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2

April 2011

News

medicalstudent

News Editor: Ken Wu news@medical-student.co.uk

Hari Haran GKT Medsoc President One of  the  privileges  of  being  Medsoc   President  is  that  I  get  the  opportunity   to  attend  meetings  with  the  presidents   of  the  other  London  Medical  Schools.   By  and  large  they  are  a  likeable  bunch,   however,   there   is   one   notable   excep-­ tion:   David   “Catchphrase”   Smith.   Never   short   of   a   motivational   cliché,   he   has   been   heard   saying   things   like   “The  only  place  success  comes  before   work  is  in  the  dictionary”.    Disliked  by   all,   his   attendance   at   our   meetings   is   becoming   farcical.   Since   his   appoint-­ ment   in   September   he   is   yet   to   make   a   useful   contribution,   and   I   am   sure   that   this   is   a   direct   result   of   the   fact   that  he  is  unable  to  tear  himself  away   from  his  book  “Being  The  Best  Means   Screwing   The   Rest”.   Predictably   his   performance   in   the   recent   Presidents  

Editor-in-Chief John Hardie examines his personality issues

social was   equally   pathetic.   Well   off   the   pace,   he   was   last   seen   loitering   outside   the   female   lavatories   having   had   his   advances   rebuffed   by   numer-­ ous   local   women!   It   speaks   volumes   that  this  is  the  best  that  Imperial  have   to  offer  and  I  can  only  see  their  unfor-­ tunate   institution   regressing   further   into   the   doldrums.   GKT   on   the   other   hand   continue   to   go   from   strength   to   strength,  a  fact  substantiated  when  we   recorded  a  clean  sweep  of  victories  in   the   recent   football   UH   Cup   Finals  

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Laura Brenner BL President What a  successful  month  it’s  been  for   us   here   at   BL!   With   our   RAG   week   having  finished  today  I  am  very  proud   to   say   that   we’ve   smashed   last   year’s   record   of   £109,000   raised   in   a   week!   Enjoy   the   special   RAG   pullout   in   this   edition   for   all   the   juicy   gossip. It’s   also   finals   time   for   our   fifth     years  and  you  can  feel  the  nervousness   in  the  air  at  W hitechapel.  It’s  made  a  lit-­ tle  easier  with  some  good  news  though   as   a   recent   study   shows   that   our   stu-­ dents   came   second   (to   another   school   with   a   mandatory   BSc   year)   in   the   country  in  FPAS  scores  this  year.  With   finals  of  course  comes  preparation  for   the   Graduation   Events   and   our   VPs   have  been  hunting  down  the  best  deals   and  venues  for  us.  We’re  also  planning   the  BLSA  Summer  Ball  which  this  year   is   themed   around   the   1950’s   Grease   Era,  think  American  Diner,  Rock  and  

Roll and   fun   fair   rides   it’s   definitely   going   to   be   an   unforgettable   night!   The  date  is  set  for  the  14th  of  July  and   tickets  will  be  going  on  sale  very  soon.   It   has   also   been   announced   that   our   beloved   Warden’s   successor   has   been   chosen   and   we   look   forward   to   welcoming   him   into   the   BL   family;;   Richard   Trembath   will   succeed   Sir   Nicolas  Wright  this  summer  and  will,   I’m  sure,  be  keen  to  continue  the  out-­ standing   supportive   relationship   be-­ tween  our  staff  and  students.  Peace  

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Luke Turner SGUL President I have   a   very   serious   matter   to   bring   to   the   attention   of   all   UH   students.     ICSM  President  David  Smith  has  been   engaging   in   corporate   espionage   at   St   George’s.     With   a   little   more   dig-­ ging,   I   discovered   that   his   mother   is   our  admissions  tutor  and  his  father  is   a  consultant  here.    Firstly  this  begs  the   question,   how   in   the   hell   did   he   still   not   get   in!?     I   guess   he   is   lucky   Im-­ perial  were  willing  to  take  him.    Sec-­ ondly,   what   is   he   doing   here?     Is   he   just  desperate  to  be  a  part  of  the  finest   medical   school   in   the   land   or   are   his   intentions  more  sinister?    I  recently  in-­ terrogated   David   (More   with   Strong-­ bow   and   Sambuca   than   waterboard-­ ing)   and   he   admitted   making   contact   with   Daily   Mail   reporters.     I   believe  

he aims  to  divert  attention  away  from   Imperial’s  recently  sullied  name  with-­ in  the  tabloids  by  dragging  us  through   the  mud  with  him.  Who  knows?    Per-­ haps   he   is   still   seeking   revenge   fol-­ lowing   his   rejection   from   George’s! I   attempted   to   discuss   his   shady   back   room   deals   with   Medgroup,   but   was   quickly   side-­ lined   by   GKT   President   Hari   Haran.   I   suspect   they   are   all   in   cahoots  

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C

harismatic authority.   Isn’t   that   what   the   public   ex-­ pects   to   see   in   their   con-­ sultants   and   senior   GPs?   The   cardiac-­arrest   alarms   go   off,   the   crash   team   hastily   scuttles   down   the   corridor,   only   to   find   the   consultant   anaesthetist  already  there  with  the  sit-­ uation  coolly  in  hand  –  Colgate  smile   and   well-­coiffed   hairdo   still   intact. There   is   a   minor   pitfall   here.   These   two   words   are   strongly   as-­ sociated   with   Max   Weber’s   defini-­ tion   of   the   Cult   of   Personality.   You   know,  that  thing  Stalin  and  Hitler  did.   Perhaps   we   should   shy   away   from   that   one   then.   It’s   time   to   tone   down   that   sharp   wit   for   the   ward-­round. After  having  completed  your  com-­ pulsory  reading  of  the  GMC’s  Tomor-­ row’s  Doctors,  you  might  be  under  the   impression   that   the   omnipotent   com-­ mission  would  prefer  you  to  have  no  dis-­ tinguishable  personal  features  whatso-­ ever.  Aside  f rom  a  different  barcode  on   your  ID  badge,  of  course.  It’s  become  

apparent that   having   a   presence   on   social   networking   sites   could   put   you   in  jeopardy  as  well  (page  6).  Huzzah. This   month,   we   seem   to   have   amassed  a  whole  series  of  medics  des-­ perate   to   create   fascinating   personas   for   themselves   outside   their   day   job.   Max  Pemberton,  writing  for  The  Daily   Telegraph,   was   the   insightful   junior   doctor  struggling  through  his  founda-­ tion   years   (page   10).   Having   adapted   the  column  into  a  book,  he  shot  to  mi-­ nor   journalistic-­stardom.   Although   he’s  since  w ritten  other  books,  he’s  still   best  k now  as  ‘that  junior  doctor.’  Adam   Kay  turned  his  hand  to  the  UH  Com-­ edy  Revue  whilst  at  Imperial  College,   wrote  a  little  ditty  about  his  loathing  of   Transport   for   London,   and   a   fair   few   people  on  the  internet  liked  it  ( page  18). Meanwhile,   BBC   Three’s   jun-­ ior   doctors,   are   currently   trying   to   shake   off   some   potentially   career-­ long   branding   as   ‘barbie’,   ‘that   one   who   failed   her   exams’   and   ‘that   mas-­ sive   guy   who   plays   rugby   but   can’t  

get down   the   hospital   corridor   very   quickly   and   looks   like   he’s   about   to   have  a  heart  attack  himself’  (page  12). Here   in   the   office,   the   edito-­ rial   team   are   putting   together   the   April   issue   -­   Macbook,   latte   and   thick-­rimmed   glasses   at   hand,   mull-­ ing   over   what   impression   they   them-­ selves  might  possibly  be  radiating…  

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Find us on Facebook and Twitter medicalstudent newspaper (cont’d from   front   page)   and   in   meet-­ ings   up   and   down   the   country   -­   does   not  support  this  Bill”  to  which  he  was   greeted  with  a  standing  ovation.  In  ad-­ dition,  his  letter  to  Lansley  stated:  ‘‘the   SRM  also  recognized  that  some  aspects   of  the  Bill  have  the  potential  to  improve   and  safeguard  care.  In  particular,  mo-­ tions  were  carried  supporting  the  prin-­ ciples   of   clinician-­led   commission-­ ing”.  However,  even  this  was  met  with   concerns   about   how   these   commis-­ sions  are  intended  to  work  in  practice. The   conclusion   of   the   meet-­ ing   was   to   call   on   the   government   to   put   a   halt   to   the   current   plans,   which   was   again   passed   with   a   nar-­ row   majority.   The   general   consen-­

the

sus was   summed   up   by   public   health   physician,   Dr   Layla   Jader:   The   NHS   needs   ‘evolution,   not   revolution’. A   public   statement   given   by   the   BMA   on   the   SRM   iterated   that   “the   government   should   not   be   left   in   any   doubt   about   the   strength   of   feeling   among   the   medical   profession.   Many   doctors  have  serious  concerns  about  the   scale  and  nature  of  the  planned  reforms   which  are  hugely  r isky  and,  potentially,   highly  damaging”  and  that  “the  BMA   will   continue   to   publicise   and   oppose   the   damaging   aspects   of   the   Bill”. In  a  webcast  where  BMA  members   could  pose  questions  to  Lansley  on  the   reforms,   almost   a   third   related   to   the   lack  of  evidence  prompting  the  shake-­

medicalstudent

/msnewspaper up. Many  prompted  for  so-­called  ‘Ev-­ idence-­Based   Politics’.   Travistoker,   a   blog   run   by   senior   BMA   members,   claimed   Lansley   was   changing   the   NHS   radically   “without   recourse   to   research,  pilots  or  evaluations  [which]   seems  to  be  anathema  to  doctors  t rained   to  deliver  evidenced-­based  medicine”. Without   the   support   of   the   BMA   and   the   people   they   represent,   the   government   will   find   it   increasingly   difficult   to   put   through   their   reforms   without   a   serious   rethink.   Oppo-­ nents   to   the   reforms   should   take   this   as   a   strong   positive   step,   but   should   keep   the   pressure   on   the   government   to   ensure   protection   of   the   NHS  

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Contact us by emailing editor@medical-student.co.uk or visit our website at www. medical-student.co.uk

Editor-in-chief: John Hardie Assisstant editor: Amrutha Sridhar News editor: Ken Wu Features editor: Neha Pathak Comment editor: Sarah Pape Culture editor: Robyn Jacobs Doctors’ Mess editor: Abe Thomas Sports editor: John Jeffery Treasurer: Alexander Cowan-Sanluis Sub-editors: Martha Martin, Giada Azzopardi, Lucia Bianchi, Kiranjeet Gill, Hayley Stewart, Bibek Das Image editors: Chetan Khatri, Purvi Patel Distributing officer: Sevgi Kozakli


medicalstudent

April 2011

3

News

Day X exposed

Alex Nesbitt RUMS MSO

Ellis Onwordi reports from the ominously named event

I

t was   estimated   that   up   to   1000   people   turned   out   on   Wednes-­ day   9th   March   at   the   Royal   London   Hospital   in   the   East   End   to   protest   against   the   govern-­ ment’s  Health  and  Social  Care  Bill  and   planned   hospital   trust   redundancies. The   march   was   organised   and   led   by   Keep   Our   NHS   Public,   ‘Tow-­ er   Hamlets   Hands   Off   Our   Public   Services’   and   ‘Right   To   Work’.     It   was   joined   by   a   diverse   range   of   campaigners   and   workers   alike. Doctors,   nurses,   a   host   of   health   workers,  medical  and  nursing  students,   trade   unionists   and   political   activists   gathered   from   5pm   to   march   to   St.   Bartholomew’s  Hospital  in  Smithfield,   the  City  of  London.    Delegations  from   Bart’s,   the   Royal   London,   Homerton,   Guy’s,  St.  Thomas’,  King’s,  University   College   and   the   Royal   Free   Hospitals   made   sure   their   voices   were   heard. The   government’s   proposed   NHS   reforms,  absent  both  f rom  the  Conserv-­ ative   and   Liberal   Democrat   manifes-­ tos,  and  from  the  coalition  agreement,   has  been  met  with  widespread  opposi-­ tion  f rom  healthcare  workers  and  mem-­ bers  of  the  public  alike.    Many  have  ex-­ pressed  deep  worries  that  the  plans  will   result  in  a  significantly  increased  pri-­ vate  sector  involvement  in  healthcare. Alastair,   who   attended   the   march   and   is   a   former   patient   at   the   Roy-­ al   London   and   member   of   the   an-­ ti-­cuts   and   anti-­privatisation   cam-­ paign,   the   ‘Coalition   of   Resistance’,   said   the   reforms   “would   be,   in   ef-­ fect,   the   privatisation   of   the   NHS”   and   that   the   government   will   “break   the   NHS   up   into   competing   units”. The   government   plans   to   trans-­ fer   80%   of   the   NHS   budget   into  

250 or   so   newly   created   GP   con-­ sortia.     This   would   mean   the   aboli-­ tion   of   the   151   Primary   Care   Trusts   and   the   10   Strategic   Health   Authori-­ ties   tasked   with   managing   them. The  government  is  also  looking  for   services  to  be  obtained  by  “any  willing   provider”,   which,   together   with   plans   to  increase  patient  choice  by  allowing   people  to  select  from  approved  private   hospitals,   has   led   the   British   Medi-­ cal   Association   and   other   trade   un-­ ions  to  fear  privatisation  as  the  result. Michael  Eliasz,  a  medical  student  at   Guy’s,   King’s   and   St.   Thomas’   Medi-­ cal   School,   expressed   his   worry   that   private  companies  would  “cherry-­pick   the   simpler   cases”,   leaving   the   NHS   to   carry   the   burden   of   the   more   com-­ plicated   and   expensive   procedures. Some  are  describing  it  as  the  biggest   overhaul   of   NHS   structure   since   its   creation  in  1948.    As  the  Conservative   Party   ran   its   2010   election   campaign   on  the  back  of  pledges  such  as  ending   top-­down   reorganisation   of   the   NHS   and  announced  their  plans  to  “cut  the   deficit,  not  the  NHS”,  there  was  much   bitter   feeling   among   the   protestors. A   doctor   who   did   not   wish   to   be   named   described   the   Health   Secre-­ tary   Andrew   Lansley’s   Bill   as   “ideo-­ logical”   and   “highly   destructive”   and   said   it   would   “privatise   healthcare   and   leave   an   inequality   of   healthcare   throughout   the   UK”.     She   also   re-­ ferred   to   government   claims   that   the   NHS  budget  is  due  to  be  increased  in   cash   terms   as   “complete   whitewash-­ ing”,   and   said   that   such   words,   when   thousands  of  posts  are  due  to  be  cut  in   hospitals  across  the  UK,  are  “massive-­ ly  demoralising  for  the  public  sector”. Barts   and   the   Royal   London   have  

planned 630   redundancies,   includ-­ ing   the   cutting   of   250   nursing   and   83   other   clinical   posts   (including   doc-­ tors’  positions),  and  100  beds.    Resent-­ ment   was   most   keenly   felt   outside   a   branch   of   the   84%   nationalised   RBS,   defended  by  police  lines,  in  Aldwych.     Protestors   chanted:   “Health   cuts?   No   way  –  make  the  greedy  bankers  pay!” A   similar   confrontation   ensued   outside   Deutsche   Bank,   where   some   members   of   staff   were   witnessed   waving   wads   of   money   from   win-­ dows  at  the  evidently  riled  protestors.     They   were   met   with   calls   to   “jump”. Bishopsgate  was  blocked  by  an  im-­ promptu   sit-­in   staged   by   200   demon-­ strators  as  protestors  sang:  “If  you  hate   Andrew  Lansley,  clap  your  hands”  and   “No  ifs,  not  buts,  not  public  sector  cuts”. Dr   Rose   Taylor,   who   works   as   a   GP  in  Hackney  and  was  on  the  march,   questioned   the   logic   behind   asking   medically-­trained   professionals   to   ap-­ ply  themselves  in  management.    “It  is   very   tempting   to   offer   GPs   more   say   in   the   services   they   can   provide   for   their   patients.     However,   there   will   be   a   conflict   of   interest   between   the   GPs   who   will   hold   all   the   money   and   the   patients   because...when   I’m   hold-­ ing   the   purse   strings,   I’m   going   to   start   considering   the   costs.     The   pa-­ tient   then   won’t   know   whether   I’m   making   the   decisions   based   on   their   best  medical  interests  or  on  the  costs.” Dr   Taylor   stated   that   “the   PCTs   carry   out   an   enormously   helpful   ser-­ vice   in   enabling   us   GPs”,   and   that   the   plans   to   scrap   them   would   re-­ sult   in   enlisting   “more   expensive”   private   commissioners   to   do   the   job   she   feels   GPs   are   not   trained   to   do  

.

The last  month  has  been  a  busy  one  for   RUMS.  I’d  like  to  congratulate  the  new   group   of   officers   elected.   We’ve   also   had  our  Spring  Ball  and  AGM,  where   we  passed  motions  on  the  NHS  Health   &  Social  Care  Bill  and  Widening  Par-­ ticipation.   Planning   our   Sports,   Sum-­ mer  and  Finalist  Balls  has  been  anoth-­ er  hive  of  activity.  We’re  also  working   on   some   research   around   Workplace   Based   Assessment   to   improve   the  

student experience   in   this   area   and   are   looking   forward   to   progress   on   the   renovation   of   a   student   com-­ mon  room  at  the  Royal  Free  Hospital.   Look   out   for   the   big   opening   par-­ ties   of   our   brand   new   union   build-­ ing   at   the   new   Huntley   Street    

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David Smith ICSM President It causes  me  great  sadness  to  see  that   my   colleagues   at   lesser   institutions   are  running  a  vicious  smear  campaign   against  myself  and  ICSM.  St  George’s   President   Luke   Turner   was   so   upset   that  he  failed  to  get  into  Imperial  (his   personal  statement  must  have  been  lit-­ tered   with   the   same   type   of   hideous   grammatical   errors   as   his   report)   that   he  t ried  to  sabotage  our  R AG  week,  in-­ forming  Imperial  students  that  raising   money   for   dying   children   was   illegal.   In  spite  of  this,  we  still  destroyed  them   in  the  fundraising  stakes,  leaving  him   with  no  choice  but  to  spread  lies  about   my  d rinking  ability.  I  have  alerted  the  St   George’s  admissions  tutor  and  a  senior   consultant  at  the  hospital  to  his  misde-­ meanours.  I  am  even  more  shocked  and   appalled   to   see   GKT   Medsoc   (they’re   not  even  allowed  a  Union)  ‘President’   Hari   Haran   criticise   my   ability   with   the   fairer   sex.   Jealous   of   my   obvious   popularity,   he   behaved   the   only   way   he  k nows  how  and  whipped  out  his  one   inch   wonder   to   widespread   disgust.   I   expected  nothing  more  from  a  student   at   this   poorly   regarded   polytechnic.

Our sports  teams  continue  to  dom-­ inate,   with   ICSM   easily   beating   St   George’s  25-­10  in  the  UH  Rugby  final.   George’s   were   just   happy   to   be   there   for  the  first  time,  after  the  match  pro-­ gramme  had  been  prematurely  printed   with   GKT   listed   as   the   other   finalist.   The  annual  JPR  Williams  rugby  match   against  Imperial  College  RFC  saw  the   medicals   completely   dominate   our   ri-­ vals   for   the   ninth   year   in   a   row.   The   Drama  Society  put  on  a  fantastic  per-­ formance  of  James  &  The  Giant  Peach   and  the  Light  Opera  Society  pulled  off   a  spectacular  performance  of  ‘Glee  The   Musical’  with  only  24  hours  to  prepare. We  were  once  again  contacted  by  the   Daily  Mail  asking  for  help  with  a  story   about  fees.  We  felt  it  best  to  refer  them   on  to  the  BMA,  as  it  is  well  k nown  that   dealing  with  the  Mail  causes  cancer  

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Anil Chopra ULU Medgroup Chair

There seems to be some sort of message here... Image by Ellis Onwordi

The spirit  of  intra-­London  rivalry  was   strong   as   ever   at   our   last   Medgroup   meeting.   The   behaviour   of   some   of   the   SU   Presidents,   specifically   those   of  Imperial,  St  Georges  and  GKT  was   particularly   delightful.   After   drink-­ ing  at  Guy’s  bar,  they  were  at  it  -­  hair   pulling,  full  on  slapping  and  even  the   throwing   of   handbags,   David,   Luke,   and  Hari  gave  us  a  catfight  that  would   have  made  even  Jerry  Springer  proud.   It’s  a  good  job  they  will  be  out  of  office   soon...  Congratulations  to  the  officers   of  the  newly  elected  student  unions  for   the   year   2011-­12.   It   was   good   to   see   that  of  the  elections  taking  place  most   positions  were  contested  at  the  schools.   For  the  medical  schools  who  are  yet  to   have  elections,  please  do  consider  run-­ ning  for  positions  on  the  Union;;  its  in-­ credibly   rewarding   not   only   because   of  the  service  that  you  will  provide  to  

students, but   also   the   people   that   you   meet  and  the  skills  that  you  will  gain. On  the  note  of  intra-­London  r ivalry,   one   of   the   oldest   competitions,   RAG,   has  dominated  the  past  few  months  and   I  am  pleased  to  see  that  it  is  still  a  pop-­ ular  tradition  (especially  at  Barts!).  As   medical   students   we   need   to   embrace   RAG.   It   is   NOT   just   for   freshers;;   it’s   an  integral  part  of  medical  school  life   and  should  be  enjoyed  by  all  students. Please   do   come   down   and   sup-­ port   your   schools   at   the   UH   Revue,   Bumps   and   UH   athletics.   Being   the   social   bunch   that   we   are,   Medgroup   have   also   decided   that   they   will   be   coming   to   each   school’s   Sum-­ mer   Ball   –   look   our   for   our   table!  

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4

April 2011

News The financial pains of graduate medicine

Branavan Rudran reports on St Georges RAG vs TfL

Throwing hats at graduation. More like throwing money into the air

Ben Goodman Guest writer Most graduates  wishing  to  study  Med-­ icine   will   soon   need   to   find   around   £70,000  cash  upfront  before  being  able   to  accept  their  place  at  medical  school.   The  decision  to  become  a  doctor  is  an   expensive  one  for  all  due  to  the  length   of  training,  but  financial  pressures  are   particularly  challenging  for  graduates   since   government   support   is   limited   for  those  undertaking  a  second  degree.   Although   generous   provision   is   made   by   the   NHS   for   students   on   Gradu-­ ate/Professional   Entry   Programmes,   places   on   such   schemes   are   exremely   competitive   and   in   short   supply.   he   majority   of   graduates   actually   enrol   on  undergraduate  courses,  where  they   now  make  up  a  significant  proportion   of   the   medical   student   demographic. For   people   with   previous   experi-­ ences  of  higher  education,  the  need  to   support   themselves   through   medical  

school involves  not  only  being  able  to   cover  living  expenses,  but  also  having   immediate   funds   available   for   tuition   fees  since  graduates  are  not  eligible  for   tuition  fee  loans.  Even  as  it  stands,  this   is   difficult.   While   the   NHS   pays   the   final   year   fees,   graduate   students   pay   around   £3300   for   four   years   without   finicial  support.  For  the  fortunate  few   who   have   come   from   well   remuner-­ ated  careers,  this  is  just  about  possible   with  careful  management  of  finances.   Medicine,   however,   attracts   appli-­ cants   from   an   exceptionally   diverse   range   of   backgrounds,   which   means   for   many   the   door   to   medical   school   remains   firmly   shut   and   the   hope   of   becoming   a   doctor   is   relegated   to   the   status   of   unaffordable   pipedream.   No  one  is  in  any  doubt  that  all  med-­ ical   schools   will   need   to   charge   the   maximum   rate   when   fees   are   raised   to   £9000   in   2012.   It   is   important   to   be  aware  that  the  government’s  prom-­ ise  that  no  one  need  pay  fees  up  front   does  not  apply  to  graduates  -­  who  will  

still be   expected   to   cover   tuition   fees   on   demand   without   support.   Some   fi-­ nancial   assistance   is   available   for   liv-­ ing  costs  in  the  form  of  a  maintenance   loan,   but   this   generally   only   covers   around  half  of  a  single  person’s  outgo-­ ings  in  any  given  year,  excluding  fees.   The  funding  problem  has  further  been   exacerbated  by  the  withdrawal  of  Pro-­ fessional   Development   Loans   which   were   previously   available   to   medical   students   from   the   UK’s   three   largest   banks.   With   few   facilities   to   borrow   from,   a   graduate   medical   student   on   a   standard   course   will   therefore   need   to   have   £36k   plus   half   of   their   liv-­ ing  costs  actually  in  their  pockets  be-­ fore   being   able   to   start   their   studies. With   the   tight   constraints   imposed   on  the  NHS  budget,  it  is  unlikely  that   any   further   GEP   places   will   become   available,   so   this   raises   the   question   of   what   will   happen   to   the   graduate   medical   student   population   once   the   new   fee   regime   is   in   place.   Undoubt-­ edly  competition  for  the  already  mas-­

medicalstudent

sively oversubscribed  accelerated  pro-­ grammes   will   become   even   fiercer,   since  candidates  on  such  courses  only   pay   fees   for   one   year   so   the   increase   over  the  full  course  will  be  a  relative-­ ly   modest   £6000.   For   the   many   that   would   normally   have   looked   to   un-­ dergraduate   courses,   what   has   un-­ til   now   been   a   difficult   sacrifice   will   immediately   descend   into   an   absolute   impossibility.   Unless   a   graduate   is   able  to  rock  up  to  medical  school  with   £70k   (estimated   as   four   years   of   tui-­ tion  fees  plus  half  the  living  expenses   for  five  years)  cash  in  their  hand,  they   will  be  forced  to  abandon  their  dream. We   are   looking   at   a   transforma-­ tion   of   the   proverbial   landscape.   Some     five     year   courses   currently   have  a  graduate  population  as  high  as   60%,  but  we  may  see  2012  usher  in  a   new   era   (or   rather,   a   return   to   a   pre-­ vious   one)   of   medical   school   becom-­ ing,   for   graduates   at   the   very   least,   the   preserve   of   the   very   wealthy  

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St Georges RAG week was put to a halt this week by the threat of arrest by the TfL authorities. The traditional ‘mashing’ was cancelled to the displeasure of many keen Georges Raggers. RAG week, “raise and give” to the layman, is definitely the highlight of the charity calendar whether it be for Imperial, UCL, St Georges, Kings or Barts. There is a contagious enthusiasm which sweeps the universities for the fortnight where all events are dedicated to the various charities that the universities support. At St Georges, there is an additional buzz about retaining its reputation as the most successful university at raising money during RAG week. One of the most crucial elements of the week, which is also one of the most enjoyable, is ‘mashing’. This year, something rather bizarre was to halt this tradition. It was the threat of arrest by the Transport for London authorities! Who would have thought that the men and women who ensure the prompt arrival of our trains, immaculate carriages and wonderful services would get in the way of this beautiful charity initiative? A certain song called the ‘London Underground song’ by Amateur Transplants (who were ironically London medical students and are now fully qualified doctors) comes to mind, with lyrics such as “they are such greedy c****, I want to shoot them all with a rifle”. If you are unaware of this song please listen to it after you finish reading this article. I was thoroughly enjoying my RAG experience, singing a little song with my lovely ukulele partner, when upon our arrival back at St Georges to return our bulging buckets, we were told that we were forbidden to return to the tubes as the TfL had threatened any other student with arrest. Since when did dressing up as a buxom nurse cause offense? We were even offered £5 for a feel by builders! With my dignity gone and ‘mashing’ banned, what else do we have left? The SGUL President, Luke Turner said that while he was extremely sad to cut RAG short, “As a Students’ Union, our first priority is to our student body, not to RAG. For this reason, with the threat of arrest (and a subsequent criminal record) for students who are all studying professional courses, we had no choice but to cancel ‘Mashing’. TfL refused to comment. Classic.


