MS_Dec_12 by The Medical Student

the

medicalstudent December 2012

The voice of London’s Medical Students

ICSM Students Unsatisfied? UN Director talks AIDS Page 6

Festive Fatty Page 11

Ken Wu

The faculty at the Imperial College School of Medicine recently held three ‘town hall style’ meetings with students to discuss the results of the 2012 National Student Satisfaction (NSS) survey. The meetings, held either at the Charing Cross Hospital, South Kensington or St Mary’s Hospital campuses, were prime opportunities for the students to directly engage with the senior staff at Imperial and discuss the results of the student response, as well as ways to improve student satisfaction in future. This is the first time such meetings have been held at ICSM, and it comes on the back of the NSS results which saw satisfaction decrease to 83% from 90% in 2011 for Medicine. Furthermore, the 2012 results are especially significant for the Faculty of Medicine as they reflect the views from the first cohort of the fouryear Graduate Entry Medicine program. Each of the three meetings followed roughly the same format, with an initial presentation of the NSS results by Mr Martin Lupton, one of the deputy directors of education, which was followed by an open-forum question and answer session. The meeting then moved into a more informal setting, where students and

staff wrote post-it notes outlining their views and suggestions about the Imperial medical course. All of the meetings were well attended, with senior faculty members such as Deputy Principal of the Faculty of Medicine, Professor Jenny Higham; the newly appointed Pro Rector of Education, Professor Debra Humphris; the Deputy Directors of Education, Mr Martin Lupton and Professor Karim Meeran present. Students from across all year groups came to share their opinions in the meeting, as well as the ICSM students’ union, with the current president Shiv Vohra and past presidents Suzie Rayner and Anil Chopra all contributing their views. Similar themes and views cropped up across all the meetings. Students were generally dissatisfied with the quality of feedback, especially concerning exams. This is an area of particular concern to the faculty as it received one of the worst scores on the NSS survey, scoring 57% with a ranking of 66th. Furthermore, in a poll conducted at the meeting, improving feedback and exams was the most popular choice by students if only one aspect of the course could

be improved. Students also expressed their desire for better organisation of the course, and the need for a course overview and a stronger curriculum. On the positive side, students were especially pleased with the quality of teaching and learning environment, particularly praising the opportunity to be taught by world-leading academics and clinicians. Furthermore, each meeting also produced its own unique discussions. One meeting was dominated by a debate about the BSc year, which Imperial currently places in the fourth year after the first clinical year: the only medical school in the UK to adopt this format. A heated debate ensued as to whether Imperial should consider switching the BSc to year three, aligning itself with all other institutions and having a continuous three-year clinical program. Supporters of the change say that it would benefit their clinical experience and help with fifth year specialities and final year exams, while opponents pointed to the benefits of having one year of clinical experience and the impact that has on BSc project choices. Exams dominated another meeting, with students saying that Imperial's exams are

disproportionately difficult compared to other institutions, which has a detrimental effect on the decile rankings for Foundation Program applications. The NSS survey results have always been much of an enigma to ICSM students and staff. Despite strong national and international league table performances, with Imperial coming 5th in the Times Higher Education World University rankings for clinical and pre-clinical medicine, Imperial has always struggled with student satisfaction. Even in London, the overall satisfaction for Imperial ranks third, behind UCL and Barts. These town-hall style meetings have been highly successful in gaining a clearer understanding of what students still need from the university, and the ways in which the faculty can bring this about. Encouragingly, steps have already been taken to bring about improvements in the course. The results from the review of the graduate entry course have just been published and the undergraduate course is also undergoing its early year review. Hopefully, the results from the reviews and meetings will produce an effect and improve student satisfaction in the future

Look for the Silver Lining Page 12

The stresses of being an editor Page 14

UH Sports Night Back page

December 2012

News

News Editor: Katherine Bettany news@medical-student.co.uk

Editor-in-Chief

David Smith & Luke Turner ULU Medgroup Chairs As we write this column, we are still awaiting the final decision from BUCS with baited breath. Regardless of how it turns out, we would like to thank all of the Presidents, sports officers and many exec members for working tirelessly over the past two years to hold BUCS to account. At times we disagreed on the best way to proceed, but what we never doubted was the way in which every union and med soc listened to what their student bodies wanted, and then fought tooth and nail to make it happen. I would also like to reassure you that whatever happens, UH Medgroup will continue to support United Hospitals sports teams and defend our proud history of competition. We would also like to congratulate Annie, Lizzy, Kal and Sunny for organising an incredibly successful

Purvi Patel on the December issue

UH sports night in aid of 'Right To Play,' yet another demonstration of that United Hospitals spirit; we hope it will become an annual feature on the calendar! Finally, we would like put out a heartfelt plea to the rest of UH: have you seen the St George's sabbs? If so please contact us ASAP. After they missed the only medgroup meeting to be hosted at St George's this year, we gave them up for lost. The milk cartons are being printed as we speak

Andrew Smith BLSA President The week of the 26th November saw BL host its annual S.H.A.G. (Sexual Health and Guidance) week, spearheaded by BLSA's Welfare Officer, Emily Forshall. Events included a talk on the Biology of Sexuality; the Truth about the Sex Industry and even an Ann Summers' Party! The infamous charity calendars also went on sale. Needless to say clothing was heavily discouraged for the pictures. Behind the scenes at BL, Mark Gregory (BLSA Sports Officer) and I have been working tirelessly on the BUCS issue. The sense is that we're approaching make or break time. Every institution in the country has been lobbied now. Let's just hope

we can negotiate a favourable outcome with BUCS. Watch this space. On a student council front, there has at least been some success in amending the union by-laws to more adequately reflect how BLSA and our clubs and societies function. Doesn't change day to day practice but allows the bureaucracy to at least reflect practice. Finally, I shall close with wishing everyone a refreshing festive break! See you in the New Year

Mathew Owen SGUL President Movember has been another action packed month for George’s. Our charities officers have been working hard to banter students (male and female) into donning dodgy facial hair for the month; what an array of fine moustaches we have seen. As well as the obvious fashion benefits, our efforts have managed to raise a whopping total of over £1,700 in aid of charity. I see our counterparts' efforts were not quite as successful, with Imperial leading the rest and just about managing to scrape over £700 (though this may be more of a reflection of the general facial-hair-growth-abilities of their men than their charitable attitudes). As mentioned last time around, Movember is show season at George’s and last week saw the Diwali show, the first of the three annual Movember shows, hit the Monkton stage. This year we were treated to ‘Aladdin’ and what a show it was! ‘Blown away’ was the review from the SGUL principal, which mirrors the thoughts of all of those who attended! In putting on

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thethe show thethecast show castand andcrew crew managed to raise over £4,000 for charity, so a massive well done to you all! We are all now eagerly awaiting the Fashion Show (which also raises £1,000s every year) and Revue, to complete the trio. George’s don’t just show their caring side when raising money for charity, this also extends to some sporting events; at a recent rowing meet, the SGUL boat club did just that. Approached by the boat-less Bart’s team, George’s generously loaned them their boat to enable them to compete. Unfortunately however, Bart’s managed to plough the boat into another team’s vessel. We will remember next time to include a map and a dash of spatial awareness in these agreements, or perhaps just loan them our talented crew as well

t’s only the first week of December, but the rest of the world thinks Christmas is here, and the appearance of the new John Lewis advertisement means that I must join in the enthusiasm. Mulled wine, mince pies and fairy lights can be seen everywhere you look, although this has been the case since the clocks went back. This Christmas issue of the Medical Student is full of interesting and exciting topics. The NHS bursaries (or lack thereof) received by final years, an interview with the executive director of UNAIDS, being an atheist at Christmas, a review of the Silver Linings Playbook, and lots of lovely pictures from UH Sports Night – among others. My favourite article this month (if I’m allowed to have one) is along the lines of feminism and rape culture. Rant alert! In light of the recent ruling by the Church of England that women are not allowed to be Bishops, the University of Bristol Christian Union has followed suit and tried to ban women from speaking at events unless they are accompanied by their husbands. What makes people think that they can impose restrictions on what women can or cannot do? There is no excuse - espe-

cially in an age where the most financially secure country in the EU has a female Chancellor - to say that women are in any way less capable than men. Despite this, the amount of sexism that occurs in everyday life, simply because it is seen as acceptable, is incredibly concerning. It is never – I will repeat it for dramatic effect: it is never okay for anyone to be denied opportunities simply because they lack a penis, unless of course, the hypothetical opportunities are directly related to the presence of aforementioned anatomy. And that will be end of my angry rant. It’s my last issue! I don’t want to go, please don’t make me go! As tempted as I am to let this last editorial turn into a long, painful goodbye, I must resist. Nobody wants to read that. This year has been interesting, to say the least. Having had no experience of running anything – ever – I was thrown into the metaphorical deep end in January. Serves me right for trying to be assertive! Despite struggling with everything that came my way, the newspaper managed to survive my questionable leadership, and will soon be passed into much more capable hands. The next editor of the newspaper is yet to be determined,

so you will all have a lovely surprise next year. This is under the assumption, of course, that the world doesn’t end and we all live to see the New Year. I am going to take this opportunity to inform anyone who may choose to read this that I was expecting a public apology for being called incompetent – however much in jest it may or may not have been intended – and have yet to receive one. I realise I am not receiving an award, but lastly, I want to thank all the people who have tolerated me over the last year! My family and friends have had to deal with blood, sweat and tears every month. The section editors have had to deal with my every passing thought, including anger at presidents as well as incessant humming. They have made this newspaper what it is, and their company has made the process infinitely more enjoyable; thank you!

