V

I'm the oldest sister of three girls.

This time last year I was sitting beside a hospital bed with my mum and dad and my brother Jack. I was holding my sister V's warm hand and hoping and praying that she would stay with us. She had lovely soft hands, with long slim fingers and manicured nails that she took great care of. I suppose I was still shocked - I was due to fly off on holiday to Tunisia with Big Man and Carb Addict on this day, not keep a bedside vigil in a malignant Northern city - but Babcia had called me and there was never any chance that I wouldn't drop everything and drive for five hours, hoping this was another false alarm. V had quite a few of those and had battled her way through. Surely she could do the same this time?

V was four and a half years younger than me, a beautiful, bouncing, healthy-looking child. She was always hungry and the health visitor advised Babcia to feed her with very runny Weetabix through a wide hole bottle teat (!), which she did, being young and lacking in confidence. Could that have had any bearing on what came to pass?

When she was two-and-a-bit V got a skin condition called impetigo. She was given penicillin which made her very ill and she spent a couple of weeks in hospital. After that she became very clingy, mardy and ill-tempered. As she got older V preferred to stay at home with Babcia, making cups of tea and watching TV...we called her 'Miss TV Times' because she always knew what was going to be on. She was quite pious (well, we WERE taught by nuns!) and a bit of a goody-goody compared to my rebellious ways (I had a pin in my ear....OMG!).

V started losing weight at about age 11. She went to the toilet frequently, drank loads of water and one morning when Babcia went to get her up for school she found V almost comatose...the smell of pear drops filled the room. V was diagnosed with Type 1 diabetes and spent a short time in hospital. You need to understand that in those days the only treatment was daily injections and strict observance of food rules - I think things are a lot different now with insulin pumps and so on. V was given an orange to practice injecting and a diet sheet and that was about it.

By the time V was 15 or 16 we were back living in the UK and V wanted to be like everybody else - drink, eat whatever she liked, smoke, never let on that she was a diabetic - and so she started to regulate her insulin according to her blood sugar readings. She also got it into her head that she was fat which was another reason to mess with her insulin. I know now that this has a name, diabulimia and that it's a very serious condition that can exacerbate the different complications associated with diabetes. And apart from everything, V was very bitter that, of four siblings, she was the one who had lucked out healthwise. Quite honestly she was fiendish to everybody...Babcia and Dad took the brunt of it but she wasn't nice to to many people. However she got a job, moved in with a boyfriend and things continued on as even a keel as they can for somebody whose diabetes is totally out of control.

The years passed by and V's health deteriorated. She had finished with the boyfriend and lived alone in a flat. She still had friends and was close to our other sister, our baby girl. She continued to work but things were starting to go wrong. Diabetics should be very careful if they shave their legs (should try to avoid it really) but she'd nicked her shin and it became ulcerated, resulting in ultra-painful skin grafts and a dent in her leg to the bone. Also diabetics need to have regular foot care appointments, which V didn't bother with. The nerve endings in her toes and feet were damaged and she had toes on both feet amputated. This would be devastating for anybody but especially so for a young woman. However, far from being the wake-up call it should have been V carried on smoking heavily, self-regulating her insulin and generally playing Russian roulette with her health.

Shall I cut a long story short?

By the time she was 35 V had lost one leg to just below the knee; the other at her hip; been on kidney dialysis; had a kidney transplant and gone blind in one eye. And just to add insult to injury she'd had pre-cancerous cells removed from her cervix. Never, ever think diabetes isn't serious. Through all this she carried on the same as always. Smoking, starving herself, going into hypos and hypers...twice Babcia had to get the police to break into V's little house when she could see her flaked out, almost dead on the settee and ride the ambulance to hospital with her. Yet every time she somehow battled back. Brave. Bloody-minded. Fierce.
 Once a week my Dad took her in her wheelchair to Asda for her shopping (and that's another thing....she spent £70-£80 a week on food and didn't eat any of it. Typical eating disorder, yes?) and that first week in August last year there was an epidemic. Lots of kids were in the supermarket on school hols and V, who never had any childhood illnesses as a kid, picked up chickenpox. Because her immune system was so compromised by the anti-rejection drugs she took following her transplant and, I suppose, because of her years of self-neglect the chickenpox went to her lungs and caused pneumonia. V was never keen on children and she'd probably been cursing them all the way round Asda that day. I wonder would she see the irony?

So we sat around V's bed in the ICU. The doctor had told us that there was no more hope and that the life support was going to be turned off. We were relieved that we weren't asked to make the decision. We all left her room whilst the nurse turned all the machines off. Babcia and Dad didn't feel they could go back in so Jack, his wife and I went in to V and sat with her. It was so quiet. We held her hand on either side and the last monitor showed that her heart rate was increasing. What I didn't realise was that a body tries to carry on fighting....self-preservation I suppose. Jack and I told V that it was okay to let go and that she could leave us now. This last year I've beaten myself up so many times thinking that if I hadn't said that she might still be here. When I'm missing her I think that, mostly.
And then it all just....stopped.

I was amazed at how quickly V's hand, that seconds ago was still warm and malleable in mine, began to grow cold and stiff. Almost instantaneous....really odd. Babcia and Dad came in and nobody really knew what to say. I suppose we were all thinking that she was peaceful now. And how angry V would be to be dead. That sounds strange but she was an angry person and when she had first been taken into hospital a few days before I'm sure she never imagined for a minute that she wouldn't leave there again.

Now she's been gone a year. I miss her. I've wanted to tell her things so many times, picked up the phone so she could be outraged on my behalf, or to tell her something funny. She always sent those cards they sell in Oxfam - you know the ones with old photos and a witty comment? - and I think of her when I see them. She was generous, madly intelligent, sardonic, ironic, talented, funny and sensible - at least where others were concerned. But she'd set her path to self-destruct and she was never going to make old bones. We had known that for a long time and I think inside V knew that too. She'd been given so many chances, so many wake-up calls and she ignored them all. Everyone tried so hard to help her but she could be so prickly - she once ignored me for a year when I wrote and suggested she gave up smoking - and she was an adult after all. It was like she was in a barrel heading towards the falls and instead of jumping out into the safety of the shallows she paddled even faster to the edge. I guess we just weren't enough to keep her here.

Much love, V. Miss you xxxxx