(1) Tell me about your background.

I come from Singapore - was born in Singapore in 1942, February.  My father‘s father is Scottish; my father‘s mother is Japanese.  My mother‘s father has got Annamite blood as well as Scottish blood, and my mother‘s mother has got Scottish, Italian and French blood, so I‘m quite a mixture.

And what did your parents do for a living?

My mother was born in Bangkok and came to Singapore to further her education, and she was, what was known then as, a stenographer with Nestle‘s.  My father was a Deputy Head Health Inspector.  And they got married in 1941, April, and I was born the following year, February, five days before Singapore fell.

(2) It was the invasion of the Japanese, inland from Malaysia into Singapore, and Singapore fell then on the fifteenth of February and the British were victorious. (Slip – meant to say Japanese were victorious.)

Would you say that your family was fairly well off?

Yes, my parents were middle class, and we lived with my father‘s mother.  She was widowed.  She lost her husband when my father - he‘s one of five, and he‘s the eldest - he was eleven years old when he lost his father.  And his grandparents - his father‘s mother and father - moved out to Singapore.  His grandfather was - they came from Scotland - his grandfather was an architect, and his grandmother became headmistress of one of the schools in Pinang; that‘s an island off west coast of Malaysia.  His mother and family emigrated from Tokyo, Japan, to Singapore, and my father‘s one of five, and they all did well.  Met my mother, got married, and, as I said, my mother came to Singapore to further her education.  It so happened, because my grandmother was Japanese, they were saved from being slaughtered by the Japs, because I was very blond when I was born, and my grandmother‘s older sister lived with them as well and she was traditional Japanese - always dressed in a kimono, spoke very, very little English; mainly Japanese and a bit of Malay.  And my father‘s youngest brother used to work for the Cable & Wireless, and he did all the coding during the wartimes, and used to pass on all the messages of where the Japanese and all were - more or less like a spy.  And the Japanese got to hear about it, and they came to the house - the Kempetai; they‘re the worst of the Japanese lot.  And came to the house one day and asked where my uncle was, and they said "no" he wasn‘t in.  And they were just rounding up the whole family when Oba-san - that‘s my grandmother‘s oldest sister - came to the door.  And they saw her in her kimono, and they just bowed down to her and said in Japanese "we didn‘t know that you were Japanese here", and Oba-san said "yes, this is all my family".  And they left them then in peace, and they didn‘t round them up to take them to the concentration camp.  We had servants: one to do all the cooking, marketing, housework, and another one to do the washing and ironing.  And, at the age of two, I contacted dysentery, and my father thinks that my diabetes stemmed from this, but who‘s to know - we don‘t know, yeah?  Yeah, that was the only time that I really got very ill when I was little.

And what other early memories do you have?

I think I must have been about three or four years old when all the Japanese subjects were sent to the concentration camps (She says she meant to say prisoner-of-war camps) in Jurong; that‘s in Singapore.  And I remember going there to visit my grandmother, her older sister and her two younger sisters, because they were all Japanese subjects.  And they lived in sort of wooden huts on stilts, out in this area in Jurong.

And this camp would have been run by the British?

Yeah, this was the British Head set this camp up.

(3) And did you have any brothers and sisters?

Yes, I‘ve got a sister who was four years younger than me, and a brother who‘s six years younger than me.  My sister is now resident in Scotland, just outside Edinburgh.  She‘s married with two siblings - two children, sorry - and my brother‘s in Australia with a daughter, and he‘s happily settled out there in Brisbane.

And how were you educated?

I was sent to the - my aunt was a Roman Catholic, my mother‘s older sister - and schooling was very important out in Singapore, and so my mother asked my aunt if she could approach the nuns.  And I was accepted and started in the kindergarten at the Convent of the Holy Infant Jesus in Singapore at the age of, I think I must have been six - five or six years old - I can‘t recall it, yeah.  And I went right through till I did O Levels, yeah, at the age of sixteen.

Were they called O Levels?

Yes, O Levels at that time!  Overseas Education something - I can‘t remember what it was, yeah, but no GCSEs those days, yeah.

What O Levels did you do?

Oh, I did seven: Maths, English Literature - oh, I can‘t remember - Religious Studies, Geography, History, but I know I did seven - Art.  Can‘t think what the other one was.  I passed in all of them; did well.

And at what stage were you diagnosed with diabetes?

It was when I was twelve years old.  Prior to that, I was losing a lot of weight, and nobody could understand why, because I had a good appetite.  And even my spine tended to tilt towards the right side, and my parents noticed it, and they said probably because carrying the heavy school bag with all the text books and all in it.  And they told me to use my left hand instead, but made no difference at all - my spine was still tilting towards the right side.  And my aunt, who was the sister in charge of the school section - because she was a nurse - she was quite worried as well, and took me down to the clinic.

(4) This was a clinic for all school children, and my aunt worked there and took me down to see the doctor.  And he couldn‘t really think what it was that was causing it, so he referred me for physiotherapy at the Singapore General Hospital.  And, oh deary me, the exercises they gave me really traumatised me.  I had to climb bars, swing on bars - I felt like a blooming monkey - but made no difference.  Anyway, I used to drink a lot and spend a lot of pennies, and at home they discovered that there were ants around the toilet.  And they couldn‘t understand where these ants were coming from, and so my father decided to take specimens of urine from all the grown-ups.  I had my mother‘s mother and father living with us, and my mother‘s younger sister as well, because it was a four bedroom house, and we managed it all right comfortably.  Servants‘ quarters were an extension of the house.  Anyway, they all had their urine tested, all came back clear, but they never thought of taking urine specimens from my brother, sister or myself.  And so, diabetes was not diagnosed at all until April 1954.  I remember going to a relative‘s wedding, and I had a really good time, but I drank so much pop, because I was that thirsty.  That evening, we came home after the wedding do and I started getting ill.  And late in the night, my father realised that my breathing was getting very, very laboured, and so my mother was worried as well.  My father - I can remember this very clearly - my father felt my pulse, and he told my mother "hospital", and my mother said "what about sending for the doctor?", my Pop said "no, hospital".  And he carried me out of the house into the car, and he just flew down the road, because we were living in Newton and it was a drive to the Singapore General Hospital.  Red lights, the lot - he just went flying through it.  They got me - I can remember this very clearly - got me to the General Hospital.  I was still conscious, but breathing with great difficulty.  And they admitted me, and the last recollection is just being on the trolley going down these corridors, and then nothing after that - don‘t remember anything, except coming round in the hospital bed with a drip up.  And it was then that it was diagnosed I had diabetes.  I was very lucky, because I was admitted with pneumonia, but it was a German doctor, who was married to a British Squadron Leader stationed out in Singapore.  Because she didn‘t have a British qualification, Singapore government required her to do her housemanship again, and so she was on night duty that night when I was admitted.  They put me up onto intravenous antibiotics and all.  She couldn‘t understand why I was still comatose, and, as a last resort, she told one of the nurses "catheterise her and test her urine", and they found out then.  My sugar levels were out of the window, I was ketotic as well, and that was when they started me on to insulin.

