Murmur - 2021, April by Griffith University Medicine Society (GUMS)

murmur The official GUMS magazine

A P R I L

2 0 2 1

CONTENTS 3

President's Note

Editor's Note

Terrifying Time Loop: The Déjà vu Pandemic

50 things they do not tell you about being a patient (and what I will tell my patients)

Janis Fernandes

Ashraf Docrat

Abdikarim Said Abdullahi

Alexandra Wilson

COVID-19 Vaccine FAQs

Where There's Smoke...

Ignored Things

An Introspection on Inheritance

Recipe of the Issue: Carrot Dip

Aiah Al-Saig

Keeley Brettell

Dalia Abu-Ghazaleh

Kentai Arichi

Ashraf Docrat

GUMS Scrub Crawl 2021 Photo Album

Front cover design by Stephanie Lau Photo credit: cottonbro from Pexels

MIPS, proud indemnity partners of GUMS. MIPS provide indemnity to 4 out of 5 medical students; more than just indemnity, we provide you with protection and support throughout your medical career. Throughout this journey you will see us at events organised by GUMS, you may see MIPS representatives at your Clinical Schools. You will also have access to our online webinars and modules, if ever you have a question, a concern or you need a helping hand, MIPS are here for you. Not sure what indemnity is? We will provide cover for any acts, errors or omissions you make in providing healthcare. This includes being sued. We are a not for profit, membership-based organisation, committed to providing more than just indemnity cover to our members. In addition to the comprehensive indemnity cover that is part of membership, members also have access to 24-hour Medico-Legal Support provided by experienced doctors and lawyers, electives cover, MIPS protection for non-indemnity related matters such as bullying and accredited risk education. Student membership is free and available to healthcare students, healthcare practitioners practising medicine, dentistry, oral health or nuclear medicine technology and international healthcare practitioners. mips.com.au | 1800 061 113

President's Note Dear Readers, Welcome to the first issue of our 2021 edition of The Murmur magazine!

Janis Fernandes GUMS President 2021

As I reflect on this first quarter of 2021, I am amazed at how much has happened in the life of GUMS already. The theme of this issue of the Murmur- living through history- made me think of the small fragment of ‘history’ that has been my time in university. As a GUMS member since day one, I have grown to really love our medical society and all it does for students. In my role as President this year, it has been a privilege to see our GUMS Management Team settling into their roles and developing new and creative initiatives that help Griffith Medical students enjoy medical school and thrive within their studies. I am constantly reminded of the amazing talent and drive that exists within a pool of medical students. When I was thinking about the reason that GUMS events hold so much value for students, I kept coming back to one central theme- community. Every event or initiative aims to foster community- whether this is within a cohort, between cohorts or within a professional space. Just over the short period of this year that has elapsed, I have watched our GUMS communities grow. I have watched first years mingle with each other at Disorientation Camp and Orientation week mixers, watched our LGBTQIA+ community come together at Trivia Night, seen our Wellbeing mentorship BBQ Brekkie take off and been privy to the wonderful behindthe-scenes of our GUMS volunteer community- just to name a few!! I have been so thankful for the opportunity to gather in-person and online over the last few months and to foster new relationships that make medical school so memorable. I hope that as you reflect back, one day, on your time through medicine, you will remember sharing stories, stresses, and a coffee after class. I hope that these are a part of your personal fragment of history, much like they have been a part of mine. Warmest regards,

Janis Fernandes GUMS President 2021

Editor's Note “We’re living through history” was a phrase that started springing up when lockdowns started around the world just over a year ago. It had a kind of innocent excitement behind it. The 21st Century is probably the most prosperous and peaceful periods of human history (notwithstanding COVID-19). For younger generations, this has created a kind of disconnect between our present and what we study in history books. The idea of life at home being disrupted by rations and power cuts like in World War II or mass displacement and migration like during the partition of India were all foreign concepts despite occurring less than 80 years ago. When combined with technological and scientific progress, it seemed like there was nothing significant could possibly affect everyone so completely, that we could experience history. At least initially, we seemed to approach the challenge of COVID-19 through a kind of upbeat positivity as measured by the universal barometer of mood: memes. Before lockdowns, there were cheerful memes matching song lyrics to handwashing steps and reminding people to ‘dab’ when they coughed or sneezed. Even as lockdowns commenced, there were memes reminding people that Isaac Newton developed calculus and his theory of gravity when he ‘worked from home’ when Cambridge closed due to an outbreak of the bubonic plague in 1665. And, of course, there was the explosion in popularity of Tik Tok and its encouragement for people to not only dance but produce all sorts of fun and engaging video content from their homes. However, as lockdowns dragged on, and as the historical ‘moment’ seemed to be morphing into an epoch, fatigue set in. “We’re living through history” moved from innocent excitement to a tired refrain to increasingly concerning news updates. As daily case numbers and deaths rose around the world and economic ruin was unleashed, any optimism or excitement about ‘being part of history’ was lost to the difficult realities.

