The Jugular Issue 1

THEJUGULAR

THE FOLLOWING IS INTENDED TO ENCOURAGE REFLECTION ON HEALTH & THE DISCIPLINES, CONCEPTS, AND LIVES CONNECTED TO THE FIELD CONTENT

The Jugular is part of the Queen’s University community and is situated on the territory of the Haudenosaunee and Anishinaabek. We are grateful for their stewardship of this land where we live, learn, and create. As uninvited guests upon these traditional territories, we acknowledge its longer history, predating the establishment of the earliest colonies. We strive to work towards reconciliation by recognizing and highlighting the practices and spiritualities tied to this land while developing a relationship with the territory and its other inhabitants through our culturally sensitive activity and publications.

CONTENT WARNINGS

“Lets Sit for Awhile”

Disclaimer: Sensitive Content

This piece contains discussions about suicide, a topic that can be distressing and triggering for some individuals. Our intention is to provide support, awareness, and resources for those who may be affected. However, it’s important to approach this content with caution.

If you or someone you know is struggling with suicidal thoughts, please seek help immediately. Reach out to a mental health professional, contact an appropriate helpline, or inform someone you trust. Remember that there is help, and you don’t have to face these challenges alone.

Emergency Helpline Numbers:

Telephone Aid Line Kingston (TALK) is a confidential, anonymous, non-judgmental, and volunteer-based listening service. They aim to meet the needs of the KFL&A community.

Phone number: (613) 544-1771

AMHS-KFLA crisis programs provide urgent and immediate response to individuals experiencing emotional or mental distress. Crisis Line Crisis services are free, confidential and delivered in a respectful, non-judgmental manner by a team of mental health and addiction specialists.

Phone number: 613-544-4229

In case of extreme emergencies, Kingston General Hospital is available as a 24/7 emergency department. Call 911 in case of life-threatening emergencies.

Student Wellness Services (SWS) - supports the personal, academic, and social health development of students at Queen’s University by providing a range of programs and services. They offer a welcoming, confidential, and integrated service that is responsive to your health and wellness needs.

Phone number: (613) 533-2506

Disclaimer: The information provided in this post is not a substitute for professional advice. It’s essential to consult with qualified mental health professionals for personalized guidance.

EDITOR’S NOTE

Our team and our authors are students of health, however, rarely are we presented with the opportunity to express and explore concepts of health and human biology in a creative, reflective manner. The goal of The Jugular, and the reason why I founded it, has always been to encourage and provide space for creative engagement with health, and the disciplines, concepts, and lives it intertwines with. Creative reflection deepens our understanding of health, of those impacted by illness, and of ourselves as students of health, as future health professionals or researchers or advocates. The Jugular also aims to bridge the pragmatic way of thinking about health sciences, the creative aspects of expression, and the generation of original thought through reflection, providing an outlet for students while contributing unique and diverse perspectives to Queen’s University’s arts and literary community.

I am honoured to present the inaugural issue of The Jugular. Within these pages, you will encounter a curated collection of creative works and insightful reflections, all centered around health. The pieces in our very first issue include empathetic deliberations on terminal illness, a little bit of health history, and symbolic imagery connected to healing. The creative works featured are not confined to a specific medium or format. We believe in the boundless expression of ideas, as long as they resonate thematically with health sciences. This flexibility allows us to showcase the distinct perspectives of health sciences students—promoting well-being and a deeper interaction with the concepts we encounter through courses, through various activities and experiences, and within our own lives.

Thank you to our fantastic team of editors, designers, artists, and writers. Thank you to those who shared with us their work. Thank you Fatin, Iliana, and Jamie for all of your work behind the scenes and the brilliant ideas you brought to the table. Thank you HanShu for your dedication and Hailey for your incredible vision – this first issue would have been impossible without the countless hours you put in.

Readers, I invite you to connect with this rich tapestry of thought engaging with health, through poetry, visual pieces, and reflections, and hope you enjoy reading this as much as we enjoyed putting it together. Welcome to The Jugular: Issue I.