(5) Why do you think people were so slow to realise that you‘d got diabetes?

It was unheard of for children to suffer from diabetes in those days, and they were quite shocked when it was diagnosed.  And when - the doctor said afterwards - when they looked back on previous cases of children dying, they died from secondary diseases, caused by the diabetes.  And I found out later that there was another youngster who was admitted the same night that I was admitted, but she was under a different consultant.  And the doctor she was under didn‘t bother to look further, as regards catheterising her also, and sadly she passed away.  Yeah, so I was very, very fortunate.

How long were you in hospital?

I was in hospital for quite a long while.  And they had to stabilise me, they had to work out my diet, and in those days your diets were all weighed on portions and whatnot.  And I had to learn to inject myself, and they started me off with an orange, but oh deary me, after two tries I said "forget it, I‘ll do it on my own self", and from then on I‘ve been injecting myself.  In those days you injected either in your thighs or in your arms, so I used to do the thighs, but my Pop used to help me with my arms to give me a break - you know, alternating, yeah?

Can you remember what insulin and how often?

Oh, I can‘t.  I‘m very sorry; it‘s so far back - I was twelve years old!

What about testing for sugar levels?

Oh, no such thing as finger pricks then.  You had to have, I can‘t quite recall how many drops of urine to how much water in a test-tube, and then with this solution you had to pour into it - I can‘t remember what it‘s called - and then what you call it over a gas flame.  Oh, what fun and games.

What was it like for you to do that, aged twelve?

Well, it was strange at first, but I knew I had to do it, otherwise I‘d be none the wiser, and just plodded on and got on with it.  But from my case, the doctors then were on the lookout for any young ones, patient-wise, who came in with signs and symptoms.  So, they were the lucky ones after that, so if they did have diabetes, they would have been discovered earlier.  But my aunt and the doctor from the children‘s… the clinic, they never forgave themselves to think that they‘d overlooked it, but it was unthought-of that children had diabetes at that young age then, yeah.

How did you find changing your diet?

Didn‘t bother me really, because my main diet was rice or noodles, and as long as I had the correct amount, it was okay.  And we ate a lot of fish and vegetables and fruits, and it was all right.

Had you eaten many sweet things before that?

Yes, after a fashion, because a lot of the desserts out there, they were sweet.  But they didn‘t bother me, I just went onto fresh fruits - a lot of fresh fruits out in Singapore -and I enjoyed that.

Can you remember how people reacted to your having diabetes when you came out of hospital?

Oh, they were shocked.  And I‘d lost so much weight, and once I‘d been diagnosed and treated, oh, I put on weight - you should see my face was like a watermelon!

And did your spine straighten up?

Yes, strangely enough my spine corrected - the curvature of my spine corrected itself.  And I was always laughing, and my father said "oh, god, they didn‘t give you oxygen, they gave you laughing gas"!

(6) And what was it like when you went back to your convent school?

Oh, it was all right.  My friends were very understanding.  They‘d been told what to look out for, as regards hypos and all that, and they were very supportative and very helpful.  But, of course, certain food things that I used to enjoy before, but I had to abstain from then, and they were always on the lookout to make sure that I didn‘t overstep the mark.  I was very fortunate; I had very, very good school friends.  And up to today - although I‘ve got one who‘s in Bournemouth, emigrated here, married to an Englishman - but the others are still back in Singapore, and we still keep in contact, yeah.

Did you have to do any injections or testing of sugar levels during school hours?

No.  If I remember correctly, I injected - could have been, but I can‘t quite recall - morning and evening, and I did my urine testing then, morning and evening.  But I participated in all forms of sports, like netball, and when it came to school races and whatnot, participated in relays and all.  Led a very healthy life in that respect; I didn‘t hold back on anything.  And during holidays, there used to be a group of us - very, very close friends up to today - used to go out.  Used to hire a lorry, and we used to go out, down to the harbour, and then catch a boat and go out to one of the islands and picnic there for the day, or we used to go up to the coast.  And you used to really have a good time during holidays.  And one of our friends, her family had a bungalow up in Serimbun; that‘s the north coast of Singapore, overlooking the Straits of Johor.  When we used to go up there, and stay there probably a week or two weeks, and we used to cook for ourselves and used to swim, and really have a really good time.

And how did you cope with your diabetes during those times?

Oh, I managed all right; no bother at all.  As I said, I always had the support of my friends, yeah, so I was very fortunate, in that they looked after me.  And strange enough to say, of all of them… one, two, three of them all took up nursing; the rest became school teachers, yeah.

Did your diabetes affect your choice of what to do when you left school?

