The "SOME PEOPLE" Essays
No Human Being Should Be Forced to Choose Between Rent or Blindness, a Mortgage or Amputations, Healthcare or Bankruptcy by Alex Flynn | Edited by Kimberly J. Soenen - May 22, 2025
I have Type 1 diabetes, an autoimmune disease with no known cause, wholly separate from its better-known counterpart, Type 2. Type 1 means my pancreas no longer performs its primary job, the production of insulin, and I am forced to use insulin to serve as its stand in.
Every day, I stab myself upwards of 15 times with multiple needles.If I do not manually inject myself with insulin, I will die.
There are two steps.
First, I prick my finger, producing a droplet of blood that I hold against a test strip connected to a machine that relays my current blood sugar level. Over time, from this process, my fingers have developed callouses. The callouses help a bit with the pain.
Next, I stab myself in the stomach with another needle, this time from my insulin pen. There are no callouses on my stomach. This always hurts.
The amount of insulin I inject into my body is dependent on many factors, but the aim is to ensure my blood sugar hovers between the magic numbers of 70 and 140—the 60-point margin that physicians consider “healthy.”
The process of testing my blood sugar and administering insulin is not an exact science. Mistakes are common, and mistakes can be dire in the immediate. Too low for too long, and I’m at risk for diabetic hypoglycemia, a medical emergency that can lead to seizures and loss of consciousness. Too high for too long, and I risk going into diabetic ketoacidosis (DKA), a medical emergency in which lack of insulin turns my blood acidic, which would kill me.
DKA is an extremely unpleasant way to die. I was initially diagnosed with Type 1 after an episode of DKA. It left me hospitalized for nearly two weeks, with several of the initial days spent in a coma.
As I age, maintaining my balance on the 70 to 140 tightrope comes with a host of consequences not confined to the immediate. If I practice poor self-care and allow my blood sugar to run high over extended periods of time, I will develop complications that include blindness, nerve damage, heart disease, amputations, and kidney disease, to name a few. As my doctor first joked, “The eyes go first, bud.”
In the end, I will administer roughly 65,000 injections over a lifetime 12 to 16 years shorter than the average lifespan of a person living in the United States. This regimen is one that I, and millions of others, will tackle every day, of every month, of every year, for the rest of my life because there is no cure.
This is the unpreventable burden of the disease. However, there is a second, preventable hardship that accompanies being a Type 1 diabetic, which is the financial burden of the disease as a citizen of the United States.
A survey by the The Journal of the American Medical Association (JAMA) found that the price of insulin nearly tripled between 2002 and 2013. For the last two decades, the three exclusive manufacturers of insulin—Sano, Novo Nordisk, and Eli Lilly—have been raising the list prices of their insulin in lockstep through, what Reuters has called, “shadow pricing.” That means when any of these three companies increase their price of insulin, the other two follow suit within a dollar of their competitors.
A lawsuit led in January of 2017 accused those drug manufacturers of conspiring to drive up the prices of their insulin. Eli Lilly, the biggest supplier of insulin, has faced several lawsuits by the United States Department of Justice, Food and Drug Administration (FDA), and the Securities and Exchange Commission (SEC) for insulin price related charges.
For financially strained insulin-dependent diabetics like me, running out of insulin is a death sentence. To avoid this, many resort to rationing the remaining supply they have on hand, or rely on minimal insulin intake to fill coverage gaps.
One in four diabetics report that they have rationed insulin as a cost-cutting measure. I have rationed insulin as a cost-cutting measure. Insulin rationing, lack of access, and poor self-care caused by financial strain lead to life-altering complications, and for many, an early and preventable death. Every time I look at my bank account and make the decision to ration insulin for the sake of continuing my existence, I damage my body in ways I cannot yet see but will actualize as horrifying medical emergencies as I age.
Inadequate healthcare access is a life-altering roller coaster of anxiety and stress that permeates every aspect of a life. It takes healthy, positive, determined people fighting tooth and nail to manage a disease, and forces them to pick an aspect of their self-care routine they can bear to nix in the moment, but will pay for dearly as those moments continue. This is a blight that comprehensively damages the United States and murders its citizens. It has caused untold damage to my life, and the lives of millions of others, as we collectively weather the horror show that our For-Profit healthcare model has imposed on us.
No human being should be forced to choose between rent or blindness, a mortgage or amputations, healthcare or bankruptcy.
No amount of healthcare policy reform will reverse the damage that unchecked greed has already imposed on me and millions of others. The distress and death these companies have wrought on vulnerable populations is preventable.
It doesn’t have to be this way.
(Photos by Alex Flynn.)
ABOUT
Alex Flynn is a photojournalist who used to split his time between New York City and Missouri. He enlisted in the United States Army in 2008 and spent four years as a infantryman, then three more as a combat correspondent. He served in Japan, and Afghanistan. His written and photographic work to has contributed to understanding the narrative of the United States Military Veteran experience. He currently works as an Emergency Medical Technician (EMT.)