Final years denied NHS bursary Katherine Bettany News Editor The Imperal College School of Medicine Student Union, ICSMSU, according to a source, have been approached by many worried final year students who, upon recieving the first installment from the NHS, realised they had been awarded far less than expected. Students who contacted the NHS Student Bursary helpline where told that Imperial College was at fault for the issue, with the NHS claiming the university failed to supply them with the correct term dates. However, according to ICSMSU, this is a completely false allegation. Imperial College, on the other hand

the

was told by senior staff within the bursary scheme that the 'reduction in payment only applies to those [..] who have had a change in circumstances', something ICSMSU believes to be untrue. The response of the NHS bursary scheme has been to send out a letter, telling affected students that they had been awarded a 'provisional bursary payment', provided to ensure students were still in reciept of funds 'even where their applicaiton missed the normal application window or where items of information needed to process their application were outstanding.' In the letter, students were also warned that if they did not supply a 'complete and valid application' by the 31st of December, payments would stop entirely from Febuary 2013. The

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affected are understandably worried, as many rely heavily on the payments. Medical students in their final two years at university normally use the bursary to pay for their tuition fees, rather than drawing a loan from Student Loans Company PLC. It is unclear at this time whether any Imperial students have been unable to pay tuition fees because of the mix up, but students experiencing financial difficulties have been urged to apply for an Imperial College emergency loan to help as an 'interim measure'. The NHS bursary staff have also urged students to get in touch if 'the payment you are recieving is signficantly different from your 2012/2013 bursary application', and are suffering from financial hardship as a result

Editor-in-chief: Purvi Patel News editor: Katherine Bettany Features editor: Alex Isted Comment editor: Robert Vaughan Culture editor: Kiranjeet Gill Doctors’ Mess editor: Rob Cleaver Image editors: Chetan Khatri Sub-editors: Keerthini Muthuswamy Treasurer: Jen Mae Low Delivery Boy: Chetan Khatri

medicalstudent

December 2012

News Research in brief ICSM: Scientists have created a simple formula that can predict a the child’s likelihood of becoming obese at birth. The formula estimates the child’s obesity risk based on birth weight, BMI of the parents, family size, profession of the mother and whether or not she smoked during her pregnancy. Once children are identified, it is the hope of researchers that preventative measures can be taken to prevent at risk children from becoming obese. GKT: A non-invasive, painless imaging technique has been developed by researchers, designed to track the build up of plaque in the arteries, with the aim of having a role in preventing heart attacks and strokes. The technique uses Elastin-Specific Magnetic Resonance Contrast Agent (EMSA), and is hoped to be able to identify at risk patients before they are symptomatic. RUMS: Low level exposure to organophosphates (OPs) produce lasting damage to neurological and cognitive function, according to new research. Pesticides which contain the compounds are used to maximize food production worldwide, but researchers hope that their findings will prompt governments to review their pesticide usage. SGUL: Deaths from solvent abuse rose from 38 in 2008 to 46 in 2009, new research reports. Although there was an overall rise between this time period, there has been a significant decline from the 1990 peak of 152. Deaths caused by solvent abuse are still more common in males than females, with 34 to 12 deaths respectively.

Bid to save Charing Cross A&E reaches Downing Street Katherine Bettany News Editor A petition has been handed in to Downing Street in the latest effort to save Charing Cross A&E department from closing. As we reported in October, the NHS proposal ‘Shaping a Healthier Future’ was announced at the end of 2011, and detailed a number of options, the most popular of which would see Charing Cross Hospital, spiritual home of Imperial College School of Medicine (ICSM), be downgraded from a general to a local hospital. Ealing, Hammersmith and Central Middlesex hospitals, all ICSM teaching sites, are also under threat. Campaigners fear that the closure of A&E departments will precede the closure of the entire hospital, something that would devastate the local communities and medical school alike. The proposal has met with giant opposition from local residents and caused concern amongst the medical school. Save our Hospitals, an action group, led a demonstration in Whitehall at the end of November, before handing the petition in at Number 10, in a bid, according to Chairman Carlo Nero, to show there was ‘huge opposition’ to not only the proposal but also the consultation process. So far, over 66,000 signatories have been collected in 18 different petitions from the Hammersmith and Fulham area, and an 80,000 strong petition has recently

been handed in to Downing Street from the Ealing district. Unfortunately, NWT Trust is only counting the 66,000 signatures from the Hammersmith and Fulham area as 18 responses to its consultation. According to the NHS, the proposal was primarily designed to improve patient care, but the North West Thames NHS Trust needs to save at least one billion over the next three years in order to remain financially viable. Chairman of the Save Our Hospitals Ealing Campaign Dr Onkar Sahota called the consultation process a ‘sham’, claiming ‘NW London NHS will not listen to the public in Ealing.’ With perfect timing, the results from a new report by analysts Dr Foster suggests that England's hospitals are 'full to bursting', and highlighted that when hospitals are overly busy, patient care suffers because 'systems [start] breaking down.' Roger Taylor, co-founder of Dr Foster pointed out that "when that happens, patients are put in whatever bed can be found, orderly management of admission and discharge can become strained, infections are harder to control and mistakes are more likely to happen." The medical director for the proposal, Dr Mark Spencer, refuted this argument, claiming all responses, including petitions, would be considered. ICSM and the local communities wait anxiously for Heath Secretary Jeremy Hunt’s decision, expected sometime in the New Year

I write this article whilst still recovering from the RUMS Winter Ball. Things certainly got heated and steamy in the rainforest, and judging by the 1000 plus photos taken in our photo booth, a good time was had by all! With a never-ending supply of good food and free flowing drinks, we showed UCL why RUMS is and will always be greater than UCLU. The re-development plans for the Cruciform Library are coming along, and

after a Q&A session with the architects and UCL Libraries we are hopeful that the needs of decades of medical students to come will be met with the new Medical Students Hub. But please keep the ideas coming in as to how we can make this as medic friendly and non-medic unfriendly as possible

Shiv Vohra ICSM President Welcome to the Christmas edition of the Medical Student! I can’t quite believe how quickly this term’s gone by – feels like only yesterday since freshers’ fortnight… and the freshers’ flu. Our freshers did us immensely proud with the RAG Christmas Collect, breaking all previous records attendance-wise (I’m sure that will translate into money too)! So what better way to celebrate than with the ‘too tight, too bright’ bop in the Reynolds bar? This appropriately turned into a mishmash of the Christmas Collect after-party, and what our Light Opera society affectionately refers to as ‘Bopera’ – with an army of the cast and crew invading the Reynolds after their final Friday night rehearsal of ‘Oklahoma’, before the eagerly anticipated opera week kicks off. Needless to say, many of our clubs & societies have had an incredibly active November! Drama started the month with the Freshers’ plays, and warmed into the international debut of ‘All the Meanings of Spring’, written by two of our very finest. Continuing on the performing arts front, Music Soc put on a couple of fantastic concerts, and will be hosting the ICSM Carol Service this coming week. There has also

been a scattering of recent student-led conferences, including the Vision Junior conference, as well as the Global Health and Surgeon conference, both of which were squeezed into the same weekend. All that, topped off with tours left, right and centre made it a November to be remembered! The next two weeks look set to end the term with a bang! Imperial Right to Play have already set the precedent by hosting a hugely successful UH Sports Night at Clapham Grand last Wednesday, which I hope you all enjoyed. ICSMSU will be hosting the ICSM Snow Ball on Monday 10th December at the very exclusive River Room, Altitude Bar. I’ll admit it’s bit too close to GKT – sorry, I meant KCLMS – for my liking but it promises to be a cracking night nonetheless! I hope you all have a suitably festive Christmas break to soak up the excitement of term one. Bring on the New Year

Faheem Ahmed & Dheeraj Khiatani KCLMSA Presidents

BL: Surprising new research from CASH (Consensus Action on Salt and Health) has found that cheese is saltier than seawater. Cheddar was found to contain more salt than the average packet of crisps when compared weight for weight. On average, UK adults consume around 8.1g of salt per day, when they should consume only 6 - research like this, it is hoped, will make consumers aware of hidden salts.

