Nottingham Medical Students' Journal - 2020 (re)Vision

NMSJ Nottingham Medical Students’ Journal

Issue 3: January 2021

2020 (re)Vision Cover Image: Emma Midgley

Within this issue: 2020 (re)Vision • • • • • •

2020 - Hypocrisy’s Finest Year 2020 - The year the world rediscovered itself 2020 and Health Inequalities. How do we make things better?

Instagram Activism: @Medschool_racism Teaching in a Pandemic Every mask has a silver lining

Societies • •

Student MedAID Nottingham and COVID-19 SCRUBS – How to Make a Hand Tie Trainer

Advice and Wellbeing • • • • • •

COVID-19 vaccine myth buster and how to talk to sceptics The simple trick that your doctor doesn’t want you to know about Table for one Surviving your clinical placement: a few resources Managing finances in University The Hungry Medic Presents: Roasted Veggies with Middle-Eastern Inspired Cous Cous

Stories and Views • A return to reading My part in the pandemic Juggling a job and settling in

• •

Creatives • Londoners trying and spectacularly failing to wear masks • • • • • • •

Test to protect She sits high in the tower Inspire Art of Research Competition The beating machine A Year in Retrospective Take this as a PSA A 'splashing' time

With contributions from: Adithiya Janani Aisia Lea Alisha Gupta Angel Rowlett Anna Kober Anshu Firake Catherine Furlong Chant Navarro Daniel Taylor Derby Anatomy Art Society Eleanor Wedgewood Elizabeth Mullins

Hassan Akram Ignacy Kozlowski Issy Walker Natasha Harris Nayan Dey Nic Miller Prashamsa Manchiraju Raisa Jaffer Ritu Rajan Sepand Malek Sophie Shallish Talia Patel Yasmin King

Welcome from the editors Nic Miller and Issy Walker

This is perhaps not the journal we expected to be putting together back when it was first born. If you’d told us we’d be releasing a third edition, in the midst of a third lockdown, we’d have either laughed or cried probably. Maybe both.

This journal we wanted a chance to reflect on 2020 as a whole. The successes, the failures, the lessons, the miscellaneous even! In a year that saw change in our lives on a scale never known, not all that change was negative.

Hopefully as you’ll see from the latest edition, people have re-found old hobbies, found new ones, learned things about themselves they didn’t expect or engaged with new communities.

The pandemic has undoubtedly taken things from us. There has been a global sense of loss on a scale our generation has never known. But in these pages there’s a subtly optimistic reminder that there are also things that we may not have even realised that we have gained.

We’re also really happy to have expanded the team, presenting our new team of editors that you can find on the next page.

So enjoy this issue, and take care out there.

January 2021 4

Year Rep Team

Year 1 Rep- Prashamsa Manchiraju

Year 2 Rep- Ignacy Kozlowski

Year 3 Rep- Yasmin King

Derby Rep- Catherine Furlong

We are still looking for a Clinical rep – get in touch if you want to get involved!

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Editors Team

Features - India Capper

Societies- Anna Kober

Advice and Wellbeing- Ahsab Chowdhury

Stories and Views- Natasha Harris

Creatives- Melissa Begue

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2020 (re)Vision Perspectives on 2020 2020 - Hypocrisy’s Finest Year 2020 - The year the world rediscovered itself 2020 and Health Inequalities. How do we make things better?

Instagram Activism: @Medschool_racism Teaching in a Pandemic The Simple Trick Your Doctor Doesn’t Want You to Know About Every mask has a silver lining

2020 – Hypocrisy’s Finest Year Nayan Dey

This year hasn’t been smooth-sailing to say the least, yet our innate ability as humans to adapt has normalised mask-wearing, social distancing and many more things that we just accept as part of this COVID world we now live in.

Having said that, this year has been riddled with hypocrisy on a household, community and national level, which doesn’t sit well with me.

Firstly, cast your minds back to the first lockdown where every Thursday at 8pm we’d go outside and clap for the key workers and NHS staff who were selflessly risking their lives on the frontline of the pandemic. A gesture of togetherness and gratitude was it? Yes, perhaps it was, but I couldn’t help but notice how a significant number of people who were outwardly showing their appreciation of our nation’s heroes, were the same people who continued to make nonessential trips, go over to friends’ houses, some even trying to paint this pandemic as one big conspiracy of some sort. Hypocrisy, right there in plain sight if you looked hard enough. Surely a nurse on the frontline would rather have no ‘Clap for Carers’ but with stronger public adherence to COVID guidelines, which actually saves lives, than a Thursday evening of clapping by an audience that celebrates the selflessness of key workers yet lack it themselves.

A Questionable Method of Herd Immunity Herd Immunity, a term coined by the WHO, is only ethical if the population is vaccinated to prevent the spread of disease; yet back in March Mr Johnson claimed allowing the virus to seep through the UK population would build up herd immunity, completely disregarding the concept as outlined by the WHO. This and many other notions put forward by scientists and medical professionals were blatantly ignored by politicians, and to what end? To avoid widespread panic? To uphold a façade of everything being under control? It still amazes me how during this pandemic the government and public health bodies rarely ever have sung from the same hymn sheet; and when they finally do, it is once a time lag of 2 weeks has elapsed in most cases.

The ‘Eat Out to Help Out’ scheme is another demonstration of the government’s disregard for scientific advice and rash attempts to recover lost profits, all whilst portraying the scheme as a well-earnt reward for the public after the 3-month lockdown. This, ultimately, planted the roots of public complacency in social distancing, and in the following months led to alternations between a flawed tier system, which is constantly criticised by SAGE, and periodic month-long national lockdowns. All this points to a government which chose to prematurely risk all efforts to drive down the R rate to merely recover GDP.

The Christmas No-one Wanted Saving Hypocrisy ran its course into December, with the government allowing interhousehold mixing at Christmas in an attempt to save face and not be seen as the administration that ‘cancelled Christmas.’ Many Britons opposed the mixing, profits weren’t increased and so the whole point of this one-day exception to the pandemic baffled me. No economic or public approval benefits so was this pure indifference? This was also the month in which students were given an ultimatum of a Christmas at university residence or a premature return home between 3rd – 9th December. Those who chose the latter would consequently end up paying rent for accommodation that they had abandoned until the New Year. The failure of organisations in possession of these residencies to compensate students for the unfair payment of unoccupied flats and halls is truly an injustice. Preying on the finances of students, many of whom depend on grants, loans and hard-earnt wages to pay for their rent highlights how, regardless of these public campaigns to promote togetherness, selflessness and goodwill, greed prevails; in the 21st century it seems no war, no injustice, no pandemic and no crisis will ever be able to crush human greed. This same greed has emerged in many ways in 2020, such as meeting your friend at their house in tier 3, going to a flat party during lockdown, not social distancing in queues to avoid missing out on Black Friday bargains, staying over at your partner’s in tier 2 and so on.

2020 has been a year where we’ve all changed, hopefully, for the better. Going forward I believe it is imperative that we are much more self-critical and actively scrutinise aspects of ourselves that are hypocritical as that’s where real, meaningful change will happen.

2020: The Year the World Rediscovered Itself Prashamsa Manchiraju

“All grown-ups were once children but only a few remember it” ~ Antoine de Saint Exupery I think about the above quote a lot, it’s from a story called “The Little Prince”, which some of you may be familiar with. For those who aren’t, it follows the journey of the titular prince – a little boy - as he leaves the familiarity of his home planet and discovers that the “grown up” inhabitants of other planets are nothing like him.

While his innocence, curiosity and open-mindedness define his character, greed, routines, and narrow-mindedness define theirs. When I first read the story, a long time ago, it was unthinkable to me that anyone could forget the magic of childhood – writing whatever stories came to mind, losing ourselves with abandon in novels that took us to faraway lands and playing outside till the sun came down. Growing older means having to write facts instead of fiction, reading textbooks over novels and having to stare at a screen rather than putting on sunscreen.

This year, it was different. The pandemic descended upon us, and for nine months most of us were confined to our homes. Without the hours and hours spent on trains, buses, and cars, for the first time in a long time we had a lot of free time. Time which was ours to use as we wished – to have fun, to laugh and enhance our creativity and live as we once used to. The only problem was... we had forgotten how.

“Chains of habit are too light to be felt until they are too heavy to be broken” ~ Warren Buffet As phrased by the above quote, habits forged aren’t easily broken, but if this year has taught us anything, it is that we managed to do just this – one step at a time.

Some have tapped into their childhood and broken habits forced upon them by the mundanity of daily life. Taking up poetry, reading and bike riding (as I have), singing, drawing, cooking or simply living day to day without planning each minute.

Hearing stories of people rediscovering themselves is an uplifting outcome of this pandemic, which has otherwise taken so much from so many. Perhaps the ability to reflect upon on the year with gratitude is also something that we’ve gained.

Stories of rediscovery aren’t limited to humans, but also the beautiful and breath-taking wildlife that surrounds us. Reading stories and seeing pictures of animals repossessing their natural habitats without human interference is a poignant reminder that the Earth is not ours alone, but the responsibility to ensure it is safe and hospitable for everyone definitely is.

This year certainly has been unique. It has afforded us with the time and energy to slow down and rediscover what truly makes us happy. It enabled us to connect with friends and family on a deeper level. It opened our eyes to important issues within society and called to arms our sense of justice. Most importantly, it united us all in a shared sense of purpose. Here’s hoping this feeling extends into the new year and paves the path to many more discoveries and “re-discoveries”.

Happy New Year!

2020 and Health Inequalities. How do we make things better?

Nic Miller

In 2020, there was a lot of headline news. COVID-19 ruled the airwaves. But a pandemic that has been going on far longer than, and threatens to outlive, COVID-19 was also highlighted. It’s not the first time this pandemic has come to the fore and, sadly, it probably won’t be the last- but it’s one we need to confront.

And that’s the systemic racism and oppression of minoritised groups that exist within our healthcare system, a system we are all an active part of.

This could be an article discussing the many ways 2020 laid bare the obvious disparities in our healthcare system- I’ll link a few key reports at the end in case you missed them.

But I wanted to write a more practical article here- not one that tells you about issues we should already be aware of, but that discusses how to learn from mistakes of the past.

1. Acknowledge the problem, learn about the problem The best thing you can do to instigate change is to learn about the issues. There are many resources to appeal to how you learn best, including a range of important voices you can follow on social media.

