience.

Perhaps this should come as no surprise, but when at loose ends I found myself wishing to analyze the various readouts that were available. Here before my eyes were large collections of data about my mom’s heart rate, breathing rate, blood oxygen, and blood glucose. As someone who works in a lab that specializes in data analysis, I felt an impulse to play with this data. Unfortunately they did not have any way to get that data onto my computer, but when I returned to Chicago, I brought my mom’s old blood glucose log book. I learned a lot about my mom’s blood glucose and prepared a five page writeup for my sisters with the goal of understanding what is “normal” for mom. I wanted to understand my mom’s blood glucose thoroughly and I employed the same curiosity and energy that propells me through my research at work. Sometimes I proposed small hypotheses about what might predict an extreme event and then analyze the data to see if my hypothesis was correct. Other times I would slice the data in a new way, perform a basic analysis, and scratch my head until I could give a basic interpretation of what I found. In all of this, I was handling a very personal issue—-my mom’s medical condition—-in a very scientific way. Unlike most personal dilemmas, analyzing the numbers could lead to legitimate degree of confidence for what constitutes safe and unsafe blood glucose levels.

When personal emergencies arise, I’m sure that most people look for ways to feel normal by bringing their job skills to bear in handling the emergency. Apparently, my response is to develop a full understanding of the science behind the emergency, whether that means learning about the medical condition or analyzing whatever data I have at my disposal.

— David Mertens