In this edition of Murmur, a significant portion of our pieces are based on writers reflecting on these ideas. There is an exploration to how similar the Spanish Flu and COVID-19 pandemics are (despite occurring over 100 years apart), a reflection on how we take past innovation for granted, and more creative and stylistic pieces reflecting on ‘living through history’. We hope you can find some joy and intrigue through these pages. We also have a brief and simple COVID19 Vaccination Q&A explainer which we hope you can use a resource to share with family and friends or just for your own reference. While COVID-19 undoubtedly has and will continue to leave its mark on history, what it has hopefully taught us is that what we do each and every day is significant and becomes part of the fabric of history. After all, if staying at home and baking sourdough helped literally save lives, then how can we assume how history will judge our other actions? Perhaps we have more control and influence individually than we give ourselves credit for. If you have any thoughts or comments on the pieces or the magazine as a whole, feel free to email them to publications@gums.org.au .

Ashraf Docrat Editor in Chief

And so now, in April 2021, with a mass vaccination campaign being rapidly scaled up there is an emergence of hope that this is the beginning of the end for this historical moment. However, this also represents an opportunity to reflect on what living through this period of time has meant to us as well as how the past influences our present and how the future may look back on us.

TERRIFYING TIME LOOP

Top: 1918 Influenza Pandemic Bottom: 2020 Covid-19 Pandemic

The Déjà vu Pandemic By Abdikarim Said Abdullahi Design by Stephanie Lau

mpty streets, closed movie theatres, deserted train stations, padlocked restaurants, and land borders proliferate like the virus. No, these scenes are not from 2020 New York or Toronto, or even Sydney, but are from the 1918 influenza pandemic that ravaged much of the world. Indeed, while this particular coronavirus may be new, pandemics and contagions are not new phenomena and have ravaged empires and societies since the beginning of time. What is also not new is the pandemic public health playbook which was largely developed from knowledge gained from previous pandemics such as influenza (1918), polio (1940), AIDS (1970), and Ebola (2016). Early public health interventions were critical in curtailing the spread of these contagions and saving countless lives. For instance, cities in 1918 that implemented stringent public health measures, including school closures, bans on public gatherings, and other forms of isolation or quarantine, slowed the course of the 1918 influenza epidemic and reduced total mortality rates. The histories of these past pandemics not only offer us considerable advice and wisdom on how

to tackle contagions, but also give us a stern warning of the devastation that can ensue if public health measures are not taken seriously. If the past is prologue, then have we learned anything? If our response to the Covid-19 pandemic with 2.5 million deaths and the 114 million infected people worldwide is our litmus test, then the answer to this question becomes apparent. Certain things from the past, like the bad fashion faux pas and outrageous hairdos deserve to stay there, however, when it comes to life and death matters all tried strategies and knowledge from the past need to be studied.

There is a term that eloquently summarizes my point: “clioepidemiology”, which is the practice of studying information from past epidemics for advice about the present. So why have we treated the concept of “ clioepidemiology ” as just another fancy addition to our vocabulary and haven't implemented its practice into our Covid-19 response? Instead of foot-dragging and denials of the pandemic, why were governments and their citizens so hostile and reticent to the most basic public health measures like quarantine, face masks, and social distancing? Some have argued that government officials flouted lessons from the past on implementing early quarantine and lockdown measures during the height of the Covid-19 pandemic because they feared backlash from their citizens due to the inconveniences these measures would impose. Are we that much of a delicate flower?