Two of my favourite resources for beginning to read around this area are: • UCL’s Decolonising the Medical Curriculum group’s reading list: https://docs.google.com/document/d/1_H8mm4CRP0yzt0ms_c2lfWV1zO5A4tQJSiTg9rw_ZI/edit • This list from Medic Reads: https://www.medicreads.co.uk/decolonise-the-medicalcurriculum-r

Some great social media accounts to follow on Instagram/Twitter to get you started with some resources: @racendhealth @blackandbrownskin_ @declononisingcontraception @lgbtqia_glasgow_med Amongst many more.

The key is to expand your social media following to include voices of doctors and other medical professionals dedicated to improving healthcare for minoritised groups.

2. Start a conversation with others One issue with the gaps in healthcare is that we, as medics, often don’t discuss them. We see medicine as largely non-political, and the course keeps us pretty busy with studying the things actually on our exams.

But disparities in healthcare facing minoritised groups have real effects on our patients, and as doctors it’s our responsibility to advocate for optimal health for everyone.

So, start a conversation with your peers. Tell them about books or podcasts you might have read/listened to. If chatting about your day on the wards, think about the journeys patients from minoritised groups may have undergone, potentially leading to different care.

3. Follow and support UoN Medic groups that widen access to medicine You may not feel you belong to these groups, but following and supporting them on social media is critical to pave the path to improving healthcare for our patients. An important part of this is improving diversity in medicine and the doctors we produce. Some of the groups at Nottingham in this area include: • UoN Widening Access to Medical School (WAMS) • UoN Women in Medicine and Surgery (WIMAS) • UoN African Caribbean Medical network (ACMN) • Islamic Medical Association of Nottingham (IMAN) • UoN BME Medics

4. Engage with tutors/lecturers on these issues Once you’ve gained a knowledge in these areas and discussed it with friends, engaging tutors and lecturers you feel comfortable with in this topic can be productive too.

In case-based discussions for example, if relevant, ensure you’re mentioning potential sources of discrimination in healthcare. If you don’t encounter situations where those discussions are relevant, is this because some patient groups aren’t represented in your work?

This could present an issue in itself.

If you envisage changes that could be made to the curriculum and you or a group of friends feel confident to, engage with your lecturer for that element and request those changes. Medicine is, as we all know, a vast and varied field with new research emerging all the time. Highlighting some literature from the above could prove helpful to encourage lecturers to develop their teaching to be more inclusive.

5. Be reflective on your own biases and the biases of those around you Particularly in clinical phase, we interact with lots of patients and colleagues.

These people will all come from varied and multiple backgrounds, many of which may differ from our own.

Self-reflection is important in this process.

When reflecting on your experiences from the ward, some questions to contemplate may be: did you consider the impact of these differences on your care today?

On reflection could, or should, you have reacted to an incident with a patient or colleague from a different background differently?

Would you have treated the patient/responded to the colleague the same way if they were from a background more like your own?

Reflecting in this way is a personal task but allows you to identify and remove biases which you will inevitably have, and allows you to be a better doctor to your future patients.

Harvard have a great resource for assessing the implicit associations you may have with a number of minoritised groups here: https://implicit.harvard.edu/implicit/takeatest.html (with relevant cautions and explanations) Think, also, about reflecting on the actions of others- are there subtle or even obvious ways in which colleagues have interacted with patients or each other that expose underlying bias? Did you feel able to call this out? And, if not, why/what might you do next time?

6. Think beyond the wards Consider joining groups in the local community that tackle inequality more broadly. Health inequality is not restricted to hospitals or GP surgeries. Outside healthcare settings housing, employment, poverty, systemic racism and oppression, all have consequences on the health of our patients.

All of the above illustrate the tip of an iceberg, but may also impart changes to your future practice or the practice of others that could improve the care you deliver to all your patients. It is not a process that has an endpoint. Like medicine, it is an ongoing process of learning, reflecting and improving. It is not a process we should do as medics because we will appear to be more inclusive or diverse, it is a process we must undertake to minimize additional injury and mortality inflicted on minoritised groups resulting from a system in which we are complicit.

Further reading on the issues presented: https://www.theguardian.com/world/2020/oct/27/structural-racism-led-toworse-covid-impact-on-bame-groups-report

https://www.health.org.uk/publications/reports/the-marmot-review-10-yearson https://www.gov.uk/government/publications/covid-19-understanding-theimpact-on-bame-communities https://www.nejm.org/doi/full/10.1056/NEJMc2029240 ‘Is COVID racist?’ on Channel 4’s All 4 player

Instagram Activism: @Medschool_racism Chant Navarro

In light of the Black Lives Matter (BLM) movement, one of the largest civil rights movements in US history, millions of us in the UK were shocked by the overwhelming wave of online activism that flooded our newsfeeds. From sharing petitions to supporting local black businesses, many of us asked the all-important question: "What can I do to help?"

Today I sat down with the creators of @medschool_racism. Amber and Simi are medical students in their clinical years at Imperial College London. They began an Instagram account that aims to shed light on the experienced racism in medicine by sharing anonymous stories of Nursing and Medical students. The account currently has over 5000 followers, including but not limited to, aspiring applicants and universities admissions teams.

C: So, how did the account come about?

A: There was so much going on with George Floyd, his murder and the BLM movement had me thinking about the racism encountered in our everyday lives. A lot of stuff was being shared by South Asian activists, Black activists and everyone was sharing every piece of information that they could. I saw Simi was also writing a piece about BLM in a magazine. We were both enthusiastic about it and then it just went off from there, it went crazy.

C: Performative activism has been a hot term lately; would you say that that starting this account was a call for action by opening up the dialogue about racism in your own sphere of work?

S: I remember when it first started, I had a lot to say about this - don't tag 10 people to BLM challenges etc. But the way we use Insta has changed so much, especially since the start of the pandemic, people have been using it to spread information but there is a lot of pressure and expectation to keep doing it, not necessarily from other people but from yourself.

This account was used to show people that these things happen, these things are real but not speaking from my experience only. Being able to share other people's experiences is really important to me, and I think that’s why we've done so much with that and it’s still going. It seemed like a really positive thing to channel our energy into.

A: I think our goal at the start was a story telling, letting other people have their platforms and actually share their stories anonymously because most people don't want to talk if it's their name and their face behind something. Giving people that opportunity to speak out and vent and share their thoughts without being targeted.

C: Did you think it would gain as much popularity as it has?

S: From the first post, I did not think it would get this much traction and engagement from this early on and I really thought that we would run out of steam but other than sharing stories we can also try and find ways to change it so they're less frequent for people.

A: And we've got a few stories as well that aren't in placement, some are passing comments made by family members or other people. Which is interesting because we have the clinical ones i.e., from patients or colleagues. Some directed from peers, friends and lecturers as well. I think that's what gives our account a wider scope, there’s issues behind the initial name of "Racism" in general, such as microaggressions, undermining, many different types. I think that’s what grabs people’s attention as well, the different types of racism experienced and different stories.

C: What surprised you the most since starting the account?

A: How quickly the page grew, how ready people were to support the idea and how many people messaged the account saying, "this is so needed".

S: Some of the stories we receive, not being able to reply immediately because you can't quite believe the scope of what you've read. I just can't believe it actually happened, in a clinical setting. And I do think as people of colour ourselves, we tune it out sometimes. You'll read something and be like I've experienced something like that and didn't make a big deal of it.

But it's really helped us do some self-reflection as well. Which is quite surprising.

C: What do you feel are the next best steps UK medschools and universities can do to address these issues for their BAME students?

A: There's a BMA Racial Harassment Charter that, prior to the influx of the BLM movement, only two UK med universities had signed up and now a lot of them have due to the pressure of students. But if they haven't yet, I would say they need to be signed up to the charter and be thinking about how to implement everything in it because it says useful things, it breaks things down, it gives advice for medical schools and students. If you're a bystander as well. They need to be pro-active as well, but also adapt it in the teaching, put in the effort that students do learn. Medschools need to accept responsibility and liability for everything and they need to step up and teach how to be actively anti-racist.

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S: There is this unconscious bias training that many professions receive and understanding that this simply isn’t enough. A lot of stuff seeps through, especially if it isn’t treated at the foundation level and all of it comes from ignorance mostly.

There isn’t a drive to teach people about the impact of certain things on race, but as people who are going to be influencing people's health and quality of life, it’s something fundamental that we need to learn from the beginning. It can start from something as simple as implementing the BMA charter, or making reporting mechanisms clearer, or implementing a no tolerance policy. Very simple things that can be added, but also things that people may not even know are part of the framework so they may not even know that these resources are available to them.

An increase in transparency is needed.

S: They need to really think about how to get these students engaged and it’s a matter of welfare as well and how we will be as doctors as well, it needs to be a priority too all these things. Transparency and ensuring students know what is going on.

To reach out and share your own stories, or to show your support please see the below:

Teaching in a Pandemic: A Conversation with Professor Susan Anderson, Head of Anatomy Catherine Furlong

At the beginning of the Christmas break, I sat down for a Teams call with Prof Anderson to see how online teaching and COVID19 has affected her personally. This is what she had to say.

First of all, how has 2020 been for you?

I know it's been a heck of a year for everyone!

It has been a heck of a year. 2020 was my first full year of being as head of anatomy at Nottingham (since September 2019). So that first term I was teaching, but I was also just trying to see how things worked because the last thing you want to do when you’re new somewhere is change everything without first seeing how it works. I spent a lot of time observing sessions, listening to academic staff, technicians, demonstrators and students. So, the first part of 2020, for me, was still the first full teaching cycle for me, so it was a shock! One of the overriding priorities was getting everyone home and everything online. I could see lockdown coming because you probably know I’m Irish and it happened in Ireland before it happened here, so I knew it was going to happen. We were preparing to get stuff online, preparing for staff to be at home. Everything was all go, every night and every day. We were all bringing our books home, laptops resources, anything we needed in case we couldn’t go to work the next day. We felt really prepared for the crisis when it happened, I think. And then, you know, we put everything online and we did the best we could.

I was very determined at that point that we would deliver face-to-face teaching come September. Whatever happened, we would do our best to do that because that was the right thing to do. We would also try and replace the learning that was lost by the second years. But the other thing I was really determined was we weren’t just going to do all this work to undo it the next year. Whatever changes we made, I wanted them to be thought through so that we would make our teaching better as well. That was the aim. How it’s been is just relentless, totally and utterly. Relentless planning, replanning, rethinking, worrying how it's all going to work.

Relentless is one word for it! I think all of us have been struggling to adapt to a virtual world. How has it been for you, teaching online?

