Diabetes education art science and evidence 1st

Edition Trisha Dunning (Editor) - Downloadable PDF

2025

https://ebookfinal.com/download/diabetes-education-art-science-and-
evidence-1st-edition-trisha-dunning-editor/

Visit ebookfinal.com today to download the complete set of

ebooks or textbooks
Here are some recommended products that we believe you will be
interested in. You can click the link to download.

Care of People with Diabetes A Manual of Nursing Practice

4th Edition Trisha Dunning

https://ebookfinal.com/download/care-of-people-with-diabetes-a-manual-
of-nursing-practice-4th-edition-trisha-dunning/

Care of People with Diabetes A Manual of Nursing Practice

Third Edition Trisha Dunning

https://ebookfinal.com/download/care-of-people-with-diabetes-a-manual-
of-nursing-practice-third-edition-trisha-dunning/

How to Read a Paper The Basics of Evidence Based Medicine

4th Edition Trisha Greenhalgh

https://ebookfinal.com/download/how-to-read-a-paper-the-basics-of-
evidence-based-medicine-4th-edition-trisha-greenhalgh/

Vagabond Vol 29 29 Inoue

https://ebookfinal.com/download/vagabond-vol-29-29-inoue/
Concise Thermodynamics Principles and Applications in
Physical Science and Engineering Second Edition Jeremy
Dunning-Davies
https://ebookfinal.com/download/concise-thermodynamics-principles-and-
applications-in-physical-science-and-engineering-second-edition-
jeremy-dunning-davies/

A Modern Art of Education Foundations of Waldorf Education

R Steiner

https://ebookfinal.com/download/a-modern-art-of-education-foundations-
of-waldorf-education-r-steiner/

Rethinking Contemporary Art and Multicultural Education

2nd Edition New Museum

https://ebookfinal.com/download/rethinking-contemporary-art-and-
multicultural-education-2nd-edition-new-museum/

The Art and Science of Psychotherapy 1st Edition Stefan

Hofmann

https://ebookfinal.com/download/the-art-and-science-of-
psychotherapy-1st-edition-stefan-hofmann/

The Art and Science of CSS 1st Edition Jonathan Snook

https://ebookfinal.com/download/the-art-and-science-of-css-1st-
edition-jonathan-snook/
Diabetes education art science and evidence 1st Edition
Trisha Dunning (Editor) Digital Instant Download
Author(s): Trisha Dunning (editor)
ISBN(s): 9781118702666, 1118702662
Edition: 1
File Details: PDF, 3.20 MB
Year: 2012
Language: english
 Diabetes Education

BookCreation.indb 1Chapter No.: 1 Title Name: <TITLENAME> 8/21/2012 11:23:05 AM

Comp. by: <USER> Date: 21 Aug 2012 Time: 11:23:05 AM Stage: <STAGE> Page Number: i
 Education is not the filling of a pail but the lighting of a fire.
(W.B. Yeats 1865–1939)

BookCreation.indb 2 Name: <TITLENAME>

Chapter No.: 1 Title 8/21/2012 11:23:06 AM
Comp. by: <USER> Date: 21 Aug 2012 Time: 11:23:05 AM Stage: <STAGE> Page Number: ii
 Diabetes Education
Art, Science and Evidence

Edited by

Professor Trisha Dunning AM

RN, MEd, PhD, CDE, FRCNA
Chair in Nursing and Director Centre for Nursing and Allied Health Research
Deakin University and Barwon Health
Geelong, Victoria, Australia

A John Wiley & Sons, Ltd., Publication

BookCreation.indb 3Chapter No.: 1 Title Name: <TITLENAME> 8/21/2012 11:23:06 AM

Comp. by: <USER> Date: 21 Aug 2012 Time: 11:23:05 AM Stage: <STAGE> Page Number: iii
 This edition first published 2013
© 2013 by John Wiley & Sons, Ltd.

Wiley-Blackwell is an imprint of John Wiley & Sons, formed by the merger of Wiley’s
global Scientific, Technical and Medical business with Blackwell Publishing.

Registered Office
John Wiley & Sons, Ltd, The Atrium, Southern Gate, Chichester, West Sussex, PO19
8SQ, UK

Editorial Offices
9600 Garsington Road, Oxford, OX4 2DQ, UK
The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK
2121 State Avenue, Ames, Iowa 50014-8300, USA

For details of our global editorial offices, for customer services and for information
about how to apply for permission to reuse the copyright material in this book please
see our website at www.wiley.com/wiley-blackwell.

The right of the author to be identified as the author of this work has been asserted in
accordance with the UK Copyright, Designs and Patents Act 1988.

All rights reserved. No part of this publication may be reproduced, stored in a

retrieval system, or transmitted, in any form or by any means, electronic, mechanical,
photocopying, recording or otherwise, except as permitted by the UK Copyright,
Designs and Patents Act 1988, without the prior permission of the publisher.

Designations used by companies to distinguish their products are often claimed as

trademarks. All brand names and product names used in this book are trade names,
service marks, trademarks or registered trademarks of their respective owners. The
publisher is not associated with any product or vendor mentioned in this book. This
publication is designed to provide accurate and authoritative information in regard
to the subject matter covered. It is sold on the understanding that the publisher is not
engaged in rendering professional services. If professional advice or other expert
assistance is required, the services of a competent professional should be sought.

Library of Congress Cataloging-in-Publication Data

Diabetes education : art, science, and evidence / edited by Trisha Dunning.
p. ; cm.
Includes bibliographical references and index.
ISBN 978-0-470-65605-1 (pbk. : alk. paper)
I. Dunning, Trisha.
[DNLM: 1. Diabetes Mellitus–therapy. 2. Diabetes Complications–
prevention & control. 3. Patient Compliance. 4. Patient Education as
Topic–methods. 5. Self Care. WK 815]
616.4′62–dc23
2012022778
A catalogue record for this book is available from the British Library.

Wiley also publishes its books in a variety of electronic formats. Some content that
appears in print may not be available in electronic books.

Cover image: iLexx/iStockphoto

Cover design by Garth Stewart

Set in 9.5/12.5 pt Palatino by SPi Publisher Services, Pondicherry, India

1 2013

Dunning_ffirs.indd iv 8/11/2012 8:41:24 AM

 Contents

List of Contributorsxi
Forewordxiii
Prefacexvii
Acknowledgementsxxi
List of Tables, Figures and Boxesxxiii
List of Abbreviationsxxvii

1 Brief Overview of Diabetes, the Disease 1

Trisha Dunning AM
Introduction1
Overview of diabetes 1
Prevalence of diabetes 2
Overview of normal glucose homeostasis 2
Signs and symptoms of diabetes 3
Diabetes management and management aims 7
Long-term diabetes complications 8
Summary9
References9

2 The Journey of the Person with Diabetes 12

Jane Speight and Harsimran Singh
Introduction12
Psychological factors: the role of beliefs
and attitudes 14
Psychological factors: emotional reactions
to diabetes 19
Social factors: influence of personal situation 21
Factors that affect illness/wellness behaviours 22
Summary23
References24

BookCreation.indb 5Chapter No.: 1 Title Name: <TITLENAME> 8/21/2012 11:23:06 AM

Comp. by: <USER> Date: 21 Aug 2012 Time: 11:23:06 AM Stage: <STAGE> Page Number: v
 vi  Contents

3 Teaching and Learning: The Art and Science of Making

Connections28
Trisha Dunning AM
Introduction28
Purpose of diabetes education 29
Principles of learning and teaching 29
Learning theory 31
Laws of learning 32
Knowledge32
Nudging34
Learning and the brain 35
Memory36
Keeping the brain fit: brain training 37
Brain training: mind-body fitness 38
Sleep: vital for learning and memory 39
His brain, her brain 39
Technology40
Helping people learn: proactive strategies are
more effective 41
Summary46
References46

4 Making Choices, Setting Goals 49

Timothy Skinner
Introduction49
Why don’t people do what is best for them? 50
Self-regulation, goals and values 52
Behaviour-serving goals 53
Limited resources 56
SMARTER58
Sleep59
Summary60
References61

5 The Teacher: Moving from Good to Exceptional 62

Trisha Dunning AM
Introduction62
Healing63
Who is a teacher? 64
Attributes of a ‘good’ teacher 65
Moving from good to exceptional 67
Philosophy of diabetes care and education 67

BookCreation.indb 6 Name: <TITLENAME>

Chapter No.: 1 Title 8/21/2012 11:23:06 AM
Comp. by: <USER> Date: 21 Aug 2012 Time: 11:23:06 AM Stage: <STAGE> Page Number: vi
 Contents  vii