If the citizens in 1918 were able to tolerate public health practices of lockdowns, social distancing, and wearing face masks, why can’t we, with our modern access to virtual learning, grocery deliveries, Netflix, and Uber eats? While countries like Australia and South Korea were able to heed the lessons from the past to deal with Covid-19 , other nations like the United States ripped the pandemic playbook response to shreds and suffered dire consequences. However, before we award Australia a gold medal for its response to Covid-19, it too could have done more to respond faster, as is evident by its blenders with the Melbourne outbreak and the devastating aged-care fatalities. Some would argue that the 1918 influenza outbreak is too far in history to remember any lessons and practices to deal with modern-day pandemics. Even if one concedes this outrageous notion, then what about the recent 2003 SARS pandemic? Surely, if 17 years ago I can remember the girl I took to the school dance (Michelle) or the top hit song of that year (In da club), our government health agencies can also remember the ill-preparedness and botched public health response to the 2003 SARS pandemic. Among the two key lessons not learned from the SARS pandemic that should have been ingrained into our memories was regarding our healthcare workers and hospital resources. In 2003, hospital healthcare workers were ill protected and represented almost half of the deaths attributed to the SARS pandemic. Fast forward to 2020, healthcare workers continue to represent a sizeable amount of those infected with Covid-19 and deaths attributed to lack of personal protective equipment available to them as they cared for infected patients.

Another key lesson missed from the 2003 SARS pandemic was the importance of ensuring stockpiles of ventilators to deal with future respiratory pandemics. Not surprisingly, this important lesson was also ignored as illustrated by stories of doctors all over the world deciding which Covid-19 patient gets a ventilator and a fighting chance to beat the virus due to scarce supply. Looking ahead, with climate change, changing ecosystems, and an overuse of antibiotics we are likely to face more deadly contagions in the not-so-distant future. If we don’t start hitting the history books for guidance now, reality will hit us so hard that even modern medicine won’t be able to save us. Indeed, as each new contagion surfaces, it will undoubtedly be smarter to evade not only our immune systems but mutate at a rate so fast that vaccines won’t keep up. This grim forecast is already happening with Covid-19 and the emergence of unprecedented mutant Covid-19 strains. So, will we learn from Covid-19 or once again ignore the lessons another pandemic has to offer us? As George Santayana once wrote, "Those who cannot remember the past are condemned to repeat it." To put it more bluntly, “Fool me once, shame on you. Fool me twice, shame on me.”

things

being a patient

about

(AND

WHAT

they do not tell you

WILL

TELL

PATIENTS)

By Alexandra Wilson IT IS NO SECRET

that I have a zipper scar clasping the skin either side of my sternum together. After 7.5 hours of open-heart surgery on a strawberry sized heart, it is an evolving mark (quite literally 20+ cm long) of my own patient history.

13. You will feel comfortable in a sterile environment. 14. You become extremely efficient at knowing the best parking spots, traffic route, or duration of medical tests. 15. Take that warm blanket on offer. 16. You will know the paradox of pain and relief all too well.

Over the course of a mere 21 years, treading my black, worn out, frayed stitching doc martens on this concrete playground we call earth, I have learnt that being the patient will always influence the way I work.

17. It is okay to be frustrated with your medical history. 18. You will make your younger self proud. 19. You end up holding many job titles: a fighter, a healer, a journalist, an advocate, a storyteller, a patient. 20. Ask health professionals to talk with you not to

And so here are 50 things they do not tell you about being a patient (and what I will tell my own):

you. 21. Always smile – it is a highly effective and potent medication. 22. It is okay to be gratified by your own medical

1. You will have a niche knowledge set.

history.

2. Your R value for empathy will be greater than

23. Medical staff will blast music, audiobooks, or

others.

podcasts in the operating room – this sense of

3. Your medical ID will become as important as

madness or distraction is their sense of calm

your driver’s license or loyalty cards.

and focus.

4. Ignorance is bliss.

24. For the many forks in the road, potholes or

5. Ignorance is definitely not bliss.

missed turn exits, with a few flat tyres and

6. You are filled with a sense of warmth when you

some panel scratches you will take, it will only

hear your name beamed by a familiar medical

serve to reaffirm your character.

face.

25. It is okay to feel weak and it is okay to feel

7. Sometimes that warmth is coated with a cool

strong.

shock of why they know your name.

26. You can always dress up or dress down your

8. You wake up every day being more grateful

scars.

than the one before.

27. If you have a contrast CT scan, you 99.98% of

9. How you react to your situation is your mind

the time have not had a lapse in bladder

asking something of you – listen.

function, even if it feels like it.

10. It is exhausting.

28. A lung lobe collapse feels like a never-ending

11. There is always extra ice cream in the freezer. 12. You will feel uncomfortable.

restrictive hug – a beautiful but painful irony.

