Sweet & Sour

by Peter Corris

  Dr Kidson, presumably out of respect for Pincus Taft, who was a revered man in the field, gave me an almost immediate appointment. He examined me and was concerned enough to refer me to Dr Paul Beaumont, a Macquarie Street ophthalmologist, again urgently.

  I distinctly remember that first appointment in Paul Beaumont's crowded rooms. I arrived on time at 2pm, expecting to be seen almost at once. Instead I found that, after submitting to some preliminary examinations from a team of highly efficient female technicians, and leaving a urine sample, I had to wait what seemed like an interminable time while elderly, obese diabetics, as well as some younger people and non-diabetics, filed through.

  I have always been impatient by nature and the wait went on for so long that I was offended and seriously considered leaving, but eventually I was taken in to see Paul, who conducted a long and detailed examination of my eyes through some elaborate and rather frightening equipment. His conclusion was that I had very severe retinopathy, a condition common among poorly-controlled diabetics. With this disorder, the delicate, peripheral blood vessels to the retina haemorrhage, leaking blood onto it. The eye vessels may also grow haphazardly, become scarred and obscure the vision. Scarred vessels can pull the retina off.

  My case was severe and I later learned that the doctors considered removing my pituitary gland, a procedure suited to a kind of retinopathy called 'diffuse capillary retinopathy'. A side-effect of that would have been a decrease in libido, requiring hormone replacement therapy to compensate. Happily, I had few features of this type of the disease: my particular kind of retinopathy responded well to laser treatment and so pituitary removal was not necessary.

  A few years earlier I would certainly have gone blind, but the technique of treating retinopathy with an argon laser beam had been introduced to Australia by Associate Professor Fred Hollows, who was Head of the Ophthalmology Department at the University of New South Wales and Prince Henry Hospital in 1972. Paul Beaumont was then the Senior Registrar at the Prince of Wales eye clinic, looking after diabetics. As Paul recalls:

  'Fred, with his characteristic ability to delegate, just said, "It's all yours" and allowed me to go full steam ahead, lasering diabetic eyes… The results, of course, were quite dramatic.'

  I consider myself very lucky to have been a patient of the man with the greatest experience in Australia at that time at using the argon laser. As I understand it, the laser beam was used to blot up the blood on the retina and to seal off and burn away the leaking and unwanted blood vessels.

  Over the next year, I came to know Paul Beaumont's surgery as well as I knew my own living room. I went for treatment twice a week, never getting away in under three hours. At first I resented this until I discovered that Paul began work at 7am and worked at least 12-hour days. The treatment was anything but pleasant. Initially, drops were put into the eyes to dilate the pupil – apparently a necessary preliminary to taking certain measurements. After a time this made reading difficult and the only way I have ever been able to endure waiting is to read.

  Furthermore, I could ill afford these great chunks out of my day as I was earning a scrappy living by book reviewing. Usually I had to read a book and sometimes write the review itself in the waiting room. By some lucky chance, I was able to retain enough vision to permit reading and writing long after most people give up. Paul's nurses would see me reading when many other patients were sitting staring blindly about, and shake their heads.

  The laser treatment came in two forms – light and heavy. In the former, the beam touched less sensitive parts of the retina and the procedure was not supposed to be painful. It was though – always. A contact lens attached to a device like a jeweller's glass was inserted and I had to place my chin on a rest and keep perfectly still while the beam was directed into my eye. A treatment lasted for several minutes and was always uncomfortable and stressful, despite Paul's soothing manner. Sometimes it hurt almost as much as having a nerve touched by a dentist's drill.

  Having heavy laser necessitated getting a local anaesthetic administered to the bunch of nerves under the eye. The needle coming over and down looked to be three inches, and as the eyes are possibly the most vulnerable organs in the body (apart from the genitals) this invasion was hard to endure. The injection hurt, and while the procedure that followed was not painful, several pain killers had to be administered at the end of it.