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Gareth Chan RUMS Senior President

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We're definitely in the Christmas spirit now at GKT. It's been another amazing year for the Christmas Comedy Revue, which entertained us with the usual slightly inappropriate songs, videos and sketches. They sold a record number of tickets, raising over £5000 for RAG. Speaking of RAG, they're gearing up for Jingle RAG this Friday the 7th, a one-off day of RAGging that's usually the most successful day of collections of the year. Dutiful RAGgers will be rewarded by the MSA Christmas Party that evening - Santa will be in attendance, assisted by his scantily clad elves, to see who's been naughty and who's been nice this year! As if that wasn't enough, we're also preparing for the first ever MSA Christmas Dinner - a black tie event that should round off the term in a slightly classier manner. Parties aside, good luck to all final year students who will be sitting the SJT this month! We delivered two highly successful workshops on this dreaded

exam to conclude our FPAS series. At the other end of the spectrum, pre-clinical students assembled to hear a panel of experts discuss the pros and cons of intercalating as well as finding out what’s on offer in an intercalated BSc either at King’s, externally or other weird and wonderful options including medical placements overseas. We were also delighted to host Professor Keith Willett, the National Director for Trauma Care, who brought us to the halfway point of our SMLA Lecture series last month, with an insightful and interesting talk on the current healthcare system and the impact of the new NHS reforms. It’s been a fantastic first term for the MSA with more academic and social events at GKT than ever before and we hope to carry this through to the New Year

December 2012

medicalstudent

News

Diary of an FY1 Guest writer Chiu Lee takes us on a Christmas journey

ne blisteringly cold December day, as a young medical student walks home from a long, unproductive day in firms, he wonders: what is medicine about? Really, when you get right down to it. That night, he is awakened by a by a strange chill. He opens his eyes to see a strange figure standing over him: stethoscope and lanyard around its neck, sleeves rolled up to the elbows, and of course, a Christmas hat. 'Are you the Ghost of Christmas?' our groggy eyed medical student asks. 'Don’t be silly,' replies the apparition. 'I’m just the F1.' With that, he grabs the medical student by the arm and they disappear out the window. They find themselves by the bed of an elderly lady. Her eyes are closed, she is slumped to one side, she is sweaty and has a feeding NG tube. 'She fell,' explains our F1 explains in hushed tones. 'She has a extradural, traumatic subarachnoid and chronic subdural haemorrhage. She was admitted with a GCS of 15, it dropped to 10 a few days later. The neurosurgeons have seen her scans and there is nothing that can be done. She hasn’t shown any signs of recovery and today, her GCS is 3. We think she is dying.' Our medical student then notices an elderly gentleman standing by the bed, gently crying into some hospital tissues. It is the lady’s younger brother, and beside him is the junior doctor. Sometimes, this is what being a doctor means. It means standing witness while someone dies. It means being there for the family as much as for the patient. My first rotation was in trauma and orthopaedics and I was fortunate enough not to have a patient death (well, one but that’s an entirely different story). My current rotation is care of the elderly. That lady will likely be the fourth in as many weeks. During the first one, I didn’t even know how to pronounce someone dead and the week after, the very friendly be-

reavement officer had to show me how to write a death certificate and cremation form. The funny thing is, I’m not 100% sure what caused the death of those four. Sure, we put down the most likely cause of death down but we didn’t have any clever diagnosis. It wasn’t the good doctors against the evil forces of disease waving the mighty sword of modern medicine. It was old, frail people getting sick with the mildly stressed doctors trying to make them as comfortable as possible while letting the family know their loved one was dying. All this, of course, while there are 20 other patients to see.

"I wouldn’t go so far as to say it is difficult. Yes, it can be stressful, but I think you have to be very rational about it: you have done your best, all you can do is continue to do your best. I’m not trying to be blasé about death but I do not believe Medicine is about the indefinite extension of life. At some point, everyone has to die." I wouldn’t go so far as to say it is difficult. Yes, it can be stressful, but I think you have to be very rational about it: you have done your best, all you can do is continue to do your best. I’m not trying to be blasé about death but I do not believe Medicine is about the indefinite extension of life. At some point, everyone has to die. After a few moments of silent contemplation, our medical student and ghostly F1 leap out of the adjacent window and travel 6000 miles into a very different, but familiar, scene. This time they are in the ICU of a private hospital and the patient is barely 2 feet long. Her eyes

are closed and she has a large scar down her chest. Her eyes are closed and she is gently sleeping to the quiet beeping of her various monitors. Before our medical student becomes too glum, the F1 tells him about the patient: 'This little girl was born with a tetralogy of Fallot. Her parents are poor but the surgeon and other doctors agreed to waive their charges. The local newspaper raised the funds from the public for the hospital charges. She would have likely died before she was a teenager but now she has a near normal life expectancy.' Our medical student just smiles and watches the sleeping child. Unfortunately, that girl wasn’t my patient, but she was the patient of a cardiothoracic surgeon I saw on elective in Malaysia. Contrary to everything I just said in the past 600 words, medicine sometimes is about slaying disease. It can be about making people better and perhaps giving them 50-60 years of life. And it is such a privilege when that happens. Come to think of it, it was such a privilege to stand by that lady as she lay dying. Just like it is for your happily demented patient to tell you he can’t see out of one eye because he was bitten in the eye by a cobra in Germany. To see life and death; happiness and sorrow; sickness and heath; and everything in between. That is all part of medicine. So what is medicine? When you get right down to it? I think it’s about people, and in all sorts of small and large ways, making their lives better. 'Wait', asks our medical student, 'aren’t you going to show me a third patient?' 'Well,' replies our guide, 'I only have 900 words. Plus, I have a Christmas party to go to. Why don’t you take the rest of the night off?' And that too is part of medicine. Merry Christmas

GKT gets in the Christmas Spirit with annual Comedy Review Katie Allen Guest Writer Talented GKT medical students have entertained record crowds with another excellent Christmas Comedy Revue. Whilst the show, consisting fastpaced sketches, songs and videos, has always been popular, this year saw the highest ticket sales in many years, with the Greenwood lecture theatre packed out for three consecutive nights with students and some of the braver staff members. Profits from the ticket sales, amounting to over £5,500, were donated to this year’s RAG efforts in aid of local hospital charities. The cast – made up of the familiar faces of Christmas Show veterans and an impressive new batch of freshers – worked hard on the show for three months, holding auditions, writing and rehearsing new material, and filming video sketches around London. Whilst it was clearly hard work, the show’s producer Sujan Sivasubramaniyam insists it was all worth it in the end: 'Even with all the stresses we all had such an awesome time! The cast and crew have so much fun putting on the show and we really bonded during rehearsals and show week, which are full of inappropriate banter that makes up for lack of life for

3 months!' The sketches, making reference to popular culture, medical conditions and practices and some of the more notable GKT students and staff, were well-received by the audience - although there was the inevitable heckling from the Wednesday night crowd. This year, the show was entitled ’50 Shades of Gray’s’, after the erotic publishing phenomenon of the year, and the cast and crew certainly lived up to this name, with plenty of both male and female nudity, from the cast as well as the Dancing Boys and Girls who each put on great performances with clever choreography that left little to the imagination. Unfortunately one dancing girl injured herself while celebrating a little bit too hard after opening night, and appeared on stage on crutches for the remaining shows. Even the backstage crew got in on the '50 Shades’ action, dressing in S&M attire for the final night. Cast, crew and audience alike celebrated the successful show with afterparties on both the Wednesday and Friday nights, and the Christmas Show has once again proved to be a highlight of the GKT calendar. Now all that remains is for Director Alex ‘Captain Jack’ Underwood, Musical Director Sophie Strong and Producer Sujan Sivasubramaniyam to maintain their success at the upcoming UH revue

Photo by Charlie Ding/Kiss London Photography

Calendar of Events

BL Strictly Come Dancing

7th December

Clubs&Soc Christmas Dinners

8th December

GKT As barren as RUMS

Forever

ICSM Snow Ball

10th December

Pride and Prejudice Auditions

10th-12th December

Electives Evening

Netball Christmas Dinner

'The Smoker'

Football Christmas Bop

10th December

19th-21st December Christmas Concert

20th December

12th December 14th December Ski Tour

14th-22nd December

RUMS Still Nothing

Forever

SGUL Xmas Jumper Night

10th December Refreshers

9th-18th January

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December 2012

Features

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Features Editor:Alexander Isted features@medical-student.co.uk

