GKT Gazette - Jan-Feb 2014 by GKT Gazette

JAN - FEB 2014

Volume 127, Est. 1872

Guy’s, King’s College and St Thomas’ Hospitals FREE on Campus gktgazette.org.uk

Inside:

Dry January

Temporary teetotalers

London Student Protests ULU Closure, 3 Cosas & Cops off Campus

GKT Christmas Comedy Revue Exclusive Pictures and an interview with the cast and much more

Anaesthesia

at a Glance Julian Stone William Fawcett

with on l

ases dC

MCQs a n ine

Obstetrics and Gynecology

at a Glance Fourth Edition Errol Norwitz John Schorge

Haematology

at a Glance Fourth Edition Atul B. Mehta A. Victor Hoffbrand

at a Glance Third Edition Dorian J. Pritchard Bruce R. Korf

Ophthalmology

The Foundation Programme

at a Glance Second Edition

at a Glance

at a Glance PRACTICE WORKBOOK

Jane Olver Laura Crawley Gurjeet Jutley Lorraine Cassidy

Edited by Stuart Carney Derek Gallen

Medical Sciences Jakub Scaber Faisal Rahman Peter Abrahams

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Established 1872

ge ima s

Oncology

Physiology

Graham G. Dark

Third Edition

at a Glance

at a Glance Jeremy P. T. Ward

ISSN: 0017-5870

at a Glance

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Front and back cover photos courtesy of Charlie Ding

Edited by Michael Randall

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Medical Sciences

Website: www.gktgazette.org.uk Email: editor@gktgazette.org.uk GKT Gazette, Room 3.7, Henriette Raphael House, Guyâ&#x20AC;&#x2122;s Hospital, London, SE1 1UL

ards

Vol. 128, Issue 1. Number 2581.

MCQs

Roger W. A. Linden

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GKT

GAZETTE

Medical Genetics

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The at a Glance series The market-leading at a Glance series is used world-wide by medical students, residents, junior doctors and health professionals for its concise and clear approach and superb illustrations. Each topic is presented in a double-page spread with clear, easy-to-follow diagrams, supported by succinct explanatory text. Covering the whole medical curriculum, these introductory texts are ideal for teaching, learning and exam preparation, and are useful throughout medical school and beyond.

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Jan - Feb 2014

GKT Gazette

Contents 6

Editorial

Issue highlights and updates from the Gazette team

Letters

News

Shields swapped Dry January, No more Cambridge transfers and more

Features

Arts & Culture

Exclusive interview with Christmas Show cast, London student protests New year, new music, Females in film

History

Research

54 56

Thomas Addison, Guyâ&#x20AC;&#x2122;s at war: The home front Drugs for respiratory disease in development, Kingâ&#x20AC;&#x2122;s role in fighting antibiotic resistance

Dental

Foundation interview process

Nursing & Midwifery

Out and proud: Life as an LGBT nurse Healthcare for the homeless

Book Reviews

Careers

Obituary

73 75

Oxford Assess and Progress: Medical Science, Slow Man by J.M. Coetzee Aussie elective tips, Ethical judgement and the SJT Bill Sheeran

Sport

Dental sports day, KCL vs Cambridge boxing

EDITORIAL

LETTERS

I am also keen to draw your attention to a feature on recent student protests in London – misrepresented by many other media outlets - and to two articles on research projects at King’s that I hope will translate into new therapies for two areas of significant unmet need, antibiotic-resistant bacterial infections and obstructive airway diseases. Also featured in this edition is an exclusive interview with the team behind December’s excellent Comedy Revue, accompanied by previously unreleased photos taken

GKT Gazette

by our talented staff photographer, Charlie Ding. To further challenge the misconception that students on clinical and scientific courses are one-trick ponies, we also have articles on art, film and music as well as some creative writing in the Arts & Culture section, and fittingly given the passing of Guy’s Dentist and boxing enthusiast Bill Sheeran, the Sports section has reports from the College boxing team and the Dental Society sports day.

publication back up and running. In particular I’m very grateful to our team of students, many of whom have balanced their studies and part-time jobs with hours of work on the Gazette. I’m also indebted to supportive members of staff, including our trustees, as well as our subscribers, the Friends of Guy’s Hospital, King’s College London and our advertisers for their continued support.

In other matters, I’m pleased to announce that the memorabilia we sell are now available at a cash shop kindly hosted by Bill Edwards at the Gordon Museum on Guy’s Campus, as well as through mail order. Our new website (www.gktgazette.org.uk) is now running smoothly and will soon host an online shop and the Gazette archives in their entirety.

Simon Cleary

Lastly, I’d like to say a huge thank you to everyone who has helped get this

Jan - Feb 2014

Cheers,

Editor, GKT Gazette editor@gktgazette.org.uk

The Gazette always invites its readership to interact with our writers. See an article you like? Want to disagree vehemently with the opinions of one of our contributors or writers? Please let us know! Send all correspondence to editor@gktgazette.org.uk, and you will see it in the next issue of the Gazette.

Photos from left to right: Silent UK, King’s College London and Bing

would like to start this issue by raising a glass (of water) to those of you who have stuck to soft drinks for Dry January, an awareness-raising campaign organised by Alcohol Concern which I’m happy to recommend supporting. Find out more about what the temporarily teetotal members of the Medical Students’ Association has been doing for this cause in the News section.

Letters to the Gazette

ear Editor, It is good to see the old Gazette back on its feet again after the unfortunate hiatus last year. Well done for this but unfortunately I write to you on a somewhat less congratulatory note. As a Guy’s alumnus, now working at King’s College Hospital I have an appreciation and commitment to two of the different hospitals which now make up this fine medical school. I proudly wear my Guy’s hospital cufflinks to this day and like many alumni, the sight of those three lions evokes more feeling in me than those on a football shirt ever could.

While it gets less airtime, I also feel attached to the crest of King’s College Hospital, having provided my services there for the best part of 15 years. I am deeply saddened to see that the logo for your publication, as well as the

merchandise in your shop bears the crest of King’s College London as one of the trio, rather than the hospital crest which should rightfully be there in its stead. I choose not to get upset about the KCL, GKT dichotomy for its own sake (though I do rather enjoy attending the Macadam Cup), it strikes me as odd that a historic and high quality publication such as the Gazette should get its heraldry so obviously wrong. Please sort it out. Yours,

Above: The shield swap

Dismayed of Denmark Hill

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GKT Gazette

LETTERS

ear Dismayed, The image of the hospital shields that we currently use was given to me by someone at the King’s College London image library when I was starting at the Gazette as a layout editor a few years ago. I must confess that I was oblivious to the replacement of the hospital shield with that of the college when I moved to the newer, higher reolution image but the shield swap has since been pointed out to me on a couple of occasions.

A trustee of the Gazette has explained this to me – apparently, when the College corporate image department requested pictures of the shields for the production of high-quality vector images, no image of the King’s College Hospital crest was to hand. I also have (completely unfounded) suspicions that the designer did not want to try and tackle the hospital’s shield-within-a-shield, and that there might have been a brand-strengthening motive to use the current image on the part of the College.

I’ll see whether anyone on our team can draw up a high-quality shield and welcome readers to send in any good-quality images of the crest in question. Best wishes, Simon Editor, GKT Gazette

The GKT Gazette Invites Companies to Use Our

Advertising Space For more information, contact advertising@gktgazette.org.uk

GKT Gazette

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Medical Students Sober Up for ‘Dry January’

Photo Courtesy of Charlie Ding

NEWS

Katie Allan MBBS4

lthough medical students might not be best known for their sobriety, a group from GKT have pledged to abstain from alcohol for a month, as part of a nationwide fundraising campaign. The Medical Students’ Association (MSA) assembled a team to participate in Dry January, a charity campaign in which participants are sponsored to stay ‘dry’ for the month of January. The team of 38

participants is comprised mostly of medical students, although they are joined by Sebastiaan Debrouwere, the president of King’s College London Students’ Union. The sponsorship money they raise will be donated to Alcohol Concern, a national charity which campaigns to raise awareness of alcohol misuse, and reduce the effects of its harm. In addition to fundraising for Alcohol Concern, the MSA have pledged to donate an extra £10 to the GKT

Raising and Giving (RAG) charities for each student that successfully completes the challenge. Should any of the participants fail to abstain on any occasion during the month, they are invited to continue the challenge regardless, but add a £20 ‘tipple tax’ to the total sponsorship to make up for it! The MSA have also supported the campaign by hosting a range of alcoholfree events during January, including a meal exclusively

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GKT Gazette

NEWS

for the Dry January team, and an evening of bowling open to all students. Dry January is a nationwide initiative, which the MSA committee decided to promote specifically amongst medical students. ‘The MSA is proud to be

taking part in Dry January. As well as raising money, we are hoping to promote alcohol awareness on Guy’s Campus and encourage students to moderate their alcohol consumption’ said Juliet Laycock, the president of the MSA. ‘The team

are noticing the positive benefits of abstaining, including increased energy levels, more time for other activities, and more pennies in our pockets!’

Hospital Trust Staff Banned from Smoking in Uniform Simon Cleary Editor uy’s and St Thomas’ Hospitals NHS Trust is among the first in the country not only to ban staff from smoking on hospital grounds but also to prohibit employees from lighting up anywhere in public if they are in uniform or have an ID showing.

A Wednesday night in Guy’s Bar seen in January Photo Courtesy of Charlie Ding

GKT Gazette

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The new anti-smoking rules, which apply from 1 January 2014, were introduced as a response to new guidelines from the National Institute for Health and Care

Photo Courtesy of Charlie Ding

Hospital Trust staff will face disciplinary action and could potentially be dismissed if they break the new rules. In an interview with the Evening Standard, director of workforce Ann Macintyre said “Yes, they can [be dismissed], but we would want to avoid that where possible – we pride ourselves on being a good employer.” Excellence published last year, which recommended the removal of smoking shelters and enforcing a blanket ban on smoking on all NHS sites. According to a press release from Guy’s

& St Thomas’, managers will now try to legislate against patients and visitors lighting up on all sites run by the Trust.

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GKT Gazette

NEWS

Students Raise over £6000 for RAG Charities at ‘Jingle Rag’ Katherine Leung MBBS2

After a long day of frantic coin counting, a grand total of £5,435 was raised from donations from the general public. With some of the proceeds from that night’s Christmas Party in Guy’s Bar also supporting the charities, the day raised an incredible total of more than £6000. Jingle RAG was only the start of this year’s fundraising

efforts – RAG are back with a whole week of events starting on February 1st. In return for students’ bucket collecting efforts, the RAG committee will be hosting an event every day of the week. This year they’ll include the legendary RAG raid, GKTake Me Out, a very special Pub Quiz, and to top the week off, an interdegree University Challenge featuring everyone’s favourite lecturers. The RAG committee are always looking for new faces to join in the fun – follow RAG on Facebook (fb.com/ groups/RAG.GKT) and Twitter (@GKTRAG) to keep up to date with the society.

Photograph courtesy of Katherine Leung

n Friday 6th December, the GKT Raising and Giving (RAG) society held its first street collection day of the year, Jingle RAG. Armed with free breakfast for the earliest RAGgers and Michael Buble’s Christmas album, the RAG team set up in Boland House at 6am. Throughout the day, students collected all over London for our chosen RAG charities (The Evelina Children’s Hospital, Guy’s and St. Thomas’ Cancer Unit, Medicinema, and the Multiple Sclerosis Society) as well as selected KCLSU

charities. In total more than 70 buckets were taken out with each one raising an impressive average of £70! The day also saw a performance by King’s very own a cappella group, All the King’s Men, who sang outside St. Paul’s Cathedral.

GKT Gazette

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No More Cambridge Transfers Joshua Getty MBBS4 The path from Cambridge to London has been well trodden over the last 60 years, with many Cambridge students joining GKT for the clinical years of their medical training. Yet from this September, medics beginning their studies will no longer be able to transfer to a London medical school. In a move celebrated by Cambridge’s Clinical Student Society, Cambridge University has expanded

its clinical school to accommodate all preclinical medical students for the final 3 years of the programme. The Oxford University transfer scheme will continue unaffected.

Notable Cambridge Transfer Alumni Eric Hanson Trinity College – St Thomas’ First New Zealander to become a specialist in anaesthetics David Owen Sidney Sussex College – St Thomas’ British Foreign Secretary from 1977-1979 Phil Hammond Girton College – St Thomas’ GP, comedian and health service commentator David Nutt Downing College – Guy’s Neuropsychopharmacologist and government advisor before Equasy controversy

Registered charity no. 803716/SC038827

NEWS

Government Report Calls for Greater Disclosure of Trial Data and Questions Tamiflu Evidence Lucy Webb Intercalated BSc

General recommendations from the government’s report include ensuring that all clinical trials are registered and that all results and methodology are made available to all including

or over a year now, the AllTrials campaign has tried to expose to us how pharmaceutical companies have withheld ‘unfavourable’ clinical trial data, despite the implications that this may have for patient care and clinician confidence in the medicines they prescribe. The campaign’s aim is to ensure the publication of the methodology and results of all clinical trials and finally the government are getting on board.

