by Marika Azzopardi

 Rachel Agius does not give the impression of being a doctor until she starts talking. Then it’s all about medicine as this Higher Specialist Trainee in General Medicine, Diabetes and Endocrinology focuses on the main topic that intrigues her most – diabetes with a capital D.

 

“The problem is not how many diabetics there are in this country but how many remain undiagnosed. This is a recipe for disaster considering the repercussions of living with undetected diabetes. And mind you, diabetes is not only something which happens to the Maltese. It is something which happens to people the world over and it is on the increase.” Rachel knows full well all about it, having lived with the presence of diabetes alive and kicking in her immediate family. She speaks about it as if it were an old enemy, one about which she and all the rest of us must remain constantly wary.

 

Living on the front line, meeting the people suffering from the chronic illness day in, day out, has not made her any less receptive to the problems that these encounter. “The diagnosis and follow-up of diabetic patients can actually be pretty systematic and boring for a doctor. But the excitement lies in picking out those people who are susceptible, helping them come to terms with the illness and going with them through the paces of self-medication and of adopting a new lifestyle. It is amazing that today, even with all our awareness campaigns, people still make no time for health care. I pity the ‘intelligent’ people who should know better. They remain unaware of the simple fact that once you get diabetes, you are liable to have it hanging over you for life, with the risk of it attacking your eyes, legs, kidneys… the works.”

Dr Agius speaks about the different types of diabetes, namely Type 1 and Type 2 (the latter being the more common in Malta), and of the different treatment modalities available. Even so, she is sadly confident that diabetes is here to stay and its incidence will increase in the future. This is not only because of the genetic factors which remain present in Maltese families anyhow, but also because we all generally lead more sedentary lifestyles, eat that much more junk food and sweet nothings that contribute no good to our general health.

 

“I chose to study this specific field because my father has diabetes and the illness has always been ever-present in our family.  I can say I have grown up experiencing most of the common day to day problems diabetics deal with.  I was always aware that diabetes is a silent killer and unless you take care of it, it is easy to succumb to its complications.  Somehow this armed me with a determination to try and undermine its persistence in claiming yet more victims.”

Rachel was brought up in a family wherein medicine was ever-present. Rachel’s father was an ophthalmologist and both herself and her sister followed suit in taking up medicine as their field of study and profession. Their brother is also presently studying medicine and so she was breathing practically breathing medicine from day one.

 

Dr Agius’s daily challenge is to help people discover how they can turn their life and lifestyle around, creating space for a different diet, less stress, more aerobic movement and a strict regime of medication. “It is the easiest part to prescribe pills for a doctor and the easiest thing to pop pills for a patient. But the crux of the matter remains the difficult part responsible patients take on – that of fighting diabetes in a fashion which admittedly is simply embracing the kind of lifestyle ideally each and every one of us should be adopting anyhow.”

 

She speaks of her amazement at how some diabetic patients render themselves helpless up to the point of retaining absolutely no knowledge of what kind or frequency of medication they should be taking. People diagnosed with diabetes erroneously believe their life has ended and that they are now so chronically ill that they are invalids. “This is so far from the truth. People who are diagnosed with diabetes should be pro-active and recognise that today medicine has made great steps forward and that ultimately their cooperation with their medication will lead them to live practically normal lives.”

 

Speaking about herself and what she does in her free time, Dr Agius speaks of her love of pianoforte playing, which she started studying at age three, which she wanted to drop several times during her childhood days, but which eventually led her to acquire five diplomas and an LRSM. “For some time I used to teach music too, but today I just thank God for some free time that I dedicate to play music. I don’t need to fret about music, I just let go and play, letting the music flow through me and around me.  I am thankful to my parents for giving me the opportunity to learn such a beautiful instrument and I often find myself turning to the piano to relax and unwind myself especially after a busy night shift. My second favourite pastime? Travel. After I graduated in 2004 I travelled a lot and my best experience of all was working and studying in London at Queens Hospital. I was lucky enough to do both a stint in neurology as well as diabetes.   Apart from having the opportunity to deepen my knowledge and broadening my clinical skills in both subjects,  I also learnt so much about different beliefs, different cultures. Ultimately even this reflected on new discoveries associated with my speciality in diabetes as I found how different diets and lifestyles  associated to cultural traditions create problems for people who have to contend with their illness – ultimately everything and anything can impinge on the way people deal with their diabetes. It is then just up to the individual to wade through and learn to cope.”