Gubernaculum:
M is for Medicine
Contents Features: 7.
M is for ... Minister
8. M is for ... Monash 18. M is for ... Medical Experiments 22. M is for ... Meadows 24. M is for ... MSCV 25. M is for ... Morgan 28. M is for ... More Silliness
Regulars: 2. Editorial 3. President’s Report 4. Book Reviews 6. Medicine Around The World 12.
Strange Medical Conditions
13.
Photos
17. Silly Corner 21.
Horoscopes
29. Your Calendar Photos: MSS on its way to thrashing the music students in the MSS vs MSS Grudge Match
Medicine and Surgery - Lim, Loke & Thompson $125 Churchill Livingstone Elsevier This 1000-page book aims to serve a huge purpose – to be both a medical and surgical resource for the medical student and clinician. First impressions don’t get much better than this – presentation is absolutely top-notch – colour use, layout and organisation of sections in each chapter. Each chapter contains the anatomy and physiology of each organ, clinical symptoms, detailed examination of the system and investigations. Moving into pathology, it describes the epidemiology and pathology after which is discusses specific clinical features, investigations, medical management, surgical management and finally prognosis. With tables on causes, key points and recent advances in technology beautifully illustrated, it tries very hard to present as much information is as few words as possible – making sure you’re not memorising pointless extra detail.
Netter’s Illustrated Pharmacology - Robert B. Raffa, Scott M. Rawls, Elena Portyansky Beyzarov $85.00 Elsevier This latest addition to Netter’s rapidly expanding stable of medical books is a visually appealing pharmacology book with a strong clinical focus. Treat it as a visual companion to your Rang and Dale, if you will. Each chapter starts with an overview of the body system under consideration, and is followed by a section on the body organ in diseased states and then ends with the pharmalogical agents to treat these. Large diagrams show the sites of action of all the drugs discussed in this book; there are lots of nice flow charts, if you like them. As you would expect, Netter’s drawings, with his signature life-like detail and clarity is the main attraction here - they really form the substance of this book. All illustrations and diagrams are accompanied by brief explanatory text, which summarises the information you would find in standard pharmalogical books.
Editorial Molweni! (Xhosa greeting) Welcome to the third and final Gube of the year. If you’ve ever wanted to write an acrostic poem about medicine but were stuck on the first letter, we have the magazine for you! Or more plausibly (for medical students anyway), if you’re looking for an excuse to procrastinate during swot vac, or if you’re bored as hell post exams, this Gube is your ticket to happiness! In this issue, we experience first-hand what it’s like to be a medical student in zone 2 among our Monash cousins by infiltrating their lectures one morning. We also experience through Ahmed Ali, our foreign correspondent, what it’s like to study medicine in Sudan. In addition to all that, this issue of the Gube is jam-packed with interviews of highly successful doctors, including Dr Brendan Nelson, Professor Trefor Morgan and the newly appointed Clinical Dean of the Austin, Professor Richard O’Brien. We take a peek into their lives and find out how each of them have ended up where they are now. Last but not least, we explore the creativity of the medical mind, as we take a look at some of the more unusual products of medical research. Enjoy, and see you next year! Anny Huang and George Thomas UMMSS Publications Officers
Thank you!
Ahmed Ali Jonathan Galtieri Rahul Khanna Matthew Ng Rasha Rahman
We would like to thank the following people for their contributions to the October Gube ...
Publications Subcommittee: Michelle Baek Alyssa Chan Jocelyn Chan (Photo editor_ Lucy Cochrane-Davis John Guinane Daniel Hamill Sarah Heynemann Vivien Li Grant Ross Kevin Tan Raymond Wen Jessica Wong Amir Zayegh Betty Zhang (Photo editor)
Publishers:
Elsevier (special thanks to Effie Papas) Cambridge University Press (special thanks to Louise Engstrom) Lippincott Williams & Wilkins (special thanks to John Kelly) Oxford University Press (special thanks to Jess Howard)
Sponsors:
MDA National (special thanks to Lucy Mara) MIPS (special thanks to Maryanne Balanzategui and Michelle Ward)
Printer:
BigPrint (special thanks to Gregory Dedman)
Other contributors:
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“Stress permeates all aspects of this mechanism.” - Jeremy Kam
President’s Re port How time flies when you’re having fun. Looking back on an amazing year of highs and lows with the MSS, I really sit here humbled by the opportunities the team has had to represent and entertain you all. I just wanted to start my report by thanking everyone for their support of the MSS throughout the year, you’ve made each and every minute worthwhile. As we move closer and closer to hand-over, the proverbial eyes of the MSS are turning very much to the future. The focus is now on making sure the next committee is able to hit the ground running and achieve even more than we did this year. To this end, we have been reviewing each aspect of our tenure and to see where improvements can be made, what we would’ve liked to do differently with the benefit of hindsight. Hindsight itself is, of course, impossible to transfer in itself, but moves have been made to ensure that the MSS is constantly able to improve itself. We now have an advisory council of old MSS members who serve to advise the committee on any pertinent matters, ensuring that we get a solid transfer of knowledge, expertise and skills. This also allows us to look at the long term strategy of the MSS, particularly looking at what structure will suit us best as we go into a completely new 4-year medical course. The particular challenge will be ensuring equal opportunity and represntation of students in two separate but simultaneous medical courses. Needless to say, we are working hard on this issue to make sure that our organization lasts far past the 127 years it has already lived.
leads nicely to our disaffiliation with the student union. As of a few weeks ago, the MSS is no longer affiliated with the university’s student union. This decision was made based on the increasingly draconian regulations of their Clubs and Societies wing, regulations which included forcing us to charge membership fees. The MSS is strongly against charging anything we don’t require and, in the interests of our students, it was decided that we should strike out on our own. In lighter news however, no report could leave out the amazing success of our Grand Medical Ball. This sellout event brought 950 students together for a night of celebration and love ;) Many thanks go out not just to our talented Social Secretaries but also the many people that helped out on the night. After the record breaking success of the M&M ball, I had no doubt that this would be a miracle of a night for all. As always, please feel free to send us any feedback. Whatever we do, we do for you, so we love to hear from you. Next year I intend to send out a proper survey so we can find out how to tailor the MSS more closely to your needs and desires. Much love, Rahul Rahul Khanna President University of Melbourne Medical Students’ Society
In other news, we recently held a clinical training forum with our cousins at the Monash medical society. Attended by various stakeholders in our education, including the deans, government and training colleges, the event gave students an opportunity to raise their concerns about clinical training places. As many of you would know, the burgeoning numbers of medical students (Almost double over the next 5 years) raises significant challenges for the health system and, as the ones effected most by these changes, it is important students play an active role in how the situation is handled. It was heartening to see the broad acknowledgement of the challenges faced, but the real task now is for students to keep pushing for details and ensuring that the planning is through and considered. This was also the day we officially launched with Medical Student Council of Victoria (temporarily housed at http:// mscv.ummss.org.au but soon to move to www.mscv.org. au). The MSCV will ensure that issues such as these are addressed in a way that reflects both the interests of the public and that of the medical students of Victoria. We, as the most significant stakeholders in any issue in medical education, needed a united voice to address this issues and the MSCV provides that voice. The MSS’s affiliation with the new organisation is also part of the new constitution passed at our recent AGM, which
“It is really quite humbling, in fact extremely humbling, to find out that all you are is a repackaged worm.” - Graham Parslow
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Before We Are Born (7th Ed)
A-Z of Chest Radiology - Andrew Palmer, Mangerira C. Uthappa, Rakesh R. Misra $79.95 Cambridge University Press
Essentials of Embryology and Birth Defects
- Keith L. Moore, T.V.N. Per- saud $85.00 Saunders Elsevier
Radiology is something that isn’t covered well enough in preclinical med, considering how important reading X-rays will be in our hospital years and beyond. This book provides a comprehensive guide to Chest X-rays, and is set out in a dictionary format, listing all sorts of disorders that affect the chest. The introductory chapter first takes you through the one-two of chest X-rays, doing a good job of explaining both the tough concepts that we never got to learn properly, and the really simple things that people forget to consider, such as patient rotation and inspiratory vs expiration. The disorder section then looks at the presentation, differentials and management (albeit briefly) of each disease with an X-ray for each. Its use would be mainly as a handy reference if you come across the name of an uncommon disorder and need to know about it quickly.
Only half as thick and twice as colourful as Larsen’s Human Embryology, this book provides a concise introduction to embryology. It is organized much like Larsen’s, with chapters on human reproduction, the first few weeks and the genesis of each organ system thereafter. A limited selection of birth defects relevant to the text is highlighted in boxes. A useful feature of this book is the clinically orientated questions found at the end of each chapter (answers are provided). If you like your embryology fodder in easily-digestible, bullet-point form, with lots of diagrams to keep you awake (the ratio of pictures to text is approaching 1: 2) – then this might be what you are looking for.
The Medical Student’s Survival Guide 1: The early years - Elizabeth Cottrell $79.95 Radcliffe Oxford
The Developing Human (8th Ed) Clinically Oriented Embryology
- Keith L. Moore, T.V.N. Persaud $105.00 Saunders Elsevier With colourful step-by-step diagrams and clinically orien-ted problems, this book sure beats Larsen. The wonderful diagrams are supplemented by somewhat scary photos of what happens when it goes wrong, and there are text boxes galore explaining clinical conditions in terms of embryological development. Although this book puts me off having babies, it definitely makes the difficult concepts in embryology much more accessible. An improvement would be to have things explained in 3D, but until books with more than two dimensions are invented, Moore and Persaud is a very good bet and it has animations online.
