ECHOLALIA - Issue 1

ECHOLALIA The Official UoN Medics’ Magazine

Issue 1, May 2012

Editorial Editors-in-Chief,

Editorial

Ali Blatcher and Rohan Tharakan

Deputy Editors

The University of Nottingham medical school is renowned not just for its fine quality academic achievements and countless number of scientific publications, but also for its fantastically imaginative yet despicably inaccurate inter-student rumour telling…

Delicately put together stories leak from one innocent medic’s buccal cavity and emanate their way, fog-like, through the walls of Greenfield, into LT1, up through the B floor corridors moving sweepingly up to the dissection room. This wildfire-like spread of hearsay can even be known to cross borders of British counties, seeping into Lincolnshire and the faraway town of Boston, as long as there are willing medics to receive it on the other side.

And so, Echolalia is here, to provide all misinformed medical students of the truth they have until now been starved of. Where there is a story to tell, we will tell it right. This brand spanking new magazine is an opportunity for you to get your voice out there whilst exploring your creative side, a component of you that our course seems adamant to quash (CS2 coursework aside).

IN THIS ISSUE: For anyone who has taken all the Lincoln badmouthing to heart and dreads any kind of existence there, our side of the story will fill you with a bubble of relief “What to do on Placement” in Lincoln (p 39).

To be alternative these days is greatly respected in our all too normal world. Impress your non-medic crew with our list of quirky, edgy hideouts in our “Alternative Guide to Nottingham” (p 24-25).

And for all you lucky pre-clinical students who should cherish every second of your 3 month long summer stint, our travel advice on how to spend your summer should more than satisfy your boredom (p 40-43).

So, as your eyes hungrily crave anything readable that can’t be checked out of Greenfield, feast them on this. First things first, let’s meet the team that helped create Echolalia:

Ali & Rohan Katie Roth, 2nd year With her extensive “gap yah” experience of publicising, Katie has now set out on a mission to make Echolalia as loud and well known as possible in any of the places a Notts medic might ever set foot in, from LT1 all the way to uhhum, Boston.

Find her frantically tweeting and posting on faceyb about upcoming articles.

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Susan Larcombe, 3rd year When she isn’t enjoying the infinite wonders of Mansfield, Susan is dedicated to working hard to make Echolalia appeal to our future doctors, ensuring there is as much medic goss as can possibly be squeezed into 40 odd pages.

Lorna Neill, 3rd year Don’t let the fact she is the only blonde committee member deceive you, Lorna has a beady eye for uncrossed t’s and undotted i’s! The inventor of our “Character on the Couch”, Lorna is very much in touch with her infantile side and always has a beaming smile plastered on her face.

Finance

publicity

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Liam Beamer, 4th year Forget Obs and Gynae, Liam spends all his hospital working hours pondering over the ins and outs of English grammar, and all his efforts have been put into making this magazine legible and easy on the weary eyes of all you hardworking medics.

Anouska Lerner, 2nd year Anouska is a level-headed number cruncher and exactly the sort of person you’d want in charge of your finances. Anouska’s job is to ensure Echolalia gets tip-top deals for printing and her budding journalistic nature means she fits in well with our team.

In This Issue

News NHS Reforms—What You Need to Know…………………………….4 NHS Pensions—Why You Should Care……………………………….5 Occupy Nottingham…..…………………………………………………………..6 #StopKONY……………………………………………………………..………..7 It Was Fun While It Lasted: USA Healthcare Reforms………….8 Time Flies (2nd year columnist)………………………………………...9 Global News……………………………………………………………………..….10

Sports inFOCUS: Hockey...…………………………………………………...………..12 A Question of Sport…………………………………………………………..14

Societies Design Mei Ling Henry, 2nd year Mei has an eye for detail to ensure an aesthetically pleasing finish to our beautiful publication.

Her talent for creativity has flourished throughout the making of this first issue and we are sometimes even lucky to get a fascinating story behind her handiwork.

GPSoc Profile of Chris Steele ..………………………………………….16 Matt’s Word Salad (4th year columnist)……………………………..16 An APPle a Day: App Reviews…………………………………………….18 inFOCUS: Heartstart..…………………………………………………………19 Cohort Study (1st year columnist)……………………………………..20

Features How I Met Your Mother………………………………………………..……..22 Marcus’ Story : 21 and 3 Weeks to Live……………………………...23 An Alternative Guide to Nottingham………………….………………..24 How to Plan Your Elective…………………………………………………..26 Character on the Couch……………………………………………………...29

Arts and Culture Sponsorship Oliver Burbidge, 2nd year Easily the most organised committee member, Oliver is a minute taking, e-mail chasing brainbox and an eager beaver in general. He is the best man for his and Sarah’s job of pestering companies to part with their cash in order to fund all you lots’ perusing pleasure!

Sarah Cowan- Rawcliffe, 4th year Sarah is definitely the level headed manoeuverer in our squad. Her common sense overrides ideas that are quietly unfeasible (naked photo-shoot anyone?) and her smooth persuasiveness sure does pay off when the money is involved!

Music Review………………….………………………………………….……….30 Should We Practise What We Preach? (3rd year columnist)..30 Actors Who Could Have Been……………………………………………..32 Film Review: The Hunger Games………...………………………………33 Film Review: Cabin in the Woods…………………………………………33 Film Review: Titanic 3D……………………………………………………….34 Do You Follow?..………………………………………………………………….34 I Swear By Apollo………………………………………………………………...35 Essential Browsing.……………………………………………………………..36 Doctor, Doctor.…………………………………………………………………….37 Which Textbook?................................................................38 What to Do on Placement…………………………………………………... 39

Travel What to Do With Your Summer…………………………………………...40 How to Plan Your Gap Summah…………………………………………..42 Explore Europe…………………………………………………………………...43

Essential Lecture Handouts Case Study: Collapse on the Pitch……………………………………….44 What to Do in Your OSCE…………………………………………………….45 Puzzle Page………………………………………………………………………...46

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The NHS Reforms

News

What you need to know On the 27 March the Government’s controversial Health and Social Care Bill completed its passage through Parliament to enter the statute book.

The reforms to the NHS in England have been called some of the most radical since its creation in 1948, and the Government has been forced to make several compromises during the long consultation process.

Ministers have argued that although the NHS budget is protected from cuts, the cost of providing care is rising so rapidly that efficiency savings need to be found or services would have to be rationed in the future.

their own budgets. It is hoped the change will free up money that can Key Points instead be spent on providing care.  Abolition of PCTs and SHAs. An estimated 20,000 management GPs and other health and administration staff are to be  professionals put in charge made redundant by 2015, saving the of budgets, forming CCGs. NHS £5bn.

The reforms also create an independent NHS Board, charged with allocating funds to the CCGs. Until now the Secretary of State, Andrew Lansley, allocated funding, and has argued the reforms will leave the NHS ‘free from political interference’. The responsibility of providing specialist services will become the The reforms involve major shakeups responsibility of the Board, in an to the structure of the NHS. Primary attempt to make services more Care Trusts (PCTs) and Strategic efficient and co-ordinated.

Health Authorities (SHAs) are to be Critics argue that altering the abolished. These currently administer structure of the NHS is unnecessary, NHS spending by buying health costly, and the transition process services for local communities, and could lead to poor acquisition of are composed mainly of managers services, thus compromising patient and administrators. In their place will care. The Labour Party have accused be Clinical Commissioning Groups Conservative ministers of hypocrisy; (CCGs), run by GPs and other health quoting their last election pledge of professionals.

The Government ‘no more top-down reorganisations of argues this will increa se the NHS’.

The changes the accountability and efficiency by Government has been forced to make putting clinicians directly in control of to its reforms has led many to believe that the reforms lack a clear objective, are poorly thought through, and will leave the NHS fractured.

The most controversial aspect of the reforms is the emphasis they place on introducing more competition within the NHS.

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

Redundancy of administrators and managers to save £5bn by 2015.



Creation of a national NHS Board, to allocate the budget.



Promotion of within the NHS.

competition

Competition is nothing new to the NHS, and a significant proportion of care is already acquired from the private sector. Critics have raised concerns that the Government is trying to ‘privatise the NHS’, as the reforms are likely to proportionally increase care provided by the private sector. The amount hospitals can earn from private patients will also rise from 1.5% to 49%. Those in favour argue that competition will reduce costs and allow patients to choose services.

There has been much exaggeration on both sides of the debate, and although we are likely to see some substantial changes to the way the NHS in England is run, front-line services are likely to remain largely as they are. Whether the reforms will improve the running of the NHS can only be judged in the years to come.

Oliver Tomkins

Tony’s Trivia Titbits: The nuchal ligament of sheep/cattle is known as the paddywhack

NHS Pensions — Why you should care The student loans company, overdrafts, the bank of Mum and Dad; that is as far as most of our financial knowledge goes at the moment.

Finances are boring, economics is confusing - who cares? If you give me your attention for the rest of this page I will tell you why you should.

Last year the newly appointed government, who neglected to mention any NHS shake up in either of their manifestos, decided to change the NHS pension scheme for the second time in less than 4 years.

Their reasoning was that the current scheme (that really archaic one from 2008) was unsustainable in the long term and the only way to keep the NHS afloat was to have another overhaul. This simply isn’t true and it is the medical students of today who will suffer the most if these changes go ahead.

Currently doctors pay between 6.5% (at the beginning of their career) and 8.5% (when earning a higher salary) of their pay into pensions and when they retire their pension is worked out from their final salary. Concessions made in 2008 mean those that earn more pay more into their pension fund and doctors can expect to retire at 65 not 60 if they recently graduated. These changes have made the scheme sustainable; it will raise nearly £11 billion for the treasury in its first 7 years, so why on earth does it need changing?

Next time you talk to an economics student pose the following question.

How is it possible to pay more than double for something only to get less out? It must make sense though because the government says so, and when have they ever mislead any of us? Clearly there is a crucial piece

of economic logic my medic brain can’t work out.

This is what the new scheme will mean for us: as junior doctors working our entire career under this scheme, we can expect to pay 2.25 times more (that means at least £200,000) over the course of our careers and when we retire, at 68 not 60 we will get 16.5% less out of our pensions. So for those of us who came straight from school to university we will have spent half a century training and working in the NHS and paid hundreds of thousands pension scheme, the government has of pounds more into our pensions abandoned that agreement, simply before we even get a look at what’s for the sake of trying to raise more left of them. money from public sector workers.

Does that seem fair to you? The Moreover, it cannot be fair that general consensus amongst the hospital doctors on the same pay will medical community is that it isn’t fair have to pay twice as much for the at all, which is why for the first time same pensions as their civil service in almost 40 years the BMA are counterparts.” balloting to consider industrial action He added, “I know that, for medical to convince the government to students, retirement seems a long further negotiate on the scheme. The way away but older doctors have medical profession is notorious for made it clear that they are fighting as not taking industrial action to avoid much for the future generation as any potential harm to patients; the they are for themselves. Whatever fact it is even being considered happens, we would not put patients should send a strong message to the at risk but we will try to persuade the government that this scheme is being government to think again.” seen as unfair and unacceptable, especially when the current scheme So what can you do? Search for is perfectly sustainable. In the survey p e t i t i o n 29071 on the conducted by the BMA over 80% flat epetitions.direct.gov.uk website to out rejected the new pension scheme have your say in the fight against and two thirds said they were willing these changes. to take industrial action over it.

The coming months look set to be Dr Hamish Meldrum, chairman of the very eventful for the NHS and those BMA, told Echolalia that the BMA was that work in it, I hope now you will be only considering industrial action one of the people following the very reluctantly. He said, “Doctors changes and caring about the feel betrayed and let down by the potentially great effect they will have government. Having only recently on you and your career. agreed to major changes to the

Anouska Lerner

and is dried and sold as a dog treat, hence "Knick-knack paddywhack, Give a dog a bone"

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News

Occupy Nottingham

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For the past 6 months the cluster of tents on the northern side of the Old Market Square has been a familiar sight for Nottingham residents. The campers are a branch of an international protest group who are fighting socio-economic inequality, focussing on the claim that the current financial system disproportionately benefits a wealthy minority, the so-termed ‘1%’. The protest has stirred up a lively debate in Nottingham, with the group saying that they are often abused by drunks, citing the example of a protestor who was punched in the face on the evening of Sunday 9th April. However they say that they are also approached by around 50 people a day offering their support.

The camp has attracted controversy with the city council fighting a court battle to evict the protestors, claiming that they are damaging local business and have been urinating on the adjacent flower beds. The council are disgruntled that the protestors are camped on a public highway and say it has cost them £3000 to clean up the mess.

Furthermore they have stated that the camp has no public health license, and that they do not intend to issue one. However the protestors refused to move, citing human rights reasons and claiming the land as public property. The later claim is supported by a local land-ownership enthusiast who agrees that the land where the square sits was given to the people

of Nottingham in 1275 and was where people would seek justice in the presence of the Sheriff of Nottingham.

Occupy Nottingham’s inequality claims initially seem to fare well when scrutinised, with the government-appointed National Equality Panel agreeing - it says that the UK is one of the least equal countries in the developed world, the top 10% of households owning 100 times more wealth than the bottom 10%. However critics point out that the argument isn’t quite as simple as that statistic would suggest - no socialist country has ever achieved the standard of living seen in the developed world. The New York Times gives something for Nottingham medics supporters of the Occupiers to consider, declaring that 20% of American medical professionals make up this top 1% in America. With the UK being renowned for how well it pays its doctors the situation is probably similar in this country.

Echolalia spoke to a few medics in the library to see how they felt about Occupy Nottingham. Sam, 1st year, said, ‘Although the camp looks messy, I am grateful for

their presence as I think they serve a good purpose by reminding us that our society is frequently unjust.

They may not offer a cure for the disease, but they serve as a symptom, reminding us we are unwell. We should look more closely at why they are there in the first place.’ Medical analogies aside, Oliver, 2nd year, had a very different view, ‘Occupy are deluded to think they can achieve change through their squatting. Their views are delusional and reactionary, and they seem to resort to banker-bashing whenever their policies are questioned.’ For good measure he also added, ‘I can take nobody in blue hair seriously’.

Just before Echolalia went to press, Occupy Nottingham dismantled their camp because they couldn’t afford the £30,000 legal fees required to fight the case.