Yes.  The kindness and the care that the nurses gave me when I was in hospital made me decide that I‘d like to do nursing.  And I completed my education in 1956?  I completed my education in 1958, and I wanted to do nursing.  And I applied to the Singapore General Hospital, but, because of my diabetes, they wouldn‘t accept me for fear that I wouldn‘t withstand the vigorous training, and so that went out of the window.  I was very, very upset.  So, I did one year of typing and shorthand, but I‘m not one to sit down for long.  I‘m on the go all the time, and it bored me... really made me tired, just sitting at the desk typing and doing shorthand.  So, I used to play truant, and I used to go and visit a friend instead of going to the YMCA in Orchard Road in  Singapore for my lessons.  And one day, the tutor - because my father was the first international referee for rugby in south east Asia - and he went to The Padang in Singapore and met Mr Menon, who used to take the lessons - typing and shorthand - at the YMCA.  And he said "I haven‘t seen your daughter for quite a while, is she not well?", and my Pop said "no, she goes every day", and he said "I‘ve not seen her".  So, when he came home that day, I got a good telling off, and I had to confess I‘d been to visit Rosie instead of going because I was bored silly!  God, I got a good telling off then.

(7) So, what did you do next?

My aunt had married an Englishman and had come back to England, and they were living in Bristol.  And she had been nursing in Singapore, and had come over here and started nursing at the Bristol General Hospital.  And my parents wrote to her to say was there a possibility that I could come over and do nursing in England, because Singapore Nursing School weren‘t willing to accept me because of my diabetes.  My aunt approached the matron, and she said "yes, there‘d be no trouble at all", but she would recommend me to go to Weston-super-Mare, which was a smaller hospital, so it would be easier for me.  And so I wrote to the matron of Weston-super-Mare General Hospital, and she sent me the application forms.  And I filled them in and sent them back to her, and she said "yes", I could come over.  And in June 1960, on the twenty third June 1960, at twenty-thirty hundred hours, I left home by air.  I stopped at Bangkok, in transit - met my two maternal uncles at Bangkok airport - and then I flew on to England, arriving at Heathrow on the twenty fourth of June.  And I was met then by my auntie, my uncle and my two cousins.  I settled into life in Bristol.  I went to Weston-super-Mare, met Matron Hindley, and she suggested that I start as a cadet in 1960, just to get used to the routine.  I enjoyed the summer with my aunt and family.  I found it a completely different way of life.  The food was different, but I remember very clearly the lovely mellow, warm evenings, right until eleven pm at night in the summers, then.  Oh, it was really delightful.  You could go out in the evenings just with a cardigan, and you really felt good.

Did you find it difficult to adjust to the diet as regarding your diabetes?

In a way, yes.  To a certain extent I missed my rice, and it was mainly potatoes.  But I adapted, and I‘m easy going where food is concerned, yeah.  I adapted, and my aunt was very good.  Being in the nursing profession, she knew exactly how much and what to give me, and that was it.

Because you said in the hospital that you were taught to think in portions.  Were you still thinking in portions by the time you came to England?

Oh, yes, those days, everything was in portions.  And things had to be weighed as well, as you count the carbohydrates, yeah?

(8) And when did you begin your training?

I moved on to Weston-super-Mare in September 1960.  I stayed in the preliminary training school house, and I had a room to myself.  I started as a cadet on the gynae ward and I thoroughly enjoyed it.  Early October, my room mate arrived from Lagos, Nigeria, and she was a very, very good room mate to me.  She was a mother of two children.  She‘d done her midwifery in Nigeria and come over to England to do her general nursing, and she looked on me as another sibling.  She was nearly thirty years of age and I was only eighteen then, and she was a great help to me, and she really mothered me.  We commenced our general training in October, and I went through my three years of training with no hassle, except during my first lot of night duty.  When you‘re on night duties you move to the night quarters, so that you‘re not disturbed, and I‘d just come off night duty and gone to bed.  And the cleaner didn‘t realise that, and she came into my bedroom and called out to me, because she thought I‘d overslept.  And when she found that there was no response, she felt me, and I was all cold and clammy, and she went running, screaming out of the room to the home matron to say that I was dead.  Anyway, home matron came along and realised then that I‘d gone into a hypo.  That was the first hypo I had - what do you call it - since leaving home.  I can‘t remember having hypos when I was at home.   And they transferred me to the nurses‘ sick bay and they brought me round.  I don‘t know what they gave me - I can‘t remember now.  Anyway, after forty eight hours, when they realised I was stabilised, they discharged me and I went back to the nurses‘ home.  And I happened to come out of my bedroom, and blow me down, this same domestic was in the corridor.  She took one look at me, screamed and yelled - she thought it was my apparition come back!  The poor soul nearly had a heart attack.

(9) And how did you manage your diabetes and your nursing routine?

In those days, my regime was quite strict.  My insulin was given at a certain time, and I had to eat - I had to have my breakfast at a certain time, lunch at a certain time, tea at a certain time, dinner at a certain time and supper at a certain time.  But the matron, Matron Hindley, was a very, very kind person, and she made sure that everybody realised I was diabetic and I had to stick to those times.  Even when I was on night duty, I reversed my day into nights, and I managed all right - I had no bother, except for just that hypo, yeah?  Even with the ‘flu.  I caught the ‘flu, and I was hospitalised for that because blood sugars went a little bit high, but I managed to - what you call it - maintain my insulin intake and my diet, and I was stabilised again and discharged.  During my general nursing, I spent six weeks on the John Milton ward in Southmead Hospital in Bristol on the paediatric ward, and that‘s when I came across the Thalidomide babies and nursed them, and that‘s when I decided that I wanted to do paediatric nursing.  I completed my general nursing in October ‘63, and matron very kindly put me on - oh, and meanwhile, I wanted to do a midwifery as well, because if I had gone home with only a general certificate in nursing, they wouldn‘t consider you a qualified nurse.  You had to have midwifery as well, in those days.  So, matron kindly put me on to the maternity ward to get an insight of what I was heading for, as I was going to do my midwifery course.  I worked on the maternity ward and on the pre and postnatal wards.  I thoroughly enjoyed it.  Then I left Weston-super-Mare and commenced my midwifery part one in February 1964 in Marston Green, North Birmingham.  Thoroughly enjoyed it.  Commenced my midwifery part two in September ‘64.  I spent three months in hospital on the antenatal and postnatal wards and clinics, and I started the district midwifery in December ‘64 with midwife Miss McMahon.  She was Irish and she was a dear old soul.  We walked most of the time or bussed it.