Factors that influence philosophy 69

Therapeutic relationship 70
Listening72
Know yourself 72
Wounded healer 74
Reflection74
Being present in the moment 75
Self-care75
Summary76
References76

6 People Do Not Always Speak the Same Language Even

When They Speak the Same Language 78
Trisha Dunning AM
Introduction78
What is language? 78
Components of language 80
Learning a language 81
The power of language 82
Body language 84
Culture86
Exchanging information: a complex process 89
Language and attitude change 90
‘Voices’90
Narrative medicine 91
The value of reading fiction 91
Using writing in diabetes care 92
Education materials 94
Winnie the Pooh has the last word 94
References95

7 Role and Use of Creative Arts in Diabetes Care 98

Jean-Philippe Assal and Tisiana Assal
Introduction98
Medical identity 98
The four cardinal axes of healthcare delivery 99
Listening to patients and modes of self-expression 101
Promoting creativity 101
Painting as a process of transformation 101
The theatre of lived experience 106
Artistic expression favours communication 106
Two examples 107
Key learning 111

BookCreation.indb 7Chapter No.: 1 Title Name: <TITLENAME> 8/21/2012 11:23:06 AM

Comp. by: <USER> Date: 21 Aug 2012 Time: 11:23:06 AM Stage: <STAGE> Page Number: vii
 viii  Contents

Art and therapeutic education 112

Summary114
Recommended reading 115

8 Turning Points and Transitions: Crises and Opportunities 117

Trisha Dunning AM
Introduction117
The seven ages of man 118
Common major life transitions 120
Neutral zone 122
A new beginning 122
Major life transitions 123
Signs a person may be entering or is in a life transition 125
Strategies to help people manage life transitions 125
Building resilience 127
References131

9 Sharing Stories of the Journey: Peer Education 133

Gretchen A. Piatt, Rhonda Lee, Helen Thomasic,
Norma Ryan and Millie Glinsky
Introduction133
Empathy and sympathy 142
Empathy and social support 142
Empathy and patient relationships 143
References147

10 Diabetes: A Lifetime of Learning 151

Michelle Robins
Introduction151
The clinical experience 152
Learning styles 156
Be honest 159
Consistent and correct terminology 159
Simplifying complex concepts into easier to
understand concepts 160
Using the individual’s knowledge and experience 161
‘Catchy’ phrases 161
Visual aids 162
Asking the right questions 163
Health literacy 164
Group education 166
Educating people with disabilities 169
Being flexible about where diabetes education is delivered 170

BookCreation.indb 8 Name: <TITLENAME>

Chapter No.: 1 Title 8/21/2012 11:23:06 AM
Comp. by: <USER> Date: 21 Aug 2012 Time: 11:23:06 AM Stage: <STAGE> Page Number: viii
 Contents  ix

Cultural sensitivity and diabetes education 170

Be aware of language 172
Where to start 172
Chapter summary and key points 173
References174

11 Medicine Self-Management: More than Just Taking Pills 177

Trisha Dunning AM
Introduction177
Medicine self-management 178
Complementary and alternative medicines and therapies 181
‘Compliance’: to use or not to use, that is the question 183
People with diabetes’ perspective 184
HPs, especially prescribers and educators perspectives 186
Carers, particularly family members 186
Extent of non-compliance 187
Is there a relationship between medicine compliance and
optimal health outcomes? 188
Factors that influence medicine compliance 190
How is compliance assessed/measured? 190
Quality use of medicines 194
QUM, diabetes educators and medicine management 194
Summary196
References197

12 The Advance of Health Information Technology:

Travelling the Internet Superhighway 200
Kari Harno
Introduction200
Internet and networks 200
Diabetes education 202
Diabetes management tools 205
Personal health tools and self-care 207
Summary211
References212

13 Leadership—Know Yourself: Influence Others 215

Trisha Dunning AM
Introduction215
Leadership: a brief historical perspective 216
What is leadership and what/who is a leader? 218
Leader functions 220
Leadership philosophies, theories and models 220

BookCreation.indb 9Chapter No.: 1 Title Name: <TITLENAME> 8/21/2012 11:23:06 AM

Comp. by: <USER> Date: 21 Aug 2012 Time: 11:23:06 AM Stage: <STAGE> Page Number: ix
 x  Contents

Leadership styles 221

Leadership competencies and attributes 221
Leadership education and care of people with diabetes 224
Leadership in diabetes clinical care 225
Leadership in diabetes education 225
Leadership in diabetes research 225
What do diabetes educators think about leadership? 227
How can we grow diabetes education leaders? 228
Summary229
Acknowledgements230
References230

Appendix232
Index235

BookCreation.indb 10Name: <TITLENAME>

Chapter No.: 1 Title 8/21/2012 11:23:06 AM
Comp. by: <USER> Date: 21 Aug 2012 Time: 11:23:06 AM Stage: <STAGE> Page Number: x
 List of Contributors

Jean-Phillippe Assal Gretchen A. Piatt

President Research Instructor
Foundation for Research and Training Division of Endocrinology and
in Patient Education Metabolism
Geneva, Switzerland School of Medicine
University of Pittsburgh
Tisiana Assal and
Foundation for Research and Training Director of Evaluation
in Patient Education Diabetes Institute
Geneva, Switzerland University of Pittsburgh
Pittsburgh, PA, USA
Trisha Dunning AM
Chair in Nursing and Director Centre Michelle Robins
for Nursing and Allied Health Research Nurse Practitioner
Deakin University Corio Medical Centre
and Corio, Victoria, Australia
Barwon Health and
Geelong, Victoria, Australia Barwon Health
Geelong, Victoria, Australia
Millie Glinsky
Indiana Regional Medical Center Norma Ryan
Indiana, PA, USA University of Pittsburgh Medical Center
Brownsville, PA, USA
Kari Harno
LKT Dosentti FHIMSS Harsimran Singh
Kerava, Finland Department of Neurobehavioural Sciences
Behavioral Medicine Center
Rhonda Lee School of Medicine
University of Pittsburgh Medical Center University of Virginia
Pittsburgh, PA, USA Charlottesville, VA, USA

xi

BookCreation.indb 11
Chapter No.: 1 Title Name: Dunning 8/21/2012 11:23:07 AM
Comp. by: PPriyadevi Date: 21 Aug 2012 Time: 11:23:06 AM Stage: Proof Page Number: xi
 xii  List of Contributors

Timothy Skinner Helen Thomasic

Director Rural Clinical School University of Pittsburgh Medical Center
University of Tasmania Pittsburgh, PA, USA
Burnie, Tasmania, Australia

Jane Speight
The Australian Centre for Behavioural
Research in Diabetes
Diabetes Australia
Melbourne, Victoria, Australia
and
Centre for Mental Health and Well-being
Research
School of Psychology
Deakin University
Geelong, Victoria, Australia
and
AHP Research
Hornchurch, Essex, UK

BookCreation.indb 12Name: Dunning

Chapter No.: 1 Title 8/21/2012 11:23:07 AM
Comp. by: PPriyadevi Date: 21 Aug 2012 Time: 11:23:06 AM Stage: Proof Page Number: xii
 Foreword

Trisha Dunning and her co-authors have compiled a book that knits
state-of-the-art research findings with best clinical practice and good
­
­common sense to produce a most readable book of everyday application to
clinicians and healthcare professionals in diabetes, as well as to the more
enquiring person with diabetes seeking quality information. They are to be
warmly congratulated for the many recommendations and h ­ elpful tips in
the book, which derive from their lifetime in professional practice.
What particularly struck me was the vein of empathy with the person
with diabetes that runs throughout the book. Those with diabetes so often
fear that disappointing results at their clinic visit will earn ­disapproval or
judgement, but the most welcome standpoint of the authors is to be non-
judgemental and thoroughly supportive of those whom they serve, those
with diabetes. For that reason, people starting their journey of ­diabetes
and their carers would also profit from reading this book. Although
learned, it contains a wealth of valuable information that can support
them in the daily challenge of living with a chronic disease whose compli-
cations can, indeed, be life-threatening.
Although it is now over 25 years since I carried my comatose five-­year-
old daughter Kate into hospital with diabetic ketoacidosis, I shall never
forget the sense of bewilderment and anxiety that engulfed me and the
brutal realisation that this little child now faced a lifetime of insulin
­injections. How it would have helped to put everything in perspective for
my wife, Naomi, and myself had we encountered at the outset, health
practitioners of the sensitivity of the authors! That said, Kate was well
cared for, and I can testify to the continuing gratitude parents and carers
feel for those who care for their dependent child with diabetes. Together in
Glasgow’s Royal Hospital for Sick Children, a ‘triangle of care’ was formed
between the caring professionals, my daughter Kate as the person with
diabetes, and Naomi as the principal carer. When that triangle of care
works well, there are immense benefits for all, and there are frequent
references in the book to that potential for successful and mutually
­
­beneficial relationships between professionals and patients.
Without in any way denying the impressive support of the paediatric
diabetologist, the key professional in that triangle of care was the Diabetes

xiii

BookCreation.indb 13
Chapter No.: 1 Title Name: Dunning 8/21/2012 11:23:07 AM
Comp. by: PPriyadevi Date: 21 Aug 2012 Time: 11:23:06 AM Stage: Proof Page Number: xiii
 xiv  Foreword