Nevertheless, the discussion in this article is still being played out in many other cities around the world.

George Hulston

Tony’s Trivia Titbits: Eccrine sweat glands are distributed all over the skin

#stopkony StopKONY. Last month, my newsfeed was filled with everyone I know sharing and tweeting this video, and encouraging others to do the same.

Now over 87 million people have watched the video on YouTube.

So who is Kony, and why does everyone I know suddenly want to stop him?

Social media at its best or slacktivism at its worst?

Ordinary Ugandans are not a fan of the video either. Reports emerged that at the screening of Kony2012 in northern Uganda, to an audience full of Kony’s victims, the viewers responded with confused and then indignation. The “action packs”, described as an essential purchase for any young activist to become an “advocate of awesomeness” caused particular offence. The Guardian reported that one victim, who had lost not only an arm but also four brothers to Kony’s guerrilla soldiers said: “How can anybody expect me to wear a T-shirt with Kony's name on it?” He has a point. Would it be appropriate to hand out t-shirts emblazed with Hitler’s face to Holocaust survivors, or to hand out Bin Laden bracelets at Ground Zero? I think an attempt at this would provoke exactly the same reaction as it did in northern Uganda.

The now infamous Joseph Kony is the leader of the Lord’s Resistance Army, a group which has been active for over 25 years, who have forced over 30,000 children into being child soldiers and sexual slaves, as well as having a penchant for rape, and for hacking off the noses and lips of their victims. Invisible Children is a charity set up by an American, Jason Russell, after he and friends were moved by the story of child soldiers in northern Uganda. The organisation created the StopKONY campaign with the aim of Others berated the attempts of so making Kony famous, “not to called “great white saviourdom” and celebrate him but to bring his crimes how Invisible Children seem to be to light.” advocating American solutions to However, after the initial craze of African problems.

Some have retweeting and posts, came the commented that the campaigners are backlash. The main criticism was presumptuous and patronising in their that it oversimplifies a complicated belief that now Justin Bieber and an issue and is low on fact and high on army of keyboard activists want to emotion. The video briefly mentions stop Kony, and that 100 US military how Kony and his militia have “begun advisors have been flown in, Kony will to move into different countries”, immediately be captured, despite 25 however what they fail to mention is years of the Ugandan army’s failed that the LRA have not been active in attempts at catching him in the northern Uganda for 6 years, and in impenetrable jungles of northern fact now only a group of about 250 Uganda. rebels remain, scattered across the Invisible Children’s finances have also Democratic Republic of Congo and the been scrutinized, with claims that Central African Republic.

The despite being a wealthy organisation Ugandan Prime Minister Amama with an income of $8.8m, only 30% of Mbabazi has expressed his dismay that sum went to what it describes as that the video has given the “on the ground services”, with 25% impression to the world that Uganda being spent on film costs and 20% on is “still at war”. staff salaries in the US.

of the human body except for the lips, the tip of the penis and the clitoris.

But can you really ever criticise good intentions, however naïve? Surely it is a good think that the 100,000,000 people who have viewed the Kony video are more informed about the situation in central Africa, even if the facts are a bit hazy? Many commentators disagree. As one stated, “awareness of American college students is NOT a necessary condition for conflict resolution in Africa.”

In an effort to combat this criticism, and to further explain their message, Invisible Children have released a second video “StopKONY 2012—Part II –Beyond Famous”. However this video has failed to live up to the hype of the first; in the first week it racked up 1 million views on YouTube in comparison to the near 75 million of the first video.

Invisible Children have also launched an extensive question and answers page on their website, where they have defended the accusations made against them. They admit that perhaps they were not “clear enough” in the facts presented in the video, and they defend the criticism of their fund allocation by stating that they feel spreading their message via social media is just as important as funding projects on the ground.

It’s undeniable that as a campaign, StopKony2012 has been the most successful viral awareness video ever.

However, what happens when #stopkony stops trending and disappears from our newsfeeds?

Despite its best intentions, it’s clear that the issues raised by this video are deep seated and more complex, and stopping Kony in 2012 might take more than YouTube hits.

Lorna Neill

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It was fun while it lasted:

News

Will America Fail to Realise Obama’s Health Reforms?

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While the candidates for the Republican presidential nomination continue to twist and tussle for voter attention, projecting their policy proposals in areas concerning taxes, jobs, education, the environment and gay rights, there is one area on which they can all agree: the nation's healthcare. Concerning any changes, the short answer is that if 2013 witnesses the introduction of a Republican to the White House, so too will the country fail to realise the full extent of President Obama's landmark healthcare legislation, with many provisions not being implemented until the end of this decade. The 2010 Healthcare and Education Reconciliation Act labelled "Obamacare" by it's opposition - has already made health insurance available for some 32 million who were previously uncovered. But this minor figure

seems to matter little to any of the four men remaining in the Republican nomination race, who are challenging to become the 45th President of the United States.

The four men in question - Mitt Romney, Newt Gingrich, Rick Santorum, and Ron Paul - have all committed to the repeal of Obama's healthcare bill, with little proposed concerning an alternative. The threat by many of an executive order (which will bypass a congressional vote for a repeal) would suggest that the priority is to remove the changes implemented under the Obama Administration, and that any reform will come further down the road, if at all.

that has experienced increased exposure with the rise of Tea Party activism- which would decrease competition within the health insurance industry. This is a direct contradiction of the Hayek principle of unregulated competition, still held as a near religious belief by the 4 free market liberals still in the race. The incumbent President has, therefore, found himself the victim of attacks branding him a "socialist" by those hoping to replace him in this year's elections.

But this name calling that has become so effective in rallying Republican support is often connected to the increased contributions to Republican campaign finances by the insurance companies The main reason for opposition themselves. The debate that seems to against the 2010 amendments is the be at the heart of American political controversy of increased Federal life at present is that corporations Government "interference" - a claim

Tony’s Trivia Titbits: Monday is the day with greatest risk of heart attack (20% occur

should not be considered "people," (as ruled in a Supreme Court decision in 2010 under Citizens United vs the Federal Election Commission) and for this reason their influence, and with it their interests, should play no part in U.S. politics. But while the decision stands, corporations may continue to support politicians running for office.

Many critics believe this so called “payto-play” incentive gives them overwhelming and unfavourable clout in influencing political campaigns and the policies proposed.

These claims have been applied to the 2012 presidential race. Since the passing of the Healthcare and Education Reconciliation Act in 2010, the campaign contributions on behalf of the insurance giants has witnessed a 8 to 1 swing in favour of Republicans.

Newt Gingrich, for example, has been backed by the health industry since the early years of his political career, and to date, according to research group 'The Center for Responsive Politics,' it has been the fourth largest contributor to the campaign finances of the former Speaker of the House. Similarly, Rick Santorum had received around $140,000 in campaign contributions from the health industry, his third largest source of donations. It is claimed that these contributions have played a large part in the candidates' stand against Obama's health reforms.

Gingrich commented in 2006 that the health care program implemented by then Governor of Massachusetts, Mitt Romney was a "most exciting development," which had the potential to "effect major change in the American health system," but now this has become a target subject to strong criticism for its resemblance to Obamacare. Rick Santorum has also voiced his concerns over the Government's increased involvement in the free-market.

Outrage over the changes of the past few years by Republicans, some might believe, is in relation to an increased Republican voter backlash against the proposals. While this is true to an extent, the reality would suggest otherwise. In a New York Times poll, only a small majority of 54% of adult Republicans supported the total repeal of the health care law of 2010, and only 24% of adults overall. What is even more astonishing is that the repeal of the law by the Republican Party would be to the greater detriment of their own constituencies, claims a Politico report. The article shows that "Americans living in congressional districts represented by Republicans stand to benefit as much —if not more than those in which a Democrat holds the seat."

The reforms will remain a highly debated topic right up to the election. Whether or not the provisions already in place will be enough to prove to the electorate of its worth in their society remains to be seen.

What is sure is that the Republican who triumphs to challenge Obama in the presidential elections will be giving no ground on the issue, and will likely use health care as a way to swing independent voters who became so crucial in the election of 2008. If they go on to introduce a practical alternative, it could just be enough.

Matthew Prescott

Time Flies

Second Year Columnist Time is a funny thing. We flash along the timeline of life at what feels like an ever increasing rate, and yet at any point it can appear to move slower than a man wading through treacle. This is hardly a ground breaking statement – it’s obvious to any four year old on Christmas Eve that time sometimes moves at different speeds. I only mention it because the medical school seems especially sensitive to this effect. You step on board the merry-goround in week one, and suddenly the weeks are flickering past at a dizzying speed. Events loom large on the horizon, and then in the blink of an eye are receding into hazy memory. One moment you have weeks until Celebrity Cocktail party and plenty of time to arrange a costume, and then suddenly it’s tomorrow, and you face a panicked hunt for cardboard and face paint.

Exams, which minutes before seemed comfortingly distant, grow rapidly until everything else is blotted out.

Occasionally though, the ride stops and you find yourself in LT1 in a seemingly endless CLS lecture. You try desperately to maintain focus on what is being said, but inevitably slide into a trance like state as half heard phrases blend with your imagination, and what you’re having for tea. Fascinated by the question of when the person in front of you will realise they’re drooling, you suddenly realise you have no idea what the lecturer has been talking about for the last twenty minutes. People are playing angry birds on their phone, but the lecturer, seemingly blissfully unaware that everything they say is being reflected back off universally glazed eyes, carries on regardless.

Despite the fact that I am sure it has stolen hours of my life, LT1 has been our home, and occasionally our prison. Like Brooks in ‘The Shawshank Redemption’ we have become institutionalised and I fear that, like Brooks, we may struggle to cope when released into the real world. One thing is sure - time will pass quicker than we imagine. And so the merry-go-round spins.

Samuel Quarton

on a Monday), it is believed to be caused by the stress of going back to work.

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News

Canada: Wisdom is something that apparently doesn’t come early to Americans. A study at a Canadian University recently revealed that North American youngsters were regarded as having much less quantitative wisdom than their elders, whilst young Japanese people match the older population point for point. How do you quantify wisdom? The study graded a participant’s perspectives and suggestions over the outcome of hypothetical situations involving conflict against a scale that marked the degree of the 5 components of wisdom. Modern psychological theory suggests wisdom is made up of a 1) willingness to resolve conflict; 2) willingness to compromise; 3) admittance of one’s own limited knowledge; 4) awareness that more than one perspective on a problem can exist; and 5) understanding the concept of ‘getting worse before getting better’. You weren’t aware of this? Don’t worry; neither were many of the 25 year old Americans involved in the study. In drawing conclusions the researchers suggested Americans as a whole match Japanese levels of wisdom, but that the Japanese are seemingly born wise whereas an American has to work for it.

Global Liam Beamer highlights some of the major news stories from around the world this spring.

Argentina: The Argentinian medical profession wasn’t cast in a particularly flattering light this month after a mother discovers her stillborn baby alive in the hospital morgue. Analia Bouter went into labour at only 6 months gestation and was told that her daughter was dead on delivery. 12 hours later Ms Bouter and her husband went to visit their daughter in the morgue and opened her casket to the sound of cries. Officials are understandably sympathetic to the Bouter’s distress over the situation and have promised an investigation. I’d probably start with the midwife that thought it was dead.

Mali: Mali’s new civilian president Dioncounda Traore promised ‘total war’ against the separatist rebel forces that have taken control of the northern half of Mali at his inauguration. Rebel forces in the north are of the Tuareg ethnic group, a nomadic, livestock farming people from North Africa. The leading rebel force, the National Movement for the Liberation of Azawad (the Tuareg homeland) MNLA, stepped up armed attacks in the north of Mali in January of this year. The President at the time, M. Amadou Toumani Toure was felt to have handled the conflict poorly and a coup d’état led by mid-ranking military officers ousted the president. In response to sanctions imposed by Mali’s neighbours following the coup the military strongman Capt. Amadou Sanogo promised to transfer power to a civilian politician, cue M. Traore’s entrance into the presidential palace. The interim resident was given 40 days to organise democratic presidential elections and co-ordinate a military response against the MNLA who, since capturing Timbuktu at the beginning of April, effectively control half of the country. No easy feat seeing as many of the Tuareg rebels are extremely well equipped with Libyan purchased weaponry acquired from Col. Gadhafi’s regime whilst fighting as part of his mercenary force during the Libyan uprising last year.

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Tony’s Trivia Titbits: Nutmeg is toxic if injected intravenously and in large oral doses as it

news

North Korea: All is ago in the world’s most secluded nation state as the new Supreme Leader, Kim Jong-un finally catches his breath after his expeditious rise to power in December last year. April saw the 100 th anniversary of the birth of Kim Il-sung , the founder of the modern Democratic People’s Republic of Korea. It also bore witness to the new Supreme Leader’s first foray into public speaking as he delivered a speech in Pyongyang emphasising the importance of continuing his father’s policy of military development and lauding his predecessors (Grandfather and Father) for their efforts in producing an army 1.2 million strong. Unfortunately for Mr Kim, April also saw a failed attempt to test his military’s ballistic capabilities after a rocket supposedly attempting to carry a satellite into orbit.

The rocket exploded mid-air after only a minute and travelling just 100 miles. Critics in the US, Japan and South Korea have insisted the rocket was not intended to reach orbit but was a test of the countries long range missile capabilities and ambitions of delivering a nuclear warhead to the US mainland.

China: There will be one fewer officials at the 18th National Congress of the Chinese Communist Party in Beijing this autumn. Bo Xilai, a former cabinet member and the senior communist party official in Chongqing (the most important city in southern China), was a favourite to enter the Standing Committee of the Politburo of the Communist Party until events transpired against him at the beginning of 2012. In February, Mr Bo’s most senior lieutenant attempted to defect to the US, taking refuge in the American consulate for 24 hours before being carted off to Beijing by central government strongmen. The loss of faith of his closest advisors did not do much to endear Mr Bo to the current leadership. Unfortunately for him the current party leader Hu Jintao and premier Wen Jaibao have advocated a relative liberalisation of society whilst in power; and it’s fair to assume they probably didn’t view Bo and his high profile heavy-handedness and more conservative opinions in a good light to begin with. And it would seem that they didn’t, as defection in the ranks was enough of a reason for Mr Hu to expel Bo from his positions within the communist party when in April it was revealed he was no longer a member of the party’s central organisations. To add much insult to injury, Bo’s wife has recently been accused of attempting to transfer large quantities of capital out of China and involvement in the murder of English business man Neil Heywood t’boot.

