But perhaps you can help me with a question which affects me personally. I shall be going from San Francisco to Orlando the beginning of next month and haven't ridden Amtrak in years, and I am a Type 1 diabetic. This means that I shall by carrying insulin and syringes. What security measures does Amtrak have for this? I want to keep the fact that I have these medical items with me as quiet as possible because there are no sleeping rooms available for me so I have no way of locking these things up. Can I count on Amtrak to be discreet?
Amtrak doesn't have security in the same way airports do. Luggage and carry-ons are rarely searched. If your insulin needs to be refrigerated, then I recommend a small icebox, like one of those 6-pack sizes sold for lunchboxes. You could put a small padlock through the zipper although I don't think it is really an issue. You could put the bulk of your syringes someplace inconvenient, like the bottom of your carry-on, and just have a day's worth handy. Whatever you usually do when you go out is probably fine.
You might want to make your reservation by phone or in person (as opposed to by online) and mention your disability. They'll make a note on the manifest your car attendant will see, which could be helpful. They might also give you a discount (Some diabetics get discounts, some don't, I have no idea of the criteria.).
My mother's Type 2 diabetes was controlled partly by meds, partly by diet and exercise, and partly by insulin. The food on Amtrak, even food that I thought would be OK, made her blood sugar go haywire. You might want to carry an adequate supply of something in case the cafe or diner doesn't have anything you can eat. Amtrak can arrange some special menus with advance notice, see
here.