medicalstudent

April 2011

5

News

Diary of an FY1 Junaid Fukuta on learning through new experiences

T

wo weeks   into   my   job   and   I   am   starting   to   feel   a   bit   more   comfortable.   Don’t   get   me   wrong,   I   still   don’t   feel   like   a   doctor,   not   even   a   baby   doctor.   I   feel   more   like   a   ‘your-­father-­has-­ got-­a-­glint-­in-­their-­eye’   doctor.   I   still   get  lost  in  the  hospital  partly  because,   like   all   NHS   hospitals,   it   seems   like   the   building   was   built   by   an   architect   on   speed   who   thought   the   maze   at   Hampton   Court   Palace   was   not   hard   enough.   So   when   I   go   to   request   that   15th   CT   scan   from   Dr   ‘No’,   the   radi-­ ologist,   (and   yes   he   said   no   to   my   re-­ quest)  I  somehow  end  up  in  the  back  of   the   pharmacists’   rest   room.   Although   I   often   get   lost   and   don’t   quite   know   how   everything   works,   it   is   getting   easier,   I   am   starting   to   prioritise   my   jobs   correctly   and   the   ward   is   start-­

ing to   run   less   like   a   bomb   had   hit   it   and   more   like   a   car   production   line. So  things  were  going  ‘hunky  dory’   until   I   had   my   first   experience   of   the   marvels  of  HR.  My  friend  summed  up   HR  with  these  wise  words,  “I  am  all  up   for  the  NHS  having  an  equality  and  di-­ versity  policy,  but  why  put  all  the  peo-­ ple  with  learning  difficulties  in  HR?”   Their  miraculous  work  now  means  that   due   to   the   rota/annual   leave   my   team   will  all  be  on  call  and  that  I  will  be  r un-­ ning   the   show   by   myself   on   Tuesday   morning,  but  will  have  to  finish  every-­ thing  by  13:00  as  that  is  when  I  am  sup-­ posed  to  go  on  call.  Eight  hours  worth   of   work   normally   done   by   three   peo-­ ple,  to  be  done  in  four  by  my  lonesome   self.  So  I  go  home  and  spend  the  whole   of   Monday   night   crapping   my   pants. Next  morning,  I  walk  onto  the  ward  

with a   false   sense   of   confidence   hop-­ ing  no  one  can  sense  my  fear.  Then  the   board   round   starts.   Now   for   those   of   you  who  turn  up  to  the  wards  at  12:00   and  ask  to  clerk  a  patient  you  will  nev-­ er  have  come  across  this  phenomenon.   Basically  the  MDTs  have  a  meeting  in   the  morning  to  track  the  progress  of  all   our   patients…essentially   it   means   we   all  have  a  bitch  about  why  none  of  the   nursing/residential  homes  will  take  our   medically  fit  patients  before  they  catch   their  f ifth  pneumonia.  It  goes  smoothly   enough  and  I  start  my  ward  round,  but   half   way   through   I   get   interrupted   to   see  one  of  the  patients  who  is  unwell.   Whilst  r ushing  over  to  the  other  side  of   the  ward  I  thought  to  myself  “shit,  shit-­ ting  bollocks  why  did  she  decide  to  get   ill  today”  and  I  am  presented  with  my   first   sick   patient.   I   get   a   flashback   to  

The medical registrars are the ghostbusters of the hospital

my first  day  when  my  consultant  said:   “the  one  thing  you  will  learn  this  year   is   how   to   recognise   a   sick   patient”,   and  I  think  to  myself  well  hell  I  am  11   months  ahead  of  schedule  in  that  case! I   stop   and   think:   ABC,   do   ABC   and   you   can’t   go   wrong.   That   is   what   everyone  says,  and  you  know  what,  it   actually  worked,  it  took  me  an  hour  of   cannulating,   running   tests   and   sprint-­ ing   across   the   hospital   to   the   ABG   machine  but  I  felt  like  I  did  a  half  de-­ cent   job   and   she   seemed   to   pick   up,   so  I  swagger  off  feeling  all  heroic  and   continue   my   ward   round.   Two   hours   later   I   finally   finish   said   ward   round   with   no   real   incident   so   go   back   to   check   on   my   patient   where   I   found   that   she   looked   sicker   than   before.  

“Oh crap! Six years of medical school down the drain after my first sick patient” After reassessing   her   I   have   no   more  answers.  I  literally  have  no  idea   what   to   do.   I   start   feeling   hot.   The   nurse   is   looking   at   me   expectantly   to   sputter   some   words   of   calm   reassur-­ ance   or   even   some   ideas…but   noth-­ ing  comes  to  mind.  It  is  the  most  hor-­ rendous   feeling   to   realise   you   are   out   of   your   depth   and   worst   of   all   I   have   a   patient   sick   in   front   of   me,   with   no   immediate  back  up.  The  nurse  quickly   senses  that  I  am  quickly  losing  the  plot   with   my   silent   gasping   and   suggests:  

“how about   calling   the   med   reg?”   Now   the   medical   registrars   are   the   ghostbusters   of   the   hospital,   no   mat-­ ter   who   asks   the   question:   “who   you   gonna  call?”  The  answer  is:  “the  med   reg”   (cue   ghostbusters   theme   tune). I  quickly  grab  the  phone  and  talk  to   the  medical  registrar,  who  asks  “where   is  your  team?”  and  I  reply  f rantically  “I   am  the  team!”  She  calms  me  down  and   reassures  me  that  I  am  doing  the  right   things   and   asks   me   to   do   a   few   more   tests  before  she  comes  across  to  review   the   patient.   She   arrives   and   I   give   a   sigh  of  relief  as  she  spends  about  five   minutes   looking   through   the   patient’s   notes  and  then  reviews  the  patient.  Af-­ terwards   she   tells   me   her   impression   is  that  the  patient  will  die.  I  am  dumb-­ founded.   I   feel   as   if   I   have   screwed   up.   Was   there   something   I   didn’t   do?   Oh   crap!   Six   years   of   medical   school   down  the  drain  after  my  first  sick  pa-­ tient.  The  registrar  quickly  spots  these   thoughts  crossing  my  mind  and  says  :   “you   will   learn   how   to   recognise   the   sick  patient  but  you  will  also  learn  how   to  recognise  the  dying  one  too.”  W hilst   battling  to  save  her  life  I  never  thought   to   ask   the   question   whether   the   pa-­ tient  was  too  far  beyond  saving.  With   those  words  the  med  reg  asks  that  the   family  be  informed  and  writes  up  her   notes   and   leaves   in   a   most   matter-­of-­ fact  way.  As  I  see  her  silhouette  in  the   light   of   the   doorway   I   realise   there   is   so  much  yet  to  learn  and  most  of  it  will   be   through   experiences   like   these  

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Wars, religion and bureaucracy: this is medicine, not politics Sally Kamaledeen Guest writer On a   grey   Monday   afternoon   in   Sep-­ tember,   the   first   day   of   term,   I   found   myself  begrudgingly  back  in  my  medi-­ cal   school’s   tangerine-­walled   lecture   theatre,   fondly   reminiscing   about   my   summer.   It   suddenly   dawned   on   me   how   my   world   has   come   full   circle.   I   last  sat  in  that  same  seat  three  months   ago,   and   during   that   time,   I   had   one   of   the   most   eye-­opening   and   extraor-­ dinary  experiences  of  my  life:  partici-­ pating   in   ReCaP,   the   Refugee   Camp   Project   in   the   West   Bank,   Palestine. A   joint   collaboration   between   The   Student   Movement   of   International   Physicians  for  the  Prevention  of  Nucle-­ ar   War   (IPPNW)   and   the   Palestinian   branch  of  the  International  Federation   of   Medical   Students   (IFMSA-­Pales-­ tine),   ReCaP   aims   to   raise   awareness   of  the  political  and  socioeconomic  sit-­

uation of   Palestinian   refugees,   and   is   open  only  to  8-­9  medical  students  f rom   around  the  world  every  year.  Through   a  series  of  lectures  and  workshops  dur-­ ing   the   first   week   given   on   Al-­Quds   University   campus   in   Abu   Dis   by   its   academics   and   Palestinian   medical   students,  I  began  to  piece  together  for   myself   the   intricacies   of   the   Israeli-­ Palestinian   conflict   and   the   everyday   struggle  of  living  under  occupation,  of   both   ordinary   Palestinians   and   those   living  in  refugee  camps.  A  talk  by  men-­ tal  healthcare  workers  from  the  United   Nations   Relief   and   Works   Agency   for   Palestine   Refugees   (UNRWA)   about   the   psychological   impact   and   trauma   suffered   by   Palestinian   refugees,   es-­ pecially   children,   was   insightful   and   prepared   us   in   advance   for   our   West   Bank  refugee  camp  visits,  which  start-­ ed   from   the   second   week   of   the   pro-­ gramme   after   moving   to   Bethlehem.   We   organised   play-­time   activities   for   refugee   camp   children,   and   it   was   an  

incredibly heart-­warming  and  reward-­ ing   experience   to   see   all   our   discus-­ sions   and   planning   efforts   as   a   group   come  to  life  by  watching  the  children   playing  and  enjoying  their  time  with  us.   Clinical   attachments   take   place   at   various   hospitals   in   Bethlehem   and   at   UNRWA   clinics,   providing   much-­ needed   medical   care   to   the   refugee   camps,   settings   which   felt   worlds   apart   from   what   I   had   grown   used   to   in   the   UK.   I   witnessed   the   bureau-­ cratic   difficulties   endured   by   Pales-­ tinian   doctors   trying   to   refer   patients   for  urgent  treatment  at  more  advanced   and   better   equipped   Israeli   hospitals,   and   saw   how   over-­stretched   and   un-­ der   pressure   the   refugee   healthcare   system   really   is.   Many   doctors   saw   nearly   200   patients   daily,   with   very   little   medical   care   and   drugs   to   offer.   The  project  also  includes  many  t rips   to  various  towns  and  cities  in  both  the   West   Bank   and   Israel.   On   these   trips,   I   fully   experienced   and   compared   the  

lives of   Palestinians   and   Israelis,   at   times   feeling   that   despite   being   sepa-­ rated  by  only  the  thin  grey  slabs  of  the   Separation   Wall,   they   live   complete-­ ly   different   lives   on   parallel   planets.     The  f ive  weeks  I  spent  participating   in  ReCaP  were  the  richest  and  most  in-­ spiring  moments  in  my  life.  It  is  a  once   in  a  lifetime  experience  for  those  want-­ ing   to   gain   a   comprehensive   knowl-­ edge  of  the  Israeli-­Palestinian  conflict  

and to   use   their   skills   to   bring   smiles   to  the  faces  of  some  of  the  world’s  most   deprived  children.  All  I  have  now  are   the   incredible   memories,   and   I   only   have  to  close  my  eyes  to  see  the  smil-­ ing,  innocent  faces  of  the  refugee  camp   children,  as  they  skip  and  jump  on  their   tiny,  happy  feet,  hands  on  waist,  to  the   tune   of   the   traditional,   quintessen-­ tially   Palestinian   dance   of   Dabkeh  

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Anatomy teaching. Colouring-in style. Image by Sally Kamaledeen


6

April 2011

News Facebook or face the GMC? Anand Ramesh Guest writer Social networking   sites   have   become   an  ubiquitous  part  of  modern  life  and   have  arguably  revolutionised  commu-­ nication  with  others.  According  to  the   Office   of   National   Statistics,   in   2010,   75%   of   16-­24   year   olds   used   these   sites  for  messaging  purposes,  and  one   in  two  uploaded  user  created  content.   Such   sites   remove   long   distances   as   barriers  to  maintain  contact  with  peo-­ ple,  and  offer  a  wealth  of  ways  to  share   details   of   your   life   amongst   friends.   The   concept   of   doing   this   at   a   mouse   click   is   unsurprisingly   appealing.   But   can   these   sites   be   dangerous,   and   possibly   even   jeopardise   a   per-­ son’s  medical  career?  It  has  in  fact  al-­ ready  happened.    A  junior  doctor  was   suspended  for  six  months  in  2008  for   making   offensive   remarks   about   Pro-­ fessor   Dame   Carol   Black   (a   UK   gov-­ ernment   advisor   for   health   and   work)   on   the   doctors.net.uk   website,   an   in-­ ternet   forum   for   doctors.   Now   clear-­ ly   there   are   a   few   issues   to   consider-­   there  is  a  spectrum  of  online  behaviour   which  could  conceivably  be  interpret-­ ed   as   unacceptable,   there   is   the   right   to   freedom   of   expression   and   there   is   the   dividing   line   between   one’s   pri-­ vate  life  and  professional  responsibili-­ ties   for   which   an   appropriate   balance   must  be  struck.  In  issues  where  patient   confidentiality   is   breached   through   careless  posting  online,  then  it  is  a  no   brainer   that   this   is   unacceptable.   In   the   case   of   inappropriate   comments   about   bosses,   or   fellow   members   of  

staff, the   stance   should   still   be   fairly   clear-­cut   in   my   opinion.   The   afore-­ mentioned   junior   doctor’s   comments   could   be   attributable   to   a   momentary   fit  of  passion,  but  any  kind  of  insulting   message   towards   an   individual   could   be  tantamount  to  libel.  Even  in  a  ‘pri-­ vate’   arena,   it   seems   fundamentally   unwise   to   post   potentially   inflamma-­ tory  comments  online,  as  the  Internet   is  naturally  never  totally  secure.  Free-­ dom  of  speech  is  a  relevant  issue,  but  in   medicine,  where  doctors  are  subjected   to   intense   scrutiny   and   where   behav-­ iour  is  so  tightly  regulated,  it  is  prob-­ ably   not   a   good   idea   to   justify   dodgy   online   behaviour   on   this   premise.   The  examples  above  probably  don’t   apply  so  much  to  medical  students  and   will  no  doubt  be  more  relevant  as  junior   doctors  and  beyond.  For  us,  it  is  more   likely   to   be   evidence   of   inappropriate   behaviour   on   social   networking   sites   that   could   cause   trouble   i.e.   incrimi-­ nating   photos   of   drunken   antics   etc.   The  GMC  emphasises  that  “your  con-­ duct  at  all  times  justifies  your  patient’s   trust  in  you  and  the  public’s  t rust  in  the   profession.”  So  consider  the  reaction  of   an  employer  or  patient  if  they  stumble   across  a  picture  of  their  future  doctor   collapsed  in  a  puddle  of  their  own  vom-­ it  outside  a  bar  or  club.  Medicine,  more   than  any  career,  is  based  on  projecting   an   image   of   absolute   professionalism   at   all   times,   and   it   is   this   that   under-­ pins  public  trust  in  doctors.  Anything   that   might   undermine   this   impression   doctors   must   convey   could   poten-­ tially   cause   trouble,   and   is   thus   best   avoided,   even   if   to   you,   such   behav-­ iour  is  confined  to  your  personal  life.

Research in brief ICSM: Sugary drinks can increase blood pressure by as much as 1.6mmHg systolic and 0.8mmHg diastolic for each can consumed per day, according to a study of nearly 2700 people by researchers at Imperial. The increase was particularly marked in people who consumed excess salt as well as sugar. A general link was also found between sugary drink consumption and a less healthy diet. Published in Hypertension. RUMS: New research has found that the initial treatment of people infected with drug resistant strains of HIV was three times more likely to fail than of those infected with non drug-resistant strains. This could help the initial treatment of millions of people worldwide as we can give them the most beneficial combinations of retroviral drugs possible to prevent their treatment from failing. Published in Lancet Infectious Diseases.

Facebook: friend or foe? Image by Chetan Khatri This article   is   however,   not   in-­ tended   to   scaremonger.   According   to   a   GMC   spokesman,   they   do   not   ac-­ tively   monitor   Facebook   so   there   is   no   Orwellian   style   surveillance   and   secondly,   it   is   incredibly   easy   to   ad-­ just   privacy   settings   to   ensure   only   desirable   onlookers   i.e.   your   friends,   can   view   your   antics,   which   mini-­ mises   the   risk   of   being   caught   out.  

So at  the  end  of  the  day  it’s  not  really   rocket   science:   don’t   share   material   that   could   be   misconstrued   with   the   whole   world,   exercise   common   sense   online,   and   you   shouldn’t   experience   any  trouble.  Or  alternatively,  avoid  the   issue  by  not  using  social  networks  al-­ together:   believe   it   or   not,   things   like   telephones  and  emails  do  still  exist  

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Hallucinating away the disease of depression Vamsee Bhrugubanda on an illusionary cure

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new treatment   for   severe   depression   is   being   tried   out   for   the   first   time   in   the  UK  by  a  team  of  medi-­ cal   researchers   from   Imperial   Col-­ lege   London   along   with   Professor   David   Nutt   who   works   at   the   Univer-­ sity   of   Bristol.   However,   this   is   not   an   ordinary   clinical   trial   as   the   drug   being   tested   would   normally   alarm   most   people.   The   specially   licensed   trial   is   attempting   to   get   a   better   un-­ derstanding   of   the   effects   of   Psilocy-­ bin   in   healthy   subjects.   All   forms   of   this   substance   have   been   classified   as   illegal   under   the   Drugs   Act   2005.     Psilocybin  is  naturally  found  in  f un-­ gi  known  as  magic  mushrooms.  They   have  been  long  known  as  psychoactive   drugs.   The   drug   functions   by   acting   as   an   agonist   of   the   neural   regulator   serotonin   at   certain   receptors   in   the  

brain (HT2A  and  HT1A).  Serotonin  is   involved   in   many   functions   including   regulation  of  cognitive  functions  such   as  states  of  mind.  This  would  explain   some  of  its  many  effects  as  psilocybin   essentially  partially  mimics  serotonin.  

“Medical researchers are spending resources and time on a drug that functions in ways that disable some of our most important capabilities” One effect   that   the   drug   has   been   known   to   induce   very   well   is   a   pro-­ found   alteration   of   perception   as   well   as  profound  experiences  that  have  been   described  as  spiritual  in  nature.  These   experiences   may   have   the   potential   to   permanently   alter   ones’   perception  

medicalstudent

long after  the  effect  the  drug  has  worn   off.  Prolonged  psychosis  has  also  been   found  to  occur  at  times  though  the  ef-­ fects  are  normally  said  to  wear  out  after   a  few  hours.  The  subject  gets  the  feel-­ ing  of  being  taken  away  on  a  ‘trip’  re-­ moved  from  the  immediate  setting.  In-­ terestingly,  this  altered  perception  can   either  be  a  very  positive  experience  or   a  very  negative  one,  depending  on  the   setting  and  state  of  mind  of  the  subject. While   the   drug   clearly   has   many   strong   effects   it   works   in   a   rather   counterintuitive   way.   Brain   activity   has  actually  been  shown  to  fall  rather   than   increase   due   to   its   effects.   This   paradox   can   be   explained   by   the   fact   that   the   areas   of   the   brain   that   expe-­ rience   reduced   activity   are   those   that   focus  our  sense  of  self.  Under  its  influ-­ ence   it   is   possible   to   forget   ourselves   and   the   surroundings   around   us.   This  

can easily  be  very  damaging  and  even   dangerous   as   it   is   exactly   this   knowl-­ edge  of  limitations  and  threats  that  al-­ lows   us   to   avoid   and   solve   problems. A  reasonable  question  to  ask  would   be  why  medical  researchers  are  spend-­ ing  resources  and  time  on  a  drug  that   functions   in   ways   that   disable   some   of   our   most   important   capabilities.   Clearly  temporarily  forgetting  about  a   problem  or  an  illness  does  not  make  it   vanish.   The   answer   to   this   being   that   it  would  be  very  useful  in  breaking  or   altering  a  mindset  that  is  the  cause  of   illness   itself.   Some   conditions   such   as   severe   depression   or   even   obses-­ sive   compulsive   disorder   involve   pat-­ terns   of   behaviour   or   thought   that   cause   much   more   harm   than   good.   However,   that   is   far   in   the   future   and   for   now   Psilocybin   remains   a   hal-­ lucinogen   with   interesting   effects    

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BL: Researchers at QMUL have identified new genetic variants linked with an increased risk of developing coronary artery disease (CAD). By comparing 22,000 CAD patients with 64,000 healthy patients, 13 genes were discovered that increased the risk of CAD by up to 17%. Published in Nature Genetics. St Georges: A new clinical trial is starting at St George’s to investigate a potentially lifesaving treatment for Marfan Syndrome, which affects one in 3,300 people in the UK. Using a £1.4million grant from the British Heart Foundation, the trial will involve 500 patients with Marfan Syndrome. The study will look at whether Irbesartan, a blood pressure drug, could prevent expansion of the aorta, thereby reducing the need for surgery. GKT: A new computer program is being used for the first time at KCL’s Institute of Psychiatry to detect changes in the brain that could indicate early signs of Alzheimer’s disease. The program was developed in conjuction with the Karolinska Hospital in Sweden, and aims to provide an 85% accurate diagnosis within 24 hours. Using ‘Automated MRI’ software, the patient’s brain will be compared to over 1000 images showing varying stages of Alzheimer’s. It is hoped that early diagnosis will enable patients to manage the disease more effectively.


medicalstudent

April 2011

7

News The Ultra Marathon Benjamin Perry on whether he has really gone too far this time

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he Comrades   Ultra-­mar-­ athon   is   known   as   the   'Ul-­ timate   Test   of   Human   En-­ durance'.   It   represents   a   56   mile   running   race   between   the   cities   of   Durban   and   Pietermaritz-­ burg   in   South   Africa   on   the   29th   May.   It's   the   largest   ultra-­marathon   in   the   world,   and   is   the   most   popu-­ lar   sporting   event   in   South   Africa   bar   none.   As   well   as   having   thou-­ sands   upon   thousands   of   spectators,   the  event  gains  live  TV  coverage  for  

the full   duration   of   the   race.   People   actually   enjoy   watching   running   for   hours  and  hours  on  end.  Crazy,  I  k now. If  you  don’t  complete  the  gruelling   course  within  the  12  hour  time  limit  –   you   are   disqualified.   If   you   cross   the   line   in   12:00:01,   the   organizers   will   turn  their  backs  on  you  -­  no  medal,  no   finishing   time.   The   only   solace   com-­ ing  f rom  the  fact  that  the  f irst  ‘non-­fin-­ isher’  as  it  were  becomes  an  overnight   celebrity   in   South   Africa   –   gaining   front-­page   status   due   to   the   effort   of  

having ran   56   miles   for   absolutely   no   reward.  Last  year,  out  of  the  23,568  en-­ trants,  only  14,343  finished  within  the   12   hour   limit;;   just   60%.   In   compari-­ son,  the  average  finish  rate  of  the  Lon-­ don   marathon,   a   challenge   that   most   would  seem  difficult  enough,  is  a  com-­ forting   99%.   The   race   alternates   di-­ rection  every  year  –  between  the  more   uphill   ‘up’   run,   and   the   more   down-­ hill   ‘down’   run.   It   happens   that   I’m   running   on   an   ‘up’   year   thus   climb-­ ing   a   net   height   of   around   2300   feet.    

Cutting a   very   long   (56-­mile,   or   90km;;   to   be   exact)   story   short   –   it’s   hard;;  a  definite  challenge  for  even  the   most   hardy   of   athletes.   I   am   going   to   run   it,   all   in   the   name   of   my   speci-­ fied   charity,   Mencap,   and   the   Barts   and   The   London   RAG   campaign.   Mencap   is   the   voice   of   learning   dis-­ ability.   Everything   they   do   is   about   valuing   and   supporting   people   with   a   learning   disability   and   their   families   and   carers.   Being   able   to   complete   such   a   special   achievement   for   such   a   special   charity   really   excites   me.   I   signed   up   for   this   monstrosity   last   September,   after   having   returned   from   crossing   the   Berlin   Marathon   finish   line   in   3:10:03   (qualifying   me   for   not   only   a   coveted   Boston   Mara-­ thon   place,   but   also   a   ballot-­free   en-­ try   into   the   2012   London   Marathon.)   So   you   could   say   I   was   on   a   bit   of   a   high.   It   seemed   like   a   great   idea,   and   it   was   over   eight   months   away.     All  was  f ine  until  I  picked  up  ‘What   I  Talk  About  When  I  Talk  About  Run-­ ning,’   Haruki   Murukami’s   autobiog-­ raphy   and   ode   to   his   most   important   muse.   In   the   book   he   describes   his  

battle with  a  similarly  distanced  ultra-­ marathon   to   the   Comrades.   He   intri-­ cately  takes  the  reader  through  all  the   physical  and  mental  agonies  along  the   way,  describing  in  detail  the  feeling  at   40  miles  in  which  he  felt  as  though  his   legs  were  being  d riven  through  a  meat-­ grinder,  and  even  more-­so  the  near-­re-­ ligious   experience   he   had   at   50   miles   when  he  knew  he  was  going  to  finish.   I   therefore   made   myself   a   plan.   I’m  currently  running  around  2  mara-­ thons  every  week,  with  a  weekly  mile-­ age   total   of   around   80   miles.   This   is   not   only   incredibly   physically   drain-­ ing,   but   it   is   taking   a   heck   of   a   lot   of   mental   strength.   It’s   fine   running   the   26.2   miles   of   the   London   Marathon   when   you   have   a   million   scream-­ ing   spectators   to   keep   you   moving,   but   when   your   long   runs   are   most-­ ly   spent   in   rural   Essex   with   only   the   occasional   beeping   car   and   a   lot   of   trees,  it’s  quite  hard  to  motivate  your-­ self   to   keep   going,   week   after   week.     If   I   only   ever   do   one   great   thing   for   charity   –   this   is   it.   Maybe   this   will   inspire   you   to   one   day   do   something   great   for   charity   too  

the medicalstudent is recruiting Comment editor

Features editor

Sarah Pape

Neha Pathak

What's so good about being the comment editor? Well I'll tell you. For starters (aside from the doctor's mess) it gives you the most freedom for the content, but also the style of the articles. There is also the fun of reading people's rants and arguments which, pre-editing, can be pretty juicy. Most importantly it's the section that provides a chance for you, our readers, to talk about exactly what you want. We make the medical student for you, well as long as it’s not pornographic.

My google search informs me that a “features editor ensures that their publication is full of entertaining, informative and newsworthy articles.” I’m not going to lie – it’s basically the best job on the paper bar the chief editor. If you enjoy hunting after the perfect interview, bringing careful analysis and insight to the fore with a some good hard evidence to back it up (none of this ‘comment’ nonsense, she jests), then think about applying for this position. It requires organisation, an eye for layout and you must be prepared to sift through long articles for the tiniest of mistakes. And you get to pester the ‘almost famous’.