HIV/AIDS: The Game is Changing An interview with Michael Sidibé, Executive Director of UNAIDS Christopher Thomas Guest Writer 'What I'm going to say now is very dangerous' says Michel Sidibé - Executive Director of UNAIDS, the joint United Nations programme on HIV and AIDS. It's said with a smile on his face - as the gregarious Mr Sidibé begins many of his points - however the message he then delivers is a serious and crucial one. 'I honestly think [the World Bank, World Health Organisation (WHO) and UNAIDS] need to seriously rethink their approach. They are currently organisations of the past, not tomorrow.' He continues by saying: 'If they don't have the courage to question their role in today's world, today's changing world, ... if we don't all understand that the game is changing, these organisations will be obsolete and irrelevant'. Mr Sidibé's smile returns, he knows the mischievousness of what he's said about the august institutions mentioned, one of whom is his own. Despite this, his message is clear, as it was throughout his talk - the keynote speech of the UCL-Lancet 2012 lecture, entitled 'Health Justice and the Future of Development: the global issue of HIV/AIDS has shifted from a scientific matter to a problem of society'. This is not to say that the role of medical scientific research into HIV/ AIDS is now redundant, far from it. However, the advent of competent antiretroviral drugs (ARVs) has imbued medicine with the means to combat the disease. Many of the most commonly used medicines have been around for some time, emerging in the late 1990s. Initially the challenges faced were mainly economic and logistical in nature: how to fund and deliver expensive medicines in parts of the world often infrastructure and money poor. These challenges remain ever present, but are now seen as part of a broader picture. One that inextricably links the goals of UNAIDS, summed up by Mr Sidibé as the 'aim of an HIV-free generation', with a view for a better, more equitable and socially cohesive world. Mr Sidibé refers to this process as 'taking HIV out of isolation', stating that a new 'social movement' must be embraced. How apt then that Mr Sidibé has overseen this shift as the first nonscientist in his role, which he has occupied since 2009. A man obviously at ease in company, his own mixed background (an African man, of both French and Malian descent) combined with a long track record of improving health and welfare for those in the developing world, you feel equips him, in a way that no scientific education could, to face the global challenges ahead.

they are not just Malian or British, they are world citizens, with a world view of the issues surrounding them'. Mr Sidibé remained crystal clear when he described how he foresaw his 'world citizens' enacting real change stating that 'young people will not wait anymore, they will demand change, a more democratised society. The leaders will have to respond'.

"Young people today are not passive, they want to be actors of change and they want to use the technological revolution - mass media and social media - to be connected to each other, to propose a new society. For me their view of this new society is important and they are telling us they refuse exclusion, they refuse stigma, they refuse discrimination"

Image courtesy of Thinh Ha, UCL Photo Soc The road ahead is indeed still long, and taken out of context, many of the things Mr Sidibé says could be dismissed as rhetoric. This would be losing the true message though. When he speaks of a 'journey from despair to hope', they are not the vacuous words of a bureaucrat, but a wake-up call from a man who deeply understands human emotion, a man who understands that global health has to be seen as an 'investment, not just an expenditure', that human rights inalienably include the right to health and that new advocates in this battle must be engaged, particularly as in many countries the gap between government and the governed is getting bigger. There is one demographic that Mr Sidibé sees as particularly key: this

is no more clear than when he speaks of his expectation that 'young people will lead the transformation'. He began the lecture by expressing his delight at the number of young people in the audience and it was a theme he returned to many times throughout. Afterwards I spoke to him further and his view was emphatic: 'Young people today are not passive, they want to be actors of change and they want to use the technological revolution - mass media and social media - to be connected to each other, to propose a new society. For me their view of this new society is important and they are telling us they refuse exclusion, they refuse stigma, they refuse discrimination'. He used the example of parts of Eastern Europe and Central Asia, to

illustrate where change of this nature could be seen by saying, '[these are] places that have enough resources, why do they still have an AIDS epidemic?'. He alluded to the negative stigmatisation of many of the people with HIV/AIDS in these parts of the world, hinting that only through a societal shift will these people's lifepaths differ: 'Unless they are considered citizens, with the right to healthcare, these people won't be reached and AIDS will grow and move from specific groups to the general population.' He was also quick to highlight the role of education in the empowering of young people, saying that as people become more informed their views shift 'bringing a new citizenship, which I call 'world citizenship',

Many of the old problems remain in the fight against HIV/AIDS, for example outside funding currently pays for around 95 per cent of the ARVs in Africa. This model remains unfeasible for a sustainable future. What Mr Sidibé called for, however, was to use World AIDS Day - which falls on 1 December every year - to 'create a new platform of awareness' in order to tackle many of these problems. 'We need to give the opportunity to young people to lead a world AIDS day' with the view to 'creating a new world movement on one day through a virtual connection, from Jakarta, to Ouagadougou, to London, leading to young people being on the streets asking for medicine at a fair price'. While this statement does smack of idealism, its message rings true: the 21st century is shaping up to be defined not by the elite, as might have been the case in bygone centuries, but by the proletariat. An election is now not the only way that the voice of the people can resonate and Mr Sidibé recognises this. It is the arrogance of every age to believe it the most sophisticated, the most civilised, the most important. Regardless, there has never been a time before when the mechanisms to further social change have been so widely distributed and available to so many. Mr Sidibé recognises this also, speaking of his want for the day that young people [call] the leaders of the world to respect the dignity and rights of all the people of the world'. A noble want indeed

medicalstudent

December 2012

Features

Are Medics too Cliquey? Mena and Onkar, SGUL Equality & Diversity Officers, investigate medical student cliques Mena Farang & Onkar Rehal Guest Writers

gether to develop and advance clinical skills practice in a professional setting that is truly reflective and representative of the typical clinical environment. There is no question that Medicine is time-consuming, rendering a limited amount of time for extra-curricular activities. If you become part of a clique you essentially limit yourself and your experiences. Life will only get busier after you graduate and so you need to make sure you broaden your horizons and experiences while you are still at medical school, even at the expense of stepping outside of your comfort zone. After all, mixing with peers from a range of backgrounds is more likely to ensure that we are more tolerant and understanding of others. This is particularly important in the context of healthcare when we encounter everyone from the drunks and addicts, to the homeless and immigrants. By integrating at an earlier stage of our medical training we will be better equipped to understanding the social (as opposed to solely medical) needs of patients from backgrounds that differ to our own

You only have to step outside your front door and walk for two minutes in (most of) London and you will be hit by an explosion of cultural diversity. During the gold rush of the London 2012 Olympics, David Cameron aptly described London as ‘probably the most diverse city in the world’ – and rightly so. The capital is renowned as a nation with distinctive demographics, populated by a polyglot of people of all races, cultural backgrounds and religious faiths. Such diversity is arguably captured across all of the London medical schools, irrespective of whether you are a medical student based in Mile End or South Kensington. Medicine is demanding, both academically and socially. By nature, medics tend to stick to themselves. What they don’t tell you in the prospectus is how that clique of medics can be further subdivided into subcliques. Parallels can be drawn from the scandalous cafeteria scene in ‘Mean Girls’. Instead of having your freshmen, preps, J.B. jocks, varsity jocks and sexually active band geeks, it could be argued that the Arabs, Asians, GEPs, revue crew, rowers and rugby boys represent a sample of the equivalent major cliques that irrefutably exist across all London medical schools.

"Instead of having your freshmen, preps, J.B. jocks, varsity jocks and sexually active band geeks, it could be argued that the Arabs, Asians, GEPs, revue crew, rowers and rugby boys" These groups lie in the fabric of med school culture and form early on. Once you become settled in a particular clique or group, it can be very hard to dissociate oneself. This may be attributed to tribal psychology. People will naturally stick to what they know, for example, by integrating and socialising amongst others that share similar ideas and values. In doing so, they protect themselves, reflecting a response governed by our primal animalistic instincts. However, by sticking to our ‘own’, we may actually do a disservice to the greater cause of ensuring equality amongst all. How so? Well, treating a patient is more efficient when a doctor possesses contextual knowledge of the practices, beliefs and daily routine of the commu-

Image courtesy of Mena Farang nity that individual belongs to. There is no avoiding the fact that London is a multicultural city where we will be faced with patients from all walks of life. In hospitals, surgeries and clinics, we will be working alongside other medical staff from varied backgrounds where being comfortable with each other can mean the difference between life and death for a patient. Being able to tell whether someone is Bengali, Geordie or Tamil can help them to be more at ease when working with you, as you appreciate who they are.

