Medicor 2019 #1 by Medicor MF Magazine

medicor medicinska föreningen’s

2019 #1

student magazine

WHO HOLDS THE KEY TO OUR DATA? page 10

WHICH SURROGATE WOULD YOU CHOOSE? page 14 YOUR GUIDE THROUGH WINTER SADNESS page 24

FROM A TO ZZZZZ THE SCIENCE OF SLEEP

EDUCATION REFORM UNDERWAY page 26

THE REALM OF DREAMS page 30 1

Prelude medicor magasin Grundad 2006. Fjortonde årgången. Utges av Medincinska Föreningen i Stockholm. ISSN: 1653-9796 Ansvarig utgivare: Isabelle Wemar Tryck och reproduktion: DanagårdLitho Utgivningsplan 2019: nr 1, februari; nr 2, maj; nr 3, oktober, nr 4, december. Adress: Medicinska Föreningen i Stockholm Nobels Väg 10, Box 250, 171 77, Stockholm Kontakt: www.medicor.nu medicor@medicinskafWoreningen.se. www.medicinskaforeningen.se Frilansmaterial: Medicor förbehåller sig rätten att redigera inkommet material och ansvarar inte för icke beställda texter och bilder, ej heller för tryckfel. Upphovsperson svarar för, genom Medicor publicerat, signerat frilansmaterial; hens åsikter representerar nödvändigtvis inte Medicors eller Medicinska Föreningens. Freelance material: Medicor retains the right to edit contributed content and does not take responsibility for unsolicited texts or pictures, nor printing mistakes. The contributor agrees, through published and signed Medicor material, that their opinions do not necessarily represent those of Medicor or Medicinska Föreningen.

Photo: Caroline Olby/Olby Foto for Medicor

Dear Medicor readers, As the darkest and coldest winter months in the North are passing, the yearning for daylight among the Swedes could not be more palpable. The lack of sun can have different effects; making some of us retreat home over the holidays to recuperate, like the writer of ”Eat, Sleep, Retreat”. In others, it triggers Seasonal Affective Disorder, a form of depression, which you can read more about in “Your Guide through Winter SADness”. The overarching theme of Medicor 2019 #1 is sleep, which for me is very closely related to the season. Though not as troublesome as Seasonal Affective Disorder, many of us experience increased tiredness and difficulty getting out of bed during the winter months. This is likely due to our circadian rhythm, the biological clock in our bodies, adjusting to the daylight or lack thereof. You can find out more in our cover story ”Sleep, Dream, Wake, Repeat”, in which we explore the science of sleep and interview a prominent researcher in the field, Professor Torbjörn Åkerstedt. Those of you interested in the ways of combating winter-related tiredness should turn to “If You Do Not Snooze, You Lose”, which tells you how to improve your sleep hygiene to rest more effectively. ”¡Viva Siesta!” also makes a case for napping, and “Do Not Tell Young Adults to Count Sheep” investigates the possibility of later school hours to better suit adolescent sleep patterns. For those of you with interest in the spiritual, “The Realm of Dreams” tells us what we know, and what we do not know, about dream interpretation.

Cover: Photo by Isabelle Wemar for Medicor. 2

An entire magazine on sleep could be tiresome, so we have mixed it up with some hot topics. Our Science section discusses data protection. The Global Focus section dives deep into the debate surrounding commercial surrogacy. Campus explains the upcoming reform of medical education in Sweden, which may affect students as soon as fall 2020. Culture reflects on the current political climate in Sweden and the scandal surrounding the Swedish Academy. The aforementioned topics are controversial to varying degrees, so be aware that the articles may contain some polarising comments. As always, the opinions are those of the writer, not of Medicor. However, Medicor is happy to facilitate debate - if you have a view that you want to share, get in touch with us! Now, if you will excuse me, my circadian rhythm is compelling me to finish this piece and go to sleep.

Wishing you all a joyful read and sweet dreams, Isabelle Wemar Editor in Chief

Overture 6

SCIENCE 6

DO NOT TELL YOUNG ADULTS TO COUNT SHEEP

8 10

THE PANDEMRIX VACCINE WHO HOLDS THE KEY TO OUR DATA?

GLOBAL FOCUS

11 12 14

¡VIVA SIESTA! SUN, SEA AND SURROGACY WHICH SURROGATE WOULD YOU CHOOSE?

COVER STORY

SLEEP, DREAM WAKE, REPEAT

CAMPUS

IF YOU DO NOT SNOOZE, YOU LOSE

24 25

YOUR GUIDE THROUGH WINTER SADNESS EAT, SLEEP RETREAT

EDUCATION REFORM UNDERWAY

PRESIDENTS’ WORD

17 25

CULTURE

THE REALM OF DREAMS

OPINION: THE STALEMATE IN SWEDISH POLITICS

SNILLE OCH SMAK

medicor

Isabelle Wemar • Editor in Chief Paula Valente-Silva • Associate Editor Lauren Lyne • Editor of Campus | Patrik Bjärterot • Editor of Science Millie Cepelak • Editor of Global Focus | Yolanda Rao • Editor of Culture

Karyn Lewis, Lauren Lyne, Maria Lysandrou, Milja Miettinen, Yolanda Rao, Elizabeth Vaisbourd, Paula Valente-Silva, Isabelle Wemar • Layout Design | Giovanni Cioffi, Sunjay Jude Fernandes, Lauren Lyne, Milja Miettinen, Victoria Muliadi, Natalie Sippl, Isabelle Wemar • Photographers| Josefine Andersson, Patrik Bjärterot, Millie Cepelak, Giovanni Cioffi, Sunjay Jude Fernandes, Leif Karlsson, Markus Karlsson, Sofia Pilström, Irina Polishchuk, Yolanda Rao, Dasha Shvaiskovskaya, Elizabeth Vaisbourd, Emmanuel Zavalis • Writers | Charlotte Jackson, Johanna Hagman, Irene Kessler, Theresa Mader, Sofia Pilström, Yolanda Rao, Sissela Sjögren, Gunter Yeagle, Emmanuel Zavalis • Proofreaders | Gonçalo Brito, Makyzz/Freepik, Caroline Olby/Olby Foto, Pexels, Pixabay, Unsplash • Other Graphics

Photo: Isabelle Wemar for Medicor

Aperture Sleepless in Stockholm. As the full moon is rising over Sankt Eriksbron, the ice on MĂ¤laren is slowly melting; a sign of spring or of global warming? Maybe the cars racing by on the road below have something to do with it. Want to showcase your photography skills? Contacs us on Facebook or email medicor@medicinskaforeningen.se and you just might see your photo here in the next issue of Medicor.

SCIENCE

Do Not Tell Young Adults to Count Sheep by Markus Karlsson Sleeping Through Puberty Starting from our early teens, we tend to go to bed later and later, something which has popularly been attributed to external factors, social activities in particular. However, this does not account for the whole picture. It seems that, during adolescence, we humans experience a shift in our natural sleep cycle, resulting in an average delay of 2-3 hours compared to the preteen years. This shift persists into the early twenties and is confirmed by a corresponding delay in endocrine rhythms, that remain even after several weeks of attempted sleep schedule regulation. However, society pays little heed to the whims of our developing brains. School generally starts the same time of day from elementary until high school. Meanwhile, in a world with a preponderance of constantly-connected handheld devices, it is all too easy to succumb to late-night browsing through our social media feeds or watching just another episode on Netflix. The resulting lack of sleep may make us try to compensate by sleeping in on the weekend. This variation in school day and free day sleep-wake patterns has been termed “social jet lag”, and its size correlates with adverse effects on school performance. This raises an interesting question: would compensating for adolescents’ sleep pattern shifts by delaying the start of the school day improve their academic results? Early findings Initial studies seemed consistent with this idea. Data from an early small-scale study published in 1998 suggests that moving school starting time from 08:25 am to 07:20 am does not impact the average time a student went to bed, resulting in reduced total sleep time with adverse effects on academic results, traffic safety, and psychological well-being. Indeed, more evidence that early school starting times correlates with increased health risks has since been released, with studies done in a multitude of countries, including academic heavy hitters such as the US, UK, Singapore, and Hong Kong. The topic has received particularly increased attention during the past couple of years, giving rise to a number of sys-