For more information email editor@medical-student.co.uk Deadline is May 31st

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8

April 2011

Features

medicalstudent

Features Editor: Neha Pathak features@medical-student.co.uk

32 years, 18 countries, 3 careers and still counting

Playing the hero. Image provided by Dr Alex van Tulleken

Rashmi D’Souza & Sana Ajmi Guest Writers

In a   few   weeks   you   will   be   sitting   in   that   sweltering   exam   room,   deliberat-­ ing  between  option  B  or  C  on  that  te-­ dious   MCQ   paper,   dreaming   of   when   you  find  yourself  sitting  on  that  plush   swivel   chair   in   a   GP   practice   sur-­ rounded   by   a   leafy   suburban   utopia.   But   have   you   considered   straying   from   the   narrow   road   of   foundation  

years, specialist   training   and   con-­ sultancy?     We   sought   an   interview   from   the   man   who   has   done   just   that   -­   Dr   Alexander   van   Tulleken.   Ox-­ ford   graduate,   Channel   4’s   ‘Medi-­ cine   Men   Go   Wild’   presenter,   global   health  doctor  and  only  32  years  young. So  how  did  he  embark  on  his  journey   into  the  murky  jungles  of  Global  Health? “As   soon   as   I   was   able   to   work   overseas,   I   did.   Darfur   was   in   the   headlines  at  that  time:  everyone  knew   about   Darfur   –   it   was   a   very   promi-­ nent  disaster.  I  thought  it  would  be  ex-­ tremely  difficult  to  get  a  job  in  a  place  

I assumed   everybody   would   want   to   work,   but   in   fact   I   don’t   think   there   were  any  other  applicants  for  my  post.” Why  not?  Considering  every  medi-­ cal   UCAS   statement   proclaims   aspi-­ rations   of   saving   the   world,   it   seems   strange   that   just   six   years   later   newly   qualified   doctors   seem   reluctant   to   venture   outside   the   safety   of   the   de-­ veloped   world.   Perhaps   Xandy,   as   he   is  known  to  his  twin  brother  -­  co-­host   of  ‘Medicine  Men  Go  Wild’,  and  fellow   global  health  conspirator,  can  explain. “I   think   you’re   more   constrained   than  I  was.  When  I  qualified  you  could  

do a  six  month  training  post  and  then   take   six   months   off   and   then   come   back   -­   it   was   much   more   flexible.   I   think  it’s  probably  more  difficult  now  

“The difference you make will probably be less practical and more symbolic” for a   junior   doctor   to   work   overseas.” He   seemed   adamant   that   get-­ ting   out   of   sheltered   little   Britain   and  

‘finding yourself’   made   you   a   bet-­ ter   doctor,   think   gap   year,   but   bigger. “A  doctor  who  has  spent  time  over-­ seas   or   engaged   in   public   health   as   a   global   issue   will   have   a   much   more   nuanced   view   of   the   culture   in   medi-­ cine,   of   the   role   of   individual   experi-­ ence   -­   of   the   patient   -­   than   you   will   if   you’ve   only   gone   through   normal   western   biomedical   training   which   just   prepares   you   for   the   set   of   ill-­ nesses   you’d   encounter   in   a   hospital   in   the   UK.   The   main   medicine   tur-­ bine  in  the  West  now  is  evidence  based   medicine   that   imposes   an   idea   of   ra-­


medicalstudent

April 2011

tionality which  very  often  isn’t  there.” On  a  different  note,  we’re  sure  many   of   you   selflessly   sacrificed   careers   of   world-­wide   fame   to   become   modest   doctors,   but   Dr   van   Tulleken   proves   that   the   two   are   not   mutually   exclu-­ sive.   He   has   co-­presented   the   docu-­ mentary  about  alternative  medicine  in   ‘Medicine   Men   Go   Wild’,   hosted   the   BBC’s   ‘Secret   Life   of   Twins’   and   ap-­ peared   in   various   TV   documentaries.   Referring  to  the  media  he  says  “the   power  of  narrative  to  highlight  an  issue   is  extraordinary.  If  you’re  able  to  find   an  individual  with  a  compelling  story   -­   putting   a   face   to   an   illness,   putting   a   face   to   a   social   problem   -­   it   means   that   people   are   able   to   understand   it   more  easily  and  engage  with  it  better.” And  what  about  working  so  closely   with   his   twin   brother,   Dr   Christoffer   van  Tulleken?  “I  think  we  get  along  ex-­ tremely  well.  But  anyone  who’s  worked   with   us   would   know   that   we   shout   at   each  other  constantly.  It’s  fantastic  be-­ cause  I’m  unconstrained  in  what  I  say.   When  we  were  climbing  in  the  Hima-­ layas  he  was  five  minutes  ahead  of  me   the  whole  day  and  by  the  time  I  arrived   at  the  tents  he’d  got  my  sleeping  bag  out,   made  tea  and  started  cooking  dinner.  I   was  completely  exhausted  and  he  was   like,  ‘Oh  Xandy,  how  are  you  doing?’,   and  I  just  burst  into  tears.”  Bless  them. But   even   with   such   support   there   must   have   been   challenges?   “Darfur   was   the   best   example   of   not   being   able   to   do   what   you’d   like   to   do.   My   way   of   coping   was   to   find   another   role   I   was   performing,   as   someone   who   can   advocate.   If   you   go   to   Darfur   expecting   that   you   can   fix   the   problem   by   building   a   hos-­ pital   you’re   fundamentally   wrong.” “Darfur   is   a   political   crisis   and   you   don’t   fix   a   political   cri-­ sis   by   sending   healthcare   workers.” “The   difference   you   make   will   probably   be   less   practical   and   more   symbolic.   You’re   always   frustrated,   you’re   always   constrained,   but   be-­ ing   able   to   see   it,   being   able   to   ac-­ company   people   through   it   and   to   try   and   do   some   medicine   in   some   small  way  is  as  much  as  you  can  do.” This   viewpoint   is   strikingly   dif-­ ferent   to   the   polished   awe-­inspiring   sermons   you   see   on   brochures   ad-­ vertising   volunteering   opportuni-­ ties.   It   resonates   with   pragmatism   and   the   sense   of   the   true   hardships   involved,   which   does   far   more   to   tempt   us   off   the   tarmacked   road   and   into   the   jungles   of   global   health. We  wondered  if  he  has  any  reserva-­ tions  about  not  climbing  up  the  conven-­ tional  professional  ladder  and  it  seems   not  even  the  most  philanthropic  among   us  is  exempt  from  having  doubts.  “The   thing  that  plagues  me  is  the  ‘what  will  I   do  when  I  grow  up’  problem.  At  32  I’m   still  balancing  decisions  about  whether   I  continue  clinical  medicine,  whether  I   can   work   for   the   UN   or   international   organisations,  or  whether  I  should  work   for   the   private   sector   or   academia.” “I  think  global  health  careers  often  

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Features take longer   to   assemble   than   UK   col-­ league  equivalents,  who  have  a  secure   salary  and  a  secure  structure.  That  for   me   is   deadlock   thing,   I   look   at   some   of   my   students   and   wonder   at   what   point   will   you   be   offering   me   a   job?” We  were  humbled  by  this  -­  it  seems   astonishing  that  a  televised  globe  trot-­ ter   who   has   travelled   to   more   than   eighteen   different   countries   doing   the   work   he   loves,   can   still   wonder   ‘what   he   will   do   when   he   grows   up’.   Despite   this   he   speaks   high-­ ly   of   this   career   route,   regard-­ less   of   the   lack   of   structure.   “We  have  a  very  organic  network  in   global  health,  it  unites  people  because   there   aren’t   that   many   people   who   do  

“I was completely exhausted...I just burst into tears” it. The  more  structured  it  is,  the  more   constraining  it  becomes.  The  most  im-­ portant  thing  is  that  it  retains  independ-­ ence  –  a  maverick  quality  which  does   not  come  with  the  severe  political  con-­ straints  of  a  lot  of  aspects  of  healthcare.” He  makes  a  career  in  global  health   seem   fickle   and   elusive   -­   a   career   not   for  the  faint-­hearted.  He  has  convinced   us  that  exploring  the  wilderness  might   open  our  eyes  past  the  blinkers  of  bio-­ medical  rationality,  integrate  with  other   societies  and  could  even  get  you  on  TV.   Oh,   and   it   might   just   make   you   a   better   doctor

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Gap Yah? Davina Kaur Patel Guest Writer

“Gap year?   Why   would   you   take   a   gap   year   in   the   middle   of   med   school?”   –   these   were   my   initial   thoughts  when  two  of  my  friends  ran-­ domly   struck   up   the   idea   one   day   in   my   second   year   of   medical   school.   I   am   Davina   Kaur   Patel,   a   medi-­ cal   student   at   UCL   and   I   am   writ-­ ing   from   Durban   in   South   Africa. While  initially  dismissing  the  con-­ cept   of   a   gap   year,   during   the   first   year   of   clinical   training   I   found   that   my   attitudes   towards   the   notion   of   a   gap  year  had  changed.  As  each  heavy   day   at   the   hospital   passed,   the   pros-­ pect  of  a  year  away  in  order  to  pursue   a  whole  host  of  opportunities  that  my   continuous   education   never   permit-­ ted   seemed   increasingly   appealing. Having   developed   a   strong   inter-­ est   in   global   health   during   my   Inter-­ national   Health   BSc   and   co-­presi-­ dency  of  UCL  Medsin,  I  increasingly   felt  the  need  to  explore  opportunities   open   to   me   to   gain   further   experi-­ ence  in  this  field,  beyond  the  univer-­ sity   setting.   I   now   craved   exposure   to   this   world   and   further   insight   into   how  I  could  be  involved  in  addressing   global   health   concerns   in   a   positive   way  as  a  future  medical  professional.   In  this  quest  I  eagerly  applied  for  an  

internship with  the  Department  of  Ma-­ ternal,  Newborn,  Child  and  Adolescent   Health   and   Development   (an   area   of   particular  interest  to  me)  at  WHO  HQ   in  Geneva,  and  was  accepted  to  start  in   September   2010.   Despite   not   contem-­ plating  my  plans  beyond  an  internship,   I,  without  hesitation,  accepted  this  op-­ portunity.   Suddenly   my   gap   year   had   become   a   reality   and   I   felt   great   an-­ ticipation   about   what   was   to   ensue.   First   year   clinics   came   to   a   close   and,  after  a  short  break,  I  moved  to  Ge-­ neva  to  embark  on  this  new  adventure.   Over   the   coming   weeks   I   immersed   myself  into  the  world  of  the  WHO.  Not   only  did  I  work  on  interesting  projects   such  as  writing  for  the  WHO  Nutrition   Review  and  editing  videos  for  commu-­ nity   health   worker   training   materials,   but   I   also   attended   seminars,   work-­ shops,   Spanish   classes,   and   confer-­ ences,   meeting   many   intelligent   and   inspiring   individuals   along   the   way. I  embraced  Geneva’s  wonderful  so-­ cial  scene  and  the  fascinating  blend  of   students   that   the   city   continues   to   at-­ tract.   Each   day,   work   would   inevita-­ bly   follow   with   some   sort   of   activity   be   it   sipping   wine   by   the   lake,   going   to   ice   hockey   matches,   hosting   din-­ ners,  or  tucking  into  pots  of  gooey  and   deliciously   salty   cheese   fondue   at   the   Bains   des   Paquis.   Overall,   the   expe-­ rience   was   an   unforgettable   one   that   solidified   my   ambitions   in   this   field.     As  my  time  at  the  WHO  came  to  a   close   in   December,   I   was   offered   an   internship  post  on  a  new  public  health   research   evaluation   on   the   effective-­ ness   of   community   health   workers   on  

the uptake   of   essential   ‘prevention   of   mother   to   child   transmission   of   HIV’   (PMTCT)   interventions,   to   be   con-­ ducted   in   the   HIV-­stricken   province   of   KwaZulu   Natal,   South   Africa.   Be-­ ing   a   continuation   of   some   work   that   I   performed   and   was   enthralled   by   at   the   WHO,   I   jumped   at   this   oppor-­ tunity,   and   quickly   decided   to   move   to   the   city   of   Durban,   South   Af-­ rica,   for   a   period   of   three   months.   So   today,   I   am   living   in   Durban   working   the   WHO-­initiated   Public   Health  Evaluation  with  a  local  univer-­ sity-­based   team,   called   the   ‘20,000+   Partnership’,  and  am  enjoying  the  work   thoroughly.  Every  day  I  am  interacting   with   and   learning   from   local   clinics,   hospitals,   district   and   provincial   DoH   staff  as  well  as  experienced  and  inspir-­ ing  researchers  in  the  area  of  PMTCT.   I   have   already   quickly   settled   into   the   beautifully   relaxed   South   Af-­ rica   way   of   life.   I   have   spent   days   working,   relaxing   by   the   beach,   go-­ ing   to   jazz   and   arts   evenings,   and   exploring   the   city   and   its   quirks. My  ambition  now  is  to  reach  South   America  and  to  travel  through  Bolivia,   Peru,  Ecuador  and  Colombia,  but  who   knows  what  the  rest  of  year  will  have   in  store  for  me!  What  I  can  write,  how-­ ever,   being   over   halfway   through   my   gap   year   is   that   so   far   I   have   had   the   most   tremendous   experiences   and   I   can   undeniably   say   that   this   is   one   of   the   best   decisions   I   have   ever   made.   So  for  those  who  dismiss  the  idea  of  a   gap  year  during  medical  school,  I  invite   you  to  reconsider  because,  like  me,  you   might  be  overwhelmingly  surprised  

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Image by Alexander Isted


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April 2011

Features THE WRITE STUFF Zoya Arain discusses ‘media medics’ During the 1940’s, Charlie Hill, an infamous ‘radio doctor’, became a household name through delivering frank and sensible advice to his listeners such as ‘breast milk is the best food’ and ‘eat something raw every day’. The past two decades have seen an explosion of doctors in the media. From writing weekly columns in national papers, to appearing on reality TV. However to what extent do the spheres of media and medicine complement one another? Raymond Tallis, professor of geriatric medicine at Manchester University has greatly crticised the portrayal of medicine in the media by journalists. Refering to the ‘organ retention scandal’ (babies’ organs at Alder Hey Children’s Hospital were kept without parental consent), Proffessor Tallis condemned journalists of preying on “grieving parents” and transforming the “routine practice - organ retention - into a macabre ritual”. He critiqued the sensationalism as well as the equal weighting of opinion of those “in a position to give an authoritative comment…with those unable to do so”.

medicalstudent

A finger on his pen, I mean, pulse Radhika Merh Guest Writer

An hour  and  a  half’s  wait  following  his  talk   on  his  journey  from  medical  student  to  med-­ ical  journalist,  and  reading  excerpts   from  his  f irst  book,  ‘Trust  Me   I’m   A   (Junior)   Doc-­ tor’  and  his  upcom-­ ing   book,   ‘The   Doctor   Will   See   You   Now’,   I   finally   saw   my  

chance to   talk   to   Max   Pemberton   himself. Max   was   gracious   and   friendly   enough   to   speak   to   every   single   person   in   the   lec-­ ture  theatre  who  wanted  to  ask  him  a  ques-­ tion,  get  his  autograph  or  get  advice  on  how   to   pursue   their   dreams   in   medical   journal-­ ism.  I  was  genuinely  surprised;;  this  was  one   famous  doctor  who  had  no  airs  about   being  one.  Max  Pemberton  is   a   recognised   writer,   journalist   and   doctor,   with   regular   columns   in   ‘The   Daily   Tel-­

Similar controversial instances include the publishing of the opinion of a US virologist Peter Herberg in the Sunday Times. He said that HIV does not cause AIDS in the 1990’s - the effects this statement, wholly unsupported by the medical profession at large - are still being felt today. Does this naturally, then, open a role for doctors in journalism, to discuss medicine objectively and expertly in a way that other journalists can’t? Some argue that this would only result in a censored presentation of facts by doctors who are bound by their reputation, the profession and its regulating bodies. Dr Max Pemberton, a well known columnist and author of ‘Trust me, I’m a junior doctor’, seems to have found a balance between the competing interests of telling a story in the right context and identifying potential issues that need to be addressed with regard to policy and infrastructure of the NHS. For instance, in an article for The Independent, Dr Pemberton comments on the financial incentives being offered by the government to GPs. He said “it will be disgracefull for doctors not to choose treatments that are clinically indicated and in the patient’s best interests, based on the fact that to do so saves the NHS money” and that this will “undermine the doctor patient relationship”. Christian Jessen, a celebrity GP known for his television series ‘Embarassing Bodies’ has stated that he wants to break “painful taboo”, but - at the same time - ensure that no participant is humiliated. He further justifies some of the less delectable scenes from ‘Embarassing Teenage Bodies’ by saying that “British teens have the worst sexual health in western Europe” and “we have to get people to watch it, but while they are being shocked at fascinated, they are learning something”. With the opportunity to preserve and uphold the reputation of the medical profession, safeguard the doctor patient relationship, and play an important role in public health awareness, the role of the ‘media medic’ is becoming increasingly well established in today’s society. If I keep pretending to write do you think they’ll b***** off? Image by Rhys Mansel

egraph’ and   ‘Reader’s   Digest’.   During   the   talk,  I  noted  his  laughter  was  infectious.  His   true  stories  of  being  on  the  ward,  tinged  with   an  innate  sense  of  humour,  meant  every  stu-­ dent  in  the  audience  could  relate  to  him  on   an   individual   level.   That   was   the   secret   of   his  success:  writing  about  normal  everyday   situations,   curtained   with   core   human   val-­ ues,   cynicism   and   comical   value   to   touch   the  heart.  He  agreed,  saying  “sometimes  the   ones  which  you  think  are  quite  good  are  not   the  ones  the  readers  feel  the  same  about.  But   it  is  those  stories,  the  ones  with  the  human   instincts,  which  stand  out  the  most  to  them”.   However  I  wanted  to  know  the  real  per-­ son   behind   the   veil   of   ‘Max   Pemberton’.   I   asked   if   this   pen   name   was   inspired   by   a   particular   person,   having   already   specu-­ lated   it   might   be   a   reference   to   Sir   Max-­ well  Pemberton,  the  founder  of  the  London   School   of   Journalism.   “My   grandmoth-­ er’s   favourite   name   was   Maxwell   and   my   mother’s   maiden   name   was   Pemberton.   I   wanted   my   close   friends   and   family   to   re-­ alise   that   it   was   me   that   was   Max   Pember-­ ton,  the  author”.  He  adds  after  a  pause,  “and   it  was  the  name  of  my  great  grandfather”.  I   exclaimed  on  having  correctly  made  a  con-­ nection   between   the   names.   “Yes   I   would   not  have  expected  many  to  make  the  link”.   So  perhaps  it  was  meant  to  be.  He  delib-­ erates  that  his  step  into  the  world  of  journal-­ ism   has   been   sheer   coincidence   and   driven   by   the   pure   need   for   financial   support   in   medical   school.   “It   was   never   planned.   My   family   was   very   poor.   I   wasn’t   even   expected   to   continue   higher   education.” He  smiles.  “When  I  knew  I  wanted  to  do   medicine  I  had  to  fund  myself.  I  was  asked   to  leave  medical  school,  as  I  just  couldn’t  af-­ ford  the  fees.  When  I  saw  an  advert  in  ‘The   Guardian’   advertising   for   a   medical   jour-­ nalist,   I   was   desperate   for   any-­ thing.   Even   though   I  had  no   experi-­ ence,  it  


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Features

The doctor attends to his adoring fans. Image by Rhys Mansel was my   last   resort.   I   was   amazed   when   I   got   the   job.   I   would   start   at   four  in  the  morning  and  finish  at  half   eight,  and  then  rush  to  my  lectures  af-­ ter.   It   was   hard   work   but   I   was   earn-­ ing   double   that   of   my   mother   and   fa-­ ther’s   salaries   put   together!   Once   I   gave   up   that   job,   I   never   attended   my   lectures   again,   so   it   was   quite   helpful   in   that   way   too!”   he   laughs.   So   does   his   media   image   af-­ fect   his   profession   as   a   doctor?   “Yes   it   helps   my   profession   most   definitely.   People   are   more   under-­ standing.   When   I   am   too   busy   with   my   writing   and   haven’t   prepared   well   enough   to   sit   the   exams,   I   miss   them.   And   University   College   Hos-­ pital,   where   I   work,   kindly   extends   my   contract   keeping   me   as   an   ST3.”

So being  a  writer  has  its  perks.  Not   just  within  the  hospital  but  also,  some   would  argue,  into  the  world  of  recrea-­ tional   drugs   for   an   arguably   altruis-­ tic   goal.   I   had   read  in  one  of  his  arti-­ cles  that  he  tried  mephedrone  (‘meow   meow’).  I  wanted  to  k now  if  he  thought   that  as  a  doctor,  and  more  importantly   a   psychiatrist,   this   might   have   wid-­ er   implications   on   public   perception   of   the   safety   of   recreational   drugs.   “Yes  I  know  what  you  mean  but  if   one   reads   the   article   you   will   realise   that   I   have   written   it   very   carefully   and   not   alluded   to   any   such   referenc-­ es.  It  is  important  for  us  to  think  about   drug  regulation;;  we  just  cannot  ignore   the   fact   that   Meow   Meow   is   out   and   legal   and   readily   available   and   every-­ one   is   taking   it,   even   young   children.  

I was   amazed   and   horrified   at   how   easily   these   drugs   were   available.”   He  recalls  his  trip  to  a  card  shop  in   Soho  and  finding  the  plant-­food,  very   innocently  placed  next  to  rubbers  and   sharpeners.  “I  thought  it  would  be  hid-­ den  or  put  somewhere  on  a  high  shelf   behind   the   counter   -­   but   no,   anyone   could   get   this.   No   age   restrictions.   And  if  we  do  ban  this  drug,  then  they   will   bring   out   an   analogue,   as   they   did.   So   I   wanted   to   create   awareness   about   this.   I   felt   I   had   to   try   it   and   I   must  say  it  was  good.  Although  I  was   very   careful   and   only   took   a   very   small  amount.  If  a  doctor  takes  it  and   writes  about  it,  it  creates  more  aware-­ ness,  which  it  did.”  He  k nows  the  value   of   having   a   voice   and   using   it   wisely. With  the  new  television  series  cov-­

ering seven   junior   doctors   placed   in   Newcastle,  there  is  a  lot  of  public  spec-­ ulation  on  how  foundation  year  doctors   cope  with  the  struggles  of  being  new-­ ly   qualified   on   the   wards.   He   seemed   the  right  person  to  ask  for  one  piece  of   advice  for  final  year  medical  students   about  to  start  their  F1  training.  “Stock   up  the  f ridge!  No  honestly.  It  is  t rue  that   as  a  student  in  London  you  go  get  the  

“it is those stories, the ones with the human instincts, which stand out the most” midnight bite  anywhere,  but  once  you   finish  late  at  night  you  don’t  want  to  go  

somewhere to  get  food  and  London  is   okay,  but  no  one  tells  you  that  is  not  the   case  in  DGHs  [District  General  Hospi-­ tals]!  The  shops  there  close  at  5pm.  You   live  by  eating  takeaway  pizzas  and  of   course,  stocking  up  your  fridge  well”.   And  lastly  before  we  part,  on  behalf   of   all   his   ardent   book   lovers,   what   is   happening  with  his  laundry?  He  grins   as  this  is  a  question  a  lot  of  people  have   presumably   asked   him.   “Now   I   am   a   doctor,  and  earning,  I  have  kept  a  clean-­ er”.  Perhaps  it  is  not  too  bad  after  all. He  poses  for  a  photo,  comments  on   his  jumper  bought  in  the  sale  and  casu-­ ally  calculates  the  limited  time  he  has   left  before  midnight  to  submit  an  article.   Max   Pemberton’s   third   book,   ‘The  Doctor  Will  See  You  Now’,  will   be   published   on   4th   August   2011  

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April 2011

Comment

Comment Editor: Sarah Pape comment@medical-student.co.uk

The BBC’s ‘Junior Doctors’: is this our future? Zainab Sansusi Guest Writer I, like   every   other   NHS   service   user,   was   genuinely   interested   in   the   con-­ cept   of   the   BBC   program   following   junior   doctors,   and   rather   curiously   observed   the   type   of   service   I   was   to   expect   when   told   I   would   be   seen   by   a  young  doctor.  As  a  third  year  medi-­ cal  student,  though,  I  was  also  secretly   hoping  to  see  that  the  myths  I  had  heard   about   life   as   a   junior   doctor   weren’t   true  -­as  you’ve  probably  gathered  none   of   there   stories   were   very   positive! The   foundation   doctors   I   had   seen   in   action   described   a   common   theme   of   being   unable   to   spend   the   money   they   make,   and   an   erratic   shift   pat-­ tern   that   hinders   them   from   the   ac-­ tive   social   life   that   was   so   enjoyed   during   medical   school.   In   short   they   seem   stressed   and   dejected.

“There are numerous occasions where our fresh faces are accused of possessing inadequate knowledge” For those   who   don’t   know,   the   programme   follows   seven   newly   qualified   doctors   working   on   vari-­ ous   wards   in   one   of   two   hospitals   in   Newcastle.   The   film   crew   follows   them   during   their   shifts   at   work,   as   well  as  at   their   home   -­   all   seven   have   been   housed   together   -­   in   a   bid   to   portray   all   aspects   of   their   lifestyles. We  have  seen  each  character  be  in-­ troduced,  and  I  love  to  that  they  have   found   a   good   variation   in   personali-­ ties  and  consequently  work  ethic.  The   first  episode  introduces  both  the  cool,   calm,   collected   doctor   who   definite-­ ly   knows   her   stuff,   the   one   anybody   would  be  glad  to  be  stuck  with  in  A&E,   and  the  arrogant  one  who,  thinking  he   knows  his  stuff,  falls  at  the  first  hurdle   -­though   I   am   sure   the   pressure   of   the   situation   could   have   been   the   cause. Throughout  the  series  we  see  their   day-­to-­day   conduct.   I   can   confidently   see   some   of   the   stories   I   had   already   heard  coming  to  light.  Medicine  defi-­ nitely  seems  to  be  more  than  just  f un  and   games.   We   see   an   exhausting   pattern   of  shifts,  some  of  which  include  highly   pressured   nights,   while   others   consist   of  routine  tasks  such  as  taking  bloods   or   inserting   cannulas   coupled   with   some   very   uninteresting   paperwork.   For  those  attached  to  wards,  medi-­ cine   doesn’t   seem   to   live   up   to   ex-­ pectations  and  they  find  there  are  not   enough   patients   and   far   too   much   pa-­ perwork.  Emergency  medicine,  on  the  

medicalstudent

other hand,   is   fast-­paced   and   laced   with   plenty   of   responsibility..   There   are   numerous   occasions   where   our   fresh   doctors   are   accused   of   possess-­ ing  inadequate  knowledge,  and  we  are   shown   five   years   of   medical   training   put   to   good   use   proving   them   wrong. We  also  see  some  of  the  highs  of  be-­ ing   a   doctor,   with   our   fantastic   seven   saving   lives,   but   then   some   tear-­jerk-­ ing   lows   when   we   are   reminded   that   not   all   people   can   be   saved.   We   are   shown  that  all  medics  are  also  humans;;   being  tired  and  overworked  can  result   in  mistakes  during  routine  tasks,  and  a   failure  to  live  up  to  the  high  standards   we   all   set   for   ourselves.   We   see   their   experiences  dramatically  affect  future   career   choices,   and   they   are   all   faced   with  tough  choices  related  to  speciality.   When   we   follow   our   young   doc-­ tors   home   the   long   hours   and   hectic   timetables   really   can   take   its   toll   on   their  social  life,  though  they  are  fight-­ ing  the  “all  work,  no  play”  stereotype   that   doctors   are   so   commonly   as-­ sociated   with.   Each   doctor   attempts   to   keep   up   with   lifelong   hobbies,   at   the   same   time   as   juggling   the   books   and   the   night-­shifts.   All,   in   my   opin-­ ion,  an  accurate  portrayal  of  what  be-­ ing   a   foundation   doctor   will   be   like,   not   that   I   am   pleased   to   admit   it. Unfortunately   I   can   say   there   are   a  few  negative  aspects  of  the  portray-­ al   of   doctors   on   this   programme.   To   house   them   in   a   large,   all   expenses   paid   accommodation,   living   lives   a   lot   more   comfortable   than   the   norm   of   those   recently   graduated   is,   in   my   opinion,  very  inaccurate.  We  don’t  see   the  struggles  of  a  person  that  is  newly   finding   their   feet   within   their   career   and   needs   to   balance   acquiring   their   first   home,   paying   bills   and   manag-­ ing  their  first  pay  cheques.  Moreover,   their  rather  active  social  lives  are  also   rather   questionable.   We   see   our   doc-­ tors   are   also   dancers,   rugby   players   and   members   of   bands,   all   of   which   I   am   sure   they’d   be   unable   to   dedi-­ cate   as   much   time   to   as   we’re   are   led   to  believe.  It  seems  the  BBC  are  keen   to   depict   them   as   well   rounded   so   we   hear   more   about   these   out   of   hours   activities   than     we   would     when   talk-­ ing   to   doctors   in   other   hospitals.     To   conclude,   I   would   say   this   pro-­ gramme   is   an   accurate   representation   of   life   a   junior   doctor,   featuring   vari-­ ous   aspects   of   the   emotions   they   ex-­ perience   as   a   result   of   it.   I   frequently   question  my  reasons  for  studying  med-­ icine,  often  letting  the  negative  aspects   override   the   positive   ones,   and   feel   seeing   this   firsthand   depiction   where   the  pros  clearly  outweigh  the  cons  has   reconfirmed   in   my   mind   my   initial   reasons  for  studying  medicine.  Kudos   to   the   BBC,   I   am   glad   to   see   my   Li-­ censing   Fee   is   going   to   good   use!  