(10) And were you still intending to return to Singapore when you were fully trained?

Yes, I was intending to go back.  But after I completed my part one and two midwifery, I had applied to quite a few sick children‘s hospitals and Great Ormond Street accepted me, and I thought "right, that‘s the Mecca of children‘s nursing, I‘m not going to turn the offer down".  I wrote home to my parents, and they didn‘t reply to that particular letter, and I wrote home again the second time, and my father said that they wanted me home.  But meanwhile, a very good friend of the family, she was matron of the St Andrew‘s Children‘s Hospital in Singapore.  My father approached her - she did nursing with my aunt, you see, so a friend of the family - and asked her that what were the prospects of me with my… if I went on to do sick children‘s nursing.  And Auntie Molly - that‘s how we called her - turned round and said "let her do it".  She told my parents to let me do it, hoping that when I went home I‘d go and work at St Andrew‘s Sick Children‘s Hospital.  Anyway, I started my... I applied to Great Ormond Street, I was accepted, and I started my training there in May 1965.  I completed my training in June 1966, because it was a postgraduate course.  After my course in London, I decided that I wanted to move out of London, because I found it a very, very hectic life, and I was losing weight with all the comings and goings.  The theatre tickets we got free; we used to enjoy all that.  And a friend of mine, who did midwifery with me, came down to Great Ormond Street, did paediatrics with me, she came from Stourbridge and she was going home.  So, I applied at the Corbett Hospital in Stourbridge, and I got a post there.  I stayed there for a while, and then a post came up in the East Birmingham Hospital, which is now Heartlands Hospital, on the children‘s ward.  I applied for the post, and I got the sister‘s post there at the East Birmingham Hospital children‘s ward.  Whilst I was working there, I was introduced to my husband, got married, and left Birmingham prior to the birth of my son; my first born.  He was born in January 1969.

How did you meet your husband?

Oh, a friend introduced us, but meanwhile, I was being courted by one of the doctors in the hospital!  But that - what do you call it - I just don‘t know.  I decided to - what do you call it - not to break it off with the doctor, because he was very, very stingy, whereas my husband was more generous!

(11) What did your husband do for a living?

My husband opened the first Chinese restaurant in Great Malvern.  It was known as the Tai Wo, after his hometown back in mainland China, because my husband originates from China.  Went to Hong Kong to further his studies, he joined the police force, and then decided to come to England and got involved in the catering trade, yeah?

So, did you move to Malvern?

Yes, I got married in Malvern, but carried on nursing at East Birmingham Hospital.  And then I stopped just before my boy was born, because I found it very hard work.  I lived in the sisters‘ home, and could only come back to Malvern during my days off.  And it was difficult upping and to-ing and going, so I left, as I said, just before my son was born.

And how was your pregnancy from the point of view of your diabetes?

All went well with my pregnancy.  I had no bother at all diabetic-wise.  I had a good antenatal, but at thirty seven and a half weeks I had an elective lower section caesarean section done by the consultant, because, being diabetic, he didn‘t want me to go to full term.  And it was done under a general anaesthetic, and my boy was delivered, weighing in at six pounds ten and a half ounces, which was good, really.  All went well, and I breast-fed him, but three weeks postnataly I had a hypo and was rushed into hospital.  Stopped there for a while, re-stabilised and then discharged, and I was fine.

Any idea what caused the hypo?

I don‘t know, but they seemed to think - because with the Chinese, postnataly, they steam a lot of fresh chicken with wine, and they thought that maybe that could have caused it, but I‘m none the wise, really, yeah?  Probably hormonal and all that carry on, postnataly!

(12) Did you stay at home after the birth of your first child?

Yes, I stayed at home.  And when my boy was old enough, I got somebody - one of the staff‘s wives, who had a little girl who‘s a bit younger than my son - to look after him whilst I went back and helped out with the business.  And in 1971, my parents... no, sorry, before that, my son started nursery school, and that‘s when I had to learn to drive, so that I could take him to school in the morning.  And 1971, my mother and father - my father had retired then, because in Singapore they retire at the age of fifty five - they‘d been down to Australia to visit my son and his family, and then back to Singapore, and they came over here.  And my father loved England.  He loved Malvern in particular.  My mother didn‘t like it, because she missed the warmth of Singapore.  She didn‘t mind the summer, but come the winter, oh deary me, she didn‘t like the cold at all.  And 1973 I got pregnant, and in late August I was admitted to the antenatal ward with anaemia, because I kept fainting and my haemoglobin was very, very low.  So, Mr Chalmers, the consultant I was under, had me admitted in for rest.  And on the thirteenth of September ‘73, I went into premature labour, early hours of the morning, and my daughter was delivered at fourteen-oh-five hundred hours - I was then thirty five weeks gestation - by caesarean section, and she weighed in at eight and a half pounds.  She was a very good size, really, but of my diabetes - that is why she was that big.  She was breast-fed, and after two months I went back to work helping in the restaurant, and my parents helped look after both my son and the little girl.  1977, twenty ninth September at ten-ten hundred hours, I was delivered of my third child, a daughter, a caesarean section as well, weighing in at eight pounds eleven ounces.  She was thirty seven weeks gestation, breast-fed, and at same time I was sterilised, because I already had three babies by caesarean section, and that was more or less the limit.  And two months later I went back to help with the business.

And which hospital did you have your three children in?

They were all three born at Ronkswood Hospital in Worcester.

(13) Were there any changes in the treatment of your diabetes during this period?

In 1969 I was put onto Lente and Semilente insulin, and then in 1973 I was put onto protamine zinc insulin.  And in 1992, the human insulin was introduced, and then they put me onto the Human Actrapid and Monotard.

How did you get on with that?