Cecil Medicine (23rd ed) - Goldman & Ausiello $219.95 Saunders Elsevier What better way to review this book than to use it for this week’s PBL! Finding what I needed in this 3077-page volume was no trouble at all, and the information is well-organised. With its clinical focus, colour-coded text boxes, algorithms to help in decision-making and practical guidance on the usage of drugs, this book sure gives Harrison’s a run for its money. It is a handy reference book for clinical students, with a drawback being that it is far too bulky and heavy to take with you on ward rounds. Another slight drawback is that it could do with more diagrams for us more visuallyoriented ones.
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Despite the appealing nature of the title, this book is mainly targeted at British medical students just starting their preclinical course. As such, there are some limitations to its usefulness. This book takes no prisoners in its cynical and often hilarious portrayal of the types of people (from tutors to drug reps to fellow students) and the situations that med student’s will have to face. It is an entertaining and light-hearted read, despite it sounding a bit too much like a self-help book. Especially useful for college students (how to become popular without destroying your liver) and meds living alone.
Book
Essential Neuroscience - Allan Siegel, Hreday N. Sapru Lippincott Williams & Wilkins This book is only a third of the thickness of Kandel, yet it contains all of the essential information - the perfect combination for those who don’t have the time nor energy to delve into neuroscience in great and confusing detail. The language is clear and easy to understand, which proves that neurology can be explained in simple terms, and there are MCQs and clinical vignettes at the end of each chapter. However, for clinical years, this book should be supplemented with a clinically-oriented neurology text as it (like Kandel) is predominantly a neuroscience book and is therefore light on clinical cases.
“I wonder how many of you saw 4 corners last night. No, of course none of you did... you were all too busy studying. You should get out more.” - Joe Proietto
Master Pass - Rapid Revision in Endocrinology - Ben Greenstein $55.00 Lippincott Williams & Wilkins
Principles of Pharmacology Workbook - Susan E. Farrell Lippincott Williams & Wilkins
While this text lacks the extra detail needed for in-depth study, it would make a convenient study tool for some quick revision on the train or tram before exams due to its small, ‘large-pocket’ size! For students wanting to revise a particular aspect of the endocrinology gamut, different areas are clearly separated in the contents (for example ‘steroidogenesis’, ‘male reproductive endocrinology’, ‘calcitonin’), making it an easily navigable text. Each chapter begins with a set of learning objectives to ponder, some basic definitions and continues in dot-point style to outline the main points to consider. There are basic and labelled black and white diagrams which conceptually illustrate ideas throughout. Finally the highlight of the book would be the set of true/false questions (with answers at the back!) at the conclusion of each chapter, which allow the student to test their understanding.
Reviews
Although this book is the companion book to Golan et al’s Principles of Pharmacology: The Pathophysiologic Basis of Drug Therapy (reviewed last issue), it is equally useful on its own. With more than 400 case-based multiple choice questions, full explanations of all the answers and diagrams accompanying the questions, this book gives you all the preparation you need to face any question set by the pharmacology MCQ examiners. However, short answer questions are not included, which means that the book is not as comprehensive as it could be.
High-Yield Systems - Lung & High-Yield Systems - Heart - Ronald W. Dudek $29.95 each, Lippincott Williams & Wilkins The current vogue of all-in science, integrated preclinical medical curriculums has in some ways made the job of the studious medical student harder. When revising an organ system like the heart or lung we need to cover various perspectives (physiology, pathology, embryology, anatomy, pharmacology, microbiology, histology), which may necessitate several excursions to the library (or indeed the gym to develop the required musculature to lug several 10kg textbooks home!). When it comes to revising these organs, the ‘High-Yield Systems’ series saves us the trouble by providing all the basic sciences together in the one concise summary text. While each covers the basics like definitions, I imagine it would be best suited for a student who already has a grounding in the subject area, and is revisiting the material and want a quick reminder of things they might have forgotten. Coverage of clinical conditions is particularly good (for example a whole page dedicated to ECG – normal and pathological patterns), so perhaps best for a student brushing up before clinical school. There are also lots of conceptual diagrams, for example mechanisms of drug action, diagrams and tables for visual learners, such as a comprehensive table comparing obstructive versus restrictive respiratory disease. Radiology and pathology, whilst all black and white, are labelled, and while many other texts merely gloss over clinical pathologies in a few words, extra attention is given through labelled diagrams, such as for congenital heart anomalies.
Oxford Handbook of Neurology - Hadi Manji et al $100.00 Oxford University Press Not only are the Oxford Handbooks the bible of medicine for clinical students, their compact size make them ideal for carrying around when on the wards. The Oxford Handbook of Neurology is no different. Containing information from clinical neurophysiology to neurosurgery, as well as a comprehensive list of neurological disorders, this book has just about all the information that you will need when you’re seeing patients. In the appendices, there is even a section called “Clinical Pearls” containing the culmination of all the years of experience of the clinicians who contributed to the book - you certainly won’t find something like it anywhere else!
“SRY stands for sex regulation ... umm ... Y.” - Jeff Zajac
Oxford Handbook of Gastroenterology and Hepatology - Stuart Bloom and George Webster $105.00 Oxford University Press Clearly colour-coded with red for emergencies and green for approaches to common clinical problems, this book even comes with not one but two book-marks! Within its covers, it has almost all that you could possibly need when you’re on the wards, while at the same time it is pocket-sized! However, one thing is that it assumes that you know what clinical signs look like, so for your first years as a clinical student, it might be useful to supplement the book with something more photoheavy. Apart from this though, this book is gold!
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n artoum, Suda niversity of Kh Ahmed Ali, U Which year of medicine are you in? I’ve finished my sixth year, but I still have to do an internship of 16 months to be qualified. How many medical schools are there in your country? 30 How many years does it take to complete a medical degree? Most of the schools have a 6 year course, but some have medical courses that are 5 years long. Can you enter medicine straight after high school? Or do you have to complete another degree first? You enter medical school straight from high school, but in most medical schools (especially in those with a 6-year course) you have to do a year of science as part of the degree. What happens after you graduate? Are there internships? Do you specialise? How long does it all take? There is an obligatory internship for 16 months before you become a medical officer, and then you can specialise. The internship includes major rotations in medicine, surgery, obstetrics & gynaecology, paediatrics for 4 months each, and then you select 2 minor rotations of 2 months each (now orthopaedics is an obligatory minor). When do you first see patients in your medical degree? In the 4th year
How many days per week do you have class? 6 days per week What language are your classes taught in? English Do you have separate subjects (like anatomy, physiology etc), or are they all integrated into one big subject? Separate subjects What student groups are there at your medical school? Different societies with different interests (usual mixture of activities) and some for charity work What kind of social activities do students participate in? Medical missions, charities, sports, health education day Can you go on exchanges? If so, are the exchanges with IFMSA, or are they organised by the university? Yes, IFMSA exchanges (no exchanges are organized by the University). Do you live at home? Or in a dormitory? I live at home. What is the best thing about studying medicine at your university? Hmmm… difficult question! It’s the biggest and oldest school in Sudan with opportunities to participate in many activities, and it has an excellent reputation in my country.
M
is for ... Medicine Around the World Part 3
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“The quickest way to get instant strength is to jab yourself with testosterone. This isn’t a good lifestyle decision.” - Graham Parslow
M
is for ...
Minister
How does a Tasmanian GP become the Federal Minister for Defence and the MP for one of the safest liberal seats in the Australia? Jocelyn Chan tracks the medical and political career of Dr. Brendan Nelson to find out. As a politician, Dr. Brendan Nelson has filled the posts of Education and Defence Ministers. Some of the more notable initiatives instigated by Dr. Nelson involve the recent reform of higher education, including the increase in HECS fees and the introduction of VSU. However, following in the tradition of the Gube’s apolitical reporting, I shall refrain from debating politics. Prior to becoming an MP, Dr. Nelson had an impressive career in medicine. His achievements include opening Tasmania’s first after-hours GP clinic, election as the Australian Medical Association’s youngest ever Federal President and being awarded the AMA’s Gold Medal, its highest honour. After dropping out of his economics degree, Nelson briefly considered priesthood or entering the police force. Finally he chose medicine, influenced, he says, by the Jesuit teachings of living for the service of others. Ultimately, his motivations to become a politician were based on similar principles. “I realised that with only one life to be used in the service of others, it [being a politician] is a powerful way of challenging the attitudes of society and affecting them through legislation.” Asked why he first became involved with the AMA, Nelson replied that he was ‘angry at the then government’s campaign to vilify the medical profession.’