29. Sometimes you will miss out on lunch with a

40. Be curious and allow others to be curious –

friend you have not seen in five years.

this is the only way I know how to gift

30. You will savour the times when you can catch

understanding.

up with friends you have not seen in five years.

41. If you have the chance to run on a sporting

31. Needles will never get better (or at least they

field, walk up a flight of stairs or take a breath

did not for me).

in the morning, you will find a moment where

32. Beautiful moments will fill your most

you can thank your body.

debilitating hours.

42. And that thank you to your body will be with a

33. It is okay to say you do not know something,

heavier sense of gratitude.

even if you study or work in the field. Being a

43. People will find your story fascinating because

patient is vastly different to being a student or

it is fascinating.

worker.

44. It will make you better and you will be better f

34. It becomes part of your identity – and that is a

or it.

double edge sword.

45. It is your normal. And it is normal.

35. You will never stop learning as those who care

46. You are the parent of your past.

for you will continue to teach as they learn.

47. You are the parent of your now.

36. Be the only person to lower the bar for

48. You are the parent of your future.

yourself.

49. Read Oh the places you will Go by Dr Seuss.*

37. Even if you feel you “should” know the answer,

50. Your story is pretty damn cool.

still ask the question. 38. No one will see you for your health, they will

*prescription for all readers, irrespective of

see you for your heart (ignore the

medical history

contradictory aspect of my own medical history). 39. Always romanticise your patient testimony.

WRITING THE 50TH STATEMENT IS BOTH CATHARTIC AND ARDUOUS IN ITSELF AND whilst I sit here doubting whether sharing this was worth writing and writing this is worth reading, it would be remiss of me not to acknowledge those who made it possible for me to do so. It was the 3am Emergency Department visits, copious follow-up appointments and series of tests while I paraded around in a hospital gown and disposable shoe covers that guided me on my way to a career in medicine. I, like many others, have had a less than calm journey as I navigate the turbulent seas of life. Now, as I sail the waters to becoming a medical doctor, I will cherish my time as a patient. I will always remember how a smile from a doctor made me feel and every tender moment shared with the healthcare team was like seeing the distant flash of a lighthouse on a moonless night. When I get the chance to be a part of a patient’s story, I will be reliving my own as a small bulb in their own lighthouse.

COVID-19 VACCINE FAQS Written by Aiah Al-Saig|| Design by Mahnoor Kamali

new year, a new stage in fighting COVID-19– vaccinating the world. Four months into 2021 and the global effort to ............vaccinate against COVID19 is well and truly underway, with over 200 million people receiving the jab worldwide. In Australia A however, it seems to be a slightly different story. Over 1 000 000 Australians have been vaccinated since the first shipment of COVID19 vaccines arrived in Australia on February 15th, however the vaccine rollout has fallen behind schedule with evident repercussions. As future healthcare practitioners, it is essential that we accrue some fundamental knowledge of the single largest vaccination program in Australian history, and one that will likely affect our lives and livelihoods far into the future. There is no doubt many of you would have heard and read about the COVID-19 vaccines circulating, so we hope these Q&As will help the next time you get a COVID-19 vaccine question thrown your way.

WHICH VACCINES DOES AUSTRALIA HAVE ON ORDER? Oxford/AstraZeneca

Pfizer/BioNTech This vaccine has been approved by the TGA and is currently being rolled out to Phase 1a (see table) eligible recipients and will require two doses 21 days apart with a 95% efficacy rate at preventing symptomatic COVID-19 [2]. As an mRNA vaccine, the Pfizer vaccine uses novel mRNA technology to instruct production of the specific spike protein of the SARS-CoV-2 virus. Once the mRNA enters the body’s cells, the cells use the genetic code to produce the spike protein. Immune cells recognise the spike protein as foreign. This triggers an immune response through production of T cells and antibody-producing B cells. The genetic material from the vaccine does not change or become part of the recipient’s genes. Recent data has shown vaccine can be safely stored for up to 2 weeks at regular freezer temperatures as opposed to -70C initially thought [5].

Novavax Although not yet approved by the TGA, Australia has contracted the purchase of over 50 million doses of the Novovax vaccine, which will require two doses administered 21 days apart [2]. As a protein subunit vaccine, this vaccine uses a labmade version of the SARS-CoV-2 spike protein combined with adjuvants, similar to current influenza, HPV and Hepatitis B vaccines.