"Being able to tell whether someone is Bengali, Geordie or Tamil can help them to be more at ease when working with you, as you appreciate who they are" In cases of emergencies, some knowledge of people can go a long way when they are unable to communicate with you, as it is not only courteous but also crucial to take into considera-

tion a patient’s dietary, health and religious stances in the strategy adopted for delivering the best quality of care. For example, knowing whether a patient is a Jehovah's Witness or that uncut hair is one of the five symbols of faith for Sikhs will greatly enhance the clinical decision-making process for that patient. We spoke to Kea Horvers, the Equality and Diversity Manager at SGUL, who stated that, ‘No matter how different a patient might appear to be from the health professional who treats them, it is vital to good health care that the value and individual difference of each individual patient is recognised. Cultural competence expertise is a very important skill to hone as a medical professional’. As such, the need to explore the cultural beliefs and practices of others is paramount. So far, our discussions have assumed that social divide at medical school is driven solely through student self-segregation. Yet by catering for the varying needs of different groups, do medical schools inadvertently reinforce segregation and a tendency to, in fact, isolate certain groups of indi-

viduals? Take, for example, formal clinical skills teaching during the preclinical years at St George’s. The medical school provides single sex clinical skills cubicles for females as a means to comply with the strict requirements of their faith. Although this is widely regarded and accepted as the ideal situation in order to protect cultural expectations on privacy and dignity and to avoid causing offence, it could be argued that special accommodations like the aforementioned only serves to exacerbate the existing segregation in medical school. If equality of opportunity truly means working to ensure that no student or group receives less or, as in this case, favourable treatment, with respect to any of the nine strands of equality protected by law, where does that leave the rest of the cohort of students? A failure to integrate and mix clinical skills teaching groups may compromise the promotion of good relations and co-operation amongst an ever-increasing diverse student population. In addition, this segregation essentially creates a learning barrier that restricts students from integrating to-

Hello, we are the Equality and Diversity Officers for St George’s Students’ Union (SGSU) for 2012/13. So far we have been involved in organising and promoting a variety of events and campaigns such as Black History Month, Disability Awareness Week and a number of open forums that explored discrimination in the context of disability, race, religion, gender equality and sexual orientation. Our debut as writers for The Medical Student will allow us to expand our horizons and share our work on a larger platform. Between us we have studied at George’s, King’s and Imperial and combining this with our Coptic Orthodox and Sikh Punjabi backgrounds, we feel that we have accrued a wealth of experiences that allow us to offer meaningful perspectives on issues pertaining to equality and diversity. We believe that embracing diversity at all levels will serve to facilitate the development of an inclusive and supportive infrastructure, enabling students from all backgrounds to thrive in both academic and social domains. In today’s world, particularly at medical school, diversity can be quite a touchy subject. As is often the case, it is easier to shy away from difficult and uncomfortable issues and sweep them under the rug. In this month’s edition of The Medical Student, we probed into the benefits and drawbacks of diversity in medical school.

Rape Culture, or Why

Rape culture, in a nut shell, is a collection of attitudes and behaviours which enable rape and Only certain rapes are 'real’ rapes and only certain people are raped Here is a list of things that I've been told to do in order to avoid sexual assault in my twenty-one years of walking this earth with a vagina: do not walk alone, do not walk at night, do not walk through certain areas, do not drink or do drugs, do not accept a drink from a stranger, do not go anywhere alone with men, don't sleep around, don’t hang out with certain groups of people, don't trust men, don't get an unlicensed cab, don’t leave a drink unattended, do not wear that dress/top/skirt/bra/pair of shoes.

The best advice I've received - and by best, I do mean the worst - was to 'tone down my walk' because apparently the manner in which I put one foot in front of the other excites every man I pass into a sexual frenzy. This is not an exhaustive list but you get the idea. The best advice I've received - and by best, I do mean the worst - was to 'tone down my walk' because apparently the manner in which I

put one foot in front of the other excites every man I pass into a sexual frenzy. I was twelve when I was told this. The fact that I can so easily regurgitate these messages probably shows how often I’ve been told them by so many different people. Here's the kicker though: all of this well-intentioned advice didn't stop me from being sexually assaulted. I'm not arguing that women (or anyone actually) should go strolling around Hyde Park at 3am or that we should all go cruising in unlicensed minicabs, I'm just saying that this advice isn't particularly effective. Only 7% of rapes are committed by strangers; it is far, far, more likely that a woman will be raped by her significant other or someone known to them than a random predator lurking down a dark alley. However, I haven't been told by anyone not to get married to reduce my risk of rape even if apparently every other freedom I have is fair game for criticism. The fact that the only advice we're given as a society to avoid rape is to avoid strangers sets up this idea of what 'real' rape is - it's an innocent young girl being violently attacked by a stranger - and so other

rapes and other victims can be more easily dismissed or discounted. It says that if a woman fails to abide by any of these rules, which are usually referred to as 'self-responsibility', their rape is their fault. Which it isn't. Ever. It also says that women who don't fit this model of a victim probably aren't victims at all: maybe they didn't fight back hard enough, maybe they didn't scream loud enough, maybe they fit into a group we don't commonly think of as being victims of rape e.g. the elderly or disabled, maybe they fit into a group of women who 'can't be raped' at all, such as prostitutes.

Rather than telling women not to get raped, we should start telling men not to rape I personally think it would be super if we stopped telling victims to just not get victimised and instead shifted the blame back where it belongs: onto the rapist. Rather than telling women not to get raped, we should start telling men not to rape. But this isn't compatible with the rape culture that we currently live in.

Stop blaming the victims

A woman is at least partially responsible for her rape.

Rapists are responsible for rape

A poll by Amnesty International found that around a third of Britons think a woman is totally or partially responsible for her rape if she 'behaves flirtatiously', more than a quarter if she wears revealing clothing, and around a quarter if she had been drinking. A charming fifth of respondents thought a woman was responsible for her rape if she had lots of sexual partners or if she walked alone in a deserted area. This is appalling and probably even worse if you consider that we select a jury from these people, or we make police officers, lawyers and judges out of these people, or that some of these people will go on to be raped themselves or have friends or family who may be raped in circumstances they consider are 'partially or totally' the victim's fault. Our conviction rate for rape is

shockingly low, in fact it currently hovers around 6% and maybe this isn't all that surprising if we consider the idea that victims incite their own rapes are prevalent in our society.

A charming fifth of respondents thought a woman was responsible for her rape if she had lots of sexual partners or if she walked alone in a deserted area And maybe, the fact that our conviction rate is so low is a reason why so few rapes are reported - current estimates suggest that between 75-90% of rapes are unreported. This silences victims and allows rapists to go free.

y Rape is Acceptable

d validate rapists. Marrisa Lewis tells us why certain attitudes mean we live in a rape culture Rape is uncommon and doesn't need to be taken seriously: rape jokes are acceptable. Rape jokes are common. Some recent examples include: UniLad’s infamous ‘85% of rapes go unreported. That seems to be fairly good odds’ joke; or comedian Daniel Tosh responding to a female audience member objecting to his use of rape jokes with 'Wouldn't it be funny if that girl got raped by, like, five guys right now? Like right now? What if a bunch of guys just raped her …'; or Imperial’s student newspaper printing an article about using Rohypnol to get a Valentine’s date last year. And this is just the tip of a colossal misogynistic iceberg. Rape jokes simply aren’t funny, ever, because they make light of what is the worst experience of many people’s lives and also creates a culture

where rape is seen as acceptable and rapists are validated for being ‘lads’.

It is pretty much inevitable that rape victims hear these jokes and having your experience mocked or used as the punch line of a joke is possibly one of the most alienating experiences imaginable. The other major issue is that rape is common: it is thought that around 1 in 4 women in the UK will experience rape in their lifetimes.

It is pretty much inevitable that rape victims hear these jokes and having your experience mocked or used as the punch line of a joke is possibly one of the most alienating experiences imaginable. It is not just jokes that do this either, it is the use of ‘rape’ to mean anything other than sexual assault. Changing someone’s Facebook status? Not rape (and no, using the contraction ‘frape’ isn’t any better). Doing badly in a test? Not rape. Getting shot in a computer game? Not rape. Saying that any of these experiences is at all equivocal to rape is incredibly offensive, diminishes the experiences of rape survivors and perpetuates rape culture.

Reclaim the Night: National march against sexual violence organised by the London Feminist Network

Ask before unwrapping - would these work?

A large proportion of women who claim they have been raped are liars This is surprisingly common and just flat out wrong - false reports of rape make up 2% of all reported cases – lower than false reports of most other crimes.

