Even though I read those things in books, seeing them through the eyes of someone like Theo who had observed change over time brought a more human scale to what I could gather about changing foods and farms. From his car window, the “sclerotic landscapes”52 and constricted food systems that scholars write about made more sense. Sclerotic arteries kept showing up in diabetes clinics, but from the road I could also see sclerosis even in the lush land that nonetheless choked free movement through it—like the United Fruit bridges and the roads that followed, still constricting the motion of food and people long after the corporation and its train tracks were gone. Some historians of science used to search for what they called the “machine in the garden,” moments when industrial technologies entered nature.53 But I realized that the banana train, missing now, wasn’t the machine in this garden any more than the crumbling mills and their rusting wheels. When it came to wild sugar and its landscapes, what looked like the garden was the machine—altered infrastructures and biologies, living sugar “absorbed” into bodies and absorbing them in turn, overgrown excesses of fixed and moving parts.54
But whenever I thought I had found some connecting plotline to think with across scales, the events I wanted to wrap a story around seemed to shape-shift again. Some months after our last trip, I was shocked to learn that Theo had been murdered in the same car we had driven in the past summer. Memories of those trips and the stories suddenly changed gravity. The last time I saw him, he was listening to country music and said his sugar felt low. He was going to buy a piece of fruit.
No matter how many times I read headlines in Belize like “Sugar and Bullets,” I can’t really grasp the scale of the numbers.55 Yet according to national statistics, what happened to Theo is not strange at all in the sense of numerical probability. Murder was the most likely way for a man to die in Belize, followed by diabetes (for women, diabetes was still number one). What makes this reality especially hard for both Belizeans and scholars to understand is that the country’s homicide rate was very close to zero only a few decades ago.
The rise of militarized forms of policing within the United States has deeply affected Central America, as has the growing demand for opioids headed for U.S. markets. Current homicide rates are well over the so-called civil war benchmark countrywide. At last count by the U.N., Belize City’s homicide rates ranked third highest on the planet.56 Some 90 percent of Belizean children have seen a dead body, compared to 20 percent in Mexico.57 Yet unlike many nearby countries where violence is also a major issue, there is no legacy of civil war in Belize. Once I asked a prominent journalist who regularly publishes on what he calls the “violent triangle” of Guatemala, Honduras, and El Salvador why he leaves Belize out of Central America, even though its violence rates are comparable to or higher than those in the surrounding countries he focuses on. “Nobody understands Belize,” he said.
Since many of my memories of Belize’s landscape were learned through the windows of Theo’s car, now the whole landscape felt learned anew through the memory of what happened to him there. Being afraid to move around at certain times or places was part of sclerotic landscapes too, and one of fear’s many unpredictable effects. You couldn’t easily see it on the surface, but on glucometer screens you could watch the way an untimely death made an entire family’s blood sugar erratically rise and fall. Fear of safely moving through a place could make a daily exercise routine feel like weighing immediate security against future health. I began to learn how easily a country’s relaxed atmosphere can be mistaken for an absence of social problems, rather than a hard-won effect of the way people absorbed hardship and undertook the labor of transmuting it for those around them. These realities are now also part of “what it means to be human in a place advertised as paradise.”58
Theo used to say that he was jealous of friends who had HIV/AIDS instead of diabetes. He said the two chronic diseases shared similar daily demands—except that with AIDS, “if you take your medications in time, you can eat just about anything.” And the difference that most preoccupied Theo: “With AIDS, they don’t cut you up.” He started laughing at this harsh contrast, the way blood with high sugar doesn’t make others afraid, unlike AIDS. “They don’t want to cut you!”
They cut him more than a dozen times, face and neck. When I listen back to recordings from his car now, Theo’s storytelling as we crisscrossed Belize feels impossible to separate in my memory from what happened to him later in his vehicle. Slow violence bleeds into violence of other tempos. The stories he told me about food and landscapes as I looked out the window already held the quality of blurring past, present, and future, and now make me imagine looking back at him in the driver’s seat with a similar sense of “simultaneous time.”59
I recalled his carefully stowed hard candy in quick reach in the console and thought back to Theo’s story about his tough old friend, who the police initially thought had been murdered but seemed to have died fighting his way toward the kitchen with low sugar. Everyone in Belize called diabetes the “silent killer,” but I never grasped it as clearly as in that story of what police had mistaken for a crime scene. Staying on guard against other violent killers could share a gut-level feeling with diabetic sugar: There were measures you could take, but there were things far out of your hands, and life with it meant just knowing that.
Theo fought back hard, his gashed arteries undoing the delicate investments behind decades of care. The story that he had told me most often was about the time a few years ago he’d tried putting a teaspoon of sugar in his morning coffee, after hearing it was good for diabetes. But it had caused Theo’s toe to “crack open like a statue.” His son had brought him an aloe plant to massage onto the injury each day for months until the threat passed.
DIABETES MULTIPLE
One woman in Dangriga asked whether she had type 3 diabetes. In medical journals, “type 3” would reference theories of Alzheimer’s as an additional or comorbid form of diabetes, linked to insulin disturbances in the brain that interfere with insulin’s role in memory.60 But for her, this meant something else. She clarified: type 3, the kind of diabetes that means your arms or legs get cut off.
Nobody needed a visiting ethnographer to tell them about “diabetes multiple,” an interpretation I had once felt clever for proposing. In Body Multiple, Annemarie Mol examined different hospital treatments of sclerotic arteries—the hardening blood vessels linked to ischemic leg ulcers, often associated with diabetes—to reflect on how different bodies come into being, depending on the treatment approach chosen.61 This insight also has crucial implications for observing care inequalities (though Mol doesn’t choose to go there). Yet juxtaposing her book with this one offers a case in point: its front cover depicts an image of two legs being readied for precisely the surgery that helps to prevent diabetic amputations.
In one sense, this provides an uneasy demonstration of Mol’s insights: physically different bodies get produced through differences in medical practices and technologies. By putting into play (or not) different possible treatments, diseases can become physically distinct entities. This can create multiple versions of a condition like diabetes—as when clinics in Belize amended the preprinted posters that listed the disease’s warning signs, writing in by hand severe manifesting symptoms like “blindness” next to milder warning signs like “blurred vision.”
Yet comparing how multiple versions