‘The majority of Roche’s Phase III [Tamiflu] treatment trials remain unpublished over a decade after completion.’ Parliament’s Public Accounts Committee has given their report on results being withheld. The report specifically addresses the clinical trial information and stockpiling of Tamiflu, an 14

GKT Gazette

To compound this woeful state of affairs, a £74 million stockpile of Tamiflu was not kept refrigerated, or at least the records to prove that it had been were not kept. The whole stockpile was therefore destroyed.

doctors and auditors. Information should be shared between the Medicines and Healthcare products Regulatory Authority and the National Institute for Health and Clinical Excellence to ensure that clinical care in the UK is based on the latest evidence. Regarding Tamiflu, following a complete review of the drug by the Cochrane Collaboration, the evidence with regards to efficacy should be re-evaluated.

The future path may well be difficult, but it is imperative that we keep up the pressure to ensure that all trial data is recorded and made available for analysis. The recommendations made by the report are an important first step towards clinical trial transparency and ensuring that optimum care is delivered to patients.

Author of almostadoctor.co.uk Named a ‘Top Medical Innovator’ Photograph courtesy of Charlie Ding

antiviral drug indicated in reducing rates of complication in influenzae A and B infection by its action as a neuraminidase inhibitor preventing release of the virus from the host cell. Tamiflu was stockpiled by the Department of Health (DoH) in anticipation of the swine flu pandemic at a cost of £424 million, but the efficacy of the antiviral is contested, largely due to the fact clinical trial data have been withheld. Stockpiling of the drug took place in line with World Health Organisation (WHO) recommendations, though the data upon which

Jan - Feb 2014

these recommendations are based has been called into question. The British Medical Journal’s Tamiflu Campaign has a ‘bottom line’ stating: -“WHO recommends Tamiflu, but has not vetted the Tamiflu data.” -“The majority of Roche’s Phase III treatment trials remain unpublished over a decade after completion.” -“In Dec 2009, Roche publicly promised independent scientists access to “full study reports” for selected Tamiflu trials, but to date the company has not made even one full report available.”

Lewis Moore MBBS4

r Tom Leach, a recent graduate of Manchester medical school and founder of the website ‘almostadoctor.com’ was recently named in a list of top medical innovators published by Health Services Journal (HSJ). While at medical school, Tom’s notes were shared widely among his fellow students and he decided to extend his audience further by posting them online. Since then the site has grown significantly in

both readership and content and is now used by medical students around the world. While the prominent banner ads can be annoying, the site’s content is extensive and is thought to be of a high quality. In a recent interview with The Bolton News Dr Leach was quoted as saying, “It’s like the Wikipedia of medicine, with doctors as editors to verify the content”. Along with the refreshingly concise notes, the site contains other materials such as mind maps, flashcards, reviews of books and apps and a collection of blogs sharing

Photograph courtesy of Charlie Ding

often humorous stories and thoughts from Dr Leech and other contributors. Other top innovators mentioned by HSJ include Sir Bruce Keogh, Medical Director of the NHS and Ben Goldacre, founder of the AllTrials campaign.

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GKT Gazette

FEATURES

sorting to invasive central venous access. The surprising finding of this study was that medical students performed far better than more senior staff in identifying this parameter. One explanation could be that medical students had simply practised more, having attended weekly cardiology ward rounds during which they were expected to evaluate the JVP of all patients.

Photograph courtesy of Charlie Ding

Is Clinical Medicine a Dying Art? Zoya Arain MBBS4 Case 1

wheeze.

25 year old woman presents to the Emergency Department with 2 day history of breathlessness and audible

Airway patent

Respiratory Rate 22 breaths per minute Oxygen Saturation 92%

Capillary refill 2 seconds Pulse 100 bpm BP 120/80

Temp. 37 °C

GKT Gazette

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The history and clinical examination form the backbone of the assessment and examination of every patient. However with the exponential development of imaging and plethora of sensitive laboratory tests that have become available over the recent decade, has the reliance upon these resources by the modern doctor occurred at the expense of these hardwon essential skills? Are we witnessing the death of clinical medicine as we know it? There is growing concern that the quality of examination skills is fast declining. One US study evaluated the inability of intensive care staff to correctly determine the jugular venous pressure (JVP) on intensive care patients from examination alone, without re-

Another group, Noel et al, produced videotapes with deliberate mistakes in history taking and examination such as palpating the thyroid gland in the wrong place, and not asking a patient with a history of diarrhoea about blood in stools. These fundamental errors were missed by many of the senior medical faculty asked to critically review the tapes. The authors raised the question “are clinicians replacing instead of augmenting their diagnostic armament”.

“Are clinicians replacing instead of augmenting their diagnostic armament? ” This problem may be less applicable in the UK than the US, as fellowship examinations assess the clinical skills of trainee doctors at every career stage up until becoming a consultant. The training system in the US lacks an equivalent. Although one facet of the problem is that clinical skills are not being performed to the standard that they could be. Another point to address is whether there is an inherent insensitivity of the clinical examination at its best in identifying a clinical sign? Despite many attempts to elicit the diagnostic sensitivity and specificity of many di-

agnostic bedside tests against the relevant gold standard, the results may be unreliable as these studies often do not account for important variables such as the varying degree of experience between trainee doctors and experienced staff, making interpretation of their findings difficult. However, one study which evaluated the sensitivities of elements of the respiratory exam in correctly identifying pneumonia, found that although the individual sensitivities of each stage in the examination were low, in combination the cumulative probability of correct diagnosis was much higher. For instance given that the pretest probability of pneumonia in a patient with an acute onset of cough is 10%, a finding of asymmetrical chest expansion would subsequently increase the odds to 47%. The authors suggested changing our approach to applying the physical examination. Although the uncertain sensitivity of the physical examination would argue against its usefulness in screening the asymptomatic population for disease; which requires a high sensitivity not met by many respiratory signs, it remains valuable in the acute setting where positive findings increase the likelihood of diagnosis as shown in the above example. However, our over reliance on diagnostic tests may have other consequences, Dr. Wes Spence, identifies the problem of incidentalomas; incidental clinical findings, unrelated to the principle presenting complaint with unknown significance. He says “medicine hasn’t caught up with the decline in pathology, our investigations seek even smaller needles in an even bigger haystack of wellness. Incidental findings can incur unnecessary anxiety for the patient, and also accrue substantial cost in sparking further investigations; cost is an important consideration in the business of healthcare. NHS Scotland reported a spend of over £178 million on radiology over the

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FEATURES

past decade, including CT, MRI and Ultrasound with £246 million additionally spent on laboratory tests. This trend looks to continue with specialised diagnostic tests becoming increasingly available in the primary care setting. To slow the veritable decline in clinical ability and the mounting expense of health technology, it is important to identify the principle driving force underlying the excessive use of diagnostic tests. One aspect to consider is whether patients expectations from doctors has changed with the advent of new technology with fear of litigation considered to be an important factor in resorting to ancillary diagnostic tests. Additionally, the ‘volume-based reimbursement’ culture of current medical practice, means that a doctor is little accredited for picking up subtle physical signs after a lengthy examination, with more patients after a bang for their buck. However,

one study suggests that despite the increasing utility and availability of new tests and investigations, a patient’s expectations from a consultation have little changed, with 90% who still expect a routine physical examination in their consultations, involving measurement of blood pressure, and examination of their heart, lungs, abdomen and reflexes. Therefore is this trend simply a product of a doctor’s lack of confidence in their clinical experience when making decisions, as Spence colourfully puts it,“ has evidence-based medicine pecked the last flesh from the bones of medical opinion?”.

t c i d e I Pr ! t o i R A

“A doctor’s role is neither to investigate nor to follow guidelines but to interpret, and often ignore, them—that is, to short circuit the mechanised medical machine for the benefit of patients”.

Kate Anstee Biomedical Science BSc 2nd Year

ovember 2010 saw thousands of students, staff and unions marching through the streets of London in protest of the prospective rise in tuition fees. Clearly this protest made no difference to the government’s education plans, but it was ground-breaking in changing legislation

on police management of protests. Kettling, a police method of containing demonstrators in a small area to maintain order, came under scrutiny when both police and activists were injured. After 153 people were arrested, all demonstrations must now adhere to public safety guidelines to ensure police collaboration. Since 2010 many student demonstrations have taken place. The recent decision to close the University of London Union (ULU) as a student led organisation and replace it with a management run services centre, motivated many students to express their dissatisfaction by protest. Similarly, the 3 Cosas campaign has organised strikes and protests to pressurise the University of London (UoL) to bring sick pay, holidays and pensions of outsourced workers in line with those of its employees. Although these disputed issues are supported by MPs, students and unions, few protests have caught the attention of the national media; perhaps as uttering the words “student protest” often results in eye rolling amongst the great British public. However, on 4th December 2013 the media was drawn to a student occupation of Senate House, University of London. These students demanded the management took notice of the 3 Cosas campaign and their views on the ULU closure, privatisation of student loans and outsourcing university accommodation. Instead, disapproving management of UoL brought in police to forcefully remove offenders. Chaos ensued; 3 students were arrested, a video of a policeman punching a student protester went viral and UoL filed an injunction against occupying some of its premises. The spark had been lit.

Increasing radiology activity in Scotland over the last four years. Source: Audit Scotland, Nov. 2008 18

GKT Gazette

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FEATURES

The following day approximately 200 students gathered in a new found fury to reaffirm requests of the previous day and demand their right to protest on campus without police presence. According to one student, the initial idea of the “Cops Off Campus” demonstration had been to march around the campus, brandishing placards and chanting, but this plan was thwarted with an intimidating police presence surrounding UoL buildings. “Snap decisions were made to keep moving and prevent police kettling” she explains, “this sense of chaos forced us to choose to march on Euston Road, where other protests have been before.” Seemingly spiralling out of control; traffic held up by protesters, police helicopter observing from above and a few trouble makers throwing bins to form road blocks, was not only against the public safety guidelines but produced an adrenaline –infused atmosphere of confusion. As the protesters tucked back into the side streets, the police began kettling outside Euston Square station. Again this protest affected innocent bystanders: another student tells of a patient on his way to A & E and a medical student on his break contained within the kettle metres away from University College Hospital. As scenes of pandemonium continued with one peaceful student protester suffering head injuries from police knocking him to the ground, a member of the press being illegally arrested and fights breaking out between violent protesters and police, some kettled students managed to escape and flee the demonstration. One unfortunate student, who wishes to remain anonymous, describes how she was “tackled to the ground by a police officer” as she attempted to run and had two other failed escapee students thrown on

GKT Gazette

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top of her. “My behaviour within the protest was non-violent and should not have been met with such brutal policing,” she states. “It suggests the police treated all students as aggressive.” When UoL declared disruption on their land, she was one of the 37 students arrested for breach of peace; one student was arrested for assault. Arrestees were bundled in a police van and driven around central London for hours, in a police attempt to calm the situation and eventually decide on the fate of these detained students. Ultimately, all were re-arrested for affray and taken to police stations outside central London where they spent the night. Following confiscation of mobile phones and no interviews, all were released on bail with what were deemed “ridiculous conditions” such as not being permitted to assemble in groups of 4 or more people; an unfortunate circumstance, if not unrealistic for a student.

demonstration to gently guide the protesters on the unplanned route, eventually ending 4 hours later back at Senate House. Many protesters were pleased to have revived the student movement with the biggest student response since 2010, but most also condemn the actions taken by UoL and the inconsistency of police management at demonstrations. In hindsight, however, if it were not for the police mis-handling the initial occupation of Senate House, not only could the occupiers have spent their Christ-

mas holidays in a university building, but also the protests would not have achieved the same amount of coverage from the national media. In reaction to December’s inferno of protesting, the fight against the establishment begins again on 22nd January 2014. There is an expectation for lessons to be learned by University management, police and students, which maybe for once will allow the public to hear the student voice and not merely the bedlam that surrounds it.

Photograph courtesy of Oscar Webb

After the condemnation of police management of these protests, a large national demonstration was organised for 11th December 2013. Over 3000 students turned up to show their support. Although the majority of students remained peaceful, a few masked individuals took the opportunity to throw smoke bombs, set fire to bins and break into Senate House. Another group was witnessed burning the injunction preventing occupation of University of London premises. Since none of this behaviour motivated any police presence, the protest took the opportunity to convey their dissatisfaction to the city, causing disruption as they marched along Kingsway. It was only after stopping outside the Royal Courts of Justice that police cautiously began to intervene with the use of police sirens and officers walking alongside the

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GKT Gazette

HISTORY

FEATURES

Joshua Getty When did you start coming up with the sketches? Alex Warren I remember starting to write sketches all the way back last January when I scribbled down Jeremy Kyle meets Joseph and Mary, then coming back to it in the Autumn and turning it into an actual sketch. The best thing about the Christmas show is that there are so many different minds, which are all warped in a slightly different way, so you get lots of different inputs and these things grow and grow.

Behind the Christmas Show Joshua Getty MBBS4

Lucy Webb Absolutely and for one of the first times since I’ve been involved there actually was a theme running through the show. JG Plus you have the recurrence of special characters Despo [Papachristodoulou] and [Stewart] Paterson, who are never absent. AW Yeah, I think it’s excellent that we have a faculty here who are so comfortable

interacting with the students and are so respected by the students that we feel able to imitate them in increasingly offensive way. After all, imitation is the greatest form of flattery… JG Lucy this year you were backstage manager, so when did you decide to do the job? LW Well that came about because Vat [Ljungqvist] is the producer and we were both contemplating producing last year but we came to the agreement that he would go on and produce and I would act as stage manager and he did an incredible job this year. I first got involved in the Christmas show a few years ago because a few of the rugby girls were involved and they asked if any of us wanted to join in, so I started in my second year and then just gradually got more involved then stage managed this year for the first time, which I’m not going to lie was quite stressful at times!