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Featured Interview Junior doctor Katherine on her time with the BBC, and the dangers of editing Interview by Bibek Das One of the doctors is 24-year-old Cambridge graduate, Dr Katherine Conroy, who is an aspiring surgeon. From the first episode, we see her starting off on the busy plastics ward, trying to manage her life alongside a busy schedule that includes weekends and night shifts. But what would initially motivate a young junior doctor to sign up to a BBC documentary? ‘I think my main motivation was that I felt really lucky that I came from a medical background, so when I was first applying to medical school I knew people who had gone through the whole process and I knew what being a doctor is about. I think knowing people who have gone through it makes it less scary, and I thought it would be good for people who weren’t from a medical background to be able to see that you don’t have to be some super-amazing-perfect person to do this job; it is something that is attainable.’ As for actually making the show, was it an enjoyable experience overall? She describes it mostly as ‘interesting’: ‘there were good bits and bad bits of it. I was new to the city and I didn’t really know many people, so being put in a house with six other junior doctors was just brilliant because it meant that I didn’t feel I was on my own starting out and I had readymade friends (laughs); that was really nice. Also the camera crew were absolutely lovely. Sometimes it was quite nice that when you had a tough day you’ve got someone who you could talk to; it’s actually quite therapeutic.’ It wasn’t always easy, however, to undergo the stress of filming while starting off on a house job: ‘I think I didn’t realise when I signed up for it just how busy my job was going to be. They would come towards me in the afternoon and say: right Katherine, we just need a 5-minute chat at some point. And I thought, well, I haven’t even been to the toilet since 7 o’clock this morning, so good luck trying to fit in a five-minute chat when I’ve got all these bloods to take and all these patients to see! So there were bits where it added to the stress of the job. But overall, I think I’m glad I did it.’ Each day, the junior doctors carried out their usual tasks, which would include clerking patients, working with nurses and presenting to their seniors. The notable addition, however, was that a camera crew would be following them through a busy hospital. The reaction on the wards was initially mixed: ‘I think the nurses on my ward were initially very wary because I think they were worried that it was going to be some sort of Panorama-style exposé of NHS failures, and I think they’re right to think that because there is so much bad press about the NHS and everyone’s so quick to put it down and jump on any mistake, and not to see the bigger picture and all the good things about it. So they were quite defensive at first, but I think as the filming progressed, I think they became a lot more comfortable about it and, certainly the nurses on my ward, they really had my back and were really protective of me, and they would really look out for me.’

And how did the patients react to being filmed? ‘Some patients don’t like to be involved, but I felt the way it was put to them, they didn’t feel like they had to become involved in the filming.’ The reaction from patients could occasionally be surprising: ‘some of them actually really enjoyed it. I remember when I was on-call I went to see an elderly lady with acute cholangitis. She was in so much pain and she was so ill, I really didn’t know if it was in her best interests to have a camera crew there. When it was mentioned to her, her face just lit up and immediately she was saying ‘Oh am I going to be on television?!’ and the transformation was amazing; and I think it was more than the morphine (laughs). A lot of them

“The camera crew were lovely. Sometimes it was quite nice that when you had a tough day you’ve got someone who you could talk to; it’s actually quite therapeutic.” quite enjoyed getting involved – especially the plastics patients – a lot of them are physically very well, and really bored in hospital and it was kind of a welcome distraction for them. So a lot of them were really positive about it.’ Was it nerve-wracking to perform clinical procedures in front of a camera crew? ‘It made you really think about what you were saying, and made you think about what you were doing. And because you were so hyper-aware of the fact you were being filmed, I found that I probably


medicalstudent

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13

Comment Was Japan ready? Toby Flack examines emergency medicine provisions

A

Katherine and the junior doctors show off hospital fashion. Photo courtesey BBC/Cat Gale did things by the book a lot more than I would have done (laughs). I also thought if my clinical skills teacher sees this and I’m not doing this properly, she would be so disappointed! So I did it exactly how I would do it in an OSCE.’ In documentaries such as this, which are edited down to six episodes, the final airing might not always tie in with the reality. Does she feel this was the case? ‘It’s difficult really. I would say in the first episode, a lot of people commented on how I couldn’t get blood out of this patient. She was a post-operative patient and just had a breast reconstruction with an axillary node clearance, so one arm was off limits and the other arm had a PCA [patientcontrolled analgesia], an arterial line, and another cannula of fluids going into the arm. I thought, well, she’s just come out of theatre, and I don’t really want to stop all the fluids and PCA to take bloods. My only option really was her feet. And when someone’s been lying in bed for a few days, the veins in their feet aren’t usually the best place to get blood from (laughs).’ In the first episode, it was portrayed as if she went straight for the patient’s foot after having a brief glance at her arms: ‘I know! So they kind of misrepresented that but at the end of the day, that’s what the public wants to see. They want a story, like ‘oh no, she couldn’t take the blood, oh, how awful’. Also, I think they want to see doctors be human.’ But overall, was it a realistic representation of the kind of things junior doctors have to face? ‘I’m not sure to be honest. I think, in some ways, yes, definitely more so than things like Casualty or Scrubs and things like that, much more realistic than that. I think one of the biggest positive things from the show is that

so many people have said to me, I enjoyed watching the show because now my boyfriend or my parents, they understand what I get up to at work, they understand what my work is about, why I’m so stressed when I come home, and now I’ve been trying to tell them for months what it’s like, but now they can watch it on the telly. So I think it’s realistic from that point of view, but obviously, it is edited. ‘I think it does show firstly that we are human and we do make mistakes, and its not because we don’t try, it’s because everyone makes mistakes. Secondly, I think it does show (hopefully) doctors in a positive light, as in, we care about our patients and we work hard.’ Having spoken to a successful female surgeon and now more confident that women can have a successful surgical career, does she think she will inspire other female junior doctors? ‘Well, I hope so. I hope people watching the programme think that no matter what career they’re in, they will take heart from the fact that this surgeon is not just a surgeon but a woman with a successful career with a family. So you can be a woman and have a successful career, whether that’s in surgery or whatever.’ Over the course of these six episodes, we have seen the junior doctors deal with the trials and tribulations that many of us will face in a few years time. While the documentary focuses on the medical profession, she says the message of show can also reach a wider audience: ‘I think a lot of what the show wanted to portray was that we weren’t just doctors, but we were young people starting out on their first job, so they wanted to make it relevant for any young person leaving university and going into their chosen career.’

t 2.46pm   11th   March   2011   thousands  of  Japanese  peo-­ ples   lives   drastically   al-­ tered  forever.  The  question   is,  was  Japan  ready  for  the  sudden  med-­ ical   needs   of   a   population   rocked   by   an   earthquake   of   such   large   a   magni-­ tude?  And  do  leading  world  politicians   have   an   obligation   to   provide   help?   It   also   leaves   the   question   of   whether   there   is   a   place   for   emergency   medi-­ cine   as   an   elective   for   UK   students.   Firstly   we   must   look   at   how   to   deal   with,  as  prime  minister  Naoto  Kan  put   it   Japans   ‘worst   crisis   since   the   war’. It   is   not   the   first   time   Japan   has   been   hit   by   such   ground   breaking   tremors.   The   Kobe   earthquake   of   1995   killed   6,433   people,   and   that   only   had   a   magnitude   of   7.2,   in   con-­ trast   to   this   months   which   reached   8.8.   The   crucial   difference   between   the   two   earthquakes   can   be   observed   in  the  subsequent  tsunami  of  the  sec-­ ond  quake  washing  away  any  hope  of   a   quick   recovery.   So   far,   over   10,000   people  have  been  confirmed  dead  with   a   further   17,440   people   missing   and   with  half  a  million  people  still  home-­ less,   medics   have   their   work   cut   out   in   keeping   the   medical   surge   at   bay. There   is   then,   of   course,   the   un-­ precedented  threat  of  radiation  escap-­ ing   from   Fukushima   nuclear   plant,   possibly   burdening   a   generation   of   Japanese   doctors   with   the   aftermath   of   disease   caused   by   the   nuclear   fall-­ out.   Iodine-­131   will   cause   cancer   within   a   few   year   if   ingested   or   in-­ haled.   If   the   Iodine-­131   does   escape,   oncologists   will   be   overawed   with   new   challenges   for   decades   to   come.   Prophylactic  measures  have  already   been  taken  for  those  in  high  risk  areas.   Previously,   the   Japanese   government   had   stockpiled   potassium   iodide   pills   for  this  eventuality.  These  are  in  lim-­ ited  supply  though,  and  are  only  being   distributed   to   those   at   greatest   risk.   Furthermore,  help  is  being  received   from   the   British   government   which   has   deployed   63   ‘relief   specialists’   to   help  with  the  search  and  rescue  across   Japan.   The   problem   is,   according   to   the   BBC,   only   4   of   these   people   are   doctors.  With  an  estimated  20,000  in-­ juries,  are  such  a  small  number  of  spe-­ cialists   able   to   even   begin   to   scratch   the   surface   in   helping   this   small   but   hugely   significant   country   recover? International   financial   support   is   no  doubt  evident,  with  close  neighbour   China   providing   $4.5   million   worth   of   humanitarian   aid.   Moreover   even   countries  with  their  own  political  and  

economic problems   have   jumped   at   the  opportunity  to  support  Japan,  with   Afghanistan  pledging  $50,000  to  sup-­ port   relief   efforts.   It   seems   the   nation   described  by  the  U N  as  ‘generous  in  its   support  to  others’  is  reaping  the  benefits   of  its  past  generosity.  The  main  prob-­ lem  is  that  there  are  simply  not  enough   medics   and   nurses   to   administer   the   medical   supplies   which   are   arriving.   This  opens  the  debate  of  whether  it   is  feasible  to  create  electives  in  disaster   medicine  to  support  the  currently  mi-­ nuscule  specialty  of  disaster  medicine.   Many   physicians   offer   assistance   in   these  situations,  but  are  they  equipped   to   deal   with   the   situation?   Although   no  specialist  in  disaster  medicine  ever   wants  to  use  their  knowledge  to  its  full   potential,   disasters   will   always   occur.  

“If the Iodine-131 does escape, oncologists will be overawed with new challenges for decades to come.” Disaster consultants  do  have  a  role   in   preparing   countries   such   as   Japan   for   these   situations.   Without   their   work,   the   damage   would   have   been   significantly   larger.   Thanks   to   their   work,   Japanese   people   are   in   a   con-­ stant   state   of   preparation   for   ‘the   big   one’.       Everyone   knows   what   to   do   should   the   earthquake   alarm   go   off,   and   with   thanks   to   ingenious   engi-­ neering,   they   can   cope   with   smaller   quakes.   It   was   not   possible   to   have   foreseen  and  prepared  for  the  tsunami   in   the   same   way   though,   due   to   our   lack  of  knowledge  on  how  they  work. The   specialty   of   disaster   medi-­ cine   is   a   competitive   one,   and   with   UK   medical   students   finding   it   diffi-­ cult   to   gain   experience   through   elec-­ tives,   maybe   it   could   be   introduced   as   a   BSc.   This   would   allow   students   to   get   a   grasp   of   the   specialty,   and   gain   experience   in   what   is   often   an   inaccessible   branch   of   medicine. Then   again,   it   is   an   inaccessi-­ ble   specialty   for   a   reason.   In   a   world   where   AIDs   is   killing   1.8   million   people   per   year   (2009   figures   pub-­ lished   by   UNAIDS),   is   it   justifiable   to   increase   spending   on   what   an   epi-­ demiologically   insignificant   cause   of   death?  Although  everyone  has  sympa-­ thy  for  Japan  and  all  loss  of  life  is  sig-­ nificant,   it   makes   you   wonder   wheth-­ er   there   are   bigger   fish   to   fry   first

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14

April 2011

Comment

medicalstudent

Comment Editor: Sarah Pape comment@medical-student.co.uk

Head to Head Are electives self-indulgent? YES

I

haven’t been   on   an   elective.   I   know   that   makes   me   an   unusual   candidate  to  write  this  article,  but   I  have  volunteered  a  lot  overseas   and  learnt  that  to  do  so  is  often  u nethical.   I  have  also  come  to  think  that  electives   can   be   unethical   for   similar   reasons. I  have  volunteered  in  a  lot  of  places   which  we  would  classify  as  less  devel-­ oped,  mostly  because  t ravelling  around   the  world  is  amazing,  and  doing  some   kind  of  work  there  for  f ree  gives  you  an   opportunity   to   experience   things   you   couldn’t  otherwise.  My  experiences  in   Uganda,  Nicaragua,  Nepal  and  every-­ where  else  were  incredible  every  time.   Yet,  since  I’ve  volunteered  so  much,   it  has  hit  me  hard,  and  in  a  way  I  can  no   longer   avoid,   that   teaching   local   chil-­ dren  when  you’re  completely  unquali-­ fied,  setting  up  a  youth  project  that  will   end   when   you   go   home,   or   building   toilets   or   steps   to   a   nature   park   when   you’ve   never   held   a   shovel   before,   all   of   which   I’ve   done,   are   patronising   towards   the   people   you   work   for   or   alongside.   Trying   to   support   health-­ care   as   an   unqualified   but   enthusias-­ tic  volunteer  in  a  country  poorer  than   your  own,  can  be  really  inappropriate.   Many   people   in   those   towns   and   villages   would   have   been   better   at   the   manual   work   and   more   able   to   relate   to   the   children   if   they   had   had   the   leisure   and   disposable   income   to   give   their   time   to   positive   projects.   If   they  had  been  involved  the  work,  they   would   almost   certainly   have   commit-­ ted   to   it   for   longer   than   I   did.   It’s   not   the   way   that   communities   become   more   affluent,   or   how   badly   needed   resources   become   more   available.   There’s  also  the  long  history  of  im-­ perialism   and   the   continuing   divide   between   rich   and   poor   which   means   you   can’t   play   games   with   children   in   a   Ugandan   village   without   think-­ ing   of   the   impact   it   has.   So   whilst   the   idea   of   working   in   a   hospital   or   clinic   in   a   country   where   resources   and   staffing   are   low   and   need   is   very   high  sounds  so  good,  I  know  I  am  go-­ ing   to   be   treading   a   fine   ethical   line.     I  am  sure  the  situation  on  my  elec-­ tive  will  be  different  from  my  previous   travels.  I  hope  I’ll  have  more  skills  to   put  to  use  than  I  did  teaching  English   when  I  was  eighteen,  but  I  have  to  ana-­

NO

Hayley Stewart Sub-Editor

lyse what  it  means  for  me  to  be  there.  If   I  see  my  work  as  helping  out  and  con-­ tributing   to   a   struggling   health   clinic   that  will  be  naive  because  I  won’t  have   much   clue   what   I’m   doing   medically.

“It’s not the way that communities become more affluent or badly needed resources become more available” If we   look   at   charities   which   do   support   developing   infrastructure   in   resource-­poor   countries,   like   VSO,   they  no  longer  allow  their  foreign  vol-­ unteers  to  do  the  majority  of  the  work   on  the  ground,  but  send  high  level  pro-­ fessionals   to   train   locals   as   a   way   of   contributing   in   a   way   that   empowers   that  country’s   own  workforce.  This  is   now   the   accepted   and   ethical   way   of   working   in   development,   but   medical   students   on   electives   do   just   the   op-­ posite.   They   use   the   low   standard   of   healthcare   systems   in   other   countries   to  secure  great  placements  doing  a  lot  

more than  they  might  back  home,  get-­ ting  lots  of  hands  on  experience,  before   coming  back  to  continue  their  training   in  the  UK.  The  point  here  is  that,  if  I   am   self-­   aware   and   acknowledge   that   I  will  have  a  lot  more  to  gain  on  elec-­ tive  than  I  will  be  able  to  give,  I  have   to   then   recognise   that   it   shouldn’t   be   me   gaining   from   the   opportunities.   If   it  is  a  resource-­poor  environment,  with   too   few   trained   personnel,   the   train-­ ing  I  gain  should  be  given  to  a  student   from   that   country,   one   who   will   con-­ tinue   to   give   back   to   the   community. So   whilst   I   admit   I   have   loved   all   the  volunteering  I’ve  done,  and  I  wish   I  was  on  my  elective  right  now,  I  can’t   ignore   the   fact   it   will   be   an   ethically   dubious   time.   If   for   no   reason   other   than   the   fact   that   a   fourth   year   medi-­ cal  student,  who  doesn’t  get  to  do  ad-­ vanced  procedures  in  this  country  be-­ cause  it  is  unethical  to  put  the  patient   in   such   inexperienced   hands,   should   not  be  let  loose  on  patients  in  another   country   just   because   people   there   are   less  fortunate  than  we  are.    It’s  unethi-­ cal  to  take  advantage  of  their  disadvan-­ tage,  particularly  since  we  are  coming   from   such   a   privileged   background  

The students get more hands on experience than they were expecting

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G

oing on   a   medical   elective   can  be  an  incredibly  mem-­ orable,   rewarding   oppor-­ tunity   and   an   invaluable   part   of   your   medical   education.   Stu-­ dents   arrange   placements   in   medical   posts  anywhere  in  the  world  (obviously   within  reason  –  Libya  and  Iraq  may  not   be   the   best   locations   at   the   moment)   and  it  provides  vast  scope  for  students   to   gain   exactly   the   learning   experi-­ ences  they  are  passionate  about  and  in-­ terested   in.   Whether   this   is   your   first   visit  into  the  developing  world,  or  you   are   a   seasoned   gap-­year   traveller,   the   medical   context   of   the   elective   make   it   an   incredibly   unique   experience.   Yet   there   are   those   people   who   doubt  its  merits,  instead  labelling  elec-­ tives  as  a  holiday  for  rich  medical  stu-­ dents,   disrupting   the   infrastructure   of   poor   health   centres,   and   not   pro-­ viding   suitable   educational   outlets.

“When students chose to spend their electives in developing countries, it can act as a way to open their eyes to some of the issues that affect the less privileged, and help them gain life perspective” I disagree.   Typically,   the   electives   are   arranged   with   hospitals   and   clin-­ ics   abroad,   although   many   students   choose  to  do  their  electives  in  the  UK   as   well.   Traveling   abroad   gives   stu-­ dents   the   chance   to   witness   cultures   and   places   they   may   otherwise   never   get   the   chance   to   see.   When   students   chose  to  spend  their  electives  in  devel-­ oping  countries,  it  can  act  as  a  way  to   open   their   eyes   to   some   of   the   issues   that  affect  the  less  privileged  and  help   them  to  gain  life  perspective.  Also,  as   most  students  will  eventually  spend  the   majority  of  their  lives  in  UK  hospitals,   overseas   electives   can   be   a   welcome   change   of   scene,   and   will   certainly   prove  to  be  a  once  in  a  life  time  oppor-­ tunity.  Clinically  speaking  there  is  also   the  chance  to  see  some  of  the  tropical   illnesses   that   you   would   otherwise  

Alex Isted Staff Writer

rarely see:   malaria,   HIV,   starvation,   Dengue   fever,   and   leprosy   to   name   a   few,  and  though  witnessing  these  will   be  undoubtedly  harrowing  it  will  help   to   broaden   medical   knowledge.   Ad-­ ditionally,   the   experience   of   working   in   foreign   health   care   systems   will   help   students   to   make   comparisons   with  the  NHS  and  highlight  our  health   care   service’s   virtues   and   failures.     Regardless   of   where   the   elective   takes  place,  they  can  provide  an  outlet   for   students   to   hold   responsibility   for   patients  and  have  a  chance  to  gain  some   experience  in  a  clinical  setting.  Whilst   you  must  practice  within  the  confines   of  your  medical  education  as  stated  by   the  GMC,  there  are  many  chances  to  get   hands  on  and  when  applying  for  place-­ ment,   students   can   chose   the   medical   speciality  they  are  most  keen  to  spend   their   time   in,   with   the   most   popular   specialities   being   surgery,   emergency   medicine,   and   paediatric   medicine.     As   for   the   fact   that   medical   stu-­ dents  are  being  self-­indulgent  by  going   abroad  for  elective,  it  can  be  very  chal-­ lenging  for  a  g roup  of  students  to  get  in   contact  with  a  hospital  half  way  around   the   world   and   arrange   a   placement,   while  negotiating  all  the  red  tape,  bu-­ reaucracy,   vaccinations,   visas,   bursa-­ ries…  the  list  goes  on.  There  are  com-­ panies  available  to  help  plan  electives,   like  ‘Work  the  World’  which  do  some  of   the  leg  work  for  you,  but  regardless  the   process   of   arranging   your   trip   can   be   a   long   one,   with   students   encouraged   to  begin  their  planning  over  12  months   before   the   trip.   Such   a   trip   is   also   fi-­ nancially  daunting,  possibly  favouring   richer  students,  but  as  there  are  many   bursaries  available  for  students  to  help   towards  the  costs  the  experience  really   is   available   to   anyone   who   wants   it. The  experience  is  ultimately  an  in-­ credibly   fulfilling   one   that   will   help   provide   perspective,   improve   your   clinical  experience,  enhance  your  cul-­ tural   awareness   and   language   skills,   help   with   communication,   and   even   act   as   a   needed   holiday   before   foun-­ dation   training.   It   is   the   one   chance   students   get   to   plan   their   education   completely   independently,   and   ul-­ timately   benefits   not   just   the   stu-­ dent,   but   everyone   they   spread   their   newly   acquired   knowledge   with    

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medicalstudent

April 2011

15

Comment The crack down on vices David Fisher Staff Writer Palms dripping   with   sweat,   his   heart   pounded.   Adrenaline   rushed   through   Mike’s   body   as   he   spied   out   his   target,   a   small   corner   shop,   just   strides   away.   His   index   finger   twitched   expect-­ antly.  Tugging  down  his  hood  to  hide  his  head,  he   nervously  glanced  f rom  side  to  side.  The  pavement   was   deserted.   Terrified   of   the   consequences   of   being  seen,  Mike  hastened  to  open  the  door.  Like   a  magnet,  he  was  drawn  towards  the  counter,  un-­ able  to  resist.  Lifting  his  head  to  stare  at  the  assis-­ tant,  he  opened  his  mouth,  ready  to  expose  himself   as   society’s   enemy.   “Twenty   Malboro,   please.” A  prolonged  government  campaign  has  made   smoking  socially  unacceptable.  It  is  forbidden  to   smoke   in   public   areas,   and   many   smokers   now   perceive  a  stigma  attached  to  smoking.  This  is  not   altogether  surprising.  Before  war  was  declared  on   smoking  over  a  decade  ago,  a  shocking  120,000   people   died   each   year   from   smoking   related   ill-­ nesses.  The  cost  to  the  NHS  was  an  astronomical   £1.7  billion.  The  diminished  productivity  of  those   incapacitated,   compounded   by   necessary   wel-­ fare  payments,  insulted  the  public  purse  further.   Battle  lines  were  drawn,  principally  targeting   tobacco   advertising.   Public   consciousness   was   bombarded   with   an   intensive   media   campaign   promulgating   the   corroding   consequences   of   smoking.   Thankfully,   the   public   were   receptive   to  warnings.  By  2010,  the  Department  of  Health   claimed  the  number  of  adult  smokers  had  reduced   by  a  fifth,  and  the  number  of  children  beginning   to  smoke  had  halved.  Deaths  resulting  f rom  smok-­ ing  had  fallen  to  80,000.  Notwithstanding,  there  is   much  progress  to  be  made.  Smoking  still  costs  the   NHS   budget   £2.7   billion,   an   avoidable   expense. Another   group   of   self-­harmers   are   es-­ timated   to   cost   the   NHS   budget   a   similar   amount,   but   seem   relatively   immune   from   public   disdain.   The   number   of   hospital   ad-­ missions   due   to   alcohol   abuse   has   been   stead-­ ily  rising,  now  in  excess  of  a  million  each  year.   In   many   ways,   the   ramifications   of   alcohol   abuse   are   more   severe   than   smoking.   Smokers  

mainly harm   themselves,   though   the   collateral   damage   of   passive   smoking   is   significant.     Al-­ cohol   abusers   on   the   other   hand,   have   far   more   impact   on   surrounding   bystanders.   Intoxicated   individuals   cause   localised   destruction,   not   dis-­ criminating   between   people,   possessions   and   properties.   Deaths   resulting   from   smoking   are   more  prevalent  in  the  elderly.  By  way  of  contrast,   alcohol   fatalities   predominate   amongst   younger   people.  Thus  the  loss  of  productivity  is  greater  as   a  consequence  of  alcohol  fatalities,  as  compared   with  the  number  of  deaths  resulting  f rom  smoking.   Despite   the   steady   rise   in   alcohol   abuse   re-­ lated   costs,   surprisingly   little   has   been   em-­ ployed   to   stem   the   tide.   In   1987,   the   ‘Sensible   Drinking’   message   promoted   advice   to   limit   unitary   intake   of   alcohol.   The   number   of   units   consumed  became  the  core  of  the  alcohol  health   initiative.   This   was   completely   misguided.   Whilst   many   members   of   the   public   recognise   the   initiative,   pathetically   few   people   can   ac-­ curately   quantify   how   much   a   unit   is.   Other   ef-­ forts   have   included   the   designation   of   Alcohol   Free   Zones   but   mostly   efforts   to   limit   alcohol   intake  have  been  woefully  weak  and  ineffective.  