tematic reviews of the available evidence. However, according to a Cochrane article published in 2017, most of the evidence is of low quality, and while results generally point in a promising direction, it is hard to draw any definitive conclusions. Sleepless in Stockholm? So, what is the lay of the land in Sweden? Hypothetically, one might think increased levels of sleep disturbances to be a possible contributing factor to poorer school results, as observed in, for example, the international PISA studies of the OECD. However, assuming this factor is similar across developed countries, it would not explain the relative drop in Swedish rankings since 2000. Indeed, a 185-page publication by the OECD on recommendations for improving the Swedish school system suggests nothing of the sort. Rather, it recommends the establishment of broader strategies for education reform – specifically concerning equitable quality, ensuring high-quality teaching, and school selfevaluation with accountability for improvement. Additionally, no Swedish trials have been performed so far and many of the schools studied in earlier trials have gone from a starting time of 07:30 am or earlier to starting at 8:30 am, which is already a common starting time here. Indeed, according to pediatrician Olle Hillman, who has long followed the topic and authored books in Swedish on the subject, domestically performed studies would be required to confirm the idea before any schedule changes are made. Further, such a change might not mesh well with the rest of our society. If school starts – and ends – later in the day, what will happen to after-school activities? Swedish stores and establishments generally close early, and there are few public spaces for adolescents to hang out in the evening. This might have a negative effect on their social development and on public life. Do late risers catch the worm? Most studies on the topic to date have compared starting times at or before 9:00 am. However, in a trial released by the open-access publisher Frontiers in 2017, a before-after-before intervention was

“Moving school time from 08:25 am to 07:20 am [...] resulting in reduced total sleep time with adverse effects on academic results, traffic safety, and psychological well-being.”

used, where starting times were changed from 8:50 am during the first year to 10:00 am during the second and third year, and back to 8:50 am during the fourth. The later starting time was associated with reduced absence due to illness and improved academic performance, which suggests that even later times may in fact be optimal for the age range of 13-16, which was included in the study. The caveat is that adolescents may in the longer term use the opportunity to stay up even later, partly reducing the potential benefits. According to Olle Hillman, one year after delaying schedules, it is common to see just around half of the extra morning time being used for sleep.

“The caveat is that adolescents may in the longer term use the opportunity to stay up even later, partly reducing the potential benefits.” Blue-light nation There is evidence that exposure to blue light from the backlit screens of modern devices, such as smartphones and computers, suppresses the production of melatonin, a hormone involved in regulating the sleep-wake cycle. More specifically, melatonin promotes the onset of sleep, and is produced in the pineal gland of the

brain upon signaling from the suprachiasmatic nucleus. This nucleus, in turn, receives signals from the retina of the eye, registering information about light levels in the surrounding environment.

“Could the recent proliferation of handheld devices be affecting sleep cycles in the general population?” Concerningly, screens disrupting this system have become all the more widespread in recent years; modern smartphones first started to hit the market in 2007, and they have since been widely adopted by the public. This brings us to another interesting question: could the recent proliferation of handheld devices be affecting sleep cycles in the general population? A prospective study published in 2016 by Christensen et al. used an app to directly measure smartphone screen-time in users; in particular, they found that average screen-time immediately before – and after – the supposed bedtime was associated with worse sleep quality and longer sleep onset latency. As quoted in the study, more than half of smartphone owners leave their devices near the bed, which is clearly an unproductive habit as far as quality of sleep is concerned.

SCIENCE SCIENCE Another interesting question is thus: might it be becoming harder for people to enact healthy sleep habits overall? Of course, these issues require public education and taking responsibility for changing one’s habits, but one pragmatic way to help ameliorate the problem might be to push starting times later for all activities, including work. Perhaps this could make it easier for people to reach a sufficient sleep duration, just as it does in adolescents, barring people stay up even later due to the increased opportunity to do so. What can we do for now? To conclude, in the face of their naturally delayed sleep phases combined with early starting times of the school day, adolescents generally experience a lack of sufficient sleep. Hypothetically, this may be exacerbated by modern habits surrounding the use of handheld devices. There is evidence from other countries that delaying school start times may lead to better health and improved academic performance, but further investigation in a Swedish setting is needed. Meanwhile, young adults or not, we can all make sure to do the sensible thing: go to bed on time, put your smartphone away, and get some proper shut-eye. It will do you good; I promise! •

SCIENCE

The Pandemrix Vaccine – a gross violation of the “trust, but verify” principle

by Dasha Shvaikovskaya

Many of us still remember the controversy around the “special” influenza outbreak in 2009: everyone on TV, radio, and everywhere around you was talking about the scary “swine flu” illness. Obviously, there are some reasons for it: an uncontrolled spread of the severe influenza virus that had no effective treatment options and the number of infected people was growing exponentially. Doesn’t sound fun, does it? The World Health Organization had declared the H1N1 influenza a pandemic in June 2009, when almost 30.000 cases of this completely new strain of virus had been reported in 74 countries. The pandemic state & the rapid spread of the virus called for “desperate measures”, and one of them was implementing the swine flu vaccination programme that was not proven safe to begin with! What is swine flu? Swine flu (officially known as 2009 H1N1 type A influenza) is a viral human disease. Normally, the strains of the swine influenza viruses (SIV) are only endemic in pigs. However, this particular subtype - H1N1 has acquired the ability to infect humans as well due to its specific gene reassortment, including some genes from birds, pigs and humans. This “special quality” allowed for the swine H1N1 virus strain transmission to humans, thus making it the zoonotic swine flu. Interestingly, the symptoms of zoonotic swine flu in humans are similar to those of “regular” influenza: chills, fever, runny nose with a sore throat, muscle pains and headache, respiratory symptoms like coughing and shortness of breath, as well as weakness, and sometimes - diarrhea. Therefore, specific lab tests like real-time PCR or viral culture are needed to distinguish H1N1 from other forms of seasonal influenza. H1N1 outbreak in numbers According to data from the US Centers for Disease Control and Prevention (USCDC), “approximately 60.8 million cases, 274,304 hospitalizations, and 12,469 deaths occurred in the United States due to pH1N1 from the 12 of April 2009 to the10 of April 2010”. In Europe, the numbers are just as striking: 925 861 cases of influenza-like-illnesses (ILI) from 27 reporting countries and 7 202 014 cases of acute respiratory infections (ARI) were reported

by the European Influenza Surveillance Network (EISN). Moreover, the population groups that were mainly affected during this pandemic were different from those suffering from interpandemic influenza: normally, approximately 90% of people dying of interpandemic influenza deaths are those aged 65 years or older. However, based on the ECDC reports of confirmed deaths (2009 “swine flu” pandemic), the opposite was observed for this pandemic, with nearly 80% of these deaths under the age of 65 years. In addition, several national studies found that around 25 - 30% of “swine flu” pandemic deaths were in completely healthy young adults. Pregnant women were also found to be a high-risk group.

“...around 25 - 30% of “swine flu” pandemic deaths were in completely healthy young adults” Any way to protect ourselves? There are a few intervention options to both seasonal and pandemic influenza outbreaks, like using antiviral drugs for prophylaxis, hygienic measures (washing hands more often, appropriate use of tissues etc,), school closure for children and “corporate solidarity” aka staying at home when sick for adults, and, of course, vaccination. While the first bunch of options are effective to prevent the transmission of seasonal influenza on the community level, vaccination programs

are often implemented after receiving a “green light” from the national health organisations. But what about their safety and possible side-effects?

