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Around time of diagnosis

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Around time of diagnosis Francis Andrews, 2004
 
 
Interview 8 Francis Andrews

Person with diabetes
Born in Cheltenham in 1931.
Diagnosed Type 1 in Cheltenham in 1939


Overview: Dr. the Rev. Francis Andrews was diagnosed with diabetes on the day that war was declared in September 1939. He was the son of a doctor who`d worked as a medical officer in Flanders during the First World War. Francis also trained to be a doctor, and eventually became a consultant physician in rheumatology, having been advised not to specialise in diabetes. He married and has 6 children, 15 grandchildren and 1 great-grandchild, none of whom have diabetes. He took early retirement to train as a Catholic priest, and was ordained in 1994.

Please note that Overview relates to date of recording Thursday, May 27, 2004

 Short samples

1 His father read “The Diabetic Life” by RD Lawrence, (co-founder of the British Diabetes Association, now Diabetes UK). Later, in the 1950s, Francis was introduced to Lawrence by one of his assistants at King`s, Wilfred Oakley [ 59 secs ]

2 A conversation with Wilfred Oakley caused Francis to reflect on what life was like for poor people in the days before the National Health Service was created in 1948 [ 58 secs ]

 
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01 Born ’31. Mother teacher. Father doctor & medical officer in World War 1.
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02 Afterwards, father treated shell-shocked patients, then GP in Cheltenham. He continued in private practice after NHS started in 48 because ill.
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03 No diabetes in family, but father had glycosuria episode after WW1 injury.
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04 I was diagnosed ’39, after whooping cough. Became ill while with grandparents. Father didn’t realise, & took me on holiday.
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05 Stayed in Wales, September ’39. Germany invaded Poland. Father drove back to Cheltenham. I was in pre-coma & brother carried me to Cheltenham General Hospital Under care of Dr. Haslett – took blood. Insulin made me dramatically better.
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06 Admitted on day war declared. 2nd blood sugar test – enormous needle. (Didn’t have another blood sugar test until 18.) Urine tests 2 or 3 times a day. Stabilised on soluble insulin. End Sept, changed to protamine zinc. Hypos, so changed to combination of soluble & protamine zinc.
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07 No training in injections. Parents did them until 13 or 14. Not taught much re diabetes. At school, games masters careful. Mother did urine tests until 13 or 14. Also when 13 or 14, changed to globin.
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08 Changed to globin shortly after introduced. Before that, used to pass out. Father gave intravenous glucose – blunt needles.
Diet not much different from family diet. In war, diabetics swapped sugar rations..
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09 …for cheese, maybe eggs.
I was day boy at boarding school. Matron & masters sympathetic. Cycled home for lunch at prep school…
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10 …& senior school. Hated games, but masters protective. Pupils accepting.
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11 Accepting atmosphere, but school couldn’t cope with another diabetic, because he was unstable.
Others noticed onset of hypos before I did.
At medical school, Alan Kekwick changed me from soluble globin to twice-daily soluble – then tingling tongue warned of hypo.
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12 Got scholarship to Middlesex Hospital medical school. Sir Harold Boldero sorry for me. In digs. Played team sports. No problems until glandular fever in…
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13 ...1950. Treated in own hospital by Prof. Kekwick. Senior registrar, John Friend, taught me more re diabetes, & helped me realise prognosis better than parents thought.
My father read RD Lawrence. After I qualified, I met Lawrence…
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14 Seemed less rigid than his books. Introduced to him by Wilfred Oakley. Father tried to keep me to Lawrence Line diet, but impossible: mother cooked for many taking refuge from bombing.
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15 Recovered from glandular fever & diabetes stabilised.
Before that, appendix out: didn’t affect diabetes.
Didn’t drink much as student.
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16 Ate in restaurant: quicker than canteen.
Landlady didn’t weigh food, but I was careful. Urine test twice daily & adjusted soluble insulin. Never obsessive.
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17 Qualified 1954. Ex-servicemen got jobs. I moved to Cheltenham General. Not well supervised, e.g. when giving anaesthetic.
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18 Busy with emergencies. Visited poor in Cheltenham with consultant, George Dorling.
