Comedian Patrice O'Neal was interviewed for Diabetes Forecast by contributing editor Carolyn Butler not long before he had a stroke in October. O'Neal had type 2 diabetes and had made it a subject of his comedy. He was interested in raising diabetes awareness so that others could avoid the complications of the disease that affected him. Sadly, O'Neal died the night of November 28, 2011. Here is the Forecast interview.

Standup comedian Patrice O'Neal has never shied away from ribbing on difficult issues, from racism and relationships to sex, politics, and even kitten abuse. So it's no surprise that the funny man has also managed to find the acerbic humor in type 2 diabetes, which he was diagnosed with in 1993.

"I got that miserable disease," O'Neal confesses in a bit from his recent Comedy Central special, "Elephant in the Room," which is now out on DVD. "It's just a pain ... 'cause I can't eat and drink what I want. Like I can eat as many vegetables as I want. 'Patrice, you can have all the brussels sprouts you ever needed.' Why can't I eat pasta and cake? But you can't and it's hard, it's like being addicted.... I'm telling you, food is an everyday [thing]. I be like 'Oh my God, food again?' Every day I got to think—I go to sleep thinking about food.... Like 'what am I going to do? Today I had salad and fruit and I'm going to celebrate tomorrow by having a whole lamb leg to celebrate how good I ate yesterday.' It's just a suffering." [Cue the sympathetic laughs all around.]

The Real Patrice O'Neal

Raw and raunchy but always real, O'Neal is unafraid to delve into any aspect of his health onstage, whether it's his long-term struggle with his weight, his fear of losing a foot, or his waning sex drive. "I will make fun of anything," says the performer, who got his start two decades ago when he heckled a standup comedian who then defied the youngster to do better—and O'Neal promptly accepted the challenge. "Diabetes is something I'm always dealing with, so of course it comes up," he explains. "I think it's hilarious, especially because no one really cares. Like, I do a joke where I talk about AIDS and cancer as being the top diseases—like if you say I've got AIDS or cancer, people go, 'Ohhhh, that's terrible.' If I say I got diabetes, they say, 'Oh really, you can't eat cookies?' It's not a disease that's taken seriously by really anyone, even a lot of people that have it—that is, until your body starts to break down and you can feel it. Then you're scrambling to try to figure it out, to eat right."

Indeed, the larger-than-life humorist, who stands 6-foot-5 and weighs in at about 300 pounds, is the first to admit that lately, his health has taken a more serious turn, after a somewhat misspent youth: "When you're in your 20s and you have type 2, even if people say, 'You're going to start feeling the effects when you're 50 so start taking care of yourself now,' it's like 'Get out of here, what are talking about? I'm not gonna listen to you!' " says O'Neal, 42, who laments that diabetes is "finally catching up with me." For one thing, his frequent work travel is starting to take a toll. "Now, when I'm flying from LA to NY, it's like I had a fight," he says. "My circulation is not as good, my legs swell up, and my body aches a little bit. It's rough."

But O'Neal, who has spent years making the rounds at comedy clubs across the country, working his way up to appearances on television specials and sitcoms such as Arrested Development and The Office, as well as various radio shows and movies, says he isn't about to let type 2 diabetes slow him down.

Interview with Patrice O'Neal

Humorist Patrice O'Neal spoke with Diabetes Forecast before a series of gigs at Caroline's on Broadway, the famed comedy club in New York City. In a slightly sanitized version of the rollicking conversation (which wasn't quite printable, in full, for a family magazine), O'Neal opens up about why he thinks diabetes needs a more effective public relations campaign, how laughter helps him deal with his aches and pains, and whether or not it bothered him when the recent Comedy Central roast of actor Charlie Sheen turned into a biting referendum on his own health.

Take me back to the beginning—when were you first diagnosed with type 2 diabetes?

Well, my body just kind of told me I had it. I was 22, 23, and my vision was getting blurry, I was going to bathroom frequently, and all of that. My mother had diabetes, and said, "Maybe you should go check it out." So I went to the doctor and my sugar was 500 at that time. My mother was like, "Oh my God!" but I didn't know the difference. Even though she had it before I did, I didn't know anything about diabetes, because when you're young, you don't care; I just knew my body was acting crazy.

How did you react?