With a little research, I found a fuller account of the story: an angry Nelson rang the Tasmanian branch of the AMA after reading a story published in the Hobart Mercury. In it, a Labor MP had attacked doctors’ allegedly high incomes. He was told that if he wanted to take action he would have to join the AMA. In his maiden speech to Parliament, Nelson acknowledged the role of his experiences with his patients as well as the Hippocratic principles upon which the medical profession is based, in shaping his own principles. He explains in the interview: “Yes, you never forget the faces of the many people whose lives I have touched and who, in doing so, shaped me.” In answer to my question, Nelson replies that he still considers himself a doctor. However, I get the impression that medicine is, understandably, no longer as relevant to him as it once was. His current job, involving detailed debates about foreign policy with pushy lateline interviewers, is about as far removed from medicine as I can imagine. Although television presents a very hospital-focussed stereotype of doctors, the reality is we will have countless different opportunities open to us. And for Brendan Nelson, as it will be for some of us, being a doctor was not the beall-and-end-all but just a path to something else.
Brief CV 1958:
Born in Melbourne
1985-1995: Worked as GP in Hobart, Tasmania 1987-1991: Director, Hobart and Laun- ceston After Hours Medical Services 1990-1992: Tasmanian State President of the AMA 1991-1993: Federal Vice-President of the AMA 1993-1995: Federal President of the AMA 1996:
MP of Bradfield
2000:
Parliamentary secretary to the Minister for Defence
2001:
Minister for Education, Sci- ence and Training
2006:
Minister for Defence
“Mmm ... my lunch was good! If only I were a cow, then I could eat it twice.” - David Chung
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M is for ... Monash Infiltration - Amir Zayegh It was an early Wednesday morning, and four brave Melbourne Uni medical students had gathered at the Clayton bus terminal. The mission was to infiltrate Monash medical school, merge discreetly with the second year meds, sit in on their lectures and interview some of them on their course and life at Monash. Or that was the plan anyway. What we experienced was interesting, funny and occasionally outright weird. Following the Monash med crowd to lecture
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With the help of some old school friends who were let in on the secret nature of the visit, we joined up with the second
year med students as they were entering the lecture theatre for their second lecture. The first thing we noticed was the excessive proliferation (histology pracs sure do extend our vocabulary, if nothing else) of emergency phones and evacuation instructions, which we promptly proceeded to take photographs of. After the PA alarm system had been ‘tested’ for the second time that morning, we were starting to be convinced that there was either a history of fires in medical lectures that has been covered up by the faculty, or that the uni doesn’t trust anyone to be left alone for more than a few hours. The second thing was the vast
“When you see a fat patient, you might suspect that they have Cushing’s, but mostly they’re just fat.” - Mathis Grossmann
difference in demographic – there were many Aussies and students of other nationalities. The description of “Asian, average height, wears glasses” could actually be useful in finding someone. In Melbourne med, that description covers about 70% of the course. That day, they happened to have three lectures in a row, the first of which was at 8:00am (yes, you heard correctly. The 8 am lecture is a common occurrence in the Monash med curriculum, not just in first semester but throughout the course). And it was just our luck that by sheer coincidence, the topic of the lecture we happened to go to was male reproductive anatomy… The anatomy lecturer was not of the high calibre that we are used to at Melbourne, so the lecture was a bit vague and hard to follow, although maybe that reflects the author’s anatomy knowledge. The random humour brought in by the lecturer has to be commended though; the lecture was made more interesting by some very funny and random jokes about the lecture topic, including random facts on the mating habits of different animals (who knew that whales don’t have a scrotum? Now that’s useful knowledge), and a multiple choice question which said the following: Q) Is it cool to have a scrotum? A- Yes B- No C- Don’t know, haven’t got one D- Never gave it much thought E- Next question please The other thing that struck us was the strange silence in the theatre throughout the entire lecture. Where was the talkative and rowdy back row which has become a crucial part of our lectures at Melbourne? One answer we were given was that the college students who live across the road were usually too drunk or lazy to come to morning lectures. Someone else told us that since the Monash meds don’t get their lecture notes until the end of the week, they had to really concentrate to take down their own notes for each lecture. I for one will never again complain when we get slightly different lecture slides. The lecture was otherwise uneventful except for a small incident where a student leaned forward and poured some water down a fellow pupil’s back. We took the opportunity before their next lecture to interview some of the students about what their course involves, the best and worst aspects of Monash medicine, and their views on Melbourne uni meds (see interview section). The Monash medical curriculum is similar to ours, at least in the body system part of their course. They start with neuroscience in first year, and then cover cardio, respiratory, locomotor and endocrinology in second year. And it’s an understatement to say that the Monash medical curriculum is less science-oriented. The majority of the course is based on health practice, professional development (how to get people to respect you?) and community service. One thing they emphatically supported was the interview that is needed to get into Monash medicine. One guy said: “The lack of an interview at Melbourne means that basically anyone can get into med, no matter how bad their communication skills are. Even Osama Bin Laden could get into Melbourne med if his marks were good enough.” The students we interviewed particularly mentioned that the massive amount of time they have to
spend doing community service which is completely unrelated to med, and the reflective essays they have to write after each one (and which are worth a big chunk of their semester score) were the most annoying aspects of the course. On the other hand, their end of semester exams are so much better than ours. Instead of short answer or PBL style questions, they have only one big multiple choice exam that tests everything. Now that would make for an awesome swot vac. Then on to the second lecture, which happened to be a HP-style (no surprise there) talk on adolescent health. And it was much to our joy that the eerie silence of the previous lecture was broken, and the famous rowdy back row finally showed itself. That’s one thing we can find common ground on: the antics of the back row of HP lectures. The lecture was otherwise quite good, except for the worrying mechanisms being taught. I for one am sceptical as to whether depression gothic behaviour, and whether ‘cutting’, inappropriate clothing and excessive internet usage are actually depression indicators. Their list of drugs of abuse was much more comprehensive than the one we learn at Melbourne, and included ‘magic mushrooms’ and other more exotic mind altering drugs. The lesson from that is if you want a comprehensive education on illicit drugs, Monash is the place to be. And it was thus that our time at Monash University Medical School came to an end. Not because their classes were finished for the day, but because we had to drive all the way back in time for our lecture, which says a lot about Melbourne meds; we never skip lectures no matter how pointless they are. Despite the vast differences in our courses, and the quiet secluded nature of Monash compared to the vibrant hub that is the University of Melbourne, we left feeling much wiser and strangely connected to the people in that ‘other’ medical school. Even though we start off as the nerdy medical school versus the school with no anatomy knowledge, we’re all going to end up being pretty much the same by the end of our courses.
What do Monash meds think of us? “Majority are brainy but think Monash is dumber ... too many fat chicks.” “Geeky and nerdy.” “They study too much and are generally from the Toorak region.” “Most of them could do with a personality transplant.” “They need more patience.” “Future researchers. Porridge and oatmeal.” “Theory, research.” “I guess the cliched image of socially-stunted super-nerds pops into mind.” “They’re no different from Monash meddies, except a lot more book-smart.”
“I’m sorry that unfortunately (the lecture) was 2 weeks before your holidays, so you’ve probably forgotten. I’ve also forgotten what I discussed in that lecture.” - Trefor Morgan
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“Just admire the beauty of all those acronyms and never expect me to set a question on what those acronyms mean.” - Graham Parslow
What is the best thing about Monash med? Gube interviews the Monash students. “The interview process ensures a range of personalities.” “Nice people.” “Cool social interaction, cool parties.” “The people.”
“No BMedSci.” “It’s not Melbourne.” “The psychosocial stuff that’s not in books is taught.” “The best thing about Monash is the course. I like the fact that it’s integrated with things like health enhancement, determinants of health, communicating with patients, CAM, etc.”
“Don’t have to learn how things work. Better books than Melbourne.” “Good people in course.”
What is the worst thing about Monash med? “8am starts.” “Sociology.” “Hardly any anatomy, and reflective essays suck.” “Only school leavers, no grads.”
What WE think Top 5 things: 1. Shorter course 2. MCQ exams only!
“Easy. One word: Clayton. We are way out in the sticks - it takes so long to get to the city, or anywhere. There is little worth seeing or doing in the Clayton area.” “Nothing.” “Death by Powerpoint.” “The wind.”
3. Free accommodation at rural clinical schools
“We have to volunteer compulsorily.”
4. Comfy new lecture theatres
“Sociology is crap. We’re not supposed to do anything but tick boxes.”
5. Easier course content
“It’s too far away.”