A note about the COVAX Facility The Australian Government has joined the COVAX Facility as part of a global effort to support rapid, fair and equitable access to COVID-19 vaccines. Potential COVAX Facility vaccines include: Oxford/AstraZeneca, Novavax, Moderna, CureVac, Sanofi/GSK, Inovio, Clover Biopharmaceuticals/GSK/Dynavax, Institut Pasteur/Merck/Themis and University of Hong Kong vaccine [2]. Australia has secured 25 million additional doses of any combination of these vaccines.

This vaccine is also approved by the TGA and currently being rolled out, this vaccine is administered in two doses 4-12 weeks apart with an 82% efficacy rate [2]. As a viral vector vaccine, the AstraZeneca vaccine uses a weakened adenovirus from chimpanzees that contains the DNA for a protein unique to SARS-CoV-2, the ChAdOx1 viral vector. Once the viral vector enters the body, the DNA instructs the cells to make a protein that is unique to SARS-CoV-2, triggering an immune response through production of T cells and antibody-producing B cells. This vaccine can be stored at 2-8C. Investigations into the link between the development of blood clots - now classified as VIPIT (vaccine induced prothrombotic immune thrombocytopenia) - are continuining but has resulted in the vaccine not being recommended for those under the age of 50 [3].

COVID-19 VACCINE FAQS

WILL THE CURRENT VACCINES BE EFFECTIVE AGAINST EMERGING STRAINS OF SARS-COV-2? This

tricky

question.

multicentre clinical trial in South Africa

the

B.1.351

variant

concluded that two doses of the AstraZeneca minimal

vaccine

efficacy

moderate

had

mild

COVID-19

cases,

specifically due to this mutation. Although there is still hope the vaccine will be effective against more severe cases of COVID-19, South Africa have halted roll out

HOW LONG WILL IT TAKE TO VACCINATE EVERYONE? According to the Australian Federal Government, vaccine rollout from Phase 1a to Phase 3 should ensure all those eligible receive their first dose by end of December 2021 [2]. However, vaccine administration rates are already falling behind schedule and some overseas vaccine supply has been disrupted, impacting the rollout. National supply of the

Oxford/AstraZeneca vaccine is secured as this vaccine is

being produced in Australia, however supply chains of the Pfizer/BioNTech may be disrupted, as this vaccine must be imported from overseas.

Phase 1a Quarantine, border and front-line health care workers will need to provide proof of occupation to demonstrate their eligibility Quarantine and border workers, including: staff at entry points to the country (such as seaports and land borders) staff working in quarantine facilities, including those employed under Commonwealth, state or private agreements, and Commonwealth employees (including Defence personnel) who are identified as having the potential to encounter returning travellers as part of their work.

of the AstraZeneca vaccine. On a slightly better note, in the UK, a Phase 2/3 clinical trial concluded that the AstraZeneca vaccine had an efficacy against the B.1.1.7 variant similar to that of other variants — 74.6% compared with 84% [1]. It’s important to note this study is also preprint, so it hasn’t yet received the same scrutiny

other

published

research. Interestingly, both the UK and South African variants have

the

same

mutation

—

N501Y — but the South African variant has an extra mutation —

Frontline health care worker sub-groups for prioritisation frontline staff in facilities or services such as hospital emergency departments, COVID-19 and respiratory wards, Intensive Care Units and High-dependency Units laboratory staff handling potentially infectious material ambulance and paramedic service GP respiratory clinics COVID-19 testing facilities *All other healthcare workers are included in Phase 1b, including tertiary and medical students with placements in these healthcare settings. Aged care and disability care staff nursing and personal care staff allied health professionals who routinely provide care kitchen, cleaning, laundry, garden and office staff Aged care and disability care residents

Number of doses up to 1.4m *Pfizer/BioNTech vaccine only, almost complete.

E484K. Research shows this mutation contributes to the virus evading

antibodies against

SARS-CoV-2 [4].

COVID-19 VACCINE FAQS

HOW LONG WILL IT TAKE TO VACCINATE EVERYONE? CONT. Phase 1b

Phase 2b

Elderly adults aged 80 years and over

Balance of adult population

Elderly adults aged 70-79 years

Catch up any unvaccinated Australians from previous phases

Other health care workers

Number of doses up to 16m

Begin vaccinating Aboriginal and Torres Strait Islander adults

*Mostly Pfizer + Novavax (if approved by TGA)

Adults with a specified medical condition *People will need to provide proof of these conditions to demonstrate their eligibility for vaccination via My health record, a health professional referral if required or a declaration form.

