A Medical Emergency: When Hearing “No” Means More

Author’s Note:

I am publishing this because silence protects the wrong things.

This piece reflects my personal experience. It’s purpose is to educate. It is not an invitation to speculate, investigate, or contact anyone mentioned or implied. Please respect the privacy of all individuals involved, including my own.

Adults with chronic illness are often expected to remain competent even during medical emergencies that impair cognition and physical function. When harm happens in those moments, it is frequently minimized or reframed to spare discomfort.

I’m writing this to be accurate, not to punish or provoke, but to make visible what is usually dismissed and to name the cost of it.

Trigger Warning

This piece contains a first-person account of severe hypoglycemia, medical neglect during a medical emergency, abandonment by a partner, and discussion of seizure risk, cardiac arrhythmias, and risk of death. It may be distressing for readers with chronic illness, diabetes, cardiac conditions, or medical trauma.

Please read with care.

Introduction

In people without diabetes, blood glucose is tightly regulated by the pancreas. Normal blood sugar generally ranges from 4.0–8.0 mmol/L, depending on whether a person has eaten. Within this range, the brain and body function normally.

I’m a Type 1 Diabetic.

Because my pancreas no longer produces insulin, I have to administer it with daily injections. Insulin is essential. The dosing is never exact. When there is too much insulin relative to available glucose, blood sugar drops. When that happens, the brain is affected first.

Severe hypoglycemia is typically defined as blood glucose below 3.0 mmol/L

Below 2.5 mmol/L is widely associated with:

• a high risk of seizures

• loss of consciousness

• coma

• death

Death can occur because severe hypoglycemia can trigger dangerous cardiac arrhythmias, a risk that is significantly higher in people with underlying cardiac conditions, which I was diagnosed with over a decade ago.

But what happened was not a transient low, but prolonged hypoglycemia.

I was between 2.9 mmol/L and 1.9 mmol/L for approximately 45 minutes.

At 1.9 mmol/L, the brain is in an energy crisis. The longer the deprivation, the greater the neurological risk. Sustained exposure results in neuroglycopenia.

Marked by:

• confusion

• impaired self-advocacy

• loss of the ability to self-correct

• loss of: cognitive processing, judgment, speech, vision, and motor coordination progressively deteriorate.

The longer the deprivation, the greater the neurological risk.

A hypoglycemic episode of 45 minutes significantly increases the likelihood of:

• loss of consciousness

• Injury from collapse

• seizure activity

• aspiration due to vomiting

• progression to coma if left untreated

• permanent cognitive effects

The brain is actively shutting down.

At these levels, cerebral glucose delivery is insufficient for normal brain function. Even after glucose correction, lingering effects are common, including exhaustion, headache, cognitive fog, and impaired emotional regulation. The event does not end when the number rises.

Clinically, 45 minutes between 2.9 and 1.9 mmol/L represents severe hypoglycemia requiring immediate intervention, particularly when the individual is immobilized, without access to fast-acting glucose, and neurologically compromised.

This is my story:

This is what that felt like - and how it happened.

Earlier that day, I realized my quick-acting sugar supply was gone. My (former) partner had eaten through it, and what was left I had already used up. I asked him to pick up Skittles from the store, something simple, shelf-stable, and standard for treating lows. He said he would, but he kept putting it off.

3.4 mmol/L

By that night, around 11:05 p.m. I realized I had starting going low.

Not yet dangerous, but headed there.

I checked what I had.

There was no juice.

No glucose tabs.

No candy.

The only thing with sugar was a small jar of expired, unrefrigerated cream cheese frosting with a few spoonfuls left.

That was it.

2.9 mmol/L. — 11:13pm

I started treating with the frosting, knowing it was not ideal and knowing it might not work quickly enough. I told him I was dropping, that I felt scared and I asked again for him to go to the store. He refused and he argued with me, and raised his voice. He told me to walk there, and when I replied that I couldn’t, he told me to Uber.

I was actively going low.

This started feeling dangerous.

I told him he was the reason my supply was gone, I reminded him that he had promised earlier. And he still refused.

Finally, I told him that if he didn’t go, he wasn’t allowed on the boat anymore, not as a threat, but as a boundary rooted in safety. I googled what was open. I told him exactly where to go. I said to get anything. Soda. Candy. Juice. Anything in case I dropped again. There were only a few spoonfuls of frosting left.

2.5 mmol/L

11:20 pm — He left, for the store.

I kept dropping.

I rationed the icing, to keep me awake until he returned.

2.1 mmol/L

When he came back, he was empty-handed. I felt my heart drop.

He said the store was closed. I asked which one. I asked what intersection. He pointed to a Circle K at a specific location.

1.9 mmol/L — 11:35pm

I kept dropping.

By then, the frosting still hadn’t kicked in. My vision was starting to black out. I was on the floor.

2.1 mmol/L — 11:40pm

I never had a low blood sugar for that long before.

I told him how scared I was, I told him I was afraid I might lose consciousness.

I asked for help.

And I begged him to stay with me.

I wasn’t asking him to fix it.

I wasn’t asking for comfort.

I was asking him to be there incase I needed an ambulance.