It’s been weird. There’s been some really high points and some quite low points. I was anxious about it; all I could think about come September was how do I teach people when I can’t see them, because I don’t just deliver a set of slides; you deliver something that you’re reacting with or responding to. You can see when people are lost, when they need another anecdote, when they’re getting bored or restless. Reading the room without that two-way conversation is difficult. When you can’t see anybody and almost 300 of you are in the room, that’s difficult. I think what worked well is that students have been really good at helping one another in the chat function and it’s been quite interactive. It kept me from feeling like I’m talking to a blank screen. The worry now about not being able to see any of you is that it is hard to gauge how engaged all the students are. There might be 30 people interacting with you and that feels very nice for us. But does that mean that 270 of you are either lost, struggling or gone off to have a shower/make a snack? We just can’t tell.

I agree, I do think the chat has honestly been a godsend to students, myself included! Although you see us interacting in the chat, do you feel less connected to us first years, having never met us?

One of the things is that when people put stuff in the chat, their names come up.

So, people that are regulars I recognise. I don’t know what anybody looks like, apart from now you! In some ways, this is like last year when I only had a few lectures... I felt quite disconnected. I didn’t know the students and they didn’t know me; I would just pop up for the odd lecture here and there and they always went well. This year, I actually felt quite connected because I do a lot of teaching now. So, I guess it's easier for me, but I cannot wait to get people in front of me again so that I can get to know them properly.

So, having this online teaching this last semester, are you at home a lot more or do you still use the university facilities regardless?

We were stuck at home from March until September. I think it was the start of September I was allowed in. I was one of the very few people allowed in during lockdown, for HTA compliance reasons. I found it much easier when I got back to work, having face-to-face teachings Mondays and Tuesdays. It makes such a difference to get up in the morning, get dressed, go to work, see people, even if not many. My online teaching I do from home because the Wi-Fi in my office is rubbish! Sometimes, I have to give an online lecture and then jump on my bike and cycle like mad to work to do a face-to-face! It’s been quite nice in the small group teaching with the second years, being able to get to know them quite well in person. I would have hated to be stuck at home all the time. I don’t think mentally I would have coped with it.

I gather you quite like these small group face-to-face sessions. Do you think aspects of online learning could be carried forward, perhaps lectures?

I think it’s made people embrace the technology of online learning. And I think people have seen that there are some positive sides to this. There are caveats too... I worry about this. If everybody suddenly embraces a flipped classroom approach, where there is lots of advance preparation, students can become overwhelmed. It is always an assumption that students have prepared. Many won’t have, so it can cause a bigger divide between those that are progressing well and those that are not. I prefer to do the groundwork with my students myself. I think there is value in flipping the odd session, but I don’t think it works well for me. I think there is research to suggest that if you’re not actively engaging in writing or listening live that you don’t really connect with it. I’m not a huge fan. I’m a fan of keeping the groups small, but not online.

I know a lot of students feel this way too, finding it hard to adapt virtually. Do you think this online teaching might lead to a disadvantage to our future careers?

I think I would reassure people. We could just give you all a pile of textbooks and say in five years, we’re going to examine that, and you could go away and learn it. So, the materials are all out there. You don’t really need us, you’re all bright enough and able enough. The benefit of us as teachers is that we are able to put a narrative on it, tell a story, and connect it to other material you have learned about – to make a network of knowledge. I think as long as we are prepared to keep putting in the effort to make sure that where you need face-to-face, you get it everyone will be fine.

So, in terms of the workload, how has that been? I can only imagine how time consuming it all is.

Yeah, I mean, I kind of got hit by a double whammy because most of the material I delivered was new to me (because I was in the new job). I hadn’t delivered last year, so although I knew it, I still had to produce the lecture itself. The first thing I would do is see how others are delivering so I can make sure it fits and that’s quite time consuming. Once that’s done, then it’s tweaking. Recording them is an absolute nightmare. I don’t rerecord, you get what you get. The actual uploading of the blooming thing takes forever and if you make a mistake, you have to start again. In the beginning, I was setting the alarm every two hours at night to make sure my laptop didn’t go to sleep and advanced to the next stage. You worry if you do something in the background, it will slow down too much. So, I just did it overnight! If my laptop had broken, I don’t know what I would’ve done.

Looking on the bright side, I think that for a lot of us, your live lectures, amongst other lecturers, is the best part of our week, having that human interaction.

I think it works for us that way as well. Speaking into the camera late at night, when you finish doing slides at 11 o’clock is just lonely, whereas on a live lecture, there’s always something or somebody that will make me laugh and enjoy myself. it is difficult not to be able to see people, but it does make my week to have some human interaction. So, I think we all can feel that it benefits all of us.

Picking up on you not being able to see people, do you think students need to be a bit braver? Perhaps a few try turning on the cameras.

I don’t know that it would make it easier because you would mostly be looking at people taking notes or whatever. For me, the benefit is being able to see the whole room. In a lecture, we’re never really looking at you as individuals.

You get an impression of everybody. It’s about reading the whole room. It is also true that some students feel really uncomfortable having their cameras on. If a student feels uncomfortable or anxious about that, they are not in the best frame of mind to learn. For me, the student experience is more important.

Exactly my thoughts! I think one good thing that’s come from the lack of cameras or in-person lectures is the fear removed when a student asks a question. I think the chat makes this much easier.

Yes, exactly. If I went into a room of 300 18-year-olds, people wouldn’t ask unless they were really confident. So before, you’d get a couple of people, whereas now, you’ve got many more. I think there’s a much greater number of people interacting and so, I think there are ways of bringing this to in-person sessions in the future. Rather than replace live lectures with online ones, if we can take the good elements, make it easier for people to participate, do polls etc; I think that’s something I’d be happy to keep.

Finally, I just wanted to know if there’s anything you would change about online teaching if you had the power to?

Oh, good question. If The one thing I would change is something I can’t change. It would be that everybody’s experience of online learning would be the same. Some people have Wi-Fi cutting in and out, some think you’re freezing on the screen and yet, it’s fine for others. So, if I could change one thing, it would be that I knew what was being Delivered was being received the same by everyone. I also think online teaching has helped us see what each other are doing a little more; there’s a lot of repetition that could be consolidated.

Every mask has a silver lining Raisa Jaffer

Do you remember a time ‘pre-covid’?

When will we be in the ‘post-covid’ era?

The fact that time is now characterised by coronavirus shows that the only thing we can compare the last 10 months to is war which, for many of us, is something we’ve only read about. It is hard to believe that we began 2020 in a ‘normal’ way with little sign of what would follow -those 2 distant months where nobody was on mute or frozen seem like they may as well have been a lifetime ago.

It is fair to say that our lives look unrecognisable, yet we are still here living them. Having had my birthday and celebrating the festive period recently, it became apparent to me how much of a parallel existence this felt, but equally the world of new and often positive opportunities that are available to us even in the darkest of times.

I had the chance to start university this year, and I think it was somewhat of a baptism of fire for so many freshers with most having to self-isolate within weeks of arriving. Spending most the day in an unfamiliar room with an unfamiliar view, navigating a new course with the risk of being infected with coronavirus a real possibility, it still sounds as extraordinary as when that was my life. I wouldn’t have thought I would ever have coped as positively as I did in that situation. Whilst I never would have chosen that as my first major university experience, when I think about it now, it taught me something about myself that possibly no other event would have unlocked. The resilience, ability to ‘get on with it’ and make do is something I think we all have within us and it is often a challenging experience that teaches us the most. The magnitude and impact of the pandemic was reinforced greatly as I learnt at times about the exact thing that was confining me to my room.

It is fascinating yet strange to have my learning shaped by a worldwide crisis, both in what I was learning, and equally in what I was unable to experience.

Completing semester 1 and returning home for Christmas was a major milestone and I was definitely ready for the break. I realised when deciding what to do for my birthday in tier 3 the options were a walk, a stroll or ramble in a public outdoor space. However, there was something special about this simplicity, as cliché as it sounds; I was happy to be at home with my family, safe and well and able to do something.

Besides, I had never been at one with nature and it gave me the chance to do something different – even in a pandemic. I used to pick one of my favourite restaurants to eat at and most birthdays seemed to merge into one, at least this year was unique and hopefully next year a pandemic won’t be the reason for being different. I think that is something we can all carry with us; so often we get stuck in a rut or routine because that’s just life- but we shouldn’t have to wait for something major for us to change how we want to do things.

The Virtual Revolution It wouldn’t be a reflection of 2020 without mentioning the revolution of zoom and everything virtual. We lived in a world that was getting smaller and social media becoming an ever-increasing presence, but in the pandemic it has been a force for good. Rather than a divisive tool, we have seen it unite people and allow us to connect and share with our nearest and dearest. Within all our busy lives it can be difficult to stay in touch with others, and often it is only when there is an occasion that we may connect again. In this unique situation where everyone we know is affected, we feel a greater duty to check in and see how people are. I hope that going forward this sense of togetherness and community remains, and we don’t wait for a reason just to see how someone is.

We have been in a bubble for the last 10 months, reminding each other that this isn’t what normal life looks like; people telling me that this is not what university actually is. We can’t deny that, despite all the new positive perspectives and experiences that have been presented to us, recently that it has been challenging; from a superficial level, in terms of our zoom fatigue or just wanting to see people, to feeling lost or alone at times or losing loved ones. As we have adapted to this new normal there have, nonetheless, been shocking reminders of the underlying cause. A tragic death caused by a trip to work or 500 families losing a loved one on Christmas Day or 70,000 families beginning 2021 without someone dear to them. This life we have been leading has come at the greatest cost to humanity and this is something we cannot forget.

A Debt of Gratitude That resilience, the ability to ‘get on with it’ and make do is something that has been so excellently demonstrated by all our key workers. For them there was no option to work from home. The sacrifices they have made, and their daily struggle, have prevented a terrible situation from becoming even worse and enabled certain aspects of life to carry on.

I, like so many, feel wholly indebted to all the key workers and cannot imagine how hard this time has been for them. Some of them have, of course, come from Nottingham Medical School - and I hope to be able to, similarly, demonstrate the same courage they have throughout my career.

Hope With the vaccine programme in full swing and the possibility of a return to our ‘oldnormal’, some things are bound to become a thing of the past. I think this year has given us a lot to reflect on, from small things we have learnt about ourselves, to what we can achieve and learn when presented with no other option. There are doors to so many new things we can open, despite our usual door being closed. But rather than forgetting this time- if we can use this experience to shape our future, I believe we will be stronger for it.