Oh, not very good at all.  Having been on animal insulin ever since I started injections, it affected me quite a bit, because with the animal insulin I used to have warnings.  My vision would be affected first, I‘d have double vision, and I thought "right, something‘s not right, do a blood test", or, in the days gone by, do a urine test, and true enough, you‘d find that the urine used to come out blue - the test results were blue.  If I did a finger prick, you‘d find that the blood sugar level was low, but with the human insulin I had no warnings at all.  I love my gardening, and that was the worst time.  And I was told by Magda Livingstone, the diabetic specialist nurse, to take an extra portion before doing gardening.  I used to do that, but it made no difference.  My mother used to come out in the mid afternoon, when I was out in the garden, with a cup of tea and biscuits.  I used to take that - still made no difference.  I used to come in about five o‘clock in the evening, after about three hours out in the garden, eyes all glazed and with a big grin on my face - that was characteristic of me when I was going into a hypo.  And she used to say "sit down", and she used to go and quickly make me a sugar drink, and I‘d be all right then.  I asked - when I went back for a check-up - I asked at the diabetic clinic if I could go back to animal insulin, and they said "no", I should stay on the human insulin.  But I said I was, you know, no reactions, nothing; it would just suddenly hit me.  Before driving, I had to make sure I did a blood sugar to make sure that my blood sugar was within normal limits and not low, otherwise I was so afraid of getting caught out whilst behind the wheel.  And it wasn‘t till - I cannot remember when - but I went for the yearly check-up, and it was Dr Goh from Singapore, who‘d come over here for her training.  And she was doing her medical stint at Ronkswood, and I mentioned to her I was getting these hypos with no signs, no symptoms, if I could go back to the animal insulin.  And she said "no, no trouble at all", and from then on I went back to the porcine insulin.  And if there‘s any low blood sugars, I get exactly the same signs and symptoms.  My vision goes first, and then, if I‘m not quick enough to do anything, then my gait - I walk around like a drunk.  But I‘m fully aware of it, so I take precautions.  Always carry Dextrosol tablets with me and Hypostop wherever I go, so that there‘s something on hand, or biscuits as well, so that I‘ve got something ready, yeah?

And have you never gone back onto non-animal insulin?

Oh yes, October 2004.  Now, 19... no, 2003, I had a very bad year.  My mother had a stroke and was admitted to hospital.  Meanwhile, I‘d gone back to nursing, and I was doing two nights a week, first at Castle Street on Bates Surgical Ward, and then I went up to Ronkswood on Riverbank Ward.  Bates Surgical was Surgical ENT and orthopaedic; R3 was the medical ward.

(14) And I was doing well - no trouble at all, no hypos, nothing.  And - what do you call it - 2003, my mother fell ill.  Oh, yes, by then we‘d moved onto the new hospital: the Worcestershire Royal Hospital.  The whole hospitals had been accumulated and were stationed there then, and I used to do two nights a week.  My mother was admitted when I was on night duty, so I was going between the medical assessment unit that she was on and the ward that I was on.  And she recovered and she was discharged, but she couldn‘t go home and look after herself.  The consultant said that she‘d have to go to a residential home.  So, we went round - my sister came down from Scotland - we had a look around and she was found one, a good place, and she was admitted to the residential home.  But she only was there for two months, and I was getting ready one night to go on duty when I had a call from the home to say my mother wasn‘t well, could I come and see her.  So, I said "yes, let me finish my supper and I‘ll be along".  So, I had my dinner and grabbed all my things, stopped at the nursing home, and my mother wasn‘t very conscious then.  We think she‘d had a stroke.  So, I picked up her left hand - she was lying on her right lateral side - and I said "Ma", I said "if you can hear me, squeeze my hand".  She didn‘t squeeze my hand, she just waved her hand, and that was the last - she lapsed into a coma.  Meanwhile, they had rung the GP.  We were waiting for him to come, and he came and he said "your mother‘s not going to make it".  So, he arranged for an ambulance, and I had to follow the ambulance to the hospital.  Gosh, didn‘t he drive fast?  I couldn‘t keep up with them.  I thought "right, I‘d better take my time, because otherwise I‘ll be another casualty".  Yep, the blue light... because apparently she got worse when she was in the ambulance, so they had to put their feet down and just make a bolt for it.  She was admitted to A&E and then transferred to the medical assessment unit.  I stopped with her till midnight.  And the doctors were very good -they came and saw to her and did all the needful.  And then I thought "right", she seemed to be stabilised, and I said "I‘m going back on the ward", because I was on duty.  And meanwhile, I‘d rung the ward from home to say that my mother wasn‘t well, and they said "don‘t worry, you take your time.  If you‘re able to come on duty, you come on duty".  So, I went back on the ward after midnight, and I told the nurses on the MAU, yeah, to... that if my mother took a turn for the worse

(15) to give me a call.  I carried on working on the ward; it was the paediatric ward, Riverbank Ward, in the Worcester Royal Hospital.  And five o‘clock in the morning, whilst I was admitting a child, call came through to say that they wanted me up there.  So, one of my colleagues took over from me, and I ran up.  It‘s on a different floor - because we‘re on the basement, it‘s on the upper floors - I ran all the way up there, and the nurse told me that my mother had vomited coffee ground vomit, and wasn‘t a good sign at all.  So, I stayed with my Mum all through the night - what you call it - aspirating her as need be every time she had a vomit, and cleaning her up and rolling her from side to side and whatnot.  Early in the morning, one of the nurses from the children‘s ward came up to see me, very concerned about my breakfast and whatnot, so…  The ward staff were very good as well - they made sure I had my insulin, I had my breakfast and whatnot.  And the consultant came round that morning and said that there wasn‘t much they could do, and we said that if my mother was to go, "no resuscitation, let her go in peace", and she seemed to be listening.  Well, meanwhile, all night I‘d been ringing up my sister, and that morning I rang her up again, and I said didn‘t look good at all.  Rung my son up, who is in Amersham Common, and he said "mother", he said "I‘m coming up, I‘ll be there for twelve o‘clock".  I said "okay".  So, meanwhile, I thought "right, I‘ll go home and freshen myself up, and then come back and meet him".  So, I stopped at the nursing home, to let them know that my mother wasn‘t good at all.  I came home, and my husband met me at the door to say "the hospital has been ringing up looking for you", and I thought "oh, that‘s not good news".  So, I rang back the ward, and sister said my mother had passed away at twelve noon, and that was it.  So, I went back again to the hospital, because I was worried about my son, you see, finding my mother gone.  And I rang him up before I left home, and I said "where are you, Kwai Sin chai?", and he said "mother", he said "I‘m just arriving at the car park in the hospital".  So, I said "have you parked the car?".  He said "yes, I‘ve just parked the car", and I broke the news about my mother, and he just broke down.