Sincerely,

Urooj Salar

Editor-in-Chief 2022-2024

JUGULAR THE

“HEALTH SCIENCES ART & LITERATURE”

EDITOR-IN-CHIEF Urooj Salar

EDITORIAL HEAD HanShu Pu

EDITORS Ava Bedard, Shreyas Konda, Meghan Ross, Sina Sayyad, Seayrohn Shelvachandren, Kori Spott, Sara Tindale, Aastha Vaidhya

COPY EDITORS Matthew Kong, Ava Vendittelli

STAFF WRITERS Delphine Ang, Sarah Husain, Joelle Masia Mandala

EDII-A ADVISOR Eshal Ali

DESIGN HEAD Hailey Walford

LAYOUT DESIGNERS Joao Vitor Bahia Cardoso, Prasun Kar, Amy Tang, Niki Zadafshar

STAFF ARTISTS Jashmira Bhinder

EVENTS HEAD Jamie Tan

COORDINATORS Erin Friendly, Maxwell He, Ellen Lee, Gloria Li, Harini Satheeskumar

SOCIAL MEDIA HEAD Iliana Crnogorac

COORDINATORS Sophie Aspinal, Lauren Cooney

WEBSITE HEAD Fatin Mustafa

COORDINATOR Jiesi Zhang

How do you explain the loss of a mother when she is standing right in front of me?

We go hurtling one by one, a race through the vessel, two cells in a row.

Always following close behind, eager to catch up to her.

It takes a great deal of luck to survive a brain stroke.

It takes a miracle to survive two.

But no amount of miracles are sufficient, when all I want is to turn back time.

The vessel is getting narrower now.

My mother is a formidable woman quick to climb the ranks as a gynecologist, an arduous task in a country that is slow to value its women.

Still she moved forward, the leading cell and I the follower who knew nothing more than to trail closely behind. We were two cells in tow, until we hit the block head on.

My mother was a changed woman. formidable still, she is the

SARAH HUSAIN

the leading blood cell, the life source that carries our family forward. Yet the bloodstream slowed And the inevitable came My mother changed And life changed And we hit a clot Seldom do we stop to really consider the loss of a life, when the living never left.

My mother was a changed woman. We would be playing a fool’s game if we did not stop to acknowledge it as such. A life abandoned, a cell knocked out of a stream that kept trickling past her. And I cannot help but mourn the life she should be living now. A life where she continued practicing, a cell free to circulate and deliver the gift of life and love, of breath and blood.

HELPLINES IN CANADA

DELPHINE ANG

Helplines provide a valuable and accessible service to the public in terms of crisis intervention and emotional support. Depending on the intensity level and nature of the helpline, they are staffed by a variable combination of paraprofessionals and volunteers, including students.

This is one of the first classifications in Canada on the moving parts that make up this essential resource, as told by a crisis line worker at a social service organization in various programs, including the 998-suicide crisis line.

Modality

The text and web chat functions increase the accessibility of helpline services to younger users and underserved groups for anonymity, privacy, and safety.1 Responders experience similar protection and can typically handle multiple interactions simultaneously, reducing user waiting time and increasing service efficiency. Additionally, video chats are a possible future modality, but they raise concerns about user/responder anonymity and misuse potential.

Emergency intervention

Helplines operate on the principles of lowest-level intervention and collaboration. However, non-consensual emergency intervention in imminent situations remains the industry standard. An effective responder must balance two opposing principles.

An imminent situation is defined by immediate risk of harm to the user or others, judged on a case-by-case basis. There is a legal and ethical duty to address an actual risk of harm and a need to limit organizational liability.

Emergency intervention can be viewed as the last resort when a responder cannot de-escalate a high-risk user -- an upward redirection. Users are often redirected downwards to lower-intensity lines focusing on ongoing emotional support and socialization.

Community first responders may also refer frequent 911 callers to crisis lines and telephone reassurance programs to reduce inappropriate usage of emergency services and fulfil the need for socialization and support.

Technology vs Privacy

Technology intensity (using IP phone systems) increases with the service scale. Community-level helplines typically use landlines without caller ID. While this protects the anonymity of users and encourages hesitant users to call, it prevents the identification of users at imminent risk and restriction of inappropriate users, and creates difficulty in handling multiple calls.