Societies Student MedAID Nottingham and COVID-19 SCRUBS – How to Make a Hand Tie Trainer

Student MedAID Nottingham and COVID-19 Adithiya Janani (President) In recent months, our world has been turned upside down.

For many, the COVID-19 pandemic has uncovered multiple previously hidden facets of our society; primarily, the impact of globalisation and lack of cooperation, pointing to the true cost of our lifestyles on our health and the environment. Perhaps more hopefully, we have realised the importance of small actions and the potential they have for change.

Climate change has been identified as a significant public health threat.

Paradoxically, medicine itself has a considerable environmental impact. The NHS is the largest public-sector contributor to the UK’s greenhouse gas emissions1 . Every year, the healthcare sector generates 100 million tonnes of solid waste, 85 per cent of which generally ends up in landfill sites across England and Wales2 . Hence, we must develop sustainable strategies and policies to benefit the health of communities as well as the planet.

About Us

Our wonderful 2020-2021 committee

Student MedAID Nottingham is a student-led society and charity formed in 2020 as a sister branch to “Student MedAID” formed in 2008 at the University of Edinburgh which hopes to tackle this crucial issue.

Aim We are a small but growing society that collects unwanted yet viable medical equipment and redistributes it with the generous help of our volunteers (elective students/ doctors, local community members or organisations), to underresourced medical institutions worldwide. This prevents both the wastage of expensive supplies in the UK and the shortages of such items in lower-income areas and hopefully aid provision of healthcare elsewhere.

Long-Term Goal In a way, we are a short-term, effective solution for the surplus of NHS waste.

However, our ambitious, long-term goal hopes to change the way the NHS operates, ensuring a sustainable future without compromising patient care.

Too often, as doctors, we focus solely on the health of the patient, forgetting that we are also intricately linked to our environment. We cannot hope to provide the best patient care while ignoring the damage, pollution and suffering we are inflicting on ourselves and our future generations.

End Note We welcome any donation of equipment, possible collaboration or even spreading the word of what we do is a step in the right direction towards a more sustainable future.

For more information, please head to our Facebook (Student MedAID Nottingham), our Instagram (@studentmedaidnottingham) or send an email to medaidnottingham@gmail.com 1 Bawden, A. (2019).The NHS produces 5.4% of the UK’s greenhouse gases. How can hospitals cut their emissions? The Guardian [online] Accessed: 14/01/2020. Available from: https://www.theguardian.com/society/2019/sep/18/hospitals -planet-health-anaesthetic-gaseselectric-ambulances-dialysis-nhs-carbon-footprint 2 Department for Environment Food & Rural Affairs. (2020). UK Statistics on Waste.

SCRUBS – How to Make a Hand-Tie Trainer Anna Kober (Skills Coordinator) Are you sat at home twiddling your thumbs? Are you missing practising some surgical skills? Then look no further as this article uses some very ordinary home objects to help you master a key surgical skill in the comfort of your own room.

Knot tying appears in a wide range of surgical scenarios, for example you may have come across it when tying a suture. A good starting point is learning how to tie knots with your hands and the great news is you have all the necessary equipment at home!

Although very long, a shoelace can work just as well as a piece of string and many people use a pen or the handle of a mug to tie around. However, this article is looking to bring out the inner creative side and will guide you through a few very easy steps to make your own hand tie trainer at home.

Step 1 You will need an empty tissue box, a rubber band, and a stapler.

Step 2 On one end of the oval opening, staple the rubber band in place. There should be one staple at each side of the oval.

Step 3 Stretch the rubber band across the oval opening and staple it in place on the other end. Again, there should be one staple on either side of the oval.

Step 4 The end result has the rubber band stretched over the oval opening, forming a rectangular shape.

And voilĂ , you have made your very own hand tie trainer. The rubber band aims to imitate a blood vessel and when you lay the knots the two sides of the rubber band should be brought together.

A video guide is available on the SCRUBS website as well as other useful resources (www.scrubsnottingham.com). Regular virtual teaching sessions are also available to guide you through the process of hand tying and other surgical skills.

Happy crafting!

Advice and Wellbeing

Advice and ideas from other medical students COVID-19 vaccine myth buster and how to talk to sceptics The simple trick that your doctor doesn’t want you to know about Table for one Surviving your clinical placement: a few resources Managing finances in University

The Hungry Medic Presents: Roasted Veggies with Middle-Eastern Inspired Cous Cous

COVID-19 vaccine myth-buster and how to talk to sceptics Anshu Firake and Aisia Lea

As the UK government begins rolling out the COVID-19 vaccine, many of us may have to deal with sceptical friends and family members. While we do hope everyone is staying up to date and educating themselves, we thought it would be helpful if we collated some FAQs and put them in one place to ease some worries and maybe stop a few arguments too.

“It’s been made in such a short time; you just can’t trust it” One of the biggest questions of concern regarding the COVID-19 vaccine surrounds how quickly the vaccine has been developed and deployed. There are several reasons as to why the development of these vaccines have taken ten months, compared to the ten years that is usual.

1. Funding for the coronavirus vaccine has been unprecedented, which is not usually the case for other vaccines. The UK government alone has spent £6 billion on developing and obtaining various vaccines. In 2018, a study in The Lancet Global Health estimated the cost of early development and initial clinical safety trials for a typical vaccine to be in the range of 31–$68 million, much less than the funding given for the coronavirus vaccine. This extra funding meant it was that much easier to test potential treatments, the financially risky decision of testing multiple vaccines at the same time was no longer risky - there was no money to lose.

2. Prevalence of the disease, not usually seen for other diseases or treatments, meant it was easier to see the effects of the vaccine compared to a rare disease.

More people have and are exposed to the coronavirus and it is therefore easier to see whether or not the vaccine will work in this case. It also made it easier to track patient progress, find volunteers and collect data.

3. Scientists also were not creating a coronavirus vaccine from scratch, but instead building on their work from their understanding of other coronaviruses such as SARS and MERS. No corners were cut in testing the efficacy of the vaccines either.

Standard phase III (the largest phase) clinical trials typically involved 300 to 3,000 participants. The Pfizer vaccine had over 40,000 participants, and the OxfordAstraZeneca vaccine had over 11,000 - both substantially higher than the usual clinical trial size.

4. Moreover, more labs were working with over 100 potential treatments being researched – the odds were just higher for us to come up with a vaccine

“DNA, RNA, whatever – it’s going to make me grow a tail” Another concern surrounding the COVID-19 vaccine is how the vaccine works.

According to the CDC, “mRNA vaccines contain material from the virus that causes COVID-19 that gives our cells instructions for how to make a harmless protein that is unique to the virus. After our cells make copies of the protein, they destroy the genetic material from the vaccine. Our bodies recognize that the protein should not be there and build T-lymphocytes and B-lymphocytes that will remember how to fight the virus that causes COVID-19 if we are infected in the future.”

No live or inactive form of the coronavirus is used in these vaccines, known as a liveattenuated or inactivated vaccine. Examples of these include the MMR vaccine, the smallpox vaccine and the flu vaccine [8]. The mRNA vaccine works by using the virus's genetic information to stimulate an immune response, not by infecting the recipient with a live or inactive form of the coronavirus.

“Testing, testing! 1,2,3” Many may ask how we can know it’s been tested rigorously enough. Is it even safe for us to take? Well, here’s the hard evidence from both the companies themselves and the FDA. Pfizer phase III trials: Phase III trials for the Pfizer/BioNTech vaccine started on July 27 th, enrolling 43,661 participants. The primary analysis of the trials showed an efficacy of 95%, with observed efficacy in over 65-year-olds – the age group most at risk from COVID-19 – being over 94%. The trails also included testing in people already inflicted with the virus. It was concluded that the vaccine does not cause any serious ill effects on already infected patients.

Astrazeneca phase III trials: The AstraZeneca/Oxford vaccine Phase III clinical trials started on April 23rd, enrolling 23,848 participants aged 18 or older across 4 studies in different countries. The overall efficacy the study showed was 70.4%. The vaccine was also tested on patients with comorbidities such as cardiovascular disease, respiratory disease and diabetes, as well as accounting for age, gender and ethnicity/race.

Overall: Thorough testing with a large, diverse patient population over multiple countries for six months is more than enough time to work out the kinks in each vaccine.

Moreover, governments are heavily invested from both a social and economic perspective to create a safe and working vaccine, so testing was one of the most regulated and important steps in the production of the vaccine.

“What about all the side effects? I heard two people died” Well, no, they didn’t die, but two patients on the first day of the UK roll out of the Pfizer vaccine did suffer severe allergic reactions which is very, very rare (less than 0.5% chance). Moreover, both patients had confirmed history of allergy to other vaccinations and they BOTH recovered, so there’s nothing to worry about.

As with any medication the vaccine, of course, comes with side effects, however, not everybody may get these side-effects and severity will vary between individuals. The clinical trials for both vaccines showed that most side-effects were mild to moderate in severity and mostly resolved within a few days after the vaccine was taken, though some were still present after a week. Very common side effects included pain at the injection site, fatigue, headache, muscle pain. Common side effects were swelling at the injection site and nausea. Uncommon or rare side effects can POTENTIALLY affect up to 1/100 or 1/1000 people, respectively. In addition, older adults reported fewer and milder side-effects.

Effects of both vaccines on pregnancy, breastfeeding and fertility is largely unknown, however, governments do not administer the vaccine to pregnant or trying parents, so this isn’t really an issue.

As you can see side effects are mostly due to the vaccine working, not due to the vaccine itself. Symptoms such as fever, body pains/aches and fatigue are also common side effects to taking the annual flu vaccine or the BCG. Having symptoms can be taken as a good sign that the vaccine is working, though not having any symptoms doesn’t mean it’s not (each person will react differently). Moreover, the nature of the mRNA vaccine itself means that it can’t really harm you either. As an immune response is induced and B-memory cells are made, viral RNA is degraded. As previously mentioned, this is also why the testing period was a bit shorter too – there wasn’t any need to test exactly how much/how weak the virus must be!

“Getting vaccinated isn’t that important anyways” Vaccinating against COVID-19 is important for various reasons: 1. It will give individuals protection (although not 100%, some is much better than no protection at all) against this dangerous and potentially lethal virus, vastly reducing the chances of becoming infected. Not only will taking the vaccine immunise individuals, but it will also develop herd immunity – a form of protection where the immunisation of a large percentage of the population will significantly reduce spread of the disease and provide protection for those not immunised or unable to be immunised for various reasons.