Nurse Specialist. As unflappable as she was caring, she was indeed the
educator, the source of advice, the encourager, the soother, the reassurer.
She was the embodiment of all the fine attributes of the educator to which
there is frequent implicit reference in the book. Without the ready access to
such support, as carers we could easily have felt isolated and helpless
when problems arose. It will come as no surprise that, to this day, I carry a
standard for the nurse educator professionals.
This book is additionally welcome because not only does it summarise
the best of diabetes care but it ‘encourages educators to reflect on their
philosophy of diabetes education and how they teach’. Educators are
encouraged to excel and the myriad of practical recommendations—
together with a vast anthology of references and research—should satisfy
the most enquiring mind. Writing in my capacity as the incoming Global
President of the International Diabetes Federation, I know instinctively
that better informed, more accomplished educators will succeed in h ­ elping
their patients to maintain better control of their diabetes.
It is not, however, just clinicians and healthcare professionals who can
benefit from this book. As the information revolution advances inexorably,
people with diabetes can inform themselves in a way that would have
been unthinkable a generation ago. Kari Harno’s compelling chapter on
the Internet superhighway highlights the many exciting opportunities
now opening up to harness technology to help those with diabetes to
obtain optimal outcomes. It set me thinking of the many imaginative ways
in which diabetes care and self-management could be revolutionised and
improved. The ‘quest for a better way’, intrinsic in the human spirit, will
bring undoubted benefits in the future to people with diabetes, reminding
and supporting them to do the basic things that help maintain good ­control
and a healthy life.
As a non-clinician, I found this book enjoyable to read but could not
help relating the observations and anecdotes to the experiences of Kate,
Naomi and myself in years past. I particularly liked Chapter 2 where Jane
Speight and Harsimran Singh describe the journey of the person with
­diabetes and their observation that ‘overcoming emotional reactions is
likely to be one of the most important steps a person can take to manage
their diabetes successfully. Yet, it is singularly the most overlooked aspect
of diabetes care. Time and money are spent on screening for retinopathy
and other complications of diabetes, and yet, very little effort is put into
screening for emotional distress’. The authors of this chapter are right to
highlight the imperative for health professionals to understand the role of
the individual’s family context in their diabetes management.
Reflecting honestly, I can see how daughter Kate’s outcomes could have
been improved if she had had access to proper psychosocial support at
key times of her diabetes journey in adolescence and young adult life
when leaving home weakened the parental influence on compliance. The
­importance of such psychosocial support is emphasised, directly and by

BookCreation.indb 14Name: Dunning

Chapter No.: 1 Title 8/21/2012 11:23:07 AM
Comp. by: PPriyadevi Date: 21 Aug 2012 Time: 11:23:06 AM Stage: Proof Page Number: xiv
 Foreword  xv

implication, in many places in the book. I remain interested in the different

ways in which such support can be offered and found myself in strong
agreement with Gretchen Piatt’s views on the beneficial effects of peer
support. Whatever else, I am convinced that parents—hardwired to be
protective—are not the best or right people to counsel when young people
find compliance a tiresome burden, not least when they see their peers
enjoying the diabetes-free existence they envy.
As with much else in life, effective communication can be the difference
between success and failure. Trisha Dunning’s chapter on effective
­communication is essential reading for those who daily interact with
patients. Nowhere is there a greater requirement for effective
­communication than in the therapeutic patient education that she rightly
identifies as an essential component of equipping the person with diabetes
to achieve optimal outcomes. Trisha’s chapters on education are pure gold,
coupling practical experience with theory to produce guidance from which
all health professionals can benefit. It is perhaps trite, but true, that
­continuing quality professional education is inseparable from good health
outcomes, and without the benefits of good recurring education, the latter
will be hard to achieve.
I hope that this book will be suggested if not prescribed reading for
those who work in diabetes care. I hope too that those who read it, ­reflecting
regularly as they do so, will find it relevant and useful and will thereby be
empowered to care even more effectively for their patients with diabetes.

Sir Michael Hirst

June 2012

BookCreation.indb 15
Chapter No.: 1 Title Name: Dunning 8/21/2012 11:23:07 AM
Comp. by: PPriyadevi Date: 21 Aug 2012 Time: 11:23:06 AM Stage: Proof Page Number: xv
 Preface

The word ‘education’ is interesting. It is derived from the Latin educare, to

bring up, which is related to educere, to bring forth that which is within or
bring out potential, and ducere, to lead. Significantly, educare also contains
the word care.
There are many scientific books and papers about education including
diabetes education—so why write another one? Ancient sages ­commanded
‘physician know thyself’ and suggested ‘physician heal thyself’. Both
these sentiments are at the heart of this book. At the end of each chapter is
a list of questions to encourage educators to reflect on what they read and
what they need to know to develop the courage to really teach, rather than
just provide information.
Therein lies an important distinction—educators share their knowledge
by providing information. The person who receives the information turns
it into knowledge through complicated mental processes and is in control
of what they learn and what they do with the information. Thus, an
­effective educator finds ways to develop the skills to ‘sell’ their messages
by tailoring them to suit the individual. To do so, the educator must be
open to new information sourced from numerous places and must know
how to apply the information effectively. Above all, they need to actively
cultivate the art of listening and being fully present in each encounter.
Sometimes, just being there is enough.
Joslin emphasised the importance of diabetes education in the 1920s,
but clear evidence for its value was not documented until the 1970s when
Miller demonstrated a link between reduced hospital admissions for
ketoacidosis and hypoglycaemia and diabetes education. A great deal of
research has been undertaken since then, which suggests knowledge is
important; however, knowledge alone is not enough to encourage people
to engage in effective self-care. An effective therapeutic relationship is a
key determining factor.
Many educators assume people newly diagnosed with diabetes know
very little about diabetes and require rigorous detailed diabetes education
to overcome their knowledge deficits to be able to undertake self-care.
In fact, many people with diabetes have some information about the
­disease, have developed an explanatory model to explain their diabetes

xvii

BookCreation.indb 17
Chapter No.: 1 Title Name: Dunning 8/21/2012 11:23:07 AM
Comp. by: PPriyadevi Date: 21 Aug 2012 Time: 11:23:07 AM Stage: Proof Page Number: xvii
 xviii  Preface

and sought ‘facts’ about the disease. These explanatory models and ‘facts’
may be very different from those of educators: in fact they usually are, but
they are no less ‘true’. Educators often regard people’s explanatory
­models as myths to be dispelled rather than accepting them as part of the
­individual’s story to be explored, discussed and understood.
Significantly, to the individual, diabetes is not ‘failure of the pancreas
to produce insulin’, or ‘insulin that does not work properly’ that needs to
be ‘addressed’, ‘managed’, ‘treated’, ‘fixed’ or ‘cured’. It is an emotional
as well as physical presence that affects the individual’s whole being for
the rest of their lives. Importantly, the physical aspects of people’s
­reactions cannot be separated from their emotional, social, economic and
environmental ­circumstances. Thus, accepting diabetes and coping with
­

the hard work of self-care for a lifetime has a significant impact and is
part of the individual’s personal journey. Most people do not make the
journey alone, so involving family and other relevant carers is essential.
Although research has identified many commonalities in the way
people react to diabetes diagnosis and their self-care behaviours, e­ ducators
­

must never assume the commonality fits the person in front of them. They
must strive to understand the individual’s unique story and the social and
environmental factors that shape their story.
In fact, psychosocial and environmental factors, including culture,
­support, health and other beliefs, fears, locus of control, effective commu-
nication and therapeutic relationship, may have a greater effect on
­outcomes than knowledge. Thus, the educator’s social and emotional
intelligence is as, or more, important than their knowledge of diabetes,
the disease.
Many valid tools are available to measure these parameters—most of
them focus on the person with diabetes, and success is largely concerned
with whether the individual with diabetes’ knowledge improves, they stay
out of hospital and whether their blood pressure, HbA1c and lipids are
‘normal’. Education and clinical care largely focuses on changing the
­person with diabetes. Equal focus must be placed on changing/enhancing,
and measuring, the educator’s capacity to communicate, engage, e­ mpathise
and engender hope: that is to effectively combine art and ­science.
Many models describe ways to help people with diabetes and optimal
diabetes services. In addition, models such as the Health Belief Model,
the Transtheoretical Model of Change and the Chronic Disease Model
are widely used as the conceptual framework for diabetes education,
­service planning and research. However, few, if any, of these models help
­educators develop the skills to move from ‘good’ to ‘exceptional’ ­educators.
Diabetes care has come a long way, since it was first described as diabetes
maigre (bad prognosis) and diabetes gros (big diabetes). Science and
­technology continue to make major contributions to our understanding of
diabetes and produce new management options. However, the prime
focus of this book is on exploring effective teaching and learning and