Phase 3

Adults with a disability who have a specified underlying medical condition Critical and high-risk workers including defence, police, fire, emergency services and meat processing * Workers will need to provide proof of occupation to demonstrate their eligibility. Number of doses up to 14.8m *Oxford/AstraZeneca for those over 50 years and Pfizer for others

Phase 2a Adults aged 60-69 years Adults aged 50-59 years

< 16 if recommended* Number of doses up to 13.6m *Currently no COVID19 Vaccine approved for <16 years old *Pfizer/BioNTech vaccine only administered for >16 years old *Oxford/AstraZeneca only administered for >18 years old but only recommended for those aged over 50 Figure 1 – Australian Government National Vaccination Strategy [2]

1. Lodge, A., 2020. ChAdOx1 nCoV-19 vaccine for SARS-CoV-2. The Lancet, 396(10261), p.1486. 2. QLD Health, 2021. Information Sheet. [online] Available at: <https://www.qld.gov.au/__data/assets/pdf_file/0024/155328/qldvaccine-rollout.pdf> [Accessed 11 April 2021]. 3. Zulli, A., Husaric, M., de Courten, M. and Apostolopoulos, V., 2021. What's VIPIT, the rare blood condition possibly linked to AstraZeneca? [online] ABC News. Available at: <https://www.abc.net.au/news/202104-09/astrazeneca-covid19-vaccine-blood-clot-linkexplain/100058258> [Accessed 11 April 2021].

Continue vaccinating Aboriginal and Torres Strait Islander adults Other critical and high-risk workers Number of doses up to 15.8m *Oxford/AstraZeneca for those over 50 years and Pfizer for others

4. Wilson, K., Boer, J. and Plebanski, M., 2021. 5 things you need to know about the AstraZeneca vaccine now the TGA has approved it for use in Australia. [online] The Conversation. Available at: <https://theconversation.com/5-things-you-need-to-know-about-theastrazeneca-vaccine-now-the-tga-has-approved-it-for-use-in-australia155139> [Accessed 18 March 2021]. 5. Centers for Disease Control and Prevention, 2021. Pfizer-BioNTech COVID-19 Vaccine Storage and Handling Summary. Available at: <https://www.cdc.gov/vaccines/covid-19/info-byproduct/pfizer/downloads/storage-summary.pdf> [Accessed 11 April 2021]

WHERE THERE'S SMOKE... Written and designed by Keeley Brettell

We wake to the smell of burning toast. It’s faint, drifting into the peripheries of awareness and straddling the line between dream and reality. More than likely, someone’s turned their toaster up too high. Again. With a stretch, a yawn, a bleary thought to how inconvenient a fire alarm – a false alarm at that – would be this early, we roll over to doze and hopefully fall back into sleep’s comforting arms. Then the yelling starts. Panicked voices overlapping either other, intertwining with crashing and slamming doors. But despite the racket, everything seems surreally, paradoxically quiet. The previously dreaded fire alarm far too silent for the chaos apparently unfolding. Suddenly we’re properly awake. We spring out of bed. Out of the bedroom into the living room before processing anything beyond the deep-seated certainty that something is wrong. Gone in an instant is the faint, almost pleasant aroma of smoke; here it’s acrid and allconsuming, coating the tongue and filling the lungs until we’re wheezing, gasping for air. Then, a memory surfaces unbidden as we struggle to catch our breath. The neighbours in the unit next door, met in passing in the lobby. Their daughter, giggling and hiding behind her dad’s legs. A teddy swinging from her grasp, loved and worn. A Ventolin puffer peeking from her mum’s handbag. We throw open the door. Heat and light and billowing smoke hit in a rush. A frantic glance down the hazy corridor confirms what we were starting to suspect: the fire alarm lies on the hallway table, scattered batteries catching the light in between fleeing shadows. A task started but never finished. A task that seemed like it couldn’t possibly be urgent enough to matter, but now has never mattered more. Then the flames arrive. Spilling over into the room as though they were waiting to pounce, licking at doorframes and fingers. A yelp. A slam of the door. We back away as flames creep across the carpet. There’s no fire extinguisher in here. It’s out in the corridor. A borderline hysterical laugh – of course it’s out in the corridor. Another thing that never seemed important. Scrambling around the kitchen, we pull the tablecloth from the table and throw it over the flames. For a moment it looks like it might work. Then the tablecloth catches alight. We retreat to the bedroom. Inspiration strikes – the ensuite! – and we’re turning on the taps in the bath, the shower, the sink. Despite not knowing what kind of fire we’re dealing with, it’s surely better than nothing. The water fills the sink. It trickles over the edge, flowing futilely towards the door and the fire behind. .

