To the Editor: McCallum and Smith’s1 quest for pathology in children’s literature took me back 50 years, to a memorable weekend in New Zealand. News had reached Wellington on the previous day that Hilary and Tenzing had climbed Everest — a coronation gift to Princess Elizabeth, who was to be crowned on the following Tuesday.

On the morning of Sunday, 31 June 1953, I was on paediatric call at Wellington Public Hospital. I had been told of the admission of a boy of 11 months, who was neither short of breath nor otherwise ill, despite being very blue.

As I approached the ward I could hear him crying at the top of his clarion lungs. He was, as it were, “blowing his horn”, upset at being abandoned by his parents, who would have to wait four more hours for visiting time. (Such was the cruel practice in those days.) He was standing in his cot bellowing energetically. Apart from his dramatic discolouration, he looked well.

I expected a cardiac tetralogy, but he had turned blue only the previous day and there was no evidence of a heart or lung problem. I was bewildered with no idea of a diagnosis.

I called my boss, John Harding, and met him in the corridor. Even before entering the ward, the paediatrician sniffed and said, “There’s a child here with diabetes.” Of course he was right, and sure enough, it was my little boy blue.

I learned a lot that day:

• A child with diabetes mellitus can be acutely keto-acidotic;

• Our patient’s distressed cries probably disguised hyperventilation;

• In some people, acidosis can lead to methaemoglobinaemia; and

• I am unable to detect acetone from diabetics, although I can recognise its smell from a bottle.

My little boy blue was too young for agricultural responsibilities and was not somnolent, so couldn’t have been the prototype for the rhyme.