For me, it’s hardly about my rape anymore when I feel bad. It’s people’s reactions to it that make me want to cry Women march for justice. Image courtesy of Marissa Lewis

However, this doesn't stop people from using this argument, espe-

cially if the rapist in question is famous, or regarding this issue as a serious threat to men everywhere. There was a submission to the Everyday Sexism blog which I think sums up the harm of rape culture: For me, it’s hardly about my rape anymore when I feel bad. It’s people’s reactions to it that make me want to cryWe shouldn’t be comfortable with a culture that makes life easier for rapists and harder for their victims. The first step to combatting rape culture is to be aware of it and then ensure we are not complicit in it

December 2012

Comment

medicalstudent

Comment Editor: Robert Vaughn comment@medical-student.co.uk

An atheist at Christmas Robby Vaughan Comment Editor

For me, Christmas is a godless affair. Long gone are the days where I would celebrate the birth of Christ come Yule morn. I, like many cynics, find it disappointing that capitalism now feels the need to so violently suck on the teat provided by the festival’s tradition of the exchanging of gifts. More chip and pin than Anno Domini now, I feel. However I’m not upset at all that the Christian, religious, meaning of Christmas seems all but gone for most. I don’t ascribe to the idea that the birth of Christ needs celebrating at all. In fact, Jesus of Nazareth was not born on the 25th of December, the date was chosen only because of its timing with the winter solstice - a Pagan holiday. Furthermore, no one was told to celebrate Christmas by Jesus, and the two just seem as man made as each other. I should add that this is fine by me.

remains relatively unreported by the cowardly BBC and the like, from fear of being branded ‘religionist’ - a term which is used by the intellectually feeble to justify the silencing of disagreement with religious dogmas. The poverty that I am not supposed to talk about, and if I were anything but editor of this article, would be expected to ‘soften up’ this piece. The poverty created not by the natural pattern of rain-

eyes of Allah, and to make them less inclined to commit ‘dhanb’ – or ‘sin’. The girls may indeed grow up to suffer depression, loss of sexual interest, and a whole host of problems with their genitals. God may have made them perfect and innocent, but apparently it wasn’t perfect or innocent enough for these Islamic extremists. Female circumcision – which I prefer to call by its real name, female geni-

weight of blame with a made-up man who decided to eat a made-up apple off a made-up tree, which condemns them to burn in a lake of fire for all time lest they be forgiven. The real joke is that I’m not even trying to make it sound ridiculous. Children will be branded ‘Christian’, ‘Catholic’, ‘Muslim’ and in the process, have their minds placed in a position which they could not, at that age, possibly choose to put themselves

"I, like many cynics, find it disappointing that capitalism now feels the need to so violently suck on the teat provided by the festival’s tradition of the exchanging of gifts. More chip and pin than Anno Domini now, I feel." Instead I find it to be solely a time to be with your family, to rest on them, and to enjoy yourself. These are values a Christian may feel inclined to follow, but they are not values that belong to the church. Why shouldn’t an atheist celebrate Christmas then? It's still good fun, it makes me happy, and it still has meaning, and if anything, it’s less complicated without a cheeky serving of theism plapped on top. I’ll still call it ‘Christ-mas’, but only for ease of communication. For me, it's a festival of relaxation.

"It makes me happy, and it still has meaning, and if anything, it’s less complicated without a cheeky serving of theism plapped on top." More critically however, another ideal of Christmas that I think still remains to not be a waste of time, is the concept of reflection or ‘To think about those who have less’. The world often wants to focus our attention on ‘resource injustice’, and poverty of food and water and money in places like sub-Saharan Africa. However this Christmas I will be thinking about what I consider to be a much greater evil than ‘natures poverty traps’, and mainstream poverty. The poverty that

Illustration by Elvin Chang fall on crops, but by the choice of ‘wise old men’ and holy books. The poverty I speak of is a poverty of morality. I will be thinking about school girls in west Africa and Indonesia, who this year, and the years before, and probably in the years to come, will be visited in school one day by a nurse, who will queue them up, lay them on a desk, and cut their clitorises off with a scalpel or a piece of sharpened bamboo. Their ‘mothers’ will celebrate and pay for the service, all because they perceive it to make their daughters purer in the

tal mutilation - occurs not just in far off lands, but as close by as Bradford and Birmingham. Unfortunate Muslim girls will be often be ‘sent to see their uncle for the weekend’, and return scarred and fractured in every sense. I will be thinking about all children of Christian parents the world over who will be born into ‘original sin’ in 2013. These children, who have not even had their cords cut, whom yet could not yet have any concept of morality, will in their youth and innocence be told that they - somehow - share a

in. I was like many of friends growing up, accused of original sin, and indeed seen-to-be-forgiven via baptism. I may have grown up to be a pretentious dick, guilty of many things, but I don’t believe I, nor anyone, can be guilty of anything in their first few moment of life. I will be thinking about children born in Palestine and Israel this coming year. They’ll spend their childhoods running from shelling in the middle of the night. Both sides of the west bank – which are almost exclusively Muslim and Jewish – will

raise their boys to fight in this endless bloody religious war. Here in the west we see only a fraction of the true horror of this bloodshed, and when we do, it is disproportionate. Barack Obama will awkwardly say that he supports Israel’s right to defend itself - I’ll leave you to decide what this really means - before tipping US budget into it. YouTube ads will pop up with ‘support Hamas – end the bloodshed’. When you separate yourself from religious bias, it is obvious that both sides are still in the wrong in this unjust war. I will be thinking about African children who will be told by Catholic Church missionaries as they reach sexual maturity that using condoms increases the risk of transmission of HIV. Morning prayer for them will be followed by an omni-shambles of a sex-ed class. The church, in the hope that ‘nature will not be interrupted’ by contraception, propagates this lie. It’s not a new idea either – Thomas Aquinas thought that genocide was committed every time a torrent of semen collided with a flannel, with every unborn child meeting a grizzly, polyester-based end. In areas that HIV is prevalent, people may well believe what they are hearing, and they may well die because of this disgusting lie. The pope will remain silent on the matter, and remain to seem meek and mild, whilst further south, innocent humans will die because of AIDS. These issues are obviously incredibly unpleasant and upsetting. They don’t pass out of my mind as easily as seeing another picture of a starving Ethiopian child with malaria. I am still sensitive to these issues, because the world does not want to talk about them out of embarrassment, or politeness, or fear. To those who think that these issues are anything but repugnant, repulsive, examples of human behavior, under any circumstance, religious or not, you should be thoroughly ashamed of yourselves. The most important relalisation is that these named wrongdoings are not committed by god, in the slightest. Man, and man alone commit them.

"The most important realization is that these named wrongdoings are not committed by god in the slightest. Man, and man alone commit them." It doesn’t do to upset yourself, but it makes me feel truly lucky to be able to live in a society which whilst still having oppression and tyranny just around the corner will not stone me to death, persecute, mutilate, humiliate, or punish me for choosing not to bow down to them. Both these issues, and Christmas, carry the same point to me as an Atheist. They are not about god; they are about true, human, love to one another. I wish you all a very happy Christmas

medicalstudent

December 2012

Comment Festive Fatty Zara Zeb Staff Writer

With Christmas around the corner, I decided to be on top this year. I’ve bought my cards, presents and party tickets already, seen the town lights being switched (it’s the same wherever, so I went out of London for this), planned my revision around the holidays and had everything in place by… well this afternoon! Now is the time to sit back and enjoy the season, listening to jingles on repeat, watching everyone rush around like headless turkeys. But, and this is a big but(t), since I’ve been preparing for Christmas early, I’ve also started the snacking early. All those chocolate boxes I have on the 25th of December were consumed on the 18th of November, and as it is still over a month away from Christmas, another box was devoured on the 19th, and then the 20th, and… you get the picture. So now not only have I got the Christmas presents, the Christmas tickets, and the Christmas excitement, I also have the Christmas belly; And it’s not even Christmas!

" But, and this is a big but(t), since I’ve been preparing for Christmas early, I’ve also started the snacking early. All those chocolate boxes I have on the 25th of December were consumed on the 18th of November, and as it is still over a month away from Christmas, another box was devoured on the 19th, and then the 20th, and… you get the picture." Since I’ve started Christmas early, I may as well start the next steps sooner. So I’ve set myself the task I set myself every year after Christmas and never achieve – to get myself down to 10 stones. To do this, I shall give up my sweet tooth, take up more exercise, and when I wake up on my 20th birthday (January 8th) I shall be miraculously thin! As if. I shall cry over the chocolate I can’t eat, spend a fortune at the gym and spend hours on long walks when I could be in bed with a movie. There’s also another story behind this. For those who read any articles of mine MedStudent were kind enough to publish last year, you’d know life has been a bit of a struggle. I was finally diagnosed with chronic depression on 31st January 2011. I remember the day very clearly. Unfortunately it took two years for anyone to notice

anything was going on and for help to be sought. Nearly two years after diagnosis, every day is still a battle, but it's a battle I'm determined to win. S So this Christmas, I want to improve my mental health by improving my physical health. At the minute I am somewhere over 11 stones (being female I refuse to be precise!) but I shall upload photos off my journey and scales as time progresses to my justgiving page. Please help motivate me by donating money to this wonderful charity, Mental Health Research UK (http:// www.mhruk.org), that seeks advancement in care for mental health sufferers. Unfortunately mental health is still not well understood, medication has been the same since the '60s and personally I think we as a community and as health professionals could be doing so much more.

