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Aged 18, Aberdeen Grammar School

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Aged 18, Aberdeen Grammar School In medical students` concert for patients, December 1976 In fancy dress on ward, Christmas Day 1978
Ken McHardy, 2007 69. 01 Old syringe donated by Head of Aberdeen Grammar Primary  School
 
 
Interview 69 Ken McHardy

Consultant in Diabetes and General Medicine
Born in Aberdeen in 1955.


Overview: Dr. Ken McHardy was educated at Aberdeen Grammar School, which counts among its former pupils J.J.R. Macleod, the co-discoverer of insulin, and R.D. Lawrence, co-founder of the British Diabetic Association. Since 1993, he has been a consultant in diabetes and general medicine at Aberdeen Royal Infirmary, where he succeeded Michael Williams. He has been much involved in integrating primary and secondary diabetes care in the Grampian region and in providing professional education. He has taught for over 25 years in the Aberdeen University Medical School, and has worked in Postgraduate Medicine since 1993, becoming Associate Postgraduate Dean in 2002

Please note that Overview relates to date of recording 18 July 2007

 Short samples

1 He did a survey of what caused stress among staff at his diabetic clinic and found that a major cause of stress was ‘where people are given apparent responsibility to make things happen, but they don't really have the power to achieve those results’. [ 58 secs ]

2 Part of his work is dealing with emergencies, and he is concerned that sometimes new diabetic patients with acute presentations are ‘over-managed’ in a situation of high anxiety that may affect their subsequent attitude to diabetes. [ 61 secs ]

 
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01 Educated Aberdeen Grammar School
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02 1973 - Aberdeen University.
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03 Met first diabetic at City Hospital where John Stowers & Mike Williams consultant diabetologists.
Training included diabetes. Project re diabetes screening: interviewed Stowers & Lilian Murchison. Watched Stowers consulting – diabetic himself.
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04 I still consult on corridor attended over 30 years ago – when many patients marshalled by few nurses. Diabetes not about acute problem-solving.
Senior lecturer berated patient for disobedience.
Training included nutrition, but probably not diabetic diet.
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05 1978 - 6 month house job, Aberdeen Royal Infirmary – new Alberti regime of multiple insulin doses. 6 months paediatric surgery. Then medical SHO rotation. 1980, accompanied Lilian Murchison to clinic in Orkney. Aberdeen provided service for Shetland & Orkney.
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06 1 year temporary lectureship in endocrinology. Completed MRCP.
Joined medical registrar rotation. 1981, 6 months as diabetes registrar - 7 ½ clinics per week. Visual aid to show different pills. No computers. Different strengths of insulin confused patients. Patients wouldn`t always obey.
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07 Provided diabetic support for inpatients in all Aberdeen hospitals with less help than junior doctors now. Non-specialist staff sometimes knew less than patients.
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08 Acute problem affected patient`s ability to manage. Good to meet variety of professionals. Mistakes made by non-specialists. I could make difference – attraction of diabetes care.
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09 John Stowers & Hamish Sutherland organised symposia on obstetric diabetes. At their clinic saw early days of human insulin.
Pregnant women motivated re control.
Stowers & Sutherland encouraged having babies, but met older women who`d been discouraged - also people advised against certain careers.
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10 1982, Raigmore Hospital, Inverness. No consultant diabetologist, but Donald Pearson had interest. Every insulin dose written up. Sliding scale insulin regimes. Nurses avoided sugar to treat hypo. Reluctance to use pre-mixed insulins – first introduced to Inverness, 1982.
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11 Returned to Aberdeen – year at Woodend Hospital. Married. Became ward-based diabetes registrar under Stowers & Williams. Did swaps with diabetic clinic registrar. Conversion to U100 insulin. Human insulin. NovoPens for sale – marketed for use 4 times daily. (Some still used only twice daily).
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12 Learnt from Stowers (academic) & Mike Williams (pragmatic).
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13 Legends re Stowers` management of own diabetes, work ethic & thrift – divided BM strip.
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14 People measured own blood glucose.
Saw Stowers have hypo – loss of awareness.
Plastic syringes introduced.
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15 1984 - Rowett Research Institute near Aberdeen: MD project. Still did clinical cover for diabetics.
1986, resumed regular clinics. Became lecturer at Aberdeen University. Continued research in diabetes & endocrinology. Completed clinical training. Shared management of complications with other units – ophthalmic, renal & cardiovascular.
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16 Learnt re nutrition at Rowett. When began, patients remembered red & black lines. In 1980s, used carbohydrate exchanges. Patients matched diet to insulin – now adapt insulin to diet.
Diabetes a disorder of fat, carbohydrate & metabolism, but focus always on blood sugar & carbohydrate – perhaps overrated. Now healthy mixed diet advocated. Dietitians take lead role e.g. in DAFNE project.
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17 1993, did part of Donald Pearson`s job as consultant diabetologist. 1994, succeeded Mike Williams as full-time consultant. Blood sugar meters. Greater understanding of patients anticipated by RD Lawrence, 1925.
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18 Pharmaceutical interest in complications – new medications.
Emphasis on team-work. Importance of DSNs.
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19 15 years ago published re management of patients solely in hospital & shared with primary care. Developed integrated care – diabetic clinics in primary care venues & professional education for GPs & practice nurses. Doubling of known cases in around 5 years, due to more screening, ageing population, less exercise, more obesity.
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20 Primary care essential, but specialist support needed.
Involve patients, but unattainable targets stressful for all.
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21 Stress caused by responsibility to make things happen without power to do so. Patients have life other than diabetes. If patients choose to ignore guidance, staff not responsible.
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22 Acute emergencies sometimes over-managed - high-anxiety introduction to diabetes affects later attitudes.
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23 Patients` self-management important, but professional input & education needed.
DAFNE programmes enable patients to reflect & meet peers, but may lead to false expectations.
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24 More renal transplants, pancreatic transplants, cardiovascular intervention & management of eye disease. Adjust targets for older patients` multi-system disorders.
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25 Diabetes care suits me. RD Lawrence recognised importance of patients` role – had diabetes himself – saved by insulin. JJR McLeod co-discovered insulin. Mike Williams wrote his biography. All attended Aberdeen Grammar School.
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Transcript
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Extras
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CV
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Publications
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