“The specific pandemic vaccines showed a good immune responsee with an acceptable safety profile”ECDC, 2010 New “swine flu” vaccines: safe & effective? Here comes the interesting part! Despite the official ECDC report from 2010 stating that “the specific pandemic vaccines showed a good immune response with an acceptable safety profile”, it wasn’t actually the truth! In the UK, for instance, credible organisations like the Department of Health, British Medical Association, and Royal Colleges of General Practitioners, were trying hard to convince NHS workers to get vaccinated by telling them that they “Fully support the swine flu vaccination programme as the vaccine has been thoroughly tested”. However, The “Pandemrix” vaccine developed by the pharmaceutical company GlaxoSmithKline was later linked with a number of various adverse effects: up to 2nd of December 2009, 253.8 adverse effects per million doses of vaccines had been administered, with 75 serious adverse events and 3 deaths among them. To make matters worse, a severe neurologi-

SCIENCE

Photo: Pixabay

Photo: Flickr.com

cal disorder affecting the brain’s ability to regulate sleep-wake cycles in humans - narcolepsy - was massively diagnosed in the UK and the other European countries, with majority of new cases being discovered in patients who received the pandemic “swine flu” vaccine, including children and people with cardiovascular diseases, diabetes, and asthma. Was it a random association? Indeed not. How could this situation have occurred? The answer is simple yet scary: not enough clinical trials of the “Pandemrix” vaccine were done prior to implementing the aforementioned vaccination program and giving the vaccine to 6 million people in the UK alone. Even though the “Pandemrix” vaccine was approved by the European Medicines Agency (EMA) and the manufacturer, GlaxoSmithKline, was given an indemnity by the governments of the UK, France, Germany, Canada and USA, the vaccine could not have been distributed to the population simply because it was not safe enough.

“Not enough clinical trials of the “Pandemrix” vaccine were done prior to implementing the aforementioned vaccination program and giving the vaccine to 6 million people in the UK alone”

Risks justified? The overall incidence rates of narcolepsy differed substantially between the signaling countries - the ones which first reported the association (like Finland and Sweden) - and non-signalling countries after the start of the vaccination campaign. Some case studies from the other parts of the world have also been reported. For instance, a 15-year old boy from Cuba had developed a rare sleeping disorder - narcolepsy with cataplexy (muscle weakness triggered by emotional factors) - following a Pandemrix vaccination in his hometown Havana. Even though narcolepsy which is the most common type of central hypersomnia, the boy could not get the right diagnosis for many months. The unexplained fatigue, increased appetite at night and consequent weight gain have led him to seek medical attention in November 2010, almost 6 months after he received the well-know Pandemrix vaccine against H1N1 influenza. He also started experiencing sleep attacks during school classes and muscle weakness episodes. No physical or neurological examinations could rule out the cause of his rapidly progressing disease. Only after the Polysomnographic study that was performed in February 2011, the boy was finally diagnosed with narcolepsy with cataplexy and received proper treatment that allowed him to continue studying and living a relatively normal teenager’s life. Unfortunately, his case was not the only one - many young people in Europe, the United States, and Brazil were diagnosed with a similar condition. By January 2011,

there were also 162 reported cases of narcolepsy after vaccination with Arepanrix™ (the “sister”-vaccine of Pandemrix from the same producer). However, despite all these reported cases, the discontinuation of the vaccination programme did not happen. You might be wondering - why? Partially, the agreement to grant licences to pandemic vaccines was based on data from pre-pandemic “mock-up” vaccines produced using a different virus (H5N1 influenza). Then, provide vaccine manufacturers like GlaxoSmithKline indemnity from liability for wrongdoing, thereby reducing the risk of a lawsuit stemming from vaccine-related injury. Sadly, such “agreements” will no longer serve all the people who developed narcolepsy following a Pandemrix vaccination. The case of the Pandemrix vaccination has unfortunately shown, that sometimes the economic interest of a company can outweigh the possible health risks of the patients. Is there something to learn from? Most definitely.

“Sometimes the economic interest of a company can outweigh the possible health risks of the patients” To conclude, one must ask the authorities the following question: how can we ensure the vaccine safety in the future for the sake of transparency during public health emergencies? •

SCIENCE

Who Has the Key to Our Data? Are we taking information about our digital life for granted? by Patrik Bjärterot

Modern society has brought many good inventions, many would credit advances in transportation as the greatest achievement, gastronomists might credit the way modern life has improved cooking, but most would agree that the growth of technology is the best thing to have happened. However, with advances in technology comes the expansion of technology’s byproduct: data. According to IBM, 2.5 exabytes (2.5 billion gigabytes) of data were generated every day in 2012. 75% of which was text, voice and video. Subsequently, with this kind of expansion comes many challenges; the biggest one: security.

Encryption, the guardian of data One major improvement in data protection is the advancement of data encryption, a core part of data protection and security. It is the process of encoding a message in such a way that it can only be read by authorized people. It could be described as a safe where the key is hidden somewhere else. You can see the safe, but not see what is inside unless you have the key.

You can see the safe, but not see what is inside unless you have the key. There are two main types of encryption. One is called symmetric key and the other is called public key. Symmetric key has the same encryption and decryption key, meaning that the same key is used to lock the safe and open the safe. An example would be the Enigma machine used by Germany in the second world war. In contrast, for publickey encryption schemes, the encryption key is published for anyone to use and encrypt messages, although, only the receiving party has access to the decryption key.

The dark side of data protection The digitalization of criminal activity has led to a few ethical issues with encryption, a lesson the FBI would come to learn in 2016. The FBI were investigating an Apple iPhone used by one of the perpetrators in the San Bernadino terrorist attack. In order to access the phone, they wanted Apple to create and electronically sign new software that would enable the FBI to unlock the phone. At first, it might have seemed like a good idea to allow for judiciary bodies to access information about criminals in the matter of law. However, what might not have been as evident was that every backdoor used by the FBI, police or others, would also be in danger of hackers, making the matter a real conundrum.

At first, it might have seemed like a good idea to allow for judiciary bodies to access information about criminals. The issue with hackers will always be a persistent one, so now the question becomes, how will the developers stay a few steps ahead of the hackers? One way would be to make sure encryption and security are always improving. However, when considering the time and resources it would take to

make sure everyone always has the newest and greatest security, it would be near impossible. The best solution now is to do our best to keep the security intact, minimize breach, and hope there is a great solution in the future. Data security, a story about fragility? Someone watching the news would not be unfamiliar with stories about groups of hackers accessing classified and sensitive information. An example of a huge data security breach happened in 2013 with Yahoo. This attack compromised the real names, email addresses, dates of birth and telephone numbers of 500 million users. Sadly, the misfortune did not stop there. Three months later, a different group of hackers compromised 1 billion accounts. However, this information was later revised by Yahoo to say that in fact, all 3 billion user accounts had been compromised. Moving on It is certainly a very humbling and scary fact that a few coders can access most information in the world. This gives great incentive to continue the goal of better data protection and security. Hopefully, people will think twice about their own data protection and privacy. •

GLOBAL FOCUS

¡Viva Siesta!

– the world’s favorite nap by Elizabeth Vaisbourd

Nap, noun; a short sleep, especially during the day. Student’s best friend, or worst nightmare. We all avoided them like the plague as kids, but now they are coming back as unattainable dreams; a chance to pause our hectic day and let our minds and bodies have some rest. Whether at home, on public transportation, during on-call duty or even occasionally during a lecture, most of us, students, have had at least one nap this month, with studies suggesting figures of up to 75% [1]. Here, we will look into the history of naps, from the early days to today’s culture, and dive into the health implications of getting some midday shuteye. The origins of the Siesta The habit of daytime snoozing originates in warm climates that are located around the equator, such as Central America and the Mediterranean, but most customary in Spain and Spanish-speaking countries, where it served as common practice and is widely known as a Siesta. The need for taking the daytime off was to avoid working outside during the hottest hours of the day; recharge towards the afternoon and avoid daytime drowsiness. A common outcome of the habit was shops and public buildings being closed during designated napping hours, with remains of this practice still existing to some extent to this day. Nowadays, our fast-paced life leads 1035% of adults to experience sleep deprivation, termed at less than six hours of sleeping per day [2], with 55% taking more than one nap per week [3]. The question “to nap or not to nap” does not occupy the minds of the ´common folk´ (and myself in particular) exclusively: even NASA is trying to write a program that will advise astronauts when to take naps while in the outer space! 11

Power-napping: A medical miracle? After thousands of years of napping, recent studies are confirming that the practice does indeed have its benefits. It has been shown that naps that last no longer than 30 minutes - power naps - are characterized as causing little to no sleep inertia- the feeling of post-sleep grogginess and impaired performance. Napping facilitates enhanced emotional processing, alertness and cognitive function, and could even be used as a primitive treatment for inflammatory diseases, as it is known that sleep is a regulator of immune processes

have relied heavily on the daily doze-off to boost their creativity and alertness. So cozy up with this fresh issue of Medicor, a cup of your warm beverage of choice, and have a restful day, be it with or without a nap! •

On the other hand, some health complications emerge from frequent and long napping due to sudden peaks in blood pressure and heart rate upon awakening. Regular practice of napping may result in permanent increase of cardiac-related problems and diabetes, especially in middle aged to older adults.