For many at GKT the Christmas show is one of the highlights of the year, with wit, humour and chaos all rolled up into one show for three nights in the Greenwood Lecture Theatre. When asked to sum up the show, words like nakedness, crazy, fun, outrageous and raucous are often used. But what is the Christmas Show to those involved? To Alex Warren, this year’s director, it is “the last bastion in irreverent comedy in today’s politically correct world and somehow it manages to do so whilst raising significant sums for charity.” This conjures up images of a rebellious group of students putting on an underground sketch show, but the Christmas Show is embraced by staff and students alike and far from being an outlying group of individuals, it is a mammoth collaboration with an extensive cast and crew before even adding the dancing girls and boys to the mix. To find out more the GKT Gazette sat down with Alex Warren and Lucy Webb (this year’s stage manager) on a cold January evening in a quiet corner of the Thomas Guy Club.

GKT Gazette

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GKT Gazette

FEATURES

AW Yeah this show was probably the most stressful backstage we’ve ever had.

the next six sketches were cut and we were frantic.

LW The more stressful it became the more smoothly it ran though, it was really weird!

AW Although I was upset that we had to cut sketches and stuff, I remember walking away from that Wednesday feeling great as you’re working with such a good team of people so when there’s a crisis like that you know that they’ve got your back.

AW It was such an excellent team, not just backstage but also with the tech with light and sound and they were just incredible. Lara [Staffurth] and I were being typical directors, shouting orders and screaming that we were cutting sketches so go and make it happen. LW I know, this was on the Wednesday and we had less than 30 seconds notice that

JG The great unpredictable element of the Christmas show is the audience, though in a way it’s all very predictable as you will get huge amounts of heckling, so how do you react to that? Photographs courtesy of Charlie Ding

Christmas Show ‘13 Snog-Web

AW The Wednesday night audience was certainly worse than any of us have ever had before. I think the Christmas show is not something critically appreciated, at least not on a Wednesday night, so you roll with the punches and a lot of the comedy comes with the interactions with the audience. JG The snogcam always seems to be your best weapon for that. AW The snogcam is a great equaliser. LW It’s the big saviour as it’s the only thing that will make everyone in the audience shut up, even if only for 20 seconds as it just gives us a bit of quiet backstage so we can organise because at times it is difficult to hear what’s going on, particularly on a Wednesday night.

Jan - Feb 2014

JG How about the dancing boys? I know there was a little bit of controversy over the prison story in their sketch… AW I think that’s a strength of the dancing boys (though I’m slightly biased as I had a cameo) they had a narrative going throughout their dance. I think lots of people have said it’s the best dancing boys they remember. LW I think that the dancing boys this year really were fantastic, as usual they’re a little bit more difficult to organise backstage but that’s just what they do. JG One of the best photos from backstage that I saw was of the snogweb.

JG Speaking of the dancing girls, how on earth do you manage them?

LW that’s a tradition!

AW The lead dancing girls were very good with us and they were trying their best not to get in the way. There was drama, which is inevitable, but it was controlled drama that we could deal with. But yes, sometimes it is a challenge having 68 intoxicated breasts on your hands.

GKT Gazette

AW Well you haven’t seen the plan for my elective…

AW backstage do such a good job as well because whenever they have everything under control a group of drunken third year girls will arrive screaming that each of them needs their hat and to have their cane ready and they do a great job.

LW Well there’s a routine that happens in terms of bringing them down and getting them ready backstage but what I personally find very useful when they’re in the wings and won’t shut up is you just threaten to not let them on stage because usually they believe you.

LW That’s something you’ll never say again.

LW ah the snogweb. JG who came up with that?

AW That goes back at least as far as the cast can remember. I have to say that this is something Lucy’s department has to handle because what I’ve never understood is how so many of the backstage crew manage to get involved with the snogweb… LW We just feel underappreciated so we like to appreciate each other, that’s all it is… JG So what was the highlight of the show for you guys? AW God what a question. My personal highlight of the Christmas show had to be being in the Blue eyed maid on the Thursday

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HISTORY

Photographs courtesy of Charlie Ding

night with the cast, those of them who hadn’t passed out.

like family. I was absolutely gutted when the week ended.

LW There were very few of us left by the end of the night.

AW Every time I hear You Make Me by Avicii, the opening song to the show, which I traditionally spend jumping up and down outside the foyer to psych myself up, I still get that little heart palpitation.

AW Having the lecturers company on the Thursday night was a lot of fun. Also the Friday night curry when we all got together, I was just on a high and hadn’t really settled that it was all done. This year we probably had the biggest team we’ve ever had, both on and off the stage but we still really felt like a unit and made friends. It is something of a family, as my predecessor said. LW I definitely do and the longer you’re in it the more you feel like part of the family but this year even the people who were fresh in the cast and in the crew, everyone was together for everything. But this year more than any other year for me personally it felt 26

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LW I always look round for other people in the cast and crew if it comes on in Guy’s Bar. AW we find each other, get together in a circle and jump up and down. JG Another great aspect is that you do have such a range of years involved. AW Yeah it’s very important because you have to think about the future as people aren’t going to be around. This year we lost an excellent crop. I only started the show last

year and this year I was directing, luckily we had Lara who has been around a bit longer as well. JG Plus there’s quite a lot of fourth years involved, will they be there next year? AW A lot of them have said they’re definitely not going to be in the show but we know how hard it is to stay away. Actually that’s something that behind the scenes we take very seriously and certainly towards the end of the process we made a point of involving a lot of the young members so they’re ready next year. LW I know that as you do in the cast, you gradually give them more. So we have a couple of fantastic people in the second year as members of the crew, so this year we made sure they know how to run a really tight ship which is important since we’re losing some

really experienced members of the crew to either graduation or final year. JG Are you two going to stay involved next year? LW absolutely, I don’t intend to leave until I can’t cope with the stress of medicine anymore. AW I certainly have every intention to LW I just want to say how much I enjoy it, there’s nothing like the stress or the fun of the Christmas show AW People take the piss out of us for never going on about anything else but I must say you can’t understand unless you’ve been on or behind that stage, the sheer physical, emotional and sexual effort that goes into every one of those three nights.

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GKT Gazette

ARTS & CULTURE

CHLöE HOWL

New Year, New Music

Morolake Segun-Ojo MBBS4

Howl has been waiting in the wings since 2010 developing her indie pop chops. Now 19 years old, she’s coming of age supporting Ellie Goulding on tour, and working on her debut album with Grammy Award winning writer and producer, Eg White who’s worked with the likes of Adele and Duffy. Howl contrasts her mature vocals, with her youthful musical identity, taking a realistic view of the ‘gross’ (in her own words) adolescent experience. Her currently released singles ‘No strings’ and ‘Paper Heart’ are upbeat tasters of her album with soulful aspirations.

His R&B influenced vocals have already featured on Disclosure’s ‘Latch’ and Naughty Boy’s 2013 number 1 single ‘LaLaLa’. Now Smith is stepping out on his own and taking centre stage on tracks ‘Lay me down’ and ‘Nirvana’ (available for download) which showcase his exceptional voice with wide appeal. Smith’s debut album ‘In The Lonely Hour’ is to be released in May, but in the meantime look out for his next single money on my mind released in February.

Sam smith

Photo Courtesy of Rebecca Trenear

he soundtrack to the new year is in. If you haven’t heard of these upcoming acts you will soon, so why not get ahead of the curve?

BANKS

George Ezra

This Los Angeles musician likes to keep a low profile, for a long time only sharing her music on Soundcloud and avoiding social media. Unfortunately for BANKS the buzz around PBR&B or hipster R&B has slowly been intensifying, and she might just be the girl to bring it to the forefront. BANKS finally let us in on the dark dulcet tones of her inner musings, with the 2013 release of her stirring EPs ‘Fall Over’ and ‘LONDON’. The singer garnered more attention after supporting The Weeknd on tour. So now the secret is out, have a listen to her standout tracks ‘This Is What It Feels like’ and ‘Waiting Game’.

Within a year of leaving home to study music in Bristol, Ezra instead found himself hitting the road with his guitar and a few freshly penned tunes. It’s true, on paper he sounds like a character featuring in a Bob Dylan song (a big influence for Ezra), and his talent has often been fabled by music columnists since his performance at Glastonbury last year. Ezra’s folk rock sensibilities and distinctive course vocals make for an interesting narrative, as he draws inspiration from an English upbringing with American acoustic score. Listen to some melodious tales from the well travelled musician in his tracks ‘Budapest’ and ‘Benjamin Twine’.

Sam smith

GKT Gazette

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GKT Gazette

ARTS & CULTURE

Women’s Parts: The Bechdel Test Sabina Checketts MBBS5

ave you heard of the Bechdel test? If not, then you are not the only one. Until a friend mentioned it recently, I’d never heard of it either. The Bechdel test is an uncomplicated way of assessing gender bias in works of fiction, although it has been mainly applied to films and television. The test was named after Alison Bechdel who drew a cartoon about it in 1985, after her

you look at many recent productions from the illustrious Hollywood. A surprising number of films fail the test, particularly if you look at recent blockbusters. Those that fail include: all The Star Wars films, the complete Lord of the Rings trilogy, The Hobbit 1 & 2, Avatar, all but one of the Harry Potter series, The Social Network (irony anyone?), Pulp Fiction, Run Lola Run and even When Harry

Source: Alison Bechdel, 1985 friend Liz Wallace came up with the idea. To pass the Bechdel test, a film has two have: 1. At least two named female characters 2. Who have a conversation with each other 3. About something other than a man Simple right? Well, no actually, especially if 30

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Met Sally despite its strong female lead. You can find many, many other examples if you look further. In fact there is a database website online that does just that, called ‘bechdeltest.com’. The Oscars are touted as representing the “best of the best” for each year. If one uses

the Bechdel test to analyse the six films up for Best Picture 2013, only three would pass, Zero Dark Thirty, Les Miserables, and Silver Linings Playbook, while the three that fail are Lincoln, Life of Pi and Django Unchained. A study from the US-based Centre of Study of Women in Television and Film found that of the top 100 US films in 2011, women accounted for only 33% of all characters and for only 11% of all protagonists. They suggest that “Hollywood thinks that films with male characters will do better the box office” and that this may be due to male domination of most aspects of film production such as writing, production and direction. A different study from Annenberg Public Policy Centre at the University of Pennsylvania found that over the last 60 years the ratio of male to female characters in films has remained at about two to one. Recently I went to a panel discussion at a well-known London theatre in which the Bechdel test was mentioned; the panel consisted of actors, playwrights, producers and directors. Ironically but perhaps accurately reflecting the current state of theatre, the panel only included one woman, who was an actress and came across as having been included as the ‘pretty face’ on the panel. In recent times, a number of cinemas in Sweden have introduced the Bechdel test as a way for audiences to analyse the gender portrayal in their films. One Swedish cable channel even has a ‘Super Sunday’ where they will only show Bechdel A-rated films. The Swedish Advertising Ombudsman reprimands companies whose adverts reinforce gender stereotypes, such as including scantily clad women for no good reason. Mentioning no names but it is not hard to call to mind adverts, not to mention most music videos, which fail on this very simple point. Perhaps the rest of Europe will follow Sweden in time. The Bechdel test has been criti-

cised as a blunt tool but perhaps its simplicity allows it to easily raise gender bias issues that go unnoticed all too easily. It is not only in film that gender bias occurs. Historically shameful for King’s is the fact that University College London was the first British university to allow women to attend their degree courses in 1878 while King’s College London followed suit in 1882. However UK universities did not let women ‘matriculate’ i.e. become members of the university until much later. Oxford began in October 1920 while Cambridge followed much later in December 1947 along with other universities at various times. In science, there exists the Finkbeiner test for articles on women. To pass, a story cannot mention: 1. The fact that she is a women 2. Her husband’s job 3. Her child-care arrangements 4. How she nurtures her underlings 5. How she was taken aback by the com petitiveness in her field 6. How she’s such a role model for other women 7. How she’s the “first woman to…” Medicine should apply a similar test for female doctors and other healthcare workers. It seems apt to end by paraphrasing George Orwell, “All people are equal, but some people are more equal than others.”

A metaphor for ‘modern’ feminism?

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GKT Gazette

ARTS & CULTURE

Keats’ Corner

level. They seemed to revel in every glance, every word spoken to them, by the senior physician. Numen took a deep breath and silence reigned, “Twenty-two items on today’s list, lets begin.” He rumbled.

Keats’ Corner is our section dedicated to pieces of poetry and creative writing from authors in the GKT community. Feel free to send in any poetic works or other short pieces of prose to editor@gktgazette.org.uk.