BookCreation.indb 18Name: Dunning

Chapter No.: 1 Title 8/21/2012 11:23:08 AM
Comp. by: PPriyadevi Date: 21 Aug 2012 Time: 11:23:07 AM Stage: Proof Page Number: xviii
 Preface  xix

s­ uggesting how educators can continue to learn and grow professionally

and personally, rather than on the disease, ‘diabetes’.
The book is not concerned with what diabetes is, or medical care, and
the focus is not on what people with diabetes need to know, or what they
should be taught. Such information is clearly documented in many care
standards, clinical practice guidelines and other publications. The book
aims to encourage educators to reflect on their philosophy of diabetes
­education and how they teach.
Hopefully, the book will encourage educators to read widely, including
fiction as well as clinical publications and evidence-based literature.
Reading fiction enhances people’s social and emotional intelligence.
Debating about and reflecting on a broad range of topics can help ­educators
understand themselves as well as people with diabetes. Significantly,
­educators are not immune from illness, including diabetes, which can
affect the quality of their lives and how they teach and provide care.
Carl Rogers stated:

Relationships can’t flourish if they do not operate in a climate of listening and

non-judgmental acceptance of the other person’s point of view. Empathy is the
hallmark of a genuine person.
Rogers (1902–1987)

Trisha Dunning AM

BookCreation.indb 19
Chapter No.: 1 Title Name: Dunning 8/21/2012 11:23:08 AM
Comp. by: PPriyadevi Date: 21 Aug 2012 Time: 11:23:07 AM Stage: Proof Page Number: xix
 Acknowledgements

Many people were inspirational during planning and writing this book.
Most of the inspiration and challenges came from the people with diabetes
I have been privileged to know since I began my journey as a diabetes
educator in 1984—they were and continue to be my true teachers and a
source of inspiration.
I am also grateful to the many fiction/creative writers whose great books
help me reflect on how I behave in my personal and professional lives.
These include the members of Geelong Writers and Deakin Literacy
Society who critique my stories and poetry and share their life experiences
and insights through their writing.
Many national and international colleagues shaped my thoughts about
diabetes education over the years through formal discussions, committee
work, clinical care, casual conversations and their contributions to ­diabetes
education research.
I am grateful to my wonderful research team at Deakin University/
Barwon Health, Sally, Sue and Nicole, who understood my need to
­constantly scribble ideas in notebooks and endlessly discuss them and
who managed to smile as they helped me track down references and sort
out the table of contents.
I am, as always, indebted to my publishers, Wiley-Blackwell, for their
enthusiastic response to the book proposal and their continued advice and
support throughout the publication process. I especially thank Alexandra
Mc Gregor who championed the book from the outset, Magenta Styles and
Sarah Claridge for their advice and support, SPi Global who typeset the
manuscript and the book cover designer, Garth Stewart.
Michelle Robins and I thank Diabetes Australia-Victoria and the
Victorian Aboriginal Community Controlled Health Organisation
(VACCHO) for permission to reproduce the Feltman teaching tool shown
in Figure 10.1.
My thanks also go to the people who reviewed the book proposal and
found it worthy of publication. I do not know who you are, but thank you.
Thanks are also due to Michelle Robins, Adjunct Professor Margaret
McGill, Dr Sheridan Waldron, Dr Bodil Rasmussen, Dr Martha Funnell,
Dr Seyda Ozcan, Eva Kan, Anne Belton, Anne Marie Felton, Dr Linda

xxi

BookCreation.indb 21
Chapter No.: 1 Title Name: Dunning 8/21/2012 11:23:08 AM
Comp. by: PPriyadevi Date: 21 Aug 2012 Time: 11:23:08 AM Stage: Proof Page Number: xxi
 xxii  Acknowledgements

Siminerio and Dr Ming Yeong Tan for providing a wealth of information

on the questionnaire about leadership that is discussed in Chapter 13 and
to the peer educators who shared their stories in Chapter 9—Rhonda Lee,
Helen Thomasic, Norma Ryan and Millie Glinsky.
The book would not exist without the fabulous work and enthusiasm of
the authors.
I am deeply grateful to Sir Michael Hirst, President Elect of the
International Diabetes Federation, for agreeing to write the foreword and
for writing such a great foreword despite being so busy.
Finally, my thanks go to my husband, John, my Westies, MacBeth and
Bonnie, for their love, support and understanding when meals and walks
were delayed so I could write just a few more lines, and my alpacas and
chooks whose social interactions are a constant source of learning.

Trisha Dunning AM

BookCreation.indb 22Name: Dunning

Chapter No.: 1 Title 8/21/2012 11:23:08 AM
Comp. by: PPriyadevi Date: 21 Aug 2012 Time: 11:23:08 AM Stage: Proof Page Number: xxii
Another Random Scribd Document
with Unrelated Content
The text on this page is estimated to be only 27.52%
accurate

92 SIR GEORGE WHITE [1860 the apparent decrease in

discipline. His views are the views of a subaltern of less than twenty-
five, and he did not perhaps know the serious grounds which the
British soldier had for discontent, but his letter to his mother on the
subject is worth quoting : — ALLAHABAD, March 1860. There is a
spirit of insubordination and mutiny very strongly developed
amongst the soldiers in India ; in fact, the Army is not what I
remember it when first I joined it. ... You cannot treat soldiers as
you would other men ; they have already out here dictated terms to
their superiors, & it will take a Napier or a Wellington to make them
forget that. Do you know what the whole secret of discipline is ?
what is derisively called " Pipe Clay." Depend upon it, the more Pipe
Clay the more discipline. The regiment that has its hair cut to the
eighth of an inch in accordance with regulation will excite ridicule
amongst civilians, but that is the secret of keeping soldiers under
command. It was a long time before I would believe my own
experience on this head as it is so degrading to human nature, but
by the beard of the prophet it is a fact ; this system of educating
soldiers will end in the overthrow of the English monarchy. Oh, you
may laugh ; but when you are called " citoyenne " instead of Mrs
White you'll say that fool George said so. Give me the dear old
soldiers who had to bring their letters to their officers to read for
them, men of six feet high, who had not an idea beyond their
captain & their colours. I am living in a very out-of-the-way place
here, but somehow or other a drunken British soldier found his way
here the other day & demanded grog; the amount of 100 tots are
the allowance for 100 men in one day. When the fellow, pushing
aside my servant, came into my house I asked him what he wanted.
Answer — " I'm a British soldier & I want my gr°g-" I said, " You had
better be off out of this sharp if
The text on this page is estimated to be only 28.75%
accurate

i86o] UMBALLA 93 you don't want me to have you put into

the nearest guardroom." The brute looked at me with the utmost
composure & said he wasn't going until he got his grog. I had been
exercising, as I usually do every day, & was in good wind, so I took
the fellow by the neck of his coat & seat of his breeches & sent him
flying out of the door. I did not make any demonstration of attack
before I got hold of him, but when he got up outside he stood up
again, & I, thinking he wanted more, was going to give him a little of
the biceps, when he took to his heels and cut like a demon, & my
belief is he's running still, but a case like this could not have
occurred ten years ago ; a soldier would have as soon thought of
hanging himself as walking into an officer's house in that manner.
White's staff appointment did not turn out to his taste, and before
he had been in it many weeks he came to the conclusion that he
would resign it as soon as he could properly do so. Meanwhile he
found Allahabad a depressing place. Cholera was at that time a
fearful scourge among our English troops, and the regiments in
Allababad were suffering severely. White writes that instead of going
out of your house to get into spirits, the first thing you hear is the
Dead March from generally two different regiments in opposite
directions wending their slow and solemn step to the graveyard. The
cholera is holding its revels among the troops here. A rich harvest
may be expected before many months are over. The ground is
already well prepared. As his letters show, White had for some time
thought of taking leave to England. The fact was that he was getting
tired of India and wanted a
The text on this page is estimated to be only 28.25%
accurate