(16) Now, with all this upset, to-ing and fro-ing to hospital visits and working and all that, my diabetes got a little bit out of hand, and blood sugars were a bit on the high side.  November, December 19... no, 2003 - hang on a moment - either November, December 2003, I went for my yearly check-up at the diabetic clinic, and Dr Jenkins found that my HbA1c was raised; I think it was thirteen-point-something.  Anyway, he was concerned about it, and he told me, in three months time, to go back to my GP and have another HbA1c to see how things were going.  So, that‘s what happened.  Thirteenth of April 2004 I had another HbA1c done, and the results were eleven-point-one.  Anyway, my own GP, Dr David Radley, was concerned, and he advised me to see the diabetic specialist nurse as regards advice on getting better blood sugar results.  I phoned the diabetic specialist nurse up, and I saw her at the Malvern Community Hospital, and she asked me where about I was injecting my insulin, and I told her the front of the abdominal area.  She looked at it, and she said - I had, you know, these pockets there - and she said probably what was happening was insulin was being retained and not dispersed evenly, so she advised me to inject my insulin on the sides of my abdomen.  And I did that, and remarkably my blood sugars just started dropping.  So, when I went back to see her, she was very interested.  She said "right", she said "the next time you have a meeting", she said "just mention that to them", she said "because it‘s, you know, worthwhile knowing about it".  I saw the diabetic specialist nurse again on the eighth of October, and as my blood sugars were improving she suggested that I start on to Glargine.  And I thought "well, give it a try", but I warned her - I asked her first - I said "is it human or animal insulin?", and she said it was human.  And I said "when I was last put onto human, I wasn‘t happy on it, because I had no signs or no symptoms; it just didn‘t seem to agree with me", but she said "give it a try".  So, on the eight of October 2004 I commenced on the Glargine.  I went to the diabetic clinic on the tenth of November, and… no, sorry, tenth of November I had my blood test done.  The results came back as my HbA1c six-point-nine per cent, cholesterol was four-point-three, liver, kidneys, creatin were all okay, and my blood pressure was a hundred and twenty over sixty.  And the sister at the diabetic clinic said "good god", she said "if my blood pressure was that low, I‘d be very happy!".  Anyway, on the twenty fifty of November 2004, I went for my check-up - saw Dr Jenkins.  He did an eye... a check-up on my eyes, he was very pleased as well, and he gave me a clean bill of health, and said "fine".  Anyway,

(17) I carried on with the Glargine before going to bed, ten o‘clock at night, because it was made clear to me that whatever time I started it on, I had to continue nightly at the same time.  But meanwhile, I had Porcine Neutral before breakfast, Porcine Neutral before lunch, Porcine Neutral before dinner, and then my Glargine every night at ten o‘clock at night.  And I carried on with Glargine until it came... I had a few hypos with it and with no warnings at all - suddenly it would come over me.  And my children were very concerned, and even my daughter-in-law, who‘s been nursing, commented about it.  She said "you‘ve never been like this before, you‘ve never had hypos.  How come?  Is it the new insulin that you‘ve been put on?".  I said "I don‘t know".  Anyway, I thought about it, but things got worse from the twelfth of January.  And it used to be early hours of the morning, between two thirty, three fifteen, three forty five, something like that, my blood sugars used to just drop down.  But on the twenty ninth of December - probably it‘s my own fault because I got up a bit late that morning - and I‘d had my breakfast and I‘d gone and done some laundry.  And I was pegging out the laundry, and I looked at the clock - I said "oh, good grief, it‘s nearly lunchtime", so I missed my mid-morning break, which I usually have.  And I thought "right, it soon be lunchtime, I‘ll go down and do the lunch".  And it was whilst I was hanging out my husband‘s shirt that I must have had a hypo, because the next thing I knew, I was on the floor with a very sore right ankle that was beginning to swell and get a bit bruised, and I thought to myself "oh, I feel a bit clammy".  So, picked myself up, went and did a blood sugar, true enough it was two-point-two, and then I knew that I‘d had a hypo.  But no warnings at all - just flaked out like that.  Anyway, I went to the A&E.  I came down, quickly had something to eat, and then I had my lunch afterwards, rang my husband up, who was out, and I went to the A&E.  And they x-rayed my foot, and they said "yes", I‘d fractured my right lateral malleolus, so I was put in a back-slab and asked to return the next day to have the back-slab removed and the plaster of Paris applied.  So, then I started getting very worried, because for a hypo to occur with no warnings, but I‘d been warned that I might have no awareness of hypos coming on, but never like this before.  But on the twelfth of January 2005, things started getting worse.  As I said, early hours of the morning, twelfth, thirteenth, fourteenth, right through to the eighteenth of January, I kept waking up.  So, I rang the diabetic centre up and spoke to the diabetic specialist nurse.