Syria:

New Zealand:

There isn’t enough space on the page to cover what needs to be said about the happenings in Syria.

In an attempt, perhaps, to stave off any more acts of God, the city of Christchurch has announced its intentions to build a cardboard cathedral to replace the 19th century structure damaged beyond repair in the earthquake that left 185 dead in February last year. The Japanese designed Cathedral should be able to seat 700 people, although it’s admitted that it isn’t only made from cardboard; some steel and concrete are essential to make the structure stand upright.

contains the narcotic myristicin, causing hallucinations, nausea, vomiting and circulatory collapse

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inFocus: Hockey

Sports

The 2011-12 season has been another successful year for NUMHC, both on and off the astro. With the usual 3 mixed teams scoring wins across the board, the 1st team making it all the way to the national final, and another sterling intermural effort, 2013 has much to live up to.

made it one of our first ever penalty flick victories, and paved the way for a marathon 6 hour round trip to Southampton for the semi-final. The stakes were high when the fixture was eventually played in the early spring, and the score remained goalless for the whole game until Steve Poole’s last minute winner sparked the celebrations. The final in March pitted NUMHC against arch rivals Sheffield, with whom we have shared the NAMS trophy with for the last 11 years. With some ex-national league players on the opposition side, the standard of play was incredibly high. An early Notts goal silenced the 100 strong crowd of partisan supporters, before 3 quick Sheffield goals made it 3-1.

Much of the 2nd half was end to end, and although we pulled back one goal, it was no disgrace for the match to end 3-2 after such a huge effort.

Medics Hockey has traditionally been phenomenally successful on the NAMS stage, with the first loss for 6 years coming in the 2010 season, after 5 consecutive years as champions. 2011 gave the chance to make amends, and the campaign got off to a flying start in the group stages with 26 unanswered goals scored over the 3 games, all without goalkeeper Stewart Hunter touching the ball once- in over 200 minutes of play. When normal time ended 2-2 all against Manchester in the quarter final, things were not looking up given NUMHC’s England-football-like Highlights from the 11-a-side Sunday penalty record, but some cool heads league team this year included seeing

Season Awards Players of the Season : Steve Poole, Becky Hutchinson Golden Stick : Steve Poole Champagne Moment : 14-0 Win vs Leeds Lifetime Achievement : Vish Bhardwa five opposition teeth scattered across the astroturf, as well as some very respectable results against strong teams.

This season’s social calendar featured several never to be forgotten Ocean visits, another classic black tie alumni ball, as well as a weekend tour to Liverpool at Christmas. After a dominant display on the hockey front, the Scousers were treated to an alternative nativity scene that saw Mary giving birth to off license spirit bottles as well as our very own messiah Mat Bloch. Variations on this will no doubt be seen in the 2012 edition- tickets on sale soon.

Special mention must go to the 5th years leaving this summer, who have all made huge contributions in their time. Many thanks to the committee for all their efforts, and congratulations to everyone involved in the club for such a good year.

Medics Hockey runs every Wednesday from 7-8pm on the University sand astro. Newcomers of all abilities are always welcome, and we hope to see you down there next year.

Nick Boddy

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Tony’s Trivia Titbits: Damage to the upper trunk of the brachial plexus leads to waiter’s tip deformity.

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A Question of Sport

Sports

Following yet another fantastic year of sport at the University of Nottingham Medical School. MedSoc sports sec, Ben Collis, gives us the highlights from various teams, showing how sports have improved here, maintaining Nottingham's title as the country's best medical school for sport (official confirmation pending).

The traditionally very strong Rugby and Hockey teams both reached NAMS finals, with the Hockey team waltzing through to the last two, only to be narrowly beaten following a year of success both on and off the field. The Rugby final against Southampton unfortunately also resulted in defeat but the team are more determined than ever not to let this happen again.

the highest division in the East Midlands Public Authorities League which would represent back-to-back championships and a testament to the clubs sound structure and organisation. One would have to be Meanwhile, although both Men’s and a brave individual to argue that Women’s Football were knocked out they’re not the best Medic’s Football of their NAMS tournament on team in the UK, especially with the penalties, it was a superb effort to get three full teams all the way up to Dundee and competing at a high level. Additionally the Men’s first team look to be running away with

Photos (left to right): Football team, the NAMS Rugby final, Basketball team, Medics’ Tennis, Netball team

Ben Collis

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Tony’s Trivia Titbits: The penile bone (baculum), used to aid copulation is present in all

Basketball however, managed to narrowly defeat the netballers as just one segment of a highly successful year for them - with the number of members growing to over 30. They took part in 2 NAMS tournaments: Brighton in November (2nd place) and Manchester in March (controversially 3rd). They have cemented themselves as one of the best Medic teams in the country.

current young cohort of players currently coming through. Watch out for them in the next few years.

Netball have powered their way through the sporting calendar, with an exceptionally strong side and a host of new players. Their second team won IMS and the first team put in a good showing in NAMS revealing the depth they have in the club - too much talent for the football team actually who succumbed heavily in the Netball vs. Football netball game.

However, the Footballers ‘won that night’ at the ensuing Crisis social and although some lasting friendships were formed, the boys are still waiting for a call back regarding the return fixture on the football field.

Our Badminton team hosted a friendly tournament between Southampton and Nottingham in late January putting in a tremendous effort, full of the unusual combination of grit and flair in equal measures to make it a highly enjoyable tournament for all involved.

Cricket almost goes without saying they won NAMS for the third time in a row, and it seems to get easier for them to crush the opposition every year.

Closer to home they vanquished a number of rival university teams to win the Indoor Cricket tournament. What is most worrying for other world cricketing forces is the Nottingham Medic Cricket team season hasn’t even got into full swing yet.

MedSoc are also proud to announce that a brand new major sports club was set up this year - rowing. Starting up a club is never easy but with an ambitious and hard-working committee it was made a reality and one of their members had this to say:

In September I started up rowing And I really was not very good But we made the committee a promise That we'd try just as hard as we could.

Each week we trekked down to the river Through the wind and the rain and the snow For ergos and weight-lifting circuits And then out on the boat we would row We all started off with the basics With backstops, square blades and slide As we barely knew what an oar was But I guess you can say that we tried!

Within weeks all our blades had been feathered Our slide it was half and then full Our 2k times they were dropping, and Yet harder and stronger we'd pull Every week we get better and better And quite soon we'll be ready to race The other med schools better watch it As Notts medics are sure to be ace!

placental mammals except humans. Some believe it is the ‘rib’ taken from Adam, to make Eve.

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Matt’s word salad Fourth year columnist

GP Soc A Profile of Dr Chris Steele MBE

Societies

Best known as: This Morning’s resident doctor.

Qualified as a GP in: 1968.

Worked in: South Manchester.

Areas of particular interest: Smoking cessation, weight loss and coeliac disease.

Dr Chris was given his TV break by Richard and Judy Madeley, the original presenters of This Morning. They were patients at his practice in Greater Manchester and recommended him to their producer based on his friendly, approachable nature and no-jargon approach to medicine.

During his 24 years on the show, Dr Chris has provided advice on thousands of medical issues. He is a keen advocate of media as a medical education tool, arranging live broadcasts of previously unseen procedures such as testicular self-examination, vasectomy and cervical smear. Dr Chris is the patron of Coeliac UK, and suffers from the disease himself (though ironically, his diagnosis came after becoming an ambassador for this charity) and has struggled with depression for many years. He recently retired from General Practice, but continues to appear on This Morning and lecture on smoking cessation, a subject in which he is regarded as an international expert. Retirement has given Dr Chris more time to spend with his family, and he enjoys watching his son Andrew, an Olympic 400m sprinter, competing at a national and international level.

Want to write for Echolalia?

Contact us at: echolaliasubmissions@gmail.com

Tell us your name and what you are interested in writing about.

To view the GPSoc newsletter online, scan this barcode.

Studying medicine is like having sex while you are drunk. You never actually finish, you just keep going until it’s not worth it anymore. Or so it seemed, as the start of Fourth year presented us with a new set of obstacles to climb over, crawl under, or just bash straight through. Four fearsome new placements and a rabbit-caught-inthe-headlights feeling that it will soon be us becoming F1 doctors. The mutual feeling of just wanting to get there by any means has given us a "we're all in it together" style attitude and has really brought the year closer together.

This, our penultimate year, is often described as the hardest in medical school. As we've been allowed to do more and more in the clinical setting in the hope that we might just make vaguely competent F1s, we've learnt valuable life lessons such as how to change a nappy, how to recognise personality disorder traits in our friends and even how a baby is born. You poor, poor ladies! Even if it is just one tiny stepping-stone across the mighty pond that is medical training, we have all become more experienced, more confident and more mature in our practice.

Many would say one of the highlights has been the successful production of the musical 'Footloose'. The créme-de-lacréme of actors, singers and musicians (and Edd Crook -a top ten guy), supported by a first-rate production team, worked hard for several months culminating in a week of shows. They had some great reviews from both medics and the general public. One of this year's leads, Paddy Clarke lay down the gauntlet for next years budding thespians, "I am incredibly

proud of what we achieved in Footloose and for me it has undoubtedly been a highlight in 4 fantastic years at uni. I would avidly encourage any third years to get involved next year, your turn in the spotlight is coming and rest assured we will be closely watching!". Deep Paddy, real deep.

Matthew Hall

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Tony’s Trivia Titbits: Nearly 10% of patients are harmed in well-funded technologically advanced hospitals.

NEW MEDSOC WEBSITE RELEASED The brand new MedSoc website is now officially released, after a year and half in the making,

by Tony Mathew and Rohan Tharakan... It will be one of the most functional and useful MedSoc websites in the country and will massively change the way our medical school runs. We hope you will love it....

www.nottsmedsoc.com FEATURES: EVENTS LIST – You can see every upcoming medic event/talk/teaching session via the main page events feed and central calendar...

SOCIETIES/SPORTS- All societies and sports teams have their own page and so you can join these societies/sports online. Each organisation can update their page and add their own events, timetables, news, sell memberships/signups, event tickets, hoodies and kit. There is also an integrated sports timetable to show when and where each team meets.

SOCIETY MAILING LISTS- With online memberships, each society/sports team will have their own individual specific mailing lists which hopefully means a lot LESS MASS EMAILS SHOP- Buy events tickets online as well as hoodies/sports subscriptions/ MedSoc cards/ committee clothes and much more...

MARKETPLACE– Here you can sell books and advertise houses, jobs and more TEACHING- For all the events and resources from MedSoc Teaching and its umbrella teaching societies. Includes an area where anyone can upload and share notes/documents/websites that they find useful...

An Apple a day App

Description

Medscape

FREE

Societies

Qx Calculate

FREE NICE Guidelines

FREE 12 Lead ECG Challenge

£3.06

Rating

A clearly organised reference for thousands of medical conditions and procedures. Articles can be downloaded to your device for offline reference, and a drug interaction checker is also included. An American App, so drug dosages and some guidelines are not relevant in the UK, but overall a brilliant App for medical students and doctors alike.

9/10

An App containing hundreds of medical calculators, from risk predictors to dosage conversions. Step by step value input makes calculations brilliantly simple, and result interpretation guidelines are provided with most results. The challenge of this App comes in finding the calculator you want from the plethora on offer.

8/10

This App allows one-touch download of quick-reference NICE guidelines. Simply search for and choose a guideline and it will be downloaded to your SD-card as a PDF. Once downloaded, this guideline will be available in-App without an internet connection. This App is not affiliated with NICE, but is a great alternative to trawling their website for the same guideline documents.

One of the best paid-for Apps for Medical students. Over 150 high-resolution, clinicallyobtained ECGs with interpretation questions and guidance. Case-based, with answer feedback in both text and graphical form (important ECG details are highlighted and labelled). Even on phone screens, this App is easy to use; a handy pan and zoom feature allows detailed examination of the strips.

8/10

Available on

Medical Apps Reviewed QR code

(iPhone and iPad Apps coming soon)

10/10

Unusual phobias Chris Kingsnorth

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Mageiricophobia

Fear of cooking

Amychophobia

Fear of being scratched

Bufonophobia

Fear of toads

Euphobia

Fear of good news

Lachanophobia

Fear of vegetables

Omphalophobia

Fear of belly buttons

Peladophobia

Fear of bald people

Syngenesophobia

Fear of one’s relatives

Tony’s Trivia Titbits: The antigens of Brazil nuts can be passed on

inFocus: Heartstart Societies and I Upon starting Uni, the idea of joining as many societies as humanly possible appealed to me. I wanted to join massage soc for the free massages, cheese soc for the free cheese and korf ball because I didn’t (and still don’t) know what it is. Yet 4 years on, here I am, despite wanting to join these societies, I never have.

In fact I’m yet to attend the infamous “Fresher’s Fayre” and retrieve my free Domino’s pizza slice!

So on failing “Fresher’s Fayre”, I made a huge effort to attend the notoriously superior “Medic’s Fresher’s Fayre.” All I can really remember were hoards of people, a million free pens being shoved in my face, SCRUBS, MARROW and BMA… That was it. So although I technically went to it, I wouldn’t say it was successful.

I did manage to join Medics Badminton and Medics Tennis, and of all the weekly practices they have, I have been to a grand total of… zero.

As you can probably tell, I love the thought of societies but the reality is that I’m a bit lazy and I’m not THAT bothered about them.

What I gathered from this email was that it was a society involving kids, CPR and you could attend sessions as and when you liked. This appealed to me. Everybody likes kids, unless you’re a bit of a cold hearted b**ch (A. King) and the pick and choose attitude of the sessions was in tune to my lazy half arsed committee joining attempts.

So in order to become a member you have to attend a training session whereby they give you a talk on what HEARTSTART is, a child protection talk where the moral of the story is “Don’t touch kids”, and finally a quick demo of the recovery position and CPR.

Then one day, when I was trawling through hundreds of emails about “spare graduation tickets” and “textbooks for sale”, I looked at the messages from my most loyal email correspondent, the one and only, R. Airey. Every day I would just tick all the boxes next to that name and head straight for delete, without even reading them. But that day, was not any other day.

