The Substitute Teacher

Trent came home from school recently. Said he had a frustrating day. When I asked why, he said, “I had that substitute teacher that thinks I can’t eat candy.” I already knew what this meant. Ever since Trent was 4 years old and in pre-k, there has been one substitute that gives candy to the entire class at the end of class. The entire class except Trent. Because he has diabetes and she doesn’t think he should have candy. Many times over the 10 years he has been in the school, he has tried to explain to her that he can have candy and that he merely needs to give himself insulin to “cover” the carbohydrates in the candy. She hasn’t budged over the years. Instead, she brings him a pencil. (He has a sizable collection of the pencils she has given him.)

Every year when Trent was younger, we went into school and had a little Diabetes 101 session with the class. We explained what diabetes is. We explained that Trent did not do anything wrong to get it. We explained that it was not contagious. We explained that he could eat anything as long as he had insulin to convert the glucose to energy. We answered questions. (“No, it is not at all related to AIDS.”) We talked about how Trent might look if his blood sugar was too low or too high. (“When little, the kids were always very protective of Trent and would inform the teacher if he looked funny.) And sometimes we had a little demonstration of how he checked his blood sugar by pricking his finger for blood and putting the blood on a strip in a glucose meter. (“If you think it’s gross, you don’t have to look. But Trent has to do this many times each day just to stay healthy and alive.”) Mostly, the kids were in awe that he was so brave and could check his own blood. They also thought his pump was “way cool.” The teachers were sometimes nervous and never real happy to see a needle or lancet in their classroom. But they were always impressed that Trent could calculate insulin doses for his H-tron or D-tron pump (pumps that Trent had before the new technology that calculates doses for the person with diabetes).

Sometimes teachers would make comments or do things that weren’t in keeping with our philosophy of diabetes. Our philosophy is that it is better to allow sweets and dose insulin than to deny them and risk Trent sneaking sweets without insulin. (Indeed, I once told Trent that if he asked I would give him ice cream for breakfast – and the insulin to cover – so that he needn’t ever sneak sweets. Would I really have done that? He never put me to the test. But he also never snuck sweets without bolusing insulin.) We tried to explain to the teachers that if cake and ice cream were healthy for the other children, it was also healthy for Trent. And that only foods that were unhealthy for other children were unhealthy for Trent. Too often, they didn’t get it. They often couldn’t get past the fact that they knew that their aunt Frannie or grandfather had diabetes and couldn’t eat sweets. Instead, they just assumed we were too permissive as parents. No matter how hard we tried to distinguish Type 1 from Type 2 diabetes, in some minds, it would not stick. Amazingly, even one of the school nurses didn’t get it and would give sugar free candy to Trent, assuming that he did not need insulin because it was “sugar-free." She did not understand that the sugar was not what we counted; that it was the carbohydrates that mattered.

We tried to talk to the teacher or the principal or someone at school whenever these misunderstandings arose and made Trent feel left out or segregated. But no matter who we spoke with, there remained the one substitute teacher that refused to believe that Trent could eat candy. She thought she was being protective and nice by bringing in pencils for him. But she didn’t seem to understand the issue from the kid’s point of view. A kid wants to be treated, usually, like the other kids in class. Especially when they are getting candy. So, when Trent came home again announcing that The Substitute With the Special Pencil for him had been at school, I sighed and asked to see his pencil. Instead of showing me, he went on to describe how he finally convinced her to give him candy, by showing his pump and how it connected to his stomach. Success! I thought. Finally, after 10 years. Given that Trent is leaving this school at the end of the year, to go on to high school, I thought this was a fitting end to his time at the school. Trent wasn’t so sure. It had been frustrating for him to endure yet another time. And, in the end, she would only give him one piece of candy. Even though she gave the other kids more than one piece. However, he didn’t miss the pencil.