94 SIR GEORGE WHITE [1860 change "home." The longing

that comes after a time to every Englishman for a sight of the old
country had come upon him. Nevertheless when a chance of
congenial work and advancement in India was held out to him he
was inclined to take it. During and after the Mutiny there was a
great opening for young men in military commands with Indian
troops, and in various kinds of civil work ; and White was tempted
by the idea of making a career for himself in some new line of
service where he could get rapid promotion. He writes to his mother
: — When I had made up my mind to cut home & fully intended
sending in for leave, the last day of the month what should come
but a letter from the Private Secretary to Sir E. Montgomery, Lieut. -
Govr. of the Punjab, asking if I had passed in the languages, & if so
what appointment I would like. I wrote back I should like command
of a regiment, but that liking & getting were different things, but
that I should be very much obliged to Sir R. Montgomery if he would
be kind enough to give me any appointment he might select himself,
& strongly hinted that no matter what it was I would do it better
than anybody else, which appears cheeky but is nevertheless fact. I
now await the result. I said one thing is very certain — I cannot bear
my present appointment. If I am offered a good appointment, why,
I'll stay ; if not, I'll go home. I am able to fill any appointment in
India with the exception of those requiring an intimate acquaintance
with native intrigue, which, thank goodness, I know nothing about. I
think His Excellency will be a little surprised at my reply ; I don't care
one penny (a coin I have not seen for 6 years) whether I get
anything or not. I'm sick of everything Eastern ; I want to eat
strawberries instead of Mangoes this summer. .
The text on this page is estimated to be only 27.80%
accurate

i86o] UMBALLA 95 March 27t?i. I am a fatalist to a great

extent. Surely Something brighter must be in store for me. So far I
have seen little of the bright side of life, if it has a bright side. I have
been singularly unlucky in not seeing service of -any sort, and have
no prospect of seeing any. . . . No copy of White's letter to Sir Robert
Montgomery's private secretary is to be found ; he had not yet
arrived at the point when one keeps copies ; but his letter to his
mother and another to his father of the 1st April, 1860, show that he
had not been unduly modest in his suggestions, also that he was
prepared if he got a good opening to give up soldiering altogether.
Like most young men who have missed a chance or two of seeing
active service, he thought the era of war had ceased, and that he
would never get another chance. What he wanted from Sir Robert
Montgomery, he tells his father, was a " command of something, I
don't care what, but Sir R. may think this too high a flight for a
beginner ; if so, I would be obliged if he would give me a second in
command in the Punjab, cavalry if possible." . . . "I also mentioned
an appointment in the Woods and Forests." . . . " I also said I bated
my present appointment." He explains to his father some of the
drawbacks to this appointment. One need not accept as strictly
accurate all that a man of five-and-twenty thinks about the methods
of the authorities ; but the letter is characteristic.
The text on this page is estimated to be only 28.08%
accurate

96 SIR GEORGE WHITE [1860 ALLAHABAD, April 1st, 1860.

I have been cut 315 Rupees, £31, since I came here for sticking up
for poor soldiers' wives and giving an order for their baggage to be
given up to them. However, I'll get the money back, I expect, by
fighting. I had two rather alarming letters one morning — one about
the above asking by what authority I had ordered the baggage to be
given up without the carriage of it from Calcutta being paid ; this I
am fighting. The other was demanding authority for my giving a
brigadiergeneral a passage to Calcutta at the public expense. This I
explained, and I have not been cut for it, & I don't expect I shall.
The other I will win also if there is any truth in the value of
importunity. If I don't get it I will make the Govt. pay for it in franks
of the letters I'll write about it " On the public service." This
retrenching a man's pay in India is an awful do. You are never safe,
sometimes two years after you have got a month's pay it is all
retrenched for some reason or other. When one is with their
regiment it seldom happens, as you have nothing to do that the
Auditor-General can take hold of, but the moment you get into a
responsible position then down he comes on you with a rush. He has
about 100 babus (native clerks), who get a percentage on
everything they discover that can be retrenched from the pay &
allowances of officers, so you may be sure they don't let many
things slip through their fingers. It's a dirty trick, is it not ? Even the
Cr.-in-Chief gets cut ; he has no authority over the Audit department.
On this account most Staff officers in this country won't undertake
any responsibility. I always do, & will to the end of the chapter. I
suppose I will lose by it in the end, but if I think it for the public
good I'll do it & fight it afterwards. A great thing in life is to have a
little irritation ; it acts as oil and keeps all the machinery in working
order. . . . Apparently White's irritation with his surroundings, or his
desire to " eat strawberries instead of mangoes
The text on this page is estimated to be only 28.14%
accurate

i86o] UMBALLA 97 this year," got the better of his ambition,

for a letter to his mother of the 26th June 1860 shows that he had
written to Sir Robert Montgomery saying he was going home on
leave, " and therefore it would not be advisable to do anything for
me." So ended the possibility that White might become an officer of
Indian cavalry or a Conservator of the Punjab Woods and Forests.
He remained at Allahabad a few months more — how long I do not
know — but the following letter to his sister shows that he was there
on the 10th of August. It is the last letter he seems to have written
to her before leaving India. ALLAHABAD, August 10th, 1860.
Allahabad is in great beauty at present. As I daresay you know, it is
situated on the banks of the Ganges and the Jumna, which meet
close to the station; in consequence of the rains these rivers are
both very high, in fact more like seas than rivers, and the banks are
very green and covered with vegetation. I have a great habit of
wandering about on horseback to all sorts of out-of-the-way places,
and I constantly visit the haunts of the Hindu fakirs or priests of the
sacred Gunga (or Ganges), natives with long matted hair, nearly or
quite naked, with nails growing into the flesh, who live in a condition
more wretched than it is possible to imagine. They are the most ill-
looking set of men you see, and do not show off their countenances
to the best advantage when a cursed Gora (white man) approaches
their holy places, as they always meet him with a scowl and
muttered incantations. . VOL. I. G
The text on this page is estimated to be only 28.24%
accurate

98 CHAPTER IX. ON LEAVE — RETURN TO INDIA. 1860-

1868. THERE is nothing to show when George White went on leave,
or what he did with his holiday, or how long it lasted. According to
the regimental history, the battalion in which he had been serving
since 1854 remained in India until 1867, and he evidently was not
with them. Apparently he joined the second battalion, then in
Ireland, but the regimental history does not say so, and there are no
family letters between 1860 and 1868. In after years he often spoke
of Rome and Naples, saying he knew both well ; and it is possible
that he visited Italy on his way home from India, as Indian officers
often used to do. The only materials I have for this period of his life
are some notes about him by Sir John Dunne and Capt. Brooke, of
the 92nd Highlanders. I have already quoted White's old friend Sir
John Dunne with reference to the ill-luck of the Inniskillings in not
being sent to the Crimea, and the
The text on this page is estimated to be only 27.74%
accurate

i860] ON LEAVE— RETURN TO INDIA 99 effect which this

had upon White's advancement in the army. After showing how the
writer himself and one of his contemporaries, Lord Wolseley, saw
Crimean service and got rapid promotion in consequence, the
memorandum goes on as follows : — No wonder that when I joined
a Depot Battalion in Cork in January 1862, and found George White
there in his twentyseventh year, still a Lieutenant in the unlucky
Inniskillings, that he should tell me that all military hopes had been
eaten out of his heart. The next year — 1863 — seeing me, six
months younger than himself, a Major, caused him to roll out many
expletives at his misfortunes. But all this had no effect on his cheery
charm of manner, his Irish wit and love of good stories, and his
genuine devotion to sport, which endeared him to us all. In those
days there were four packs of Foxhounds within reach of Cork,
besides a lot of first-rate Harriers. George's pocket never went to
well-trained hunters. He would get on some half-broken three- or
four-year-old, and with his Archer grip, his strong hands, and
determined fixity of purpose, he would grind his teeth, and put the
fear of the Devil into the beast as he came to a big fence, and
absolutely lift him over it. Except Colonel Snipey Green, R.H.A., I
have never seen any man with such will-power to make a screw
jump and gallop. I remember driving him over some fifteen miles to
Rye Court one afternoon to help me to buy a mare belonging to a
nephew of Captain Rye — the Master of the Muskerry Foxhounds,
and one of the finest huntsmen and riders in all Ireland. Rye
suggested that a stable boy should show the mare over some made
fences near the house. But George, though in an ordinary morning
suit, insisted on getting on her himself, and took her right away into
a bit of the Muskerry country abounding in great big — rather rotten
— razor-back banks that require a most perfectly trained horse
The text on this page is estimated to be only 27.82%
accurate