References 1. Ye L, et.al. Napping in College Students and Its Relationship With Nighttime Sleep. Journal of American College Health. 2015 2. Faraut B, et. al. Napping: A public health issue. From epidemiological to laboratory studies. Sleep Medicine Reviews. 2017 3. Sleep Foundation. Summary of Findings. www.sleepfoundation.org. 2015

Just sleep on it... Worry not, fellow nappers, we are in a fantastic company! From Leonardo Da-Vinci, to Albert Einstein and John F. Kennedy, many of history’s great minds

“Napping facilitates enhanced emotional processing, alertness and cognitive function”

GLOBAL FOCUS

Sun, Sea and Surrogacy by Millie Cepelak

Parenthood is a life-changing experience and is unique to every individual who welcomes a child into the world. As society moves forward, we have changed our ´traditional´ view of what constitutes a family, and instead are embracing the many different and wonderful ways that families can be built. As long as parenthood remains such a emotional aspiration for many, it makes sense that we continue to improve the ways that we can help individuals realize this particular dream. Unfortunately, many couples´ quest to fulfill their dreams of welcoming a child into the world have already come at the expense of vulnerable women. Last year alone, 32 surrogates were jailed in Cambodia on human trafficking charges, and an Australian nurse was jailed in the country for running a surrogacy clinic. As many previously popular surrogacy destinations tighten their laws, “surrogacy tourism” is now making its way to Europe. Surrogacy or trafficking? In December 2018, 32 surrogate mothers were released from jail in Cambodia. They had been jailed in June the same year on charges of human trafficking, with Cambodia´s Secretary of State for the Interior Minister Chou Bung Eng saying that the children in question are “sold as ´goods´” (1). The women were released on “humanitarian grounds” following an agreement that they would raise the children as their own. An unnamed official from the National Committee for Counter Trafficking told the BBC that “While the women had committed a crime, their babies were innocent.” After Thailand imposed limits on surrogacy in 2015, Cambodia chose to ban surrogacy in 2016. In November of that year, Australian nurse Tammy Davis-Charles was arrested and sentenced to 18 months in prison for providing surrogacy services in Cambodia.

Who risks the most? These stories are really just the tip of the iceberg when it comes to surrogacy. Many of us in Europe may have only ever had surrogacy presented to us as an act of altruism: reading stories about glowing Western surrogates who take on the role because they love the experience of being pregnant, and the feeling they get when they see a couple meet their baby for the first time. Sadly, the overwhelming reality is that differing laws, both internationally and, in some cases, even domestically, have has created the phenomenon of “surrogacy tourism”. This has become a hot political struggle between government, clinics, and prospective parents. No matter what the outcome of these struggles, the consequences are almost always landed on the surrogates, many of whom entered the agreement as the most vulnerable party.

For prospective parents, Asia had in recent years been popular due to its price and lack of regulation: medical costs are cheap, laws against gay couples or single people hiring surrogacy services are lacking, and many impoverished young women prepared to take on the burden in exchange for a enticing fee are rising. In the case of Australian nurse DavisCharles, the Guardian reports that surrogates at her clinic were paid about 10,000 USD per pregnancy (2). To make a comparison, according to the International Monetary Fund, the average household income in Cambodia is 1,490 USD. In the United States and Australia, surrogacy services can cost around 150,000 USD (3). Budget gestation: Europe’s newest surrogacy destination If you´re hoping by now that the moral implications of surrogacy tourism are

GLOBAL FOCUS

Commercial surrogacy has left women jailed in Asia; now it is coming to Europe limited by geography, think again. With Thailand, Cambodia and India clamping down on the ´baby-belt´ that surrogacy tourism has created, would-be parents are flocking to a new area with the same old formula: Ukraine. Apart from the fact that surrogacy is legal there, the country has found itself popular due to its liberal laws that ´”recognises the ´intending parents´ as the biological parents from the moment of conception.” (5) But, just as in Asia, there are cases where needy surrogate mothers are often losing out to clinics that refuse to operate ´above board´. “We have seen examples where Ukrainian agencies have refused to pay the surrogate if she doesn’t adhere to strict requirements, if she miscarries,” Sam Everingham of Families Through Surrogacy tells the BBC. The BBC reports that the cost for surrogacy services is the Ukraine is on average 30,000-40,000 USD. Identity crisis The different laws surrounding surrogacy also have complex and potentially devastating consequences for children born to surrogates. Because there are no internationally recognised laws surrounding surrogacy, children born via surrogate in a given country, for parents of a different nationality, could be born stateless, and it may take several months before the parents can take the child home (4). Different countries also have different views in regards to who can legally be the parent of a child, which can lead to custody problems if the parents of a child born via surrogate later split up, and can also leave the surrogate mother with the

full responsibility for a child if the parents choose to back out of the agreement. Such was the case with “Baby Gammy”, whose surrogate mother claims that his Australian parents abandoned him after learning he had Down’s Syndrome. Conclusion In the case of Baby Gammy, an Australian court ruled that the surrogate mother had become fond of Gammy and his twin sister while carrying them and had decided to keep the little boy. The court also ruled that the Australian parents could keep custody of the baby girl that they chose to take home with them. However, the case prompted Justice Thackray to highlight some of the important considerations that must be taken into account when moving forward with international surrogacy. “Surrogate mothers are not baby-growing machines, or ´gestational carriers´,” she says, and continues: “This case serves to highlight the dilemmas that arise when the reproductive capacities of women are turned into saleable commodities, with all the usual fallout when contracts go wrong.” (6) As with many cases where the emotive subjects of pregnancy, parenthood and family cross paths with law and politics, the question of surrogacy tourism feels like an unanswerable one. A well-defined international law regarding surrogacy agreements that all the key countries affected could agree on feels, of course, highly improbable, and even if it was in place, the cost of running a well-regulated system will always come back to the

´customers´. Those who can’t afford the price of a ´fair´ system will always have a cheaper alternative out there somewhere. Perhaps those of us with a need for ´happy ending´ will have to satisfy ourselves with the testimony of Ukrainian surrogate Ana, who describes the moment that her surrogate child was handed over to its parents: “When (the parents) are crying and thanking you, you feel how much you have done for them,” she says. “[They] told me that I was the most important person in their lives.” (5) After all, if a consenting adult chooses to enter a mutually beneficial agreement with a couple who are desperate for a child, maybe it’s simply the prerogative of the individuals involved, for better or worse? • References 1. BBC News. Cambodia releases surrogate mothers who agree to keep children. 08-12-2018. 2. The Guardian. Australian Nurse Jailed over Cambodian Surrogacy Clinic Has Sentence Upheld. 08-01-2018. 3. South China Morning Post. Cambodia frees 32 surrogate mothers after they vow to keep their babies. 11-12-2018. 4. BBC News. Surrogate babies: Where can you have them, and is it legal?. 06-082014. 5. BBC News. In search of surrogates, foreign couples descend on Ukraine. 1302-2018. 6. The Telegraph. ‘Baby Gammy’ was not abandoned in Thailand, court rules. 14-04-2016.

