Monday, October 17, 2011

Performance Anxiety

Earlier this month, my voice student with Type 1 confided in me that she had gone into an audition with a low blood sugar. It hadn't significantly affected her performance, but it was one more thing adding to her anxiety about an audition we'd been preparing for months - anxiety which included that she was also getting over a cold. She ended up getting selected to a choir still, but felt like she could have both performed and ranked better.

The teacher and the patient advocate in me encouraged her that she should have asked the moderator if she could audition out of turn - that it wouldn't have disrupted anything to have asked for that additional 6 minutes or so to eat her glucose tabs and get her head together.

But the performer and diabetic in me knows it's never that simple.

Saturday, I was dragging my feet getting ready for a singing gig at a local church where I'm on retainer as soloist and song leader. I gathered my music, headed to the church, practiced (and chatted) with the accompanist for half an hour, but I felt a little more tired than usual. A little less focused. In a 75-minute service, there were 14 different moments when I was to be up at the microphone leading the congregation. After the second song, it hit me.

I wasn't wearing my Dexcom.
I hadn't tested in a couple of hours and had no idea where my BG was.
I was low.

I slipped my hand into my purse on the floor and lifted my meter case, tried nonchalantly to test my BG in view of hundreds of people, saw the 54 mg/dL and the words "Treat your low blood sugar!" on the screen of my PDM, and slipped my hand back into my bag for my tube of glucose tabs. No sooner did I have a short stack of tabs in hand than it was time for me to walk up on the altar to the ambo to proclaim a very challenging psalm setting.

The whole time I sang the psalm, I tried not to think about the stack of chalky coconut and cherry tablets sitting on the chair at the bottom of the steps. I tried not to worry about missed pitches, sweaty forehead, slurred speech. I just tried to focus very carefully on the melody. It went off okay. A little on the autopiloty side, but nothing anyone particularly noticed.

What would my teacher or my doctor or my fellow advocates have encouraged me to do? It's a Catholic Mass and I'm a hired professional. It was time for the psalm. It's not like I'm going to interrupt a priest or make a public declaration of my immediate health needs to a congregation of 400 parishioners I barely know. "Just a minute, y'all. I needs my candy."

So I got up and sang. I did my job. And I popped g-tabs in between numbers for the next 10 minutes. By the liturgy of the eucharist, I was back to myself again.

And, at the risk of running long in this post, it made me realize how ingrained that suck-it-up-and-go habit is. It made me go back 13 years to my high school choral director and re-hate her with a passion, as I find myself doing on occasion. Re-hating her. Again and again.

While there were many talented kids in the high school show choir, I was barred from entry year after year despite talent or competitive successes. My junior year, she admitted to me that it was because she didn't want a diabetic in her dance/performance group. When I asked her what it would take to prove that my diabetes wouldn't be a problem, she said that she "had better never see it be a problem" in her class. She was a tough old bird with a lot of prejudices. And that was an ultimatum.

So, even though my class with her fell before lunch, I hid my blood sugar testing from her and took my injection between classes. When I had a low or a high that needed to be treated, I hid it from her. And I never scheduled appointments where they would interrupt her class. I essentially was asked to pretend I didn't have diabetes.

What she asked was unfair, unreasonable, and unhealthy.

But she finally put me in that show choir. And I hated every damn minute of it. When we'd arrive to sing for the Senior Citizens' luncheon and we'd be told we'd eat first, I'd take my lunchtime injection in secret and then be screwed as we found out we would not be eating for another hour - after a lengthy dance performance. I remember sitting on my partner's knee in a dance move with my blood sugar dangerously low, wondering if he would catch me if I'd pass out and fall backwards.

Considering what was asked of me at such a volatile age, I do feel like I gave my student good advice. Had she had her wits about her, I feel like her asking for a minute to take care of her needs would have been completely reasonable and have gone virtually unnoticed. But that's just it. When you have a low blood sugar, your wits are the first thing to go. Followed by your focus, your balance, and your confidence.

Whether you have a teacher in your corner who shames you and ridicules you the way mine so often did to her students or a teacher like myself who believes students' idiosyncrasies are the secret to their hidden strengths, the pressure of "the show must go on" is often just too much for performers. We get up and do what we have to do. There's just no room for diabetes under that spotlight.


  1. great post! I was always in choir too (but without the D yet)...I can't imagine doing all that again and having to hide my t1 like you had to! You are amazing! Now as a t1 (& substitute teacher) I find myself thinking so many of your same thoughts - and so well said "when you have a low sugar, your wits are the first thing to go". so so true!

  2. I hate your old teacher too.


    As a mom, the idea of something like that happening to my daughter makes me want to throw up :( a mom...I also know that she'll have to manage those situations the way she feels most comfortable.

    Great job on the mass.

    I was a singer back in the day.

    Many, many, many days back :)

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  4. Thank you for sharing this with me on Tudiabetes. It was a great read and I am happy to hear that you are being a great mentor and advocate for your young student. Keep up the great work. :)
    Julee from Tudiabetes