100 SIR GEOKGE WHITE [1860 to get over in safety. To

Rye's astonished admiration George sent the mare over four or five
of them, and coming back whispered to me, " Buy the mare — no
matter the price — for you can't throw her down." So I paid nearly
double her apparent value, but was well rewarded, as the mare
never made a mistake in the two years I hunted her. At last, just
about when I got command of the 99th in 1865, George got his
company in the 27th, and promptly exchanged into the 92nd.1 And
in the spring of 1867 I remember lunching with him in the Ship
Street Barracks in Dublin, and finding him thoroughly happy, and
immensely pleased with his new corps. And well he might be, for in
every respect they seemed a corps d'dlite. Ireland was full of
Fenianism, and even some regiments were tainted with it. Lord
Strathnairn, who was then Colonel-in- Chief, insisted on keeping the
Gordons in Dublin. They were called "The Duke of Abercorn's
Guards," and were the delight of all the loyal men and women on
the banks of the Liffey. How handsome George White escaped being
bewitched by soft Irish eyes was a mystery. Probably he found
safety in numbers. And then the 92nd went to India, and at last
when he was a Major of 43,2 with some 25 years' service, came the
very first time that all his latent power and energy was given an
opportunity of displaying itself. And how well he seized it, and how
quickly then he became a trusted leader of men, is part of the
history of his country. The way he had to wait for years for his
opportunity should be a lesson to all disappointed young officers of
to-day. The extraordinary amount of "go " that was in him betrayed
him at times into bits of foolhardiness. But he could not help it ! It
was in his blood. When I asked him why, as retiring Commander - in
- Chief in India, he should go " chasing " with a lot of boys in
Calcutta, and badly break his 1 He got his company in 1863.
The text on this page is estimated to be only 28.30%
accurate

1863] ON LEAVE— RETUEN TO INDIA 101 leg, his answer

was, " I saw that an A.D.C. of mine was getting the better of me,
and though I knew my horse was a bit done, I could not help going
at the jump to try and win." And after the over-exertion in taking
long walks at Mentone (which was the ultimate cause of his death),
he said to me that he felt so strong that he could not conceive how
anything in the shape of a walk could affect him. That confidence in
himself and in his powers made him the true Hero that he was ! I
have quoted Sir John Dunne's memorandum to the end, though it
anticipates the story of George White's life, because it is written by
one of White's oldest surviving friends, and gives a graphic picture of
the man as he appeared to his comrades. I will now return to the
period with which this chapter deals. According to the official record
White got his company on the 10th July 1863 — after less than ten
years' service, and when he was twenty-eight years of age. This was
not rapid promotion as compared with that of some of his
contemporaries, but it was not phenomenally slow, and in those
"good old days" of purchase there were very many efficient officers
who would have thought themselves fortunate if they could have
changed places with him. Why White exchanged into the 92nd there
is nothing to show. To the end of his life he used to speak in the
highest terms of the Inniskillings. But perhaps he thought the
Gordons offered better prospects of promotion. Perhaps also, though
he was by birth an Irishman, the Scottish blood which he had
inherited from his mother and many of his fore 
The text on this page is estimated to be only 28.19%
accurate

102 SIR GEORGE WHITE [1863 bears made him less

disinclined than he would otherwise have been to leave his first
regiment. And, as Sir John Dunne says, the 92nd seemed a corps d}
elite, so that any man might have been proud to belong to them.
Whatever White's reasons for the exchange, he was from this time
an enthusiastic 92nd man, and his fortunes were bound up with the
regiment to the end of his service. One of the retired officers of that
regiment, Captain Harry Brooke, who joined it, on White's advice, as
an Ensign in 1864, has lately put down his recollections of White at
this time. I was gazetted [he writes] in March 1864. From that day
on to the day of his ever to be lamented death I looked upon Sir
George as my hero and greatest friend. His cheery, noble,
adventurous, and chivalrous character was always fully realised by
me, and I would have done or tried to do anything he told me. His
kindness to me commenced at a very early date, for he met me on
the platform of the Waverley Station in the early morning of 22nd
May, when as a boy of 18 I first arrived in Edinburgh, and as I had
with the rest of my baggage my little Irish hunter, he used to love to
tell the story of a sentry at the Castle gate who was asked by the
late General D. Magill Crichton Maitland, who was then a Lieutenant
in command of the Guard : " Has Mr Brooke joined yet ? " " Yes, sir,
a young officer has just gone by with a wee Curty." Sir George (then
Captain White) was always full of humour and fun, and one evening
he and I and Captain Mackay were coming away from a big concert
in Edinburgh where Madame Grisi and Mario had been singing, when
on going down the stairs in a great crush of all the elite of
Edinburgh, a cry was raised " Beware of pickpockets." Before I could
turn round
The text on this page is estimated to be only 27.92%
accurate

1 868] ON LEAVE— EETURN TO INDIA 103 I felt myself

seized by the shoulders and heard Sir George and Mackay shout out,
" Here he is ; we've got him. Clear the road," and I was marched
through the crowd to the astonishment and amusement of every
one. Sir George was left-handed and very powerful. I have seen him
take two long Schneider rifles by the muzzles, and hold them both
out at arm's length, and when we travelled together in the west of
Ireland we used to have great fun "putting" the shot and lifting
weights against the strong men of the Irish Constabulary. Sir George
used to humbug them by first "putting" with his right arm, and then
if they beat him he would take them on with his le*t and easily beat
them aD. He also was very fond of racqr >ts, and a very good
player, serving terrifically hard with hie left arm. Many a little
anecdote could I tell you about my dear old friend, but I am so
mixed up with them all that it seems to be almost as much a history
of myself as him, which is not what you or I want. In 1867 the 92nd
was in orders for India, and soon after the beginning of 1868 White
was on his way out. He sailed with his regiment in the troopship
Crocodile as far as Alexandria, crossed the Isthmus by train, and
embarked in the Malabar at Suez. One of his companions on board
the Crocodile, Colonel Glen, late of the Lincolnshire Regiment, writes
about this voyage : " We sat together at dinner, so saw a good deal
of each other, and I induced him to write something in my Diary.
Perhaps you are not aware he was very clever in writing acrostics."
Enclosed in Colonel Glen's letter are a couple of pages of the Diary,
and though there is nothing very remarkable about White's
contribution, I think it may be as well,
The text on this page is estimated to be only 27.34%
accurate

104 SIR GEORGE WHITE [1868 once for all, to give here an
example of what was always a favourite amusement with him. A
thing of this kind gives some insight into a man's character and turn
of mind. 29th, Wcdnetday (? January). Weather beautiful, passed
Cintra, a climate where God's creatures can enjoy life — where all
save the spirit of man is divine — but his instincts being essentially
Satanic suggested the shout of Fire, and to Fire Quarters we flew.
Our state appeared with slight diversification to resemble that of the
old woman who lived in the shoe. There were so many men they
didn't know what to do. The Captain, grasping the fact, and being,
like all navy men, a man of decision, orders that in case of Fire half
the companies must jump overboard in order to let the other half
put it out. Cornet Browne being warned to the above effect, with the
impatience of youth said, He'd be d d if he would, but on being
seriously spoken to by the C.O. he saw the error he had been guilty
of and promised amendment and implicit obedience for the future,
and was allowed to resume his position at the head of the roster for
this dangerous but highly honourable duty. Passengers begin to get
very tired of all rational amusement, and some of them take to
making double acrostics, of which the following is a specimen : — i.
Where hast thou stray 'd, thou monstrous child of one Who basks his
giant length 'neath Afric's sun ? Meet child of such a sire whose
dripping face, Reclining at his ease with giant grace From sculptor's
chisel I have loved to see In massive marble, with his progeny.
Where hast thou stray 'd ? What dost thou here ? or why In falsely
acted grief now droops thine eye ? Say, canst thou feel the joys, the
griefs, the pains, Thy hideous laminated hide contains ? Thy womb
prolific and for warfare ripe, Successor to thy Trojan prototype.
The text on this page is estimated to be only 27.74%
accurate

1 868] ON LEAVE— KETURN TO INDIA 105 Where have I

stray 'd 1 to northern climes I go And capture slaves who cannot say
me
The text on this page is estimated to be only 27.33%
accurate

