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Members of Pickering firm, 1957

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Members of Pickering firm, 1957 At St Hilda`s College, Oxford, 1956 (front, 3rd from right) At Radcliffe Infirmary, 1958 (Irene front  right, Prof Pickering front centre, future husband Douglas, back left)
Consulting room, 2000 View from consulting room Irene Bainbridge, 2007
 
 
Interview 68 Irene Bainbridge

General Practitioner
Born in Florence in 1935.


Overview: Irene Bainbridge trained in medicine at Oxford University from 1953 to 1960 and became a full-time mother from 1961 to 1974. When she returned to work, she found much had changed, especially in diabetes care. After further training, she became a GP from 1978 to 2000 in a rural dispensing practice in Essex, twenty miles from the nearest hospital. The practice appointed a Diabetes Specialist Nurse in the late 1980s. At the time of interview, she was still doing sessional work in general practice and was editorial adviser to the journal, ‘Dispensing Doctor`.

Please note that Overview relates to date of recording 19 July 2007

 Short samples

1 At Oxford she was taught by many well-known people, including George Pickering, David Pyke and Hans Krebs. She remembers long wards at the Radcliffe Infirmary, where the sister ruled and a senior surgeon or physician conducted formal grand rounds [ 58 secs ]

2 Since her surgery was in a little village, far from the nearest hospital, she had to deal with any diabetic emergencies herself [ 61 secs ]

 
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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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