I was asking him to be there, incase I needed 911.

I begged in a way that felt like begging for my life.

He said no.

And at 11:43pm he said he was going to bed.

To do that, he had to step over my body.

I remember his voice saying no. That’s what I remember most.

I remember thinking, this is how people die.

I didn’t want Mom and Dad to hear that I was found dead on the floor.

The person who said that they loved me, stepped over me, leaving me there.

I was aware enough to understand the danger, but my capacity to act was disappearing.

My coordination was going faster than my awareness.

I was treating with the expired frosting, hoping it would work.

I was hoping it would be enough.

11:47 pm

I finished the last spoonful.

And I closed my eyes and I prayed.

Eventually, it did work — slowly.

2.6 mmol/L — 12:00 am (Midnight)

I could barely stand when I went to get more food. My vision was still cutting out. I felt like I had five percent of my awareness left. I chucked packages of goldfish crackers, ritz sandwiches and anything I had with slow acting carbs on the floor and sat back down, anything to keep my awareness from cutting out.

I ate everything on the boat that night, anything with carbohydrates, because I was terrified my blood sugar would drop again.

3.6 mmol/L —12:20 am

I stayed on the floor until I felt more stable, and I could feel the food hitting my system. This was the first moment I felt relief, I wasn’t safe, but I knew the food was working. I did not sleep, I continued to watch my blood sugar.

I stayed awake because I didn’t trust my body, and I didn’t trust the person onboard with me anymore.

I was so scared. Frightened. And fragile.

5.3 mmol/L — 12:35 am

I called my parents — three hours away.

It was heartbreaking that I had to explain to them that the person who I trusted to keep me safe didn’t. I was crying and shaking on the phone.

This was the moment I broke down — I was hysterical.

5.7 mmol/L — 12:43 am

The realization of what happened hit me all at once:

I’ve sailed through storms, but somehow this felt worse.

My headache was unimaginable, made worse by my crying. The buzzing and the ringing in my ears felt deafening.

6.4 mmol/L

Both my parents and I called around to stores.

We were all trying to understand what happened.

Every Circle K in that area was open, including the one he pointed to.

When I finally felt physically safer, and tired, a different realization landed: I can’t sleep next to someone who did this.

7.3 mmol/L — 12:50 am

The fear was still in my body, but the hurt was sharper.

Living beside someone who could step over me during a medical emergency, as I was begging for help, changed something in me that was fundamental.

I was on autopilot, but realization was forming underneath it.

This wasn’t the first time my health had been treated as negotiable.

I have a heart condition. During a specific heart episode, instead of de-escalating, he argued with me and then chugged ten beers after I told him my heart was arrhythmic and I was struggling.

Another time, after I refused alcohol on my ship — he left me in public during arrhythmia, alone again.

Each incident carried the same message:

My health was something to push against, test, or punish.

So when I was left on the floor at 2.1 mmol/L, it wasn’t an anomaly.

It was confirmation. And I wondered why I hadn’t “seen it before”.

It was his language, his ability to convince you he had expanded and grown.

And I believed him.

I survived that night.

But I did not come out unchanged.

But this time my body didn’t forget it. My nervous system recalibrated around the knowledge that help is not guaranteed. I became more vigilant. I sleep lighter. Being alone during lows no longer felt neutral, it felt dangerous. Not because I’m anxious, but because my body learned something real.

I cannot be around someone I cannot trust with my safety.

Ending the relationship was not emotional. It was preventative.

If someone tells you they are low, their brain may already be failing. What you do next can determine whether they live through the night. That is not metaphor. That is physiology.

I luckily made it through.

A brief PSA: what to know about low blood sugar (hypoglycemia)

Low blood sugar is not a mood, a preference, or a moment someone can simply “push through.”

It is a medical emergency.

When blood sugar drops too low, the brain is deprived of fuel. This can cause confusion, weakness, loss of coordination, slurred speech, seizures, unconsciousness, and in severe cases, death. A person experiencing hypoglycemia may not be able to think clearly, advocate for themselves, or physically get help, even if they appear awake.

If someone tells you they are low, believe them. Act immediately.

This can save their life.

Here’s how to help:

• Have them seated, if standing assist them to sit down.

  Standing and walking can be extremely dangerous, insure they have somewhere to sit.

• Give fast-acting sugar right away.

  Juice, regular soda (not diet), glucose tablets or gel, honey, candy anything with quick sugar works. Do not delay. This part is life-saving.

• Stay with them

  Do not leave them alone. Low blood sugar can worsen quickly and unpredictably.

  
  

• Do not argue, scold, or minimize

  This is not the moment for lessons, frustration, or disbelief. Time matters.

  
  

• If they cannot swallow or lose consciousness, call emergency services immediately

  This is not optional or dramatic, it is lifesaving.

Helping someone through hypoglycemia is not complicated, but it does require presence, urgency, and care. The difference between harm and safety is often just a few minutes.

And someone willing to respond.

If you love, live with, or care for someone with diabetes or another condition that affects blood sugar, knowing this is not extra knowledge.

It is basic responsibility.

Yours safely,

-Kate

Xo