(18) I‘d left a message for the diabetic specialist nurse as regards my low blood sugars, but I had no return call made.  So, on the fifteenth, again, my blood sugar again was down, early hours of the morning.  I rang Primary Care and I had no help from them, so, in desperation, I rang Boots The Chemist up, who advised me to reduce my Porcine evening dose and my Glargine by another two units.  Meanwhile, I‘d been doing that myself, but with no effect - my blood sugars still kept going low early hours of the morning.  And sixteenth, I rung the Primary Care up again at eleven twenty in the morning.  They advised me again to reduce.  I said I had been reducing both the late evening Porcine Neutral and the Lantus before going to bed by two units.  Anyway, twelve noon on the sixteenth, I rang the diabetic clinic up and managed to speak to one of the diabetic specialist nurse, and she advised me to take eight units of Glargine before going to bed, and then six units of Glargine in the next morning before breakfast, plus my Porcine Neutral; just to give it a try.  Anyway, on the seventeenth, no good - blood sugars still low in the morning.  And on the eighteenth, she told me to start having my Glargine in the morning instead of at night, so that‘s what I did.  On the eighteenth I had my Glargine - fourteen units - in the morning, plus my Porcine, and early hours of the next morning, blood sugars were still low.  So, on the nineteenth, I rang up the diabetic centre again, and left a message as regards these low blood sugars, and I spoke to one of the other diabetic specialist nurse.  She couldn‘t give me much help, because she‘s not dealt with my case, but she said she‘d leave a message for the nurse who was looking after me.  Anyway, in the afternoon this particular nurse rang me up.  She was very, very cross with me, and she told me not to ring around people, and that I wasn‘t the only diabetic, she had other patients to look after, and I said I was fully aware of that.  And she told me that it wasn‘t often that she listened to her recording messages.  I thought to myself "well, why do you have a recording machine for, if you‘re not going to listen to the messages?".  Anyway, I told her why I was very concerned was because of the low blood sugars on so many mornings - nearly a week of it - and I realised, you know, the long-term consequences of it, but she was yelling down the phone at me.  I was very, very upset - I‘d never cried so much.  The last time I cried like that was when I lost my mother.  I was very, very upset about it.  Anyway, she said that she‘d ring me up... for me to ring her up after the weekend to let her know how I was, but I managed to persuade her for me to go back onto the animal insulin.  So, very reluctantly she said "okay", ‘cause I‘d already rung Boots up, and they said "yes", they did have the Porcine Isophane - they still had two lots in that was what was left over from my supply.  So, she said "you‘re sure it‘s up-to-date?", I said "yes, everything‘s been checked".  So - what you call it - I saw her on the twentieth.  I commenced on the Porcine Isophane - I had seven units in the morning and seven units at night.

And you‘ve been back on the Porcine insulin, then, for five days now.  How‘s it been?

It‘s been all right, thank you very much.  It ran a little bit high, the - what was it now, let me check my book - early morning before breakfast, it ran a bit high for the first two mornings, but it‘s levelled itself out now, and I‘m fine, thank you very much.  Yeah, so, I‘m happy to be back on my Porcine, both my Neutral and my Isophane, so I‘m just keeping fingers crossed.

(19) So, now we‘ve gone through the whole history of your insulin, were there any other changes in your treatment during the ‘80s and ‘90s?

Second of February 1994, Magda Livingstone introduced the NovoPen to me, and it was a blessing, because there was less things to dispose of and it was easier to apply, yeah?  I found that it was easier, because you could click the number of units you needed, whereas with the pen you had to have very keen eye… With the ordinary syringes you had a very keen eyesight – a sharp eyesight - to view the syringes, because they were quite small syringes, depending on the amount of insulin you use, but with the pen it was much easier.  And another thing is, we went onto the Clinitest tablets, if I remember correctly, whereby you put so many drops of wee in - I don‘t know whether you needed any water - and you put this tablet in, and it would fizzle away like mad in the test-tube for urine testing.  But once the glucose strips came into use, that was a big blessing.  It did away with all the testing of urine and whatnot, and managed it well, thank you.

And have you changed your diet at all over the years?

No, not really, because my main diet is rice, yeah?  Occasionally I have noodles, but it‘s usually the rice.  And I was told with the - oh, what‘s it called now - glycaemic index that basmati rice is the best for diabetics, but I don‘t like it; I find it very, very grainy.  I‘m used to the Thai fragrant rice, and I get by with that.  And bread as well - I enjoy the Burgen Soya and Linseed Bread, because I was told that‘s good for diabetics as well, and it does me well.

Do you still weigh and measure?

No, no more!  No more weighing and measuring, just common sense, really, ‘cause nowadays they say that your diabetes doesn‘t rule your life.  You eat accordingly and you give your insulin accordingly, but all within - food-wise - all within limitations.  You have your treats.  Occasionally - I haven‘t of late, oh, since Christmas - but before that, if I just fancied a cube of Cadbury‘s Dairy Milk, I‘d have it, just to satisfy my desire, and I‘d be as happy as Larry.  But that would be it - I‘d be happy then.

Can you remember when you began to have this new freedom?

No, not really.  I think it must have come on gradually, yeah, but everything within limitations and I‘m okay.  The only thing, what I cannot do is, I cannot shed weight, and it‘s all around my abdomen.  But I was told by somebody, diabetics go that way - long-term diabetics, so!

Well, obviously you can‘t take exercise at the moment with your injured ankle, but how much exercise do you have usually?

I walk a lot, yeah, but I‘ll have to learn to do - what do you call it - bend and touch my toes

(20) a bit more, or walk more brusquely in future, yeah.  But other than that, I‘m very active; I very, very seldom sit down.  I‘ve never sat down so long on my derrière as I have since, what, the past four weeks, and it‘s really getting me down.

And have you had any complications associated with the diabetes?

No, I‘ve been very, very fortunate up to date.  I take great care of my feet - I visit the chiropodist at the diabetic centre every, I think it‘s between ten and twelve weeks, and she, Mrs George, looks after me very well.

So, when you haven‘t got an injured ankle, can you describe a typical day in your life?

