“I’ll most likely kill you in the morning”: Hard Lows and Living As a T1D Pirate

“He said, ‘Good night, Westley. Good work. Sleep well. I’ll most likely kill you in the morning.’ It was a fine time for me — I had to learn to live as a pirate, to endure the harshness, to handle the ropes, to practice my fencing, and to plunder ships. I started to dread hearing that phrase every night. And so it went, day after day, for three years.”

— Westley to BUTtercup, in William Goldman’s The Princess Bride

In William Goldman’s novel and movie, The Princess Bride, our hero Westley recounts to the heroine, Buttercup, how his kidnapper, the Dread Pirate Roberts, would threaten for three years to kill him in the morning. Westley had to live with that ever-present threat, and it affected everything he did after that.

Making any kind of big change involving type 1 is like that. Sure, you can switch to an insulin pump. Sure, you can up your dosage and achieve a lower A1C. Sure, you can start an exercise program.

If it doesn’t kill you in the morning.

Justifiable fears

Westley further explains to Buttercup that “the name was the most important thing for inspiring the necessary fear.” With type 1, it doesn’t take much more than the word “hypoglycemia” or “dead in bed” to instill fear.

For many people with type 1, the severity of consequences is what makes us fear Dread Pirate Diabetes.

Hypoglycemia is scary. Your heart races as your brain starves from a lack of glucose. You quickly lose the ability to think straight or even sit up straight, even as you drift toward unconsciousness, seizures, and potential brain damage.

Hypoglycemia on top of exercise-induced glycogen depletion is an even more dangerous and fearsome combination. Unless your recovery meal from your workout is adequate (and it often isn’t), that night, when you lie down to sleep, you go low, your body attempts to dump glycogen into the bloodstream, not finding enough, and sweats to eliminate enough water to increase glucose concentration in the bloodstream. Excessive sweating causes you to lose potassium, and your heartbeat becomes irregular. Meanwhile, you dream you’re in a puzzle box, and sometimes you don’t wake up. Ever.

It takes little more than the mention of severe, hard lows to scare the living crap out of you.

So you run the other way, as far as you can, to get away from hypoglycemia.

A doctor’s “bad” advice, a promising new tool, and…nothing

You would think that having the right diabetes management tools would help.

Ten years after my diagnosis in 1972, I got my first glucose meter, an Ames Glucometer. It was literally the size of a brick. It came in a big box and had its own insurance policy, so that in case it broke, we could get another one without having to pay another $300. (In 2025 dollars, that would be approximately $1200). But my original Ames Glucometer gave me a glucose reading in 60 seconds from an honest-to-God BLOOD sample, and for the first time since diagnosis, I knew what my blood sugar was actually doing.

After a decade of waiting, I finally had a tool to manage my blood glucose.

The trouble was that I didn’t want to use it. My meter was either going to (a) tell me I was low (my worst fear), or (b) that I was high and needed more insulin to bring my blood sugar down…which might mean I’d go low later (see (a) above).

I was still gripped by the fear that diabetes “would probably kill me in the morning.”

Knowing exactly what time in the morning it might happen didn’t actually make me feel any better.

Living as a T1D “pirate”

But there’s something Westley said in The Princess Bride that really stuck with me. He says that while nothing changed about his captivity, in the meantime, he had to learn to work the ropes, get better at fencing, and learn to plunder ships. In other words, get on with life. Whether or not he did it in fear or with a grim resolution to face what was in front of him was his choice.

I could of course have continued to avoid exercise. I could live as farmboy Westley, under the constant threat of consequences, hoping for rescue from Dread Pirate Diabetes, who had kidnapped me as a child and threatened that he would probably kill me in the morning.

Or I could do something.

It didn’t change the threat, but it might change the outcome.

One day in 2004, after a diagnosis of retinopathy and a serious brush with diabetes complications, the day for action came.

I needed to get active, but it was scary. I trained anyway, to run a 5K Turkey Trot that fall. Yes, bad things could happen; and I screwed up a lot of things. But I ran it and didn’t look back. BECOMING a pirate was the only way to remove the fear the pirate represented.

For twenty years now, I’ve been getting better at sword-fighting with the fear of hypoglycemia. Left handed. Against a larger opponent.

You either live in fear, or you do what you must to make living with type 1 diabetes work for you. Find little ways to be brave. Make mistakes. Lots of them. Learn your weaknesses so you don’t trip over them. Treat your failures as training. Get better at fighting.

20 years of fighting

The retinopathy diagnosis twenty years ago was devastating news. But mostly, since learning to fight, and continuing to fight, things have gone much better.

Looking back on thousands of miles of swimming, cycling, and running, I am STILL stressed about whether I’ve brought the right stuff with me. STILL stressed about where my pump will be in transition. Still worried about my heart rate. Still concerned about the effect of stress on blood sugar. Still worried about whether I fueled right. And I’m STILL afraid of lows. Down inside, I’m still the farmboy.

But I am no longer as afraid of jumping into the swordfight.

Even when I have no clue what I’m getting into, what I’m trying to do, or how it will end up. What I don’t know, I can learn. what doesn’t work, I can change. When the outcomes are bad, I can change the inputs.

Because even though I might be afraid that my lifelong nemesis will yet somehow manage to kill me before morning, I’m determined to do my best to be the pirate, not the farmboy; to endure the harshness, handle the ropes, practice my fencing…and even occasionally plunder a piece of cake without fearing the consequences.