GLOBAL FOCUS

Which Surrogate Would You Pick? Opinion: At-risk Asian women are birthing our next generation by Emmanuel Zavalis

Nothing has been as easy as it is now, and the world is better for it; no one mourns blockbuster, after all. Society keeps moving forward, however this progress is creating a frontier in which there has to be a discussion on how far one can go.

Adopting and Surrogacy Adoption is seemingly a good deed and (arguably) easy. The difficult part of it for many is the baser drive of wanting your child to look like you, which is where many couples fold. And this is where the rubber meets the road, where this quest for ease and breezing through life — usually for a hefty sum — comes to its extreme, where things get blurry and consciences wanton. The topic of surrogacy has gained a lot of momentum, partly due to celebrities such as Elton John and Kanye West turning to surrogates to carry their children. Genetic or gestatory? There are three types of surrogacy. Genetic surrogacy, the most common type, is when the prospective father fertilizes the egg of the surrogate; total surrogacy where both the egg and the sperm come from someone but the buyer, and then there is gestational surrogacy where both egg and sperm have been fertilized in vitro with the surrogate mother having no genetic link to the baby.

The Legal Aspects Legally the process is complicated, and usually the surrogacies are not performed in high-income countries. Belgium and the Netherlands allow only for altruistic surrogacies, and only one hospital in each country respectively is allowed to facilitate surrogacies. Belgian and Dutch laws have a distinction- as do many laws- between altruistic surrogacy and commercial surrogacy, with the obvious question being raised, where the line is drawn. Altruistic surrogacy is when the person does it without payment and commercial surrogacy is when you get paid for it. It sounds straightforward but it isn’t. Altruism isn’t really part of the deal when having children, especially when it comes to carrying someone else’s. You either do it out of pity or love or any other emotion that in the end comes back to you feeling better and even if you consider egoistic altruism deserving of the title altruism this is still a very niche type of surrogacy that usually ends with a prompt cash exchange anyway. I do not mean to edify but

it is just how it is: altruistic surrogacy is a conceit. In France it is illegal to both have a child through surrogacy as well as having a baby through surrogacy in another country and bringing it home. German law doesn’t allow for it either considering the human dignity inviolable and making children a subject of a legal contract inacceptable. The UK hasn’t made the contracts for surrogacy enforceable even though the act in itself is legal (altruistic surrogacy) allowing only for a reasonable compensation. Meaning that surrogate mothers are technically the parents after birthing the children. Furthermore, complicating the matter British courts have permitted payments that go beyond reasonable expenses to surrogates overseas. In the U.S. surrogacy within its borders is largely unregulated on the federal level leaving it to the states to decide. Most states are favorable to surrogacy or lack the legislation but still hold a significant precedent for them to be called “surrogacy-friendly”.

When it comes to international surrogacy if the child lacks biological relation to a U.S. citizen parent the child cannot acquire a citizenship automatically at birth. Should the child be born to a U.S. citizen father which it has biological connection to and a surrogate mother that is not a citizen, it is treated as a birth out of wedlock to a US citizen father and the father would have to meet additional residence requirements. (1)

“It has been projected that in Sweden there will be more surrogacies than adoptions this year.” Swedish Report It has been projected that in Sweden there will be more surrogacies than adoptions this year, even though surrogacy within Swedish borders is illegal (2). International surrogacy on the other hand is not and it is in high demand. Sweden is quite interesting because there has been a push for trying to legalize surrogacies in Sweden, enough for an inquiry to be started. This inquiry came to more or less the same conclusions mentioned above on the altruistic surrogacy and reasoned that no research has been done on the physical and psychological effects of having been born through surrogacy and that it could be dangerous for the child. It is harsh but after all the SMER (Swedish medical-ethical board) concludes that having a child is not a human right (3).

I do not think having a child should be as easy as online shopping. Levity in such matters is not going to negatively affect the parents nearly as much as it is going to affect the children and the surrogates. •

GLOBAL FOCUS

“I am actively trying to step on toes here, because [...] I want a reaction.” References 1. Ukranian Family Law. International Surrogacy Laws. www.familylaw.com.ua. Accessed on 25-02-2019. 2. SVT Nyheter. Antalet barn som föds med surrogater ser ut att bli fler än internationella adoptioner. 18-09-2018. 3. SVT Nyheter. SVT avslöjar: Utredare säger nej till surrogatmödraskap. 23-022016. 4. Mirror UK. Shocking pictures show Chinese baby factory where mothers are paid £10,000 for their newborns. 13-012015. 5. The National. Thai surrogate offers clues into Japanese man with 16 babies. 03-09-2014. 6. CNN. Surrogate offered $10,000 to abort baby. 06-03-2013.

“Having a child is not a human right. ” Children Are Not a Commodity My word choice might seem acerbic at best, because I am actively trying to step on toes here, because this aspect is not discussed enough, I want a reaction. One liberty is given, and one is taken, and one cannot argue on this topic without considering the undue pressure these women are under, the commercialization of children and the exploitation of these at-risk women. Many people will have a histrionic retort to these facts, one happy family does not justify the other -many- problematic outcomes. All ranging from a baby factory in China with women housed and fed for them to make babies (4) to an Asian millionaire that wanted to buy about a dozen children a year (5). Children are not a commodity in that way, because what happens if they turn out to be born disabled? There was a case of woman some years back whose buyers wanted to make the surrogate abort, because the baby had developmental issues (6). What happens in that case? Is it branded as faulty manufacturing and sent back to the factory?

The Editorial Board of Medicor (left to right, back to front): Theresa Mader, online coordinator Lauren Lyne, campus editor Millie Cepelak, global focus editor Isablle Wemar, editor in chief Jonny Nordström, web designer Patrik Bjärterot, science editor Yolanda Rao, culture editor Paula Valente-Silva, associate editor Irina Polishchuk, social manager Chaitra Srinivas, Instagram manager

This is teamwork. Medicor is one of the biggest student magazines in Sweden, and the only one published in English. We are very proud of the quality our content, and we need your help to keep on raising the bar. We are always looking for writers, photographers, proofreaders, layout designers and illustrators. Join our Facebook group “Medicor Contributors” or email medicor@medicinskaforeningen.se to find out more.

COVER STORY

SLEEP, DREAM, WAKE, REPEAT by Sunjay Jude Fernandes

Ever woken up in the middle of the night with a eureka moment? Or the sudden crushing realization that you could have done something better? Your brain doesn’t go to sleep when you do. In approximately the first 90 minutes as you transition from wakefulness to sleep your brain begins to slow down along with your heartbeat and breathing and your muscles relax. Then comes the REM or rapid eye movement stage of sleep. Here your brain returns to almost waking levels of activity along with your heart rate and blood pressure. Most importantly at this stage your voluntary muscles are temporarily paralyzed to prevent you from - say - walking right out the door. Leaving you to dream about everything from rainbows and unicorns to becoming the ‘king of the world’, all in the safety of your bed. Sleep is an important part of life, allowing your body to relax, recover from the days’ activities and detox. Not surprisingly then that disturbed sleep arising from a number of different disorders can impact daily life quite drastically and lead to further health complications. Photos: Sunjay Jude Fernandes and Natalie Sippl for Medicor. Model: Natalie Sippl.

COVER STORY

Dreams: Do we really need them? Dreaming can be a pleasant or terrifying experience depending on you mental health and experiences.

In Scandinavian folklore, the Sandman sprinkles sand into children’s eyes and brings good or bad dreams depending on their behavior. Normally, you’d wake up screaming if someone put sand in your eyes, but hey its folklore. In roman mythology, Somnus the god of sleep had a thousand sons. One of them was Morpheus the god of dreams aka. the Sandman. This is not the same Morpheus that pulled Neo out of the Matrix, but he is inspired by the Sandman. Where am I going with this you may ask. Well dreams, be it folklore or our understanding of it scientifically, is not a concrete science but left to interpretation. No doubt you can wake up from a dream feeling very good, very bad or just plain confused.