I retired 2004, end of July, from nursing, because prior to that I had two very nasty falls.  I‘d just come off night duty in early February after very, very hectic night, and I‘d come home, had my breakfast, showered, gone to bed, and I was woken up at four o‘clock feeling very hungry.  And I thought "right, I‘ll brush my teeth, wash my face, go down, have something to eat, come back, lie down, listen to the radio, and then get up, get myself ready for work".  And I put one foot on the step and the next foot, and I came sliding down the whole flight of steps.  I was very badly shaken but nothing fractured.  Blow me down, seven weeks later, we‘d been out for the day to visit very good friends in Hereford, came back about eleven thirty that night, and she‘d, whilst I was...  After the first fall, I‘d got some plant seeds, and this very good friend, she‘s got a greenhouse, so she said she‘d germinate them for me.  And they were all coming out nicely, so she gave me a box of these little pot plants.  And I brought them into the house, and I said "no, I‘ll put them in the porch".  And clumsy me, as I put one foot out into the porch, I didn‘t lift the other foot high enough and I went flying.  I hit my face, and - I‘ve got the table outside with the... I had my aspidistra on it - smacked into the table.  I had a very badly bruised left cheek, I cut the top of my nose, I bled from my right nostril, I went flat on my right knee.  Oh, I was in a right state.  My husband took me to A&E.  No fractures, but they cleaned my nose up, put Steristrips on.  And I went to see the GP then, and he told me, he said "I think it‘s about time you retired.  You‘ve worked hard all your life, you‘re sixty two years of age now, go and enjoy your retirement".  So, I retired end of July 2004.  I miss the company - they were great girls to work with.  I miss the babies, because that‘s where I always landed up - in the nursery, and that‘s where I got a lot of chest infection from.  But since stopping work – touch wood - my chest has been clear - I haven‘t bothered the doctor any more!

(21) And what‘s a typical day in your life now that you‘re retired?

Get up, shower, have my injection, my breakfast.  Then come down, potter around, dust and clean around, and then get ready for lunch.  Usually, in the afternoon, I visit friends or I do a bit of shopping, but I spend a lot of my time going down the motorway.  I‘ve got a son, who‘s married with two little kids, in Amersham Common.  His little boy, Dominic‘s eight years of age, and he‘s diabetic, type one.  He was diagnosed when he was twenty two months, and he‘s on insulin, but he‘s on the human insulin.  And they found out last year he was getting quite a lot of hypos, and they had to take him off the soluble and just leave him on the Isophane, but I think he‘s on a different insulin now, and he seems to be doing well.  He leads a normal life - he‘s into rugby; he loves it.  And he‘s beginning to have sleepovers, because the parents of his school friends are terrified - they know nothing about diabetes - and his friends come and stop with him, but he doesn‘t go over.  They‘re afraid in case he has a hypo, you see.  But he‘s very friendly with one of the lads whose father is a GP - good friends of my son and daughter-in-law - and the mother used to nurse, so Dominic often goes over to Samuel‘s for a sleepover or vice versa.  Amelia is fine; she‘s all right.  And I‘ve got - my second daughter is working in Washington DC, and my youngest is married and in London with a little boy of eight months.  So, if I‘m not down in Amersham Common, I‘m down in London, so friends of mine say I‘ve got a - what do you call it - one of the motorway lanes reserved for me, so I said "yeah, now that I‘m incapacitated, I‘m renting the lane out!".  So, the old man very seldom sees me at home, because I‘m with the kids and grandchildren, and I love it.

And you no longer run the restaurant?

Oh, no - we gave the restaurant up, must be about ten years ago, yeah.  My husband turned sixty.  It‘s difficult for us to get staff, ‘cause Malvern is a small town, and these youngsters like the big cities where there‘s, you know, activity going on; and catering trade - very unsociable hours.  So, when he turned sixty, he said enough was enough, and we gave it up.

Now, looking back over the many years that you‘ve had diabetes, what changes have you seen in the treatment, and perhaps changes in the National Health Service too?

(22) Treatment - I don‘t know, really.  I think it has improved, because we‘ve got all these cartridge pens, which are easy to manipulate.  You‘ve got the blood testing units, which are easy to use, as well, and very - what do you call it - you get a quick result straightaway, and you don‘t have the hassle of testing urine, except when you go to clinic and they require a specimen.  But other than that, I think it‘s easier for the newly diagnosed diabetics, whereas we had to weigh our portions out and all the different - what you could, what you couldn‘t eat.  But because, nowadays, they‘ve got this NovoRapid, for the kids who suddenly decide to go out for a meal and realise that they need fast acting insulin, they can jab themselves and they‘re okay, whereas once upon a time, you just couldn‘t do that, yeah?  But what I find, what bothers me - I‘ve accepted it, I‘ve lived with it for fifty plus years - but what bothers me at times is if I‘ve had a very tiring day and I‘m tired and I want to go to bed early, I can‘t, because I‘ve got to have my supper and my last injection.  That‘s when it gets to me.  But other than that, I just - I‘ve accepted it all along and I live with it, and that‘s it.  And I‘m fortunate: I‘ve got sight, hearing, speech, my extremities are all in working order, and I‘m in - touchwood - good health.

Have you ever reflected on how your life might have been different if you hadn‘t had diabetes?

No, not really.  I‘ve lived with it fifty plus years, I‘ve accepted it, and I just take one day at a time, except that now with this - what do you call it - human insulin playing up again, of course; that worries me a lot, yeah?  But other than that, I just sail along.  When I‘m at work, the girls say "good god alive, we wouldn‘t think that you‘re diabetic, the way you carry on with this hectic nursing life and all".  I said "well, that‘s me - I adapt and just carry on".

Did you notice, as a patient, any changes in the way that medical staff treated patients over the fifty years that you‘ve had diabetes?

Very few people know about diabetes.  Even as a nurse, when we have diabetic children being admitted, a lot of the nurses won‘t go near them, because they are fearful of how to treat them, how to go about it, yeah.  There‘s very little known, really, about diabetes.  But one good thing is, now you get the - not only the syringes -but you get the needles on the National Health.  Once upon a time we had to pay for the needles, yeah.

And what keeps you going in life?

My family - I live for my children.  They‘re a delightful bunch, and I‘ve got three lovely grandchildren.  I‘m very proud of them, yeah.

And what message would you have for anyone newly diagnosed with diabetes now?

Live your life to the full.  Only thing is, be careful - take your insulin regularly, your food regularly, and don‘t overdo anything.  But live your life to the full and enjoy it.