I was determined to stay keen and so being a super keen bean I checked Subject title “HEARTSTART”.

Airey’s emails daily in anticipation The capital letters enticed me. for a HEARTSTART visit. I waited maybe 3 days, starting to lose faith, when finally it arrived in my inbox.

Subject: “HEARTSTART visit 17th October”. The 17th of October couldn’t have come sooner; I’d been polishing my CPR skills for the past week and learning all the lingo to be down with the kids and trendy. I was ready.

We arrived at the village hall and upon entering we were faced with 30 three foot devil children. The number one “don’t touch the kids” rule was straight out when we got climbed on, tickled and occasionally kicked by this army of vertically

through semen, thus having the ability to cause an allergic reaction.

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Societies

challenged infants. However they settled down and proceedings were underway. They were incredibly young, and therefore quite stupid.

The way we teach the kids about CPR is using the pneumonic (because all medics love pneumonics) DRS ABC, and when asked what they think the D might stand for when approaching someone on the floor, one of them answered “Daddy”, another “dog”, we thought we were in for a long night. After perseverance they seemed to get it, they retained the information and they (sort of) knew it! It was a success, and I felt bloody marvellous.

window and the keenness remained!

I’ve attended (almost) every HEARTSTART session and I’ve loved every single one. After a year of volunteering I got involved in the committee and arranged dozens of visits to Rainbows, Beavers, Brownies, etc. and they’ve been fantastic. This past year I have become the President of HEARTSTART; oh yes this isn’t some nice story about me and my society endeavour, this is a shameless plug for new members to join HEARTSTART.

The events leading up to my admission into Nottingham sometimes escape me. The formfilling, incessant redrafting of personal statements and late nights spent cramming for aptitude tests/interviews all seem like a blur, remembered as a tumultuous ordeal of seemingly insuperable supertasks punctuated by periods of restless waiting, occupied by efforts to prepare for the subsequent impending trial. Maybe it wasn’t that bad. Memory has a tendency to dramatize certain events, but I’m pretty sure the insuperable supertasks part is accurate.

Annie Fields

First year columnist

And then came the panic. What if I didn’t fit in? What if I was the dumbest one there? What if this was just some sort of cosmic prank, designed to put me in my place? These concerns and many others began their marathon round my paranoid mind, threatening to overwhelm me. It worried me that I had absolutely no idea what to expect of the course workload and, more importantly, my coursemates. I pieced together a particularly vivid amalgamation of characteristics ascribed to the average student. The result: a large, singularly vulgar and irreverent ruddy-faced individual with biceps and a neck twice the I miraculously managed to size of a regular man’s whose convince the admissions staff to let consumption of alcohol was only me pursue a BM BS here at limited by drinking-induced comas.

Nottingham. I was elated at first.

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But don’t take my word for it, come along for yourself!

HEARTSTART is an organisation in association with the British Heart Foundation which teaches people of I’d turned some three foot children all ages (majority kids) the life into three foot lifesavers. saving skills of CPR. It is a I haven’t looked back since, the lazy completely free volunteer based half arsed attitude went out the organisation and we have visits at

Cohort study

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least twice a month. It’s a great way to meet other medics, practice communicating with kids and brush up on those CPR skills. You can also gain a BHF HEARTSTART certificate if you lead 2 sessions, it’s incredibly easy and looks awesome on that all important CV. The feedback is always great, the kids love it and the volunteers love doing it!

I am pleased to report that my course-mates do not at all fit that mould. As apprentice to a profession involved in making judgements based on available evidence, you can hardly blame me for having a few preconceived notions. My error was making a diagnosis before performing a proper examination and forgetting that the human condition is both fascinating and befuddling in its complexity, necessitating a multidisciplinary approach and rigorous inspection over an extended period of time before even its most superficial aspects can hope to be understood. (I just made it up – but it sounds convincing, no?).

Jonathon Yee

Tony’s Trivia Titbits: The psoas major muscle of cattle is the one that is butchered to give a beef fillet.

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HOW I MET YOUR MOTHER...

A Parenting Guide for Medics “They f**k you up, your mum

and dad.

They may not mean to, but they do.

They fill you with the faults they had And add some extra, just for you.” –

Features

Extract from This Be the Verse

by Philip Larkin They say that becoming a parent is one of the most rewarding experiences anyone can have, although I must say that I never expected to become a parent at the age of nineteen. Thankfully as medic parents we don’t have to do all the hard work and messy bits.

When we get our children they step into our lives fully formed, just waiting for us to guide them along their way through medical school.

While you’d have to be a pretty shoddy medic parent to have the effect described in Philip Larkin’s poem on your medic child, it is not easy knowing how to be a good parent and how to help your sproglet to avoid all the pitfalls you fell into in first year.

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Passing on the wisdom We all know how dads like to tell stories and pass on their many years of experience. The time has now come for you to take on that role. Let your child know how fun things like the notorious Medics’ Cocktail Party are and give them pointers on where to pick up bits and pieces for their costumes. Talk to your child about which books you bought in first year and never opened, and which ones saved your bacon in January when you realised you had slept through one too many HDT lectures.

Helping your child to succeed Throughout our school lives we have seen many a pushy parent stealing their child’s youth to ensure their offspring can afford to give them a comfortable retirement. Helping your child to succeed at medical school is a completely different process. One that involves cheat sheets. Some wonderful medic parent lovingly made these at some point in the past, doing the hard work so we don’t have to. These cheat sheets have been passed down for generations, helping many a medic to pass their exams. Don’t be the one to break the tradition.

Mei Ling Henry

Don’t Check up on your child  Forget to swap contact every now and then to see details when you first how they are getting on. meet.



Give your child hints and tips about modules.



Encourage your child to get fully involved in medic  life right from the start.

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Do

The first meeting Remember when you first meet your child they will be probably be very tired and possibly hungover, if not still drunk, so play nice and try to hold back on all the horror stories about your freshers’ year.

Instead give them the chance to ask lots of questions as well as just chatting and getting to know each other. Show some single parent solidarity by taking your child somewhere with your friends and their children. It is important that your child sees (or at least thinks) that you are vaguely normal and therefore approachable.



Let your child know about the best places to go in  Nottingham.

Be overbearing or your child won’t feel able to approach you.

Be disheartened if your child doesn’t seem interested as having an extra parent isn’t for everyone.

Shark your child. Incest is bad, even if you’re from the West Country.

Tony’s Trivia Titbits: The parasympathetic nervous system is responsible for penile

21 and 3 weeks to live Marcus’ Story

“What is stronger, fear or hope?” - transplant. I’d say you have about a 50:50 chance”.

Lance Armstrong It was 11:00pm on the 23rd of October 2008.

This was the culmination of 6 months of pain, suffering and incomparable fear. I was told that a donor liver would be in the hospital unit by 5:00am and that I needed to prepare myself for transplantation. The news filled me with the most overwhelming mix of feelings I have ever experienced.

I was 21 years old and had 3 weeks left to live.

I had been diagnosed with cryptogenic hepatitis in May that year and, through no fault of my own, had deteriorated in health and suffered almost every symptom of end stage liver failure. When only 10% of my liver was functional I was put on the transplant list as a final resort in October.

My father coped less well because of his medical background: being a GP, he was only too aware of the implications of each set of test results and took every deterioration in my health personally. Being a man that had healed for over 30 years as a professional, he now couldn’t make his own son better and I felt his helplessness everyday awaiting blood test results for yet another disappointment.

Coming from a family of over ten medical professionals, I have grown up believing that science solves everything. I was overcome with frustration, anger and fear when Professor Neuberger, a worldrenowned liver physician of the Queen Elizabeth hospital Birmingham, told me simply “well we don’t understand that much about the type of hepatitis you have. It can go one of two ways: either you will improve and make a full recovery, or your liver will die and you’ll need a

I will never forget the shock I felt as I heard those words. I searched his face for an answer, I thought he must have been joking, but soon realised Marcus pre-transplant with very there was no treatment. I had no obvious jaundice choice but to wait it out and see what When I was in hospital doctors would happened. I have never felt as try and empathise with me, and helpless as I did then; fate was to although the gesture was decide my medical outcome. appreciated, they knew as well as I My life has changed so dramatically did that claiming to understand what as a result of my liver transplant, being close to death felt like was particularly my perception of illness impossible. I am now in a position to itself. Illness is a word that means so understand the pain and suffering many things to different people. that patients go through, something Illness for me at that time meant lying that was proved to me when I spent in an intensive care bed unable to time on intensive care unit ward move, on dialysis, with lines in so rounds as part of my work experience many blood vessels, drifting in and before medical school. I could see the out of consciousness and in fear and desperation in their eyes excruciating pain. I felt as though I when under the daily onslaught of had been gutted. In the months medical questions. People want leading up to my transplant, illness nothing more than to survive. The was also the meaning of having most ground-breaking day for me approximately 5 seconds of peace was when I managed to get out of after I woke in the morning, before the bed and walk to the toilet on a reality of my uncertain future filled Zimmer frame with my dad me with dread and fear. supporting me.

The smallest Very few people get to have a second achievement can have the most chance at life. Knowing how lucky I fundamental effect on a person’s life. am to be alive affects me every day. This principal is something I will take Much of life is spent as time wasted: with me for the rest of my life. people become accustomed to My decision to study medicine was a feeling sad or unfulfilled, and struggle direct result of my hepatitis; I want to from one personal or work problem to be one of those doctors that had the another, failing to see positives and same life changing effect on me. I see letting opportunities pass them by. no other profession in the world that Having been to the edge of life, to a compares to medicine and no one I point where I was told I was going to have a greater respect for. die, there is no Although I have been within weeks of way I am going death, experienced life from an angle to let myself that no one should at 21 years old waste this and am now on permanent second chance. medication, in what must seem incomprehensible to others I simply Marcus’ ankle wouldn’t want life without my liver transplant. oedema

Marcus Mehta

erection, the sympathetic for ejaculation. An aide memoire is `point and shoot`.

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An Alternative Gu Featuring contributions from Oliver Burbidge, Imogen Firth-Jones, Mei Ling Henry and Rohan Tharakan

Malt Cross 16 St James’ Street

Features

The Organ Grinder 21 Alfreton Road Part of the Canning Circus pub crawl circuit, The Organ Grinder is not one to miss. It sells award winning real ales coming from the, Ilkeston based, Blue Monkey brewery and has a fantastic pub atmosphere. For those who like a drink in the afternoon, why not try a nice refreshing glass of BG Sips.

This converted Victorian music hall still hosts some fantastic live bands and has a great atmosphere both during the day, when it serves top quality food at affordable prices, and at night when it transforms into a bustling bar. The bar has retained many of its original 19th century features making it an ideal place to spend an evening if you want something a little classier than the standard student bar experience.

Dancing Dragon 103 Derby Road Dancing Dragon is a truly fantastic Chinese restaurant at the top of Canning Circus. You must try the ‘Hot Pot’, where each table gets a hob and a pot of boiling soup.

You add your raw food (from a huge selection such as prawns, beef, squid, lamb and much more) and it will cook within minutes. It tastes incredible, you astonishingly get unlimited food and it’s so cheap, especially with the sheer amount of food you get.

Dancing Dragon should not be missed out on.

Fancy going further afield?

The Library Bar & Kitchen 61 Wollaton Road, Beeston The library is a bijoux restaurant, which serves a variety of high-class meals and fine wines, all at a great price. The cosy atmosphere allows for a friendly dining experience, but make sure you get there early as it is very popular and fills up quickly. The food really is fantastic; you’ll definitely want to come back and try out more of the menu. It is also worth checking out their lunchtime deals, to help you get more for your money.

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Tony’s Trivia Titbits: The gene coding for polydactyly (having 6

ide To nottingham Broadway 14-18 Broad Street Invest in a student membership and it’s the cheapest cinema ticket you’ll buy in Nottingham, for undoubtedly the best experience. More often than not someone’s busking outside and inside there’s a CaféBar where they serve homemade seasonal food and a selection of drinks including continental lagers and local brews. And that’s before we even get to the films! As well as screening a range of independent new releases, foreign films and classics, Broadway offers filmmaking courses and screenwriting events, making it an inspired centre for culture and entertainment.

Lee Rosy’s Tea 17 Broad Street

Petit Paris 2 Kings Walk Serving magnificent authentic French food I couldn’t recommend Petit Paris enough. The food is utterly beautiful and I’m yet to have a disappointing meal- I particularly recommend their selection of steaks. The prices are very reasonable too, especially their lunchtime menu. The décor is cosy and unassuming; it really feels as though you’re in Paris (and the staff are far friendlier here than in Paris!). Just be sure to book early, especially for a Friday or Saturday evening.

Enjoy!

This is a quaint little tea room in Hockley, which serves and sells more than 100 types of loose leaf tea. As well as tea, they serve other hot and cold drinks, as well as delicious homemade sandwiches and snacks. It is also used as a venue for events, such as a regular film night (every Thursday except the first of every month) and one-off gigs or exhibitions. It’s the perfect place if you’re looking for somewhere a bit different to relax.

Brass Monkey 11 High Pavement Single parts of dark rum, vodka and orange juice served on the rocks A slightly lesser known cocktail, and not on the menu here, however, the extensive list of available cocktails still gives plenty of choice whether you like something fruity with plenty of mixer or something much stronger there will be a cocktail for you. All for £4.50 per cocktail (with a student card) however, you may wish to take plenty of money as once you have had one you will want to work your way down the list.

fingers) is dominant over the gene that codes for the normal 5 fingers.

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Where in the world Planning your elective

Features

It’s the start of your final year and almost immediately everyone starts talking about finals. Grim. The countdown begins and by Christmas you have lost the ability to talk about anything other than medicine. The one happy topic is your elective... so long as it is organised!

If you remember nothing else, organise your elective early!

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The international language of medicine is English, but patients and consultants may not want to speak their second language just for your benefit. But if you truly want to experience a different culture or practice another language it’s worth the extra work.

an exotic location to spend it all inside, nor do you want a great tan but no experience of working practices in that country.