The Ward Round Max Coupe-King MBBS4

“

ight Fifty-three, perfect!” I mused, passing the morning drunks in the park by the train station. “Seven whole minutes!” I knew by now the protocol to the daily ward round. Turn up at nine sharp, not five minutes before, for fear of being designated team coffee boy, not a minute after for my imagined dread of the consultants’ wrath.

house officers, assembled. I reached for my heavy silver pocket watch but did not have to complete the instinctive action. Doctor Numen strode down the corridor towards us fixing each of us simultaneously with his expectant stare. Those eyes reminded me perfectly of how a teacher would scrutinise you in class when asking you questions he knew you did not know the answer to.

One must contemplate morality when hundreds of doctors pass these drunkards every morning and do nothing whilst having the knowledge that patients are waiting inside to be treated for cirrhosis and other such complaints.

Already the sheep started to bleat!

The hospital! After entering that emotionally sterile field the dutiful medical student in me carefully printed off the patient list. I arrived on the ward with a few precious moments to catch my breath as the other members of the team, faceless registrars and arrogant

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“G-g-good morning, Doctor Numen”, one of the more junior doctors almost yelled. “Here’s your coffee, sir”, chirped another student. “Fascinating paper you wrote on squamous cell carcinoma.” The words themselves did not bother me; I have no quarrel with general pleasantries or compliments. What I could not stand was the desperate cry for attention that seemed integral to my contemporaries on an atomic

At this point the ward, with its rows of beds, always seems to transform itself in my mind into some benign scene. Last week we might have been strolling down a supermarket aisle with our shopping lists, stopping only to peruse certain groceries; never looking at any too closely, not wanting to see the blemishes that we do not have to. Today we were marching behind Numen between shelves upon which the supporting cast of patients joined us as randomly organised novels in a second hand bookshop. Doctor Numen led us past countless tales. Some old tomes, leather bound and layered with dust that had been here for so long they had nowhere else to be; others, short and brightly coloured, with so much potential. We could not pick them all out! We had our reading list. Arriving at the first patient, we arranged ourselves around her bed. We had all seen her before, a fiery haired adolescent. In fact she was in and out of here quite often. I looked at her where she laid, a turquoise paperback entitled “Amy Summer”, only 15 chapters long. The pages holding stories of the mucous filling her lungs, the accompanying chest infections, and the hospital visits. The juvenile prose telling a tale of more hardship than ought to be expected from such a small, innocent looking blue book. “Well, well what have we here…back again so soon…tut tut”, muttered Doctor Numen before rattling, “Acute pneumococcal infection with a medical history of cystic fibrosis, dullness over the right apex… shortness of breath, reduced oxygen saturation, non cyanotic, afebrile…you there

boy! What is to be done?” I froze! Then managed to stammer a long list of every antibiotic I could remember, longing for the multiple choice answer for which the examinations had prepared me. “Nonsense! Nurse, lets have this patient on 4 litres of oxygen…and start a course of Moxifloxacin.” Stated the House Officer. I smiled grimly, almost apologetically, at the girl in the bed. Her blank eyes sparkled for a moment as though I were the only person who had looked at her all her life. I wondered briefly what else was contained in those 15 fleeting chapters but Doctor Numen was already striding on to the next bed “Onwards!” I rushed after the rest of the team. Doctor Numen’s voice could already be heard through the thin, pale blue, curtains surrounding our next ‘case’. “As we can see, Miss Rivers has deranged liver function…” I thrust my way through to join the austere group encircling the woman with yellow eyes. “Jaundice…Notice her thin papery skin… Hand tremors”. Numen’s comments were met with affirming nods or vocalisations of interest from the other doctors who stood, bent forwards, looming over the shrunken body that made the single bed look like a double. The crowd of white coats began to babble about clinical tests, diagnosis, treatment, and management plan. Only picking up the odd phrase amidst this sea of incoherent jargon I wondered what the patient herself must have been feeling. Like a book she had been picked off the shelf by this vagabond rabble of white coats. This book was not to be read however. Just a quick glance at the cover would do before lackadaisically placing it back on the shelf. Someone else, a nurse perhaps, may have read the blurb but no one here would even glance at the fifty or

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ARTS & CULTURE

the laminate flooring. Approaching the man on the bed I came to a halt alongside the consultant so that I was just at about chest level of the patient. I regarded his peaceful, wrinkled face, his eyes shut and mouth open, I imagined him to be dreaming of better times. All the while the registrar systematically read from the observation chart. “Patient bed number 16, temperature thirty-seven point eight, oxygen saturation ninety-five per cent, heart rate seventy-two, blood pressure onehundred over sixty, respiration rate thirteen breaths per minute, currently unresponsive but patient is reported to have been much better over the last few days and could be sent home soon”. “Excellent, another bed cleared, job well done” affirmed Doctor Numen.

Painting courtesy of Ellen Wood

so chapters that filled the space between the thin leather bindings. “How can we care for somebody if we don’t care about them?” I had drifted off again. This thought process distracting me from what was fast becoming a mundane process of pathological examination. I may as well have been back in the museum with the pickled specimens of fibrosed lung or cirrhotic liver. These things were much easier to comprehend when seen through formaldehyde and transparent containers rather than hidden within a sack of flesh. At least the plexiglass could not ask inconvenient questions! Better to know just the facts and not become concerned with

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the life behind them. Was this from fear of final acknowledgement of what we already knew? That each of these people, hidden behind their malignancy, was penning their own narrative and that, at any moment, their story may steer dramatically away from that desired climax. Perhaps, even worse, that the pen may be snatched from their hand, their story ending suddenly mid-sentence without the chance to resolve, ending before it had even begun.

All the while the prone pensioner had not moved a muscle. One of the House Officers’ quipped jokingly “as long as he is just sleeping”. Numen stopped and looked quizzically at the junior “check him”. Even from where I was standing, less than a foot away, there was no reason I could see to suggest anything but a deep and restful sleep. “His hands are warm”. “Feel for the pulse.” I watched as the young physician grasped the wrist for a radial pulse. His fingers lingered there for a few moments until he proceeded to probe the neck for the carotid. For a full minute we stood, waiting expectantly, like the guests at a surprise birthday party. Finally he took his stethoscope and placed it firmly at

the left sternal edge in the second intercostal space as I had become competent doing over the preceding months. At this point a line of forgotten poetry tinkered its way from my hippocampus into my cortex “in a dead man’s chest, the silence before creation began”. Another minute passed before the shake of a head confirmed it. The whole team; from consultant to uninitiated medical student, stood stunned for what felt like an hour but was surely less than six seconds, intrigued by the pearls forming in the corner of the nurses eyes. The brief moment lingered until the consultant’s bark pulled us out of the daze. “Right! Next on the list, item number 17”. Before I knew it I was left alone with the body. His face had not changed at all but somehow the wide snoring mouth had stretched into a silent scream. The loudest scream I had ever heard! The eyes were shut forever, never again to lock with his wife’s. They would not gaze admiringly on grandchildren. The wrinkled skin, so accommodating a minute ago was now waxy, pulled tight across his skull. The nameless, lifeless, vacuum-packed skeleton lay before me, demanding more attention than I dared to give. His face had not changed. I suddenly had an instant desire to know this man’s story. I tried to grasp the thick, leather bound tome from the metaphorical shelf but it slipped and fell lethargically through the air. As it crashed to the ground pages spilt out of the bindings. They were all blank, all seventy chapters worth. It was too late. He was gone. I did not even know his name.

The imminent arrival at the next patient’s bedside dragged me back into my sterile white coat and polished shoes, squeaking on

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GKT Gazette

HISTORY

GKT Greats: Thomas Addison Photograph courtesy of Charlie Ding

Fi Kirkham MBBS2

ike many GKT alumni, Thomas Addison had his eccentricities, not least that his exact date of birth is unknown. Born sometime in April 1793 he had an inauspicious start to life as the son of a grocer in Newcastle-upon-Tyne. As with some of the students of GKT today Addison’s parents were determined to see him reach his full academic potential even if this meant making sacrifices to see him succeed. In time Thomas Addison gained admission to the Royal Free Grammar school where he learned Latin to the extent that in later life his annotations would be in this language and so his students required equal fluency. His ability with Latin meant Thomas 36

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Addison’s father pushed him towards a career in the Law but his shyness made him reluctant. Instead Addison enrolled at Edinburgh University and graduated just three years later in 1815 as a Doctor of Medicine. In December of that year Addison came to Guy’s hospital to continue his training as a ‘perpetual Physician’s pupil.’ In 1827, Thomas Addison became a lecturer to the students of Guy’s Hospital. Over the next ten years Addison worked tirelessly for both his patients and students. He was noted as viewing the body as more a machine than that of another being. Although not a favoured viewpoint in our era of holistic medicine and patient-centred care, Addison

In 1835, Thomas Addison became joint Lecturer of Medicine with Richard Bright, himself an outstanding physician. They worked together closely for the next three years before Bright’s retirement. Bright was an affable man from a wealthy family who had a charisma he was much admired for. Addison’s shy nature made him an unlikely replacement but his brilliance as a scholar and commitment to his students allowed him to, in the hospital at least, overcome this. Thomas Addison is most famous for his discovery of the disturbance of suprarenal capsules: a condition characterized by progressive anaemia, bronze skin pigmentation, severe weakness and low blood pressure; now known as Addison’s disease. Despite this being his most well-known discovery, his first major medical breakthrough was almost entirely overlooked. Had it not been for his devoted students, Addison’s description of pernicious anaemia, the first one made, would have been attributed to another doctor. Perhaps his taciturn nature meant that he did not publicise his findings broadly enough, but the commitment he showed his students meant they ensured he was not forgotten.

know... that, although wearing the outward garb of resolution, he was beyond most other men, most liable to sink under trial.’ Prone to increasingly depressive episodes, Addison slowly withdrew from university life. Finally, his depression became too much to bear and in 1860 he took his own life. Thomas Addison’s death was announced by the Medical Times and Gazette, but both the Lancet and BMJ failed to record it. Suicide remained illegal until 1961 and so his death was regarded as a crime. In a time when depression was treated as the mark of a weak mind Addison could so easily have been removed from the history of this medical school. However Addison’s passion for teaching means that a plaque in his memory can still be seen in the chapel at Guy’s today, remembered for what he was: a truly great man of Guy’s.

Image: KCL Digital Assets

was able to remain sufficiently detached to make many revered observations for which he is still amongst the most revered physicians.

Despite Thomas Addison’s obvious diagnostic abilities and brilliant lecturing style he had his insecurities. Samuel Wilks, the student closest to Addison, would remember: ‘We Jan - Feb 2014

GKT Gazette

HISTORY

Memorial Gates of Guy’s Hospital. What we had prepared for in the previous months had suddenly come to pass. Almost all were

question has now been answered; without thought to their personal safety, without bitterness or even a grumble, sleepless and

suffering from shock, for not a few of them had seen their relatives and friends fall victims to this wretchedness.

fatigued as they were, they piled into each new task with vigour.

The immediate problem was the adequate administration of resuscitation. This is not the time for a description of cases and a weighing of results, but one cannot help remarking on the recovery of seemingly lifeless casualties after vigorous resuscitation. Many had suffered perforating

Guy’s At War: The Home Front Compiled by Joshua Getty MBBS4 The bombing of Guernica in 1937 by the Luftwaffe left Britain and her allies in no doubt to the consequences of war with Germany. Once the British Expeditionary Force had escaped Dunkirk in 1940 during the fall of France, the people of Britain waited with baited breath for the bombs to fall. Whilst the RAF’s Spitfires and Hurricanes fought the Battle of Britain, the autumn of 1941 saw war come to the streets of London as Germany sought to bring Britain to her knees. War had come to Guy’s. 20th September 1941

uy’s has been subjected to modern warfare. The enemy has seen fit to indulge in indiscriminate bombing raids over London, and we have received casualties. On Saturday, September 7th

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a series of fires were started following an intensive air raid; using these fires as beacons, the raiders returned throughout the night to attack. From the start of this offensive, a steady stream of casualties began to arrive at the

wounds of chest and abdomen together with head injuries and burns. To avoid congestion of the wards, evacuation to base hospitals was started at once. As soon as emergency treatment had been applied and the patient had sufficiently recovered, he was accommodated in a stretcher bus. In spite of many of these operations taking place at night under constant exposure to bombs and shrapnel, there is not a single report of any patient having suffered from the journey. The performance of students and nurses throughout has been one of merit and a tribute to themselves and Guy’s Hospital. There was not the slightest suggestion of hysteria or fright among any of them, but, instead, each worked with a cool efficiency, applying his own intelligence to what had to be done. Many months ago the student body was released from the Emergency Medical Service. At the time there was speculation as to the reaction of the students, especially with regard to what might be expected of them when their services were really required. That

From the day he walked into Austria, Herr Hitler has always scored his successes by a moral victory. But every bomb that he drops, every church that he destroys, every home and person that he shatters only strengthens our resolve to win.