  A gauze patch over the eye had to remain in place for several hours and rest was advised. Many, many times I stumbled my way to the George Street bus stop, squinting with one eye to read the destination, and staggered back to Wigram Road to collapse and sleep until the throbbing in my eye woke me. Stress raised the metabolic rate and I sometimes neglected to eat enough after a treatment. As a result I would wake from the sleep sweating freely, then slip into a hypo.

  Once, I described all this to a friend, who summed it up accurately: 'That's not for squibs'.

  Indeed it wasn't. Women frequently wept in the surgery and I never saw anyone who was totally relaxed about the treatment. Paul Beaumont's manner, however, inspired confidence and he was as compassionate and considerate as the technique permitted. As a reader and writer, my vision was of crucial importance, and I never once questioned whether the pain and trauma were worthwhile. Many of the episodes, such as the biopsy, haunt me still. In the biopsy, a section of my arm was frozen, and a piece of tissue about the size of a pea was sliced out. The angiogram was worse. A dye would be injected into the vein to permit study of the flow of blood in the eye. When the dye kicked in I felt intensely nauseous, yet had to remain dead still.

  I was frequently incapacitated after laser treatment, returning home shaken and in pain. I had several serious hypos because I found it difficult to eat in this condition.

  Paul Beaumont expressed cautious optimism about the effects of the treatment. Although the retinopathy was very severe and the damage extensive, it was in my favour that I was comparatively young and otherwise healthy. I made some efforts to get the diabetes under better control at this time, testing the urine regularly, keeping to the diet and taking more exercise, mostly walking around Glebe and Annandale pushing the stroller. (I walked miles in this way and acquired an intimate knowledge of the streetscape of the area, which I used in the Cliff Hardy novels).

  At Paul's insistence, because of its deleterious effects on the blood, I stopped smoking, I had no difficulty doing so, but did not, however, stop drinking, often consuming most of a flagon of wine in a day. I had never smoked when I wrote, but I always drank, and the more I wrote the more I drank.

  I was never a binge drinker, just a steady imbiber from early in the morning until late at night. I drank every day. I did not suffer from hangovers, no matter how much cheap wine I drank. It was not uncommon for me to drink wine with my breakfast toast and scrambled eggs (as I heard Mick Jagger did), and I was often at the Harold Park Hotel for a beer shortly after it opened.

  I had become heavily dependent on alcohol in connection with writing, socialising and, especially, sex.

  After Ruth was born we moved to a bigger house in Glebe. We did the move over a number of days, making innumerable trips with boxes and small items between the two addresses. I worked hard, loading and unloading on a particularly hot day, and obviously did not eat enough. Somewhere along Glebe Point Road I entered the confused twilight zone of the serious hypo and lost all sense of who I was and what I was doing. It was very lucky for me (and other road users) that I became aware of what was happening and managed to stop the car somewhere near the water and consume the plastic-wrapped sugar cubes I at least had the sense to carry with me.

  Slowly coming out of the hypo, while still retaining some of its mind-bending qualities, I realised that I had practically been hallucinating like an LSD tripper, vividly imagining streets, intersections and other features that did not exist. Apparently, I had negotiated the real carriageways, but it must have been a near thing. I sat in the hot little car while the sweat ran off me and slowly dried, and r
eflected that I frequently had all three children with me when driving. I resolved never to drive a car when there was any possibility of my sugar level dropping: one of the few responsible commitments I made and stuck to at that time.

  We hired the Glebe identity Tom Laming to do the removal. Tom was the proprietor of The Dealatorium, a large secondhand shop, and also ran the Golden Gloves gymnasium in Arundel Street. He had been a main event boxer in his youth, a light-heavyweight who had twice fought, and lost to, the great Dave Sands. A plaque in the rockery at the top of Glebe Point Road, commemorating Dave Sands, was paid for by Tom Laming.