Visas are needed and SHOULD be The set up free for just two months, but check. Some people have their elective Some visas require you to visit the organized by August…some are still embassy or organise medical unsure it will happen going into Where and What The two biggest questions for your certification, taking time and their OSCEs! The US and Canada are popular and great choices, but elective are: where and what. The money. notorious for failed set ups. world is truly your oyster. Let your is surprisingly imagination run riot. The more What specialty is up to you and your Communication However, perhaps difficult with North America and obvious may be easier to organize, interests. but the more extraordinary may be… consider one that fits the location, some places won’t let you apply well more extraordinary. Almost* e.g ski/mountain rescue in Canada; before a certain time or only allow 4 edge interventional weeks. nowhere and nothing is off limits! cutting From ski resorts, sailing ships, to radiology in the US or emergency Bear in mind working across time surgery trains through India, and medicine in South Africa. zones means communication and even NASA. Most of medicine is of Where has a lot of implications. course indoors, which Top Tips Organise it as soon as possible.

Cost mostly - as well as language, can set up a conflict of  visa, safety, travel and work interest if the outdoors is  Have a working credit card with a decent opportunities. Idyllic islands in the why you went there. limit. pacific may not have neurosurgery, Expectations can vary,  Withdrawing money costs, so withdraw but be very hands on. Whereas, a and agreeing a balance sizable amounts per week or open a bank US centre of excellence may be the up front is a wise move. account and deposit a lump sum online .

You don’t want to fly to opposite.  Keep costs down but don’t miss out. *Almost anywhere: As a member of the reserve forces I asked if I could go to  Use any connections you have.

Camp Bastion, Afghanistan for my elective. No chance!  Go with a friend if you share an interest.  Get accommodation near your hospital.  Get maps and travel passes ASAP.  Get connected to the internet. Find free wifi spots. Email and Facebook may be your only way of communicating with people in the country or back home.  Get a pay as you go sim card .  Get a city guide to what’s going on.  Have an honest talk with your elective supervisor about what you want to achieve and what is available each week.  Find out what the University is organising and join in.  Make friends with the local students for more top tips.

Welcome to the beach

Tony’s Trivia Titbits: Five times more black men in the

getting answers can take weeks, and a split elective across different hospitals, cities or countries can double the work. Admin staff move on or go on holidays, so when emailing it’s best to copy in someone else in the department as well. Oh, and if you have contacts – use them!

Jarvis beach, South of Sydney—Hyams beach

Set up is usually through an elective or admin department. The NLE and MDU hold information on just about every hospital in the world with elective reports from previous students, which may help you decide on place or specialty:

http://www.the-mdu.com/ section_Medical_students/ topnav_your_elective_2/index.asp

Before you go

Joining is free.

Flights Booking early usually gets you a cheaper deal, so the importance of early confirmation of your elective also translates to personal cost.

When booking flights also bear in mind the unmentionable…you may not pass your finals. This means Nottingham University expects you returning early from your elective, to complete its online Elective and so rescheduling flights…in a very Application & Risk Assessment form bad mood. and submit by January 31st. While written confirmation of your elective Accommodation Accommodation can be suggested submitted by mid-December. by the University/hospital or you can The MPS covers you for most try and find it yourself…as a revision insurance and liability, but not in break…bad idea (see above).

Australia. You can get cover from their ‘sister’ company the MIPS. Your perfect elective has been agreed. Job done… not quite. The organisers will send you information and forms to complete and return, plus requests for additional documents from Nottingham University and other third parties.

HELP!

If all this is sounding like a lot to take on, there are options: 1. Organise it with a friend. Share the organising and be certain of knowing someone else when you get there.

2. Pay a company to organize your elective. Makes things easier, but adds expense.

3. Do an elective in the UK. OK so you won’t get a tan or have exotic tales, but the savings are huge.

You get time to spend with your family and may even make useful contacts for your future.

4. Stay with friends or family abroad.

Money saved, but make sure it’s not at the expense of your sanity or friendship.

Documents needed may include:  Application form – with clinical school fee and an enrolment fee, anything up to £1000.  Code of conduct agreement.  Prohibited employment declaration.  Student undertaking and declaration.  Recent immunisation documentation, possible cost.  Three forms of ID.  A new CRB check cost.  Insurance cover for public and professional liability (including medical malpractice).  A letter of ‘good standing’ from the sub-dean. Bear in mind he has to write 340!

United States develop testicular cancer than white men.

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Features

So what is it going to cost?

Electives are expensive, so working out a budget may help you plan.

Your elective is a great opportunity to see and do some amazing things and it would be a huge shame to miss out on these, so borrowing within limits is a good idea if you want to get the most from your time abroad.

Relax and have fun, but also learn something about where you are and what you are involved in.

Every supervisor remembers how much they enjoyed their elective and they want you to enjoy yours. Plus they also know how hard you have just been working Banks are willing to help, and the and what the work many bursaries available are a great coming up as a junior option. The majority tend to be for doctor involves. electives in developing countries, but there are also some that are Greg McConaghie speciality specific. You need to submit an application and usually a bid for them.

Don’t forget…

Get it organised early so you can concentrate on your finals.

The Kolling building and new hospital in Sydney

The Advantages of going with an elective company Got a hospital guaranteed?

Elective plans fall through more often than you’d think. Using an organisation like Projects Abroad to arrange your elective alleviates that fear as you are guaranteed a five star placement and insured against things that go wrong overseas.

Translator What if you go all that way and find that nobody speaks English? You end up spending your whole time oblivious to what is going on. Projects abroad can advise you on which countries are best to travel to if you are not multilingual and sometimes provide a translator to assist you.

Dates Suit?

Projects Abroad can allow you to choose when you start and when you finish as their links with partner hospitals and clinics run all year round. This also allows you flexibility in altering your dates slightly or extending while overseas if you need to.

Hands On What guarantees do you have that you can attain hands-on work experience on an elective placement? Hospitals can sometimes be vague in their assurances. Projects Abroad can offer hands-on practical experience in general medicine to elective students.

Outreach An organisation like Projects Abroad can also offer you the opportunity of at least one day of outreach in poor rural communities every week as part of our policy of providing worthwhile support in the communities we work in.

Emergency Consider how to deal with emergency situations if you’re by yourself. Organisations should have a permanent 24-7 presence in each country with staff committed to looking after you in the event of any emergency you encounter whilst overseas.

Craig Ferriman , Projects Abroad

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Tony’s Trivia Titbits: The word pudenda comes from

Character On the couch Superman Mr CK was admitted to the unit via A&E, where he had attended with an episode of poisoning. Although not acutely confused, it was idiosyncracies in the history, which prompted the clerking F1 to ring for a psychiatric review, and after one look at the lycra-clad man, resplendent with his pants outside his trousers, the on-call registrar agreed to admit Mr CK for assessment.

Despite the attire, Mr CK was found to be engaging, and well orientated to time and place. The F1 informed us however, that the patient believed himself to be the final descendant of a planet called Krypton, who had been sent here by his parents in a homemade spaceship, just moments before the explosion of Krypton and the destruction of everything he had grown up with, and that they weren’t sure how to draw the family tree for that. Psychiatric disturbances are, of course, not uncommon in patients who have lost a parent at an early age and if this can at least be taken to be true, we might have a basis from which to examine the rest of Mr CK’s mental health.

Mr CK regularly referred to himself as the man of steel, and spoke often of his duty and compulsion to protect planet earth. When pressed on how he would go about this, about whether or not he’d been imbued with any special powers he reeled off a list without pausing. To quote the patient, he said he was “faster than a speeding bullet, more powerful than a locomotive, and able to leap tall buildings in a single bound". Other reported abilities included ‘flight, super-strength, invulnerability to non-magical attacks, and super-speed’. These were, of course, textbook grandiose delusions even down to the fantasy and science fiction theme.

The tenderness displayed towards humanity was indeed touching, but such an unhealthy sense of responsibility for its safety fits with what Dr Wethman described in his 1954 book, “Seduction of the Innocent”, as “a s u p e r m a n complex”.

Such states of mind are often seen in young men, and the imbued sense of infallibility they carry can have a thoroughly detrimental effect on both mental and physical health.

I’m almost ashamed to admit that I couldn’t resist the temptation to ask how with all the powers he lay claim to, Mr CK came to be laid up in a hospital in the first place. “Kryptonite” he replied with a wry smile, “and Lex Luthor”. Having scoured both the periodic table and BNF at length for the first, I can only put it down to neologism, but found Mr CK’s reference to the famous media magnate Mr Luthor, very intriguing. It is not uncommon for people with delusional disorders – as it was becoming increasingly obvious Mr CK is suffering with – to have persecutory delusions, nor for those delusions to centre around well-known public figures.

telescopic, infra-red, and microscopic vision) to super-hearing, and, a phenomenon called super-breath – something which I cannot find reported anywhere else in the extant literature.

With this combination of bizarre delusional beliefs and hallucinatory experiences, Mr CK was given a working diagnosis of paranoid schizophrenia and commenced on a regimen of risperidone. This has been generally well tolerated, although he has put on a significant amount of weight, and developed noticeable breast buds. He is also attending once weekly CBT sessions, and a supported employment scheme with a view to getting him a job at a supermarket or establishment.

Another Mr CK also exhibited a range of similar triumph for psychiatry. extra-campine hallucinations, ranging from perceived visual powers Anon (including x-ray, heat-emitting,

the Latin word pudere, meaning ‘to be ashamed’.

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Emilie Autumn—FLAG

Arts and Culture

Emilie Autumn, where to start? Whether it’s that she could read musical notes before words, or that she attended an esteemed music college at 14 or even the fact her fans are nicknamed Plague Rats…you get the idea, this is not your dime-a-dozen musician. A mistress of the violin and harpsichord, Autumn has gained a worldwide cult following that only deserves to grow.

Autumn’s work has always had a dark edge and recently, she has refined her style to what she calls “Victoriandustrial”. This covers so much: the dangerously enticing mix of the poetic and the psychotic; the contrasting lilting and growling vocals; the effortless blend of classical and electronic instrumentals, the taboo themes, the list goes on. This is nothing like you’ve heard before. So it was with pleasure that I saw the Queen Plague Rat herself gracing our humble Rock City in March on her Fight Like A Girl Tour.

The show promised to be “musical theatre at its greatest” and boy, did it deliver. Entering the venue, the audience were greeted with an eclectic loop track which included soundbites from Disney’s Alice in Wonderland and manic speeches about the disease called madness from which “no one is immune”. Creeping and then charging onto the stage after shameless teasing, Emilie Autumn finally arrived with her Bloody Crumpets (her all-female backing dancers). Cold tea and digestives sprayed over the audience (by cup or by mouth), burlesque side-shows of pyrotechnics and featherfan dances, spells cast and kisses shared with the crowd, they knew how to win our hearts and leave us howling for more.

Autumn’s last album Opheliac was really where the Victorian of “Victoriandustrial” came along. It was a concept album focussing on mental illness and on being trapped in ‘The Asylum for Wayward Victorian Girls’. It reflected Autumn’s own time spent in a psychiatric ward due to her bipolar disorder. Loathing her time there, she penned her partly autobiographical novel on notepaper, also called ‘The Asylum…’ for which a West End musical is planned. She also had her patient number tattooed on her arm as a statement to highlight “labelling” in mental illness. Now the tour and the upcoming album are continuing that story. But this time, the inmates are hitting back, proving in the opening number that “even if you’re only a boy, you can still fight like a girl!”

This rollercoaster of fun, frolics and confectionery finally closed with the triumphant One Foot In Front of the Other, a grim but determined number stating that although the road to recovery would be long, it would be ours.

Emilie Autumn will be more of a “grower” with most people as her style can come off as grating and pretentious if taken too seriously. My advice: listen to samples of each of her albums, as some will prefer her demented compositions for electric violin on Laced/Unlaced, others will prefer her poetry and a few may favour her industrial sound. Whatever you prefer, she is unashamedly different, enormously talented and absolutely demands to be heard.

Olivia Volk

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Should we practise what we preach?

3rd year columnist Before commencing CP1, it was far too easy to sit back in the lecture theatre, reliving the questionable events of the night before – if you turned up, that is. It was easy to sink into the student persona, complete with a burgeoning hangover. The lecturer begins, regaling us with facts on liver disease that we shall flinch at, remember for our exams and later for our future patients, but not for ourselves. It was easy then to ignore the statistics in the comfort of LT1.

Or if alcohol isn’t your poison of choice, let’s review our haphazard student diets. High fat and high salt meals, with fruit and vegetables now just a distant memory, are consumed eagerly. Everything in moderation is fine, we say, but it is interesting to ponder where we draw the line. You may remember the scene in Series 1 of ‘Junior Doctors’ with the overweight doctor running to the crash call. I wondered, whilst sitting in a diabetes clinic, whether I would be comfortable conveying to the patient the importance of diet if I were overweight. Or let’s try to painlessly remember our ill-advised behaviour during exam time where the pressure to pass (or excel) drove a revision-induced sleep-deprivation.

So we learn to advise our patients to adhere to guidelines for their benefit, while blissfully ignoring these ourselves. Is this hypocritical that we give this advice and do not follow it?

And furthermore, will our patients listen – and should they? It wasn’t until now that this had crossed my mind, but the beginning of clinical practice has left me feeling distinctly uncomfortable. For now, I have made my peace with the issue: as long as I deliver good care to my patients, my personal life remains disconnected from my professional one.

However, there are certain things that overspill, and in the ever-growing climate of patients questioning treatment and advice, we should perhaps strive to retain our credibility. Until I’ve made my mind up, I’ll see you in Ocean on Friday, and then join you for a greasy kebab at Arco’s. Although, I probably will end up pulling an ‘all-nighter’ in Greenfield before our CFU deadline as a result. Oh well.

Holly O’Nione

Tony’s Trivia Titbits: A passionate kiss uses, on average, 6.4 calories per minute.

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Actors that could have been...

Will Smith (Men in Black) - (The Matrix)

Arts and Culture

Will Smith was once considered for the role of Neo in the Matrix and, while you might think turning it down was a big mistake, he has since confessed that he wasn’t ready as an actor and would have messed it up.

Stuart Townsend (The League of Extraordinary Gentlemen) – Aragorn (Lord of the Rings)

Stuart Townsend was cast as Aragorn but 2 days into filming was let go, as Peter Jackson felt uncomfortable with the casting. He was then speedily replaced by Viggo Mortensen, who has since shot to worldwide fame and acclaim.

