It was a premonition of sorts, said Donna Hilton, that moved her to give her teen-age daughter a Christmas gift in November.
"I bought her a real nice watch for Christmas. But for some reason I couldn't wait to give it to her. So, I gave it to her a month early. She needed a nice watch. If she was going to go to college next year, she might as well have a nice watch," Hilton said.
A few weeks later, an anguished Hilton said she was thankful that her daughter was able to enjoy the watch, if only briefly. On Jan. 3, Hilton, 36, walked into her daughter's bedroom and found the popular Patrick Henry High School senior dead in her bed.
An autopsy report said that Emily Erika Field, 17, died in her sleep, a victim of diabetic ketoacidosis. Medical experts said ketoacidosis is a complex but fairly common condition among diabetics. However, when patients practice proper care, ketoacidosis is rarely fatal, they said.
The condition is marked by a high blood sugar count that causes the body to produce acid byproducts which, if not treated quickly, can lead to death.
In Emily's case, diabetes experts believe the ketoacidosis may have been compounded by a bout of stomach flu that hit her hours before she died. Hilton also believes that Emily may have missed her morning insulin injection, or may not have given herself a large enough dose.
"Teens are prone to do this (miss an insulin injection), and if you get something like the stomach flu on top of it, it can lead to tragedy. If you're diabetic and have the stomach flu, you have to assume that you have ketoacidosis," said Dr. Jeffrey Roth, who specializes in juvenile diabetes at Kaiser Permanente Hospital in San Diego.
"The horror of this tragedy is that it could have been prevented. You don't have to die from something like this if you watch what you're doing," Roth said.
Diabetes in children and young adults is caused by the destruction of the body's insulin-producing beta cells. Without the natural hormone that regulates the sugar in their blood, diabetics must carefully monitor the levels and inject themselves with insulin to remain healthy.
Emily's sudden death was an especially cruel blow to Hilton. Until she married two years ago, Hilton had mostly been a single-parent almost since Emily was born. Emily had been a constant companion for nearly half of Hilton's life.
One week after her daughter's death, Hilton was just beginning to cope with the void left in her life. She has a year-old son who keeps her plenty busy, but, she asks, "How can you adjust to something like this?"
"I have trouble getting up in the morning. I don't want to wake up. I just want to crawl into a ball and stay in bed. . . . I keep hoping that this is just a horrible, horrible nightmare, and I'll wake up scared, but Emily will still be here," Hilton said.
But the nightmare is real. Two days after her daughter's death, Hilton had the furniture removed from Emily's bedroom.
"It (furniture) reminded me of death. I didn't want to keep the image of her lying there, dead," she said.
Emily died hours after returning from a day trip that thousands of Southern California teen-agers take every year. She and her boyfriend, Clark Wothe, had spent the day at Disneyland. The excursion was Wothe's Christmas present to Emily.
When Emily left for Disneyland, there was no indication that she was seriously ill, Hilton said. But when she arrived home that night, Emily began throwing up and said she had the flu. The young woman went to bed, and the last time Hilton saw her alive was Jan. 3, at 3 a.m., when she got up to check on her.
The teen-ager's death rocked Patrick Henry, where Emily was an honor student and active in campus groups. When students returned to school Jan. 6, after Christmas break, they were "in shock and total disbelief," Ruth Cox said.
Cox, who was Emily's counselor for two years, described her as an "extremely independent person who took a demanding and challenging course load." She said that Emily, who was scheduled to graduate in June, was enrolled only in advanced courses, including a college-level political science course.
"Your heart was always lifted when she walked through your door. . . . I know it sounds almost like a cliche, but we will miss her an awful lot. She was a very visible student, participating in a number of clubs and organizations," Cox said.
Emily was president of the debate team and a member of the Science Olympiad, speech team, school chorus, cross-country track team, soccer team, yearbook staff and National Honor Society. In addition, she worked part-time at a fast-food restaurant.
During the summer, the young woman also served as a counselor at a mountain camp for diabetic youths near San Bernardino.
While Emily was admired for her academic achievements, her independence was almost legendary among friends and relatives.
That independence manifested itself at an early age, "when she began questioning authority," Hilton said.