Bottom 5 things: 1. Being in zone 2 and without train or tram services 2. No common room 3. No Lygon Street 4. 8am starts and longer contact hours. Imagine how early you’d have to get up if you lived in the Western suburbs! 5. More HP
“At undergraduate level, you don’t really need to ... why am I killing time? Let’s move on.” - Tony Hughes
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Strange Medi cal Conditions
- Lucy Cochrane-Davis
Which are better? Cats, or dogs? It’s an old argument, and one that’s unlikely to ever end. Dogs are certainly more useful for things like herding sheep, pulling sleds and guiding blind people (although cats are pretty practical if you have a mouse problem!) But which make better companions? I’ve decided to look at the problem from a medical viewpoint. First: cats. Those warm, cuddly, big-eyed things that curl up in your lap and purr. Those reservoirs of toxoplasmosis.... Toxoplasmosis is caused by Toxoplasma gondii, a protozoan related to malaria, normally found in cats and mice. The mice become infected by accidentally eating smears of infected cat droppings that contain dormant protozoans. Once inside the mouse, the protozoans breed rapidly before entering another dormant stage in the mouse’s muscles, liver, and particularly brain. There, they wait for the mouse to be eaten by a cat... But they don’t just wait passively. Somehow - nobody knows how - the protozoans in the brain manage to switch off the mouse’s fear of cats. A toxoplasmainfected mouse will behave perfectly normally in almost every aspect of its life - except that when it smells cat, it won’t run away. So these clever little bugs tend to get back into cats quite fast. Humans appear in the life-cycle in one of two ways. The parasites will invade a sheep or a pig as happily as a mouse, and if that sheep or pig is then eaten by humans who don’t cook it properly, the humans will do as a cat substitute. But more often, humans catch toxoplasmosis by accidentally eating faeces from a recently infected cat (by gardening or cleaning out the litterbox without washing their hands, or if dormant parasites get spread to furniture or the cat’s fur.) In normal, healthy humans, the toxoplasma parasite isn’t very dangerous. It may cause a few weeks’ nondescript flu-like illness with fever and aching muscles. It may cause a few weeks’ tiredness and enlarged lymph nodes. It may have no effect at all. The immune system soon destroys all parasites circulating in the bloodstream. Only those that make it into the brain or muscle survive. And then they sit there quietly, causing no obvious problems, for the rest of the patient’s life. Toxoplasmosis is dangerous mainly to immunosuppressed people (i.e. AIDS sufferers) and to unborn babies infected before their mothers can develop an antibody defence. Without a proper immune reaction, toxoplasmosis can be fatal. The usual effects are severe eye inflammation and multiple necrotic abcesses of the brain; pneumonia and pericarditis can also occur. Fetal toxoplasmosis can lead to stillbirth. Milder cases can create congenital blindness, mental retardation or epilepsy. It’s also common for infected fetuses to appear normal at birth, but to develop retinal abcesses later in life.
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Traditionally, only these severe forms of toxoplasmosis are considered a public health problem. But lately, scientists have been researching the long-term effects of uncomplicated toxoplasmosis. After all, patients with toxoplasmosis remain infected for the rest of their lives, and a lot of the “dormant” parasites inhabit the brain. And we know that dormant parasites have evolved to affect mouse brains, causing mice to lose their fear of cats. So the obvious question is: Does chronic toxoplasmosis have any effect on human behaviour? Only one or two studies have been done, but they show some rather interesting results. A study done in Prague on university students suggests that chronic toxoplasmosis sufferers have slower reflexes and are at three times the risk of car crashes. There also seems to be some correlation of chronic toxoplasmosis with personality traits: affected men may be scruffier and more aggressive, whereas affected women may be more extroverted. It has even been suggested that differences between countries in rates of infection - varying from 90% in Brazil and the Netherlands to 5% in North Korea - have something to do with variations in behaviour between cultures. From this, of course, we get headlines along the lines of “Are cat parasites messing with our minds?” And the answer is... well, possibly. The “slowed reflexes” result is statistically significant, (although only one study has been done) and it’s difficult to imagine why slower reflexes would cause toxoplasmosis, or why some third confounding factor would cause both. On the other hand, the “personality traits” study was quite vague, with a lot of overlap. And it’s entirely possible that aggressive men and extroverted women are more likely to catch toxoplasmosis (perhaps they eat more rare meat, or keep more cats and wash their hands less.) It’s a fascinating set of results, but there isn’t much evidence that it means anything. It certainly seems to be worth doing more research on chronic toxoplasmosis: and given that the parasites are impossible to eradicate once they encyst in the brain, scientists are working to develop vaccines (for cats and humans.) But it’s hardly worth panicking over. A disease that affects nine out of every ten Dutch, without doing any apparent harm to the Dutch economy, standard of living or even their car accident rate, can’t be very dangerous. Are the cats themselves parasites? A cat is about the size of a newborn human, and quite similar in voice and facial features (explaining the urge a lot of humans feel to cuddle them.) Have cats developed into the human equivalent of cuckoos, siphoning off resources that would otherwise go to the humans’ children? Should we call it a symbiotic relationship? Is it worth feeding the cat just for the pleasure of its company? Or should we get dogs instead? Perhaps not. Dog diseases will be discussed in the next issue.
“The important equation is to understand the equations.” - Trefor Morgan
Med Ball
Med Ball
M&M Ball
Serengeti Sunset
Bar Night
Facing the music: Fun ways to orchestrate your own death. Imagine you have an inoperable brain tumour, or you’re in your eighties and you can’t move, speak, hear, see or go to the toilet… Or maybe you’ve decided that your natural life span is up and you’re looking to have a peaceful, inevitable death. Why not have one final bit of fun while you’re at it? At somebody else’s expense of course! I mean, seriously, what’s the worst that could happen? Some things you could do before you take that final pill or have that final heart attack: when you know you’re on the way out, simply take up one of these plans and be done with it. Cram your body into position and expire away ... just imagine the looks on others’ faces. You may as well die smiling, the non-sexual way. - Crawl into the frozen section at Coles and die. Put yourself on sale if possible - Break into somebody’s house and crawl into bed with them. It’ll be quite a scream when they wake up and
don’t recognise the dead person in their bed. - Mail yourself to somebody; perhaps the Yarra River authority for some good irony. - Die behind the soft toys in Kmart. Surprise kiddies! - Cram yourself into a vending machine. Time yourself to come out with any packet of sour cream and chives crisps for $2.30. - Cram your body into the slide at McDonald’s until you expire. For a touch of macabre, shove some fries into your mouth. - Into a popcorn machine - Dress up as Santa and crawl into somebody’s chimney. - They’ll have to clean the flue sooner or later. - Have a group theme with other older people- set yourself up as the nativity outside the local church. Even better if you do it in March. - Feed yourself into a sausage mincer. - Strap yourself to the outside of a Boeing 747. with any luck, you ought to fall off mid-flight and hit some bloke in honkers.
- Grant Ross
Silly Corner NumberCrunch Number of old ladies in Brunswick who kill and eat cats: 3,454 The percentage of those old ladies who also eat dogs: 45% Average number of beers needed for the 18-60 year old Australian male to urinate publicly: 7.4 Average number of beers needed for the 75and-up year old woman to urinate publicly: 0-1
el - Finally graduated!
The Melbourne Mod
Proportion of Tram Inspectors who can spell their own name: 32%. Proportion who served in a foreign army: 67% Average age of motherhood in South Yarra:42; in Colac: 12.5 Proportion of Law students with a romantic partner: 71.5%; proportion of Computer Science students who correctly identified a female: 12%
hool?
Answer: Grattan street entrance foyer of the medical building
Where in med sc
Years of study to become a dentist: 5; years needed to recover: 7
“How do I know it? I don’t know it - I got it out of a textbook.” - Jeff Zajac
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Wistar lab rat
Dr Jekyll and Mr Hyde
Drunken worms
M is for ... Medical Experiments The important, unethical and downright bizarre - Michelle Baek and Alyssa Chan “He is not easy to describe. There is something wrong with his appearance; something displeasing, something downright detestable...” – describing the drugged-up Doctor in Strange case of Dr Jekyll and Mr Hyde, by Robert Louis Stevenson The same thing might be said of the brains of some crazy medical scientists. It seems human beings cannot restrain themselves from conducting experiments on the most strange and random things. Granted, there abounds valid and sane research on things that change the face of medicine; however, the history books (not to mention current medical journals) give us a disturbing and sometimes baffling account of medical experimentation. We look at the top 5…
Important (and not so impotent important) work In the early 1990s, scientists in Kent, England, were exploring the potential benefits of the drug sildenafil as an anti-hypertensive and treatment for angina. It acts via the parasympathetic nervous system and has vasodilating properties. The results of clinical trials were disappointing, but to their, er, pleasant surprise, it appeared to have useful side effects as an anti-impotence agent. The drug was patented in 1996, approved by 1998, and so Viagra was born. But the infamous love drug is just the more recent of studies and experiments that have changed the world’s health. Going back through the hallowed halls of Nobel Prize winners, we happen upon the formulation of serum therapy. The 1890s saw Behring experimenting with diphtheria and tetanus concoctions, injecting hapless rats, rabbits and guinea pigs with
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attenuated viruses. In just a few years he and his colleagues went from a short-term to long-term inoculation, the work for which was largely conducted under a railroad circle in Berlin. Boring? Unromantic? Perhaps, but despite modern images of impeccable operating theatres and endless sermons on the virtues of hand-washing, medicine is a pretty dirty kind of science. In the 1860s Joseph Lister saw the potential of a sewage-deodorising chemical called carbolic acid, and decided to test it out by spraying it on surgical instruments, dressings and open wounds. Happily, this reduced the amount of infection and gangrene. Some call him the father of antisepsis. Some of you just appreciate him via the painful-but-oh-sominty feeling of Listerine mouthwash. In more recent times, U.S. neuroscience researchers have found that doctors can deactivate the part of their brain that lets them appreciate patient pain. MRI scans on physicians’ brains show activation of an emotion-controlling centre that helps them to ignore the suffering they see (or sometimes inflict). It’s good to know how human we will turn out to be. If you can’t turn off that particular empathy centre, don’t worry, turn to alcohol. Or, at least, indulge some perverse dreams by soaking worms in it. In 2004, a group at UCLA, including Melbourne researcher Andrew Davies, looked at the genetics underlying alcohol tolerance. First they treated roundworms with a mutagen to create random mutations, dropped them in alcohol and took videos (apparently it takes about ten minutes to get them really roaring drunk). An important implication for humans is that there exists a mutation in the potassium channel that lets some worms keep wriggling and partying on, while others are basically flattened. Check out the videos of drunken worms at http://www.abc.net.au/rn/talks/8.30/hel-
“Someone will come in and say something like: ‘Doc, you’ve gotta help me, my toddler, he’s eating paper all the time, my other children can’t do their homework because it just gets eaten. He’s eating through the phone book... he’s up to L!’” - Paul Monagle
B-19
Aedes egypti mosquito, the vector for yellow fever Fesmire’s hand and the technique
thrpt/stories/s1114440.htm.