2. It is a much safer way of developing immunity. Catching COVID could have serious, life threatening complications, so why run the risk? Any side-effects as a result of taking the vaccine are largely mild, will not last long and can be managed. It is a legal requirement for rigorous safety testing to be done before any medication can be released for widespread use, as has been evident with the clinical trials for the COVID-19 vaccines.

3. The COVID-19 vaccine is also an important tool in preventing the spread of disease and finally end the pandemic. Returning things to normal, like in New Zealand, requires using all the tools available such as social distancing, wearing masks and vaccinating.

4. The vaccine offers addition protection. The Centre for Disease Control and Prevention (CDC) recommends a combination of both the vaccine as well as protective behaviours/equipment in order to safeguard against COVID-19

“I just can’t convince them to vaccinate. What should I do?”

Arguing with stubborn people really does feel like an uphill battle (and it really is), but sometimes looking at it clinically and using these pointers can help you win this war of attrition.

1. It is important that you provide proof and sources as some people will either refuse to believe in you unless you provide some evidence or keep screaming “SHOW ME YOUR PROOF” without showing their own proof. As many people have told me – seeing is believing. The more actual proof you have the better off you will be and you can always fall back on it if you go down a slippery slope.

2. If you are consistently confident people will be confident in what you have to say. If you believe in yourself and what you have to say, then sceptics will have less and less reason to doubt you.

3. Having open, confident body language. Just rattling off facts won’t convince someone. Be careful not to get aggressive and in their face as they are more likely to get defensive.

4. Secondary to this avoid ridiculing or shouting at them as this will keep them on guard and inflame their pride.

5. Stroking egos is also a good way of softening someone up. Starting sentences with “you’ve probably already seen this…” or “You’ve made a great point but…”

At the end of the day, you don’t want to end up in a shouting match especially with close friends or family. Many people will try and troll you saying the vaccine has a chip in it and the government is tracking you, but hey if they’re still using Facebook or Instagram then what’s one more location tracker? Try and stay light and confident and don’t waste your energy. If they don’t want to be convinced at some point it's just not worth it.

Most importantly: LEAD BY EXAMPLE. Go get vaccinated! (when you can!)

Sources: 1. BioNTech SE, (2020), Study to Describe the Safety, Tolerability, Immunogenicity, and Efficacy of RNA Vaccine Candidates Against COVID-19 in Healthy Individuals, U.S National Library of Medicine

2. Knoll, M.D, Wonodi, C., (2020), Oxford–AstraZeneca COVID-19 vaccine efficacy, The Lancet 3. Agency, M. a. H. p. R. (2020). Information for UK recipients on Pfizer/BioNTech COVID-19 vaccine. GOV. 4. Knoll, M. D., & Wonodi, C. (2021), Oxford–AstraZeneca COVID-19 vaccine efficacy. Lancet, 397(10269), 72–74. doi: 10.1016/S0140-6736(20)32623-4

“The Simple Trick Your Doctor Doesn’t Want You To Know” Ignacy Kozlowski

This year especially a great deal of our lives was made virtual, and virtual life has a number of characteristic hardships associated with it. One that many may have noted is the often Covid-related news, coming at us from all directions. For medical students, this may be especially difficult. It’s hard to catch a break from medicine when it is being mentioned everywhere. We are constantly finding out new infection statistics, new tier restrictions, and new opinions on how the situation should be managed. This can be overwhelming: being constantly exposed to new information is manipulative and affects our mental health; the human brain is not wired for this kind of exposure. This is why this year I finally took the time to learn about information and most importantly how it is used to affect us using the most recent vaccine, lockdown, and facemask related conspiracy theories as case studies.

With the advent of social media with its aggressive content algorithms, any source that gets clicks can become mainstream. Misinformation can spread just as quick, if not in many cases faster than information. Fake news is a very potent attention grabber, and social media can help legitimise otherwise outlandish claims and opinions. This became an issue as soon as the internet provided us with almost instant access to almost any information.

We’re all familiar with “ The simple trick your doctor doesn’t want you to know about”, an online trope (now outdated and subject to many memes) promoting miraculous actions or treatments for things like weight loss. These pseudoscientific articles often had the goal of either selling something, or more commonly in recent years grabbing attention for attention’s sake itself or to profit from ad revenue.

This trope played into many people’s distrust of authority and want of the feeling of knowing something others don’t.

Similar themes carry over to present day. In the age of a global pandemic, many people struggle to make sense of the predicament they have been put in. For those who don’t have a medical background, or have not known anyone affected by Covid, life in relative isolation may feel like an unnecessary and unwelcome change. Whilst we know restrictions are essential, what we can’t ignore is the detachment these people may feel from the situation and from the decision-making process around it.

This, and the increased amount of time people are spending online and on social media has rapidly exaggerated the recent trend of online conspiracy theories and added newer medically related spins to them.

In many ways, Covid has proven to be a 2020 conspiracy theorist’s dream. A virus originating from a country we are often made to distrust and a vaccine developed under the overwatch of one of the richest men on the planet: a combination that plays into all the anti-elitist fears people hold. Many may have not witnessed the effects of the virus itself, but all have experienced first-hand the struggles of life under lockdown. To these people, the government restrictions are the cause of their negative experiences over the lockdown period, and not the virus. Hence, it’s easy to turn to explanations about plots to restrict our human rights or schemes used by the rich to get richer, as these add meaning to the negative experiences we face.

What is important to note is that this is amplified by the kind of echo groups that social media algorithms create. We are directed to more of what grabs our attention, and that only legitimises easy conspiratorial justifications for the hardships created by a complex issue like a global pandemic.

What we should recognise is that real facts can be used to wrongly back up some of these theories.

For instance: • As many lost their jobs at the height of the spring/summer lockdown, the world’s Billionaires are reported to have grown their fortunes by over a quarter (as reported by UBS).

• In the UK, companies which profited from PPE and testing contracts have in some cases been found to be in some way linked to government, or to have been part of lobbying groups who are fellow travellers on key political issues.

It’s not hard to imagine how, if correctly presented, these facts can be used to play into negative emotions we may have towards the current situation and cause us to jump to conclusions about the motivations of the people making the decisions.

But if we ask ourselves: ‘Does this information really support a conspiracy or is it more so just symptomatic of the way our modern political and economic system works?’ then the simple conclusions lose their appeal.

In 2020 we saw Facebook make moves to tackle so called ‘Fake News’ on their platform by making use of a combination of user feedback, fact checking, and proactive algorithms. Through this, Facebook can identify, review, and potentially act on false information spread on the site. Whilst a positive step, in many cases even real information can be used to push false narratives and agendas online.

The predicament brings us into a grey area surrounding freedom of expression which does not have a clear answer. Whilst such misinformation is harmful, it isn’t as harmful as setting a precedent for overt censorship.

Hence, it’s important we are conscious of what we are exposed to. When all else fails, we can act ourselves and improve our own relationship with information.

An easy starting point is to begin noticing patterns in the way news is presented, and the emotions that news wants to provoke within us.

Once we start paying attention to this, we can take control of how we react to information and start coexisting in a much healthier way with it.

I. II.

III.

https://www.pwc.ch/en/publications/2020/UBS-PwC-Billionaires-Report-2020.pdf page 6 https://www.huffingtonpost.co.uk/entry/who-profits-coronavirus-governmentspendingboom_uk_5f0890c0c5b63a72c3413817?guccounter=1&guce_referrer=aHR0cHM6Ly93 d3cuZ29vZ2xlLmNvbS8&guce_referrer_sig=AQAAAHUgsR1ZI3XtzdqXbz7taxhOiZEsvEw2 _H5lgUgvP7AfM8eeI2SYUhERqsWJLsTWZtlb_qhE94OMrhmtRIB2Tcih_CRDesqqaO8W2f4ad82BJIqi8FVPzW1UAfWObq ygKgsWKtTXW2ao9ug9WyTWMHrMZwq27qick2rb6gWKbje https://www.facebook.com/journalismproject/programs/third-party-factchecking/how-it-works

Table for one Yasmin King

“Laugh, and the world laughs with you, Weep, and you weep alone; For the sad old earth must borrow its mirth, But has trouble enough of its own.

Sing, and the hills will answer, Sigh, it is lost on the air; The echoes bound to a joyful sound, But shirk from voicing care.

Rejoice and men will seek you; Grieve, and they turn and go; They want full measure of all your pleasure, But they do not need your woe.

Be glad, and your friends are many; Be sad, and you lose them all, There are none to decline your nectar'd wine, But alone you must drink life's gall.

Feast, and your halls are crowded; Fast, and the world goes by; Succeed and give, and it helps you live, But no man can help you die.

There is room in the halls of pleasure For a large and lordly train, But one by one we must all file on Through the narrow aisle of pain.�

Ella Wheeler Wilcox, Solitude

1

Loneliness is strange. It is something we all experience one way or another, yet it is rarely spoken of, until now. The COVID-19 pandemic has exposed loneliness in society, but it is not something new, in fact almost everyone experiences it at some point in their life. It could be when you move to a new city, break up with a partner, or simply feel like you do not fit in. There is stigma associated with being lonely because obviously if someone is lonely, it is because they are not worth other people’s time, they are a “loner”… or at least that is how it can seem. Why is being lonely so shameful? I suppose like most stigmas, it comes from a lifetime of subliminal messaging and insecurities of feeling lonely ourselves. If we make people who are lonely different from us, it means we could not possibly get lonely, because that is what loners do. This creates a harmful narrative that ostracizes those most in need of human connection.

Not only does loneliness feel awful, but it can also decrease your life expectancy, perhaps more so than smoking and obesity2. So surely, as future doctors, and as human beings, we should strive to prevent and respond to loneliness to live happier and healthier lives. It is inevitable in some ways but rather than feeling shame in loneliness, we should respond to it much like hunger or fatigue. We have evolved to feel loneliness so that we reach out and find the social connection we need, because we are social creatures, and thrive on inter-dependence. The issue comes when you are put in an environment where the narrative prevents you from responding to your (very valid) feelings, causing a downward spiral of Instagram scrolling and selfimposed isolation. We need to break the cycle and make the world a safe place to acknowledge loneliness and ask for help. There is no shame in feeling lonely, and it does not mean you are not worthy of love and attention.

Loneliness and isolation are not the same, with the former being a subjective feeling that someone can experience even when in the physical presence of people, and the latter being a physical state of lacking social contact. The two are intertwined, with one encouraging the other and vice versa, but one can exist without the other. What this means is isolation does not have to make us lonely, and loneliness is still valid when you are surrounded by people.