At larger crisis organizations, IP phone systems allow multiple responders to handle multi-modal interactions and simultaneously coordinate with colleagues, all while working remotely. IP phone systems can identify incoming callers and block inappropriate users. Geolocation of callers is possible for emergency intervention purposes, depending on local police capabilities, especially when high-risk callers are unwilling to give their location.

This comes at the expense of user anonymity. A user’s phone number, location, and personal details can be obtained without explicit consent and will be logged into a centralized database accessible to many workers.

Conclusion

Within limits, help lines can ‘fill-in’ as a healthcare service for frequent callers when other supports are unavailable or as low-intensity support for users with modest needs. However, 2.6% of users comprise 70% of total call volume2, creating a significant workload in a constrained triage system. Crisis calls are intended as brief and one-off support for each situation. Frequent callers often present with complex needs that cannot be fully resolved by brief support and may be redirected to more appropriate, intensive support, such as an in-person caseworker or a therapist.

Helplines provide valuable and accessible support to a broad audience. The specialization of helplines enables users to access situation-specific support from trained paraprofessionals. While suicide crisis lines have existed in Canada previously, the 988 program aims to simplify access by using a memorable 3-digit number modelled on the US 988 program. The Canadian 988 program utilizes numerous local partners to implement the service in multiple modalities to serve the projected high volume of clients. These measures improve the reach of the 988 program to underserved groups.

CRISIS LEVEL TYPE SCALE

Emergency services (e.g. 911)

Suicide crisis lines (e.g. 998)

Crisis Lines (e.g. CMHA Crisis Lines)

Distress (e.g. Telecare Distress Lines)

National number that connects to local dispatchers

Regional or national programs with local program partners Regional Local

Warmlines (e.g. Friendly Voice, Peer Support)

Local or regional

Resource navigation (e.g. 211 Connex Ontario, 811 Poison Control Centre)

Reporting hotlines (e.g. non-emergency police, Ontario Animal Protection Call Centre)

Provincial and nationally funded programs with local partners

Varies by region

1. Pisani AR, Gould MS, Gallo C, et al. Individuals who text crisis text line: Key characteristics and opportunities for suicide prevention. Suicide Life Threat Behav. 2022;52(3):567-582. doi:10.1111/sltb.12872

2. Spittal MJ, Fedyszyn I, Middleton A, et al. Frequent callers to crisis helplines: who are they and why do they call?. Aust N Z J Psychiatry. 2015;49(1):54-64. doi:10.1177/0004867414541154

3. Hoffberg AS, Stearns-Yoder KA, Brenner LA. The Effectiveness of Crisis Line Services: A Systematic Review. Front Public Health. 2020;7:399. Published 2020 Jan 17. doi:10.3389/fpubh.2019.00399

TECHNOLOGY PROFESIONALIZATION

Professionalized

FUNCTIONS

IP phone systems, caller ID, monitoring, geolocation. Emergency service intervention.

Staff and volunteers with increased professionalization at larger scales.

IP phone systems, caller ID, monitoring.

24/7; crisis support and 911 intervention.

Staff and volunteers

Largely volunteer based

Technology varies according to scale.

Landlines and cell phones with blocked ID.

Varies with scale; focuses on crisis and emotional support, 911 intervention, resource navigation.

Professionalized

Increasing levels of technology with scale.

Fixed hours; focus depends on the crisis intensity of the helpline.

Fixed hours; socialization.

24/7 service; resource navigation and crisis support.

Technology varies according to scale.

24/7 service; Non-emergency and mandatory reporting

DISCLAIMER: SENSITIVE CONTENT

Today I want to kill myself. But unlike usual, the thought doesn’t come crashing into the room. Unlike usual, it doesn’t leave me gasping for air, thrashing, holding on for dear life. Today the thought visits me with a simple knock at the door And I let it in like an old friend. We sit together for a while.

“The sun was really bright today, perfect for an afternoon stroll. I walked home and I felt thrilled to be alive,” I tell the thought.

ILLUSTRATION: “REFLECTIVE GAZE” JASHMIRA BHINDER

TOGETHER HILE LET’S sit

It sits in quiet contemplation, an easy silence fills the room. Through the window, the sun shines down on us. I get up to close the blinds, And I want to kill myself.