Then, with a final protesting shudder, the bathroom wall gives in. White hot embers fly, stinging when they land. We flinch and cough as smoke pours in anew, retreating further into the bathroom towards the overflowing sink where a handtowel dangles tantalisingly. If we can only reach it, maybe we can breathe through the smoke. Maybe we’ll have a chance. Then, we see it. Partially hidden under the rubble is the frayed arm of a teddy – soot black but unmistakeable. We frantically scan the room next door where the collapsed wall has opened it up. There! A little girl, almost invisible between the smoke and how she’s wedged into the corner. Her breathing is fast and laboured, whole body moving with the force of it. Momentarily, the smoke thins enough for us to meet her panicked eyes. Then, piercing through the roaring flames and rushing water, is the sound of sirens. Someone’s called the fire brigade. But the chaos (and the ever-growing ringing in our ears) makes it impossible to tell how close they are. Whether they’ll reach us before the flames do. We make a split-second decision. Grabbing that handtowel that’s just come within reach we turn back the way we came, crawling through crumbled bricks and seizing the teddy on the way. The damp towel is heaven to our scorched hands, which shake as we tie it loosely over the girl’s face as a makeshift mask, pressing the teddy into her arms. Her tiny hands grasp it like a vice. Her breathing eases slightly, though it’s unclear whether that’s from the towel or the comfort of her teddy or sheer exhaustion. We slump next to her, light-headed. Then, a shape bursts from the haze. Through rapidly-darkening vision, it takes our sluggish mind several moments to process the bulky shadow as a person. A tug on our arms drags us towards it. We protest weakly, waving in the girl’s direction. She’s curled up, small frame barely moving. It’s not until they turn their attention to her that we relax. Distantly we register another figure appearing and arms under our shoulders and knees, the world tilting on its axis. The last thing we see before our eyes fall closed is the girl cradled in her rescuer’s arms a few steps ahead as they disappear through a gap in the rubble that might have once been a doorway. Then, there’s a rush of fresh air on our face, and we drift into unconsciousness.

Ignored Things Dalia Abu-Ghazaleh

Design by Charles Reyes

I don’t know if the past Can ever stay in the past If we can leave our luggage behind “forgive and forget” I don’t know if we can ever ignore some things If we can really sweep them under the carpet In search of peace of mind I don’t know if my mind registers history What I try to ignore What I “keep” in the past As “unimportant” Or if it keeps it lurking under my skin Ready to lash out Whenever an opportunity strikes If it collects debris in every cells of my body If it weighs me down Without me knowing If it seeps through the advice I give If it guides my ways And shapes my days If it is what makes me uneasy On days where everything seems to be Breezy I am curious as to how my mind deals with what I dismiss Curious to know the power of “ignored” Things

AN INTROSPECTION ON INHERITANCE By Kenta Arichi | Design by Charles Reyes Consider for a moment that your very existence means that your ancestors have survived hundreds of thousands of years in human history to be able to pass down the genetics you have inherited. Your ancestors may have faced the atrocities of various wars across the globe, endured pandemics caused by other viral and microbial agents (that aren’t the SARS virus). You are living proof that their contributions have allowed humanity to endure despite all that the world has thrown at them. It truly is something we don’t consider in our daily lives, however with the noise produced by the daily reports surrounding the coronavirus, it has given birth to such introspection I don’t think I or others would have come to without the pandemic. Living day to day during this pandemic, it was more important than ever to establish a healthy relationship with my own mind. One of the things that I have found helpful to keep me sane is starting to become aware of the feelings of gratitude I can have for the many things surrounding me. For example, did you know that William Osler (yes, the very same Osler who the nodes are named after in your cardiovascular examination) established the backbone of our current medical education: clinical teaching in your third and fourth years. This is all about a hundred years ago, but many of his proposed structures have remained intact throughout many medical schools globally. The actions of William and those like him a hundred years ago have given the clinical year students the opportunities we have today. I couldn’t help but feel incredibly lucky that such people existed to create this precedent. Let us escape from the medical context for a moment. I had also recently finished reading ‘12 Rules of Life’ by a clinical psychologist, Jordan Peterson. In this book, one of the passages which resonated with me was how we tend to shut off the complexity of the many parts of our modern day lives and only get exposed to them when things go wrong. The example cited was a car. I am no engineering student, but we can all agree that a car is more than just something with four wheels and gets us around to the places we need. Inside the car are many parts which operate to achieve the end goal of transportation. Imagine how many years of engineering and iteration have led to the very car you drive today. Years of people’s lives have been poured in throughout the ages to allow us to drive around conveniently. So, the next time you strap into drive, picture the years of ingenuity, the trials and error of engineers and mechanics all allowing you to drive and grab your groceries.