Bizarre but … Country music increases suicide rates among at-risk groups. The effect is “independent of divorce, southernness, poverty, and gun availability”. The music is said to cause a suicidal mood. Stay away from those Dixie Chicks, kids. Yellow. In the early nineteenth century, a medical student by the distinguished name of Stubbins Ffirth, became convinced that yellow fever was not contagious, but rather caused by overstimulation from heat, food and noise. He was so convinced of his theory, that he essentially immersed himself in all forms of vomit – he obtained “fresh black vomit” from a patient, and proceeded to pour it on cuts on his arms, drop it into his eyes, fry it up and breathe in the fumes, and even drink full glasses of it. He didn’t get sick, but only because the virus requires direct entry to the bloodstream, usually via a mosquito. Very dedicated but very wrong. Hiccoughs, a pain in the butt. Hiccoughs are caused by deviant messages down the vagus nerve. Francis Fesmire (an American, of course) attempted to stop these messages, and found that by stimulating the vagus by digital rectal massage, he could cure hiccoughs. A little bit of clinical, er, fun occurred in Israel recently, where doctors used the technique (twice) to cure the hiccoughs on a sixty-year old man, ultimately recommending it as preferable to drugs. (Fesmire won an Ig Nobel Prize in 2006 for his work, originally published in 1988. You can read the winners of this prestigious award at http://www.improb.com/ig/ig-pastwinners.html)
Gay to straight? In 1970, a guy called Robert Heath thought up a novel idea: could repeated stimulation of the ‘feel-good’ septal region in the brain turn a homosexual man into a heterosexual? He was, for some reason, inspired to go on and try it. His homosexual subject, aka ‘B-19’, had electrodes attached to his septal region, and after controlled amounts of stimulation was allowed to self-stimulate himself. B-19 liked the ‘pleasure button’ so much that he once pressed it 1500 times in a 3 hr session. Heath felt he had achieved something when B-19 eventually had a successful sexual encounter with a female prostitute brought into the lab. However, B-19’s later life reportedly reverted to that of homosexual prostitution, though he did apparently have an affair with a married woman. Call it partial success if you like (Heath did, the optimistic guy). It can bite but it can’t run. Some people were just too imaginative in the late 1920s, like Soviet physician Sergei Brukhonenko, who satisfied the curiosities of many scientists who wondered if it was possible to keep a head of an animal alive apart from its body. Brukhonenko made a heart-lung machine called an ‘autojector’ with which he managed to keep the severed head of a dog alive. And when he said alive, he meant alive: banging a hammer on the table caused the head to flinch, light shining in the eyes caused them to blink, and the head even ate a piece of cheese (needless to say, it got no further than the oesophagus before popping out again). Source: http://www.museumofhoaxes.com/hoax/ Top/experiments/
Time for HP to die, literally. Freezing Experiments. Probably the most horrific instance of unethical experimentation in the 20th century were the
“The tubule finds its way back like a homing salmon to the renal corpuscle.” - Colin Anderson
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Nazi experiments in concentration camps in World War II. There were many monstrosities performed on Jews and other prisoners in the name of medicine, including the freezing experiments. The purpose of the study was to learn how to treat hypothermia. Studies included putting subjects into tanks of icy water for up to 3 hours, or putting them naked outside in sub-zero temperatures. The icy tank was found to be most effective at lowering temperature. Apart from causing them a painful death, the doctors made sure to experiment with resuscitating their prisoners. However, these methods were just as cruel: placing the victims under sun lamps that burned their skin, or forceful irrigation of hot water into the stomach, bladder and intestine. The best method was eventually found to be a warm bath, though there was another method, suggested by Heinrich Himmler, that also had some success: to warm the subjects up with body heat by having them sleep with women. ‘Perverted’ doesn’t really do it justice.
Dog head - alive but not attached!
Vivisection. The Nazis weren’t alone in their medical pursuits during WWII. Japanese experimentation in the infamous Unit 731 was just as ugly: experiments on thousands of prisoners included vivisection without anaesthetic, because they felt that anaesthetic might have interfered with results. The subjects were called ‘maruta’ (‘logs’) by the Japanese. They were infected with diseases such as cholera and anthrax, and then dissected, and had organs removed, while still alive and conscious. For a chilling firsthand account of the vivisections performed, check this out: http://www.centurychina.com/wiihist/confess/demondoc.html The ‘Tuskegee Syphilis Study’. The name might sound humourous, but that starts to change when you find that the full title was ‘The Tuskegee Study of Untreated Syphilis in the Negro Male’, and it just keeps on going downhill from there. The biomedical research study of syphilis was conducted by the US Public Health Service (PHS) in Tuskegee, Alabama between 1932 and 1972. It began with around 399 diseased African Americans, and left only 74 alive by the end. The subjects were told that they were being treated for “bad blood”, and were promised free medical treatment, meals, even burial insurance in case of death. But these promises were all false: although different treatments were initially tested, the ‘free medical treatment’ was eventually purposely denied to the subjects so that the disease’s progression could be observed. The PHS also did not allow any other agencies to administer treatments, and left the subjects off the list when penicillin was introduced as a standard treatment for syphilis sufferers in 1943. The Tuskegee Study is thus known as the longest non-therapeutic human experiment in history. Source: http:// www.tuskegee.edu/Global/Story.asp?s=1207598 Radiation Poison. Still in America, the US government was involved in radiation poisoning experiments in the 1940s. This included such experiments as feeding 73 disabled children with ‘nutritious’ oatmeal containing radioisotopes, giving 829 pregnant women so-called ‘vitamin’ drinks which really contained radioactive iron, and plutonium injections for at least 18 Americans, who mostly appeared to believe that they were being treated for other disorders. Source: http://www.democracynow.org/article.pl?sid=04/05/05/ 1357230&mode=thread&tid=25 Cancer Injections. Experimenters generally seem to like experimenting on the young, so perhaps it makes sense that they like to use the old as well. This was the case at the Jewish Chronic Disease Hospital, Brooklyn, when 22 elderly patients were injected with live cancer cells in 1962. The purpose of the experiment was to find if foreign cancer cells would live longer in debilitated non-cancer patients than in those debilitated by cancer. This was done without the patients’ consent, as there was no wish to give them “unnecessary anxieties” when they might have “phobia and ignorance” about cancer. Talk about paternalism… Source: http://www. rbs2.com/humres.htm#anchor491511
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Freezing experiment
Aftermath of Japanese vivisection
Poster for the Tuskegee Syphilis Study
“Calcium: it must be seen. It must be seen by something to be able to do something. How attentionseeking.” - David Williams
Aries March 21 – April 20
Taurus April 21 – May 21
Gemini May 22 – June 21
Mr G eat your heart out. You are obsessed with drama, every inch of you cries out for universal acclaim and acceptance by the serious dramatic establishment. Acting is your life, but sometimes you need to tone it down, because being the centre of attention 24/7 really takes its toll. There is a very thin line between being universally loved and being universally loathed.
You are obsessed with catch phrases that were funny the first, second, third, and if you are really pushing it, the fourth time you uttered them. However, “that’s what she said,” only works in response to an innocent comment that can actually be misinterpreted as a sexual innuendo. Simply saying it in response a greeting gets annoying incredibly quickly. Think “dragging your fingernails down a blackboard” annoying.
The stars must really love the ABCs “Summer Heights High” this month because Geminians all resemble Jaime. Luckily none of you share her more extreme views on public school students or if you do you are too well mannered to admit to them. Hopefully none of you have also attempted to stage a school wide hunger strike with the sole aim of extorting the school’s leadership into permitting a school formal. That would be a little risqué even for you Geminians.
Cancer June 22 – July 23
Leo July 24 – August 23
Virgo August 24 – September 23
You should feel energised and invigorated by the very thought of life today and if not a triple espresso hold the milk should put you over the edge.
Dr Cameron seems to have left “House”, all self-respecting Leonians should stop what they are doing right now and pause for a minute’s silence. She truly was the triple-threat, she was smart, attractive and was no afraid of chasing Gregory despite the risking extreme pash rash with all that designer stubble.
Apparently a woman in Russia just gave birth to a baby weighing in at 7.75kg (17.1 lbs). The baby is obviously a Virgo so I just felt the need to mention it here.
Horoscopes ane - John Guin
Libra September 24 – October 23 You spend way too much time watching random clips of women vomiting on live TV, mysterious Japanese folding techniques and strange barely legal game shows on Youtube. If it has gotten to the stage where you have now watched more than 50% of all the clips on Youtube it may be time to seek professional help.
