Living With: Self-Portrait of a Diabetic Life

A collection of approximately six months' worth of insulin bottles. This supply would have cost $3,000 ten years ago. Now it costs nearly $10,000.

Ten years ago, while rummaging through my childhood bedroom, I found a collection of red biohazard boxes that were completely full of my used diabetes-treatment supplies. Upon opening them, I was hit with the smell of insulin like a soda can filled with rubbing alcohol. The visual chaos of nearly two decades of medical equipment overtook me. Instead of taking them to the hospital or other collection site for disposal, as is recommended, I saved them, and have been adding to the collection ever since.

I was diagnosed with type 1 diabetes in the late 1980s, when I was six years old. At that time, treatment for the disease hadn't evolved too much since researchers discovered insulin in 1921. They sold the patent for one dollar to make sure it was accessible to all who needed it. Because my immune system treats my pancreatic cells as foreign invaders, my body stopped producing insulin. To maintain a normal level of glucose in my blood, I had to inject it. The process sounds simple, but the truth of diabetes is more complicated: It requires the rigor and focus to count every calorie, an understanding of how every type of food and exercise affects my blood sugar, and constant vigilance, which I have now maintained for thirty years.

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Taken collectively, these photos are self-portraits, composed of nearly a lifetime's inventory of all the items I have used to treat my diabetes. Sharp needles. Dried blood. Small lancing devices. Cloth tape of the type found in a doctor's office. Every object has been intimately connected to my body in some way—as a vessel for blood, a connection to an insulin source, or even to be put inside me, sometimes for as long as ten days.

This portfolio tracks the emotional, physical, and financial costs of the disease. It documents decades of winces, yelps, cringes, and gritted teeth, as well as hundreds of thousands of dollars. Take the mostly black-and-white image of test strips, which are so numerous they resemble television static. A test strip is a small piece of plastic that is inserted into a machine to analyze blood. This process provides an accurate blood-glucose reading, and it was revolutionary—the previous method of testing sugar through urine was inexact and inconvenient. The change, however, came at a price. Each test strip cost about one dollar, a price which never fluctuated, and the medical community advised frequent testing to improve long-term control. This single photo represents $20,000 worth of test strips.

I have probably tested my blood sugar well over one hundred thousand times. My fingers will always carry scars from those tests. But in the past decade and a half, the day-to-day treatment of diabetes has changed. The test strips that used to mark my days have been replaced with glucose sensors and insulin pumps. Yet the cost remains. A sensor lasts for about ten days, and a box of three costs between $300 and $400. Insulin is stored in a small machine, the size of a pager, which regularly pumps out a dose as needed and, when I enter the amount of carbohydrates in a meal, sends out a large dose.

This new technology has turned me into a cyborg. But not the human-machine hybrids rhapsodized about by futurists and able-bodied biohackers who use glucose monitors like mine to collect data in order to "enhance" themselves. Most cyborgs are not superhumans approaching a postbiological future, but rather people with disabilities trying to live a normal life. The corporeal reality of that life in no way resembles the glossy sci-fi vision of machine-enhanced humanity. These photos show the personal struggle of having a body that relies on a machine—brown tones of dried blood, manifold silver needles that could...