Tom Cruise (Mission Impossible)- Jack Dawson (Titanic) and Tony Stark (Iron Man)

With the re-release of Titanic in 3D it is pertinent to consider that it could have been Tom Cruise precariously dangling Kate off the Titanic. Cruise was also once the top choice to play Tony Stark aka Iron Man. Imagine Iron Man bouncing up and down on Oprah’s sofa.

Paul Bettany (A Knight’s Tale) - King George VI (The King’s Speech)

Dougray Scott , most recognisable as the Scottish villain of Mission Impossible II, was originally cast as Wolverine in X-Men (2000) but due to Mission Impossible II running over schedule by several weeks, he was recast with then unknown Hugh Jackman, who made his career off X-Men and the subsequent tears of Dougray Scott.

Now I feel really bad for Paul Bettany. The role of King George V I in the King’s Speech was actually written for Paul Bettany but he turned it down to ... The role was given to Colin Firth; and 4 Oscars, 76 wins and 99 nominations later, Paul might be feeling a tad annoyed…

Robert Englund (Freddy Krueger) - Luke Skywalker (Star Wars)

Jake Gyllenhaal (Donnie Darko)- Bruce Wayne/ Batman (Batman Begins)

Henry Cavill (Immortals, The Tudors)– Superman, Cedric Diggory (Harry Potter), Edward Cullen (Twilight), James Bond

Not only was Cavil replaced as Superman in Superman Returns, he also lost the role of Cedric Diggory (Harry Potter) and Edward Cullen (Twilight) to Robert Pattinson, despite the endorsement of Twilight’s author. Cavill was in the final two choices for 007 but was too young for the producers and lost out to Daniel Craig, (ironic as he lost Twilight because he was too old). Ouch.

Nonetheless, the silver lining is that he will once again don the red and blue tights for the upcoming Superman reboot, Man of Steel (2013).

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Sean Connery was once offered the role of Gandalf including10% of the trilogy’s profits. In retrospect of the multibillion dollar success of the film, maybe turning it down might have been a mistake Sean?

Dougray Scott (Mission Impossible 2)Wolverine (X-Men)

Robert Englund -best known as the razor tipped, dream stalking, teenage slashing killer from the Nightmare on Elm Street franchiseonce auditioned for the role of Luke Skywalker but upon not winning the part, encouraged his pal Mark Hamil to audition. The rest is film history...

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Sean Connery (James Bond)– Gandalf (Lord of the Rings)

Can you see Jake Gyllenhaal growling his way through Batman Begins? A strong contender for the role, It certainly would then have been rather interesting if his sister Maggie Gyllenhaal was still cast as his love interest in the sequel, The Dark Knight...

John Travolta (Pulp Fiction) – Forrest Gump, Paul Edgecomb (Green Mile), Jim Lovell (Apollo 13)

Tom Hanks really does owe John Travlolta a lot. John Travolta declined a string of career changing lead roles in Forrest Gump, the Green Mile, Apollo 13 and Splash (not so much this one) and Tom Hanks just picked them up one after the other and cashed them into worldwide successes... #winning. With the Oscar, that almost could have been Travolta’s, on his mantelpiece, I think Tom Hanks owes John Travolta a drink ...or two.

Rohan Tharakan

Tony’s Trivia Titbits: Milliners in the 1800s often used mercury compounds when

Review: The Hunger Games (12a) Harry Potter’s all grown up and Bella has ‘broken her dawn’, so who’s up for a new film series? With impeccable regularly regular timing, up steps ‘The Hunger Games’, the first in Suzanne Collins’ series of fantasy thrillers. If you’re not familiar with THG, the main theme involves a post-civil-war futuristic North America, where each of the impoverished districts from the losing side annually provide two of their youngest and brightest to participate in a battle to the death. All for the amusement and ‘Big Brother’ style viewing pleasure of the ostentatiously affluent ruling class.

We make our way through this gruesome scenario following the progress of Katniss (Jennifer Lawrence) and Peeta (Josh Hutcherson) of District 12. Katniss instantly makes her way into the audience’s favour by volunteering for the brutal tournament in place of her younger sister, who by the looks of things would have lasted about as long as free pizza in LT1. From this start, Katniss goes from strength to strength, developing into an intelligent and likable character who is not too keen on the murder malarkey, but more than capable of looking after herself when she needs to. The same unfortunately can’t be said for Peeta who seems to have about as much backbone as a jellyfish.

The film impresses with a sensitive approach to a hellish scenario played out over the medium of reality TV. Where I think it does slip up a little though lies in the decision of a 12A rating. We are following characters as they literally fight for their lives, however there is a distinct lack of feel to the kind of violence and desperation we can only imagine a situation like this would involve.

This is certainly no ‘Battle Royale’, a film which has certainly been a source of inspiration to the THG. But what the film does achieve, is to deliver a surprisingly entertaining first stage adaptation of a well-liked literary series, with a bit more bite than certain other teen thrillers. The great difference with THG being that some of the characters you aren’t too keen on will probably come to an early and bloody demise! Result.

Simon Millington

Review: The Cabin in the Woods (15) This hour and a half tribute to the horror genre marks the directorial debut for Drew Goddard, here working in collaboration with Joss Whedon of Buffy the Vampire Slayer fame. For fans of both Whedon’s previous work and the horror genre, this film functions as a demonstration of all that is great about both of them.

We kick off with an age old premise. Five American teens head to a cabin out in the back country for some good old-fashioned all-American fun. This mainly seems to involve drinking beer, swimming in lakes and being menaced by local gas station employees. As you might have guessed, there’s more to the cabin than meets the eye and in the fine traditions of horror film characters, our protagonists ignore the creepy old paintings of ritual sacrifice, mounted wolf heads and randomly opening cellar doors. So far, so predictable, but what Whedon successfully produces an enjoyable ninety minutes of gore, trademark wit and ever increasing madness. With every plot twist and sudden change of direction you are swept along by an admittedly mental storyline that could come in for some criticism if the whole thing weren’t so enjoyable.

It’s hard to write more without ruining the film, but I really can’t recommend this piece highly enough. For those looking for a simple thriller, it contains all of the elements of your classic American slasher flick. From the occasional semi-exploitationist nudity to well-worked action sequences, the film delivers on all counts. At the same time, serious horror fans will enjoy the way the film incorporates these elements in a way that gently mocks and parodies the genre itself. For a fantastic twist on a classic formula, it’s hard to get much better.

Adam Butterworth

making hats that caused psychosis, hence the expression ‘Mad as a Hatter’.

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Titanic 3D (12A)

Arts and Culture

Let’s get something out of the way – very few people who go to see Titanic 3D will be doing so without a healthy dose of rose-tinted nostalgia. It is now 15 years since James Cameron proclaimed himself king of the world after Titanic (two dimensional) smashed every box office record around and took home an impressive 11 Oscars. Whilst its creator has moved on to the forefront of cinema technology with Avatar, Titanic sits now as something of a curiosity.

It is probably the last great epic film of the pre CGI age, with actual sets around which to build its story, rather than acres of green screen for the actors to work in. This works well in its favour for its new all singing all dancing 3D retrofit, as the ship has always been the star of this film. With an extra dimension to work with and an impressive, surprisingly subtle use of 3D (saying that, you wouldn’t expect Cameron to produce a Clash of the Titans style hatchet job) the ship leaps off the screen, making a highly believable world for its characters to inhabit. It is just as well that it does however, as when you strip the nostalgia away, the problem with Titanic was always the slightly overblown love story at its centre and paper thin supporting characters. Indeed, Winslet’s Rose and DiCaprio’s Jack aside, the rest of the cast are left with roles barely more fleshed out than that sketch, with Billy Zane’s scenery chewing as the ludicrously caricatured love rival, Cal, being especially grating. Yes, it takes its time to get going and yes, we still all know how it ends but once the iceberg hits, the film comes to life and the ship’s demise is genuinely thrilling cinema.

Whether you enjoy Titanic in its new incarnation is ultimately down to whether or not you enjoyed it the first time around. It has probably not aged into the classic many initially expected, but it is still one of the films to be watched at least once and with this new transfer it is worth seeing on the big screen to fully appreciate its truly epic scale.

James Kitchin

Do you follow?

Pointing out that student politics is a massive popularity contest fuelled by unwarranted self-importance and crude Photoshopping is somewhat like pointing out that Westminister is comprised of a shiny faced old-Etonian and his chums. There’s nothing particularly edgy about being right about these self-serving, sandal wearing Labour MPs of tomorrow.

Unfortunately, there is a far better disguised evil that lurks within the hearts of many students; the desire to own a society polo shirt with your own name on it. This is the holy grail of some students and very much like the Holy Grail, it will drive you mad and turn you into a Nazi treasure hunter (if this does happen to you, remember to only drink from the plain looking cup.)

most of them are bloody useless.

Whether they’re organising their summer holidays under the pretence of volunteering or scrabbling desperately to arrange the minimum number of events per year to keep their funding, these people seem to exist solely to fill up my goddamned inbox. 50MB is not nearly enough to cope with the badly formatted flurry of self-promotion and offers of free pizza. The one question I want answered is who did Ruth Airey cross in the past to have been allocated the Sisyphean task of sending all of these?

I may have been unfair in calling these emails badly formatted. The truth is that I have no idea what they look like these days because I stopped reading them some time in 2010. What I There are too many societies and haven’t been able to escape,

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unfortunately, are the massed ranks of the cake sellers and bucket shakers who besiege LT1 every single week.

[Insert Career Path Here]-soc may be useless MTAS form filler, but at least they don’t want me to fund their trip to darkest Africa to help the dear children. Normally by climbing Kilimanjaro, for some reason. I’m no expert on international development (despite what I tell girls who I’m trying to impress in the Crocus Cafe) but I imagine that the children would get more out of a water pump and some goats than watching a bunch of middle class white kids prancing up a hill.

There is only one solution to this problem. We have to fix African poverty so that these morons stop annoying me. Do you follow?

Tony’s Trivia Titbits: You laugh most at the age of 6, on average 300

I swear by Apollo...

It is hard to define when medicine first started, and who it was that started it. However, most would agree that it all began around the 5th Century BC in Greece, and it was Hippocrates ‘The Father of Western Medicine’ who was its creator.

Although, as far as medical students are concerned, the history of medicine can be summed up in just a few lines of a personal statement, and enough to get them through an interview. Two and a half millennia have passed since the time of Hippocrates, and I intend to see why we still follow what he said all that time ago.

the modern world. One begins to wonder then, if so much has changed, why we still follow this aged principle, even though our education seemingly never explains how it came about, and what it means to us as students from day one.

So who was Hippocrates? He was a physician, a bit of a radical among his contemporaries for holding the belief that disease occurred naturally, and not due to possession by evil spirits, or because of the wrath of the Gods.

Hippocrates also suggested the idea of treating both the body and mind as a single entity, and that diagnosis should begin with observation of the whole body, an idea still drilled into us in clinical skills. He managed to accurately describe diseases such as pneumonia and childhood epilepsy, and outlined how the effects of disease may differ between people.

The old oath has been adjusted slightly, to make it more modern; however, the principles stated in it remain pretty much the same. The oath refers to medicine as an ‘art’ as well as a ‘science’, and that ‘warmth, sympathy and understanding’ may be better than surgery or drugs. This is something that we must all remember, before we casually dismiss the reason why a patient has come to see us.

It may also help to explain the t o rr en t of le ct u re s on communication skills we have to endure during the first couple of years of study.

a ‘cancerous growth’. It is very easy to get bogged down in patient histories, social histories and investigations, that we can forget ‘the patient’ is an actual person.

It tells us that we are to learn, and respect the ‘hard-won scientific gains’ of those have preceded us and to pass this knowledge on.

Were it not for this, the study of medicine would not have developed at the rate that it has, nor would we be able to become promising doctors of the future.

Most importantly, we are taught to understand our limitations; doctors are after all, only human (however highly medical students may rate themselves above others). It says, ‘I shall not be ashamed to say “I know not”, nor will I fail to call in my colleagues when the skills of another are needed’. We must remember this when on placement, and in OSCEs (pretending really doesn’t work), and that our colleagues extend beyond other medical students, but to the nurses, midwives and other health professionals with whom we shall work for the remainder of our careers.

In short, there doesn’t need to be much of a summary explaining why we still follow this ancient group of principles. I have looked at but a few of them, and in each one we can learn how to improve ourselves as doctors, and find reason to use them every day of our careers.

We all know him for his famous oath, which all doctors swear upon; even if only in principle, rather than practice. Much has changed in the time since Hippocrates, with medicine being one of the fastest We are told to treat patients as Oliver Burbidge evolving and developing studies of patients, not as a ‘fever chart’, nor

times a day, in adulthood it is on average only 15-100 times a day.

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Essential bro Arts and Culture

A guide to some of the best and most useful apps and websites within your grasp...

Essential Websites BBC Radio4 Extra- One of the best hidden gems of the internet. For those who love audiobooks, this station broadcasts (also via iPlayer) all kinds of audiobooks and radio dramatisations from the best loved novels, plays and short stories, from ‘The Shawshank Redemption’ to ‘I Am Legend’ to ‘Nicholas Nickleby’ to ‘The Twilight Zone’ and ‘Casino Royale’... One of my most favourite accidental finds ever.

Seefilmfirst.com – Sign up (free) and get preview tickets to see loads of films early and completely for free, before their national release... I was offered tickets for the recently released Titanic 3D, way back in February. Sign up and enjoy...

Stumbleupon.com- The cleverest and greatest site ever. First tell stumbleupon the kinds of things you like, then click ‘stumble’. It will uncannily take you to all the best of the internet, based on the things you love. By liking or disliking each result, you can let stumbleupon further ‘learn’ and ‘atune’ itself to your tastes.

Wesplit.com – No more awkwardly reminding your housemates for money. This website records all and

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any outstanding bills, for the entire house to see. With automatic email notifications when you’ve been added to a bill, this is an easy way to a stress free house.

Medscape.com- This is a brilliant free medical encyclopaedia app that doesn’t require internet access. This is especially useful when you’re in a clinic and you don’t have time to wait for your rubbish 3G connection to load Wikipedia. You will also have access to Medscape’s fantastic online articles, cases, quizzes and practice questions.