Capricorn December 22 – January 20 “Leave Britney Alone,” Chris Crocker is the man. Listen and learn all girls and guys born under Capricorn. Remember if you want to mess with Britney you have to do it through him. Men who wear mascara during the day and live under a sheet are just plain scary. I never want to meet him in a dark alleyway.
Scorpio October 24 – November 22 Whatever happened to short shorts, flares, visible G-strings and perms that look like they could survive a nuclear holocaust intact? It is your sovereign duty to bring all of these fashions back, Scorpios. You can’t fight fate, it is written in the stars.
Sagittarius November 23 – December 21 If you ever attempted to dissect your teddy bear and then painfully sew every single stitch back together then surgery is most definitely your calling. Start rote learning Grey’s Anatomy now (go on, I dare you).
Aquarius January 21 – February 19 You tend to be a little pessimistic when it comes to your world view; i.e. you are a glass-half-empty type. Remember this, the world did not come to a screeching halt with the Y2K bug and it shall endure well beyond the last season of Seinfeld, the impending break-up of Coldplay (wait…. I just made that up) and the death of the 30 cent cone at McDonalds.
Pisces February 20 – March 20 Get off MSN, Facebook, Myspace, Youtube, iTunes and every other distraction because its time to go to bed and dream up the next Nobel Prize winning medical breakthrough. Goodnight.
M
is for ...
Meadows
-Daniel Hamill, Anny Huang, Jessica Wong Spring is here, and with that comes the urge to spend as much time as possible outdoors. A few members of the Publications Subcommittee have been spending their lunchtimes soaking up some sun on the lawns around uni. They give us the lowdown on where to find the best patch of grass.
South Lawn (Diary map ref I14)
Strategically located in the heart of the campus, South Lawn is one of the University’s iconic spots. Basking under the sun against a backdrop of gothic-influenced architectural masterpieces and watching the blue sky as time elapses… it does not get any better, that is, if you do not mind sharing the moment
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with students from other faculty. During peak hours, the noise level and the crowd do not make it an ideal study-spot or for those looking for some alone-time. However, its central location does make it a great venue for holding the much-loved, free barbeques. If you enjoy the hustle and bustle, there is no better place to be. The only other downside is the sign stressing “the playing of games, in particular football and cricket, is not allowed”. Couple-friendliness: Group-study-friendliness: Sunbaking-friendliness: Events-friendliness: Tiggy-friendliness:
6/10 7/10 8/10 8/10 5/10
“More young people are binge drinking ... the way young people come out from behind their computer and go out and get drunk together, then they go back to behind their computers.” - Graham Parslow
Union Lawn (Diary map ref E17)
Only a stone’s throw from Union House, this is a great spot to have lunch. However, the high concrete-path-to-grass ratio means that there is a constant stream of people walking past you while you sit there. Still, this doesn’t seem to deter couples who populate the lawn for as far as the eye can see on sunny days. Interspersed among these couples are solitary students with readers on their laps, oblivious to all that is going on around them. However, at certain times of the year, the peaceful bustle of Union Lawn is interrupted by events such as the O’Week stalls, the Open Day marquees and the occasional gathering of protesters. Although this might be slightly annoying, you can’t help but to agree that the central location of this lawn means that when there is an event here, even the med students are able to find out about it. Couple-friendliness: Events-friendliness: Group-study-friendliness: Sunbaking-friendliness: Tiggy-friendliness:
and Engineering students only, as the disadvantages of the long travelling distance outweighs the advantages of free food for everyone else. Therefore, unless you were really desperate, this is a bad venue for holding medical events. Couple-friendliness: Events-friendliness: Group-study-friendliness: Sunbaking-friendliness: Tiggy-friendliness:
9/10 2/10 4.5/10 6.5/10 4/10
6.5/10 9/10 4.5/10 4/10 3/10
System Garden
System Garden (Diary map ref E12)
Also known as the Systems Gardens, the words ‘chill out zone’, ‘shady retreat’ and ‘magic garden’, along with the phrases ‘quiet’ and ‘woody’ come to mind. This out of the way little Eden is surrounded by walls on 4 sides, never crowded and on a nice day is arguably the pleasantest spot on campus. Whether dappled shade, a spot’o’botany, outdoor study with or without friends, peace and quiet or meditation are your intentions systems has a place for you. Not really one for loud gatherings though I have wrestled here and played hackysack as well in my time. Oh... it’s also considered the premier garden for courting couples considering cuddles on campus. Couple-friendliness: Events-friendliness: Group-study-friendliness: Sunbaking-friendliness: Tiggy-friendliness:
10/10 3/10 (during hours) 7/10 (after hours) 8/10 5/10 10/10
Alice Hoy Lawn (Diary map ref I20)
With first-year lectures now held at the Sidney Myer Asia Centre, this lawn tucked into the corner between the Arts Centre and the Alice Hoy building is quickly being discovered by medical students. Although at first you may feel slightly uneasy (as if you were trespassing on the land of another faculty), the feeling of being incognito among education students soon becomes enjoyable. This is also a good location for outdoor group study, and occasionally education students have their tutes here. However, the distance between this lawn and the medical building means that it may take a lot of persuasion to get your study group to meet here. Ditto with trying to draw a large crowd for a med event. Sunbaking is also difficult, as most of this lawn is usually in the shade of one building or another. Couple-friendliness: Events-friendliness: Group-study-friendliness: Sunbaking-friendliness Tiggy-friendliness:
South Lawn
1888 Lawn (Diary map ref L20)
To come here is to venture deep into unknown territory. Although you risk being attacked by engineering students, you will not get this much privacy on any other lawn on campus ... not from other couples, but from other medical students. With its high fence, wrought iron gates and the impressive red brick facade of the 1888 Building, this lawn is definitely an undiscovered and exotic corner of the University. It is great for couples looking for a place to spend time alone with each other, with its only drawback being that occasionally, rowdy Arts students may choose to hold barbeques there. These barbeques are attended by Arts
“MOUTH - in to ANUS - out.” - Lecture slide “Hahaha!” - One person “Hahahahaha!” - Everyone else in lecture
7/10 1.5/10 6.5/10 1/10 2/10
Medical Building Lawn (Diary map ref L11)
Despite its proximity to the hub around which the lives of medical students revolve, this lawn is not frequented often by students. However, this is not to say that it is always deserted, as the nurses from RMH across the road use this piece of grass to soak up the sun during their lunch breaks. Being next to the Medical Building and across a footpath from Royal Parade, there is potential for events to be held here. However, for those very reasons, it is probably not a good spot for couples seeking privacy. It is also one of the smallest lawns on campus, and is therefore not suited to most ball games. Couple-friendliness: Events-friendliness: Group-study-friendliness: Sunbaking-friendliness: Tiggy-friendliness:
2/10 5/10 5/10 6/10 1/10
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M is
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MSCV
State Level Representation for Victoria’s Medical Students
- Jonathan Galtieri, AMSA Representative, University of Melbourne Medical Students’ Society The Australian Medical Students’ Association (AMSA) is the peak representative body for medical students nationally. AMSA provides this representation by lobbying government and other national health stakeholders such as Medical Deans Australia and New Zealand and the specialty colleges and by sitting on a vast array of health-related committees. There can be no denying the effectiveness of AMSA campaigns as shown by the Federal Government’s recent relaxation of the conditions imposed on Bonded Medical Place students. When it comes to issues that are only relevant to one particular state, however, it is more difficult for AMSA to amass the resources necessary to campaign effectively. It is for this reason, that representatives of the University of Melbourne Medical Students’ Society (UMMSS) and the Monash University Medical Undergraduates’ Society (MUMUS) are establishing the Medical Student Council of Victoria (MSCV). The concept of a state-based medical student council has been around for a few years now with similar councils already up and running in Queensland and New South Wales. With the explosion in medical school and medical student numbers in these states, the MSCs were viewed as a way to bring students from the state’s medical schools together to discuss and campaign on various issues. With the new Deakin University medical school opening in 2008, MUMUS and UMMSS representatives have decided that it is an excellent time to establish a state-level representative body that has the local knowledge and experience to work with a broad array of
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state health stakeholders including: • Melbourne, Monash and Deakin medical schools • The Victorian Government and De- partment of Human Services • The Postgraduate Medical Council of Victoria • The Australian Medical Association (Victoria Branch) and AMAV Doc- tors in Training Subcommittee • Public and private hospital group management bodies • Medical Practitioners Board of Vic- toria Naturally, the MSCV will work closely with AMSA in a synergistic relationship to achieve the best possible representation for Victoria’s medical students. Initial MSCV campaigns will include: • Guidelines for hospital sharing amongst medical schools • State health workforce planning in light of increasing numbers of me- dical graduates • Maintenance of standards for pre- vocational training and quality pre- vocational positions within hospi- tals The Medical Student Council of Victoria will become operational towards the end of this year when council positions will be formalised for 2008. Initial work will include establishing a presence amongst medical students and gaining representation with our key stakeholders. For further information on the MSCV please contact: Jonathan Galtieri amsa@ummss.org.au
“I’ve had amenorrhea for about twenty years!” - Jeremy Kam