"So this Christmas, I want to improve my mental health by improving my physical health." Christmas is a stressful time for some – not just financially for all those presents we have to buy, or emotionally having to put up with families or cooking for loads of people or travelling during busy times and with unpredictable weather, but for many of us we have exams on our return. It’s also easy to let our physical health slip, when science has proven time and again physical health and mental health are interlinked (and seeing as this isn’t an essay, I am not going to go listing journals and papers and all that academic pizzazz)

"Unfortunately mental health is still not well understood, medication has been the same since the '60s and personally I think we as a community and as health professionals could be doing so much more." So take some time every day, be it for 15 minutes, to get some fresh air, to listen to your music, to read a book, to be alone, to have a lovely bath, to do something for you, to take care of your needs over this enjoyable but often frustrating time. Have a lovely Christmas everyone, and be sure to keep yourselves fit and healthy, both mentally and physically! Please visit my just giving page (http://www.justgiving.com/ZaraZeb) be it to donate or to leave a supportive comment. I aim to raise £50.00 by the 8th of January

December 2012

Culture

medicalstudent

Culture Editor: Kiranjeet Gill culture@medical-student.co.uk

Silver Linings Playbook It's a rom-com about mental illness, without (much of) the schmaltz, writes Rhys Davies

sychiatry is, to me, a fascinating subject, but mental illness is so often maligned and mis-represented in the popular media. However, from the first trailers I saw of this film, I hoped for something different. I also hoped that it would be interesting. 'Silver Linings Playbook' succeeds on both counts. This is a film about mental illness, romance, American football and dancing. After being released from a psychiatric hospital, Pat (Bradley Cooper) returns home to rebuild his life, with the purpose of restarting his marriage to his wife Nikki. Things had become difficult between them when he nearly beat to death her naked lover, was sectioned, and she filed a restraining order. To Pat though, it’s nothing more than a bit of a rough patch. As he reintegrates back into his old neighbourhood, he meets Tiffany (Jennifer Lawrence), a recently widowed family friend. As a depressive reaction to her husband’s death, she slept with everyone in her office; because of this, she has something of a reputation around town. Though initially quite prickly to each other, the two strike up a friendship, debating who is the crazier person. Ah yes, the mental illness. Pat has bipolar affective disorder - or manic depression, if you must - and is reluctant to take medication, instead trying to re-

main well with exercise and 20th century literature. Meanwhile, Tiffany has major - or unipolar - depression. They joke about being crazy, compare notes on their medications and recognise that society is fake and hypocritical, while they are more true and genuine.

"To his dad, Pat’s elevated mood can only be a result of his illness, or the inaccurate dosing of his medication. This one scene eloquently illustrates that once diagnosed, every aspect of your behaviour and personality is viewed through the lens of mental illness." I’m no psychiatrist so I can’t comment greatly on their diagnoses, but from what I do know, they appear fairly accurate. Which, for Hollywood, is really saying something. As the protagonists, they are the normalised characters, and we are supposed to sympathise with them. Conversely, the odd ways in which their friends and family treat them stand out as more unusual. For example, after spending a great

deal of time with Tiffany, Pat is genuinely quite happy. Understandable. However, his dad, Pat Senior (Robert De Niro) asks why is he so 'up'. To his dad, Pat’s elevated mood can only be a result of his illness, or the inaccurate dosing of his medication. This one scene eloquently illustrates that once diagnosed, every aspect of your behaviour and personality is viewed through the lens of mental illness. Other characters are not entirely sure about how to act around this new Pat with a mental illness, and give bashful excuses for why they didn’t visit him whilst he was in the psychiatric hospital. Though we may be guilty of similar actions in real life, this film highlights how awkward they really are. Though Pat and Tiffany are the diagnosed characters, there are quiet hints of mental illness in the background. Pat Senior, an American Football bookmaker, is obsessively suspicious and regimentally compulsive about the game - probably not obsessive-compulsive disorder but somewhere in that region while Pat’s friend Ronnie quietly admits to Pat the difficulties he is having in his life, to which Pat replies, 'that’s crazy!' Part of Pat’s reluctance to take medication is that they make him feel so blunted, so doped up. I couldn’t help but smile in gratitude to the inclusion of this genuine problem for patients with bipolar disorder. When

they’re up, they feel fantastic and don’t believe they’re ill. Hence, why take medication that makes them feel so (relatively) low and drugged? While I admit that the protagonists' opinions of their medications is a nice touch, I had a harder time with their theory that society is hypocritical

"The acting of Cooper and Lawrence make this film. They are so idiosyncratic, so different, so 'crazy' but at the same time, relatable, sympathetic and human. They are people with mental illness, not monsters or aliens or something other unknowable thing. In short, they get it right. " while they are the ones that are true to reality. A sniff of Zsasz’s medicalisation of problematic individuals, a whiff of the increased insight of those with mental illness. While I have met patients with opinions like this, in this film, it came across as a conspiracy theory crossed with teenage angst. A minor point, however. Goodness me, so much psychiatry!

Wasn’t I reviewing a film at some point? The acting of Cooper and Lawrence make this film. They are so idiosyncratic, so different, so 'crazy', but at the same time, relatable, sympathetic and human. They are people with mental illness, not monsters or aliens or something other unknowable thing. In short, they get it right. They are supported by an equally talented cast, including De Niro, and Chris Tucker as Pat’s friend, Danny, from the psychiatric hospital. I’m not sure what Tucker adds to the film but he does it, well, unobtrusively. There is a wealth of playful tricks of the camera, which cleverly further and deepen the story. The music is by Danny Elfman so nothing more be said on that. There is a lot of talk on American football, which, if I’m honest, flew over my head, but, hey, I’m British, I’m not supposed to get it. The dancing, which also comes into the plot, is an example to films like 'Step Up' et al., of when a dance-off is both dramatically and narratively necessary and relevant. In short, this is a fresh and interesting romantic comedy that avoids the usual excesses of Hollywood schmaltz. That void is instead filled with humour and mental illness, two of my favourite things. Though it has a slightly protracted running time, I would be surprised if this wasn’t in the running for an Oscar or two next year. This is certainly a film to watch

medicalstudent

December 2012

Culture SGUL Fashion Show 2012 in Pictures

ICSM Drama Presents 'All the Meanings of Spring' By Purvi Patel ICSM Drama performed its autumn play on 21st23rd November. Written by students Matt Rinaldi and Rich Newman, this coming of age tragic comedy centred around three students trying to adjust to life at university. It dealt with various issues faced by students, including to what extent we are responsible for other people and the use of drugs to help blunt emotions. Unsurprisingly, the play itself was well written and produced some thought-provoking lines; ‘the only consciousness I can experience is my own, and so everything I do must be selfish’. Despite this, the actors were not particularly convincing; their belief in the characters they played was half-hearted. There were, as always, exceptions to this. The actress playing Sophie was musing and awkward, which suited the character perfectly.

The Fashion Show raised £8000 for the Helena Kennedy Foundation and Everyman campaign. Photos courtesy of SGUL PhotoSoc.

Pain Less - The Future of Relief Hayley Stewart Guest Writer This exhibition is like a combination of a Harvard School of Public Health lecture on pain, and that urban myth where someone felt everything in their operation but couldn't move to tell anyone. And in more than one way. It's a bright installation made up of videos and a game just like 'Angry Birds', amd it also features four pieces of research around the theme of pain. The introduction warns us against the overuse of painkillers and how they have unpleasant side effects we want to avoid. But I think most medics know that morphine stops you going to the loo, NSAIDs can cause ulcers, aspirin makes you bleed... And addiction really is interesting. I’ve only once witnessed a patient addicted to a medication trying to convince her GP to give her more of something she shouldn’t have been prescribed in the first place, and it's fascinating. But the exhibition doesn't explore that. The first piece of research is about how happy people often feel less pain and unhappy people feel more. This was demonstrated by playing melancholy Russian music slowly in an MRI machine and looking at the brain itself. This isn't new information but it seems good that the idea is being spread around as interesting popular science, as greater awareness and acceptability of these things might encourage more patients to try psychological therapies to help them. The second research focus is a Wii-style computer game for people with phantom limb pain that seems to train the brain not to feel pain in that limb anymore. The computer game looks really basic and unglamorous, with a helmet like

that game where you catch velcro balls on your head, and considering that, and that chronic pain is such a terrible condition, it's amazing that such a budget-looking game works. A video of a grateful amputee emphasises just how effective it is. The third section looks at how anaesthetists cause sedation and memory loss. Sadly it doesn't explain how anaesthetics really work, it only leaves us slightly interested and worried that the doctor asked one patient to do things under sedation, and she was awake enough to do them, but not to remember anything about it! The last is about people with congenital insensitivity to pain, which really is like a lecture, and talks about the SC9Na gene mutation. In the future we could use make use of this for pain relief in the future, but not now. In addition to all this there's an arty visualisation of pain by some chronic pain sufferers, which is rather depressing. Overall the exhibition is thought-provoking, but overall I felt quite disappointed - I've been more enthused by my lectures before. I know I'd definitely have enjoyed it more if I wasn't a medic. I wanted to know why and how all these things happen, and meet the people myself and see it all work. However, it did remind me how interesting Medicine is, and that I am really lucky that I do normally get to see all these kinds of things in action. And the rest of the museum is fun, particularly if you go to one of the Science Museum 'Lates' on the last Wednesday of each month. They have crazy things like a silent disco where everyone wears headphones and dances around in silence. And they have alcohol. If I went to a ‘Late’, I’d have a look at this exhibition, but probably wouldn’t make the journey otherwise

At the Science Museum until November 2013

The use of green morph-men to indicate inner thoughts was not as effective as might have been, although the point was conveyed – eventually. The long and painful scene changes, accompanied by garish music and lights, made the entire process much more uncomfortable than it already was. Unfortunately, a good script is not enough for a good play, as ICSM Drama should have realised. Next week they will be holding auditions for their production of Pride and Prejudice. We can only hope that this will be an altogether better experience.