“The diminished productivity of those incapacitated, compounded by welfare payments, insults the public purse” Lamentably, binge   drinking   is   estimated   to   cost  the  U K  between  £17  and  £22  billion.  Two  and   a  half  million  adults  admit  to  drinking  more  than   twice   the   recommended   daily   limit.   It   is   mysti-­ fying  why  the  Government  investment  to  tackle   binge   drinking   is   disproportionately   less   than   to   combat   smoking.   This   irresponsible   neglect   does   little   to   improve   standards   of   healthcare. The   root   of   the   problem   is   that   people   ac-­ cept  irresponsible  drinking  as  normal.  An  even-­ ing  socialising  is  often  considered  a  failure  if  it   does   not   lead   to   inebriation.   This   unhealthy   at-­ titude  towards  alcohol  must  be  changed  to  effec-­

Illustrations by Giada Azzopardi tively engage   with   the   issue.   The   Government   must   initiate   a   high   profile   media   campaign   to   shock  the  public  into  appreciating  the  poisonous   complications   of   excessive   drinking.   This   has   been   highly   successful   in   the   past   when   tack-­ ling  drink-­driving  during  the  Christmas  period.     Whilst   education   is   essential   to   sway   public   attitudes   against   excessive   alcohol   consump-­ tion,  price  is  the  most  responsive  stimulus  likely   to   influence   alcohol   intake.   Economic   models   leave  no  doubt  that  taxation  r ises  reduce  demand.   A   taxation   rise   would   unfortunately   punish   the  innocent  majority  who  drink  in  moderation.   It  would  also  have  severely  detrimental  effects  on   the  alcohol  industry  but  beverages  such  as  beer,   cider  and  vodka  should  be  taxed,  since  they  are   commonly   abused   by   binge   drinkers.   Judging   by   measures   in   the   latest   budget,   this   is   clearly   the   direction   in   which   the   Government   is   start-­ ing  to  travel.  However,  further  tax  rises  will  be   needed   to   substantially   reduce   alcohol   abuse.   Despite   being   unpopular,   there   is   little   doubt   that  additional  tax  rises  should  be  levied  on  alco-­

holic drinks.   The   Government   needs   to   bravely   and  forcefully  grab  the  drunken  bull  by  its  horns. In   addition,   the   Government   needs   to   recog-­ nise   that   the   clout   of   supermarket   control   has   a   choke-­hold  on  alcohol  pricing.  Confronting  alco-­ hol   abuse   without   restraining   supermarket   pric-­ ing  is  futile.  It  is  commonplace  for  individuals  to   buy  significant  quantities  of  alcohol  from  super-­ markets  to  consume,  before  stumbling  into  pricier   bars  and  pubs.  It  is  critical  to  curb  these  discounts;;   otherwise   they   will   undermine   any   attempt   to   tackle  binge  drinking.  An  effective  policy  would   impose   a   minimum   unit   cost,   so   that   it   would   be  illegal  to  sell  alcohol  at  such  low  prices.  This   would   fly   in   the   face   of   fierce   opposition   from   the   alcohol   industry   but   the   Government   must   prioritise   public   health   above   industry   profits. It   is   ludicrous   that   smoking   is   vilified   but   intoxication   accepted.   Public   health   has   im-­ proved  as  we  have  successfully  battled  smoking.   A   new   line   of   attack   is   long   overdue.   We   must   wake  from  our  alcohol  induced  slumber  and  take   strong   action   to   remedy   years   worth   of   abuse  

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Rory Barr discusses the benefits of getting engaged

O

ne of  the  most  exciting  (and   terrifying!)   moments   of   life   in   your   early   twenties   is   when   friends   start   an-­ nouncing  their  engagements.  Of  course   you’re  delighted,  but  it’s  all  so...serious.   When   did   we   start   growing   up?   Mak-­ ing  big  decisions,  and  taking  responsi-­ bility  for  your  future?  Indeed,  not  just   your   future,   but   the   future   of   others? While  I  have  yet  to  receive  the  requi-­ site  jewellery,  I  have  found  another  way   to  get  engaged.  As  BMA  Rep  at  K ing’s,   part  of  my  role  is  to  put  students’  con-­ cerns  to  those  who  can  influence  poli-­ cy,   and   improve   outcomes.   Therefore,   after   months   of   nagging   and   conflict-­ ing   calendars,   I   managed   to   arrange   a  

meeting with   Mark   Durkan,   my   local   MP   from   Foyle   in   Northern   Ireland. Although   Mark   is   no   longer   the   leader   of   the   Social   Democratic   and   Labour   Party,   and   is   stepping   down   as   an   Assembly   Member   in   Northern   Ireland   (where   most   decisions   affect-­ ing   students   from   NI   will   be   made),   his   influence   within   the   party   and   ability   to   represent   our   interests   re-­ mains   strong.   With   that   in   mind,   I   trundled   along   to   Westminster   on   the   day   that   the   Budget   was   announced.   After  a  friendly  chat  and  a  coffee,  I   began  explaining  the  various  financial   pressures  faced  by  all  medical  students   –  ours  is  a  longer  course  than  most;;  we   have   higher   travel,   equipment   costs  

etc;; and   the   difficulties   of   Widening   Participation   when   costs   are   so   high   and   support   so   low.   I   highlighted   the   reduced  Student  Loan  support  for  Final   Year  students,  and  the  fact  that  the  Stu-­ dent  Loan  Company  (SLC)  in  Northern   Ireland  gives  approximately  2%  less  as   a  Maintenance  Loan  than  other  SLCs.   I   then   explained   the   relative   lack   of   support   for   Graduate   students;;   no   loans   for   tuition   fees,   no   grants/ bursaries   from   LEAs,   and   no   bursa-­ ries   from   universities   who   usually   give   50%   of   what   the   LEA   awards   –   as   Mark   said,   “half   of   nothing   is   nothing.”Also,   unlike   graduates   from   elsewhere   in   the   UK,   NI   gradu-­ ates   are   not   given   the   NHS   bursary.

I walked  Mark  through  each  of  these   areas,  then  demonstrated  the  financial   impact   that   these   decisions   have   had.   I  showed  how  much  better  off  I  would   have   been   if   I   was   from   England   in-­ stead   of   Northern   Ireland,   due   to   the   lower   financial   support   available. Finally,  we  talked  about  the  govern-­ ment’s   White   Paper   for   Health.   Mark   is   clearly   a   Social   Democrat   at   heart,   and   does   not   look   fondly   on   the   in-­ creased  role  of  the  Market  in  the  NHS.   He  shared  my  concerns  about  a  wors-­ ening   “Postcode   Lottery”   as   Consor-­ tia   make   different   decisions   on   what   treatments   to   fund.   He   also   agreed   with   my   concern   about   how   the   Doc-­ tor/Patient  relationship  might  be  dam-­

aged if  patients  suspect  that  decisions   about   their   treatments   may   be   more   related   to   the   financial   health   of   the   Consortium,   rather   than   their   own. I  found  it  hugely  beneficial  to  have   a   face-­to-­face   meeting   with   my   local   MP.  It  is  a  g reat  way  to  raise  awareness   of  the  issues  we  face  and  ask  what  peo-­ ple  can  do  to  help.  To  that  end,  I  encour-­ age   you   all   to   discuss   your   concerns   about  Student  Finance,  or  the  future  of   the  NHS.  Getting  engaged  is  a  big  step   –  but  when  you  really  care  about  some-­ thing,   and   are   committed   to   a   better   future;;  it’s  the  grown  up  thing  to  do

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16

April 2011

medicalstudent

Culture Culture Editor: Robyn Jacobs culture@medical-student.co.uk

FOOD

Vegetarian Cuisine

Jianan Bao explores London’s Meat-free Cuisine. Saturdays at Broadway Market are not only good for a game of hipster-spotting; it also makes for a quality culinary field trip, accompanied by street musicians and elderly Hackney locals dancing to reggae music. I stood patiently for French creole chicken, and then sat down in London Fields where I was joined by my friend who had bought a thali box from an Indian food stall. “Mmm, try this” he said and I had a skeptical spoonful of his homogenous stew. It was amazing – sweet, sour, spicy all at once exploding in my mouth. “And it’s vegan friendly!” he said. A meat-free meal that delicious? This was astounding. Maybe there’s more to vegetarian food than I had previously given it credit for. I was inspired to hunt down some more tasty (and affordable) meat-free options in London. First stop was the Hare Krishnas - they are on the LSE campus every day during term time, giving out free food to promote vegetarianism. I got there at 12:30 and even though they were just setting up, there was already a line forming. 15 minutes later, I was handed a plate of pasta with a greenish sauce and a slice of cake. It was heavy, starchy, and put me into a food coma for a few hours. As much as I’m grateful for a free lunch, I think I may have to spend a few quid on finding my vegetarian muse. Next stop was Food For Thought in Covent Garden. I had spent some time on their website salivating over their menu; it changes regularly and there was a variety to salivate over. I visited the wellknown vegetarian establishment full of hope and, unfortunately, a next-to-empty wallet. A main costs £4.90 but it came in an unsatisfactorily small portion, and the £8 meal deal was too much for lunch. I would’ve loved to stay in their homely basement, feasting on Japanese stew and strawberry scrunch, but I had to tear myself away. It can be so tragic being a frugal student. Beatroot on Berwick Street in Soho was the next stop on my vegetarian food crawl. Smoothie lovers rejoice – they have a selection of fresh fruit blends that will leave you feeling virtuously healthy. Personally I don’t believe in spending £3.50 on pureed fruits, so I went straight for the food. The friendly staff did a good job stuffing many different foods into one box; he managed to fit in a Shepherd’s pie, broccoli quiche, broad bean salad, brown rice salad, spinach curry and, balanced on top of all that, a sausage roll. The quiche was my favourite. Unfortunately, towards the end, all the food blended into each other and all I could taste was bean and curry. I was reminded of why I could never give up meat: nothing in the vegetable kingdom can substitute for its delicious flavour.

FILM REVIEW

Limitless: Living Every Med Students Dream

Pranav Mahajan Guest Writer As medical   students,   we’ve   all   been   there,   especially   around   exam   periods;;   wishing   there   was   some   way   of   being   able   to   re-­ tain   knowledge   just   by   glancing   at   a   text   book.   Longing   for   that   magic   bullet   that   would   mean   that   everything   you   have   ever   read,   heard   or   experienced,   would   sud-­ denly   click,   allowing   you   to   sail   through   medical   school,   safe   in   the   knowledge   that   your   brain   is   taking   everything   in   for   you. ‘Limitless’   is   about   that   very   bullet.   It’s   in   the   form   of   a   translucent,   almost   crystal   looking  pill,  called  NZT.  We  are  introduced   to   Eddie   Morra   (Bradley   Cooper),   a   writer,   in   the   loosest   sense   of   the   word,   who   finds   himself   single   after   breaking   up   with   his   girlfriend   Lindy   (Abbie   Cornish)   who   has   grown  tired  of  his  general  stagnation  in  life. Eddie  acquires  NZT  from  a  questionable   source,  and  after  initial  hesitation,  takes  the   tablet.   He   finds   that   regular   use   of   NZT   al-­ lows  him  to  take  in  and  retrieve  information   like  never  before,  to  manipulate  any  situation   to  his  benefit.  Suddenly,  he  was  able  to  write   an   entire   novel   at   an   incredible   pace,   sleep   with   scores   of   beautiful   women,   bamboo-­

zle experts   in   their   own   fields,   and   eventu-­ ally   land   a   highly   lucrative   job   in   the   stock   market   working   for   a   no-­nonsense   business   mogul,   Carl   Van   Loon   (Robert   De   Niro). Eddie  soon  realises  that  life  on  NZT  isn’t   without  its  problems.  Side  effects  start  as  he   increases  the  dose,  and  Eddie  f inds  that  he  suf-­ fers  prolonged  blackouts  in  which  he  is  unable   to  account  for  his  physical  actions.  However,   stopping  NZT  all  together  has  serious  reper-­ cussions   that   include   headaches,   weakness,   coma   and   eventually   death.   On   top   of   this,   Eddie  becomes  a  target  for  those  who  will  do   anything  to  get  their  hands  on  NZT.  All  this  

“Ironically though, the film was more limited than limitless” leads to  Eddie  having  to  make  difficult  deci-­ sions  about  his  future,  with  or  without  NZT. This   film   would   be   an   interesting   watch   for  medical  students.  It  gives  an  insight  into   the  effects  of  drug  tolerance,  the  seriousness   of  side  effects,  and  the  dangers  of  complete   immediate  withdrawal  of  substances.  It  also   looks  at  the  reliance  people  may  feel  for  the   drugs  they  take,  and  the  extent  they  will  go   to  in  order  to  achieve  their  fix.  There  are  no-­ table   parallels   between   the   effects   of   NZT  

and the  effects  of  other  drugs  such  as  mari-­ juana,  heroin,  ecstasy  and  alcohol.  However,   this  film  is  riddled  with  avoidable  scientific   inaccuracies   that   unnecessarily   undermine   the   plot,   the   most   blatant   being   the   refer-­ ence  to  the  myth  that  humans  only  ever  use   20   percent   of   their   brain   at   any   one   time. This  f ilm  is  bound  to  split  opinion.  Visual-­ ly,  it  is  unique  with  plenty  of  panache;;  it  con-­ stantly   varies   camera   angles,   rotations   and   lenses,   giving   a   great   viewing   experience.     Ironically   though,   the   rest   of   the   film   was   more   limited   than   limitless.   Bradley   Coop-­ er’s  weaknesses  as  a  lone  main  character  are   exposed  as  he  struggles  to  engage  the  audi-­ ence  fully,  showing  that  he  has  yet  to  mature   from  being  part  of  a  g roup  of  main  characters   as  in  ‘The  Hangover’  or  ‘The  A-­Team’,  to  be-­ ing   a   star   in   his   own   right.   De   Niro   brings   real  class  to  the  picture,  but  there  is  a  sense   that  he  is  above  a  film  like  this.  The  general   story  line  had  much  more  potential  for  pos-­ ing   real   questions   about   the   human   psyche   and   the   possibility   of   untapping   a   wealth   of   knowledge   we   all   may   possess.   There   is   a  general  feeling  by  the  end  of  the  film  that   it   only   touched   the   surface   of   an   intriguing   idea.  Limitless  is  a  real  treat  for  the  eyes,  but   not  the  sort  of  ‘Inception-­esque’  psychologi-­ cal   journey   that   excites   the   imagination  

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Student Artwork of the Month By Sherina Peroos

After the Mortuary “Sketched after my first visit to the mortuary to observe the signing of a death certificate. I was reflecting on the distinctive smells, the chill of the room, the silent worry I felt that I had apparently spoken to the gentleman when he was alive and now couldn’t recognise him, and the surreal chirpiness of the post-mortem technician” If you would like to see your artwork, photography or poetry featured, please email culture@medical-student.co.uk


medicalstudent

April 2011

17

Culture REVIEW

Sexual Nature at the Natural History Musuem

Jack Harding Guest Writer I was   given   a   set   of   options   for   what   I   wanted   to   write   about   for   my   first   article  and  I  immediately  went  for  the   one   that   had   the   word   sex   in   it.   Can   you  blame  me?  I  was  sort  of  hoping  for   some  interesting  fieldwork  but  instead   I  was  hit  over  the  head  with  the  word   ‘museum’.  Something  about  museums   strike  depression  and  boredom  into  the   very  souls  of  every  young  person  but  I   was  determined  to  go  along  to  the  Sex-­ ual   Nature   Exhibition   at   the   Natural   History   Museum   with   an   open   mind.   It  wasn’t  f ree,  which  sucked,  but  it  was   only   £4   with   my   trusty   student   card. Inside   I   was   spellbound   by   the   intricacy   and   beauty   of   the   exhib-­ its.   Well,   that’s   a   lie,   the   whole   thing   was   pretty   dimly   lit   and   there   were   large   parts   that   had   absolutely   noth-­ ing  of  interest  in  them.  But  I  suppose  

that’s ‘the   modern   way’   and   I   should   get  my  backside  into  the  21st  century.  I  took  note  of  some  fantastic  look-­ ing  sexual  positions,  which  were  dem-­ onstrated   by   various   species   of   ani-­ mals.  I’ll  have  to  try  them  out  with  my   girlfriend  sometime  (who  am  I  kidding,   I’m  a  writer  who  just  went  to  a  freak-­ ing  museum,  I  don’t  have  a  girlfriend).   The   whole   exhibition   was   like   walking   through   an   episode   of   QI.   Facts   and   figures   were   attacking   me   from   every   direction,   like   the   male   boar   who   ejaculates   up   to   half   a   litre   of   semen   with   every   ejaculation.   The   thought   that   went   through   my   mind   was   “Jesus,   that   must   take   a   while”. The   exhibition   strikes   me   as   try-­ ing  a  bit  too  hard,  but  there  are  aspects   that   really   work.   Dotted   throughout   the   exhibit   are   video   screens   show-­ ing   actress   Isabella   Rossellini’s   “Green   porno”   movies.   The   movies   were   factual   and   featured   Rossellini   dressed   as   various   different   animals  

and explaining   the   acts   of   sex   with   moderately   amusing   dry   humour. My   favourite   part   of   the   exhibi-­ tion?   It’s   a   tie   between   two   actually.   Firstly,  the  male  tarantula  has  to  get  in   and   out   pretty   quickly   after   he   ejacu-­ lates   because   if   he   isn’t   fast   enough   the   female   will   eat   him.     Apparently   they   confuse   him   for   a   fly   and   just   go  ahead  and  get  their  feast  on.  I  can   think   of   a   few   girls   this   reminds   me   of.   My   other   favourite   is   the   repre-­ sentative   for   the   medical   student:   the   Adélie  penguins.  The  males  are  slaves   to  their  hormones  with  such  strong   sex  drives  that  they  will  attempt   to   mate   with   anything.   Alive   or  otherwise,  female  or  other-­ wise.  I  can  definitely  think  of   a  few  guys  that  this  reminds  me  of. On   the   way   out   there   is   a   wall   of   notes,  posted  by  people  who  have  vis-­ ited,   and   written   down   little   taglines   on  pieces  of  paper.  It  is  there  for  your   thoughts,  experiences  and  feelings  on  

sex. A   few   of   them   were   classic.   My   personal   favourite   was:   ”It’s   not   rape   if  you  take  your  socks  off”  followed   by   “I   love   Jutin   Justin   Bie-­ ber   <3”.   I   decided   to   add   to   the   wall   by   writing   my   phone   number   on   it.   What?   A   guy   can   dream   can’t   he?  

Sexual Nature is on at The Natural History Museum until 2nd October. For more info, visit www.nhm.ac.uk

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Sarah knew Jimmy was a prick for more than one reason... Image thanks to the Natural History Museum

COMPETITION BOOK REVIEW

The Heart Specialist by Claire Rothman Amrutha Sidhar Assistant Editor In a  story  that  takes  the  reader  on  a  com-­ pletely  u nexpected  journey,  ‘The  Heart   Specialist’  begins  in  the  bedroom  of  a   young  child  on  the  night  of  her  perse-­ cuted   father’s   disappearance.   It   pro-­ ceeds  to  take  the  reader  through  a  cap-­ tivating  and  endearing  tale  of  an  adult   who   never   ceases   to   be   the   child   you   meet  in  the  opening  words  of  the  book.     In   contemporary   society,   where   female   medical   students   outnumber   their   male   peers,   we   take   women’s   access   to   education   and   opportunity   in   the   world   of   medicine   for   granted.   ‘The   Heart   Specialist’   transports   the   reader   to   a   time   where   such   things   were   deemed   ludicrous   and   impracti-­ cal.   The   reader   is   invited   to   walk   in   footsteps  akin  to  those  of  a  pioneering  

female doctor;;   the   Canadian   Maude   Abbott.  Though  Dr  Abbott  shares  sev-­ eral  aspects   in  common  with  the  pro-­ tagonist  of  the  book,  Agnes  White,  au-­ thor  Claire  Holden  Rothman  intended   the   novel   to   serve   as   a   tribute   to   Dr   Abbott’s  inspiring  journey  rather  than   a   biographical   account,   stating   that   it   was   Dr   Abbott’s   “education   and   pro-­ fessional   struggle   that   inspired   the   book”.  It  serves  the  reader  better  as  the   first   personal   account   of   the   fiction-­ al   story   allows   them   to   form   a   closer   bond  to  the  protagonist,  who  herself  is   an  outsider  looking  in.  It  perhaps  teth-­ ers   even   better   with   an   audience   who   carry  a  medical  background,  as  several   of  our  populace  know  well  the  feeling   of   being   the   geeky   child   of   the   class. The   protagonist   takes   the   reader   into   her   confidence   as   both   a   doctor   and  a  woman  –  a  sister,  a  friend,  a  ri-­ val  –  and  is  frank  regarding  the  torren-­

WIN a free copy of the book Would you like to win yourself a copy of ‘The Heart Specialist’? Send a photo of yourself, with a copy of this month’s paper, to culture@medical-student.co.uk and the three most unusual photos will win a copy! You will also get a dashing photo of yourself in next months issue....

tial storm  of  human  emotions  that  she   experiences  in  the  events  of  her  com-­ promised  life;;  the  feelings  of  achieve-­ ment,   loss,   exclusion,   victory,   loyalty,   frustration,   despair,   disappointment,   and   rebirth.   One   of   the   most   appreci-­ able  aspects  of  the  book  was  the  hon-­ esty   regarding   the   depth   and   flaws   of   human   characters,   giving   the   tale   a   dimension   that   adds   to   how   much   the   reader  can  garner  from  it.  In  a  way,  the   first  person  account  that  broadens  the   readers  grasp  of  the  twists  and  turns  of   the  novel  also  narrows  the  world  to  one   that   is   seen   through   the   protagonist’s   imperfect  perception  –  an  effect  that  is   at   its   most   potent   toward   the   mellow,   yet  gripping,  dénouement  of  the  story.     It   is   an   unusual   course   that   en-­ capsulates   both   the   slow   and   arduous   professional   ascent   of   a   1900s   female   doctor,   and   the   abandonment   of   the   women   left   behind   in   the   outbreak   of   the   first   world   war,   which   saw   much   of   the   male   population   enlisting   out   of   patriotism,   obligation   or   idealism.   The   protagonist   steps   into   the   role   of   the  reader,  where  she  endures  the  harsh   realities   of   the   frontline   war   through   letters,   mirroring   the   way   the   reader   experiences  her  life  through  the  novel.   When  asked  regarding  the  intended   readership  for  the  novel,  Rothman  stat-­ ed  it  was  written  to  appeal  to  as  wide   an  audience  as  possible,  and  indeed  it   does.   This   is   also   perhaps   where   one   of   my   few   issues   with   the   novel   lies;;   it   does   little   to   reflect   the   aspects   of   a   doctor’s   role   that   have   changed   lit-­ tle  over  the  last  century.  However,  the   author  stresses  that  the  story  was  more   a   focus   on   her   professional   achieve-­

ments, and   in   fairness,   not   much   is   known   regarding   these   elements.   ‘The   Heart   Specialist’   is   a   tale   of   an   enduring   grasp   on   a   goal,   dream   and   an   internal   emptiness   of   a   human,   yet   inspiring   character.   It   moves  the  reader  through  the  chang-­

ing and   eventually   turbulent   dawn-­ ing   years   of   the   20th   century.   It   en-­ gages  t he  reader  i nto  scenes  a nd  v ista   rich   with   velvety   tones   of   physical   stimuli   and   human   emotions.   It   is   a   charming   yet   compelling   debut   nov-­ el  definitely  not  one  to  be  missed

Photo copyright Nicholas Seguin, 2008

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18

April 2011

medicalstudent

Culture AN INTERVIEW WITH...

Adam Kay of the Amateur Transplants Adam Kay, comedian, songwriter…and doctor? Robyn Jacobs speaks to Adam on songs, quitting medicine, and the Moira Stewart cup

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amed for   being   half   of   the   Amateur   Transplants,   Adam   Kay   reached   the   limelight   with   the   Youtube   sensa-­ tion   ‘The   London   Underground’.   A   favourite   amongst   medical   students   and   doctors   alike,   he   is   currently   at-­ tempting  to  break  into  full  time  com-­ edy   at   the   BBC.   Despite   this,   he   still   manages   to   do   student   shows,   and   is   compering   at   UH   Revue   this   year.   RJ:   How   do   you   feel   com-­ ing   back   to   compere   at   shows   you   were   once   involved   with? AK:   Very   proud   and   surprised   that   they   are   still   going,   that   the   UH   revue  is  still  going.  I  think  that  when   we  set  it  up  we  presumed  that  it  would   die   when   we   left,   but   it’s   very   ex-­ citing   that   every   year   a   new   bunch   of   people   put   in   a   huge   amount   of   work.   As   an   alumnus   of   the   UH   re-­ vue,   I   am   very   proud   to   help   it   out.

“That was called Handjobs for Crack” RJ: Do   you   feel   that   comedy   is   important   for   medical   students? AK:   I   think   that   everyone   needs   a   diversion.   It’s   quite   easy   to   go   a   bit   mad  in  six  years  of  medical  school  and   whatever   your   outlet   is,   whether   it   is   music   or   drama   or   sport   or   comedy,   you  need  to  have  some  outlet.  For  me   it   was   comedy,   for   lots   of   people   it’s   comedy  and,  like  sports,  it’s  enjoyable   for  both  the  people  on  the  field  and  for   people   who   come   and   watch.   I   think   comedy   for   sure   has   an   important   role,  and  also  you  get  to  take  the  piss   out   of   your   lecturers   and   the   system. RJ:   You   mentioned   ‘when   you   set   up   the   UH   revue’.   How   ex-­ actly   did   you   come   to   start   it   up? AK:   Obviously,   there   are   the   five   medical   schools,   or   what   are   now   the   five   London   medical   schools,   and   there   has   always   been   the   rivalry   on   the  sporting  field.  I  got  together  with  a   few  people  and  we  discussed  the  pos-­

sibility of  the  various  medical  schools   getting  together  for  comedy  purposes.   I’d   been   to   St   George’s   revue   in   my   first  year  and  had  become  friends  with   a   guy   called   Mike   Wozniak   and   we   were   talking   about   this   and   the   first   thing   we   did,   which   was   probably   in   2000,   was   to   set   up   a   comedy   troupe   with   one   person   from   each   medical   school.   Well,   there   were   a   couple   of   people  from  each  of  the  London  medi-­ cal  schools.  And  that  was  called  Hand-­ jobs  for  Crack.  We  did  a  gig  at  the  St   Thomas’  bar  which  went  very  well  and   then   from   that   we   decided   we   should   do  more  of  a  competition  thing,  where-­ by  every  university  would  put  forward   a   short   little   show,   and   that’s   the   for-­ mat   that   the   UH   revue   currently   runs   to.  When  we  set  it  up,  the  first  year,  we   said  it  was  the  62nd  or  something  an-­ nual  UH  revue,  and  that  it  hadn’t  been   going  for  the  last  few  years  but  that  we   were  starting  it  up  again,  to  make  peo-­ ple  believe  that  that  might  be  true  and   in  the  f irst  year,  I’m  not  sure  anyone  re-­ ally  believed  that  it  had  been  going  for   62  years,  but  by  the  second  year,  every-­ one  did.  And  now,  I’m  not  sure  anyone   would  believe  me  if  I  said  I  had  set  it   up  a  decade  ago.  So,  yes,  that’s  how  it   started  and  as  I  said,  it’s  nice  that  it’s   still  going.  It’s  a  fun  evening.  Initially   it  was  always  at  the  Bloomsbury  thea-­ tre  in  UCL  but  obviously  great,  and  it   makes  much  more  sense,  that  it  rotates   around   the   various   medical   schools. RJ:  A nd  in  the  f irst  few  years,  was  it  a   big  event?  Or  did  it  g radually  get  bigger? AK:   No,   it   was   big.   We   only   did   one  night  and  we  sold  out  the  Blooms-­ bury   theatre   every   year   we   were   do-­ ing  it,  just  because  it  had  five  medical   schools  publicising  it,  which  meant  you   only  had  to  sell  100  tickets  between  ‘x   thousand’   per   medical   school,   yeah   it   was   good.   And   it   got   itself   a   repu-­ tation  such  that  a  few  years  in,  it  was   difficult  to  actually  get  tickets,  which   is   obviously   a   nice   position   to   be   in.   RJ:   The   winners   of   the   night  

Key UH Facts 2011 2010 2009 2008 2007 2006 2005 2004 2003

WINNER HOST --ICSM GKT GKT RUMS RUMS GKT SGUL ICSM RUMS GKT GKT SGUL RUMS SGUL RUMS SGUL RUMS

r&BDIPGUIFGJWF-POEPO.FEJDBMTDIPPMT has 20 mins to perform sketches, songs, skits…anything they think might be funny r$PNQFSFUIJTZFBSJT"EBN,BZ POFPGUIF founding group of the UH revue r4PJSFFTBOESFWVFTBSFHFOFSBMMZOBNFE after films - this year’s revue is called ‘The King’th Th’peeth’ r5IFXJOOFSJTEFDJEFECZBIJHIMZ democratic clap-o-meter r5IJTZFBSJTUIFGJSTUZFBSUIBU*NQFSJBM College is holding the Revue

get the   Moira   Stewart   cup;;   can   you   tell   me   why   it   is   called   that? AK:   It   came   back   to   the   fact   that   it   was   a   ‘long   established   thing’.   We   thought   we   should   give   the   cup   some   form   of   credibility,   so   we   chose   ‘The   Moira  Stewart  Cup’  –  a  friendly,  ran-­ dom   celebrity   to   have   the   cup   named   after.  A  friend  of  mine  showed  me  on   Wikipedia,  that  on  Moira  Stewart’s  en-­ try,  there  is  a  section  about  ‘The  Moi-­ ra   Stewart   Cup’,   listing   the   winners,   which  I  think  is  just  phenomenal.  Now,   I  am  in  entertainment  full-­time,  I  now   think   I   should   probably   get   in   touch   with  Moira  Stewart’s  agent  to  see  if  we   can  make  it  an  official  thing,  and  maybe   get  the  g reat  lady  to  present  it  one  year.