14th December 1941

nce again the enemy have descended upon us in a concentrated attack more furious than anything yet. This time different kinds of bombs were used, since in addition to their incendiary nature, there was incorporated an explosive feature which made them much more dangerous. The whole sky around Guy’s was lighted up by a brilliant array of colour, serenaded by the explosions of our guns and their bombs. In spite of the severity of the attack and its concentration in our area, Guy’s Hospital presented an unaltered appearance the next day. This is a very lucky escape, made all the more thrilling by the news that a land mine had fallen within a few hundred yards of us but that its parachute had been caught on a structure, preventing the mine from touching the ground. The mine contained twelve hundred pounds of explosive, and boasted seventeen detonators. The fire and ambulance workers deserve Jan - Feb 2014

GKT Gazette

HISTORY

a great deal of recommendation for the brilliant way in which they performed their duties. Without regard for their personal safety they carried on, knowing that where they were called to was an enemy target. Nevertheless, the wounded were carefully and methodically extricated from the debris and delivered at the Front Surgery door. Inside, the surgery was completely altered. Instead of the usual O.P.O., a large staff of medical officers, dressers and nurses, waited in cool readiness for any emergency. In these days, when daily stress and anxiety tend to colour our views and opinions about things and people, it is very easy to become discouraged with oneself and one’s colleagues. However, it is just such an occasion as that described above, with everyone pulling in harmony, that restores faith in one’s fellows and just as long as that sense of comradeship exists, democracy can never die. 25th January 1942

n the dark dreary and starless night of December 30th, the population of the Hospital was scattered in the different buildings; a gloomy few were dining in the Spit. Outside, there seemed to be an excessive commotion which seemed to be due to a couple of incendiaries in Maze Pond just outside the Surgery. Somewhat weary of it all, a few of us wandered towards the scene of activity more to escape from our present surroundings than out of curiosity.

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Hardly had we set foot outside when a shower of incendiary bombs rained down. Snatching at sandbags, running with buckets of water, nurses, students and medical staff alike fought those glowing bombs without thought of personal risk. While our efforts were successful, neighbouring buildings were unattended. It was not long before Guy’s was ringed by fire on all sides. In some places electrical switches were melted by the heat and electric lights began to shine. Although these had about as much effect as shining a torch on a bright day, so automatic had we become that it seemed that the emergency of the moment was to extinguish these lights.

Down Bros.’ building that it was impossible to descend into the front quadrangle. Another famous landmark and standby that is no more is the old Ship and Shovel, but the timehonoured initialled table was saved from the fire and now resides in Guy’s Hospital. Poor Flossy of the Ship, who in better times helped Guy’s men out of their depressions, took refuge with her small retinue in the underground passage near the kitchen.

All but one wing of the College has been gutted and even this wing has lost its roof. Whatever opinions about the adequacy of the College we might have held, to see the College so wantonly destroyed was a tragic sight. With most of the students occupied in fighting the fire that had started in the roof of Hunt’s House and others busy evacuating the patients into waiting ambulances, it was not possible to save a lot of their personal belongings. The fire in Hunt’s House has

Early in the evening, we had the misfortune to be hit by two high-explosive bombs. The first scoring a direct hit on the surgical block, the second involving the bakery and neighbouring buildings. Parts of Evelyn and Naaman Wards no longer exist. Dorcas Ward, which was filled with patients and nurses, was very badly shaken. However, when the fire and fury had cleared, there was really very little damage to the ward itself; before many minutes had passed the students appeared on the scene and began transporting the patients to safety. By the time all these proceedings had been carried out, Guy’s was surrounded by a blaze of fire which rivalled Dante’s inferno. In the Colonnade alone, one was confronted with such a blast of smoke and heat coming from

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GKT Gazette

HISTORY

Photographs courtesy of Imperial War Museum Archives

already been referred to. In fact, by the time this had got under way, Guy’s was virtually cut off from the outside world by fire. It became necessary to evacuate all the patients, a task which was carried out with commendable smoothness, again with thanks to the tireless energy of the students. It was due to them that Hunt’s House, in fact Guy’s Hospital, still stands, a veritable miracle in a district of burning ruins. The rest of the history of that eventful evening concerns the splendid work done by the firefighting squads and the Works Department. Some of the fire parties arrived from some distance away and everyone was delegated to save Guy’s Hospital at any cost. On behalf of Guy’s Hospital we should like to thank the Fire-Fighting Services for their wonderful service which was rendered so generously. 42

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How they arrived is difficult to understand, but next morning when the doors were opened at 8.30 a.m., the Out-Patients’ Hall was filled with patients; all of them were examined, diagnosed and treated, if necessary they were admitted to Hospital. In less than three hours from the time we had sought out a mattress in some underground corner to rest our aching limbs we had returned to business as usual.

22nd March 1942

ecently two more bombs added themselves to our already impressive list of direct hits. The first exploded in the quadrangle. The second bomb became buried some thirty feet in the ground. A few days later the Bomb Disposal Squad, with

enviable daring, removed the neoplasm. An interesting sidelight on these men is that they receive no extra pay for their dangerous occupation and they are not voluntary. On asking one of the men whether he did not resent being made to serve on such a hazardous job, he proudly replied: “If you made this job voluntary you’d have the entire British Army turning out.” That old criticism concerning the civilian medical staffs not taking their part in the uniformed services, certainly finds its answer in the performance of Guy’s. We have received a very considerable fraction of all casualties due to enemy action in Great Britain. When our wards have been destroyed, we screen off the wrecked portion and use what is left, when the stream of casualties threatens to fill all the available beds, the evacuation service

starts up and the congestion is relieved, and this is accomplished during an aerial bombardment. Yes, this is an enviable record, with accomplishments enough to satisfy the conscience of any man whose sole desire is to serve his country. While everyone is now familiar with the increasing aid that the United States of America, is giving, the knowledge that Guy’s Hospital has been singled out for assistance, makes us feel its reality all the more. The American Organization Bundles for Britain, who have done so much to assist in the work of alleviating the distress caused by air raids, has sent this hospital the magnificent sum of over £2,200 to help. To our American readers, we offer our gracious thanks. Next issue: The Liberation of Europe. Jan - Feb 2014

GKT Gazette

RESEARCH

RESEATCH

First in class:

expected to cause bronchodilation and inhibiting PDE4 should reduce lung inflammation.

Professor Clive Page

Drug in development at King’s shows promise in asthma and COPD trials Dylan Padmakumar BSc Biomedical Sciences 3rd Year Ajay Shah BSc Pharmacology Extramural Year

he development of the compound RPL554 holds one of the most exciting and eagerly anticipated advances in modern respiratory medicine.

The small molecular entity RPL554 was one of many compounds co-invented by the extraordinary late Sir David Jack, whose teams developed all of the mainstay pharmacological interventions for treating asthma - salbutamol, salmeterol, beclometasone and fluticasone. Verona Pharma, a biotechnology company co-founded by King’s College London Professor Clive Page, took on RPL554, which is now set to become the first novel class of drug in decades for the treatment of COPD and asthma1. For years the main treatment for asthma and COPD has been inhaled corticosteroids plus bronchodilators (short or long-acting). However corticosteroids can have profound adverse effects, while long-acting bronchodilators have come under scrutiny for possibly

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Jan - Feb 2014

worsening asthma symptoms. Moreover, in each disease there are populations of patients who are resistant to current treatments. There is therefore significant need for novel therapies to be developed for treating asthma and COPD. Could RPL554 be the answer? What is so special about this inconspicuously named compound? RPL554 is a dual action inhibitor – a single molecule that has the ability to inhibit two enzymes in the phosphodiesterase (PDE) family, PDE3 and PDE4 – siblings of the PDE5 enzyme targeted by sildenafil (Viagra)1. PDE enzymes break the phosphodiester bonds of the secondary messengers cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP), thus regulating their cellular effects. PDE3 is involved in the regulation of contractility of airway smooth muscle and PDE4 is involved in the activation of various inflammatory cells. Rationally, inhibiting PDE3 would therefore be

However, previous attempts to inhibit the enzymes have proved to be therapeutically problematic. Theophylline, a non-selective PDE inhibitor and PDE4 specific inhibitors such as roflumilast highlight the problems behind the use of PDE inhibitors2, 3. Both have a narrow therapeutic window but more significantly, come with a catalogue of untoward side effects with emesis the most problematic. Increased cAMP in the area postrema (the vomiting centre) of the brain are thought to mediate the emesis mechanism. Roflumilast in one study showed the incidence of adverse events at 16% against 5% for placebo3. After a series of proof-of-concept studies, RPL554 however, appears safe. Between 2009 and 2013, a series of early clinical studies were undertaken where the drug’s safety was either the primary or secondary endpoint1. The compound, unlike its PDE inhibiting predecessors, was well tolerated- the frequency of adverse events was comparable to that presented in the placebo group1.

When given to COPD and asthma patients, the findings are promising. In COPD patients, RPL554 led to an increase in forced expiratory volume in 1 second (FEV1) by 17% versus placebo and interestingly, a peak effect comparable to inhaled beta 2-agonists1. COPD is a disease lacking any real effective treatment, so RPL554 holds potential. In asthma patients, the increase in FEV1 was smaller, but still significant, an increase of 14%1. Moreover repeat dosing in asthmatics for 6 days indicated that the bronchodilator effects were maintained1. Only time (and larger, double-blind, randomised controlled trials) will tell if RPL554 will live up to the enthusiasm surrounding it and what impact it will have, if any, on both current respiratory medicine and on the directions taken in future drug development. RPL554 remains in clinical infancy but initial findings are encouraging.

References: 1. Franciosi, L.G., Diamant, Z., Banner, K.H., Zuiker, R., Morelli, N., Kamerling, I.M.C., et al. (2013). Efficacy and safety of RPL554, a dual {PDE3} and {PDE4} inhibitor, in healthy volunteers and in patients with asthma or chronic obstructive pulmonary disease: findings from four clinical trials. Lancet Respir. Med. 1: 714–727. 2.Barnes, P.J. (2013). Theophyline. American Journal or Respiratory an Critical Care Medicine, Vol.188, 901-906 3.Antoniu, S.A. (2011). New therapeutic options in the management of COPD - focus on roflumilast. Int. J. Chron. Obstruct. Pulmon. Dis. 6: 147–55.

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RESEARCH

being developed and tested, for example, antibiotics that specifically and directly target bacterial DNA – pyrrolobenzodiazepine dimers (PBDs). PBDs possess a profound bactericidal effect against gram-positive bacteria, as well as having potential anti-tumour effects, as found in other antibiotics2. It has been found that pairs of PBD molecules (dimers) have a novel and potent mechanism for bacterial cell killing. They bind to specific DNA sequences, and cause DNA cross-linking; this cross-linking renders the DNA inaccessible by the internal machinery of the bacterial cell, and the bacteria eventually die3.

Fighting antibiotic resistance at King’s College London Tristan Dennis BSc Biomedical Sciences 3rd Year

n the 11th of December 1945, Sir Alexander Fleming delivered his Nobel Prize lecture on penicillin. In it, he stated that ‘It is not difficult to make microbes resistant to penicillin…if you use penicillin, use enough.’ This is not some feat of extraordinary prescience by Fleming, but extrapolation of experimental data. From the 40s until the 80s, over 17 different classes of antibiotics were discovered. Since then, we have developed 3 classes1. Following Fleming’s speech, over 400 infectious diseases have emerged to maim and kill. Part of the issue lies with the fact that resistance is an inevitable consequence of antibiotic usage. The creation of a selection pressure (something which causes greater evolution46

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Jan - Feb 2014

ary success in a portion of a population) in a fast breeding species will lead to a rapid rise in strains that are resistant to the environmental change. In this case, bacteria have rapidly adapted to the panoply of antimicrobial drugs developed in the 20th century, and are beginning to become more of a threat. Despite dire warnings of ‘apocalyptic superbugs,’ by Dame Sally Davies, the fight against drug-resistant bacteria is gathering momentum. King’s is playing a part in the fight against resistant microbes; some of the work is done at the Institute of Pharmaceutical Science, a department responsible for research aiding drug discovery and development. To help bolster our dwindling arsenal of antibacterial drugs, novel compounds are

The Randall Division of Cell and Molecular Biophysics also participates in research concerning the characterisation and investigation of the mechanisms of resistance, specifically the structure and function of enzymes involved in resistance, so that novel drug targets can be identified. As an example beta-lactam antibiotics, such as amoxicillin, are a core element of antibacterial therapies. In response, bacteria have developed enzymes that disarm many beta lactam antibiotics. These beta-lactamases have become drug targets in themselves. Whilst we possess beta-lactamase inhibitors which are used in combination with antibiotics (Co-amoxiclav, for example), the offending bacteria have inevitably developed further resistance mechanisms in the form of metallo beta lactamases (MBLs) – a new breed of anti beta-lactam enzyme discovered in 20104. The Randall Division is currently involved in work determining the precise structure and mechanics of MBLs5. With this research, we can begin to identify possible drug candidates that could inhibit this enzyme. The activity of compounds can be modified by the addition of different molecules; the addition of an acetyl group to hydroxyl groups

Penicillin embedded in agar

Lysozyme embedded in agar

Sir Alexander Fleming’s orginal petri dishes demonstrating antibiotic resistance. Source: Nobel Lecture Archives

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RESEARCH

Together, this research represents many of the facets of combating antibiotic resistance; the elucidation of mechanisms, identification of drug targets, development of new drugs, and the prevention of infection by resistant organisms. Despite warnings of the post-antibiotic apocalypse, research is gaining traction7, 8. Work done at King’s does much to represent the funding, resourcefulness and innovation involved with tackling the issue – an encouraging prospect for us all.