106 SIR GEORGE WHITE [1868 7. Just as I plunge, and ere

I wet my pate, I call an architect to tell my state. 8. A swimmer bold
who let no coward fear Prevent his hieing to his Dinah dear. 9. Oh
land of fairy tales and gorgeous hue, Land of punkahs and of
endless stew. On a separate leaf is given the " Solution." 1. Coast. 2.
River. 3. Ola Podrida. 4. Cabin. 5. Oasis. 6. Deep. 7. In-i-go (Inigo
Jones) 8. Leander. 9. East. Arrived at Alexandria at 8 A.M. on the 8th
February. 9th, Sunday. Left the Crocodile this afternoon. Very sorry
to leave the officers ; all very good fellows. 10th, Monday. Arrived at
Suez early this morning, very tired with our long journey by rail.
Embarked on board the Malabar about 10 A.M. On the 16th February
White writes to his sister : — MY DEAR JANE, — I have now another
chance of reporting my progress towards India, as we expect to
reach Aden tonight. I last wrote from Alexandria before landing, and
will take up my story from that. I had merely passed through
Alexandria when coming home from India last, so it was breaking
new ground to me. What struck me most was the
The text on this page is estimated to be only 28.09%
accurate

1 868] ON LEAVE— RETURN TO INDIA 107 exceeding filth

of the streets, mud a foot deep, and of the most offensive odour ; in
fact, in all my experience of Eastern cities I have seen none that can
touch it. My next strongest impression was of the great mixture of
nationalities by which it appears to be peopled — Jews, Turks,
Greeks, Maltese, French, English, Americans, Bedouin Arabs,
Nubians, and Abyssinians, besides a number of others. I believe
Alexandria to be about the worst city in the world, as it combines the
vices of Europe, Asia, and Africa. I did the sights — viz., Pompey's
Pillar, a grand column, Cleopatra's Needle, a facsimile of the
Egyptian obelisk in the Place de la Concorde in Paris, but without its
setting. What interested me most was an encampment of Bedouin
Arabs just outside the town, which I lit upon by accident. My
dragoman could not understand my anxiety to see this camp and my
indifference to Cleopatra's Needle. They appear to live in perfect
peace and filth with their dogs (little pariahs) and pigeons. One thing
that I was sorry to notice was the number of French shops and
institutions there appear to be. However, some of those whom I
questioned declared the English were much more liked than the
French. We disembarked from the Crocodile on Sunday evening and
crossed the Desert in three trains— about fourteen or fifteen hours.
The train I was in started just as it was getting dusk, and arrived
about eight in the morning, so that one had very little chance of
wearying one's eyes on the desert. The officers got a supper at one
of the stations. The night was cold, and there were wood fires at the
stations, and the natives, wrapped in their loose-flowing robes,
formed a fine effect by firelight as they mixed with and wondered at
the warriors of Scotland in their national garb. On arrival at Suez we
had some delay, but got on board the Malabar about eleven o'clock
after a tiresome night. Two of our subalterns volunteered for
Abyssinia,1 as they are in need of subs to look after the Land
Transport mules — Massey and Hives. They 1 Sir Robert Napier's
Expedition against King Theodore of Magdala was then in progress.
The text on this page is estimated to be only 28.32%
accurate

108 SIR GEORGE WHITE [1868 will have but a poor time of
it, I think, as they must naturally be kept in rear and will come in for
little but mule-driving. The Malabar is on the same model as the
Crocodile, so once on board everybody knew where to stow himself
away. Where we lay off Suez was opposite to the valley down which
Moses led the Israelites, and on the opposite side a few stunted
trees standing out from the wilderness around point out the wells of
Moses. Soon discovered that the Malabar was on the wrong side of
the Overland route by the great falling off in the feeding. We got a
glimpse of Mount Sinai coming down the Gulf of Suez. The last three
days have been very hot. Although I have lived where the
thermometer has been twenty degrees higher, I don't think I ever
suffered more from the heat ; it quite knocked me down, but I am
right again to-day. I think it must have been as much the board ship
life as the heat. The water taken fresh from the sea was 79°. We
have now passed through " The Gate of Tears," and are out of the
Red Sea. We expect to be in Bombay on Tuesday, the 23rd. I am so
sick of board ship life, I shall be glad to get on shore anywhere,
even at Aden, which is only one degree removed from Hades.
White's active habits and eager temperament always made him
impatient of life on board, and it must be admitted that a troopship
is not, or was not fifty years ago, a luxurious means of conveyance.
He had not many more days of it, for the Malabar duly arrived in
Bombay before the end of the month, and the 92nd was soon in a
part of India with which White was familiar — the Punjab. The
headquarters of the regiment was Jalandar, with a detachment at
Amritsar.
The text on this page is estimated to be only 28.94%
accurate

109 CHAPTER X. SECOND TERM OF INDIAN SERVICE.

1868-1871. GEORGE WHITE was nearly thirty-three years of age
when he started on his second term of Indian service. He seems to
have had no further desire for a command with Indian troops, or for
staff or civil employment, but he was not by any means content with
his prospects as a regimental officer. The fact is, I think, that he had
been somewhat disheartened by his loss of early chances, and had
lost for the time some of his military ardour. There is nothing in his
letters to show that he had been anxious for service with the
Abyssinian force, and in a letter written to his sister a few months
after his return to India, he even contemplates the possibility of
retirement. The letter was written from Srinagar in Kashmir, where
he had gone on a shooting expedition. He tells his sister that two of
the field-officers of the regiment propose to remain in India two
years and then go home on eighteen months' leave,
The text on this page is estimated to be only 27.99%
accurate

110 SIR GEORGE WHITE [1868 And undecided after that. If

they carry out these intentions I may cut it at once, as I cannot wait
so long for a majority, but when I get back I will be a better judge. .
. . I think I shall never be able to put up with all the restraint of
soldiering again after so free and wild a life. This was perhaps at the
bottom of his discontent — the growing attraction of Himalayan
travel and sport. I find by my journal l [he says] that I wrote last to
my father on the 8th June. Very soon after that I discovered that the
game was disappearing in a wonderful way, and I soon traced it to
its being hunted by wild dogs. When these come it is time for the
human hunter to pack up and be off, and as I was getting short of
money and stores I marched in here, which is (as I daresay you
remember from former letters, '56 and '57) the capital of Kashmir.
However I am going out almost immediately again, as I find I prefer
the wilds and snows to the demi-civilisation and heat here ; in fact
nothing would suit me better than the solitary life in the wilds if I
could get rid of Shikaris and natives generally, but when they get
you to themselves in the jungles they try every sort of dodge to do
you, and are a constant source of irritation. ... I wish Johnny was
out here with me. I think it would set him up, as I never have been
in such health and strength before. This love for a solitary life in the
Himalayas grew upon White year by year, and never left him — a
rather curious fact, — for he was by no means a man unfitted for
society. On the contrary, he seemed to enjoy it well enough when he
was in it, especially women's society, and he was undeniably popular.
But the family shyness and reserve, though they were concealed by
his pleasant Irish manner and genuine 1 The journal is not
forthcoming.
The text on this page is estimated to be only 27.94%
accurate

1 869] SECOND TEEM INDIAN SERVICE 111 kindness of

heart, were constantly drawing him towards a life of sport and
solitude. His kindness of heart, by the way, did not prevent him from
being very irritable at times with natives of India, whose little tricks
exasperated him. In later years he got over this failing, which is
generally the failing of young men not long out from England, with
small knowledge of Indian habits and languages. To the man who
spends his life among Indians they are not dishonest and irritating "
niggers," but, as a rule, very patient and faithful servants, very brave
and loyal comrades. Their ways are not our ways, but an Indian
gentleman of the best type sets in some respects an example which
most Englishmen would do well to follow. On the 3rd January 1869,
White writes to his sister again : — Many happy new years to you
all. We have had a fearful time of it here. It is the great day in the
year with the Scotch, and we have had to keep it up for two days.
First we had a very large dinner at the officers' mess on the 31st and
sat at table to see the New Year in. At 12 o'clock the band and pipes
marched straight into the room, followed by about 100 private
soldiers, who commenced to wring the officers' hands and wish
them a hoppy New Year. I think some of the guests were a little
astonished at the familiarity of the gay Gordons. . . . Some of the old
civilians who have reigned as kings in these parts and rarely been
approached by an inferior unless with his hands joined in front of his
face in token of submission, were seized by half -clad Highlandmen
and patted on the back with the roughness which Scotch whisky and
national feeling alone could produce. One little king I saw — not the
least like Saul in stature —
The text on this page is estimated to be only 28.15%
accurate