“We had a bit of luck with this London Underground song” RJ: Do   you   have   a   fa-­ vourite   UH   Revue   memory? AK:   Yeah,   because   I   was   one   of   the   group   in   charge   of   the   show,   I   didn’t   let   anyone   else   from   Imperi-­ al   do   it,   so   it   was   just   me   and   Suman   [Biswas]   as   Amateur   Transplants   do-­ ing   our   own   tunes,   and   there   are   an   awful  lot  of  songs  that  we  did,  a  lot  of   songs   that   we   still   do   now,   were   first   ever   performed   on   that   stage.   And   we   worked   quite   hard   for   those   little   slots,   and   we   wrote   some   fun   stuff. RJ:   How   did   you   make   the   move   from   medical   school   com-­ edy   into   more   professional   shows? AK:   It’s   been   a   fairly   slow   tran-­ sition,   whereby   initially   we   were   known  amongst  medical  students,  and   that   escalated   to   doctors.   And   then   we   had   a   bit   of   luck   with   this   Lon-­ don   Underground   song,   which   did   the   rounds.   And   then   we   got   inter-­ est   for   wider   gigs.   And   obviously   if   you   are   doing   one   of   those,   you   can’t   just   do   medical   in-­jokes,   you   have   to   do   general   comedy,   so   that’s   what   we   did,   and   that’s   what’s   happened,   and   every   year   it   just   gets   bigger. RJ:   Do   you   think   there   is   a   line   for   songs   being   racist   or   offensive? AK:  I  don’t  think  a  song  should  ever   be  racist,  that’s  a  personal  thing.  How   best  to  answer  this  question?  You  actu-­ ally  don’t  want  any  song  to  be  offensive   to  anyone.  Essentially,  if  you    come  to   a  comedy  event,  you  want  to  leave  hap-­ pier  than  you  came  in,  and  the  come-­ dian,  whoever  they  are,  has  failed  quite   dramatically   if   anyone   leaves   feeling   worse   than   when   they   came   in.   So   the  line  to  tread,  is  saying  things  that   people  are  shocked  about,  or  surprised  

about, or  shocked  on  behalf  of  others,   but   no   one   should   actually   have   per-­ sonal   offence   at   anything,   and   if   they   did,   I   would   be   more   surprised   and   occasionally,  we  have  been  doing  this   for   a   few   years   now,   and   early   on   we   made  a  few  mistakes  and  we  pitched  it   wrong,  and  its  learning  the  line  to  t read. RJ:  There  is  a  whole  host  of  students   at  the  moment,  who  perform  at  UH  re-­ vue  and  soirees.  Do  you  have  any  tips  for   anyone  who  wants  to  work  in  comedy   later  on  and  break  free  from  medicine? AK:  Well  yeah,  I  mean,  it’s  quite  a   big   step   to   completely   drop   medicine   and   go   full   time   into   another   profes-­ sion,   it’s   a   step   that   I   only   recently,   in   fact   I   did   my   last   bit   of   medicine   at   Christmas   because   I   was   tail-­ ing   it   off   a   bit.   You   have   to   be   sure   that   you   can   earn   a   crust.   And   the   tip   is   just   to   persevere,   to   keep   go-­ ing;;   you   have   to   start   with   terrible   gigs.   You   can’t   start   with   big   amaz-­ ing  gigs.  You  need  to  be  vaguely  good   at  it,  and  you  need  to  hack  away  at  it. RJ:   How   did   you   feel   giv-­ ing   up   something   that   you   worked   6   years   for;;   your   medical   degree? AK:  I  mean,  I  got  to  the  stage  with   comedy   that   I   wasn’t   able   to   do   eve-­ rything   I   wanted   to   because   of   other   commitments,   and   I   thought   “now   is   the   time   to   give   it   a   go”.   And   you   know,   if   this   is   all   a   terrible   disas-­ ter,   I’ve   always   got   medicine   to   go   back   to.   But   ultimately,   you   have   to   do   something   that   you   really   want   to   do,   not   just   do   something   because   you’ve  done  it  for  the  previous  decade. RJ:   And   finally,   GKT   won   the   cup   last   year,   Imperial   are   host-­ ing,   who   do   you   think   will   win   the   Moira   Stewart   cup   this   year? AK:  I  haven’t  seen  any  of  the  shows,   I’d  have  to  check  with  my  magic  8  ball...

Check out Amateur Transplants gigs at livetransplants.com or check out Adam’s twitter at @amateuradam

The History of the Soiree... The soiree is an age old tradition dating as far back as even the oldest consultant can remember. The RUMS soiree, held at Christmas time every year, is by the MDs (Manic depressives). The show is said to date back to 1898, when, on New Years day, a group of students at the Middlesex hospital, thought that they would cheer up the patients (who wouldn’t need to be cheered…it’s Middlesex hospital…) by performing skits and jokes. The tradition lives on until today, and they still perform a soiree each Christmas. The St Mary’s soiree dates back to the 30’s when the Soiree society would perform a night of comedy at Wilson House after the operetta society performed their autumn term show. The late queen mother was the patron of the St Mary’s soiree up until 2002 when she passed away (somebody showed her the lyrics to ‘The London Underground’). St Georges has been famed for their low-brow humour, with one student even claiming that the only reason that they have won the UH three times is their ability to somehow procure really attractive female medical students to perform. Bart’s and GKT also have Christmas soiree shows. With GKT in current possession of the Moira Stewart cup, it’s anybody’s guess as to who will win this year… (But it will be Imperial. No editor discretion needed)


medicalstudent

April 2011

19

Culture THEATRE REVIEW

BOOK REVIEW

The Knot of the Heart Rhys Davies Guest Writer When we  think  of  addiction,  we  tend   to  think  of  rock-­stars  snorting  coke  off   of  groupies’  stomachs,  homeless  junk-­ ies   shooting   up...and   Charlie   Sheen. The   thought   of   a   children’s   TV   presenter   getting   her   supply   from   her   mother   is   not   one   that   immediately   springs   to   mind.   Nor   do   we   imag-­ ine   it   happening   in   the   lush   environ   of   Islington.   But   it   is   this   combina-­ tion   that   comes   together   at   the   small   albeit   trendy   Almeida   theatre   in   ‘The   Knot  of  the  Heart’  by  David  Eldridge. The   play   focuses   on   Lucy   and   her   ever-­loving   mother,   Barbara.   It   opens   with   Lucy   having   been   fired   after   be-­ ing   caught   with   opium   on   the   set   of   Animal  House,  prompting  her  to  move   in   with   her   mother   until   she   finds   her   feet.   Lucy   spirals   out   into   IV   hero-­ in,   and   the   dark   world   that   surrounds   it.   She   moves   to   rehab   to   try   and   get   clean,   which   would   be   easier   if   Bar-­ bara  would  stop  buying  her  drugs;;  the   mother   who   will   do   anything   for   her   daughter.  Lucy  realises  the  only  way  to   get  clean  is  to  cut  away  from  Barbara. Technically,  the  play  is  simple,  per-­ formed   on   a   rotating   table   divided   by   glass   into   three   rooms   which   serve   a   multitude   of   settings.   The   acting   is   strong   throughout,   but   not   without   lapses.   I   wasn’t   entirely   convinced   by   Lucy’s   euphoric   bliss   or   being   wretchedly   strung   out.   The   Stanley   knife-­wielding   dealer,   while   aggres-­ sive   and   slimy,   made   me   feel   more   awkward   than   intimidated.   But   these   were   momentary   faults   in   an   other-­ wise  engaging  performance  by  the  cast. At   intermission,   I   was   ambivalent   towards   the   play.   Lucy   had   few   re-­ deeming   features,   she   seemed   selfish   and   self-­absorbed.   I   was   worried   the   performance  would  stray  into  moralis-­ ing.   But   in   the   second   half,   I   came   to   sympathise  with  Lucy  as  she  struggled  

THEATRE REVIEW

Rhys Davies Guest Writer Frankenstein, recently   opened   at   the   National   Theatre,   directed   by   Danny   Boyle   and   starring   John-­ ny   Lee   Miller   and   Benedict   Cum-­ berbatch   is,   in   one   word,   Fantastic! From   the   start,   where   lightning   ripples   through   a   wedge   of   myriad   stage-­lights   to   a   great   womb-­like   sack,  through  to  the  finish,  where  the   Monster   leads   Frankenstein   further   on   into   the   luminance   of   the   Arc-­ tic   wastelands.   I   was   enraptured   by   a   powerful   story,   powerfully   told. Based  upon  the  book  by  Mary  Shel-­ ley,   a   scientist   gives   life   to   an   inani-­

to escape  both  heroin  and  the  smother-­ ing  presence  Barbara.  This  is  not  a  play   simply  about  addiction;;  it  is  about  fa-­ milial  love  and  k nowing  when  to  say  no. Most   of   the   action   happens   off-­ stage.  What’s  left  are  a  series  of  prob-­ ing   conversations,   and   a   few   spilled   fluids.   Medical   staff   are   portrayed   well  by  the  play.  The  chipper  Brummie   nurse  in  A&E  takes  no  nonsense  from   Lucy   but   is   at   the   same   time   deeply   sympathetic  to  her  horrific  revelations.   The   Brummie   rehab   worker   (there   were   an   awful   lot   of   Brummies   for   North   London)   is   gently   insistent   that   Lucy   try   group   therapy.   The   psychia-­ try   SHO   (affectionately   nicknamed   ‘Dr.   Twat’)   comes   across   as   well-­ meaning  but  a  bit  plummy.  There  were   certainly   a   few   phrases   in   his   script   that   sounded   quite   familiar;;   when   he   walked   on-­stage,   I   could   have   sworn   I  was  looking  in  a  mirror.  As  the  few   positive  influences  in  the  performance,   the  play  reflects  well  on  the  profession. Late  in  the  play,  there  is  heated  ar-­ gument   over   whether   addiction   is   an   illness  or  a  character  flaw.  Whilst  we   invest  in  medical  and  cognitive  thera-­ pies   to   treat   the   consequences   of   ad-­ diction,  should  we  consume  resources   on   people   who   harm   themselves   de-­ liberately,   when   there   are   thousands   dying   on   cancer   wards?   The   break-­ downs   of   Lucy   and   Barbara   show   that   addiction,   and   its   ramifications,   have  a  devastating  impact  on  families,   something  that  should  not  be  ignored. This  is  not  a  moral  tale  on  the  dan-­ gers   of   drugs.   Instead,   it   is   an   engag-­ ing   story   on   the   demon   of   middle-­ class   addiction,   and   the   far   worse   demon   of   middle-­class   enablement.   If   you’re   looking   for   a   show   out-­ side   the   glitz   and   schmaltz   of   the   West   End,   that   cuts   a   little   deeper,   I   thoroughly   recommend   this   play.

The Immortal Life of Henrietta Lacks Kiranjeet Gill Guest Writer As Henrietta   Lacks   lay   dying   in   the   ‘coloureds   only’   ward   at   John   Hopkins   Hospital   in   1951,   she   had   no   idea   she   was   about   to   change   the   course   of   medical   history.     She   was   just   31   when   diagnosed   with   an   ag-­ gressive   and   invasive   cervical   can-­ cer,  dying  later  that  same  year.    A  cell   sample   was   taken   from   her   initial   tu-­ mour   and   grown   in   a   lab   by   her   doc-­ tor,  George  Gey.    Instead  of  dying  like   countless   other   tumour   cells,   Henri-­ etta’s  cells  kept  growing  and  dividing   in   vitro,   and   so   became   the   world’s   first  immortal  cell  line,  named  HeLa.     Today,   nearly   60   years   after   her   death,  Henrietta’s  cells  continue  to  di-­ vide,  and  have  been  involved  in  many   of   the   major   medical   advances   of   the  

mid-­20th century,   including   the   polio   vaccine   and   the   discovery   of   chemo-­ therapy   agents.     However,   there   is   a   darker  side  to  all  this;;  Gey  did  not  ob-­ tain   permission   for   a   cell   sample   to   be   taken,   and   Henrietta’s   family   did   not  discover  for  many  years  that  their   mother’s   cells   were   still   alive,   being   produced  in  their  t rillions  each  week  as   part  of  a  multi-­million  dollar  industry.   ‘The   Immortal   Life   of   Henrietta   Lacks’   by   Rebecca   Skloot   tells   the   story   of   this   remarkable   woman   and   her   family,   who   lived   in   poverty   in   the   heart   of   a   segregated   America.     Born   in   Virginia   in   1920,   Henrietta   lived   with   her   grandfather   in   former   slave   quarters,   next   to   the   tobacco   fields   in   which   she   worked.     She   had   her   first   child   aged   just   14,   and   was   pregnant   with   her   fifth   when   she   re-­ ceived   her   devastating   diagnosis. The   family   Henrietta   left   behind  

The Knot of the Heart is showing at the Almeida theatre until 30th April. Tickets start from £8.

was immensely  troubled.    Her  young-­ est   daughter   was   institutionalised   whilst  her  other  children  were  brought   up  in  an  abusive  environment.    22  years   after  Henrietta’s  death,  the  family  was   rocked  by  the  revelation  that  her  cells   were  still  alive.    It  was  even  harder  for   them   to   accept   given   their   continued   poverty.     Some   members   of   the   fam-­ ily  certainly  felt  that  they  were  owed  a   debt;;  as  Henrietta’s  eldest  son  asked  “if   our   mother’s   so   important   to   science,   why   can’t   we   get   health   insurance?”. The  book  fulfils  many  roles:  it  is  a   biography,  a  family  history  and  social   commentary,  as  well  as  a  crash  course   in  some  of  the  major  medical  advances   of   the   20th   century.     It   also   provides   a   brief   account   of   the   dozens   of   ethi-­ cally  unsound  experiments  carried  out   by  doctors  and  scientists,  eager  to  test   the  power  of  their  new  research  tools,   highlighting  the  murky  history  associ-­ ated   with   modern   medicine.     With   a   background   as   a   biologist   and   a   jour-­ nalist,   Skloot   has   crafted   a   compel-­ ling   narrative   that   seems   to   tread   a   fine  line  between  fact  and  fiction.    The   effort   she   has   put   into   her   research   is   obvious   throughout   the   book,   yet   it   often   reads   like   a   novel,   partly   due   to   the   Lacks   family’s   fascinating   his-­ tory   but   also   due   to   Skloot’s   skill   as   a   storyteller.     She   combines   medicine   and   literature   to   great   effect,   mak-­ ing  it  of  interest  to  scientists,  but  also   very   accessible   to   the   non-­specialist. One   minor   criticism   I   have   of   the   book  is  the  author’s  insistence  to  make   herself   part   of   the   story.     Whilst   her   hard   work   and   perseverance   are   ad-­ mirable,   the   constant   reminder   of   her   struggle   to   write   the   book   detracts   somewhat   from   the   matter   at   hand.     However,   it   is   still   a   very   worthwhile   read,  and  I  can  only  praise  Skloot  for   returning  the  human  side  to  a  woman   whose  name  has  for  years  been  reduced   to  a  mere  four  letters:    Henrietta  Lacks,   who  unwittingly  changed  the  world  

.

Danny Boyle’s Frankenstein at The National Theatre mate body  but,  terrified  by  his  success,   drives   the   Monster   away.   After   being   taught  by  an  old  and  blind  former-­lec-­ turer  in  the  woods,  the  Monster  returns   to  confront  Frankenstein  and  bargains   with   him   to   create   a   wife.   Franken-­ stein  is  torn  between  the  revulsion  he   feels   for   his   creation   and   his   Faustian   curiosity   in   refining   his   occult   ex-­ periment.   The   story   explores   the   idea   of   whether   a   creature   is   born   evil   as   well  as  moral  limits,  something  which   Frankenstein   appears   oblivious   too. The   play   opens   with   the   birth   of   the   Monster,   and   it   does   feel   like   a   birth.  After  repeated  lightning  strikes,   he   flops   out   of   a   leather   frame   and   spends   ten   visceral   minutes   learning   to   move   and   walk,   stark   naked.   Even  

as a   medical   student,   I   truly   believed   that  these  were  first  attempts  at  co-­or-­ dinated   movement.   The   development   of   the   Monster   was   finely   crafted.   From   clumsy   steps   and   unintelligible   moans,   we   witness   his   movements   and   speech   become   finer,   and   with   them,   reason   and   logic   blossom.   This   might   be   a   shock   to   those   expecting   a   clunking   hulk,   replete   with   neck-­ bolts;;   indeed,   the   Monster’s   flourish-­ ing   is   a   surprise   to   even   his   maker. The  night  I  went,  Miller  played  the   part  of  the  Monster  and  Cumberbatch   Frankenstein,   each   actor   was   superb.   In   a   quirky   casting   twist,   they   alter-­ nate   the   main   roles   with   each   perfor-­ mance.   The   prospect   of   seeing   each   actor   tackle   the   other   role   is   some-­

thing that   might   tempt   me   back   for   a   repeat  viewing.  What  I  found  impres-­ sive  was  the  innovative  use  of  staging.   The   play   employs   a   turntable,   tracks   (for   an   intricate   steam-­punk   train),   and  raises  and  drops  parts  of  the  stage   for   different   scenes.   Props   descend   from   the   ceiling   on   wires,   as   well   as   a   morning   rainfall   and   a   wintry   bliz-­ zard.  Though  clearly  complex,  none  of   this  interrupts  the  f low  of  the  story  and   all  the  scenes  are  remarkably  swift  and   fluid.  The  downside  of  all  this  techni-­ cal  wizardry  is  that  it  is  unlikely,  nay,   impossible,  for  the  play  to  go  on  tour. With  films  such  as  ‘28  Days  Later’,   ‘Slumdog  Millionaire’  and  ‘127  Hours’   on   his   CV,   Boyle   has   a   strong   story-­ telling   reputation.   Between   him   and  

the play’s   author,   Nick   Dear,   the   pro-­ duction  f lows  with  a  strong  pace,  a  feat   for   a   two-­hour   play   with   no   interval.   Though  heart-­thumpingly  dramatic  in   places,  the  play  is  suffused  with  a  dark,   wry  humour.  When  not  experimenting   in   the   storm-­beaten   Outer   Hebrides,   the   play   has   an   earthy,   real   feel   to   it,   with  moments  of  sex,  love  and  violence. Though   this   review   may   sound   hagiographic,   I   assure   you   not   a   sin-­ gle  word  is  hyperbolic.  For  two  whole   hours,  it  did  not  put  a  note  w rong,  build-­ ing  on  an  already  strong  story  to  cre-­ ate  an  engaging  and  enthralling  work.   Simply  put,  this  is  theatre  at  its  finest.

Frankenstein is running at the National Theatre until April 17th


DOCTORS’ MESS By Abe Thomas and Oliver Woolf Friday was international procrastination day, but its French founder insisted he had no issues with people putting it off until today. Tomorrow can often be the busiest day of the week for seasoned procrastinators and these are some of the most popular time-wasting activities. In fact, 1 in 5 people are chronic procrastinators and the act of procrastination can often be a gruelling task. Imagine the prospect of a looming essay, a non-procrastinator will sit down and write the essay in a couple of hours, the procrastinator will spend the whole weekend preparing. They will think about it and plan it, go for a walk because exercise fuels the mind, download music for inspiration. By the time they come round to writing the thing they’ve completed 101 other tasks.

However, PROCRASTINATORS, you do not need to punish yourselves, just induge:

Facebook We’ve all heard of it, most of us have signed up for it and the unlucky few can’t get enough of it. With updates from all your friends at the touch of a button it’s harder to resist than a greasy kebab after a week long bender. We all love peering into other people’s lives, especially at a distance. Hey, why talk to people when you can indulge your voyeuristic tendencies with the touch of a button? This is almost the ultimate procrastination tool since the constant refreshment of your facebook page produces a 100 ‘new’ statuses from people just as bored and uninteresting as your life is right now

Online shopping So you’ve been planning to buy that new designer handbag or ball gag that the missus has been harping on about, for ages. And what better time to do the research, waste countless hours examining low quality pixelated pictures of items you can’t afford than when you have an important exam or paper due? The main benefits include short term endorphin release as your windows (see what I did there?) shopping activates your reward pathway according to some survey conducted some time in the past, based on the wishful thinking area of your brain.

Youtube Have you seen the latest person hurting themselves comically/ animal doing vaguely cute thing/ celebrity sex tape/rant about absolutely nothing from people who are experts on the subject? Well here’s the place to catch up! The fact that after you’re done watching whatever you intended, there’s always 20 more options to choose from via the right hand column means this procrastination requires little thinking beyond the first video. So now, you can watch things that are barely related to something you weren’t really that excited about watching in the first place! But now you’re in the loop, you must forward this link on or the fact that the world doesn’t know that you have been privy to the latest Charlie sheen rant means your head. might. just. explode.

Sleeping Ok, so all the thousands of words have turned into black squiggles against a white background and you have idiopathic thrombocytopenia purpora echoing in your head in the voice of a little girl from a bad horror movie. By

Whilst utilizing the best medical www.postsecret.com resource around i.e. Wikipedia, why Postsecret is a bit different. Read not stop off at some of these equally people’s intimate confessions useful websites. portrayed on the back of a postcard. Funny, sad and thoughtwww.sporcle.com provoking. QUIZZES! On everything you can think of from naming every country www.youtube.com in the world, to identifying medical Endless hours of entertainment. Latin terms. And then there’s the Try this one : “Baby dancing to Harry Potter Quiz. Beyonce.”

www.fmylife.com

www.facebook.com

Having a down day? Someone’s is Enough said. worse.

this time, the 4 pro-pluses and 7 cans of imitation red bull you’ve consumed in the last hour has been processed by your system (due to your exponentially increased tolerance) and the caffeine crash has almost hit you. Just give up and let your REM cycles take you to a land far away where science and medicine don’t really exist. Or if you’re like the rest of us, you’ll wake up from a dream where you failed your exams to another dream where all your submissions were nullified to reality where there’s still a whole lot of shit left to do and those last 2 things just haven’t happened yet! Shouldn’t have fallen asleep in front of inception, should you?

Planning This is the best procrastination tool since you don’t even realise you’re doing it. Start by making a list of the things you need to do immediately, then the things you want to do soon, then the long term plans, and finally pipe dreams and other who-are-youkidding plans. Once you’ve compiled any of these lists you can spend hours in a semi conscious daydream simultaneously panicking over the huge to do list and fantasising about all the things you could do once this ‘essential’ work is complete. This leaves you in a nirvana like state where nothing is really being done, even though you’re thinking about doing it. It’s the ying yang of procrastination, alleviating your guilt and indulging your wet dreams all at once. So whichever way you’ve decided to conduct your precious time, I imagine you’ve at least managed to stave off 5 mins of revision reading this. I hope I’ve been helpful. Maybe I will be tomorrow…

www.stumbleupon. com

This is a stroke of genius. Sit back and absorb the world wide web as stumbleupon presents you with websites and images tailored to your tastes. A beautiful experience.

www.wouldyourather. co.uk

Profound questions you may not have considered in life. Have your middle finger stuck in your nose forever OR live in a giant’s nose forever


CROSSWORD How to look busy during lectures By Robert Cleaver There comes a time in all our lives when monosodium urate crystals no longer matter to us. Their incessant niggling at our toes only makes us recoil in so much fear we smack our heads on the desk behind us and get a concussion. Of course to not attend a lecture you’d have to group yourself in with the ‘bad people’, the ‘parttime studying of the bottom of beer glasses’ people and the ‘my parents made me do medicine, all I wanted to do was study Fine Art at the local poly, please let me go home now’ people. Nobody wants the hassle of an angry lecturer emailing you. If you want to stick on the right side of lecturers, but avoid every single word they spit out of their monotone, rigor mortis inducing speeches, then there are some tips that you should follow. Looking intrigued. This one takes some mastering. This is because it’s a fine line between intrigue and paedophilia. Of course the likelihood that a child is attending the lecture is unlikely, just try to avoid it during such courses as ‘The Human Life Cycle’ especially the labour process. The idea goes as follows: oscillate your eyebrows between up and down (in a confused state) and screw your mouth up slightly. Not so much it looks like you sucked 500 lemons for lunch. You’d have such a low body pH that if anyone were to touch you they’d melt, and not because you’re so devilishly handsome either. So you’re looking intrigued. You’re

A N S W E R S

interested. The next thing to do is ensure you are looking at the screen. Don’t be looking intrigued at the girl next to you. It’s probably a bit creepy, and the fact her boyfriend is there might get you an unwanted meeting with his metacarpals. Of course this would be a legitimate way to leave the lecture theatre, but you’d probably be bleeding the world a whole new amazon river at the time, so it’s not the most effective way of departing. The screen is what you should look at, and whether, in your head, you’re watching Tom and Jerry or the 2006 Nuts Top Babes DVD, just looking at the screen can help.

Take a computer. This is a brilliant technique. No longer do you have to feign writing by drawing vicious cartoons of the 3rd year that rejected you last friday, or etching a landscape of hills and flowers to take you away from this wretched hell, now you can sit in a lecture and just because you have a computer you’re leading the race in dedication. However, just by simply lugging your windows 95 burdened 400kg beast to the lecture, doesn’t mean you have to access any information; you can whip Solitaire out. What’s more time consuming than a game that very few people win every round? Remaining conscious. The obvious

way to avoid a lecture would be to slip into unconsciousness. Someone hitting their face off the wall or eliciting the help of a friend to smack you round the face with a cricket bat would draw unwanted attention to yourself. The juvenile thing to do would be to paint eyes on your eyelids, but of course this is far beyond your stubby chipolata fingers; you’re more ‘war zone’ than ‘Warhol’ so try to actually remain conscious. There are other ways to stay awake and for real results, it involves a little bit of pain. Try pinching yourself at regular intervals just to make sure you don’t fall asleep or to remind yourself that this boredom is actual waking life. Caffeine offers a quick fix and is legally available in starbucks and most people’s cupboards although we recommend buying your own. Chocolate offers a quick sugar fix and ensures that some serotonin is released from your brain, something that most lectures seem to drain in abundance. If all of that saves, try the oldest trick in the book – and just get a good night’s rest, you silly student! So now that you’re an intrigued, solitaire playing, giant laptop lugging quack you should be more than capable of faking your interest in a professional medical situation...