Scientific speculation states dreams are more a necessity than a nonsensical byproduct of unconscious brain activity. In REM sleep the brain is completely devoid of a key anxiety triggering molecule called noradrenalin. This allows the brain to re-process upsetting memories in a calmer and safer environment. So, if you wake up with that eureka moment or that crushing realization, it may be your brain ‘figuring’ something out. In non-REM sleep memories can be blended together in abstract ways allowing the brain to process and incorporate acquired 18

knowledge. So, if you dream of a monkey riding a unicycle over the rainbow and then you land on a dolphin who thanks you for all the fish before it leaves planet earth to return home, just let it go. Your brain is processing. The stuff of nightmares While occasional nightmares occur and are normal, in certain diseases their frequency and interpretation can change. Depression is a common and serious medical disorder which affects the way you feel, think and your daily activities. Individuals with depression experience frequent nightmares. Bipolar disorder is a disorder where individuals have episodes of depression followed by mania or extreme feelings of irritability, aggressiveness, happiness or show risky behavior. Negative dreaming can also increase or decrease between the depressive and manic states in individuals with bipolar disorder. Lower recall rate of dreams and playing less of a role in their own dreams is also seen in individuals with depression. Schizophrenia is a mental disorder characterized by abnormal behavior, a reduced understanding of reality, confused or unclear thinking among others. Frequent hostility in dreams directed towards the dreamer is seen in these individuals. Personality disorder is a disorder where individuals have impulsive behavior, disturbing ways of thinking and problem controlling their emotions. These individuals show more distress within and after awakening from dreams. With nightmares increasing in frequency with more severe symptoms. REM sleep behaviour disorder results in individuals acting out their dreams due to a malfunction in the temporary paralysis induced by REM. This results in small hand movements to more aggressive actions such as kicking, punching or jumping out of bed. Often leading to injury, can also lead to individuals developing Parkinson’s disease.

”Do dreams meaning?”

really

have

Can we really interpret dreams? While most of us have vague dreams which can be from the activity of a recovering, self-repairing brain, recurrent dreams tell another story. Some themes in these recurrent dreams strangely are shared by a number of us. Some dream of whimsical things like flying, while others dream of serious things like falling. Still others dream of being naked in public, sex and many more such things.

Psychoanalysis which is a set of theories and therapeutic techniques suggested to study the unconscious mind gives different interpretations for our dreams. Two of its most famous scientists were Sigmund Freud and Carl Jung. Freud believed the wishes of the dreamer were manifested in the content of the dream. While Jung believed dreams were an expression of repressed wishes, often compensating for aspects underdeveloped in waking life.

Though not an exact science, interpretations for flying are happiness, joy, a sense of motivation, for falling is letting go of something you’ve been holding onto, being naked in public is a fear of being embarrassed or ridiculed and for sex is, well I’ll let you figure that one out! We should probably start talking to each other about our dreams more often, if we can remember them. We share day to day experiences far more easily than our dreams. We might end up finding more in common with each other. Sleeping the sleep of the dead Is sleep more important than dreaming? The short answer is - they are not mutually exclusive. Good dreams and a good night’s sleep can bright-

en up the next day. Bad dreams and bad sleep can leave you reacting to the next day very unpleasantly. Good and sufficient sleep can help you eat more healthy, improve your productivity, help you exercise better, improves immune function, etc. Over time a lack of sleep can lead to a number of health issues such as depression, obesity, increased inflammation, increase risk of diabetes, hamper social interactions, and many more. Is too much sleep good? Unfortunately not, it can lead to many of the same problems as a lack of sleep.

So when it comes to how much we should sleep, like many things in life adopting the ‘lagom’ philosophy helps.

COVER STORY Sleep, not too little and not too much. We compromise on our sleep by working excessively, lack of exercise, poor diet, stress, dehydration and of course the darling of first world problems, the smart phone. Can’t sleep? Let’s reach for that phone and before you know it the sunlight creeps into your bedroom. Gaah!! So, if you find yourself sleeping badly and think it’s something you can control then try the health diary. A little aid that helps you document you food, exercise, coffee/tea/alcohol consumption, sleep habits, etc. Over time it gives you insights into what suits you best and at the same time helps you take better control of your lifestyle. Though a little tedious, has long term benefits. Chances are there is an app for it on your smartphone. Oops.

leep apnea is caused by blockage of the upper respiratory system. S While partial blockage can lead to snoring, complete blockage can lead to a halt in breathing followed by choking or gasping for breath

after which breathing resumes. This leads to the brain partially waking up to cope with the choking in addition to heavier breathing. Insomnia is characterized by poor sleep in general due to difficulty in going to sleep, waking up in the middle of the night, waking up earlier in the morning. Restless leg syndrome is a neurological disorder, where an overwhelming and/or persistent desire to move one’s legs due to sensations of itching, creeping, burning, etc. Finally, narcolepsy which is also a neurological disorder is characterized by the brain’s inability to control sleep and wakefulness cycles. This can lead to individuals unexpectedly falling asleep during the day, for instance while driving. Do you experience some of these symptoms sometime? That may be normal, but regularly experiencing these could be a good reason to consult a doctor.

In today’s world considering the amount of opportunity we are bombarded with, and our desire to be everywhere, all the time or FOMO (fear of missing out) we take up more than we can digest. In addition, the minimum amount of required work is not the same minimum it was say 20 years ago. So we have to cope.

But, if we don’t develop our coping mechanisms adequately, we have a very real possibility of burning out. Very often we ‘cope’ at the expense of sleep. When sleep goes out of control While healthy sleep is within our grasp, it requires good health. We can do our best to stay in good health but sometime it eludes us. While many sleep disorders exist some of the common ones include sleep apnea, insomnia, restless leg syndrome and narcolepsy (see text box). Then there are the sleep related issues related to your circadian rhythm. What is circadian rhythm? It’s the internal body clock which sets patterns of brain wave activity, cell regeneration, hormone production, etc. all linked to a 24 hour cycle. Marvelous isn’t it! It can however go haywire, 20

completely out of sync for a number of reasons, like shift work (or even just the odd-schedule!), mental health problems, the above mentioned sleep disorders, pregnancy, menopause, and even changes in time zone. Some of these you can control, like how you deal with jetlag or change of time zone, while

others can be harder to deal with.

The circadian rhythm can go completely haywire for a number of reasons...

-----------------------To get insights into sleep patterns, behaviour and some advice on good sleep, we spoke with Torbjörn Åkerstedt, senior professor at the department of clinical neuroscience; professor emeritus at Stress Research Institutet at Stockholm University. Interviewers: Paula Valente-Silva and Sunjay Jude Fernandes We live in a society were a stressfree life seems impossible. What is the best way to deal with it? Stress is a situation where you are under pressure, which increases metabolic activity and counteracts sleep. A lot of people are pushed by their own ambitions, to show to their environment they are capable. The best way to deal with stress is simply to say no to too many new things. In stressful times, thinking about problems before sleep increases brain activation. Setting aside a few hours before sleep and employing relaxation techniques can increase sleep quality. Odd sleeping hours are known risk factors for developing diseases such as cancer, diabetes, brain disorders, premature cognitive decline, etc. What strategies could help counter this? There are no good ways because it is simply non-physiological. Advice is that they should try get as much sleep, as and when possible and eat healthy. Sleeping in a dark room with low temperature helps in reduction of metabolic activity and heat escape. Is the “8 hours of sleep a night” really the holy grail? No. 7 hours is more likely but depends on age. Some people are born with an efficient sleep mechanism which is inherited, others require longer sleep for the same amount of restitution. But never tell anyone how much

they should sleep cause it gives the wrong impression. As long as you feel alert and non-fatigued during day means you are getting enough sleep. Is a ‘Siesta’ good or bad? A nap close to bedtime will impair sleep. Any sleep you get during the day is reduced from the overall sleep you need. A nap can increase your alertness and your intelligence. Time your nap carefully! Duration of sleep and quality of sleep are not the same. What makes quality sleep? You need duration to have quality. Duration is more important than quality because most people have good quality sleep but reduce the duration. Reducing duration by 50% impairs the quality quite a lot. 7 hours of sleep with a lot of awakenings can be the same as fewer hours with the absence of awakenings. Duration and quality can be affected by lifestyle. What is the difference in sleep pattern between men and women ? Woman sleep little longer and claim to need more sleep. Women have objectively better sleep than men with less awakenings and more deep sleep. This is an enigma. It is a common pattern that the older we get the less we sleep. Why is this? Duration falls from 8 half hours to 6 hours with increasing age . Hypothesis is that with increasing age you under less stress or demands. Learning costs a lot of energy which usually decreases with age. Also, the cortex gets thinner with age and might be that the brain needs less “reconstitution”. Older people sleep less yet feel they got enough sleep Short sleep also predicts dementia. Short sleep means waste removal process in the brain reduces and pro