  By this time, however, Tom, a late-life-onset diabetic, was obese. On that hot day in December he drank an entire two-litre bottle of Coca Cola. I shuddered at the thought of what his blood sugar might be.

  12Meeting Fred Hollows

  'If you don't get off the piss and get fit, you'll be blind in five years and dead in 10.'

  Fred Hollows, 1978

  The turning point in my diabetic life came when I met Fred Hollows. Towards the end of 1978, Jean and I attended a birthday party for Pat Fiske, an American-born film-maker whose documentary on the Builders Labourers Federation was to win many awards. (She went on to make an outstanding film about Hollows.) The party was held in his home, Farnham House.

  I had wanted to meet Hollows for some time because of his pioneering role in introducing laser treatment to Australia, and also because I admired the work he'd done in the trachoma program in Aboriginal communities, particularly his defiance of the detestable Bjelke-Petersen. By this time the laser treatments were almost completed and my vision was saved. I had stopped smoking and cut down my drinking, but I was overweight and not taking regular systematic exercise.

  Pat introduced me to Fred, a stocky, hard-bodied man with a shock of thick grey hair. She said something about diabetes, the laser and Paul Beaumont. He looked at me over the tops of his half-glasses, took the curved pipe out of his mouth, and prodded me hard in my soft belly with his fist.

  'What's this gut you've got on you? You've had all this expensive treatment and you're just fucking throwing it away. Diabetics should be thin! If you don't get off the piss and get fit you'll be blind in five years and dead in 10.'

  He then asked me what my latest glycosylated haemoglobin reading was, but I didn't know what he was talking about. He turned away in disgust.

  I was profoundly shocked. I hadn't been so rudely and abruptly addressed since becoming an adult, and my first reaction was anger and resentment. Who was this little pipe-puffing runt to talk to me like that about fitness and drinking? He probably wasn't stone cold sober himself.

  Nevertheless, his words struck home. 'Blind' and 'dead' have a ring to them that can cut through laziness and complacency. Not many days later I got out an old pair of tennis shoes, pulled on shorts and a T-shirt, and set off to run the 200 metres to the Jubilee Park oval and do a few laps. I was astonished to find that I couldn't complete the 200. I conked out, completely puffed, well short of the oval.

  Humiliated yet challenged, I felt that at 36 I ought to be able to run a kilometre or two, despite never having been much of a distance runner. I persisted that morning, interspersing jogging with walking, until I had completed about one-and-a-half kilometres.

  I went out again the next morning, and the next. I bought a pair of Adidas running shoes and within a couple of weeks was able to jog quietly to the oval and complete four laps. I built it up to 10 and then experienced an agonising pain in my ankles. Hooked on jogging by this time and in despair at having to stop, I hobbled along to the doctor in the Fairfax building, where I was working part-time as Literary Editor of The National Times. I was asked where I was running.

  'Around a football ground.'

  'Good', said the doctor. 'Is it cambered?'

  I reflected.

  'I guess so, slightly.'

  'No problem. You've got tendonitis from running too far, too early. Rest it for a while and then run one lap around one way, and the next the other. You'll be all right.'

  I did exactly that and soon was running almost five kilometres every morning – not fast, but without stopping. By now we had a dog, a splendid border collie-cross, and Jim was my companion on these early morning runs. He'd lope along beside me to the oval, complete a few laps, and then run off to chase birds or sit under a tree and watch as I completed my sweaty circuits. He was a magnificent dog – handsome, obedient, playful – and the children adored him. The big block at our new house gave him space to play and dig and do everything dogs do, and he became a favourite of the local shopkeepers, particularly the gay proprietor of a mixed business, who gave him treats.

  I bought the Complete Book of Running and was inspired by Jim Fixx's account of how he had turned his life around. In a magazine I saw a photo of the old Fixx, flabby and tired-looking, and was astonished at the transformation. Running Jim looked years younger and much happier. I cut down drastically on my drinking and the weight fell away. I ran every day and began to complete the distance in a shorter time, so I ran further.