Well, there were definitely times in my younger days when I would stop taking my medication 'cause I felt good, and I guess my body was young enough to deal with eating poorly, at the time. When I found out I had it, my body was saying something's wrong, but then it just behaved like nothing was wrong. And it was like cakes, cookies, pies, bread, and rice all the time—for a long time, there would be bouts where it wasn't affecting me. But in the last five years it's been pretty much an everyday awareness.

Tell me about that, about how things have changed?

Well, I'm starting to really feel it now—your body feels achy, your feet hurt, you start getting a little retinopathy, the neuropathy. You just start feeling the effects more.

Nowadays, my diabetes is a hell of a thing. It just affects everything—your bowel movements and sex drive and sexual everything, your feet, your eyes. I've got to take fiber all the time now, because my body just doesn't do what it needs to do, so I have to help it. Some days you feel really good, and then others it weighs you down and takes everything you got to just move. But you do.

[Diabetes] just makes you old—it makes you think old—way before you should be. You think about falling and cutting yourself, about getting bit by a bug, you think about those things. When you're clipping your toenails you got to be careful, even. I cut my foot last year and I was really scared. I could see where it didn't heal up a little bit. When you're young, you just heal up.

If I'm eating right and taking my medication and doing what I have to do and walking every day, I feel good. But diabetes is a thing where it can trick you—it makes you feel like you're OK, if you're doing the right thing. But you know you got to do the right thing diligently, so the sugar isn't truly eating away at your body.

So how's the "eating right" going, these days?

My diet is so much more important now. I just ate a piece of steak by itself—no potatoes, no rice—and I've learned how to eat vegetables. I don't want to ever suffer, so I learned that I do like asparagus cooked in a certain way; I do eat broccoli. Juicing also helps me a lot—greens and beets and the whole thing—and eating raw helps, too.

There was a time when I was doing a vegan diet, and I only drank water. But then I slipped, and it's like being on drugs, once you mess up, then it's all over. Sometime I buy sweets just to watch my woman eat sweets, 'cause she likes them, or I get sugar-free stuff, but that stuff is all crap. Mostly, I've gotten used to eating good foods that are good for you. It really does take some effort, but I have.

Can you truly joke about a condition as serious as diabetes?

Look, if I put my mind to it, I can joke about anything; I have a natural sense of humor that I can apply to any subject I want. And type 2 diabetes is very easy to talk about, because it's not polarizing. It's really only a disease that people who have care about. Cancer scares everybody—you just think it's death; you think, "No, I don't want to get that"—but with diabetes people don't really care if they don't have it or don't have a person around them that has it. I'm not saying that to victimize the situation, but it's not a hot-button word or issue.

Where do your diabetes quips come from?

Well, I don't have any "knock, knock, who's there?" jokes about diabetes or anything else, to be honest. I'm more of a humorist than I am a comedian, and I just talk about my life, whatever's going on, including my diabetes.

Basically it's about being addicted, about having an addiction. People who smoke cigarettes, I don't judge them because I know that I eat cookies and that can be death for me, too. If you know there's something you can get ill and die from, you figure you just walk away from it and say "no," but sometimes I have to fight it. I have to fight even a cookie. [The topic] can be morbid, but I try to deliver it all with an explanation of human nature—I try to make it less morbid and more entertaining, and to make people understand.

Why do you think it's important to help people learn more about diabetes, through humor or otherwise?

Because the average person doesn't even know what the hell it is or what it does; they don't say, "Oh, diabetes, I've heard of it—your pancreas doesn't produce something." I don't think most people even know that diet and exercise have something to do with it. Hell, I don't think half the people who have it know what it does.

Again, with the two big names in diseases, AIDS and cancer, you know what it is, but diabetes is like "huh, what, your sugar, what happens?" It's funny. This is a disease where you talk about "don't eat a whole cake, don't eat doughnuts, stay away from apple juice.." No one goes, "It affects your kidneys 10 years from now, your heart, and it's going to cause sugar to build up in your body." It's just not scary enough.

Diabetes needs a campaign or something—an effective campaign to show people that it can be really serious, that you don't want to get it, that you suffer, there's a breakdown of your body, and your inside is suffering even if it's not painful or agonizing and even if it's not death. Because it is death if you don't take care of it.

Is there anything you wouldn't joke about?

