This was the article published in PULSE magazine dated 9th September 2000. This is the unedited version, there being around 200 words cut in Pulse....



It's hard to remember a time when 1 wasn't diabetic. I have the odd flashback to eating toffees from well-meaning relatives and Easter eggs with gay abandon, but as childhood memories go, they are all eclipsed by the memories that followed when I reached five and three quarters as 1 remember telling the nice doctor at the time; I was suitably impressed when he actually clearly wrote with his thick tipped fountain pen the 5 and then the fraction after it.

This was 1976 and pre-dated the days when parents could stay with their children on the wards and 1 remember the nurses being overly nice to me as my parents crept away on the first day of my stay. However, those childhood attachments were still strong and 1 made sure my distress was heard as I banged on the window screaming as Mum & Dad's white car pulled away.

The memories after that blend into a nightmare that seems at times all too vivid. The visits to the path lab to have someone in a white coat stab me in the thumbs, the endless butterfly needles stuck into the backs of my hands and, of course, the daily needles jabbed into my arms and legs for no apparent reason. Even at that age I tried to manipulate my Dad as both parents had to be trained to give me my insulin. "Don't do it, Dad, don't do it!" I remember screaming at my poor Father, shaking and sweating as he took hold of my plump little arm and did the deed he knew he had to do. Cruel to be kind I guess but try telling that to a 6 year old. Oh, and then there was the "diabetic diet" I was forced to endure. Whilst all the other kids had apple pie and custard, what did I get? A stewed cooking apple. Euurgh! It had to be eaten, of course; the sour tartness tingled in my mouth as I cried myself to sleep for our ritual afternoon nap. 1 can still taste it today.

Then there were the endless requests for urine samples. Many was the time 1 would be presented with a recepticle and forced to micturate whilst anxious parents and nursing staff looked on; God only knows what effects on later life that Freud would have ascribed to this ritual but 1 am sure it had an impact - even now I can't pee in a public loo if others are around.

It was on one occasion when some hapless junior doctors came around to take blood from me that was the turning point for me. As they probed my ante-cubital fossa for a well hidden vein, something clicked into place in my mind. It was like the proverbial light bulb appearing over my head; "If I was the doctor then it would be me doing this to others rather than having it done to me." OK, the logic was fundamentally flawed but hey, it made perfect sense at the time. I guess it has a lot to answer for.

I spent the rest of my childhood being "different" to the other kids. I soon learnt to manipulate the situation to my advantage ; the primary school teachers would look terrified if I suggested I was feeling "funny" and it would often result in a supply of chocolates or sweeties being supplied as well as gaining their undivided attention over and above the other kids.

For some strange reason 1 was made to feel even more different from the rest of my family by the fact that I had a high IQ apparently. My Dad told me this was a gift to make up for the fact that I was diabetic but frankly, I think I would have preferred to be just ordinary.

Well, the upshot of the psychological scarring and the higher than average intellect (ho ho) was that I achieved a scholarship to a posh public school and from there went onto medical school.

A recent article I read in the BMJ suggested that children diagnosed with type 1 diabetes mellitus go on to have a higher incidence of psychological disorders as an adult. No doubt those who know me best will confirm this, but the upshot was that after doing house jobs I was drawn to a career in psychiatry which I stuck for 2 years before having enough insight to see that 1 did not wish to end up like any of the consultants I worked for. Thus, I decided to become the proper doctor I had always envisaged becoming since childhood and completed my general practice training.

Hospital training is not the most conducive environment to good diabetic control I have to say. The hours play havoc with any semblance of regular diet and the food available tends to be chocolate or crisps from a vending machine. Needless to say, my HbA1c during my hospital years was somewhat embarrassing for one who now lectures to overweight smokers in the practice diabetic clinic about the importance of tight control. Interestingly enough, it was not so much the punishing on calls all weekend involved in jobs like working on SCBU or on labour ward, but worst was the shift work of A&E. I have great sympathy and respect for anyone who is on insulin who works irregular shift patterns. I only did it for 6 months but lost a stone in weight through running my blood sugars high; a hypo would mean letting down the department or turning up late, which was frowned upon of course. The old adage of doctors not being allowed to be ill rings all too true I'm afraid.

The advantage of general practice has been fairly regular hours. OK, I do the odd session on the local rota but I don't have to work nights any longer.

The disadvantage being diabetic is that I am automatically "the diabetic expert" (literally suppose). I was instantly made the lead for the practice when I joined 8 months ago despite knowing little more than my colleagues about the management of type 2 diabetes. I hope this situation has now changed after having read with some concern all the key texts, the latest UKPDS results and attending any meetings that had the words "diabetes" and "PGEA" in the title. It was somewhat disconcerting to learn that 50% of diabetics are dead after 20 years diagnosed, when one has had the condition 24 years this year. I also find myself becoming almost hypochondriacal about things such as my blood pressure, having read all the data on mortality. I guess a lot of it boils down to my impending "maturity" as I approach the big three-o. Or is it perhaps my concerns of at least being able to see my children grow up. I pity my own GP who smiles sweetly as I nervously sit down with my own agenda and what new drugs 1 would like to try out. If she's reading this 1 would like to publicly thank her for her patience. Thanks, Anne.

Today I saw a 4 and a half year old little girl of a new patient. She had just been diagnosed as diabetic too. I shudder to think of what she has to face and I can only hope that she has an easier childhood than myself what with there being more enlightened views on paediatric wards these days. I do sometimes wander if we appreciate the long term scars that children with chronic illnesses bear through to adulthood and beyond.

Learning points

Allowing parents to stay with children in hospital seems a good idea.

Children do actually remember when they undergo traumatic medical procedures - hopefully they forgive in later life but it is not too surprising that this leaves psychological sequelae.

This also applies to allowing children a degree of privacy – too often, as adults, we forget to value this particular childhood right thinking that the child will “forget it all”.

Kids with chronic disease become extremely adept at manipulating the fears of adults.

It seems wrong to make a big deal of a child with a chronic illness and thus make them feel even more different to other kids – parents should try to act normally and not spoil the ill child as this could lead to problems later in life.

Having a chronic illness does not make one an automatic expert in the field.

There is still a culture of bravado and machismo in medicine, which says that a doctor should not become ill.


H. Drury, 24/04/2000


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