COVER STORY -teins like tau and beta amyloid start accumulating at least 5 years before symptoms manifest themselves. Sports before sleeping. Is it good or bad? Sports immediately before sleep is not good as it increases metabolism and prevents restful sleep. Muscle pain from exercise can also hamper sleep. However, exercise in the daytime can improve sleep . Sleep is mostly dependent on brain usage, so activities that relate to brain activity can impair sleep more. Sleeping pills – do they provide “good sleep” ? What´s your opinion on it? Consensus is that if you have good sleep, taking pills can be bad because it reduces deep sleep stage. If you have extreme difficulty sleeping they will give you decent sleep but if you do it continuously there is a long term negative effect on mortality and habituation. Usage should be intermittent .However, hypnotics are efficient as therapy for sleep disorders. -----------------------While good dreams and good sleep can be wonderfully exhilarating, the effort to keep them so can sometimes drift beyond our grasp.

But, considering we spend one third of our day sleeping and dreaming there is no doubt it forms a fundamental requirement of life. So go out into the world (aka. The bedroom) and take what is rightfully yours. Don’t just dream it, do it. #sleeplikeababy #notacareintheworld #adultsneedsleepjustlikebabies #medicor_mag • 21

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If You Do Not Snooze, You Lose

CAMPUS

by Sofia Pilström

It feels like a given that to feel and perform our best, we must be wellrested. Still, many of us tend to neglect the physiological necessity of sleep in favour of things that we deem more productive or entertaining, like pulling all-nighters before an exam or, you know… partying. Photos: Lauren Lyne for Medicor.

The importance of proper sleep, and sleeping long enough, cannot be overstated - a 2003 study from the University of Pennsylvania showed that even a two-hour sleep deprivation per night for two weeks drastically decreased cognitive performance in all areas studied. Notably, the difference was greatest between no sleep deprivation and some sleep deprivation; a greater sleep deprivation (four hours lost per night) only slightly increased the negative effects compared to the 2-hour deficit. Improper sleep messes not only with your brain’s memory, mood and concentration, but also with other functions in the body such as your metabolism and immunity. Over time it may even increase your risk of diabetes and cardiovascular disease.

“...what can we do then to ensure that we get the best quality sleep that our bodies deserve?” So, it seems like an important thing to get that shut-eye, but what can we do then to ensure that we get the best quality sleep that our bodies deserve? There are the obvious ones that we’ve all heard a million times: don’t consume caffeine too late, get off your phone and computer a good while before going to bed, and keep your bedroom cool and dark. Some other tips may not be as well-known, though, and who knows? Maybe you can learn a trick or two from these “sleep hacks”:

Keeping your bed a place solely for sleeping makes sure that your relaxation spot doesn’t get associated with the stress of studying, which otherwise can make it harder for you to drift off to dreamland. Try compartmentalising your life!

“It may be appealing to lay in bed late on a weekend, but...” Keep a regular sleeping schedule. Our bodies run off 24-hour clocks, that best keep time when things are predictable. It may be appealing to lay in bed late on a weekend, but getting up at the same time as during the weeks will help you retain a good sleep/wake rhythm - which makes you fall asleep easier and get better quality sleep!

running and cycling are excellent for increasing sleep quality. Taking a hot shower and then stepping into a cool room lowers your body temperature and prepares you for sleep. Also, what’s better than the clean feeling of a shower, new pajamas and fresh sheets? I hope you’ve learned something and will remember it by the time next exam period comes around. Maybe adopt a few tips, up your sleeping game and become superhuman sweet dreams! •

Try to avoid drinking alcohol before going to bed. Although alcohol may make you drowsy, drinking late at night actually decreases your sleep quality, since it prevents you from going into deep REM sleep (which is the phase where you organise and store memories), dehydrates you and may interrupt your sleep for midnight bathroom visits. So maybe keep it for rare special occasions at least! Working out too late gets your body energised and throws your sleepiness off, which is why exercising around 4pm is best to ensure a good night’s rest later. That being said, physical activity does also help you snooze better, so don’t neglect that either. Especially cardiovascular exercise such as 23

CAMPUS

Your Guide through Winter SADness by Victoria Muliadi

The wintry months are here. With the chill rising in the air as darkness falls, one must beware the return of a certain visitor. Commonly known as the ‘winter blues’, it can do a lot more than just put a damper on your holiday spirits. More than the blues Are you constantly exhausted and lacking the motivation to carry out your daily routine? Feeling sleepy at odd hours, or an unusually strong urge to eat? Or are you depressed and uninterested in activities you used to enjoy? If you frequently experience these during a similar time frame annually, our visitor – seasonal affective disorder (SAD) – might be at work. SAD is a periodic form of depression that can be debilitating and should be taken seriously. Its symptoms usually manifest as winter begins and disappear come springtime. In some cases, related symptoms (insomnia, poor appetite and agitation) appear during summer (caused by overexposure to sunlight). Hence, ‘winter blues’ is a rather misleading and inaccurate definition of

“People at greater risk of SAD include young adults...” SAD. While its real causes remain debatable, the onset of SAD is linked to seasonal changes in sunlight levels. Decreased sunlight exposure during winter decreases the levels of serotonin and increases the levels of melatonin, which regulate mood and sleep patterns respectively. Furthermore, shorter daytimes disturb the coordination of the body’s circadian rhythm (‘internal clock’) with ‘external clocks’. Disturbances in the circadian rhythm is also linked to disturbances in melatonin levels. Altogether, these factors lead to depression, lethargy and disturbed sleeping patterns associated with SAD. People at greater risk of SAD include young adults, those living far away from the equator, or with other mental disorders.

Photo: Victoria Muliadi for Medicor.

“Most students are already experiencing high levels of stress...” The student’s winter Students are particularly vulnerable to SAD and should therefore be cautious of its symptoms. Most students are already experiencing high levels of stress, (possibly) depression (a risk factor!) and irregular sleep schedules from their daily battle against hordes of assignments, exams and miscellaneous responsibilities throughout the term. During winter, add in additional work (winter break for students – just a myth?) and shortening daylight hours. The result? An unenjoyable, unproductive holiday: the tiredness and mood slump will not only hamper the students’ ability to focus on work, but also their enjoyment of recreational activities. Here are some tips on how you students can stay fit and keep the winter bleakness at bay: Brighten up: The premise for the popular light therapy is compensating for low

sunlight exposure and restoring both the regular circadian rhythm and melatonin levels. Dawn simulators and light boxes aside, a simple trick you could try at home is to turn extra lights on and light some candles to create a warm and soothing atmosphere. Break a sweat: Exercise is a favourite prescription for depression, as it boosts the production of neurotransmitters and endorphins that reduce depression and additionally promote learning and concentration. If it’s too cold to go for a walk outside, head to the gym or roll out a yoga mat at home - just get moving! Have a chat: Talk to your family and friends about your symptoms. It helps them understand your condition, and they could offer you some helpful solutions. Alternatively, talk to your doctor for advice on therapies. Keep in mind that, unpleasant as it is, SAD is not an uncommon, nor a permanent, occurrence. Identifying symptoms early and taking the right steps to alleviate them can make your dark winter days more bearable. Lastly, stay positive - after all, springtime is coming! •