Across

Down

1. Symptom of ulner nerve compression (4,4) 5. Competitive medical student (6) 7. Commonest cause of small bowel obstructions (9) 8. Non fluent aphasia (6) 10. Syndrome of dysphagia, glossitis, & iron deficiency anaemia (7,6) 13. Muscle in the arm (7) 15. Assessment of the newborn (5) 16. Drug for spasticity (8)

1.Home of Barts and the London Rugby team (11) 2. Artery supplying oxygen to the olfactory bulb - Second word (8) 3. Nocturnal teeth grinding (7) 4. Literally a flesh like process (11) 6. Ranked 14th best UK medical school according to the Guardian (5) 9. Artery supplying oxygen to the olfactory bulb - First word (8) 11. Hormone regulating appetite (6) 12. Adrenal gland core (7) 14. A surgeons favourite tool (9)

Look for the answers in next month’s paper!

SUDOKU


22

April 2011

medicalstudent

Sport Sports Editor: Jonny Jeffery sport@medical-student.co.uk

ICSM take on Imperial College in Varsity ‘11 Imperial College win overall but Imperial Medicals RFC take home another trophy

Medicals captain Johnny Fisher-Black tries to find a way through the IC lines. Image by Chetan Khatri

Jonny Jeffery Sports editor

Imperial Medicals..25 Imperial College.....12 On the   17th   March   hundreds   of   Impe-­ rial   College   students   took   part   in   25   matches   in   10   sports   from   water   polo   to   football   as   the   Medics   battled   the   rest   of   the   university   in   Varsity   2011.   Matches   were   played   in   a   num-­ ber   of   West   London   venues   and   the   day   culminated   with   Imperial   College   RFC   and   Imperial   Medicals   RFC   go-­ ing   head   to   head   in   the   JPR   Williams   cup   which   was   held   this   year   at   the   impressive   Twickenham   Stoop   Sta-­ dium,   home   to   the   London   Harlequins   RFC.   This   Rugby   cup   competition   is  

It’s an underdog eat dog world Andrew Smith Guest Writer

Barts.....................17 St. George’s..........18 It is   probably   fair   to   say   that   every   UH   team   (except   George’s...)   fancied   Barts   and   The   London   RFC   for   the   win   in   their   1st   round   UH   Cup   match   against   St   George’s   Hospital   RFC.   It   was   perhaps   this   slight   arrogance   combined   with   George’s   palpable   de-­ sire   to   reach   the   final,   seasoned   with   a   few   controversial   referee   decisions  

named after   St   Mary’s   old   boy   John   Peter   Rhys   Williams,   a   former   Wales   full   back,   and   is   the   largest   spectator   event  in  the  Imperial  sporting  calendar.   Coaches  began  to  d rop  students  off  at   the  Stoop  from  18.00  onwards  to  watch   the  much  anticipated  finale  along  with   past  students,  Imperial  staff  and  guests.   With  a  venue  such  as  this  and  approxi-­ mately   1,400   people   present,   the   two   Rugby   teams   must   have   been   feeling   the  pressure  to  perform  more  than  ever. Having  never  lost  the  rugby  Varsity   since   its   inception   eight   years   ago   and   still   fresh   from   their   UH   successes   of   the   previous   week   the   Medicals   were   strong   favourites.   The   team   remained   relatively   unchanged   since   the   win   against   George’s   and   the   starting   XV   included   Club   president   Jamie   Rutter   who  had  sustained  an  open  dislocation  

that allowed   George’s   to   seal   the   win.   What   a   nail-­biting   end   it   was   though,   with   BL   scoring   a   try   in   the   last   play   of   the   game   leaving   a   tough   kick   at   goal   to   decide   whether   it   was   win   or   lose.   One   would   expect   to   see   such   an   ending   in   a   Hollywood   sports   film.   Unfortunately   though,   there   was  no  happy  ending  (for  BL  at  least). Over   the   last   4   years   BLRFC   have   gained  t wo  promotions  in  the  university   (BUCS)  leagues  and  currently  compete   in   the   SE   England   1st   Division   where   they  f inished  in  3rd  place  this  year.  Last   year   they   achieved   3rd   place   in   UH,   their   highest   ranking   for   many   a   year.   However,   if   this   year   has   proved   any-­ thing  it  is  that  one  cannot  predict  a  cup   fixture;;  especially  one  in  the  oldest  cup   in  rugby.  Good  on  George’s  for  getting   to   the   final   and   bring   on   next   year    

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“He doesn’t want to be a surgeon anyway so it’s ok if his thumb falls off”

of the   thumb   5   days   earlier.   However   I   was   reliably   informed   that   “he   doesn’t   want  to  be  a  surgeon  anyway  so  it’s  ok  if   his  thumb  falls  off”.  Thank  God  for  that. Entertainment  for  the  onlookers,  as  if   they   needed   more,   was   provided   by   the   Imperial  College  Wind  Band  and  the  Im-­ perial   College   Titans,   the   College’s   new   cheerleading   squad   which   had   everyone   transfixed  by  their,  ahem,  choreography. It   was   an   energetic   start   from   both   teams  on  the  pitch  and  from  the  support-­ ers  who  were  in  good  voice.  It  was  clear   that  nerves  needed  settling  as  both  teams   missed  early  penalties  f rom  in  f ront  of  the   posts.  It  wasn’t  long  before  the  Medicals   got  another  chance  and  kicker  Dan  Nev-­ ille  put  the  f irst  points  on  the  board.  How-­ ever,  within  minutes  IC  had  hit  back  with   the  f irst  t ry  of  the  game.  Shortly  after,  the   Medicals  had  a  man  sent  off  leaving  them   one   down   until   the   half   time   whistle.   An  early  try  and  conversion  by  IC  in   the   second   half   took   the   score   to   12–3.   The   Medicals   then   finally   relaxed   into   their  game  and  we  began  to  see  some  of   the   fantastic   rugby   that   has   made   this   team   such   a   force   to   be   reckoned   with.   Imperial  Medicals  got  a  try  and  con-­ version   as   well   as   another   great   penalty   kick   by   Dan   Neville   taking   them   into   the   lead   for   the   first   time   in   the   match.   With   15   minutes   to   go   the   match   was   still   for   the   taking   until   Craig   Nightin-­ gale’s  converted  try  catapulted  the  Medi-­ cals  into  a  solid  lead  of  20-­12  which  they   secured   with   another   try   in   the   closing   minutes  taking  the  final  score  to  25–12. A   very   disappointed   Imperial   Col-­ lege  side  received  medals  from  Sir  Keith   O’Nions   and   their   number   13   Ben   Adu-­ bi   went   home   with   the   much   deserved   Man   of   the   Match   award.   JPR   Williams   himself   presented   the   Medics   Captains,   Ed   Pickles   and   Jonny   Fisher-­Black   with   the   JPR   Williams   Cup   trophy   which   has  now  been  lifted  by  them  9  times    

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George’s take down GKT titans Charlie West Guest Writer

GKT.......................15 St. George’s..........17 GKT have   been   in   the   final   against   the   Imperial   medics   for   over   10   years   now   and   George’s   were   determined   for   their   chance   to   play   in   the   cup   fi-­ nal.   This   was   obvious   from   the   start   whistle   with   the   George’s   boys   scrap-­ ping   for   everything   they   could.   The   pitch   was   in   an   atrocious   state   making   it   hard   for   GKT   to   get   a   good  

But it wasn’t all about the rugby... The rest of the varsity matches kicked off at 9:00am (as did the boozing) with hockey, football, lacrosse and rugby 2nds and 3rds playing at Harlington Sports Ground, home to QPR FC. The ICSM men’s Hockey 3s were playing their first varsity fixture ever and after a long and closely fought match lost 1-0 to IC. The ICSM Women’s hockey 2s had a repeat of last year with a no score draw although the match was far from uninteresting. Injuries on both sides, sending offs and a disallowed medic goal in the closing minutes kept the crowd of onlookers amused. As did the clashes between the IC fans and the ICSM ‘mascot’ which consisted of the most intoxicated fresher being dressed up as a phoenix and sent to the other end of the pitch to bait the IC fans until either the ref stepped in or someone stole his head, thus ensued a rather lively game of ‘get the head back’. Lacrosse at Imperial is a mixed medics and non medics club but for the purposes of varsity they had split themselves into respective teams of mixed gender. A few of the men found it hard to tone down the full contact sport they are used to resulting in some nasty injuries, but the Medics came out top with a comprehensive 13-4 victory. Meanwhile on the neighbouring pitch the rugby 3rd teams were getting physical. An early IC lead was soon cut back by an ICSM penalty and try taking them into the second half with an 8-5 lead. As the game entered the closing minutes, the Medicals had a 1412 lead but scrappy play gave away a penalty giving IC the opportunity to kick for the match win. There were gasps all around as the IC kicker grazed the outside of the post handing the win to the ICSM. Back to the hockey, the Medic men’s 2s won after goal keeper Preth De Silva saved a penalty off the line but both the men’s and women’s hockey 1st teams lost their matches to IC after a few last minute scrambles in the IC danger zone didn’t deliver the goods. As the matches at Harlington drew to a close, students retired to the club room for a few not-so-quiet drinks whilst they awaited the coaches that would take everyone to the rugby.

grip and   out-­muscle   the   smaller   St   George’s   pack.   The   match   started   off   well   for   GKT   with   the   ball   won   from   a   kick   off   deep   in   George’s   territory.   The   resulting   pressure   from   several   scrums   made   it   easy   for   Rob   Hone   to   cross   for   the   5   pointer   in   the   corner. George’s   hit   back   with   aggressive   running   from   their   smaller,   fitter   for-­ wards   that   forced   a   penalty   right   in   front  of  Guy’s  posts.  The  George’s  kick-­ er   missed   one,   but   converted   the   next.   George’s,  spurred  on  by  the  large  crowd   that   had   come   to   support,   maintained   possession   and   forced   an   overlap   out   wide  and  crossed  in  the  corner  to  score. Further   attempts   from   Guy’s   to   get   an  attack  going  failed  as  drives  up  the   pitch  were  played  too  wide  and  players   ran   out   of   support.   However   the   GKT   defensive   line   was   solid   and   remained  

unbroken until   the   close   of   the   half.   In   the   second   half   Guy’s   had   some   passages   of   play   that   really   showed   what  the  team  can  do  forcing  a  relative-­ ly   easy   penalty   for   Freddie   Hartley   in   front  of  the  goal  (which  he  missed),  al-­ though  this  was  soon  put  right  when  his   next   attempt   sailed   between   the   posts.   More   ill   discipline   cost   the   GKT   boys  another  penalty  and  scrappy  play   continued  up  until  the  last  10  minutes  of   play.  The  George’s  line  faltered  briefly   allowing   GKT   through   for   a   try   giv-­ ing   them   a   brief   one   point   lead.   With   five  minutes  left  on  the  clock,  George’s   forced   another   penalty   in   front   of   the   GKT   posts   and   converted.   The   game   closed   at   17-­15   to   George’s,   a   brilliant   result  for  a  side  that  hasn’t  been  in  the   UH  f inal  for  many  years  but  a  tough  one   to  take  on  the  chin  for  the  Guy’s  boys    

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medicalstudent

April 2011

23

Sport 136 years of rugby The history of the UH cup

I say, pass the pigs bladder old chap. Image from ICSM archives

Jonny Jeffery Sports Editor Rugby has   long   been   described   as   a   hooligan’s   sport   played   by   gentlemen   (football  of  course,  being  the  opposite).   Throughout   most   of   the   20th   Century   this  was  certainly  the  case.  Rugby  had   been   developing   in   UK   public   schools   since  the  1820s  but  it  was  another  20  or   so   years   before   it   became   a   university   sport,  soon  becoming  incredibly  popu-­ lar   within   London   Medical   Schools.   In  1875,  Guy’s  and  St  George’s  hos-­ pitals   took   to   the   field   at   The   Oval   to   play  what  would  be  the  first  Rugby  Cup   competition   ever   to   be   played   in   the   world;;  The  United  Hospitals  Rugby  Cup.   During   this   match   the   Guy’s   cap-­ tain,   an   English   International   forward   named   Gray,   managed   to   dislocate   his   shoulder   and   was   unable   to   relocate   it   despite  the  help  of  four  Guy’s  orthopae-­ dic  surgeons.  He  finished  the  match  as   a  full  back  and  managed  to  relocate  his   shoulder  afterwards  with  the  assistance  

of the   anaesthetists   using   chloroform. Guy’s  went  on  to  win  what  has  since   become   one   of   the   most   influential   rugby   competitions   in   the   world,   pio-­ neering  the  15-­a-­side  rugby  match  seen   in   the   sport   today.   Numerous   Interna-­ tionals   have   played   in   UH   Finals,   the   most   obvious   of   which   being   the   pre-­ sent   UH   patrons,   Dr   John   O’Driscoll   and   the   legendary   JPR   Williams.   George’s   last   won   the   final   in   1882   and   have   won   3   times   since   the   com-­ petition’s   inception.   Before   this   year’s   match,  Imperial  Medicals  and  their  con-­ stituent   medical   schools   of   St   Mary’s,   Charing   Cross   and   Westminster   had   won   the   Cup   49   times   and   this   year’s   victory   takes   them   to   equal   wins   with   the   schools   that   now   make   up   Guy’s   Kings   and   St   Thomas’   at   50   apiece.   This  continues  a  long  period  of  UH   cup   success   for   ICSM,   who   have   now   won  12  of  the  last  14  f inals,  although  it  is   fair  to  say  that  both  teams  were  thorough-­ ly  deserving  of  their  place  in  the  final  of   the   oldest   and   one   of   the   most   exciting   rugby  cup  competitions  in  the  world    

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Continued from back page ing it   wide.   Strong   carrying   from   the   forwards   and   some   injections   of   pace   from   the   back   three   again   continu-­ ally   saw   ICSM   break   into   George’s   territory   but   unfortunately,   lax   dis-­ cipline   around   the   breakdown   con-­ tinually   meant   that   the   Medicals   came   away  from  the  red-­zone  without  points.     Eventually,   the   pressure   showed   as   the   Medicals   forwards   domi-­ nance   came   into   its   own   and   Graham   Corin   was   able   to   go   over   from   the   base   of   a   scrum.     The   kicker   added   the   extras,   making   the   score   a   more   comfortable   lead   of   20   points   to   3.     With   the   Imperial   pack   tiring,   the   George’s   captain,   Ollie   Rupar,   led   by   example   as   his   team   began   to   edge   the   battle   into   ICSM   territory.   The   George’s   forwards   demonstrated   that   ,despite   a   considerable   weight   disad-­ vantage   in   the   scrum,   they   were   able   to   match   the   ICSM   pack   by   consist-­ ently   changing   the   point   of   attack.   Finally,   this   paid   off   with   the   George’s   scrum   half,   Gregory   Davies   collecting   the   ball   from   an   ICSM   lin-­ eout   and   darting   through   a   gap   in   the   Medicals   defence   to   score   under   the   posts.   The   extras   were   duly   added   by   Rossiter   taking   the   score   to   20–10.

“There isn’t, never has been, and never will be anything quite like hospital cup rugby.” Despite Georges’   try   they   never   managed   to   get   back   into   the   game,   and   ill-­disciplined   defending   resulted   in   them   needlessly   conceding   a   yel-­ low   card.   ICSM   capitalised   on   their   one-­man   advantage   and   Graham   Cor-­ in   was   able   to   break   from   10   metres   to   score   his   second   of   the   match,   with   the   kicker   converting.   The   score   was   now  27-­10  and  the  chances  of  a  come-­ back   were   looking   increasingly   slim. George’s   had   not   come   this   far   to   concede   defeat   yet   and,   once   restored  

Don’t go towards the light. Image by Chetan Khatri

to their   original   15   men,   they   contin-­ ued  to  test  the  ICSM  defence  as  the  last   few  minutes  ticked  away  but  to  no  avail.   The  final  whistle  blew  with  no  fur-­ ther   points   scored   and   ICSM   were   to   retain   the   title   of   UH   cup   champions   for   another   year.   The   Imperial   crowd   hurled   what   was   left   of   their   pints   in   the   air   and   the   George’s   fans   ap-­ plauded   a   performance   which   bodes   extremely   well   for   a   rugby   team   that   have   gone   from   strength   to   strength   in   recent   years   and   could   be   a   regular   contender  for  the  cup  in  finals  to  come.

Ollie Rupar   received   the   man   of   the   match  award  for  a  heroic  display  as  captain   for  SGHMS,  but  the  ICSM  captain  Jamie   Rutter   unfortunately   spent   the   evening   celebrating  his  team’s  success  in  A+E,  af-­ ter  sustaining  an  open  dislocation  of  the   thumb  in  the  last  10  minutes  of  the  match.   Dr   John   O’Driscoll   (previous   rugby   International   and   UH   final-­ ist)   summed   up   the   evening’s   festivi-­ ties   perfectly   during   the   medal   cer-­ emony   –   “There   isn’t,   never   has   been,   and   never   will   be   anything   quite   like   hospital   cup   rugby.”   Amen    

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The victorious Imperial Medicals RFC with the UH cup trophy. Image by Jakob Mathiszig-Lee


medicalstudent April 2011

Sport

Varsity: Medics take on Non Medics at Imperial Page 22

The UH Cup: The oldest rugby cup competition in the world Page 23

medicalstudent

More Rugby!: Match reports from George’s Vs GKT and Bart’s Page 22

Imperial Medicals win the double The ICSM rugby team continue to dominate the UH Cup and Varsity

ICSM raise a glass to their victorious rugby squad. Image by Chetan Khatri

Jamie Rutter & Branavan Rudran Guest writers

Imperial Medicals..27 St. George’s..........10 Imperial Medicals  RFC  won  their  50th   United   Hospitals   Cup   title   this   year,   beating   St   Georges   Hospital   RFC   in   a   tightly   contested   match   at   Richmond   Athletics   Ground.   St   Georges   were   an   unknown   quantity,   who   last   won   the   cup   129   years   ago   in   contrast   to   the   Imperial  Medicals,  who  have  taken  the   cup   home   for   12   of   the   last   14   years.     On  the  11th  March,  the  mascots  of  the  

respective sides   were   present,   the   well   watered  supporters  were  in  f ull  voice  and   the  scene  was  set  for  the  UH  cup  final. The   tension   in   the   air   was   palpa-­ ble  and  the  first  clash  of  the  game  oc-­ curred   before   the   teams   were   even   on   the   pitch.   One   of   the   George’s   players   ‘accidentally   collided’   with   the   ICSM   mascot   (known   as   ‘the   Mary’s   fairy’)   on  their  way  out  of  the  t unnel,  k nocking   the  unfortunate  individual  to  the  floor.   The   game   kicked   off   to   a   frantic   start,  it  soon  became  clear  that  Georg-­ es   intended   on   playing   the   match   at   break  neck  speed,  with  the  aim  of  dis-­ rupting   the   opposition’s   defence   and   stopping   the   more   powerful   Imperial   side   setting   up   any   kind   of   rhythm.     The  first  half  was  littered  with  mis-­

takes from  both  sides  and  was  charac-­ terised  mostly  by  f urious  defending  and   big  hits.    Eventually,  the  deadlock  was   broken  when  the  Medicals  were  award-­ ed   a   penalty   in   kicking   range,   which   was   duly   converted   by   Dan   Neville   to   give   Imperial   Medicals   a   3   point   lead.

“Further clashes between the team’s supporters, resulted in one of the George’s mascots being forcibly ejected by stadium security” However, the   larger   Imperial   pack   meant   George’s   had   to   consistently   commit   more   men   to   the   break   down,  

allowing ICSM   to   string   together   an   undisrupted  series  of  phases.  This  cul-­ minated  in  a  driven  lineout  in  the  cor-­ ner,  allowing  Josh  Balogun-­Lynch  to  go   over   the   whitewash   for   the   first   try   of   the  game.    The  try  was  duly  converted   to   give   the   Medicals   a   10   point   lead. This   was   soon   trimmed   back   to   7   as   St   Georges   were   awarded   a   penal-­ ty.   Chris   Record,   the   SGHMS   no.   10,   kicked   magnificently   to   put   SGHMS   into   good   field   positions,   yet   despite   consistent   pressure   by   SGHMS   and   a   few   unforced   ICSM   errors,   a   try   re-­ mained  elusive  to  the  title  challengers.   Following   a   substitution,   the   Medicals   began   to   control   possession   and   man-­ aged   to   keep   the   ball   in   George’s   ter-­ ritory   for   the   remainder   of   the   half.  

This paid   off   in   the   dying   minutes   as   a   well   worked   move   from   a   lin-­ eout   left   room   on   the   blindside,   al-­ lowing   Captain   Jonny   Fisher-­Black   to   go   over   in   the   far   corner   to   make   the   score   15–3   going   in   at   half-­time. Further   clashes   between   the   team’s   supporters,   and   a   good   deal   of   fine   ale   being   wasted   as   aerial   missiles,   resulted   in   one   of   the   George’s   mas-­ cots   being   forcibly   ejected   by   sta-­ dium   security,   much   to   the   glee   of   the   on-­looking   ICSM   crowd.     After   the   break,   Imperial’s   for-­ wards  resumed  their  ugly,  yet  effective   method   of   testing   the   SGHMS   fring-­ es,   drawing   men   in   and   then   spread-­

Continued on page 23


2-3 RAG Week

RAISE-AND-GIVE 2011

Bart’s smash RAG record, whilst George’s contend with TfL

4-5 The Results Totals, top events and RAG antics in our graphical spread

6-8 Fashion All the best images from the medical schools’ fashion shows

medicalstudent


2

medicalstudent

Bart’s smash RAG record The committee recount the week which saw Bart’s break their RAG total for the second year in a row

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his year’s  Bart’s  and  the  Lon-­ don   RAG   Committee   were   determined  to  cement  Bart’s   spot   as   the   best   RAG   medi-­ cal   school   in   London.   Over   £140,000   was   made   during   the   seven   days   of   ragging,   breaking   the   RAG   week   re-­ cord   for   the   second   year   in   a   row. After   months   of   prepara-­ tion,   meetings   (even   during   exam   week)   and   all   manner   of   adminis-­ trative   tasks,   RAG   Week   began.   The  office  was  set  and  ready  for  our   very   first   ragger   of   the   week   at   6am.   The  day  ran  as  smoothly  as  a  first  day   could   possibly   run.   However,   after   a   quiet   Friday   and   Saturday,   we   were   a   little   worried   that   things   were   going   a   little   too   slowly   for   our   liking.   The   RAG   committee   had   to   make   sure   that   ragging   from   Monday   onwards   was   up   to   the   right   sort   of   standard. The  first  planned  event  at  the  Grif-­ fin   Bar   was   Poker   Night.   Players   ar-­ rived   at   the   union,   dressed   the   part   with   their   mirror-­practiced   poker   fac-­ es,   ready   to   win   them   the   top   prize   -­   a   tab   at   the   bar.   The   night   ran   swim-­ mingly   and   generally   set   the   tone   for   what   would   be   an   awesome   week. Things   were   picking   up   after   our   first   union   night.   The   next   day   saw   a   fresher   return   to   the   RAG   office  

with a   split   bucket,   having   ragged   so   hard.   Shock   soon   became   elation.   Yes,   we   lost   a   bucket,   but   that   was   the  least  of  our  worries  –  ragging  that   hard   deserves   some   sort   of   accolade!   That   evening,   we   celebrated   with   our   BL   Arts   Evening,   which   saw   talents   from   the   BL   orches-­ tra   and   BL   bands   and   singers   per-­ form   to   a   very   packed   audience.

“The Arnold Schwarzenegger of BL, our very own Jeeves was called-up to do what he does best – motivate our freshers to get out there and RAG” Wednesday had   to   be   big,   and   the   committee  k new  that.  We  had  to  call  in   the  big  g uns.  The  A rnold  Schwarzeneg-­ ger  of  BL,  our  very  own  Jeeves  (our  un-­ ion  president  f rom  last  year)  was  called-­ up  to  do  what  he  does  best  –  motivate   our  freshers  to  get  out  there  and  RAG.   His  tear-­jerking  speech,  as  was  the   case  last  year,  managed  to  persuade  the   freshers  to  spend  a  few  hours  ragging,   which  did  wonders  for  our  total.  It  was   no  surprise  to  find  out  that  Wednesday   saw  us  raise  the  most  we’d  ever  raised  

in a   single   day   of   ragging   in   BL   his-­ tory  –  over  £36,000  -­  £6000  more  than   GKT  raised  in  an  entire  week  this  year. Thursday   saw   a   similarly   impres-­ sive   day   of   ragging.   £50   notes   were   being   donated   to   raggers   at   a   rate   faster   than   any   George’s   medic   could   pronounce   the   word   ‘dysdiadochoki-­ nesis’   without   getting   tongue-­tied.   Our   Band   Night   at   the   un-­ ion   was   just   as   successful   with   more   being   raised   for   our   charities. Friday  saw  the  culmination  of  what   was  a  fantastic  week.  Our  tired  raggers   celebrated   their   success   in   style   with   an   ‘Elegance’   and   ‘Radius’   Reunion   after   party   at   the   Griffin   –   a   night   which  saw  members  from  both  our   hugely   successful   RAG   associat-­ ed  shows  dance  the  night  away. RAG   Week   at   Barts   and   The   London   is   always   big.   We   are   renowned   for   annihilating   our   Lon-­ don   medical   school   coun-­ terparts   by   smashing   our   RAG   totals   year-­on-­year   in   a   bid   to   raise   hundreds   of   thousands   of   pounds   for   a   myriad   of   charities.   Socially,   RAG   week   is   practically   equivalent   to   Fresh-­ er’s  Fortnight  with  events  held  on  each  

night of   the   week,   except   there’s   less   of   the   awkward   small   talk   between   complete   strangers   in   the   snakebite-­ stained   walls   of   the   Griffin   Bar,   and   more  celebratory  chants  at  the  smash-­ ing   amounts   we’ve   raised   throughout   each  day. BL   saw  a   chal-­

lenge, rose   up   to   it   and   completed   it   with   style.   We   turned   it   around   mid-­ week   to   break   our   RAG   Week   re-­ cord   for   the   second   year   in   a   row,   a   feat   we   know   every   BL   student   will   be   proud   to   have   been   a   part   of.   A   ‘well   done’   simply   isn’t   enough.   BL   has   done   it   again   -­   and   done   it   big!   The  London  certain-­ ly   is   ‘the   best   place   in   the   land,   cor   blimey!’  