References: 1. Powers JH, Antimicrobial drug development - the past, the present, and the future, Clinical Microbiology and Infection, 2004;10(4):23-31

4. Kumarasamy KK, Toleman MA, Walsh TR, Bagaria J, Butt F, Balakrishnan R, et al. Emergence of a new antibiotic resistance mechanism in India, Pakistan, and the UK: A molecular, biological, and epidemiological study. Lancet Infectious Diseases, 2010;10:597–602

6. Davies AM, Tata R, Beavil R, Sutton BJ, Brown PR, I-Methionine Sulfoximime, but not phosphinothricin, is a substrate for an acetyltransferase (gene PA4866) from Pseudomonas Aeruginosa: structural and functional studies, Biochemistry, 2007;46(7):1829-39 7. http://www.theguardian.com/society/2013/jan/23/antibiotic-resistant-diseases-apocalyptic-threat (last accessed on 03/01/2013) 8.http://www.hpa.org.uk/NewsCentre/NationalPressReleases/2010PressReleases/100716MRSAandcdiffdownbyathird/(last accessed on 03/01/2013)

ELDERLY CARE MEDICINE

EMERGENCY MEDICINE

Lecture Notes

4th Edition

Simon Walker Geoffrey Beckett Peter Rae Peter Ashby 9th Edition

Claire G. Nicholl K. Jane Wilson 8th Edition

Chris Moulton David Yates 4th Edition

with extended material online'

EPIDEMIOLOGY, EVIDENCE-BASED MEDICINE AND PUBLIC HEALTH

HAEMATOLOGY

MEDICAL MICROBIOLOGY AND INFECTION

OPHTHALMOLOGY

Lecture Notes

Yoav Ben-Shlomo Sara T. Brookes Matthew Hickman 6th Edition

Chris S. R. Hatton Nevin C. Hughes-Jones Deborah Hay David Keeling 9th Edition

Tom Elliott Anna Casey Peter Lambert Jonathan Sandoe 5th Edition

Bruce James Anthony Bron 11th Edition

CLINICAL BIOCHEMISTRY

TROPICAL MEDICINE

PSYCHIATRY

Lecture Notes

Ray Clarke 11th Edition

Simon Walker Geoffrey Beckett Peter Rae Peter Ashby 9th Edition

Nick Beeching Geoff Gill 7th Edition

Gautam Gulati Mary-Ellen Lynall Kate Saunders 11th Edition

CLINICAL PHARMACOLOGY AND THERAPEUTICS Lecture Notes

DISEASES OF THE EAR, NOSE AND THROAT

Gerard A. McKay Matthew R. Walters 9th Edition

PAEDIATRICS Lecture Notes

Simon J. Newell Jonathan C. Darling 9th Edition

with extended material online'

and i st

ge ma s

5. Llarrull LI, Fabiane SM, Kowalski JM, Bennett, B, Sutton BJ, Vila AJ, Asp-120 locates Zn2 for optimal metallo-ss-lactamase activity. Journal of Biological Chemistry, 282(25), 18276 – 18285

CLINICAL BIOCHEMISTRY

Lecture Notes

Carl Gwinnutt Matthew Gwinnutt

2. Hu Y, Phelan V, Ntai I, Farnet CM, Zazopoulos E, Bachmann BO, Benzodiazepine biosynthesis in Streptomyces refuineus, Chemistry & Biology, 2007;14(6):691-701 3. Rahman K, Rosado H, Moreira JB, Feuerbaum EA, Fox KR, Stecher E, Howard PW, Gregson SJ, James CH, de la Fuente M, Waldron DE, Thurston DE, Tayor PW, Antistaphylococcal activity of DNA-interactive pyrrolobenzodiazepine (PBD) dimers and PBD-biaryl conjugates, Journal of Antimicrobial Chemotherapy, 2012;67(7):1683-1696

CLINICAL ANAESTHESIA

with extended material online'

The Lecture Notes series The Lecture Notes series provides concise, yet thorough, introductions to core areas of the undergraduate curriculum, covering both the basic science and the clinical approaches that all medical students and junior doctors need to know.

14 - 6 2 4 3 3

In addition, the Division of Immunology, Inflammation and Infectious Disease, has research underway in the prevention of healthcare associated infections, including classically resistant pathogens such as MRSA. Their work involves modelling the dynamics of resistance and past patterns in order

to develop novel preventative strategies for resistant hospital acquired infections.

self-te

by acetyltransferases on chloramphenicol molecules will inactivate them. The Randall Division recently identified the presence and mechanism of acetyltransferases in Pseudomonas6. Developing an inhibitor to chloramphenicol acetyltransferase, and administering it alongside chloramphenicol could overcome this resistance. For now, anyway.

www.lecturenoteseries.com 48

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Memorabilia are now available for purchase and collection from the Gordon Museum reception. See overleaf for price list and mail order form.

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DENTAL

to concentration. I would therefore advise students not to seek out the most silent section of the library for their preparation!

Dental Foundation Training The Interview Process

The SJT was a rather unknown entity; although both Portsmouth Dental Academy and King’s College Hospital coached us to the best of their ability, the actual test exceeded both student and teachers’ expectations in terms of it’s difficulty. It was impossible for students to leave with any real appreciation of the quality of their performance. For example, in the exercise which involved ordering 5 phrases from the most to least appropriate there was rarely a clear most and least appropriate answer as we had practiced. When picking the 3 most appropriate phrases there were always 4 or 5 appropriate answers.

Since this was the first year the SJT was used as an assessment tool, I hope there will be a greater array of useful examples for the 2014 cohort to use in their preparations. It is important to recognise that the SJT is rooted in ethics as opposed to clinical expertise so this should be a core consideration during preparations. For those receiving offers on the 8th January 2014 I hope you all get places you are happy with, and for those in years to come I wish you the best of luck with the process and enjoy learning the GDC standards!

Photographs courtesy of Charlie Ding

Lucy Clements BDS5

he 18th and 19th of November 2013 brought the Dental Foundation Training (DFT) assessments at the London Deanery Events Centre in Russell Square to final year dental students hoping to start their DFT in September 2014. Applicants ranked schemes throughout the UK (minus Scotland) before their interview. The subsequent assessment and interview process was to determine which of these schemes the applicant would then be assigned to for their first year in practice. The assessment consisted of three separate stations. Two lasted 10 minutes with an allowance of 5 minutes reading time - a professionalism, management and leadership (PML) station and a patient communication station. Following this, applicants either had no wait or waited between 40 minutes or 80 minutes for a situational judgement

GKT Gazette

Jan - Feb 2014

test (SJT) lasting 100 minutes. We hope that next year applicants will be told which group they will fall into in advance so they can plan accordingly, especially given that bags can be accessed during the waiting stage. The communication station was ‘OSCE like’ for which students can prepare for in advance, given that they are accustomed to these stations. The PML station presented a varied experience for students. Some found themselves delivering a 10 minute monologue during which they engaged with the full portfolio of clinical governance issues relating to the particular scenario provided. Others participated in a dialogue with the examiner involving numerous direct questions. It is probably sensible to practice both variations. During the five minutes ‘reading time’ we were positioned in a busy corridor, an environment far from conducive Jan - Feb 2014

GKT Gazette

Out and Proud? A student nurse’s reflection on the implications of heteronormative assumptions in clinical practice Ryan Passey Mental Health Nursing 3rd Year

icture the scene; you’re at a family wedding without a date, but the champagne is flowing and everyone’s having a great time. You find yourself standing alone with an aunt who you haven’t seen in years. The small talk dries up and she poses the dreaded question, “So could your girlfriend not make it?” Clearly the news that you came out as gay two years ago hasn’t filtered through to this side of the family. Sound familiar? I find myself in these challenging situations regularly when I return home to Dudley. They are awkward and difficult to navigate but that is about as bad as it can get. The consequences of whether or not I choose to disclose my sexual preferences stop at uncomfortable silences. As a student nurse the consequences of being “out” in practice can be far-reaching, as I 56

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have discovered whilst on clinical placement. Last year I was working on a great ward with extremely supportive colleagues. Personally I was doing well, I had been dating a guy for a couple of months and felt happy and secure for the first time since coming out. One afternoon a nurse asked me if my girlfriend and I had any Valentine’s Day plans. I was so taken aback by this that rather than saying ‘actually my boyfriend is taking me out for a nice steak dinner,’ I meekly replied that I didn’t have a girlfriend. This isn’t the first time that this has happened to me, and it certainly won’t be the last. What strikes me about this experience was how exposed I felt, as though to be honest would leave me vulnerable in some way. After speaking with gay and lesbian colleagues I realised that I wasn’t alone in feeling like this.

NURSING & MIDWIFERY

“Oh so you’re a lesbian?” was the response when Stephanie* mentioned her girlfriend to some work colleagues. ‘It was odd because I’d never say to them “Oh so you’re straight?” It’s just assumed that being straight is the norm,’ she explained. From experience this doesn’t seem to be intentionally harmful, the staff I’ve work with are often unaware of the impact of their assumptions and as Stephanie continued, ‘it’s not exactly homophobic’. Why would you admit to being abnormal if it makes life easier to pretend? Being in a same-sex relationship (or wanting to be, for those of us who’ve yet to land someone) is not abnormal. We are living in an age where Tom Daley reveals that he’s in love with a man and the nation rejoices, Ellen DeGeneres is adored worldwide and is openly attracted to women and by March 2014 same-sex marriages will be legally performed across the United Kingdom. Heteronormative assumptions, the belief that everyone is ‘straight’ until declared otherwise, are rightfully becoming a thing of the past. Like floppy disks, or Samantha Mumba’s career, time is moving too fast for them to survive. There is no need to hide or feel ashamed by what you feel. Despite this wonderful progress, a culture of ignorance and prejudice prevails. Change is taking time. ‘If I tell people and somebody doesn’t like it, then I meet them again in a job interview, you just never know,’ Judy* explained. Her fears appear less rooted in shame and more so over the practicalities of future employment. Anti-discriminatory practice is mandated in national recruitment policy, yet would-be applicants are fearful over how they will be perceived and the effect this may have on their job prospects. ‘I told my mentor I was a lesbian and he said “it’s a waste”, he was never quite the same with me after that,’ Judy disclosed. Our mentors are a close ally in practice; advising and assessing our practice and shap-

ing us as nurses. It’s worrying that this kind personal disclosure can have a damaging impact on our education and assessments. Coming out in the first place can be a traumatic experience. It can be confusing and isolating, with many people finding that their family and friends treat them differently. They say it gets better, and in my experience it has done. However, it never gets easier to come out to someone, especially as the new student on a ward. Judy hit the nail on the head; ‘it’s hard enough coming out once, let alone three or four times a year!’ Patients themselves are no more immune from making assumptions than anyone else, and having their dignity stripped away whilst in hospital can leave them desperate for normality. They may ask us personal questions, curious about the lives of those caring for them. How do you respond? The key here is to maintain a balance between developing a positive therapeutic relationship and keeping professional boundaries. There’s a fine line between being honest and oversharing. So what does all of this mean for us? Should we even bother worrying about the implications of heteronormative assumptions on our practice? From my understanding it is clear that having an open and supportive relationship with colleagues in practice can help us cope with any difficulties we may encounter. I would never encourage anyone to come out at work if they don’t feel comfortable doing so, but please remember you are not alone, support is there if you look for it. And for our straight readers, perhaps think twice before asking about someone’s relationship status. Nobody should feel as though they have to hide to protect themselves. *All names have been changed

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GKT Gazette

NURSING & MIDWIFERY

Opening the door to healthcare for the homeless Sarah Cleary Adult Nursing 2nd Year

stablished in 1948, the prevailing task of the National Health Service (NHS) is to provide free and accessible healthcare, to every person living in the United Kingdom. Wherever you live, you can register with a GP and gain access to comprehensive healthcare whenever you need it. To register you just need to provide your current address. Simple! Or is it? A survey conducted on one night in 2012 revealed over 2000 people sleeping rough on England’s streets. With the reasoning that you must have an address to access a GP, this is over 2000 vulnerable individuals who are potentially excluded from our ‘easy access’ healthcare service. This figure doesn’t account for the recent prediction of 400,000 people without a permanent address, the ‘hidden-homeless’, who may also be deprived of vital health services. We have all heard of the postcode lottery, but if you don’t even have a postcode, what chance do you have?