No. People who are funny joke about everything; there's no inappropriate thing. I look at it as, if you're self-aware, you can take anything and make it funny. And I joke about everything, because that just keeps you from killing yourself, you know what I mean? You joke about your own sadness, you laugh at things that other people cry about, and then you try to make people laugh about things that they would cry about.

Some people handle it differently, but I don't think there's anything you can't joke about it. To me, if I can get over my own misery, that's the only way to attack it—with humor. Otherwise, you just have this disease and it's ravaging your body.

When I joke about diabetes, the point I'm trying to make is like, the difficulty, mentally, of having it. And then for people who don't have it, trying to get them to relate somehow. To say "look, I know all I gotta do for this and to live a healthy life, but that's not just staying away from the sweet potato pie, you know?" For a person who doesn't have issues in the department of health and exercise and eating right, they think you're a weak person. But it's bigger than that. So I try to approach it to say, to me, eating a cookie is the same struggle as a person who's smoking cigarettes. Even if someone put a label on Hostess Cupcakes that said "sugar affects this, that, or the other and will kill you, you'll get sick," people will still buy cupcakes, because they taste good, and there's that addictive nature. If I joke about it, I approach it from that angle: You think I want to die? No. But it's tough not to eat a cookie when you're not supposed to, or to not eat breaded chicken nuggets with french fries, because it's all delicious. It's a hell of a thing.

How do you feel when other people make fun of your diabetes? Like at the recent Comedy Central Roast of Charlie Sheen, where a fellow comic introduced you with this bit: "Patrice has always been destined for stardom, and diabetes. So tonight is not just the roast of Charlie Sheen, it's also a farewell party for Patrice's foot."

Well, that's to be expected. I'm a big black guy with diabetes, what else do they have to go on? If my girlfriend was doing a roast about me, she would have many other things to say, because she knows me, she lives with me. But a couple of comics and actors who don't know me, essentially, I expect that's what they'd say. And it didn't bother me because I already joke about my diabetes, so every joke was less harsh than what I say about myself. I have a punch line about giving up the fight to eat healthy and I just go "I don't need both my feet. I will lose a foot before I care." So I'm not affected by it.

But I tell you what, an inside fact is that during the taping [of the roast], there were references to three, four, five, six different diseases—sickle cell, Tay-Sachs, Parkinson's—and they edited those out. No other diseases were referenced in the final edit aside from diabetes, which tells you what people think of diabetes. Again, that's because if you don't have diabetes, it's hilarious. To have a disease where it's synonymous with losing a foot, it's much funnier than, say, going to go to chemo and losing all your hair and fading away. That's not funny. The deterioration of diabetes is not serious enough, unless you have it.

Like one of the jokes, this actress said, "Patrice, grape soda is not considered a fruit when you're on a diet," or something like that. So that was two-pronged—racial and diabetes—and I mean, yeah, that's funny. What other disease could you say that about? It is what it is; it didn't bother me. I'm here to make fun of anything I can. I think you can make anything funny, or I attempt to, at least.

Looking back on your own experiences, what would you tell people newly diagnosed with diabetes?

For me, at the end of the day, I think there has to be some sort of concerted effort to have younger people—not children, but young adults who have type 2 who haven't felt the effects yet—where you connect them with older adults who ignored it, who didn't take care of it because they didn't think it was important, and then you see all of the negative results. Just put the seriousness of it to people. That's what I wish I would have thought about at 22, 23.

Have you ever had an interaction with a diabetic audience member?

Nah. I get some correspondence from people and they'll say, "Hey, man, I got it, too, and you make me feel a little better about having it," things like that. Because I think my approach to thinking about diabetes is basically the same mind-set as anybody else with it: I don't frivolize it, I don't marginalize it, but I do put the humor into it, and that helps people feel a little better about it.

Look, it's not like I'm the Martin Luther King of diabetes. I don't try to make a profound statement about any of it—I just joke about it, talk about it, and live it, and I think people feel that I'm authentic. I think they feel, in the way that I approach it, they know that I have it, that I think about it, that I'm taking it seriously. I'm not trying to make it a real profound, standing-on-top-of-a-pulpit kind of thing, but they know that I have a truthful ethic about it, and I think they relate to that. I'm really not trying to push people—I'm just trying to be honest about my experiences, and maybe make some people laugh, along the way.

Thank you, Patrice O'Neal, for sharing your thoughts, making us laugh, and for being authentic. We think your words are a very profound statement, indeed. You will be missed.

—The Editors