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ICSM confound circle-line commuters Steve Tran The mere   mention   of   RAG   week   is   enough   to   send   any   Londoner   or   TfL   worker   running   and   screaming.   So,   when   the   Imperial   freshers   descend-­ ed  upon  London  in  the  early  hours  of   Monday   morning   to   catch   the   com-­ muters   en   route   to   work,   many   re-­ gretted   skipping   their   morning   cof-­ fee.   Truth   be   told,   though,   not   even   coffee   could   have   facilitated   a   perki-­ ness   to   rival   that   of   the   freshers.   RAG   games   on   Monday   night   was   followed   by   the   first   “Battle   Of   the   Bands”   ever   hosted   at   the   Reyn-­ olds   bar.   It   was   one   of   bar’s   more   chilled-­out   evening   with   talents   from   ICSM   and   St   George’s   battling   it   out   for   the   title   of   “Best   Band”.   Sadly   to   say,  SGUL  snatched  the  title  from  us. Our   Super-­Hero   themed   RAG   IN-­ VASION   involved   challenges   ranging   from   getting   a   photo   with   a   police-­ man   (preferably   not   in   handcuffs),   to   making   a   human   pyramid   in   front   of   Big   Ben,   to   a   dip   in   the   freezing   Ser-­ pentine.  One  group  even  managed  the   bonus  task  by  broadcasting  their  RAG   message   on   CapitalFM.   All   Super-­

Heroes (I  know  it  sounds  lame,  but  we   all  felt  pretty  cool  at  the  time)  congre-­ gated  at  Trafalgar  Square  for  the  tradi-­ tional  photo,  where  the  RAG  chair  ac-­ cidently  revealed  to  all  exactly  what  a   cold  dip  in  the  fountains  can  do  to  you! Over  600  medics  descended  on  the   circle  line  to  complete  the  infamous  Cir-­ cle-­Line  pub-­crawl.  It  was  a  day  off  for   everyone  to  enjoy  a  casual  pint  or  two,   have  a  social  mingle,  or  for  some  to  re-­ mind  others  they  still  exist  (especially   the  4th  years  that  had  been  cooped  up   revising  for  exams  that  ended  that  day). One   reveller   decided   to   com-­ mute   the   entire   circle   line   by   Boris’   Bikes,   proclaiming   it   “Cycle   Line”.   The   finalists   ended   their   night   with   the  rest  of  the  medical  school  at  a  lit-­ tle   known   nightclub   in   Putney   -­   Fez.   Many  managed  to  party  until  the  early   hours  of  the  morning.  In  fact,  I’m  sure   there   are   some   that   are   still   partying. RAG   Games   rounded   off   the   week,   where   the   RAGgiest   fresher,   Angus   Turnbull,   was   crowned.   We   raised   over   £23,000   for   St   Mary’s   Paediatric   Department.   No   one   can   ever   say   that   all   medics   do   is   work.   We’re   fun   too.   I   promise  

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Image by Chetan Khatri


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George’s battle TfL to save RAG Ayoma Ratnappuli

dies fighting  it  out  for  a  date  with  some    of   our   smoothest   bachelors.   Ray   Sacks   un-­ A  life-­size  artistic  representation  of  Pamela   dertook   the   arduous   task   of   being   our   very   Anderson   sans   clothing,   coordinating   thir-­ own   northern   matchmaker.   Armed   with   ty   odd   trolleys   to   push   around   Wimbledon,   his   best   medic   puns   and   Bolton   accent,   dreaming   of   coin   counting…it   could   only   the   night   was   a   massive   success.   Comedy   be   the   life   and   times   of   SGUL   RAG   2011! Night,   RAG   Circles   and   Family   Fortunes   Fundraising  began  in  Fresher’s  week  when   were   also   triumphant,   with   good   turnouts. we  sold  merchandise  and  goodies  at  events.   The  first  day  of  mashing  saw  lots  of  stu-­ In  November,  SGUL  took  part  in  Movember   dents,  armed  with  their  scrubs  and  buckets,   as  George’s  guys  (and  gals)  sported  their  best   hit  the  tubes.  Students  employed  a  range  of   moustaches  for  The  Prostate  Cancer  Charity.   tactics   to   seduce   London’s   commuters   into   Joseph   Machta   single-­handedly   raised   over   donating   money,   varying   from   serenades   £3000   with   his   multicoloured   moustache.   with  a  ukulele  to  the  more  scandalous  boys   Several   SGUL   societies   and   sports   teams   in   nurses’   outfits   offering   a   grope   of   their   posed   for   the   RAG   calendar,   thanks   to   the   balloon-­filled   assets.   In   five   days   SGUL   willingness  of  George’s  students  to  strip  off. students   raised   over   £19,000   from   mashing   RAG   fortnight   kicked   off   in   February   alone.   It   was   looking   like   we   were   finally   with   the   ‘anything   beginning   with   R,   A,   or   reversing  the  trend  of  declining  RAG  totals.   G’   disco   during   which   118-­118   style   run-­ However,   a   run-­in   with   TfL   five   days   ners,   glittery   acrobats   and   bling-­clad   gang-­ into   RAG   fortnight   quickly   put   an   end   to   sters   descended   on   the   SU   bar.   George’s   mashing.   We   still   had   over   £5,000   to   raise   does   Take   Me   Out   had   our   finest   single   la-­ in   order   to   meet   out   minimum-­pledge  

GKT go Retro for RAG

amounts to   our   charities.   Thankfully   it   seemed   the   George’s   love   for   RAG,   which   we   had   feared   was   slipping   away,   was   in   fact   at   its   highest   and   students   continued   to   enjoy   the   events   being   held   despite   be-­ ing   thwarted   by   the   pesky   transport   police. Bingo   &   Band   night,   Hollywood   Dis-­ co,   Pram   Race   and   a   Baywatch   themed   Man-­O-­Man   featuring   more   slow-­mo   run-­ ning,   Barbie   rescue   and   baby   oil   than   the   Hoff   himself   could   handle,   helped   SGUL   RAG   tally   up   nearly   £21,000.   Having   manually   bagged   more   money   than   we’ve   ever   owned   (coin-­counter   fail),   felt   the   wrath   of   TfL   and   seen   more   naked   students   than   we   would   ever   care   to,   we   charity   officers   ended   RAG   bleary-­eyed   with   our   tails   between   our   legs   at   times.   Nevertheless,   thanks   to   the   generos-­ ity   of   SGUL   staff   and   students   who   do-­ nated   their   time,   money   and   dignity   for   the   greater   good,   we   have   been   deter-­ mined  to  make  this  year  a  RAG  success.  

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Veni, Vidi, Velcro - RUMS Break Out

Spot the ragger who fell off the edge just seconds later

Dominic Putt Waking up   is   hard   to   do,   but   would   we   let   our   Jailbreakers   down?   Never!   Even  after  a  hard  night  out  clubbing    we   went   about   setting   up   the   stall   to   register   the   impavid   Jailbreakers   as   they   arrived.   You   could   see   the   faces   of   the   whole   RAG   team   light   up   as   Jailbreakers   with   incredible   costumes   walked   through   the   doors:   from   lions,   bunny   rabbits   and   ravens   to   astronauts,   gladiators   and   morph   suit   ballerina’s,   we   had   them   all!   There   was   a   definite   buzz   in   the   air   as   the   teams   registered   and   waited   to   be   re-­ leased  on  their  adventure  of  a  lifetime,  trav-­ elling  as  far  away  from  UCL  as  possible  in   just   36   hours   without   spending   any   money. As   we   shouted   “good   luck”,   the   Jail-­ breakers   began   running   as   fast   as   they   could   out   through   the   main   UCL   gates. You   could   see   the   excitement   run-­ ning   through   the   Jailbreak   HQ   as   teams  

started checking   in,   with   their   loca-­ tions   being   plotted   on   the   interactive   map   provided   by   Choose   a   Challenge.   The  first  team  to  make  it  out  of  England   was   the   team   Veni,   Vidi,   Velcro,   somehow   managing  to  blag  a  Eurostar  ticket  to  Paris.

“On the way to Luxembourg, sadly don’t share any common language with our drivers so we could be wrong.” We took   it   in   shifts   to   watch   the   moni-­ tors,   as   each   team   had   to   check   in   at   least   every   6   hours,   and   if   they   didn’t   it   was   panic!  But  with  phone  calls,  facebook  mes-­ sages   and   frantic   texting,   we   managed   to   contact   the   occasionally   non-­responding   teams   and   the   mini-­crisis   were   soon   over.   Some   of   the   messages   we   received   had  

been informative,   while   others   were   just   downright   hilarious.   Some   of   the   favour-­ ites   included,   team   Blonde   Bombshells,   “staying   in   a   sweet   army   mess   and   having   a   beer   with   the   army   boys!”   and   team   Ed   and   Sam’s,   “On   the   way   to   Luxembourg,   sadly   don’t   share   any   common   language   with   our   drivers   so   we   could   be   wrong.” Teams   of   fugitives   made   it   to   Mi-­ lan,   Zurich,   Berlin,   Hamburg,     Lyon   and   even   Krakow,   Budapest   or   Prague! None  of  it  would  have  been  possible  with-­ out   the   RAG   team   of   Hana,   Jenny,   Matt,   Sarah,  Laura,  Andy  and  Charlie,  as  well  as   all   the   help   that   Rob,   from   Choose   a   Chal-­ lenge,   provided   throughout   the   weekend.   Although   I   wasn’t   a   Jailbreak   myself,   I   will   never   forget   that   weekend.   From   plan-­ ning   the   event   in   December,   to   it   actu-­ ally   taking   place,   I   never   could   have   an-­ ticipated   128   people   taking   part   and   never,   in   my   wildest   dreams,   did   I   imagine   that   the   event   would   raise   over   £13,000  

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Katie Allen takes a trip on the Mystery Machine

LSE’s penguin gets into the spirit of RAG week

GKT RAG Week 2011 was, as ever, a ridiculous week of late nights, early mornings, gin, snakebite and fun! Of course, RAG is about so much more than freezing your ‘nads off and begging strangers to empty their pockets. We made sure we rewarded our RAGgers with excellent events every night. Since RAG can do ‘classy’ just as well as ‘vomiting into your own pint glass’, we celebrated the first day of collections with a sophisticated party at the top of Guy’s Tower. The Retro Roller Disco was another success – not a single bone was broken despite some impressive pre-lashing before strapping the skates on. Wednesday saw the biggest and best sports night of the year. This year the ever-seductive Tit Squad decided to appear in some particularly raunchy French Maid outfits and covered themselves and the baying crowd in whipped cream. Throughout the week several males were left with some questionable new haircuts and a distinct lack of dignity. It was a wild week of partying, and we even managed to to take a trip on the Mystery Machine. Turning up to our Top Secret Destination (erm…Southampton), we did what RAG does best: cause mischief. Whether stealing toys, grabbing vital supplies from the local sex shop, or contravening several public exposure laws, we showed Southampton what GKT are made of! In the aftermath of RAG week, most of us were busy recovering from the sleep deprivation, liver damage, overdraft abuse and daily McDonalds breakfasts. However, we still managed to squeeze in the wonderful black-tie RAG Formal. In an amazing bar in Covent Garden we enjoyed our drinks and nibbles and gave ourselves a big, smug pat-on-the-back for all of our hard work. We also said a few ‘thank-you’s to those who’ve been particularly committed and gave our ‘RAGgiest Fresher’ award to the lovely Theo Willison-Parry. We raised almost £30,000 for some very deserving charities, chosen as they represent causes close to the hearts of our students. Particularly personal this year is Malaika Kids, which we’re supporting in memory of Muhammed ‘Haris’ Ahmed, a GKT medic (and enthusiastic RAGger) who sadly passed away last year. The cherry on top of the cake was our Jailbreak on March 5th-6th, with a record 128 people taking part. There are also rumours of other events happening throughout the year, so keep your ears to the ground for more information!


RAG

“Tube announcement: The people dressed in blue are medical students raising money for charity. Please give generously” - SGUL “We dressed up the LSE penguin in attire fitting for GKT RAG” – GKT “One of our teams hitchhiked all the way to Athens without spending a penny in RAG Jailbreak” – GKT “A fresher managed to get on capital radio and do a RAG shout out during RAG invasion, completing the ultimate bonus challenge” - ICSM

“One RAGger collected so much money in his bucket that the whole bucket split open! He proudly returned with over £850 in a binbag.” - BL “Comedian, Imran Yusuf tweeted about how awesome St George’s Comedy Night was - SGUL

Top five events - attendees

From RAGs to Riches... London medics hitch-hiked, dashed, mashed, flashed and crashed their way through their RAG weeks to raise a record total. To date, medics from the five London schools have raised over £273,412 for 74 charities, smashing last year’s figure of £241,106. This impressive number does not take into account revenue from the fashion shows, or any outstanding sponsorship, potentially making the current figure a significant under-estimate. Reports came in of buckets being split open due to the sheer weight of the cash within them, £50 notes

To date, RAG 2011 has raised over £273,412 for 74 charities. Here are just a few of them.

flowing from commuters and blank cheques put into the hands of freshers. Bart’s raised over half of the London-wide total. Traditionally, each new committee aims to beat the total raised the previous year, putting immense pressure on the individuals involved, but providing the incentive to deliver high totals. St. George’s had their total slashed due to targeting from the British Transport Police. The student union were informed that any students found collecting on the tube would be arrested and issued with a warning.

Spectrum

Great Ormond Street

St. Mary’s Pediatric Department

The Stroke Association

Spectrum is a charity run by students at RUMS that links students with disabled children. Students can broaden their awareness of disability and disadvantaged children are given opportunity to develop a level of independence outside the family.

Great Ormond Street Hospital provides world-class healthcare to young people and support to their families, as well as pioneering new treatments for childhood illness. Most of the children cared for are referred from other hospitals throughout the U.K. and overseas.

St Mary’s is an acute care hospital that diagnoses and treats a range of paediatric conditions and offers a 24-hour paediatric accident and emergency (A&E) service in London. More than 6000 lives have been saved in its paediatric intensive care unit since it opened in 1992.

Strokes are a major health problem and have a greater disability impact than any other medical condition. The Stroke Association funds research into prevention, treatment and better methods of rehabilitation, and helps stroke patients and their families.


2011

“Tube announcement: The people dress in blue are beggars and buskers. DO NOT give them any money - SGUL “Our Lion King Movie Night took place...without the Lion King” - SGUL “The RAG Chair accidentally left the ICSM president behind in Edinburgh during RAG Dash. (Fortunately others realised and went and picked him up)” - ICSM “A traffic cone funnel concussed a female fresher during the first night of RAG Dash” - ICSM

“One of our students was caught by the Transport Police (and was tazered in the face)” – SGUL “A member of the RAG Committee accidentally flashed the whole of Trafalgar Square whilst taking part in the traditional ‘Trow Down’ photo” - ICSM

Top five events - amount raised

Some students were seen fleeing pursuing officers, whilst others had the misfortune of being “tazered in the face”. The union was forced to ban collecting, after pleas of hundreds of years of tradition being destroyed fell on deaf ears at TfL headquarters. Luke Turner, President of SGUL union stated, “RAG has a long and proud tradition amongst medical schools in London. It has always been received well by the greater populous of London. However, our first priority is to our student body, not to RAG.” GKT came in third, having been

knocked off their 2009-2010 position of second place by ICSM. David Smith, president of ICSM commented on their victory over GKT – “We’re delighted to have raised more than GKT in the RAG stakes this year, although not at all surprised”. Despite ICSM’s triumph, both ICSM and GKT raised lower figures than last year. ICSM raised £1,465 less than last year, and GKT £6,257 less. RUMS have made significant progress on their past totals, surpassing the previous two years figures of around £5000 with this year’s total of £13,984.

St. Christopher’s Hospice

Malaika Kids

HEMS (London’s Air Ambulance)

Alzheimer’s Society

St. Christopher’s Hospice provides skilled and compassionate palliative care and adult and children bereavement services. Its Education Centre delivers the highest quality palliative and end of life care training resulting from research, practice and experience.

Malaika Kids gives orphans in Tanzania a future by offering them a home and a proper education; children can grow into independent adults. Managing Malaika Children’s villages as well as running a Relatives Support Programme to help relatives take care of orphaned children.

London’s Air Ambulance is London’s only Helicopter Emergency Medical Service, providing pre-hospital care to victims of major trauma throughout the city and the M25 area. Every second counts: their quick response prevents disability, enables better recovery and saves lives.

Alzheimer’s Society works to improve the quality of life of people affected by dementia and their families. Many of their members have personal experience of dementia as carers, health professionals or people with dementia themselves. Their experiences help shape the charity’s work.

John Hardie Analysis & Design Alexander Isted Graphics Linda Mao Graphics Lucia Bianchi Charities With thanks to the RAG committees


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Medics scrub up for RAG fashion

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n the  wake  of  London’s  Fashion  Week,  March  was  a  time   when  a  new  array  of  medical  students’  talents  came  on   display.   A   show,   organised,   choreographed   and   staged   within   months,   centred   on   art   and   fashion   is   impres-­ sive   enough   without   taking   into   account   the   fact   that   those   involved   are   largely   from   a   non-­design   background.   UCLU   took   this   aspect   further,   flaunting   beautiful   pieces   of   fash-­ ion  that  were  crafted  by  students  from  their  own  university.   Perhaps  this  is  where  the  real  focus  of  RAG  fashion  shows   lie-­  the  talent   of   medical   students   in   a   field   so   far   removed   from   their   study.   Everyone   can   appreciate   the   fact   that   the    

GKT strike gold with their venue choice ©

Bart’s show off Far East fashion in their fourth walk

assembly of  a  show,  and  a  night  of  partying  for  the  ma-­ jority   of   the   student   body,   demands   weeks   or   months,   of  time,  dedication,  and  creativity  from  those  involved.   This   year’s   RAG   shows   excelled   their   predecessors   in   several   ways   -­   KCL’s   bold,   brave   and   beautiful   hair   and  make-­up  moves  shone  through  the  night,  accentuat-­ ing  the  outfits,  while  Bart’s  wowed  their  audiences  with   sharp   and   stunning   choreography.   Imperial   put   their   best  foot  forward  with  an  inspired  and  inventive  theme   ‘Back   to   the   Future’,   and   UCL   continued   to   broaden   their   repertoire   with   their   attractive   and   alluring   stu-­ dent-­made  designs.  The  attention  to  detail  that    the  or-­ ganisers   poured   into   the   selection   and   decoration   of   venues  contributed  to  the  shows  in  aspects  such  as  light-­ ing   and   mood,   as   well   as   hosting   popular   afterparties.   Last  but  not  least  is  the  generosity  of  the  donators,  the   designers  and  those  who  attended  the  shows.  This,  cou-­ pled  to  the  achievement  of  the  committees,  compères  and   models,  ensured  the  success  of  the  RAG  Fashion  nights   and   has   done   much   for   the   causes   that   they   support.  

Bart’s Dancers thrill the audience as the Arabian theme awaits

Imperial

The show begins with sleek sophistication

It was   soon   Imperial   College’s   turn   to   host   their   RAG   fashion   show,   held   at   The   Venue   on   Great   Port-­ land   Street,   aiming   to   raise   money   for   St   Mary’s   Paediatric   Department.   They   boasted   a   variety   of   top   de-­ signers  providing  the  clothing  such  as   Hawes  &  Curtis,  Ad  Hoc  and  Crombie,   however,   the   venue   lacked   the   impact   desired  and  didn’t  give  the  same  take-­ your-­breath-­away  feeling  as  others. This  was  redeemed  by  the  ingenious   ‘Back   to   the   Fashion   Future”’theme   that  followed  a  journey  f rom  the  Victo-­ rian  era  to  the  future,  stopping  at  each   decade   along   the   way   to     glimpse   the   fashion  and  culture  of  the  time. The   show   began   with   a   seductive  

A set of sensual seduction enthralls the audience


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medicalstudent

RUMS

UCLU MODO  showcased  their  annual  student-­run  fash-­ ion  show,  on  the  4th  and  5th  of  March.  MODO  is  unique  in   that   all   members   are   of   a   non-­art   background,   impressive   given  the  attention  to  detail  and  hard  work  from  all  involved. Following   on   from   last   year’s   acclaimed   Green   Show   at   the  Russell  Hotel,  MODO  returned  to  its  home  at  UCL  Clois-­ ters.   Anticipation   heightened   with   entertainment   by   an   ex-­ perimental   choir   and   the   jazz   band,   The   1-­4-­5s,     and   audi-­ ences  gathered  around  the  catwalk  as  videos  played  to  show   lengthy  preparations  dating  to  September. The   show   started   with   a   bang,   opened   by   talented   knit-­ wear   designer   Michaela   Moores,   an   Evolutionary   Biology   PhD  student.  “The  concept  is  of  a  tree  passing  from  summer   through  the  depths  of  winter”. The  first  half  closed  with  the  Kate  Middleton  collection,   as  previewed  on  BBC  London  News.  The  princess  in  waiting   would   indeed   be   proud   to   wear   some   of   these   unique   piec-­ es,  particularly  the  stunning  floor  length  dress  with  the  blue   sash. Keeping  true  to  the  theme  of  The  Show,  Aminat  Omoto-­ sho,  a  Biochemical  Engineering  student,  wowed  the  audience   with  an  A rabian  Nights  theme.  This  was  followed  by  Tori  Jor-­ dan’s  fun  and  frivolous  ‘Circus’  collection  which  raised  big   cheers.   Anna   Dzieciol’s   fashion   forward   collection   of   latex   wear   drew   comparisons   with   the   Mugler   AW11   collection,   and  gasps  of  admiration.    

The starring piece of the Middleton collection, modelled by Kirsten Shastri

A tribute to the swinging 60s

Anna Dzieciol’s Latex-laden high fashion saunters through the catwalk to gasps of awe

and sexy  portrayal  of  early  1900s  black   and   red   formalwear   for   women   and   Moss  Bros  for  the  men. The  30s  and  40s  followed,  encapsu-­ lating  the  Moulin  Rouge  era  with  erot-­ ic  lingerie  and  a  twist  on  40s  fashion. Well   created   choreography   mixed   in   with   the   modelling,   which   exuded   confidence,   and   charisma.   Often,   the   decade’s  music  and  dances  were  incor-­ porated,   particularly   well   done   with   the  60s  mix  of  The  Contours. The  highlights  of  the  evening  were   the  final  walks  that  portrayed  the  90s,   00s   and   future,   moving   to   Imperial’s   own  Fabrican  spray-­on  clothing. The   compères   gave   an   entertain-­ ing   but   somewhat   controversial   per-­ formance,  but  this  was  made  up  for  by   performers   such   as   Funkology   and   a   belly  dancer,  making  a  success.  

Exotic bird inspired dress collection swans through the stage

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Beachwear and bikinis heat up springtime


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medicalstudent

GKT

Chica fashion is showed off with style

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On Tuesday   8th   March   the   most   fabulous  fashion  event  of  the  Kings   year  took  place  at  the  Hoxton  Pony,   Shoreditch. 22   gorgeous   models   strutted   through   ten   catwalks   -­a     from   for-­ mal  wear  to  f uturistic  space-­outfits,   all  that  is  hot  in  fashion  today  was   on   offer.   The   show   aimed   for   an   edgy   feel,achieving   it   with   moody   lighting   and   stunning,   dramatic   hair   and   make-­up.   The   layout   for   the   event   was   novel,   with   the   cat-­ walk  spanning  two  floors. Rokit   Vintage   opened   the   night   with   an   American   themed   collec-­ tion   complete   with   Stetsons.   Fab-­ ryan   followed   with   sophisticated   purple  and  black  evening-­wear,  and   then   lovelymonstory   whose   retro   handprinted  t-­shirts  and  coordinat-­ ed  jewelry  were  a  hit.  The  first  ses-­ sion  was  rounded  off  spectacularly   by   Fusion   Tap   form   KCL   Dance   Soc,   with   a   thoroughly   enjoyable   zombie  inspired  performance.

The second  session  kicked  off  with   Back2Eden  featuring  African   inspired   designs,   followed   by   Soul-­ja   Military’s   alternative   style.   Faye   Fraser   then   demonstrated   that   knitted   outfits   are   in   no   way   boring   with   a   funky   German   rave   scene   in-­ spired   collection.   Marmalade   had   a   contrasting   feel,   with   wearable   and   beautiful  dresses. After   a   break,   with   enough   time   for  a  fashion  show  signature  cocktail,   the   final   act   started   with   some   flo-­ ral   designs   from   Traffic   People,   and   then  a  change  of  tone  with  Cyberdog’s   neon  outfits  causing  a  stir.  Finishing   with  Chica  Boutique’s  lovely  dresses   the  show  had  something  for  everyone. The   hilarious   MedSocPresident   Hari   Haran   compèred   the   night,   and   Anna-­Karin   Faircloth   worked   tire-­ lessly  to  arrange  and  choreograph  the   catwalks.The   show   raised   money   for   Alzheimer’s   Society,   GKT   Charity,   Malaika   Kids,   MediCinema   and   St.   Christopher’s   Hospice.   Money   was   collected   from   ticket   sales,   sponsors   MPS   and   MDU   and   kind   donation   from  cloakroom  takings  by  the  venue.

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“The show aimed for an edgy feel, achieving it with moodly lighting and stunning, dramatic hair and make-up” Fabryan showcase their sexy chic pieces

Bart’s

This year   marked   the   tenth   an-­ niversary   of   Bart’s   RAG   Fashion   Show,   which   chose   to   support   lo-­ cal   children’s   charity   City   Year   Lon-­ don,   and   the   experience   gained   across   the   decade   really   showed. The   acquisition   of   Fabric,   which   has  a  reputation  of  being  one  of  the  top   clubs   in   London,   as   the   venue   for   the   evening   was   a   major   coup   for   the   or-­ ganising  committee.  This  coupled  with   designers   such   as   Jaeger,   Mark   Fast   and  All  Saints  providing  the  attire,  the   night  was  always  set  to  be  a  success. From   the   moment   you   walked   in,   you   helplessly   slipped   into   the   feel-­

Dancers pack a punch

RAG Pullout

SoulJa’s military inspired style

good atmosphere   created   by   the   de-­ lightful   duet   of   vocals   and   piano   de-­ signed  to  warm  up  the  audience.   If   that   wasn’t   enough   to   set   the   mood,   the   enthusiasm   of   the   night’s   compère   to   introduce   the   opening   dance   was   inspired,   truly   lifting   the   audience.   The   choreography   of   the   evening   was   spectacular   and   real   credit   must   go   to   the   performers.   They   held   such   precision   in   their   execution   of   every   dance   sequence   whilst   still   maintain-­ ing   explosive,   charismatic   movement   to   an   array   of   dubstep   remixes   inter-­ laced  with  chart  titles. The  first  two  walks  had  a  fast  tem-­ po  scene  created  by  the  dancers,  with   models   that   oozed   charisma   and   con-­

fidence. A   starry   lighting   backdrop   behind   the   contemporary   formalwear   exhibited   by   the   models   gave   a   sense   of  Hollywood  glamour. Things  were  brought  back  down  to  a   slow,  sensual  setting  for  the  third  walk.   A   mellow   soundtrack   perfectly   ac-­ companied  the  relaxed  swagger  of  the   models,   giving   the   audience   a   chance   to  catch  their  breath  for  the  highlight  of   the  evening:  the  fourth  walk. Every  year  the  Bart’s  Fashion  Show   attempts   to   add   something   original   and   spectacular,   and   they   more   than   achieved  this  with  an  extravaganza  of   modelling-­dancing   combination   por-­ traying  clothing  from  various  cultures   around  the  world.  

The lingiere collection raises the roof

A daringly steamy mood is weaved in the intimates walk

Editor-in-Chief John Hardie Assistant Editor Amrutha Sridhar Sub Editor Lucia Bianchi Writers Helen Smith, Rebeccah Odedun, Philippe Harbord Photographers Chetan Khatri, Helen Smith, Neha Bhargava, George Lampardariou Image Editors Chetan Khatri, Purvi Patel

KCL get bold with hair and make-up

MS_April_2011  

The Medical Student newspaper April 2011

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