Lockdown can be difficult, with loneliness being a large factor of this. However, we can reduce this by encouraging genuine human connection in whatever ways are accessible to us. Of course, there is the dreaded zoom call, but perhaps a better alternative (if you are not isolating or shielding) is meeting up with one person for a walk and a chat. “Social distance” does not have to mean social distance; the physical part is what is necessary. Perhaps the language used is damaging and we should replace “social distancing” with “physical distancing ”3.

University is sold to us as this never-ending party with your best friends ever… but it is not all it is made out to be for some. University could be the time you find your people, or it could be extremely isolating, with 60% of students saying they feel lonely4. Without forced interaction every day with classmates, you may find it is harder to make friends since there are fewer circumstantial friends, but this could be a blessing in disguise as it forces you to find the friends that you actually get along with and have a lot in common with.

I had great friends at school, people who knew my quirks and my oddness, and who loved me that way. I had forgotten that I was “weird” until I came to uni.

No one really said anything cruel, but I just did not quite fit. I have strong opinions, I wear a lot of bright colours (together), and I often lack the ability to understand jokes. Apparently, these things do not bode well for fitting in. But you find your people, and you learn how to cope with the awkward pauses after you talk in a group, and no one responds. The first step seems to be acknowledging that you are lonely, breaking the silence and encouraging others to be vulnerable too. Hi, I’m Yasmin, and I’m lonely. I have loving friends and family, but I forgot to keep making friends after “welcome week” ended… two and a half years ago. This was not really an issue until lockdown started and organised social interaction stopped. I imagine my story is far from unique, so I hope that those who feel the same way are reading this and knowing that they are not alone, and that there are ways to help stop feeling this way.

What can we do to help this “loneliness epidemic”? Here are a few tips on reducing loneliness in yourself and others: •

Be honest and genuine. Social media is full of doctored photos and highlight reels, and even in real life we can pretend to be something we are not. Being your true self will help you distinguish your good friends from your superficial friends. That is not to say they are a bad friend, but it may mean that you simply do not have a deep connection or chemistry. We need different relationships for different purposes in our lives, so not everyone you interact with must be completely on your wavelength, but it is important that some people make you feel comfortable and loved in your own skin.

•

Use social media for good. Although it can be harmful, and often is, social media can be used to reach out and find your community. What is also important is (when legal and logistically possible) to move that online friendship/relationship/community into real life. Be the person to arrange a trip to the pub, or Wollaton park, or paintball… whatever makes you happy. Once you have found your people, foster and encourage those relationships.

•

Do not stop trying. Things change all the time in life; we fall out with friends, change career location, or our priorities and philosophies change. So, it makes sense that our friendships and relationships change with that. It is okay to grow out of friendships, and as we grow and learn more about ourselves, we may find new people that provide stimulating conversation and the love and support we need. We do not stop making friends when we leave school, so keep putting yourself in new circles, with curiosity and an open mind.

•

Reach out to people. Either for yourself, for them, or for mutual benefit. If you have been lonely yourself, you might understand how difficult it can be to start the conversation or invite yourself into a group. Make life easier for everyone by encouraging those that seem isolated to attend social events or meet up for a chat. However, just because someone seems lonely, it does not mean that they are, so listen to what they say and respect their boundaries. Perhaps you could adapt an event to make it less daunting; let your friend know that it is okay for them to cancel last-minute or leave during the event if they are uncomfortable.

Everyone is different and finding some situations stressful does not mean that they are rude for leaving early. Maybe they will feel better next time.

This list is not complete, but gives you a few things to think about. If you would like to learn more about loneliness, its effects on health, and ways to combat it, I highly recommend the following:

•

Together: The Healing Power of a Sometimes Lonely World, Vivek H. Murthy

•

“Nobody Panic” podcast, Tessa Coates and Stevie Martin, episodes from 01/05/2019 and 30/06/2020… or any episodes, to be honest.

“I Weigh with Jameela Jamil” podcast, Jameela Jamil, episode from 10/04/2020 with Vivek Murthy… again, any of the episodes are great.

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Human

Connection

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Loneliness is inevitable, but it does not have to be all-consuming. Let’s work together to prevent loneliness and promote kindness :)

[1] https://www.familyfriendpoems.com/poet/ella-wheeler-wilcox/poems/ [2]https://www.cdc.gov/aging/publications/features/lonely-olderadults.html#:~:text=A%20new%20report%20from%20the,considered%20to%20be% 20socially%20isolated.

[3] https://www.motherjones.com/kevin-drum/2020/04/who-invented-the-phrasesocial-distancing/ [4] Murthy, V. 2020, Together: The Healing Power of Human Connection in a Sometimes Lonely World. Profile Books Ltd., London

Surviving your clinical placement: a few resources Natasha Harris

If you’re anything like me, you’re always on the lookout for cheap/free resources to help you study.

If you don’t feel like paying an extortionate amount for a 52nd edition of a textbook (53rd edition coming out soon - better start saving up!), check out the following websites when you’re cramming for your next exam.

(A small disclaimer before we start: the point of this article is to hopefully introduce you to a few hidden gems, so I won’t be talking about the ‘big’ names like Geeky Medics and Teach Me Anatomy… If you’ve made it to CP1, you probably already know all about them!)

Patient.info “Explain condition XYZ to the patient” is a favourite OSCE station, so it is always helpful to read articles about common conditions that are written in patient friendly terms.

By searching for specific medications, you’ll also find the answers to the everimportant questions such as ‘can I drive/drink while taking XYZ,’ making you feel more confident answering common patient queries.

And if you just need to brush up on some clinical knowledge, patient.info has you covered too. Check out the articles labelled ‘professional,’ to read articles written by doctors, for doctors (and medical students, of course).

Trust Guidelines Don’t you just hate it when the textbook you’re reading tells you that the management is dependent on the individual trust guidelines? Or have you ever wanted to know exactly which antibiotic to prescribe in a given scenario?

If the answer is yes, check out your allocated placement trust guidelines!.

The range of information available is extensive, because it has to be! After all, doctors from all specialities will be checking these guidelines and all sorts of possibilities must be accounted for.

It doesn’t matter if you want to know what to do when faced with a patient with hyperkalaemia or want to know how best to manage newly diagnosed AF, the guidelines really do have something for everyone.

Derby - https://derby.koha-ptfs.co.uk/cgi-bin/koha/opac-main.pl Nottingham - https://www.nuh.nhs.uk/clinical-guidelines. I hear there is even a handy app you can download!

Ministry of Ethics If you’re a person who struggles to understand the intricacies of how to apply ethical principles to medical situations, Ministry of Ethics may just be for you.

You can find MCQs, case videos or even good old lectures on a wide range of topics from DNAR orders to the Mental Health Act.

There is also some information on topics that you may not have encountered before in medical school, such as the laws behind organ transplantation. http://www.ministryofethics.co.uk

Managing finances in University Sophie Shallish

The thought of being in control of my own finances once moving to University was surprisingly something that was taking up a lot of my headspace in the weeks leading up to September. I found myself anxiously reading articles, listening to podcasts and asking peers for advice on budgeting, loans and much more.

Personally, I love to shop maybe a little bit too much (a person can never have too many shoes), but I was cautious of going overboard. Since arriving, it has been nowhere near as stressful as I had anticipated as I remain on top of my budget and aware of what I am spending whilst still allowing myself to have fun. I am by no means any financial expert, but I thought I would share with you some things I did in my first few months of University to start myself off on the right foot and not have to worry about money once it comes to the end of the term.

Plan ahead During summer when I was preparing to come to Nottingham and in the process of taking out a student loan, I sat down with my mother and calculated exactly how much money I was receiving from my Student Finance, how much I needed to pay back, how much my rent would cost and then how much I would be left with at the end. With the support of my mother, I calculated how much money I would have per week to spend on daily expenses such as food, going out, transport etc.

I was well aware of this figure when arriving in September therefore I didn’t go overboard at the start as I knew how much I was working with every week. Personally, I found a weekly plan easier to manage, however, I do have peers that work by a monthly budget and this works well for them as it allows flexibility between the weeks. So, my advice would be to sit down with family or someone you trust and calculate the figures that work best for you before arriving.

Meal prep Another thing which saved me money and time in the long run is planning what food I was going to eat for the week and buying the exact amount of food for what I had planned. This minimises the possibility of having excess food wasted or going out of date before I had chance to eat it. Despite having to sit down for some time before a food shop and think about what I wanted to eat over the upcoming days, it saves time in the evenings when it actually comes to cooking as I had a meal in mind and also saves time in the shop as I go in with an shopping list on my phone and pick up exactly what I need. For ideas I love to use BBC Good Food along with some student cookbooks I received as a Christmas present, they have lots of cheap and healthy inspiration. But most importantly, it is okay to be flexible and order food if you fancy a treat or are short on time as long as you don’t make a habit out of it.

Get some extra cash (if needed) If you find yourself in a position of needing more money whilst at University, I have plenty of friends who have a part-time job whilst studying at medical school. The biggest factor required is good organisational skills and time management as you do not want to get overwhelmed by the amount of work you have taken on. Jobs to consider are online tutoring, retail assistants, working at the Student Union lots more. It is definitely a manageable lifestyle as long as you remain organised and don’t let in jeopardise your university work or social life. There are also student services on campus there to help you if you need advice with your finances.

It is okay to treat yourself Probably one of my most important pieces of advice is this one! University is an amazing experience however it can get stressful or lonely at times and that is okay, more people go through these types of emotions than you would think, especially during the unexpected year that we have all had. As a result, it is okay to treat yourself when you’re feeling down or even when you’re feeling great. Additionally, I would bear in mind that the University calendar is very top heavy in terms of finances, when you arrive you’re paying to join societies, meeting new people and socialising more often but these things will calm down throughout the year and your expenses will reflect that. Therefore, it’s great to be mindful of the things you’re spending money on but it’s also important not to get wrapped up in it and enjoy your time at university!

The Hungry Medic Presents: Roasted Veggies with Middle-Eastern Inspired Cous Cous Sepand Malek

Preparation time: 10 minutes

Cooking time: 40 minutes (can be much quicker depending on the amount of veg you use) Ingredients: (for 6 meals) - 3 Courgettes - 2 Large Aubergines - 3 Whole sweet peppers (different colours) - 1 large red onion - 600 grams of couscous - 1 vegetable stock cube - 200 grams of raisins/dried cranberry - 5 tablespoons of oil - Fresh herbs (Parsley; Coriander) - Spices: Salt; Pepper; Paprika; Garlic powder; Cajun spice; Turmeric; Dried Thyme - Some Pine nuts for garnish

Recipe -

Cut your aubergines, courgettes, onion, and sweet peppers into small cubes. And place them in an oven tray. Add three spoons of your oil and all the spices above. After adding, mix it all together to ensure that all the veggies are coated with the spices.