GKT Gazette

With expensive secondary care services stretched beyond capacity, inappropriate A&E attendance is a hot topic. Homeless people attend A&E five times more often on average than non-homeless people. Before we condemn this behaviour, without access to the services provided by a GP, where are these people expected to go to receive treatment? If homeless people are not effectively linked in with primary care services, A&E would appear to be their only way of accessing healthcare, and this is often too late. I am concerned about just how many homeless people there are who don’t have access to the basic healthcare that the UK boasts is available to everyone. My concern is not unfounded. The average life expectancy for a homeless person in the UK is 47. That’s 34 years younger than the general population in the UK. The homeless are a population of people who often have multiple mental and physi-

Jan - Feb 2014

Jan - Feb 2014 Photograph courtesy of Charlie Ding

GKT Gazette

NURSING & MIDWIDERY

cal health problems. Additionally 63% have a drug problem and 32% are alcohol dependent. We can point the finger and blame their ‘lifestyle choices’, we can say their ill health is ‘self-imposed’, we can turn a blind eye because these people have little voice in society… but our health service is meant to be all inclusive. An alcohol-dependent businessman can go to his GP and get access to the help he needs to stop drinking. A 50 year old housewife who has been smoking for 30 years can go to her GP and get the help she needs to quit. What about the 24 year old boy who is addicted to heroin, because it is the only thing that comforts him when he finds himself cold and lonely on a park bench for another night? The Health Inclusion Team is a nurse-led service run by Guy’s and St Thomas’ NHS Foundation Trust. They aim to ‘reduce health inequalities, discrimination and social exclusion in Lambeth, Southwark and Lewisham’. They care for those who would otherwise slip through the system; homeless people, refugees, asylum seekers and those with blood borne viruses. With regards to the homeless, the nurses attend day centres and hostels and meet with them. They provide for their immediate and ongoing healthcare needs, however, most importantly they help homeless people gain access to the services they are entitled to, primarily a GP. Registration with a GP is simply the first hurdle for a homeless person in terms of accessing healthcare. Our GP services are often inflexible with their generic structure: book an appointment, turn up, register your arrival, sit in a waiting room, and

GKT Gazette

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NURSING & MIDWIFERY

then be called in to see the doctor. This is a well-organised model that allows easy and fair access to healthcare for the majority. However, it fails to cater for the needs of homeless people who may lead chaotic lifestyles, making it difficult for them to book and keep appointments. Many GP’s have a ‘did not attend’ policy that means after a certain number of missed appointments patients are no longer allowed to use the GP service. After difficulties in registering with a GP, losing registration could be detrimental to a homeless person’s health. Thus, the Health Inclusion Team is not only involved in registering patients with a GP, but also helping them attend their appointments, whether this is through linking them in to a buddy scheme where a volunteer accompanies them to the appointment, or through sending them a text to remind them. They also liaise with GP’s to ensure the patient is attending appointments and being provided with appropriate care. The nurses in the Health Inclusion Team are non-judgemental and build therapeutic relationships with their clients. Sitting and waiting for an appointment can be frustrating for anyone. Imagine that whilst you are waiting you become increasingly aware that the people are slowly edging away from you, that the receptionist is eyeing you with suspicion and the man across the room is frowning at you like you are doing something wrong by just being there. Imagine if when you are eventually called through to see the GP that they also treat you in a demeaning way, judging you and making you feel worthless. This may not be intentional but is often how it seems. One survey found

perceived social stigma to be the reason that 54% of homeless people did not feel able to attend appointments. Stigma is an issue we can all help to reduce, but healthcare professionals should feel a particular responsibility to prevent. Healthcare professionals are taught to be non-judgemental and compassionate. Thus, every member of the multidisciplinary team should be taking responsibility for providing the homeless with non-judgemental healthcare, valuing them in exactly the same way they would the alcoholic businessman, the 50 year old housewife, or any other member of society.

Since 1948 the UK has had a National Health Service. This means there should be free and accessible healthcare for all. The Health Inclusion Team should be a name we can give to the 1.3 million strong team of people working for the National Health Service, not just to the team of about 20 dedicated people in a section of Guy’s and St Thomas’ Trust. The first step to achieving this is to reduce the stigma associated with homeless people, particularly amongst healthcare professionals.

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GKT Gazette

BOOK REVIEWS

Big

colour photos of slides present in the middle of the book. The best thing about the book is that the answers are very detailed and explain why the answer is correct but also why the other options are wrong which is very useful given how ambiguous MCQ’s can be.

The Little Book of Questions and Answers

It is however unclear exactly who the book is aimed at as there are perhaps too many clinically orientated questions for students in their non-clinical years and yet too few for those who are in their clinical years. The questions are all rated according to their

Title: Oxford Assess and Progress: Medical Sciences Authors: Jade Chow & John Patterson Price: £19.99 ISBN: 978-0-19-960507-1

Kaushiki Singh MBBS3

his book is part of the Oxford Assess and Progress series that covers various specialities. The book contains approximately 350 multiple-choice questions (MCQ’s) covering the main medical science topics and is divided into 3 sections - cell biology, the biomedical systems and medical sciences in clinical reasoning. The questions in each of these sections are further grouped into topics with the answers present at the end of each topic. This makes it easy to navigate the book and find questions on the desired topic without hassle. The questions are mostly in single best answer format however; there are also a fair amount of extended matching questions. There is also a scattering of clinically orientated questions. In particular, the third section which is devoted to clinical questions. It is this section that makes this book useful for students in

GKT Gazette

Jan - Feb 2014

difficulty – ranging from what a graduate should know to what it would be nice for a foundation doctor to know. So this seems to be a book designed for use throughout medical school rather than for any particular year or exam. As a third year student who after taking a year out to do a BSc had forgotten a significant amount of MBBS1 & 2, I found the book useful for revision and also for testing some of the clinical information I’ve learnt so far this year.

their clinical years as well as those in the non-clinical years. Given the wide range of topics covered, the mixture of non-clinical and clinical questions and the number of questions, I would say the book is good for getting used to MCQ’s rather than for extensive practice. Some of the questions are based on very specific facts and so are also good for learning the topic as those facts may have been missed in other study. At the end of each section there are also suggestions for further study although these are only for other books in the Oxford Handbook series. In general though I think the style of the questions and the facts covered provide a good representation of exam questions making the book useful for exam practice. There are also questions covering histology that use high definition

Jan - Feb 2014

GKT Gazette

WIN A CLINICAL

PLACEMENT Slow Man – J.M. Coetzee Becky Taylor Comparative Literature MA

ut down by critics as a book all medical students should read: Paul Rayment loses his leg in a cycling accident then falls in love with his carer. The plot itself is without note but the comments on the limits of medical care are interesting. His doctor speaks too factually about amputating his leg, showing little understanding concerning the implications it will have to Paul’s life. His first nurse is patronising. Paul wants to be treated as a normal, middle aged man yet she continues to treat him as a small child, especially when bathing him. Finally, Marijana becomes his nurse and they reach a mutual, unspoken understanding concerning his needs. However, when Paul declares his 64

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undying love for her, the boundaries between medical care and human care are blurred. This results in Marijana neglecting her duties in an attempt to distance herself, which puts Paul’s health in danger. From personal experience, my medical friends take it for granted that I will come to the same conclusions as them concerning my own medical health. It’s just not true and I feel Paul’s frustration! The book will help gain an insight into the patient’s mind so it is a must read for medical students, although I would only recommend the first 50 pages as the plot itself becomes tedious. Photographs courtesy of Charlie Ding

WITH THE OXFORD HANDBOOK OF CLINICAL MEDICINE NINTH EDITION You could be practising your clinical skills in the country of your choice, be it in Africa, Asia, Latin America or Eastern Europe by entering our competition to win an overseas clinical placement.

Visit www.oup.com/uk/medicine/ohcm9 to find out more!

CAREERS

fact that I could emigrate to Australia if my junior doctor job in the UK falls through .

Struth! Get in the Ambo! Australian Elective Experience. Sabina Checketts MBBS5

o all current fourth year medics, have you decided on your elective placement yet? If not, then you better get cracking particularly if you are going to a popular destination. A (relatively) well-planned elective may be the most fun you have practising medicine in your whole medical school career - perhaps in your whole career.

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I have always wanted to go to Australia, partly inspired by watching Neighbors and Home & Away, while not forgetting Crocodile Dundee (“That’s not a knife”) and my elective seemed the perfect opportunity to obey my wishful thinking. Particularly as it is unlikely that I will ever be allowed over two months off work to study and travel – that is until I retire at least. When I mentioned my wish to my family their helpful advice included the

For those of you who are still struggling with the mystery of planning an elective then a great initial source of information was the Elective Abstract Recording System (EARS) database on the KCL medical virtual campus. It is compiled from data submitted by previous King’s medical students who have travelled on their electives across the world. They discuss what they did on their elective, where they did it, how it went, what could have been improved and enter various other useful comments regarding their electives. As for me, Sydney was my final destination, specifically in two hospitals under the Northern Clinical School: The Royal North Shore Hospital (RNSH) and Manly Hospital. I chose two hospitals, one large and central, and the other more like a small district general hospital as I wanted to experience the different ways of practicing medicine and get a good feel for the Australian health care system. Meanwhile, the Northern Clinical School runs weekly socials for it’s elective students that were well attended and a lot of fun. It is also a chance to meet a global variety of other elective students. At RNSH, I did a month of Renal Medicine, which was interesting (to me) but a bit heavy on the paperwork,

although it was useful practise for final year ward rounds. In Manly, I spent a month in their Emergency Department (ED; a.k.a. A&E) that I have to say I preferred. I can highly recommend doing at least half of your elective in the ED due to the breadth of patient that you see and the hands-on experience that you get. A recent study found that nearly 1 in 4 emergency doctors in Australia is British so I would be in good company if I did decide to emigrate. On the other the hand, one hilarious lecture I attended at RNSH described the Lord of the Rings theory of Oncology Frances et al 2005: the patient is Frodo with his ‘burden’ of the ring (cancer), the sexy medical oncologist is represented by Legolas, while the surgeon is Aragorn wielding his sword. Of course Gandalf represents the wise general practitioner who knows all. Three possibilities of travel for the cash strapped student in order of preference include: The Great Barrier Reef (there’s a reason it is one of Natural Wonders of the World), Uluru (a.k.a. Ayres Rock) and then Melbourne. Also visit Manly beach, it’s quieter and, in my opinion, more beautiful than Bondi. You can easily travel there on the renowned Manly Ferry and you should keep your eyes peeled for pods of dolphins and the odd humpback whale.

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And last but definitely not least, enjoy it! Your final year will be a marathon of work and not much play. Then you will make the largest leap of your career into your Foundation programme where you will no longer get the lovely long holidays you are used to as a student so make the most of them.

I can definitely recommend Australia and Sydney in particular. Although I did overhear one elective student expressing his opinion that Australia is like Britain in 1930’s but with sunshine and funny accents.

Summary of my Elective Tips: ‘Stalien Slang • Do take a camera and a smartphone for back up. • Keep a brief diary of interesting cases. • Keep your eyes peeled for possible topics for your elective poster. • Use it to explore your career options • I recommend doing an emergency medicine placement • Use the chance to travel Enjoy it!

Aussie

English

Ambos

Paramedics

Ankle biter

Small Child

Arvo

Afternoon

Average

Bad

Bogan

Chav/Hoodie

Crook

Sick

Sunnies

Sun Glasses

Ethical judgement:

The Situational Judgement Test Sabina Checketts MBBS5

ell, it’s finally done. I have no idea how it went though! What I’m talking about (along with every other final year medical student) is the current bane of our existence – the Situational Judgement Test (SJT). Every final year medical student that applies to FPAS (Foundation Programme Application System) has to do this exam. It counts as 50% of your FPAS application mark and has replaced the previous white space questions. The SJT seems to have a significant weighting

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considering it is an exam that technically you cannot revise for and that counts for more than your years at medical school, but in practice the SJT does not actually count for quite as much as you think it does. They say that most people achieve an average score of 38-43 out of 50, meaning that your academic mark does still differentiate between people. Structure of the exam The paper takes 140 minutes and is in two parts with a total of 70 questions. Thus you only have two minutes per question,

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therefore being time conscious is essential. In Part One (Q1-47), you have to rank in order the five responses to the situation. Marks are available for near-misses and you should not use the same rank more than once. Preparing for the SJT According to the Medical School and the FPAS website you cannot revise for the SJT. This is not true; while you may not be able to revise for it, you can definitely prepare yourself. A good starting point is to read the General Medical Council (GMC) guidance for doctors, such as the Good Medical Practice and other documents produced by the GMC. It is probably worth looking at some practice questions before you do this as then you will have a better idea of what you are looking for in each of the documents. Another source of information is books about the SJT. I purchased three different books: Situational Judgement Test (Oxford Assess and Progress), Get Ahead: The Situational Judgement Test and finally 250 SJTs (Situational Judgement Test questions). Of the three I found the Oxford Assess and Progress to be the most useful and accurate regarding explanations for answers to the questions, while the others were useful for practicing as many questions as possible. Other useful sources of SJT questions included: OnExamination (BMJ question bank) and Passmedicine (N.B. The KCL medical students’ society (MSA) may organize discounts to certain question banks so watch out for their emails). Personally, the most helpful source of questions and the rationale for answering them was the FPAS website itself, where there is an interactive mock paper. The rationale for these questions is the closest you will find to the real exam, so I highly recommend doing repeated attempts at this FPAS mock to monitor how your revision is 70

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progressing. It is worth printing out a mock answer sheet (available on the FPAS website) and practising filling it in as the layout is different from previous exams. Health warning: At times various sources and answers do not agree.Do not be alarmed as even the experts who wrote the questions did not agree on all the answers, but rather questions were included on the basis of the majority of the committee agreeing to an answer. On the other hand the main pros of the KCL mock are that it helps you develop your time management and broaden your knowledge of topics. King’s also runs other talks preparing you for the SJT and I attended a few but they were all quite similar as there is only a certain number of potential topics and a certain lecturer kept popping up to run the sessions. It is worth attending at least one of the talks though. Another question I get asked is, “Are SJT courses worth doing?” I tend to think that people do revision courses out of fear that they are missing out if they don’t do them, which is why companies can get away with charging so much for them. However I succumbed to the fear and did an ACE Medicine SJT course. It was expensive but I do think it was worthwhile to clarify my thinking on the SJT and to propel my revision further. It also provided more useful examples of questions. However, I would suggest that you find a friend to accompany you as this often means the courses are cheaper. Finally, remember to practise as many questions as you can get your hands on. Good Luck!