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Following the short interview with Trefor Morgan in the last issue of the Gube, we wanted to find out more. Here is Grant Ross with a detailed interview. What was medicine like in 1953? Completely different. There were very few drugs that we currently use. It was an exciting time in medicine; it was just changing from a descriptive medicine to a partly investigative and scientific medicine. In hypertension, the field that I’m involved in, drugs were just starting to be developed. Dialysis and transplantation didn’t exist. My speciality was renal medicine and cardiology to an extent. The main thing was that you’d be able to take a history properly. Then what you could do with a problem was really not that great. The main things were history and analysis. At that stage you would always test every patient for syphilis, because it had been rife in the early parts of the 20th century and had they not been treated with penicillin, they’d end up with problems 50 years later. Same with TB, treatment was just coming in with streptomycin and at the time there were hospitals specifically for TB. You don’t see them any more. Why did you choose to study medicine? Oh I dunno. How do you know why you do anything? I had no medical background in my family. My father came at the age of ten from Wales at 1912 (aged 6). I lived in Newcastle, his father was a coal worker and came to Australia because he had TB and was told to leave Wales. On My mother’s side, her family had come to Australia about the 1840s. I did reasonably well at school. But I wasn’t dux at my school because the person was dux had become dux the year before. I came twelfth in the state overall. How has medical selection changed since the 1950s? That’s a most interesting thing. There was none then. Provided you matriculated, you got in. In my first year, there were 650, joining 150 repeats. The class was 800. 150 got through joining 250 repeating second. Of the 3rd, 150 got through joining 50 in third year who got through most of the course. Funding was via the Commonwealth Scholarship, a new thing at the time, and basically you lost your Commonwealth Scholarship if you failed, but could repeat if you paid certain fees. It was purely based on numbers: the clinical schools could only take 180 students, so the pattern was: “how do you get it down to 180 students”. And the first year was basically zoology, chemistry, physics and botany. What are your good memories of University? I went to a wonderful college, St. Andrews. I was actively involved in athletics and a little distance running. I was active in rugby, debating and involved in the dramatic society. Of interest, I was in the same year as Leo Schofield and he
Morgan
produced a great number of the plays. Mungo MacCallum was in my debating team. The third person was called Ken Horler who set up the Nimrod theatre with John Bell (Bell Shakespeare Company). What is your funniest/best memory of your time in medical school? None that I can think of. General things were going on at the time. One of the very interesting things was that one of my tutors in 4th year in pathology was Max Lake, who performed an innovative type of heart surgery for the time. We visited his vineyard years later, at this stage I decided I’d own a vineyard. I’ve heard of your interest in viticulture, what has been your interest in making wine? My vineyard is not a hobby, it’s a commercial business. I make my own wine and do everything for bottling and production. The vineyard is in the Macedon ranges; called Mount Charlie Wine on Mount Charlie Road. I spend a lot of my time now in Melbourne still, but spend a few days each week at the vineyard. What was your favourite subject at school? Probably maths, partly because we had a very exciting maths teacher. In the last two years, the school population went down very markedly, but 20 of us did maths honours, the person who came first repeated and I came 12th and one came 4th and so it was very exciting. At the time was there still a logical progression to University for talented people? No, not necessarily, anyone could go on. Several years on, there was a criteria that you had to have done Latin. At the time, to do Medicine, you need Chemistry, Physics, English and a maths subject. There was still a definite structure. Educational Background: 1953-1959 Bachelor of Medical Science and MBBS in Sydney 1971 FRACP, MD 1963 MRCP 1972 MD on published papers 1991 Applied Science in Wine Science I first came to Melbourne in 1971 as the first assistant to medicine at the first Austin clinical school in the repatriation centre. After this I came as Foundation Professor of Medicine (1977-1981) to Newcastle University which was the first fully problem-based course. It was 20 years ahead of anywhere else. After this I was the senior specialist in charge of Medicine at the Department of Veterans’ Affairs for from 1981 to 1984. In 1984, I was asked to be the Chair of Physiology at The University of Melbourne. This department had been very innovative in teaching. It was the first medical school to use computer based learning. At one stage when we computerised our teaching lab, we had more computers than any other teaching department at any university but
“The person will be jaundiced. We’ll come back to that in a moment.” *Pause for 0.5 seconds* “The person will be jaundiced.” - Trefor Morgan
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the paradox was that I couldn’t use a computer. My son was doing a MSc in computers and doing a PhD in computer electronics. We had computers in my house but I couldn’t use them. After this the University changed their teaching format to a problem-based format. In a course called Integrated Medical Science, we rarely used the problem based format. Teaching-wise I’ve also been involved in writing books of physiology questions (MCQs) and more recently with Chris Bell (physiology at Dublin) on basically physiology through case-based studies. One of the important things is that physiology overall has generally been based on neurophysiology and neuroscience. Physiology here at Melbourne always had significant other components. The major uniqueness was that I still stayed clinically involved in medicine. Stephen Harrap is now also a clinical professor. This is particularly important for the problem-based course to have people in the basic sciences who have trained and worked as clinicians. What sort of a doctor were you? I was a very good diagnostician, very good technically and very good clinician. But also from fairly early on, I was a fairly good communicator with patients, which in general, clinicians at the time were not. Did you enjoy clinical medicine? Yes. I still practice, mainly in outpatients. I’m still involved with HT patients some three mornings a week. What were some of the exciting things happening when you started your teaching/academic career? There were all new publications, all new syndromes. I had several different things, I described two people with EatonLambert syndrome (only 20 cases in the world at the time) I described intracranial sarcoidosis, systemic cytomastosis. I was a Registrar in the unit and the person who’d sent the patient in was the president of RACP, the person whose unit he came in under was the examiner for the Royal College of Physicians and they had no idea what it was. In some ways medicine at that time was more exciting that what it is at the moment. I mean in my specialty, renal biopsies had just started up. At that time I started peritoneal dialysis and I had done 300 kidney biopsies, by far the most in Australia at that time. When I came back from London I set up the dialysis unit in Queensland and in Melbourne too. What are you doing now? Each year I teach in Malaysia; I’m distinguished professor of medicine at UTIM in Malaysia and I’m Secretary General of the Asian-Pacific Society of Hypertension, and in that regard the meeting is in Beijing and I’m organising a major workshop on HT in the Asia region, the problem and the solution.
“I was active in rugby, debating and I was involved in the drama society.” What do you think we could do for obesity? The tackling of it requires things which are a bit different from now. One thing the Government should do is to make certain that children play sport in school and that might mean the government needs to make a compulsory insurance system. The activity of children is important. I also believe that there should be truth in advertising and it really amounts to: (relating to HT issues) can you do things by individual actions to prevent people or do you have to do it by government action? In general, the answer related to smoking was that: until
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there was government action, smoking wasn’t reduced to any extent. But outside of doctors, it wasn’t effective. Nurses continued to smoke. There needs to be government action. What that action should be … if you take an extreme view, you could say that you could change the rules on the GST, processed foods could attract GST but fresh produce wouldn’t. The processing of food is what makes food bad. It makes it nicer to eat; I suppose I don’t know the solution but I do believe that it requires government action. I think it requires novel kinds of actions so that more sport is played and maybe fruit and vegetables are subsidised.
“At the time I started peritoneal dialysis, I had done 300 kidney biopsies, by far the most in Australia at that time.” What do you think of current medical education? Well, it’s all a game. I don’t object to any of the systems. The only important things are that you need to decide what the students need to know at the end of the course and how can you determine how you reach these standards. All that you do in between is a game to determine how to get them there. One of the worst things in medical education is the quota system. The medical school can’t fail people because if the medical school fail people they don’t get their funding. The new course is better than the old course. You’d have people who’d done brilliantly at school and one year later, the discrepancy between the people who did well and those who didn’t was amazing. Nowadays under the new course, this isn’t the case. The idea of progressive assessment throughout the year is a bore. It was much better to do other things throughout the year to get through. I have no objection to the present system; but I’m very sceptical whether it produced better doctors at the end. The objective evidence that the medical course has any influence on the outcome… well the only thing that comes out the end that I heard when I did my science degree was that if you did well on your English score you did better in the medical course. The most ridiculous thing in this course is the AMS year. Unbelievably stupid because the likelihood that you’d have sufficient interest to make it done properly and have enough supervisors to do it properly makes it a joke. Conceptually, it sounds alright but Melbourne never really had many who did this one off year in medical science. I didn’t do mine until after I did the first of the clinical years. I did biochemistry. At that stage, the biochemistry was unbelievably exciting. At that time, we were just finding out what the role of the mitochondria was and what the functions of the cell were. I mean even ten years ago with the genome, it was like that; making new discoveries and discovering new things. But I think there are merits in the course and I think it will change further with this. But if you take an extreme view, there is so much information available that you can just tell the student to go and find it. You see there are certain things, and this is problem that some people have – I don’t have this much of a problem – is information overload. The argument used to be that the biochemists were trying to make the students learn too much. But I mean, the clinicians were doing the same thing. I mean why were they teaching student the specific glomerulonephritis types? Because even a physician will refer them on. Even with this communication, gynaecologists were the
“This is a lady with hyperpigmented skin. Actually, I lied to you a bit. She’s actually Philippino, so she’s already pigmented.” - Jeff Zajac
worst. Unbelievable the way they treated public patients, and surgeons were very bad. It’s good that it’s changed. What about subjects like HP, ICM? I don’t disagree with them, but the problem is that I’m not absolutely certain (and some people say the science isn’t being taught) and from what I hear from people who have done these subjects is that they are fairly lightweight. I’ve always said to people that if I were to go to a physician I’d like to have someone who speaks nicely and politely but if I were to go to a cardiac surgeon, well what it amounts to is that you have to get the priorities correct of what is important in medicine. Number one is that you are talking about treating a person who is well or sick (50% of those in GP clinics are not sick or unwell) the aspect of getting the signals from this is very important. It is a necessity to get the priorities and the balance right with the scientific approach to medicine right and epidemiology.