Cover the tray with foil (pierce some holes in the cover) and Place them in the preheated oven at 170 degrees for 25 minutes.

After 25 minutes remove the cover and assess if they are semi-cooked or not. If so then place them back in the oven for up to 10 minutes to ensure that they are cooked and slightly crispy on the outside. If they are not cooked, put the cover back on and repeat the second step again. After this, the veggies should be done.

NOTE: if your oven tray is small you may have to mix the content of tray every 15 minutes to ensure all the veggies receive same amount of temperature.

In order to prepare the couscous mix your vegetable stock with 600ml of boiling water and add it to the pot with you couscous. Top it up with additional 50ml of boiling water.

Roughly chop your fresh herbs and add it to the pot alongside your raisin/dried cranberry.

Keep on stirring the pot to ensure that nothing sticks to the bottom of your pan and allow the water to evaporate.

After the water is reduced keep on tasting and add salt and pepper to your taste.

The couscous should be ready within 10 minutes. Make sure that there isn’t excess water in your pan, the couscous should have absorbed almost all of the water.

NOTE: if you are worried about the couscous turning out mushy, add 500ml of boiling water with stock and add more water as needed.

Your food is now ready. Plate up your couscous and add the veggies on top.

Use some of the fresh herbs and the pine nuts to garnish the plate.

For more be sure to follow Hungry Medic on Instagram.

Stories and Views

Personal stories and views from life as a medical student

A return to reading

My part in the pandemic Juggling a job and settling in

A return to reading Eleanor Wedgewood

Like many teenagers, the discovery of Netflix and binge watching led to a drastic decline in the number of books I read. Gossip Girl, Gilmore Girls and Grey’s Anatomy were far more important, and it’s not an understatement to say that I probably only read a book a year. But in March, many of my favourite activities (such as going to the cinema, shopping with friends, and playing netball) were no longer available to me. I quickly realised I would need new hobbies and tested out many: including painting, designing birthday cards, and crochet (my current obsession). However, the one that stuck throughout 2020 was reading.

I decided to challenge myself and try to read 50 books, knowing that a competition (even one without a real rival) would be the best way to stay motivated.

The result This year I’m proud to say that I’ve managed to read 52 books. The point of this article is not to brag (although that’s definitely an added bonus) but instead to hopefully encourage others to return to reading. I am aware that I sound like every secondary school teacher who wanted you to “Read for fun! Not just for school!” but reading really has been a great escape for me in these uncertain times. I’ve managed to read a great mix of books: from trashy young adult romances, to non-fiction books, to recently published novels, to literary classicsand you can too!

Now let me introduce you to my top 8 books of 2020!

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Everything I never told you (Celeste Ng): This book focuses on a family whose middle child, Lydia, has gone missing. The relationship between the parents and children is explored throughout the book.

The Book Thief (Markus Zusak): The book is narrated by Death, and follows Liesel and her foster parents in Germany during World War II. Girl, Woman, Other (Bernardine Evaristo): 12 characters (predominantly Black women), whose lives are connected in different ways, are the focus of this book. Race, sexuality, and gender is explored throughout.

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Kim Ji-young, Born 1982 (Cho Nam-Joo, translated by Jamie Chang) : Set in South Korea, the story follows Kim Ji-Young, a stay-at-home mother. Cho Nam-Joo does not shy away from writing about sexism and mental health issues.

Daisy Jones and the Six (Taylor Jenkins Reid): Written as a series of interviews, this book tells the story of a rock band who rose to fame in the 1970s.

I Know Why the Caged Bird Sings (Maya Angelou): The first of Maya Angelou’s autobiographies, this book details the first 16 years of her life. Perhaps my favourite read of the year, I loved the author’s take on difficult topics like family relationships, race, and sexual abuse.

The Perks of Being a Wallflower (Stephen Chbosky): This young adult novel is written from the perspective of Charlie, who has depression. It centres around the friends he makes at high school, and looks at sexuality, mental health, and sexual abuse. (You can also check out the film, I really enjoyed it!)

The Handmaid’s Tale (Margaret Atwood): A dystopian novel set in Gilead.

This book centres around Offred, a handmaid, who’s expected to produce a child for the Commander and his wife. I also really recommend the TV series that is (loosely) based on the novel.

As a complete side-note, I wholeheartedly recommend crochet. It is far easier than knitting and I made these gloves! ...and hey, it gives you something to do between reading books.

My part in the pandemic Daniel Taylor

I knew that applying to study medicine would be challenging. I did not, however, anticipate that within months of starting my career in healthcare I’d find myself in the middle of a global health crisis.

Trying to find the words to describe what I’ve been through has been difficult and although I didn’t play the biggest part, I’ll always know that I played my part. Looking back, I can only hope that one day I am a better doctor because of everything that happened.

Now that I've come to the end of my first semester as a Graduate Entry Medical student and as we begin 2021 it feels like the right moment to reflect on the events of the last 12 months.

Before GEM For the majority of 2020 I've been working as a Healthcare Support Worker (HCSW) at a large district general hospital. Although I’d had some experience of hospital life from a brief stint as a ward volunteer and the obligatory pre-medicine application work experience, applying to work as a HCSW was my first step into healthcare as a professional.

Before this I’d spent some time working as a project manager for Network Rail, alongside studying for a master’s degree in mechanical engineering, but I knew deep down that the railway wasn’t what I wanted to do for the rest of my life.

In fact, for years, I’d thought about exploring a career in medicine.

Following a diagnosis of Crohn’s in my teens I found myself as a patient on several occasions and I always used to wonder whether medicine could be the career for me. But becoming a doctor had always seemed like an impossible aspiration, after all I always thought it would be easier to pursue something I knew well.

But there was still something inside me that drove me on, telling me I needed more out of life.

Decisions In the summer of 2019, I made up my mind. I was finally going to go for it and I submitted my UCAS application.

Meanwhile, I was also acutely aware that I should explore further opportunities to prepare myself for a life in healthcare. So, I took a further gamble and left my job in the railway. I’d seen that my local hospital was looking to hire a new cohort of bank HCSWs and this seemed like the perfect way to really explore (and get to grips with) the clinical setting. I was, of course, completely unaware of just what I was letting myself in for.

The HCSW My first few months working as a HCSW were intense but despite the challenges, I loved it. I was finally working in an environment where I felt like I truly belonged.

I’d had no significant exposure to care work before, which meant that I had a lot to learn in a relatively short space of time.

However, I quickly found that it was a privilege to be so involved in some of the most essential aspects of healthcare.

Looking back, this is one of the features of the job that I’ve found most valuable; you learn exactly what it is to build a trusting relationship with a patient (as well as the importance of communication) when you’re helping them to wash and dress. It’s these ‘less glamorous’ tasks that really teach you about what’s important!

In my mind, the basics, such as personal care, are as significant as any other aspect of an individual's treatment.

I took every chance to explore the different specialties and very quickly found myself drawn to the worlds of acute medicine and cardiology. These fast-paced environments suited me down to the ground. I was able to learn a substantial amount about medical care and treatments; the other staff were always incredibly supportive in answering any questions that I had.

Although I had relatively little responsibility as a HCSW, I was often made to feel a vital part of the team. I know that I learnt so much more because of this and it really highlighted to me just how important it is to consider the thoughts of every member of the team – a lesson that I know I’ll hold onto as I start my medical career.

COVID Then, in March, things changed. I remember following the news of the novel coronavirus as it was first identified in Wuhan. At the time it seemed so remote. It was difficult to envisage the severity of this threat when it was thousands of miles away on the other side of the planet. Countries across the world started to lock down as the SARS-CoV-2 virus spread and it was disconcerting watching the images of those sick with COVID-19 in the media.

There was a palpable anxiety throughout my hospital, and everybody knew the virus was coming but nobody knew when. I couldn’t believe that only a few months into my new role I was in the middle of a crisis, but I remember feeling a strange sense of pride and excitement alongside my own anxiety. Alongside my colleagues, I was glad to find myself in a position where I could do something to help.

It didn’t take long for the hospital to start receiving patients presenting with symptoms of COVID-19 and once it started, it didn’t stop. Those first few weeks will stay with me for a long time- especially the frightened expressions on the faces of patients as they struggled go breathe. All of a sudden this had become very real.

In the beginning it was reassuring to see so much support from the public. Businesses and individuals made such an amazing effort to send gifts to hospital staff – I don’t think even the Easter Bunny could supply the levels of chocolate we were receiving. It may not have made the work less difficult, but it was comforting to know that the wider population were behind us.

The hardest part For me, the hardest part of the pandemic has been seeing patients isolated from their families and friends. It would have been unsafe and irresponsible to allow visiting to continue, there’s no doubt of that, but it doesn’t take away from the fact that sometimes there’s nothing better than seeing a friend or loved one when you’re unwell.

Where possible, the hospital would do everything they could to allow visiting in extraordinary circumstances such as for patients receiving end-of-life care; but with the ongoing national lockdown visiting could be impractical or impossible for some families, even with the support of the hospital.

I found it difficult to see patients without anyone in their last days. I know that I will always remember one patient in particular; I was with them as they took their last breaths, I held their hand, and I let them know they weren’t on their own.

Nobody should have to die alone – and if that if that patient had been my family member, I would have wanted someone to do exactly what I had done. Ultimately, even in unprecedented times kind and compassionate care underpins everything that we do.

Unfortunately, it’s not a unique story. I witnessed so many incredible acts of kindness by my colleagues, to make sure that patients were able to receive the care that they deserved, against all the pressures and stresses brought by the situation. Even in the face of adversity the patient was always the priority.

The team Overall, there was a robust camaraderie throughout the hospital; we all helped each other throughout the tough times. I’d been there for months but I felt like I’d known some people for years and many colleagues quickly became fast friends. The hospital executives did what they could to make things better for staff – and we certainly were thankful for the free meals, tea and coffee they provided. It was definitely the little things that made the biggest difference.

I was also very fortunate to be working in the hospital alongside my mum, a sonographer in the hospital’s X-ray and maternity departments. We were able to talk about, and more importantly understand, what each of us had been through which made processing some of the more difficult days a lot easier.

