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| 01 Born Florence 1935. Father Jewish from Poland - professor of organic chemistry. Racial laws introduced 1938 – came to England. | |
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| 02 Bombed in London. Father interned, Isle of Man. Moved to Manchester. Father’s family perished. Bury Girls’ Grammar School. Place to do Medicine at St. Hilda’s. | |
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| 03 Oxford training excellent - Le Gros Clark, Alice Stewart, Honor Smith, George Pickering, David Pyke, Harold Ellis, Sam Corrie. Met husband on clinical course - 2 women & 6 men admitted to Radcliffe Medical School, 1958. Hands-on medicine. | |
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| 04 During pre-clinical, diabetes part of biochemistry – Hans Krebs. Realised impact of diabetes when started clinical. Insulin & diet – don’t remember tablets. Didn’t talk re Type & Type 2. Patients felt they’d eaten too much sugar & carbohydrate – cut out. Some admitted for months – stayed in bed. | |
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05 Dr. Cook specialised in diabetes – did locum with him. Glucose monitored by venous blood samples. Patients did urine testing.
Emphasis on connection between lifestyle & obesity. | |
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| 06 Patients not told much – relative told. Patients didn’t ask questions. Some doctors told truth brutally. Diabetes patients told re short-term effects, but not long-term – perhaps not fully realised. | |
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| 07 Radcliffe wards long. No privacy – shouted questions in deaf patients’ ear trumpets! Sister ruled ward. Grand ward rounds – talked re patients in front of them, ignoring them. | |
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08 Patients wheeled into lecture demonstrations before 50 to 60 people.
Outpatients crowded & chaotic. Patients complained - saw different person each time. | |
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09 After training, did surgical house job – worked night & following day.
Appalling living conditions. Disapproval of married housemen like us. | |
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| 10 Married 1960. 1st child 1961. Moved to Southampton for husband’s house jobs. Moved to Mill Hill – 2 more children. No part-time medicine – I wasn’t fully registered. Did marriage guidance for 10 years – counselling techniques proved useful. | |
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| 11 Moved to Hedingham, Essex. Got job at Broomfield Hospital – huge changes after 10 years. | |
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| 12 After gap 1962-72 (in fact longer), no difficulty in taking history or physical examination – well-trained. But treatment different – short hospital stays. Better for diabetics to be stabilised in normal conditions. Blood testing replaced urine testing. | |
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| 13 Gap in fact 1961-74 – crucial years. Danger of deep vein thrombosis known – patients kept on move. Diabetic stabilisation more realistic. Diet moving to wider range of food. | |
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| 14 More education for diabetics – more involved in own management. They told us re new developments – learnt from Diabetic Assoc. Got own practice, 1978. We appointed DSN around 1987 | |
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| 15 Partnership with Dr.Veater – patients told me about him & didn’t want changes from his treatment. He predicted how long they’d be ill. They preferred his illegible handwriting to mine! | |
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| 16 Rural dispensing practice. Small building. Dispensing important – close involvement. Fridge for insulin. Disposable needles. | |
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| 17 General hospital 20 miles away. Had emergency kits – large glucose vials & huge syringes for hypos, intravenous drip for comas. | |
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| 18 We treated emergencies, 24 hours on call. Diabetics’ routine checks at hospital – not always diabetologist, but general physician with special interest. HbA1c introduced. Diabetics came to us with other problems. We cared for pregnant diabetics. | |
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| 19 Shift from hospital to GPs in 1980s. Our patients had far to travel to hospital, poor transport. Dispensing meant we were close to diabetics. More diabetes – hospital couldn’t cope. Others became involved in our team – local ophthalmologist, district nurse, practice DSN. Chiropodists began to work in practices, late 1980s. New 1990 contract encouraged us to do more. | |
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| 20 Transferred diabetic register to computer. Husband devised user-friendly checklist. | |
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| 21 Hospitals were bad at informing us re their admissions & prescriptions. | |
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| 22 Some elderly diabetics didn’t come to surgery. Much home-visiting. One man well-controlled without complications into his nineties. Another very brittle, despite being conscientious, lost sight – but lived to late seventies. | |
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| 23 One well-educated lady denied condition & lost leg. One teenage girl didn’t want to follow diabetic regime & had complications. | |
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24 Another adolescent girl chaotic, but eventually took responsibility. Patients often don’t take advice. Usually come round. Sometimes a bit late for diabetics.
Diabetes diagnosed after recurrent thrush or large baby or child’s sickness & diarrhoea. | |
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| 25 We started fund-holding in 1990s. Appointed fund manager for several practices – opportunity to share experience. Gave us financial control over hospital care. | |
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| 26 We chose which hospitals best. Got quick appointments for difficult cases. Hotline to diabetologist’s DSN. Diabetologist set up district register – research tool. | |
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| 27 Rural dispensing safe & instant. Dispensers spot problems. Doctor on hand to answer queries. Deliveries for remote patients. | |
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| 28 Training of dispensers important. Dispensing under threat from wholesalers & government changes – I work to safeguard it with Dispensing Doctors’ Assoc. With diabetes, government pressure to keep down costs. | |
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| 29 Diabetes was regarded as metabolic – now increasingly seen as cardiovascular. Huge increase in numbers. Better outlook for patients, if resources mustered. | |
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-t.jpg "At St Hilda`s College, Oxford, 1956 (front, 3rd from right)")
-t.jpg "At Radcliffe Infirmary, 1958 (Irene front right, Prof Pickering front centre, future husband Douglas, back left)")