Required: Culture Editor culture.medicalstudent@gmail.com Yes folks, I'm sad to say that the time has come for me to pass the torch to a new generation of budding journalists. The key qualities the Culture Editor needs are: a keen interest in the arts, a finger on the pulse, the gentle art of persuasion, a huge amount of enthusiasm and the ability to impersonate a northerner. Most are negotiable, the final one is not. If you're keen to flex your editorial muscles, e-mail the address above for more info.

Doctors’ Mess

THE GRAND OLD PUKE OF SPORT Sloshing from side to side, high on salty lemon juice, the dance floor was enriched with the coagulation of individual sports teams, standing next to or nearby the team they were paired up with. “Nudge them,” one girl said, “get them to talk to us again,” only for her friend to disregard her and sip gingerly on his spirit and mixer, showing that his spirit was never really in the mixing in the first place.

By Rob Cleaver In the past few months a plan was conceived to incorporate all-comers from the London medical schools to have a light meet and greet session in order to improve networking. It was all arranged to raise money for the Right to Play charity and charitably, in exchange, our lonely men and women would be allowed to peruse the menu and special offers across the table in the carefully selected (and not too judgmental) restaurants in order to find themselves a late night snack from the other side of the city.

For me, an outsider surveying the crowd for faces I knew, I saw a few signs of disappointment. The run up to the event was so positive and indeed it was a huge success for Right to Play, but it was not a success in terms of copulation. My imagination led me to Peter Snow rubbing his hands up and down his graphs on an election night, but predicting the exact number of yes votes needed for a whole new baby boom to spark. Instead the rubbing of hands was not up and down a brand new hunk or a brand new temptress, but back and forth across a defeated brow. “It’s just not my night,” said one punter, scratching his scalp, “perhaps the club blazer with the club tie and the club regulation cummerbund and cufflinks were a tad excessive”.

In the name of journalism - and not because of my love of lager - I took to the dancefloor at the afterparty to uncover the true nature of London's medical students. So the stage was set, after the initial pilau-and-pasanda, in a miserably cold section of south west London for a whole evening of being hot under the collar for the after party. Clapham was amok with sporting medical students, abiding by their public school upbringing by forming an orderly queue rather than allowing the inner scumbag to be let loose for a friendly bit of fisticuffs. “I want to show how much more fun I am than boat club,” the internal monologue whirred, “but if I do I won’t be able to explore the middle class definition of sexually adventurous”. Very few students seemed comfortable with the thought of being south of the river. There were glances exchanged as they quickly discovered that St. Georges students do not live in a postapocalyptic vision conjured up by video game designers. There were houses and shops and people in chinos. There was a train station and a Debenhams and even a Wholefoods! All of these students realised that the south of the river too has been poisoned by a million average gap years, clustered together by their instantaneous rejection of peruvian attire on their return for a suit and a wage

and an HSBC bank account. The mad dash for the bar commenced, a true sporting The dance floor of The Grand exercise, with forearms flailbecame a hive of activity for ing like an extrapolated thumb all of ten seconds before the war trying to usurp the other’s realisation that in order to dominant position. This is the forgo their inhibitions they 21st century human equivahad to bring tequila into play, lent of rutting stags. This a mexican super sub (think is where the male species Javier Fernandez), before the does battle now, so much for teams they’d been so kindly the beaches of Normandy. forced into a relationship with realised that it was never go- There is much debate as to ing to work and that they bet- the correct nomenclature for ter spend the time on TFL try- this kind of gathering of mediing to figure out how the hell cal students. Is it a throng? Is they were going to get home. it a gaggle? Is it a vomit, per-

haps? Yes, a vomit of medical students, for there was no term better suited to defining us that night than both a symptom of disease and a symptom of our over-enthusiasm for enjoying the finer effects of ethanol poisoning. Romance is a complex thing and although the idea here was to generate the steam to turn the turbines of true love, I heard only one expression of genuine fondness: “I love vodka, I really, really do.”

Happy faces were allowed though and even at the end of the night when everyone slipped off into the night to stalk their new friends on facebook, the general consensus was that it was a successful evening. Talk was rife with a repeat event, some applauded this idea for the contribution to good causes whilst others applauded it for the expanding of their pool of potential sexual partners. I think that through the sea of social awkwardness, there was a crowd that had a great night and a good few hundred people destined to miss their lecture on the following day. “He came onto me a bit fast,” my final interviewee said, pausing for me to decipher the double entendre and to cough onto a bus stop, “but he seemed like a nice guy. I’d like to do it again sometime.”

WHEN WE USED TO HAVE WRITERS SUDOKU Instructions, you say, rather than an almost funny, sarcastic comment? Those days are numbered, mate, from one to nine.

By A Desperate Editor I remember the time well even though it was many months ago now, before even the summer that never was. My email inbox went bold for the very first time. There it was, a solitary (1) next to it, the gmail equivalent of a dog wagging it's tail waiting for a walk to the park. That time it was a spam email and every subsequent wag of that tail has only ever been a stroll with a small, plastic bag, waiting for the inevitable dung to be placed in the recy-

cling bin. No I do not want to discover the effects that your product has on male pattern balding. No I do not want to hook up with the swingin' singles in my area between the ages of fifty and seventy five. Now I don't even get those emails any more and I feel like the wheels have fallen off of this bicycle and I am left standing astride a frame frantically pushing for it to go, encouraging it with "brum brum" noises but it doesn't go anywhere. It stays stagnant just like my jokes might do if I wasn't such a bon-

afide hilarious human being. See, I've become self-sarcastic and twisted out of focus by my loneliness! This is where even toilet jokes get published and your wildest nightmares can come true. You wouldn't see the word 'fart' in the Daily Express but we're different here, we let you kick up a stink if you want to. So at least consider it. All I really want is a friend to fill the space above the comic and beside the sudoku. Even a few spam emails here and there would be a lovely surprise.

LOOK OUT FOR ANSWERS IN OUR NEXT ISSUE!!!

XMAS JOKE CORNER 1. What did Santa say to his wife when he looked out of the window? Looks like reindeer. 2. Last Christmas I gave you my heart, but the very next day, your body rejected the transplant and you died. 3. How does an Eskimo fix his house? Igloos it together.

A N S W E R S

November 2012

A N S W E R S

4. Remember a puppy is not just for Christmas. It can be made into a salad for Boxing Day too. 5. I came home to find someone had smashed my doors in and everything had gone. What kind of person does something like that to an advent calendar? Compiled by James Orr

Send us your jokes and articles to mess.medicalstudent@gmail.com

medicalstudent

Sport

UH Sports Night in aid of Right To Play

Annabelle Mondon-Ballantyne Guest Writer Coordinating curries and a night out for sports teams from medical schools across London seemed like an easy task for the Right to Play committee as it was discussed in a meeting five weeks before the event. The idea of a UH Sports night that would build bridges between medical schools with the aim of having a good night, meeing new people and most importantly raising money for the national

charity Right to Play, was the brainchild of the ICSM project’s president Kalon Hewage. This plan that had so much potential, just needed to be executed in a short amount of time, and luckily for Kal he had the help of an extremely enthusiastic committee. With the venue booked and having extensively exhausted contacts and undertaken a wealth of Facebook stalking, the team managed to overcome their biggest hurdle. They got their idea out and got much of the sporting medical school population talk-

ing – with over 600 tickets being prebrought before the night. However, due to some unfortunate clashes Barts and Kings were unable to attend the event. Nevertheless, on Wednesday the 28th of November, when sports teams would usually drink their own unions dry, teams from ICSM, St George's and RUMS were set up with another team (of the opposite sex) for a curry before descending on the Clapham Grand for dancing and inevitable debaucherous activity. And debaucherous activity there was. As the teams

filtered into the Grand, so did the stories that were only to be continued in the club as the night went on to 3am. It is unusual for us as medical students to have the opportunity to break out of the university bubble, and by nature we are pretty social creatures, so it was not much of a surprise when this event was met with such zest from the teams. However, in an age when things can look promising on 'attending' lists on a Facebook event, only to be met with a poor turnout, it was no surprise that the organisers were anxious.

Despite this, the attendance was staggering, with over 700 students through the door and nearly £4000 made for the charity, so the anxiety was unfounded. Overall, this event could not have been more of a success. Raising money for Right to Play had been the main objective, and with that having been triumphantly reached, the fact that everyone involved seemed to have a great time was the cherry on the metaphorical cake for the organising team. Hopefully, this will not be the last UH Sports Night and it will be firmly cemented in the UH sporting calendar