While history can often be jarring for how different it looks given the progress that has been made by the innovators of the world, there are also pockets of history which provide comfort in our common humanity across time. I encourage you to watch a documentary or look up photos from the Spanish Flu just over a hundred years ago. You’ll find that the past doesn’t look so different with all the masks that people were wearing then. News articles from that period were imbued with the same panic and fear that we saw on social media during this pandemic. There were even quarantine stations for soldiers returning from overseas that were established to contain the early days of the Spanish Flu. Which were not a far cry from the principles found in hotel quarantine for those coming in from overseas. State border closures were also occuring, frustrating citizens who may have found themselves stuck. Places of social gathering were shut down with unemployment then following suit were also what the Australians living during the Spanish Flu had witnessed. These frustrations that you or the people around you have felt with these measures were something shared with those from a century ago. In our current era of technological progress, the past can feel disconnected from us and too far back to learn anything from it. However, the events of the Spanish Flu are a reminder that the human experience transcends time and can reassure us that we will be able to make it. It can be hard to appreciate all that has come before us, but I have found that working to recognise that has helped me feel incredibly grateful for what I have and am doing. If the people in the past have helped prop up our current way of living the next logical question is, ‘what can we do to ensure a prosperous tomorrow for the world?’ No matter how bleak things look, what is the greatest good you can do to leave behind for your successors?

Recipe of the Issue: By Ashraf Docrat | Design by Charles Reyes

Roasted Carrot Dip This recipe is perfect if you have a bunch of carrots that have been in the fridge just a little too long. Roasting brings out the delicious sweetness of the carrots which pairs wonderfully with the slight nuttiness of tahini and the warmth of the spices. This recipe is quite modifiable: you could add other roasted vegetables like capsicums, substitute tahini for cashew nuts and change up the spices as you wish. However, I personally find this version to be my favourite. It's great as a PBL snack or as something to reach for when study snack-attacks hit. You can dip anything you want,: crackers, celery sticks, toasted bread, even more carrots or anything else really!

Ingredients: 500g of carrots juice of half a lemon 3 large garlic cloves 3/4tsp cumin 1/4 tsp coriander seed powder 1 tsp paprika A pinch of chilli powder or 1/4 tsp red chilli flake (optional) Salt 1-2 tbsp tahini (depends on how nutty you want it) Olive oil

Method: 1. Preheat the oven to 200C conventional/180C fan forced. 2. Cut carrots across into thirds and cut each third in half along the length. 3. Spread onto baking sheet lined with baking paper, season with salt and generously drizzle with olive oil. Toss the carrots to coat in the oil. Add the garlic cloves to the tray (do not peel!) 4. Place into the preheated oven. After 10 minutes, turn carrots over and remove the garlic. Allow to remain in oven until lightly burnished on the edges with fork tender centres. 5. Peel the garlic cloves and place everything except the salt into the food processor and blend. Add water or olive oil and blend again until you achieve the ideal, thick dipping consistency. Taste and add more salt or lemon juice if needed. 6. Spoon into serving bowl or storage container and put enough olive oil over the top to form a thin layer (this prevents oxidation). Top with a few sprinkles of paprika and serve immediately or refrigerate till needed. It should last at least 1 week in the fridge (although mine always ends up eaten before that).

Photography by James Alimboyong || @boingboingsnaps

Chief Editor: Ashraf Docrat Chief Designer: Charles Reyes Design Team: Keeley Brettell Stephanie Lau Mahnoor Kamali Eesha Bajra