SJT Sample Questions:

Remember you must answer what you should do as a Foundation Year One (FY1) doctor, not what you would do. Also never assume anything and only answer the question based on the information provided in that question. Q1. You are just finishing a busy shift on the Acute Assessment Unit (AAU). Your FY1 colleague who is due to replace you for the evening shift leaves a message with the nurse in charge that she will be 15 to 30 minutes late. There is only a 30 minute overlap between your timetables to handover to your colleague. You need to leave on time as you have a social engagement to attend with your partner. Rank in order the following actions in response to this situation (1 = Most appropriate; 5 = Least appropriate). A. B. C. D. E.

Make a list of the patients under your care on the AAU, detailing their outstanding issues, leaving this on the doctor’s office notice board when your shift ends and then leave at the end of your shift Quickly go around each of the patients on the AAU, leaving an entry in the notes highlighting the major outstanding issues relating to each patient and then leave at the end of your shift Make a list of patients and outstanding investigations to give to your colleague as soon as she arrives Ask your registrar if you can leave a list of your patients and their outstanding issues with him to give to your colleague when she arrives and then leave at the end of your shift Leave a message for your partner explaining that you will be 30 minutes late

Answer: ECDBA Rationale: This question asks you to demonstrate your commitment to patient care. Although it is not appropriate for trainees to stay for an extensive period of time after their shift ends, or do this in a regular basis, staying an extra 30 minutes on this occasion is important to ensure an effective handover (E). It is more appropriate to provide information directly to your colleague to ensure they receive it (C) and your specialty trainee (registrar) could also be able to ensure that your colleague received the information (D). Leaving lists of information on the end of a bed is less effective and leaving a list on the notice board is least effective as your colleague is unlikely to know it is there(B, A).

Photograph courtesy of Charlie Ding

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OBITUARIES

In Part Two (Q48-70) you choose THREE from eight possible responses, which address the situation when done together. You must only select three options. An example of a Multiple Choice Question: Q2. You review a patient on the surgical ward who has had an appendicectomy done earlier on the day. You write a prescription for strong painkillers. The staff nurse challenges your decision and refuses to give the medication to the patient. Choose the THREE most appropriate actions to take in this situation A. B. C. D. E. F. G. H.

Instruct the nurse to give the medication to the patient Discuss with the nurse why she disagrees with the prescription Ask a senior colleague for advice Complete a clinical incident form Cancel the prescription on the nurse’s advice Arrange to speak to the nurse later to discuss your working relationship Write in the medical notes that the nurse has declined to give the medication Review the case again

Question 2 : Answer: BCH Rationale: Ensuring patient safety is key to this scenario. It is important to discuss the nurse’s decision with her as there may be something that you have missed when first reviewing the patient (B). Therefore it would also be important to review the patient again (H). Also relating to this is the importance of respecting the views of colleagues and maintaining working relationships, even if there is disagreement. As there has been a disagreement regarding patient care, it is important to seek advice from a senior colleague (C).

BILL SHEERAN 1927 - 2013

illiam Murray Sheeran, who was on born 10 July 1927, was trained in dentistry at Guy’s Hospital in the late 1940s, was a passionate advocate and notable administrator of British boxing. He believed strongly in the social value of the sport as a channel for male aggression in a controlled environment, which instilled self-discipline, and engendered a sense of purpose and direction in young people from disadvantaged backgrounds. His attitude was summed up by his car sticker which boldly declared ‘Pugilism Not Vandalism’. Born in Maghera, Northern Ireland, Bill grew up in Bow, in the East End of London, where his father, James, was a local doctor. He was bullied at school, so James taught him to box and took him to boxing tournaments locally, at The Ring, Blackfriars and at Shoreditch Town Hall. This triggered a lifelong interest in the sport. He later boxed for Epsom College and became Captain of the Guy’s Hospital Boxing Club, where he was trained by Matt Wells, a former World Welterweight champion. Bill joked that the Guy’s Hospital motto ‘Dare Quam Accipere’ (‘It’s better to

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give than to receive’) was an appropriate one for their boxers. While at Guy’s, Bill boxed Charlie Kray, elder brother of the gangster Kray twins, Ronnie and Reggie. Walter Bartleman, boxing correspondent of The Star, and later The Evening Standard, told Bill before the bout, ‘He’ll eat you’, but Bill won the fight, with his opponent unable to continue. After completing his studies, Bill married a Guy’s nurse, Anne Mulligan, in 1951. He established a thriving dental practice in South Norwood, London, and eventually settled in Chislehurst, Kent, raising eight children (his three daughters all later training at Guy’s). Bill’s interest in boxing continued. Jan - Feb 2014

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After Guy’s, he boxed for the Lynn Athletic Amateur Boxing Club in London, becoming the club’s Secretary and later its Patron. He was trained at the Lynn by Frank Duffett, who also helped train professional boxers at the mecca of British boxing - the Thomas à Beckett gym in the Old Kent Road. Though he failed to progress as a boxer, Bill soon became immersed in the London boxing world and in the early 1960s was appointed an administrative steward of The British Boxing Board of Control. He got on well with promoters, managers, trainers, boxers and sports journalists alike, and was much respected for his fairness and integrity. He was the official in charge of numerous famous nights of British boxing from the 1960s to the 1980s, and was on good terms with Muhammad Ali, Henry Cooper, Barry McGuigan and many other champions. He was appointed Chairman of the Southern Area Council of the Board and made an Honorary Steward on his retirement. Bill Sheeran’s interest in boxing also included the history and artistic heritage of the sport from the late 18th century to the Second World War. He formed a modest but important collection, assisted by his wife Anne, which they sourced from auction houses, specialist dealers and private collectors. This included paintings, drawings, prints, sculpture, ceramics and silver. Characteristically generous, Bill later gave much of his collection away to friends. He returned the 1948 World Light Heavyweight Championship belt and trophy won by Freddie Mills to the boxer’s widow, Chrissie. The National Portrait Gallery borrowed and later purchased from him a magnificent Rembrandtesque portrait showing the British World Light Heavyweight champion, Len Harvey painted by Thomas Burke circa 1938.

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In 1983, Bill Sheeran and his wife Anne retired to her childhood home – a farmhouse in the hills of North Wexford, Ireland. Here Bill’s passion for gardening, and his instinct for design and colour, found a superb outlet for more than 30 years. Bill and Anne raised funds to start a boxing club in their local town, Gorey. They called upon many friends in the British and Irish sporting scene to help out, notably the Olympic gold medallist Dame Mary Peters, who became a longterm supporter and visitor. For more than 20 years, Bill helped to train young boxers and organised tournaments and tours. He was also elected President of Gorey Boxing Club, which soon became one of the leading amateur boxing clubs in Ireland, producing several national champions. It also became an important focal point for the community and a source of much local pride. In his later years, Bill Sheeran suffered from Alzheimer’s, sadly missing out on the progress of his 23 grandchildren and four great-grandchildren. He would, no doubt, have been proud that in October 2013 one of his grandsons, the singer-songwriter Ed Sheeran, performed three sold out shows at the world’s most famous boxing venue, Madison Square Garden, New York. Bill died on 7 December 2013, aged 86. At his funeral, Gorey Boxing Club formed a guard of honour and gave its own tribute: ‘In Bill Sheeran we have lost a mentor, inspiration and a role model whose generosity and kindness have helped thousands of young men and women in the wider Gorey area.’ Two boxing gloves from the club were placed in Bill’s coffin. Obituary by John Sheeran.

KCL - Cambridge Fight Night Laurence Clarke Politics 3rd Year

n the first week of December 2013, KCL Boxing Club went toe-to-toe with a fit and talented squad from Cambridge University, in an 8-bout ‘Fight Night’. The event took place at one of KCL’s regular training spots; the Black Prince Community hub. The hosts came out decidedly on top, with a final result of six bouts to two. Of the six wins for KCL, four came by unanimous decisions, one a majority decision and one by technical knockout. On the night, both male and female fighters put on an impressive display of technique, fitness and aggression. The KCL squad consisted of Marguerite Gallagher, Natalie Cass, Nicholas Robin, Inti Raymi, Nick Higgins, Michael Strawpert, Izaak Leo and Rob Prince.

The following Tuesday, Club Captain, Rob Prince, gave his verdict on what he described as a brilliant night for the club: “All our boxers have made massive progress since our last show, and on Friday everyone boxed at their very best - we’re very proud of what we’ve achieved. We had a mix of fights on the night: we had women’s bouts, first outings, and some more experienced bouts too – everyone put on a great show.” “We’ve got a lot of people to thank – our coaches (especially our head coach, Lee Steggles), everyone who came down to support on the night, Cambridge University Boxing Club, and everyone else who was involved in putting on the show. Freddie Ellery and Rob Smith, our social secretaries, deserve a special mention too.” Jan - Feb 2014

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The club hopes to be working closely alongside Cambridge University in the New Year, assisting them in preparation for their upcoming fight against Oxford. All fighters will be enthusiastic to get back after the Christmas period and continue training, and the club is looking to carry the momentum of this big win in to 2014. The more experienced boxers at the club will be training for the upcoming BUCS tournament on 8th February in Coventry, where KCL expect to be fielding at least 4 boxers. Competing in BUCS is a big milestone for the club, which has gone from strength to strength in recent years.

Photographs courtesy of Charlie Ding

In addition, January will provide the opportunity for a fresh intake of new members of the club, with ‘refreshers’ events being planned. King’s College London Boxing Club welcomes and encourages students of all abilities to come down to the flexible training sessions, where top-quality coaches offer a whole range of skills, from ‘the basics’ to advanced sparring and competitive fighting. The club trains on Wednesday, Friday and Sunday afternoons at various locations in south London. All details can be found on the KCLABC Facebook page.

BDSA Sports Day - Cardiff ‘13 Ushma Patel & Jigar Mehta BDS2

fter a long three-month wait, we were finally heading to Wales for a weekend of unforgettable merriment with our fellow ‘Mental Dentals’. Having never been to a BDSA event before, we didn’t really know what was in store for us until we set foot on the coach. The mood was on a high right from the start, with excitement building up every mile of the journey. As soon as we hit Cardiff, geared up in our raunchy red t-shirts, we made our way to Oceana nightclub to find ourselves mixing with dental students from all over the country. Cheap drinks and good music ensured that everyone had a wild one. The following morning at 9am, we all awoke for the sports fixtures with crazy migraines 76

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(the music was far too loud...), but eagerly made our way to the fields to compete with twelve other dental schools. Our players did exceptionally well - most notably the GKT netball team who destroyed all the competition and easily defeated the Cardiff team 10-2 in the final! The team was led by the unbeatable attacking trio of Steve Conteh, Charlotte Molyneaux and Lucy Clements. The hockey team, led by Bhavesh Patel, also played extremely well coming in third place. That evening, looking stunning dressed as Vikings, we made our way to Flux, Cardiff’s infamous SU (which frankly made Guy’s bar look like a closet). Dental students from all over the country were dressed to impress in Jan - Feb 2014

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their fancy dress costumes and it was another unforgettable evening of social insanity. On Sunday morning, after barely any sleep, we stumbled out of bed to get on the coach back to London - our weekend had sadly come to an end. The organisers of the trip, Olivia Johnson King and Kaly Gengeswaran, were determined to make this weekend one to remember, and their efforts were greatly appreciated.

Previous page: Hockey team Left: Netball in action Below: The team Photographs courtesy of Sadhvik Vijay

Lewis Moore Deputy Editor News Editor

Kate Anstee Deputy Editor Treasurer

Joshua Getty Deputy Editor History Editor

Katie Allan News Editor

Zoya Arain Features Editor

Sabina Checketts Ajay Shah Arts & Culture Editor Research Editor

Megan Clark Dental Editor

Matilda Esan Careers Editor

Georgie Day Sam Evbuomwan Book Reviews Editor Nursing & Midwifery

Tom Fenner Sports Editor

Hannah Asante Advertising Officer

Nayaab Abdul Kader Merchandise Officer

Charlie Ding Photography

Lucy Webb Staff Writer

Sarah Cleary Staff Writer

Fi Kirkham Staff Writer

Rolake Segun-Ojo Staff Writer

Anya Suppermpool Layout Editor

Editor

With Special Thanks To

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Max Coupe-King - Contributing Writer Katherine Leung - Contributing Writer Tristan Dennis - Contributing Writer Dylan Padmakumar - Contributing Writer Lucy Clements - Contributing Writer Ryan Passey - Contributing Writer Becky Taylor - Contributing Writer Jade Chow - Contributing Writer John Patterson - Contributing Writer Laurence Clarke - Contributing Writer

Ushma Patel - Contributing Writer Jigar Mehta - Contributing Writer Ellen Wood - Artist Sam Alsford - Layout Rebecca Trenear - Layout Professor Stephen Challacombe - Trustee Margaret Whatley - Administrative Support William Edwards - For Assistance and Guidance Kingâ&#x20AC;&#x2122;s College London and our other donors for their generous support

The Guy’s, King’s College & St Thomas’ Hospitals Gazette

Volume: 128 Issue: 1 Number: 2581 ISSN 0017-5870