TED Talks- Listen to amazing short talks and presentations on exceptional, informing topics. This is a really easy way to improve your public speaking and presentation skills.

Sporcle.com – I feel bad doing this during the revision period but this is one of the most addictive quiz sites ever cruelly dreamt up... seriously.

Dropbox- This is an incredible free cloud based system that is also available as an app. Store your documents in the dropbox folder on your computer and it will automatically sync to your online dropbox, for you to access and

download wherever you are in the world...

Project64 – Want to relive the golden days of the Nintendo 64 and Goldeneye, Super Smash Bros and Zelda? Project 64 is an emulator that allows you to play Nintento 64 games on your PC...

Google Scholar- For all 1st and 2nd years out there... Google Scholar trawls through and find you all the scientific papers and journals you will ever need. This is a lifesaver when it comes to your dissertation (as is Endnote).

Evernote – This superb online memo and notes manager allows you to make notes and memos on your phone and then syncs it with your online account so you can always access them, wherever you are... iGoogle- iGoogle gives you an online homepage where you can collate all the best widgets of the internet into one place, such as rss news feeds, sports results, top pictures, magazines, games, trivia, recipes, quotes, jokes, medical facts - anything you like...

Tony’s Trivia Titbits: Bodies do not decay as quickly as they used to;

wsing Essential Apps Amazon Kindle App- For those of you who like to read books on a portable device but still find the real kindle not portable enough, this app is absolutely brilliant. You can sync your books (including your progress) from your kindle to your phone (and vice versa) and download any book from the massive Amazon kindle store. Plus, there are so many amazing classics, from ‘Dracula’ to ‘Pride and Prejudice’ to ‘Oliver Twist’, that can be downloaded completely free.

Shazam – Never know the name of the song on the radio?

Shazam can ‘listen’ to the song and identify it for you with its massive online database.... my favourite app ever.

Remote for iTunes – Not deliberately trying to encourage sedentary lifestyles but this fantastic app allows you to control your PC iTunes using just your phone... ideal when the shuffle function fails you.

Gmote- this brilliant app allows you to use your touchphone as a mouse to control the pointer on your computer... Utterly brilliant.

Disk Usage- For those who are magically always running out of free space on your phone (i.e. anyone with an HTC Desire) this amazingly brilliant app will tell you exactly where all your space is being used up and allows you to access each folder and delete as necessary.

I hope you find these useful and that they don’t affect your revision too much. Send us any suggestions you have, for any apps/websites/books/films/ tv shows etc, which you think medics should know about, to echolaliasubmissions@gmail.com. We are looking forward to hearing from you.

Rohan Tharakan

“Doctor, Doctor...

No matter what specialty you chose, no matter where you end up practicing, there is a class of patient that we will all encounter. A group of men and women whose very presence on a ward will trigger a mixture of intrigue and nausea in equal measure. People who gain relative celebrity amongst clinicians and finds incredulous consultants and bewildered medical students unable to look away. Who are these come-hither characters? They’re the patients who left things that little bit too long to resolve by themselves. Here is a scenario from Embarrassing Bodies that certainly had me looking on bewildered.

...I’ve come to see you about haemorrhoids” Imagine the situation: a 55 year old gentleman with haemorrhoids since his early teens. Now from my experience it doesn’t take that long to get a GP appointment, so this fella has clearly felt some odd attachment to these guys.

Whatever his reason for not seeking medical help earlier, it must have been a good one!

Passing a stool with a pile is commonly compared to passing a shard of glass (thumbs up to the sadomasochist doctor that discovered that one), so one can only deduce that for this gentleman it must have been like passing a recycling bin worth. On adopting the left lateral position with his knees to his chest a vineyard’s fill of grapes popped into sight. A massive gaggle (unfortunately Wikipedia didn’t have a pluralism for piles) of the fattest, most tortuous and ‘angry’ looking lesions Dr Jessen is ever likely to face. Seriously, these things were massive! Never mind passing a stool, I wouldn’t be surprised if he slept on his front and worked standing up. Why would you not just consult a doctor?

All characters featured are fictitious and any resemblance they may bear to persons living or dead is coincidental.

some people think that it is because of the preservatives in food that we eat.

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Which textbook?

Arts and Culture

How to get through medical school without spending your entire student loan on books you’ll never use again!

For every module at Medical School, the faculty provides a list of textbooks that even the keenest of students couldn’t dream of making their way through. Whether it’s due to the relentless call of Ocean et al in pre-clinical years, or days on placement in clinical years, there’s a limited amount of time available for studying, and knowing which textbooks to get your hands on is crucial knowledge.

post you books free.

Get advice. Different people will have different opinions. Ask your medic parent; if you’re lucky, not only will they be able to point you in the right direction, but they’ll offer to loan you a copy of said book!

If you decide to buy a book during the preclinical years, where not much will have changed, get an old edition from Amazon. However, the lectures are actually pretty comprehensive. Once you get to clinicals, having up to date knowledge is quite important, so most recent editions are best.

Pre-Medical School:

Kumar and Clark, Clinical Medicine – Just don’t. I’m sure you have something better to spend £50 on.

If you get a burning desire to read it in Freshers’ year, there are many copies in the library. If you decide it’s the textbook you want to use for finals, buy it in 5th year; your Freshers edition will be 4 years out of date.

If at all possible, don’t buy, use Greenfield library. If you end up purchasing the book out of Wait a few exasperation after it has been years for this requested back multiple times, at one! least you know that you like it. Now onto the books themselves: Alternatively, if you are a member of Third year: the BMA, their library does a nifty Bad Science (Goldacre) - Recommended little online service where they will for REM, is actually a pretty good read.

There are millions of copies in the library.

Second year: Use or borrow pharmacology, physiology and anatomy books that you used in first CP2: year.

Psychiatry Crash Course - Indispensable.

Fitzgerald, Clinical Neuroanatomy and Neuroscience – There was no general consensus on textbooks for the nightmare that is FBN, but this one always seems popular. Library it first.

The Illustrated Textbook of Paediatrics - Indisputably the one to get for Paeds.

Specials textbooks are more contentious; I’d personally recommend Corbridge, Essential ENT Practice,

Galloway, Common Eye Diseases and Management and Hunter, Clinical Dermatology.

CP1:

Oxford Handbook of Clinical Medicine - You may hear it called the “Cheese and Onion” (because apparently that’s what colour the crisps used to be back in the dark ages) – it’s pretty much worth its weight in gold on the wards.

Their

Finally, Obs and Gynae is also divisive. Ten Teachers is co-written by City Hospital consultants, but if you can’t hack the extended prose, Impey has got the basics.

Magowan is not NLE-recommended but by all accounts is a good text.

The Heron Guide - Available from Lenton Print Shop.

The advantage over the Red Guide is that you can reuse it for CP3. It’s basically Davidson’s, arranged under learning objective headings.

Medicine at a Glance (Davey) - For cramming before

CP3: Look at the reading list on the NLE. Laugh. Dig out the CP1 materials again.

the exam.

Sarah Hallet 38

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Tony’s Trivia Titbits: Without proteins and cells,

Lincoln

What to do on placement Until the meteoric rise to notoriety of neighbouring Boston, it was always Lincoln that terrified medical students as they nervously combed their placement allocations for any sign of.

The very name conjured images of a Dostoyevskian exile, miles from civilisation where notes were written on slate, internet was still a pipedream and the question of consanguity in the family became oddly pertinent.

The unlucky few who see the dreaded word, are plunged into the deepest recesses of the human grieving process - denial at first, soon giving way to anger. It feels good to rage about how unfair it is to be sent out into the countryside, whilst spreading spurious rumours about how exactly the chap who’s flitting between QMC and city has the course office eating out the palm of their hand. Then comes the bargaining phase, the desperate pleas to MZ-all undergrads offering cash prizes and a free pass into heaven for anyone willing to swap. Two days of luckless inbox checking leave you deep in the depression phase, reflecting morosely to anyone who’ll listen, about how life as you know it will end come February. As Kubler-Ross suggested though, acceptance does come, and when the dust settles, the unlucky few are left trying stoically to grin and bear it – “ at least we’ll get some work done” they say, while their friends thank their lucky stars, send texts of consolation and mutter a few choice words about how nice they’ve heard the cathedral is.

It is a bloody nice cathedral. In fact it’s a bloody nice town, replete with cobbled

streets, roman ruins, Brown’s pie shop, and a steep hill (very imaginatively named steep hill). But, as you’d hope from a city that can trace its origins back to the first century BC, ‘niceness’ is far from all Lincoln has to offer.

Knowing the importance of alcohol to a medical student, that seems a good a place as any to start. There’s a myriad of drinking establishments, to cater to your every whim, whether that be beer and the football (“The Peacock” – end of the road), the world’s most challenging pub quiz (“Magna Carta” – less than half marks) or a bar willing to keep serving you until 3 in the morning, only for you to rob its apples and magazines on the way out (“The Lincoln Hotel” –probably can’t go back).

As far as we can tell, there’s two main clubs. One is the “Engine Shed”, the Lincoln student union night out which is as cheap, sweaty and sticky-floored as you’d expect a student union night to be. The other, “Union at Home”, is electric - four storeys of highest calibre hedonistic debauchery.

For a quieter night, the ghost walk is certainly worth a look. It’s oddly captivating being led round uptown Lincoln by a lady with a skill for storytelling and an uncanny resemblance to Judi Dench in a gothic cloak.

But even she cannot hold a candle to Lincoln’s pièce de résistance: “Playzone”. 6 days a week, Playzone is a place for tired mums to take their overactive children, but every Tuesday night from the hours of 19:30-21:30, they boot out the little ones, and throw

the substance most like human blood is sea water.

open their door to adults. I’m talking tumble towers, ball pools, rope swings, spooky mazes, crawl tubes, a slither chicane, balance beam, a spider’s web, air cannons, slide races, an epic game of tig and the inevitable debate about why 40-40 is so named.

And that’s not even to mention the more obvious (albeit more mundane) upsides to a sojourn in Lincoln. You do get a lot of work done, and because the accommodation is a throwback to Fresher’s year, sociability goes through the roof and you become an awfully tight knit group. With fewer of us around, the consultant to student ratio is almost one to one, and you get a much freer run of the wards than at somewhere like QMC or Derby.

As you’d perhaps expect from the birthplace of former Sheffield Wednesday goalkeeper Marlon Beresford, the sports facilities here are pretty decent too.

There’s a climbing wall, a fitspace, tennis courts, a million big hills to run up and down, a rowing club and even on -site badminton. You’d also be amazed at how much time not having a TV or internet puts back into your life – leaving you free to do those things you’ve always wanted to, but which sitting on a sofa in Lenton has somehow put paid to. You can learn a language, you can pick up yoga, you can start playing chess, you can hit up the weekly African drumming classes.

And, of course, you can go to see the cathedral.

James Pumphrey

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What to do wit

Travel

Ask yourself: What are you doing this summer? Will you find yourself battling your way through verdant expanses of steamy rainforest, miles from civilisation? Navigating the piranha infested waters of the Amazon as macaws and toucans swoop overhead? Dodging falling coconuts on the powdered white beaches of far-flung islands? No? Then maybe you should consider travelling in your summer 2012.

With April showers beginning to clear, this can only mean one thing: British Summertime. Perhaps you’re looking at one of your final free summers EVER and with umpteen hours of revision ahead- why not do some ‘productive’ procrastinating and see what you could achieve with all this free time. Electives aside, this could be your last opportunity for an outlandish, open-jaw adventure that you’ll never forget. Now where did I put those sunnies…?

Some background: not having taken a gap year, I was desperate to cast off

the term-time shackles of exams and experience the world before a medical career impounded me forever (Impounded? I love our course really).

Backpacking in Asia and South America has left me with indelible memories and permanently itchy feet.

for you to explore, where do you start?

Many backpackers favour the traditional route of lively South East Asia, with its infamous full moon parties, stunning islands (and ladyboys). This offers the typical student travelling party experience, but there’s a whole From volunteering abroad, to host more to South East Asia that is backpacking, or a working holiday, not to be missed. travelling has something for everyone who wants a summer to remember; However, you don't have to travel to even if your bank balance is anaemic. the other side of the world for a taste of adventure. Other backpackers opt Travelling is a chance for something for a time honoured Euro-trip. Europe different, offering challenge, is home to a plethora of countries and excitement and adventure, providing a dizzying-array of cultures. Your Inan opportunity for you to immerse terRail pass is an easy and inexpenyourself in extraordinary culture, sive golden ticket to a surprising 30 history and cuisine (baked guinea pig, countries: Europe is a summer expereally)? It can be an eye opening rience that should not be overlooked. experience that has a profound impact on the way you think. Why not Or for the intrepid explorer who is ealet your hair down and relinquish the ger to discover somewhere further a responsibilities and pressures of field, how about somewhere less obmedical school. After all those CLS vious, like Central America, where the lectures – I think I need a break! tourist infrastructure is sparse and in parts non-existent, but that's all part But with so many countries out there of the adventure. The opportunities are endless…

Lombok, Indonesia

But how can I achieve all this on a student budget? Well read on.

There are some smart alternatives for the student traveller that can help to keep costs low.

Why not find a job and work during your holiday? If on a tight budget, earning at the same time could pay your way. Brits can get an Australian work visa (and benefit from the £10 an hour minimum wage)! Europeans can work anywhere inside the EU. There’s a whole host of companies out there online looking for summer workers: cherry-picking in Canada, hospitality on Greek islands, an Au Pair in Paris. Get writing that CV…

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Tony’s Trivia Titbits: In 1747, surgeon James Lind suggested British sailors should

H Your summer

Angkor Wat, Cambodia Another great way to get off the ground is fundraising and volunteering for a charity. Having chosen your nominated charity, you can use your ingenuity and creativity to find ways to raise a target sum.

Then, BAM, you’re off on your choice of adventure or voluntary project. For example, the Karnival charity challenges will see you on a mountain trek to Everest Base Camp, hiking the Inca Trail to Machu Picchu, or trekking the Great Wall of China.

(But with all that fundraising- you might just have to wait until next year).