I also got to know radiology staff quite well and it would always be a boost when, on occasions, I’d be offered cake on my way through the department.

Fundamentally, however, a hospital wouldn’t function without everyone playing their part. I have a whole new level of admiration for the nursing and medical staff, as well as the allied health professionals, porters, cleaners and countless others who are constantly on the front-line of delivering care and supporting our hospitals – if you remove any part, the whole system fails. It’s been a challenge I’d never expected, and I’m especially in awe of those working on critical care units, in emergency departments and in other hyperacute care environments.

Finally- GEM In September I started studying Graduate Entry Medicine and it feels like I’m finally heading to where I want to be – despite the significant changes necessitated by COVID-19, I’m loving the course.

I've been able to make some amazing friends and the staff are working hard to make sure that we are still able to receive a high-quality education, even amongst the current restrictions.

However, at the same time, it’s been strange to spend the last few months away from the wards. It’s difficult not to feel guilty that my colleagues are all still grinding away against the pandemic but now I know I’m doing my bit. Just in a different way.

Juggling a job and settling in Angel Rowlett

Starting as a first-year medical student in the middle of the pandemic has been such an unusual experience.

With so much online learning, it has been a challenge trying to meet new people in person but has also meant I could be more flexible with my timetable and fit in part time work around my studies.

1st Term in times of COVID The course itself has been interesting so far, but very science-focused. After all, we need to build on our foundation knowledge before we can start studying systems-based medicine in more depth.

For me, having lectures delivered online has worked out really well – I don’t know how I’d manage if I couldn’t pause and rewind them to catch the details I’m always missing! And, who would ever turn down the opportunity to do that Monday morning 9am lecture from bed with a hot coffee, buried under a mountain of pillows and blankets?

I like having the freedom to choose when I do some of the pre-recorded lectures; being able to lighten my workload on some of the busier days and spread it out more evenly over the week has really helped me balance work with having some time off. But I’ve also learned that the decision to ‘give myself a break’ by missing the Monday morning lecture can be the start of a very slippery slope for the rest of the week!

We might not be able to sit with friends in a lecture theatre this year, all crammed onto a bench (looking equally confused while we try and process the latest in a long list of tricky topics - the weeks on the nervous system, and embryology certainly come to mind), but the prestigious booths in Monica Partridge (That's 'Teaching and Learning' to some of you!) have been the perfect alternative.

I have really enjoyed being able to sit with friends on my course and work through lectures and notes together, it’s helped me to stay motivated and make sure I cover everything I need to. Though some of those days are definitely more productive than others…

The job On top of my studying, I tutor GCSE sciences for 7 hours each week. I work with different students for 2 hours each night on Monday, Tuesday and Wednesday, as well as 1 hour on Saturday mornings. I started doing this in the summer (although I did work fewer hours then) and it’s been lovely to be able to build momentum and work with more students since then.

Although there’s the obvious benefit of getting paid, this does add a lot onto my workload, because it's not just the teaching hours, but also the prep time that I need to account for alongside my own studying. I’m usually quite tired by the end of the night on the days when I’ve been tutoring, but I don’t regret the choice to teach, because I find it so rewarding to hear from my students when they’re so happy because they’ve made the progress they were hoping to make, and already hit their end of year exam targets at the end of the first term. I just make sure that I always take some time off at the weekend to have a break, and being self-catered, I find meal prepping on a Sunday for the first half of the week is so useful. It means I’m eating well for breakfast, lunch and dinner, and when I’m tired or don’t have the time I can just put something healthy but filling in the microwave, and even put it in a flask afterwards if I’m going on campus.

I’m quite independent so I have really enjoyed organising my own work and finding my own systems and routines that work well for me. I actually like the fact that I have something else to focus on besides my own studies, and have still been able to find time for myself to relax and do things with friends.

Creatives

Londoners trying and spectacularly failing to wear masks (All true)

Issy Walker

Test to protect Ritu Rajan

In the miserable, pouring rain we queued, Two metres apart, just to be safe, Suffocating silence was all you could hear Extinguishing the festive mood

And as the line began to meander Eroding our tarnished conviction, We traipsed around the lonely shell of a building stripped of its grandeur The set-up vast and the first glance Was fleetingly familiar, strange Snowy white sheets enshrouded the courts, And jolly tunes so loud you could dance

The aisles and lanes and testing stations Were operated fierce efficiency, With our masked faces, the testing card Our only identification And soon it dawned, the Deja vu Was of an airport during holiday season Alas, our purpose was not to catch, But, in fact, the opposite reason.

Issy Walker

She sits high in the tower Nic Miller

She sits high in the tower Flat 89 That’s three floors up But she wouldn’t know.

These days she barely leaves the chair Her son won’t visit, he’s out and about since there’s rules to flout So, she sits.

It may rain The wind may blow The sun could glow She wouldn’t know She sits and looks out the window But with the heating on full whack, the weather doesn’t move her.

So, she sits.

She sits in front of the tele At the side of a little table When she sits and cries, it hits the tartan blanket below.

Congealing with the porridge that missed her mouth But who would know.

She tried to get herself up once A fall, a crack, and weeks of bad hospital food later, She sits.

Four times a day, a nice lady comes The lady gets her up Gives her lunch A bit of tea

A few of those tablets And puts her bed That’s all she does She sits, or she sleeps- some days she’ll do both It depends how much her shoulder kept her up The tablets don’t work for it now So she sits, and the shoulder aches.

She’s not allowed to take her own tablets Took too many once the lady who visits says Complete accident She’s not too sure that’s what happened She just knows it hurts, and she forgets She sits, it hurts She sleeps, it hurts She forgets how many tablets she’s taken Because she can’t forget how much it hurts.

She’d like to distract herself Ring her friend But she can’t remember the numbers Or read them from the address book So, she sits.

Some colours flash on the tele Could be a quiz, could be a soap It’s just colours to her There’s the radio She likes that on her lap Though she can’t see well, she can hear better than ever Hear of the world that’s forgotten her in her tower A world by now she has forgotten herself .

The tins in the back of the cupboard went out of date last month They still get out more than her She, just, sits.

There’s a photo on her table Two people She’s told she’s one Her husband the other She can’t see far, but she knows it’s only her in the flat Sitting Alone No husband No son Just the lady four times a day.

The lady doesn’t talk much Hardly ever She just moves through the flat Silent Doing her tasks Makes beans on toast Does the pots Gives the tablets Then the door locks and she’s gone.

There’s flickering from the tele The click of the heater kicks in A treat tonight; the lady left some biscuits Chocolate She likes the chocolate ones So, she sits and munches Stares at the tele Munches, and munches until the biscuit is gone So, she sits.

INSPIRE Art of Research Competition 2020 Theme: 'HOPE'

On 4th December 2020, the INSPIRE society in collaboration with v21 artspace, hosted the first ever virtual exhibition conducted in the medical school. It was also a first for UoN! The theme was “Hope”, with pieces exploring scientific ideas and discoveries that have or will revolutionise the fields of medicine and research. Here are a few of the pieces exhibited and the online gallery can be found at https://inspirehopeexhibition.v21artspace.com/

Faces of hope – Yasmin King

Many hands make hope – Derby Anatomy Art Society

The beating machine Talia Patel

A Year in Retrospective E. Mullins

This year, I learned how to press flowers.

I learned how to read books again, like I did when I was ten.

Voraciously, consuming words like air I needed to breathe.

I learned how to sew an 18th century shirt from a lady on the internet.

I learned how to knit a scarf.

I learned the value of 3 am conversations, pondering the existence of God, what our morals are really made of, why we do the things we do.

I learned to wake up when my body tells me to, and to sleep when my body tells me to, to live on my own time, not anyone else’s.

I also learned what many people are truly made of.

That while many die, others deny the existence of the hidden enemy.

That while some do all they can, Give up all their freedoms, lives and safety for others, Many more put themselves and others in danger, with no sense of civic duty, sacrifice or selflessness.

That the minute the novelty of situations wear away, many desire to return to the status quo, consequences be damned.

I learned that people willingly choose their own cages, yet have the audacity to complain when their chosen consequences are revealed to them.

That nearly 50% of people voted for a dictator.

That money is of more importance to leaders than the lives of their people.

That bigotry and hate is still shockingly real, Is growing in a climate if disconnection and denial, Reducing the fight for equality to a petty disagreement about statues and words.

That people do not like adhering to rules that protect others, That many value one festival over reducing the reaper's harvest and that we are not as resilient as previous generations were.

This year, I have spent nine months in my home, Terrified of the angel of death that lurks in the breath and touch of others, More vulnerable to this than others.

I have seen the value in being alone, Of taking my time, Of acknowledging that while I can rage against the dying lights,

Take this as a PSA Hassan Akram

This is a drawing I did in summer, during the first lockdown, which I captioned ‘take this as a PSA’. A few months into what was an unfamiliar and unsettling time, mental health was a priority more than ever, so I turned to different forms of art, including this, as an outlet to keep me sane. It was also, and still is, a divisive time, so another purpose of this drawing and its caption was to address the debate surrounding face masks, and to make clear my stance in it. I had experienced so many more people than I had anticipated who were against face masks, and I was so confused there was even a ‘debate’ to begin with. This was my contribution to media surrounding the topic and I wanted it to be to the point, something I’ve yet to find in any argument describing masks as muzzles that squash our human rights.

For those who have not seen this style of art before, the first image is my drawing, and the second is the revealed artwork when the drawing is inverted.

There will be a metaphor in there somewhere, likely something to do with perspective or things not appearing as they seem, but as always, the art is up to interpretation. I’d just like to emphasize the importance of finding something you love, something for you. And among all those little reasons you’ll tell yourself not to, do it regardless. I think everyone needs that, especially now.

A 'splashing' time Alisha Gupta

Mud and grass underfoot, I tentatively descend the bank The sun beating on my bare back, warming me from outside to in Glancing around at my serene surroundings puts me at a slight ease The excitement acts as a temporary anaesthetic as the water creeps up my skin Adrenaline flowing in my blood, the water flowing under the bridge Gradually acclimatizing, I voyage further into the murky water Submerge my head and immerse myself with opposing feelings of SHOCK and calamity What I am doing ‘sinks’ in, I break the surface, and begin my stroke Quite literally ‘going with the flow’ has never felt so good Dry myself off and excitement plunges into me and remains for hours My mind feels like the water; fresh, cool, calm and crystal clear This experience is like no other, the desire to dive back in is ever prominent.