Gently, the thought reaches out to hold my face Turns it upwards and places a soft kiss on my forehead. Today I wanted to kill myself, But the thought simply got up, put on its coat and headed towards the door.

I walked with it and waved goodbye as it left, and felt a twinge of sadness watching it go.

SARAH HUSAIN

ARSHDEEP RAUL

GARDEN OF HOPE FLYING PAPER CRA

These acrylic-on-canvas paintings are stories of resilience and a testament to the human spirit.

Folding paper cranes is a Japanese tradition undertaken by communities to transform their wishes into reality. The artist learned of the tradition through the story of Sadako Sasaki, a young survivor of the atomic bombings in Hiroshima and Nagasaki. Faced with an uncertain future, Sadako and her classmates began folding a thousand paper cranes, a symbol of hope and determination. Her story resonated deeply to the artist, representing hope in the face of harsh reality.

“Flying Paper Cranes” mirrors the hope witnessed in patients. Much like the flight of paper cranes, healing unfolds at its own pace, where the artist’s observed experience saw the solace of the outdoors become a means of alleviating stress and anxiety, nurturing patients’ physical well-being. The artist hopes to convey the resilience of the human heart, the power of nature, and the belief that even the seemingly impossible paper cranes can take flight.

“Garden of Hope” invites the viewer to reflect on the power of the human spirit and the imperative of stewardship for our planet’s future through a visual journey from darkness to light. The painting is a reminder of the inherent strength of hope, as well as emphasizing the imperativeness of the natural world.

to the girl in the hospital bed...

AVA VENDITTELLI

ILLUSTRATED BY: NIKI ZADAFSHAR

i remember the first time i met her before the too bright fluorescent lights and the smell of antiseptic before the needles the scans the tests the phone calls that end with her mother sobbing alone in her bedroom so no one sees her break down so she can be strong even when her daughter’s hair is falling out and she can’t walk anymore

come with me honey –whisper in my ear

tell me all the things you’ve never said i’ll hold them tight to my soul you can trust me you don’t need to tell me you’re getting used to the sting the smell of the antiseptic i’m not your mother –you don’t have to lie

listen honey –come here and hold my hand we’ll collect the tears from your cheeks we’ll use them to water the flowers on the windowsill see? they’re living so are you the antiseptic smell is strong but so are you

please honey –shut your eyes tight and pray with me because sometimes there’s nothing else we can do

The Evolution and History of Medical Art and Drawings

ARMITA DABIRZADEH

Medical illustrations have illuminated the human body’s mysteries, guiding the evolution of healthcare from ancient remedies to modern medicine. Medical art, encompassing intricate illustrations and drawings depicting human anatomy and medical conditions, has been essential to medical education and communication for centuries.

Ancient Beginnings

In Egypt, papyri, such as Ebers Papyrus, dating back to around 1550 BCE represent some of the first medical illustrations. This document was one of the most comprehensive medical texts on ancient Egypt1. Rather than offering precise anatomical detail, these early drawings were rich with symbolic imagery that reflected the Egyptians’ blend of empirical medical practices with magical and religious beliefs. The magical aspects of these illustrations were not merely artistic expressions but integral to the healing process, as they believed that healing required the intercession of divine forces. Consequently, the medical drawings of this era often featured symbols and deities believed to protect or heal the patient, thus embodying a com-

plex understanding of health that intertwined the physical with the spiritual realm2. This approach significantly influenced the content and style of the drawings, making them not just medical records but also artifacts of spiritual and magical practices.

The Greeks, especially in the works of Hippocrates (460370 BCE), began to shift towards a more empirical understanding of medicine, emphasizing observation and logical reasoning to discern diseases and bodily functions3. It was not until the Hellenistic period, particularly in the work of Herophilus (335-280 BCE), that dissections and more accurate representations of the human body began to emerge, marking a significant advancement in the visualization of medical knowledge4.

Medieval Stagnation and Islamic Contributions

During the Middle Ages, particularly in Europe, the progress of medical illustration stalled. Most medical knowledge, including art, was preserved in monasteries where access was restricted, and texts were often copied from ancient sources. This practice led to the perpetuation of inaccuracies, such as misrepresenting internal organs’ placement and function, based more on speculation than empirical observations5.