Many voluntary projects operate in a similar way. They not only afford you the chance to travel but also to contribute to a society and community. Reputable charities, such

as KOP and Ameca, offer volunteering activities that truly benefit host communities and avoid all allegations of ‘voluntourism’. A project with a respectable charity can be of real value to the individual and the community you work with and offer a life-changing challenge that makes a genuine impact in the world.

what better way to further your knowledge of tropical medicine than to contract a leishmaniasis of your very own). Additionally, there is a likelihood of having no friends on your return as they have all exploded in a tumultuous burst of green eyed jealously while scanning your latest holiday snaps on Facebook. But don’t let all this put you off.

So , for a wealth of affordable opportunities, have a look through a lonely planet guidebook, the STA travel website or charities’ web pages online, there really could be something out there for you.

So whether it’s a three curries a day trip to India, delivering health education to vulnerable and orphaned children in Kenya or a grape-picking sojourn in southern France, there are limitless opportunities and a myriad However, all this excitement does of low cost ways to get involved. So, have its drawbacks. At times it can be what’s stopping you from travelling in dangerous (you may get chunder summer 2012? down your favourite chinos). You also run the risk of disease (although, Harry Trent

eat limes to prevent scurvy, ironically though, limes contain very little vitamin C.

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Photograph by Samuel Quarton

How to plan your gap summah Emma Lincoln

Vietnam

Never taken a gap yah?

Want to go backpacking but don’t know where to start? Look no further!

Going travelling with your best medic buds to some farfetched corner of the world is a brilliant way to spend your summer. So, here are six easy steps to guide you off on your adventures.

Travel

1

Decide where you want to go.

Asia is a brilliant place for first time travellers, for years it’s been the uni students’ Mecca. It’s got culture spilling out of its ears, with too many hostels to choose from. Lonely Planet online is a great place to start, giving you info on countries all over the world.

3 Book your flights.

Don’t forget to do this, and ideally three months in advance!! First, decide how many weeks you want to travel for; this may be dependent on your budget.

The longer you stay away, the more cost effective your trip will become. A month is a good amount of time, and if you really rough it, shouldn’t cost much more than a grand. SkyScanner is the best website ever invented. It compares all the different airline companies. Have a play on here and see what the best deals are.

5 Don’t forget the boring but essential bits Vaccinations and malaria tablets, in date passport, apply for a visa, get insurance, exchange money and pack!

6 GO!!!

2

Buy a guidebook.

If you want to make the most of your trip, doing research is essential. Guide books can be a tad expensive but they are a brilliant investment: useful for reading about your destination and also for info when you get out there. They have maps, things to do, places to eat and sleep and tips on cultural practices. Lonely Planet and Rough Guides are the best - decide which you prefer. Remember, this will be your bible while you’re travelling, you’ll love it like it’s your own child.

4 Book your hostels.

This all depends on how spontaneous you are. It’s a good idea to have hostels booked for when you first arrive and also for each new place you are planning to visit. After spending hours on a bus lacking suspension, sandwiched in between locals and their chickens in 40oC heat, the last thing you’re going to want to do is traipse around trying to find a bed for the night. It’s also great to have some flexibility. Once you get to a country and talk to the hippy guy you’re sharing a bunk with, he might recommend a great place to go visit which you hadn’t planned on. This will add to the excitement of your trip and if you decide you really like one place then you can adapt and stay longer.

Hostel Bookers and Hostel World will be your saviour. You pay the deposit online and the balance when you arrive. Look at other traveller’s reviews of hostels to decide on which one is right for you.

Have fun and remember to… chunder everywhahhh!

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Tony’s Trivia Titbits: The word avocado comes

Explore Europe For two years the medical school allows us to have two holidays in which we are not required to learn any anatomy or physiology, and even better they are 3 months long! Knowing what to do with that time can be a difficult choice to make, so here are several places that I’d recommend, including city breaks and beaches. All the cities which use the euro inevitably end up being more expensive, as the exchange rate is terrible, so a great way to explore Europe (but avoid the expense) is to make for Eastern Europe where the countries still use their own currency.

Prague: This beautiful city has great things to see in the day and also great nightlife, including a five storey club right next to the Charles Bridge.

Budapest: If you want to relax properly, the Turkish baths in Budapest are the best way to do it!

Krakow: Worth a visit to see the Wawel castle and the gothic old town.

If you want to combine your city tour with some time on the beach you must head to Croatia for some island hopping. In Croatia, the best rail links are from the capital, Zagreb, and from here it is easiest to travel down the coast by bus.

Plitvice lakes: A beautiful stop off in Croatia on the way down to the coast and well worth the extra effort.

Novalja (Pag Island): Hideout festival is held on Zrce Beach (29th June - 1st July 2012) Bol (Brac Island): This is the location of the famous Zlatini Rat beach, in addition to many other smaller beaches that get less crowded (although most of them are nudist beaches).

Hvar (Hvar Island): Great nightlife and incredible yachts!

Korcula (Korcula Island): Marco Polo’s alleged place of birth and the place to see sword dancing.

Dubrovnik: Get up and walk the city walls early in the morning before the crowds and heat arrive.

Reena Shaunak

from the Aztec word ahuacate, meaning ‘testicle’.

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Essential Lecture Handouts

Collapse on the pitch A Case Study You are the team doctor for a premier league football club. During a match one of your players, an athletic 23-year-old man with no previous health problems other than a strong family history of type-2-diabetes, falls to the ground off the ball.

The referee stops play and you rush over to find your player unconscious .

Q1. What is your immediate management for this patient?

Q2. List 5 differential diagnoses for sudden collapse.

Your initial assessment shows the patient has no pulse and you suspect cardiac arrest. You are able to remove him from the field whilst performing continuous CPR. A biphasic AED (defibrillator) is attached and records ventricular fibrillation. IV access is also gained. Fifteen shocks are given in the ambulance in combination with continuous CPR before a pulse finally returns. The patient regains some consciousness but is largely unresponsive.

Collateral history from his family reports that he was feeling unwell this morning and vomited 3 times before breakfast, but chose not to inform the medical staff as he did not want to miss the match.

An ECG was recorded in the ambulance (see above)

Q3. Describe the changes the ECG shows.

Q4. What is the most likely diagnosis and what further investigations could you do to confirm this?

The patient is given high flow oxygen and suitable medication . Blood samples taken from the patient were tested for FBC, U&E, glucose, lipids and cardiac enzymes.

It is decided the patient is suitable for angioplasty and is taken immediately to the cardiac catheterisation lab on arrival to hospital. An alternative to angioplasty (where subcutaneous coronary intervention is not available) is thrombolysis. This should be given as soon as possible (minutes mean muscle), once contraindications are ruled out .

Q7. In a media statement you are asked to describe what angioplasty is. Explain the process of angioplasty to a suitable level.

Q8. One of the most important contraindications to thrombolysis is aortic dissection. What features of a history would you expect or what investigations could you do to rule out aortic dissection?

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Q5. What medication would be appropriate for this patient?

Q6. Explain the reasons for performing each of these tests.

Case study provided by Cardiothoracics society. Answers can be found on p47.

Tony’s Trivia Titbits: Dogs and humans are the only

What to do (and not) in your osce First and second year OSCEs can be daunting. We’ve all experienced that feeling- It’s June, and you’ve spent the last two months with your head inside textbooks, trying to memorise the ins and outs of CRH/CLS/SF1/FBN… You’ve got through hundreds of MCQs and you are so, so nearly on that gloriously long summer holiday.

It is the last thing you want to be doing when the sun is out and all your friends have already been finished with exams for weeks, but it still counts and if anything, it is one of the more important exams that you take in first and second year. So if you are having a panic about your OSCE, have a read through this list of top tips based upon the experiences of older years. You might think some of them sound stupid, but they do happen.   

          

   

Remember SOCRATES- it applies to everything!

Take a reliable watch. With a second hand.

This person has used the wrong soap.

If your finger is bleeding because you have just tested your own blood glucose just ask for a plaster instead of dripping blood from your finger for the next two stations and apologising repeatedly.

Don’t palpate the carotid pulse on both sides- your patient may pass out.

The hepatojugular reflex cannot be performed on the left hand side.

2nd years-beware of the ‘explanation station’. Last year, students had to ‘explain’ a mid stream urine test, including a description of the labia.

When giving blood pressure readings, sound confident and don’t admit if you are lying! Of course, try and avoid lying in the first place.

Flirt outrageously with the examiner- that way if they're horrible to you it will be awkward for them too (don’t quote me on this one, I haven’t tried it).

Always ask about pain before you palpate anything. The one time you don’t will be the time the volunteer decides to test their melodramatic acting skills.

ALWAYS wash your hands. And on that note- watch out for them hiding the hand cleanser (purposefully if you ask me).

Don’t panic- if you have practiced then you are probably doing better than you think.

Even if you know the person you are taking a history from is an actor, still show them real empathy and make sure you tell them how hard it must be for them.

Time yourself when you are practicing so you don’t end up spending half the station in the exam examining the nails.

Don't throw used sharps back into the sterile box as "it's like looking for a needle in a stack of needles" when you try and fish it out. On the same note, don’t put used peak flow meter mouthpieces back into the box of clean ones!

Wear appropriate clothes. Boys- no bow ties. Girls- bend forward in the mirror, just to check the examiner won’t be learning what colour bra you’re wearing.

If you can’t get into the clinical skills centre, practise on your housemates/mum/boyfriend/girlfriend/ imaginary friend.

Trim your nails or percussion will hurt!

Overall, just remember to relax. You will probably make some stupid mistakes throughout your OSCE but just keep your cool. If you carry on and do the rest of it well, you will probably be fine. Remember they want you to pass! And- before you know it, it will all be over and 3 months of summer will be all yours. Good luck!

Louise Witham

animals in the world that have prostate glands.

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Essential Lecture Handouts

Crossword Word Wheel Find as many words as you can (Plurals are not included). There is one 9 letter word to be found.

Excellent: 23 words Good: 16 words Okay: 11 words Solutions will be printed in the next Issue.

Sudoku Across 1 – Mind power (11) 8 – Of the wrist (6) 10 – Code (6) 11 – Power (5) 12 – First man (4) 13 – Hormone acr. (1,1,1,1) 14 – Search through (5) 18 – ‘Not’ German (5) 22 – Against (4) 23 – Precipitation (4) 24 – Indications (5) 26 – Planetary movements (6) 27 – ‘The Twins’ (6) 28 – Reptilian study (11)

Who did that?

Who would have thought lecturers have a life outside LT1?

See if you can match each lecturer to their interesting fact. Watch out though— we’ve thrown in a red herring...

Down 2 – Cerumen (3,3) 3 – Cheese (4) 4 – Change (4) 5 – Greek island (6) 6 – Scientific principle (6,5) 7 – Testicular pain (11) 9 – Fibber (4) 10 – Masticate (4) 14 – Symbol “Sn” (3) 15 – Curve (3) 16 – Auction item (3) 17 – Steady (6) 19 – Egyptian god (4) 20 – Suspended (4) 21 – Ebbing (6) 24 – Stage (4) 25 – Marine mammal (4)

Dr Ian Todd

Hitchhiked to Isfahan and back in their gap year.

Professor James Lowe Dr Victoria Tischler Professor Michael Randall Dr Gareth Hathaway Dr Michael Rittig

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Used to be a prize-winning chorister.

Discovered that ubiquitin was the common factor in inclusion bodies, characteristic of many neurodegenerative diseases.

Sang in an Elvis tribute band.

Knows all the words to Baby Got Back by Sir Mix-a-lot.

Won a Blue Peter badge in 1971.

Published a paper entitled Interferon-gamma induces

HLA-DR expression by thyroid epithelium.

Tony’s Trivia Titbits : All trivia titbits brought to you by Tony Taylor (and his `Tit-ettes`).

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Case Study Answers: 1. What is your immediate management for this patient? Use the DRS ABC approach (in the notable case of Fabrice Muamba, a cardiologist watching in the stands at the game also came to assist the team and took charge of care).

2. List 5 differential diagnoses for sudden collapse. Vasovagal syncope, epilepsy, cardiac arrest, stroke, panic attack. Other differentials may include hypoglycaemia, choking, Stokes-Adams attacks, diving (wheeeey) and many others.

3. Describe the changes the ECG shows. ST segment elevation in leads I, aVL and the precordial leads (V2-V6). Also a loss of R wave progression across the precordial leads and some symmetrical T wave inversion (lead III and aVF).

4. What is the most likely diagnosis and what investigations could you do to confirm this? The ECG shows changes of an anterolateral myocardial infarction (acute coronary syndrome). Note this is usually due to occlusion of the left anterior descending coronary artery. Investigations to confirm include a blood test for cardiac biomarkers troponin and creatine kinase.

5. What medication would be suitable for this patient? Aspirin 300mg PO (has an antiplatelet effect), Morphine 5-10mg IV (pain relief), Metoclopramide 10mg IV (antiemetic with morphine), GTN spray sublingual 2 puffs (symptomatic relief) and Atenolol 5mg IV (reduce heart rate and increase ejection fraction, note CI in asthma). You may also consider Clopidogrel and ACE inhibitors.

6. Explain the reason for performing each of these blood test. FBC – check for anaemia (blood loss, work on heart) and leukocytosis (common in MI). U&E – potassium levels (electrolyte disturbances may cause arrhythmias, particularly potassium and magnesium), renal function via eGFR and hydration status. Glucose – check for hypoglycaemia. Lipids – cholesterol ratios useful in assessing MI risk Cardiac enzymes – Cardiac Troponins and Creatine Kinase. Cardiac troponins T and I have high sensitivity and specificity for cardiac damage.

7. In a media statement you are asked to describe what angioplasty is. Explain the process of angioplasty to a suitable level. For a detailed answer go to the Cardiothoracics page on the new Medsoc Website: http://bit.ly/cardiothoracics 8. One of the most important contraindications to thrombolysis is aortic dissection. What features of a history would you expect? What investigations could you do to rule out aortic dissection? History – sudden tearing chest pain usually radiating to the back (interscapular pain). Often hard to differentiate from MI on history alone. Investigations – Blood pressure and pulse are classically uneven in each arm, or between the arms and legs. Chest x-ray reveals chest widening or pleural effusion. No MI changes are seen on ECG. Who Did That? Answers: 1= Dr Hathaway, 2= Dr Rittig, 3= Professor Lowe, 4= Dr Tischler, 5= No-one! 6= Professor Randall, 7= Dr Todd

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