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19 Long hours. Other house surgeon and I worked alternate weekends. I’d just married. No trouble managing diabetes thanks to colleagues & glucose.
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20 After marriage, house in Cricklewood. Went to church next to Catholic hospital. Heard re job as house physician through church & applied.
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21 Was only Catholic on junior staff.
Wilfred Oakley discouraged me from specialising in diabetes like RD Lawrence.
Professor Scarfe advised against pathology.
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22 Got job at Seaman’s Hospital, Greenwich, suggested by Alec Wingfield.
Then went to Willesden General as registrar.
Wingfield got me job as registrar at Middlesex & at Arthur Stanley Institute for Rheumatic Disease. Decided to become rheumatologist.
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23 The Lord pushed me into it. I loved it.
Before that, no major changes in diabetes, though got infections.
No regular check-ups for diabetes. Wingfield ran diabetic clinic at Seaman’s Hospital & Willesden. I talked to newly-diagnosed diabetics. I was good at doing blood sugars for patients.
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24 Went to Arthur Stanley c.1960 for c. 2 years. Worked for Oswald Savage, Tony Boyle & Kenneth Stone.
Then went to rheumatism research centre at Stoke Mandeville under Alan Hill.
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25 Moved to Reading, 1966, as Consultant Physician in Rheumatology. Also worked as Tutor in Medicine.
Took early retirement in ’91 & trained for priesthood. Ordained ‘94.
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26 Always determined that diabetes shouldn’t rule life. Helped by wife, who was nurse.
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27 Trained for ordination for 3 years in Birmingham.
At end of 1st year, diabetes went unstable.
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28 Urgent admission to Radcliffe, Oxford. No cause found. Changed to human insulin. Lost warning of hypo.
Had cataracts removed in Reading.
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29 After removal, scintillation in front of eyes warned of hypo.
Eye checks at Royal Berks, about every 6 months.
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30 When came to Reading, cared for by GP, Tom Stewart, friend from London, who set up one of 1st diabetic clinics in general practice round here.
Since went to Radcliffe, cared for there, every 3 to 6 months – more recently 6 months. Clinic has moved to Churchill. Dr. Levy’s clinic. Changed to pen & 4 times daily injections – convenient…
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31 …around1996. Recently suggested I change night-time insulin, but didn’t want to, while caring for wife. Still on human Insulatard.
Go to chiropodists at Henley – some problems. Reading health service no longer provides insoles!
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32 Feet also examined at Oxford clinic, eyes at Reading.
Health service has improved for rheumatics.
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33 Hip replacements became too popular.
Creation of NHS in’48 meant no longer had to pay for insulin.
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34 Doctor from Ceylon said could only afford insulin every other day.
Wilfred Oakley saw more complications among poor.
Not impressed by recent changes in care for rheumatics. As for diabetes…
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35 Oxford clinic runs well. In-patient care not so good – high turnover, little time to teach new diabetics.
My wife’s nursing care hasn’t been good.
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36 At Oxford clinic, used to be seen by inexperienced doctors. No good system of problem-orientated record-keeping. Told Dr. Levy. Now I see senior person.
Junior staff not interested in…
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37 …continuity of care. They don’t work such long hours as we did, so miss continuity. Have seen it in wife’s care. Lady in next bed to wife in pain…
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38 …didn’t get pain-killer until next day.
Haven’t noticed changes in attitudes to diabetes. Once met someone who thought he couldn’t work because diabetic.
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39 Advice: don’t let disease rule. If you test 4 times a day, after stabilisation, then disease rules you. I test 3 or 4 times a week.
On typical day, I get up early for morning prayer…
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40 …come home for breakfast & insulin, go visiting, varied activities in afternoon, home by 6, evening with wife. Insulin before meals & at bedtime. I walk. Gave up bicycling because of angina.
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41 In ’54, difficult to get life insurance – less so now. When retired, hard to get travel insurance, but…
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42 easy with SAGA.
Diabetes hasn’t affected family life.
6 children, 15 grandchildren, 1 great-grandchild. None have diabetes, even though father-in-law developed type 2.
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