  I had completely caught the running bug: the shoes, the singlet, the shorts, the liniment, the lot. I took my gear to work and ran around Wentworth Park in my lunch break. I abandoned the habit I had picked up from John Morgan and followed ever since in Melbourne, Gippsland and Sydney – that of taking a small tomato sauce bottle full of red wine to drink with my lunch.

  If I had gone about it in the right way, this radical change in my lifestyle should have produced nothing but good results – better diabetic control, better health generally, and a considerable saving of money. Trying to limit myself to two or three glasses of wine per day, I had reduced my daily intake of calories by several hundred. If I had consulted Warren Kidson before embarking on the jogging life, he would no doubt have warned me to reduce my insulin to compensate for the lost weight, to eat more to balance the increased activity, and perhaps to lower the insulin dose still further on those mornings when I was running.

  I did not consult him and made none of these adjustments, still locked into taking the same amount of insulin each day and eating my six-portion meals with one portion in between. Still worse, I was proud of the lost weight and reluctant to eat more than was necessary to function.

  I was utterly ignorant of the mechanics of diabetic control, despite having been a sufferer for 20 years. The result was that I entered a phase, lasting almost a year, of cataclysmic hypos, more serious than I had ever experienced before, which caused great distress to those around me and inflicted grievous damage on my relationship with Jean.

  The first of the major hypos happened one morning after running, while taking Ruth to her creche in Forest Lodge and Miriam to her preschool in Jubilee Park. After shopping and walking home, my blood sugar dropped so quickly and severely that I became too confused to take glucose. I wandered the streets and only arrived home by accident. Somehow I found my way into the house, only to doubt that it was my house – nothing seemed familiar.

  A most peculiar notion had entered my head. I realised that I was having a hypo but, since I couldn't account for it, decided I must be miraculously cured of diabetes. In some way the pancreas was secreting insulin after 20 years of not doing so, and this plus the injected insulin had thrown me into the hypo.

  I was briefly wondrously happy with this explanation and lay down on the bed to enjoy it. The delusion soon passed and I managed to get some barley sugar from my pocket, take it and recover sufficient sense to get to the kitchen for more sugar and food. The bed linen and parts of the mattress were soaked with sweat, and I was a shaky ruin. This was one of the times I attempted (not always successfully) to conceal the hypo from Jean by washing and drying the linen and covering the damp patches on the mattress.

  I have several times experienced great joy when in the hypoglycaemic state. I can understand everything in the universe and grasp the real meaning and harmony that governs all things. Fasting and other mortifications, as practised by rel
igious charismatics, result in a lowering of the blood sugar. I conclude that their visions and visitations are delusions, caused by an alteration in the body chemistry.

  Once I slipped into hypo when working at the newspaper. It was lunchtime and I had eaten, but evidently not enough. My weight was down, my insulin dose was constant and I had run hard in the morning. There were only a few people in the office as the sweat began to drip from my head onto the desk. I crashed to the ground, upsetting my chair and wrenching my arm as I fell. Luckily, Adele Horin was one of the people there. At that time she was living with Robert Pullan, journalist and anti-censorship agitator, who is about my age and has been diabetic for about as long. Adele knew that a can of Coke, if taken in time, could raise the blood sugar quickly. That's what happened. Again, I did not tell Jean about this and swore Adele and the others to secrecy.

  I made the same request of the poet Geoff Page, whom I took to lunch on the paper's expense account. The idea was to put a poet on a retainer to select poems to be published in the book pages. I had read no poetry for years and considered myself unqualified, but I liked Page's poetry and would trust his judgment. Again, after a morning run and a busy time at the paper, my sugar level dropped so that I was soon sweating as if in a sauna, and making no sense at all. As we were in a restaurant, sugar was on the table and I spooned enough in to bring myself out of the hypo.

  I explain things to Page, who said that his first thought was that I was a junkie attempting to get off heroin by going cold turkey.