Sunday, December 30, 2012

The year that was....


So a crazy year comes to an end...and it's always good fun to look back, isn't it? You have highs, you have lows...but that's what makes the ride interesting. After all, if you don't have lows, how exactly do you feel the exhilaration of a high?

Within the diabetes world, the Portsmouth diabetes team continued to build it's reputation winning awards for a new model of care delivery..the principle being quite simple...the vast majority of patients with type 2 diabetes to be managed in the community with support from the specialists...giving the specialists the time to concentrate on areas such as Type 1 diabetes etc and hopefully, overall, improve diabetes care. Picking up recognition was great fun, and what was heart-warming was the recognition the fabulous nurses got from it. As ever, the unsung heroes...their joy was one to savour...and when local Commissioners and CCGs also won awards on the back of it...one could let loose a wry smile. One could blog about it with a lot of pride..safe in the knowledge that the hardest part to achieve within the NHS was done...making change. The rest was up to us now, as professionals to deliver. No excuses, no external factors...this was now ours to deliver.But then again, when you work with the folks I work with, you have nothing but confidence that this can- and will be- done.

On a personal level, the high had to be the recognition offered by patients, and specifically one motivated girl who felt I had contributed to her volte face as regards her battle with diabetes. To be honest, I wasn't..I just happened to be there when she was ready for it...but nonetheless, a moment of immense pride..and for that, thank you very much Ninjabetic. I recall the girl of a few years back...and see someone completely different nowadays..the drive, the passion to improve the care of herself and others...one that can only be commended and admired. And the good news?...I meet young people like her nowadays more regularly...folks ready to make a change...my job? Be there..help and support when asked for- backed by a fabulous team of nurses and dietitians.And no, I don't do anything extraordinary...just something that used to be a norm for people who have inspired me over the years.

Social media exploded for me...and even though I have never met the Anne, Hannah, the Sjolunds etc of the world..I learnt so much. Realisation sank in that there was so much to do..but also the fact that this wasn't a single handed fight...the was no lack of patients who were willing to help, nor of fellow professionals like  Elin, Dean, Andy who wanted to make a difference. Beyond the world of type 1 diabetes, Roy Lilley in his usual coruscating ways highlighted what we could do better, twitter debates raged about whether the NHS needed to be privatised or whether the state backed system was one to be feted. As ever, the reality sat somewhere in between the polarised views..as the NHS moved into choppy waters..unsure of it's future.I wrote a regular blog challenging the "super-specialisation" of hospital care which I reckon doesn't take into account multiple morbidities, challenging what a Diabetes Consultant actually does, questioning the deluge of guidelines...oh it was fun!

The lows were there too..one of the brightest light of the diabetes world, Dr Niru Goenka, went out..too early...so much potential, he had so much to give...but alas, it wasn't to be. The outpouring of grief was a reflection of the regard in which he was held but perhaps the biggest tribute we could pay to him, is perhaps getting diabetes care right...one which he was so passionate about. 
Some personal relations, regrettably soured..some perhaps due to my forthrightness, some perhaps unintentional, some perhaps due to a desire to create an aura of mystery...keep the "real" me away,some perhaps because (ironically) I tried to step outside the "normal" Consultant mode of being a bit aloof. Who knows..but either way, to those who felt hurt, it wasn't intended...and I hope to bring a calmer, a more professional approach to the table next year. You learn as you go along, don't you?

So 2013 is around the corner. Resolutions? For sure...and giving a lie to the common myth, I have yet to default on new year resolutions in the past..and don't intend to change that. Some of them are personal and may have alluded to above..but professionally, the focus now shifts to people with type 1 diabetes. At the beginning of 2012, I had promised that at the turn of the year, the new model of care for diabetes care will be in place and people will know about it. I also remember in 2010 someone "important" telling me that changing traditional diabetes care was like taking on mission impossible. 
Now I am no Ethan Hunt but 2 years later, I think that question has been answered. Now to type 1 diabetes....can we change things? Can we make it better? Can we change the perception that this isn't about being overweight, it isn't something that can be prevented? I think so...but want an idea of the level of challenge? Here you go...
The Department of Health have advertised for a series of national posts across al specialities ..Cardiology, Stroke etc..and one among them is "Diabetes....And obesity". Diabetes. And. Obesity. One and the same...correlated, hand in hand. Is it the DHs fault or is it the diabetes organisations (and I include specialist, primary care and patient organisations in it) for failing to separate Type 1 and Type 2?
Perhaps I am being pedantic...but it does give an idea of he scale of the problem..but hey...what's life without a challenge? having the last few weeks of the year has been good...it's been a nice little break...and I feel rejuvenated....ready for a new challenge.

Robert Stevenson once said.."We must accept life for what it actually is - a challenge to our quality without which we should never know of what stuff we are made, or grow to our full stature". Time to test it out...2013 is here....let's get ready for another year full of fun and pleasant surprises. The sky, after all, is the limit, isn't it?

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