In the Islamic world, scholars like Avicenna (Ibn Sina, 980-1037 AD) and Al-Zahrawi (936-1013 AD) produced works that advanced medical theory and included more detailed and practical illustrations6. Al-Zahrawi’s surgical texts depicted instruments as practical procedure guides. While still somewhat stylized, their illustrations represented a leap toward accuracy and utility in medical documentation.

Beyond the Islamic contributions, In China, the “Yellow Emperor’s Classic of Medicine” (Huangdi Neijing), compiled around the 1st century BCE, had influenced traditional Chinese medicine with its theoretical concepts illustrated through diagrams representing the meridian system, albeit more abstractly8. Similarly, Indian medical texts like the “Sushruta Samhita,” dating back to 600 BCE, detailed surgical procedures and instruments, complementing descriptions with illustrations that, while not pre-

cise by modern standards, contributed to a more global understanding of the human body and its ailments9. These examples underscore how medical illustration evolved across different cultures, each contributing uniquely to the medical knowledge and practice pool.

Renaissance: A Turning Point

With the revival of interest in classical antiquity and humanism, which fostered a culture of inquiry and respect for the empirical observation of the natural world, artists and anatomists began collaborating10. This partnership led to a dramatic improvement in the accuracy and quality of medical illustrations. Andreas Vesalius (1514-1564), a Belgian anatomist and physician, published “De Humani Corporis Fabrica” in 1543, featuring detailed and precise anatomical drawings based on direct observations from dissections11. His work not only transformed medical illustration but also challenged many of Galen’s long-held anatomical inaccuracies, such as the structure of the human heart and the blood system, based on animal dissection rather than human anatomy, setting a new standard for medical education11. This shift was met with both enthusiasm for advancing knowledge and resistance from those wedded to traditional teachings, ultimately leading to a profound transformation in medical education and practice.

The Age of Enlightenment and Beyond

The Age of Enlightenment saw further advancements in scientific inquiry and a more widespread dissection use, reflected in increasingly detailed and accurate medical drawings. Artists like Henry Gray (1827-1861), with his famous “Gray’s Anatomy,” continued to refine the art of depicting the human body, making these works invaluable for medical education by serving as core textbooks in medical schools, offering detailed visual references that enhanced students’ understanding of complex anatomical structures12.

The 19th and early 20th centuries saw new developments with the advent of photography and improved printing techniques, allowing for more widespread distribution and access to medical images. However, handdrawn illustrations remained vital due to their ability to highlight and clarify specific anatomical details and pathological conditions, which photographs might not capture as effectively13.

Modern Digital Era

The late 20th and early 21st centuries have witnessed a digital revolution in medical art. Computer-generated imagery (CGI) and three-dimensional modeling have provided new ways to visualize and understand complex anatomical structures and procedures14.

Digital illustrations are used not only in textbooks and scientific publications but also in patient

education, surgical planning, and virtual reality simulations, offering unprecedented detail and interactivity15.

Despite the surge in digital technologies, traditional medical art continues to be an essential component of medical education. Traditional techniques offer a unique depth and perspective that complement the precision of digital imagery, ensuring that the art of medical illustration remains relevant and valued in the digital age. The synergy between hand-drawn illustrations and digital methods enhances the learning experience, allowing for a comprehensive understanding of medical concepts16.

Impact and Future Directions

Throughout history, medical art has been more than just a visual aid; it has been a reflection of the contemporary understanding of human anatomy and physiology and a catalyst for medical breakthroughs. Today, the legacy of medical illustrations as a foundational element of medical science paves the way for integrating advanced technology like augmented reality (AR) and artificial intelligence (AI) into medical images.

The ongoing evolution of medical art enhances our ability to educate and diagnose. It serves as a testament to the enduring quest for knowledge that has characterized human progress since the dawn of medicine.

Nurturing Body and Spirit Through Ayurvedic Medicine

JASHMIRA BHINDER

Questions For a

From a Shadowing Student SUSAN ZHOU

Fighting Mama

THE JUGULAR ENCOURAGES A MOMENT OF REFLECTION ON HEALTH THROUGH ART & LITERATURE ISSUE ONE