112 SIE GEOKGE WHITE [1869 who hesitated to take the

hand extended to him, when he was thus reproved: "Will ye no gie
your hond to an Argyleshire mon on New Years nicht ? You're no so
big a mon nather." Brooke, who is a very mad boy, got perfectly mad
with excitement, tore the drumstick out of the big drummer's hand
and beat it out of time in the most frightful way. Altogether it was
one of the most funny scenes I have ever been witness to. Next day,
the 1st, our men had big dinners which the officers of the company
have always to attend, and on which occasion you cannot get off
without drinking about three glasses of raw whisky, — as they take it
very badly if you refuse to drink the toasts they propose. Thank
goodness it is all over now for a year. . . . Since last I wrote we have
had a little rain and the weather is perfectly delightful at night, so
cold that you are glad to get under three blankets, and the wind cold
all day with fine clear bright sky. I am still unable to walk any
distance owing to rny feet, but have a capital substitute in the shape
of a "rantoon," — in which I can work myself at the rate of twelve
miles an hour along the perfectly flat & beautifully metaled (are
there two Is ?) Indian roads. The natives don't know what to make
of it, they run after me and ask if it is the same as the railway. I
explain to them that it is a European demon, who only yields
obedience to the Sahibs, & that if a native was to dare to ride on
him he would assuredly grind him to powder in the intricacies of his
wonderful machinery. " God is one, but the Sahibs are the people of
invention & great daring." . . . When the hot weather of 1869 came
on White got leave and was soon in the Himalayas again, shooting
with Captain Blackwood of the Artillery — " a very enthusiastic
sportsman." Then White went on alone to new ground in the native
state of Chamba. There he found himself in cold and snow, which he
evidently enjoyed more than his native
The text on this page is estimated to be only 28.27%
accurate

1869] SECOND TERM INDIAN SERVICE 113 servants did.

He writes to his sister on the 15th May :— It is great fun going down
these snow slopes sitting in one's " chilunchee " (or great copper
flat-bottomed basin used universally in India), you must steer with
your pole & feet, but sometimes you get most awful upsets. A
branch of a tree, well feathered as the deodaras are, makes a capital
sleigh, but you feel as if you had been sitting on the hob if you trust
a pair of trousers as mediators. Arrived at Salumdi. Col. Reid had
told me shelter had been provided at Salumdi, but the shelter had
no windows, & it was consequently full of blue ice & the door not to
be opened from being frozen in. Had hard work to make the niggers
clear this away, at last hit upon a device, having first tried taking my
own turn, which did not succeed ; I got lumps of ice in my hand &
when any man stopped working I put a lump down his back. This
cold application to the spinal vertebrae proved a capital tonic &
reinvigorator. By dark I had the door open, & one room, if you can
dignify the accommodation by such a term, nearly clear of ice. I
made my servants spread my tents on the ice floor, or rather where
the ice had been ; they could not speak without their voices shaking
from the cold. The coolies huddled together somehow & must have
had a poor night of it. I had nothing to complain of, having all my
clothes on, a military great-coat included, two pairs of woollen socks,
and rolled up in all my bedding, & still I was cold, & never let my
nose outside the blankets the whole night. Early next morning I
thought I descried the first dawn through the space between one of
the boards that served as roof and the rock, and shouted to " get
up." My bearer after a while in a quivering voice answered " These
people say it is yet night & that they cannot proceed at this time." I
knew that this was merely that they were torpid, so knocked them
about a little and got them oft' as they would stay all day long
without making an effort, tho' they knew well that we ought to be
over the pass before VOL. I. H
The text on this page is estimated to be only 28.75%
accurate

114 SIR GEOKGE WHITE [1869 the snow commenced to

melt. Crossing the pass was the most painful thing I think I ever felt,
the cold did go thro' one altho' we were making a very steep ascent
which under other circumstances would have kept you warm. Some
found a difficulty in breathing from which I am wonderfully free. The
very surface of the snow was whirled about by the wind & cut our
faces. However, we got to the top, and I must say I enjoyed the
sunrise, not because one ought to admire the sunrise at 15,000 ft.,
but because it brought heat. My servants looked at me as if I was a
fool and a demon ; two of them had never seen snow before, & it
was a rough introduction. We left Jullundur on the 14th, with the
thermometer 90° in the shade we crossed the Sach Pass on the
28th, rather a difference. . . . I have spoken about a twig bridge,
they deserve some description. From one bank of the Chandra
Bhaga (Chenab) to the other the only means of communication is by
means of twig bridges, often more than 100 ft. above the torrent ;
the bridge is not more than about 3 or 4 inches wide, of twigs with
two other twig ropes about the same thickness to rest your hands on
as you pick your way along it, that is, provided you have not got
something in your hand to carry. Some of the coolies will not take
their loads across them, but get others with better heads to go
twice. The rush of the water below if you look down combined with
the shaking of the bridge makes it nervous work for a man with a
bad head. Many of these bridges are 100 yards long. I can now quite
realise the truth of an answer I got from a man I met at Dalhousie
when I asked him what sort of a place Pangee was, "No country for
a drunken man." . . . My life up to the time I left Pangee was a
repetition of what I have so fully described. I shot some more ibex
and did what I consider a very odd thing, I shot two bears dead with
one bullet, the bullet going clean through both. I came back the
same road as I went, but the Sach Pass was a very different thing in
June from what it had been in
The text on this page is estimated to be only 28.02%
accurate

1 869] SECOND TERM INDIAN SERVICE 115 April ; it was

quite pleasant coming back & I had no sort of difficulty. Where I had
laboured on, cutting steps in the snow on my way into Pangee, was
a beautifully grassy hill covered with brilliant-coloured wild-flowers
on my return. It was heartrending work turning one's back on the
snows, knowing the climate that had to be endured for the rest of
the summer. As I gave Pangee a last long look & turned to descend I
felt like a fallen angel turned out of heaven & about to fall into the
other place. I have had one great misfortune owing to the constant
snow & rain that I had on my shooting ground, I could not dry my
ibex heads properly, & they are all going bad, & I am afraid I shall
have no trophies of my sport to show. The heat marching in the low
hills is very great, I always get up in the middle of the night & go as
hard as I can ; but my baggage, which takes all day, lets my
servants & coolies in for great heat. I had two coolies knocked over
by sunstroke the day before yesterday : one went roaring mad. If
you would judge of what we endure, heat water up to 100°, and it
will give you some idea of what we suffer for our country. I felt the
change very much, but it has not knocked me up as yet. Not so my
bearer, the only native servant I have with me here, he is utterly
useless and pours perspiration all day long & can do nothing. When I
ask him what is the cause he says, " One week ago snow fell on us."
When I first arrived in the regular heat of the plains I started to
travel by " dak " to Umritzur ; on my way here my carriage broke
down, & I found it so hot that I got out to try and get a breath of air
; I had no shoes on, & altho' the sun had set two hours I had to get
into the " gharri " again as I could not bear the heat of the road on
my feet through my socks, it regularly burnt my feet. I find on my
return that I have been most fortunate of the sportsmen, altho' four
others were out at the same time as I
The text on this page is estimated to be only 28.37%
accurate

116 SIR GEORGE WHITE [1869 was, I killed double the

number of ibex they did all put together. The regiment is very
unhealthy, three whole Companies being away, besides a lot of
invalids, & still there are 99 men sick. I don't know why we should
be so unhealthy ; I think drink must have something to say to it.
Don't make any complaints to me about cold rooms until after
October next, as it has a tendency to make one irritable under
present circumstances. . . . You will, I fear, have some trouble in
following this letter from sheet to sheet ; the two first are pink, the
third blue, the fourth yellow. I am aware this information would have
been more useful at the beginning of the letter than here, but one's
head cannot be expected to be clear with the thermometer at 98°.
The letter was in fact difficult to follow, the writing being very small,
and crossed, on thin semi-transparent " overland " paper. The
postage for a letter to England via Marseilles was then, according to
White's statement, one shilling and a penny, and the weight allowed
was very small, so that thin paper and crossed writing were the
usual thing. But they are trying to the eyes and patience, even when
the hand is clear and good, as White's had now become. In later
years, and under less difficult conditions, it developed into a
remarkably fine open script. The welcome monsoon found White at
Jalandar, whence he writes to his sister on the 28th July :— We have
had magnificent rain for the last fortnight, and every body & thing is
picking up in consequence. I ought to except our habitations, which
are certainly not picking up, but showing on the contrary decided
symptoms of falling
Welcome to our website – the ideal destination for book lovers and
knowledge seekers. With a mission to inspire endlessly, we offer a
vast collection of books, ranging from classic literary works to
specialized publications, self-development books, and children's
literature. Each book is a new journey of discovery, expanding
knowledge and enriching the soul of the reade

Our website is not just a platform for buying books, but a bridge
connecting readers to the timeless values of culture and wisdom. With
an elegant, user-friendly interface and an intelligent search system,
we are committed to providing a quick and convenient shopping
experience. Additionally, our special promotions and home delivery
services ensure that you save time and fully enjoy the joy of reading.

Let us accompany you on the journey of exploring knowledge and

personal growth!

ebookfinal.com