“Enjoy yourself. Enjoy yourself doing the course. Try to understand things instead of trying to rote-learn things.” You have to get the level of importance right? It’s very fascinating how the medical profession, due to our scientific integrity and honesty, prevents us from using technology that prevents us being most helpful to the patient, which is why so many people go to naturopathy because they use the placebo effect. It’s like if somebody came in with chest pain, and you’re sure it’s not a heart attack and you gave them starch pills and they came back in two weeks saying, ‘oh thankyou’ . But because of our background, and honesty, I find it hard to see how we can use the placebo effect and still be honest. However, other fields use this all the time. Chinese medicine: go and climb a mountain and get one eagle nest and do this and do this. What do you think about the new Melbourne model? Should medicine be postgraduate? I believe that this should have occurred 20 years ago. I’m very supportive of it, but I’m not certain I’m supportive of the mechanism of doing it. I think there should be just 1 or 2 courses, but this is all related to the politics inside University; I can’t see why there are 6-8 different degrees. Do you dislike the idea of hounding people into a research tract? Not fully, I don’t understand why Melbourne did this. It’s related to a number of things. Sydney University had a full time Professor of Medicine 30 years before Melbourne and that had influenced the outcome early on. In the 50s and 60s Sydney was well ahead of Melbourne in scientific Medicine.
her to be a plastic surgeon and she does a fair bit of surgery at the skin and cancer foundation. For some reason they had to do a biopsy on a lion and she was asked to do it. She studied at Melbourne University. Just after I’d come here she started. And your son… Did a combined degree in science and electronic engineering then he did a Master of Science in computer science and PhD in electronic engineering in photonics, and I think he came back to Melbourne so he could become president of the Sports Union. So letters went to Trefor Morgan at the Sports Union instead of the far more important professor of physiology. Do you like travelling? I don’t mind travelling. My favourite spots are in Australia; although it depends what I’m doing. I prefer to do things when I travel now. You know, I travel to go to meetings. I’ve been to Europe with development of different drugs and literally have gone there for 24 hours or less. One year, went to Gutenberg and then to Houston for 24 hours each time. I can speak a certain amount of German or French. I’ve spent study leave in Germany, and also in Switzerland and France. What’s your favourite destination in the world? If you could go anywhere, where could you go? Where I am. My favourite destination is where I am, it’s much better than anywhere else. But having said that, I try to go skiing once or twice a year, in Australia and overseas. I go to Thredbo, downhill skiing. Cross country is too energetic. I’ve been involved with Thredbo since 1962; I used to organise the roster of doctors to go down there. What’s your favourite movie? Never go to the pictures, only on aeroplanes. I’ve read three or four of the Harry Potter books. I think they were quite good. I haven’t seen the movie for them. If you could be an animal, what animal would you be? A human. If you had to be an animal that wasn’t a human? Probably a dog. OK, probably elephants, I wear elephant ties all the time. What is your advice to current medical students? Enjoy yourself. Enjoy yourself doing the course. Try to understand things instead of trying to rote-learn things.
The person who brought a lot of scientific medicine to Melbourne was Austin Doyle, who brought a lot of science into Medicine and brought people down to Melbourne such as Collin Johnson, myself, etc. it was Austin Doyle who enabled Melbourne to go ahead markedly scientifically and there is little doubt now that Melbourne is well ahead of Sydney in biomedical research. But back in the 60s, Sydney was streets ahead of Melbourne. Professor, tell us about your first love. I met my wife at Royal Prince Alfred in Sydney on Christmas Eve. She’d immigrated to Australia for ten pounds in 1964. She was a nurse. We have children, two children. Our daughter is a dermatologist and has just had her fourth child. She’s operated on a lion. And plastic surgeons want
“Pharmacokinetics made easy ... it’s actually not that easy, just a lie - a marketing ploy.” - Tony Hughes
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combusted in flames burning down London.
In High school, we all looked forward to the Athletics day. Contrary to popular belief, I was always good at sports and enjoyed the day off spent running, jumping and smoking behind the toilets distributing Russian porn for a good price.
But one year, when I was in year 8, the PE teacher, who was in their first year of teaching, cancelled the athletics carnival. Everybody had to return to class and there was outright hatred of him for ages. I remember torching his car with a homemade bomb out of frustration.
The only problem was that our school was a public school and got allocated the shit months for use of the athletics field. Invariably it would begin to rain on the morning of the athletics carnival. With the whole of the school poised to head off on the buses, the PE teacher had to make an executive decision whether to go ahead with the sports day or not.
Two days later, he disappeared and was never seen again. Since that time, the statistics indicate that the highest category of unexplained disappearances is actually PE teachers after periods of inclement weather. Coincidence? There’s no such thing.
This was a decision based on political and scientific observation. What was the chance that a kid would slip and impale themselves on a fence? Or that one of the teaching staff was actually a witch and would melt in the rain costing the school thousands in compensation? The unwritten law is that athletics should go ahead even in the rain. It is established scientific fact that anyone who is afraid to run in the rain is either a witch or made of fire. Sir Trefor Gravefax discovered that in 1786 after Prince Charlie the 12th refused to run a sports day and
I’m a fan of the third theory. - With Dr. Grant Rosselnitski
increase numbers but found it difficult to access government funding. ‘We just need so much more in the way of resources to boost our numbers’, he said from a break in his research.
For years there has been a recognised shortage of doctors in rural areas as well as many parts of metropolitan Melbourne. Terry Mulder is an AMA spokeperson who suggests that this is because the government has limited medical student numbers at the Universities. He says, ‘for too many decades and ignored the need for increased numbers to meet demand due to population growth, greater disease awareness and an aging population’.
Margaret Neville is the current undersecretary to the Minister for health under the current government. In a recent report from the Government on the doctor crisis, she wrote, ‘The government has been putting into place a range of initiatives to combat the current maldistribution of doctors including obtaining more overseas trained doctors and increasing medical student numbers by 2000 per year starting from 2010. We will have a huge increase in the number of medical practitioners to deal with retiring doctors and the aging population.’
Q1. Why is there a doctor shortage? A The government neglected the medical workforce B Medicare induces people to waste GP time C Aging population D There isn’t really and it’s just an excuse for poor hospital funding in non metro areas Q2. Is A Yes, B Yes, C Yes,
the AMA genuinely concerned about doctor numbers? it will affect patient rights they want to make the government accountable they need to keep them low so they can have more bargaining power as a workforce D No, because the colleges really decide workforce numbers Q3. Margaret Neville is A a responsible servant of the people B highly competent and concerned for the medical workforce C in tune with recommendations of doctors to fix the shortage D trying to achieve a long term outcome and not a cheap fix E None of the above
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There are three main theories put forward by current academics. Firstly, that they simply quit their job and leave town (this is a bullshit ratio of 1). Secondly, they are tied to a goal post and harpooned for their crimes (the Henchmen theory). And thirdly, they are sliced into thin slices and slipped into copies of all the major newspapers to be wrapped up in fish and chips.
Q 23 TRIAL UMAT QUESTION; Please read this and answer the questions below based on your impression of the text. 10 minutes.
Bob Shirkin from the University of Melbourne Medical School says that they have wanted to
- Grant Ross
So my question is, what happens to PE teachers who cancel athletics carnival days?
Q4. The maldistribution of doctors is: A a pitifully transparent lie about the shortage of doctors B incorrect, it should be misdistribution C just describes how doctors won’t settle in decaying rural areas (like, duh) Q5. Delivering health care in outer metro areas is difficult because? A All those who got into med students are from cities and hate rural areas B The population needs more doctor attention C Rural areas are costly economic failures that cannot generate enough tax dollars to justify necessary hospital funding D option C Q6. Who is really responsible for the shortage? A The government because they’re grossly incompetent B The Universities because they spend too much money on research C The AMA/ Colleges because they enjoy high incomes & bargain power D All of the above
“You should be proud and boast about your flatulence. Flatulence is good! Of course, it can get out of hand...” - Graham Parslow
Your Calendar 1: New Year’s Day 3: 5:
Melbourne Cup Day
8: 9:
Gantan-Sai (Shinto)
Start of pre-clinical exams
6:
1:
Derby Day
8: Bodhi Day (Buddhist)
Oaks Day Diwali (Hindu, Jain, Sikh)
10:
13:
Stakes Day
14-27:
End of pre-clinical exams
Australian Open Tennis
20: Eid al Adha (Islam)
24-25:
Relay for Life
25:
26:
31:
Christmas Day (Christian) Boxing Day
New Years’ Eve
26:
Australia Day