Eat, Sleep, Retreat: Holiday Food Cures Insomnia

CAMPUS

Home remedies vary greatly in quality and level of scientific evidence to support them. There is the good old cup of warm milk with honey to fight off a cough and the need to layer up before leaving the house to avoid getting ill from what in Italy is known as an “air stroke”. I returned to my childhood home in Southern Italy last Christmas and New Year’s and I decided to conduct a quasi-scientific study on myself. Three weeks later I think I have found a new home remedy: eating cures insomnia. by Giovanni Cioffi Stage one: Arrival You leave the plane with the aftertaste of a Wasa-cracker in the back of your throat. It is hot and sunny. People are in an inexplicable hurry to get out. You pick up your luggage, walk past the crew waving goodbye and continue walking. Someone is there to pick you up. You are glad to see them but still in that weird half-conscious state of near-tiredness resulting from airplane sleeping. Car. Streets. Stoplights. You have arrived at your destination. The family greets you. Christmas Eve is tomorrow. Yet, what is served for dinner the first night makes your stomach kick like an 8-month fetus eager to get out. You eat your body’s weight worth of diverse dishes. You hit the bed. You sleep for 11 hours. Stage one completed. Stage two: Bargaining You wake up in a confused state. Your brain is still working in Swedish and the blurry surroundings, before you put in your contact lenses, make you think that you are late to class. Nope. It is Christmas Eve. The war has begun. You skip lunch. “I need to save my appetite for tonight” you think to yourself. Although, you know it won’t really matter .Fast forward a few hours. The table is set, the relatives have arrived. You hug them and start chatting. Then something happens. Your attention is gone for a few moments. You could be lingering in another room, you could have been away for a trip to the toilet, even a slightly heavier eye-blink will do. BAM. Food is there. Everything is fried. Nothing on that table has ever seen the inside of an oven.“That looks great. It will be fun to have a small taste” you lie to yourself. You eat your body’s weight in fried fish and sleep for 12 hours. Stage two completed.

nights go by from plate to plate, from bed to couch. Time has stopped and now and then you realize that you will have to go back to your studies, to work, or whatever it is you do in your daily life. Those thoughts bring different emotions. They are sometimes dreadful reminders that there is a life outside of the teenage bubble that your childhood home represents, sometimes they are the light at the end of the tunnel that will carry you away and set you free. Those thoughts come to you from the outside like a passing cloud. You push them away and they burst like a soap bubble. You have arrived and accepted your fate. Stage three completed.

“What is served for dinner makes your stomach kick like an 8-month fetus eager to get out...” Stage four: Withdrawal After a few days of endless eatingsleeping cycles, you hit what is known in the quasi-scientific world as food steady state. It is a state of feeling full constantly where hunger and eating are two concepts completely dissociated from one another.

Now you are ready to leave. You pack your bags and hug everyone goodbye. The bittersweet feeling of coming home to your daily life is overpowered by a sickening feeling of satiation coming from the brain and hunger coming from the stomach. These two feeling clash in a spinning vortex of “I am fullgry” (a very expressive word meaning full and hungry). You go vegan for a week and never look back, only forward, at your next trip to the fooddevouring bonanza that is your childhood home coming up in only a few months. I have now been through this exhausting research project on Christmas food and sleeping patterns for two weeks and have on average slept 12 hours a day. My coffee consumption has increased exponentially during my stay and I do not think I have any adenosine receptors anymore. Every good story needs a message and here is mine: if you have any trouble sleeping, get in contact with my family. We will fix you at the cost of a plane ticket and your productivity. •

“Feelings clash in a spinning vortex of ‘I am fullgry’...”

Photo: Giovanni Cioffi for Medicor.

Stage three: Accustomization You have been at your parents’ for a few days. You have given up. Days and

CAMPUS

Education Reform Underway by Markus Karlsson

The Swedish medical education system is facing a major renewal. The medical programme will be lengthened from 5.5 to 6 years, and the medical license will be awarded immediately upon graduation. The old ‘Allmäntjänstgöring’ (AT) internship will be removed and replaced by ‘Bastjänstgöring’. These changes are intended to resolve the bottleneck that has been created and increase the Swedish education’s consistency with standardized European frameworks. Nothing new under the sun The last time the Swedish medical education faced a major overhaul was in 1969. Allmäntjänstgöring (AT) was then introduced as a compulsory internship to develop the practical and clinical skills of new graduates, and has a legislated curriculum with rotations in internal medicine, surgery, psychiatry, and primary care. There is some leeway in structuring your rotations, but a minimum of three months is required in each area, except for primary care with a minimum of six months. Further, medical and surgical specialties must reach a minimum of nine months combined.

“The total length of the internship is at least 18, but can be up to 21 months.” The total length of the internship is at least 18, but can be up to 21 months. The AT creates an opportunity to gain a broad clinical experience, and has for a long time been seen as one of the strengths of the Swedish system. However, it is relatively unique in that most other European countries have, for several decades, been working towards adopting a common system, where the license is awarded upon graduation. 26

Photos: Lauren Lyne for Medicor.

Unintended consequences landsting’). These authorities have The times they are-a-changing: an overarching responsibility for during the past twenty years, there the publicly funded healthcare syshas been an almost three-fold in- tem. However, they have somehow crease in first-term medical stu- not been able to meet their legally dents, but little corresponding mandated responsibility to provide growth in the number of available an adequate number of AT internpositions for AT. Due to the grow- ship positions. ing bottleneck, newly graduated This may run down to a classic doctors first have to work for an tragedy of the commons problem: unspecified amount of time as sub- since each County Council makes stitute assisting physicians (‘vika- decisions individually, it would be rierande underläkare’), often with in their short-term financial interlimited supervision and job se- est not to increase the number of curity. Time spent working as an internship positions more than assisting physician (underläkare) necessary, since they require active now counts towards your applica- supervision and are presumably tion for the AT, with an average of expensive. This results in a larger 10.2 months waiting time in 2018. pool of junior doctors who have no However, the exact time frame choice but to work for lower pay. varies between different regions, “An important incentive for and the waiting times are longest this is the system’s current in Stockholm, at an average of 18.5 months. incompatibility with standardized

“ Why is there such a lack of growth in the number of positions for the AT?” Why is there such a lack of growth in the number of positions for the AT? Part of the reason is that while successive governments have mandated an increase in medical student positions, responsibility for the internship lies separately with the regional authorities called County Councils (‘regioner/

frameworks of the EU.” This is naturally inefficient and unsustainable in the long term, both for junior doctors and the health care system at large, which requires more fully specialized doctors in several fields. A revision of the system has been debated now for many years. An important incentive for this is the system’s current incompatibility with standardized frameworks of the EU.

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In many member countries, the medical programme lasts for six years and grants a medical license upon graduation. This professional qualification is then subject to the free labor movement agreements of the EU, allowing students who completed their studies abroad to transfer their license when coming to Sweden. This is especially problematic considering the fact that many Swedish students go abroad to study medicine in other European countries, while for domestic graduates, the long waiting times for obtaining an AT internship remain. Here, the AT is a compulsory step for obtaining a medical license, which slows down career progression and the education of fully specialized doctors. In Sweden the AT is a compulsory step for obtaining a medical license, which slows down their career progression and the education of fully specialized doctors. According to Swedish patient safety law (‘Patientsäkerhetsförordningen’), students are supposed to be able to receive their medical license within 18 months of graduation, but the average is currently around 31 months. On the other hand, the AT is appreciated by many as an introduction to the practical as-

pects of the Swedish medical profession, and newly minted foreign graduates have little access to this opportunity; they are not prioritized for the AT, seeing as they often already have their medical license. In this sense, for both sides, the unlevel playing field is somewhat of a double-edged sword. End of the line Nevertheless, after almost a decade of debate throughout all levels of the profession, a final decision on the issue was passed by vote in Swedish parliament in November 2018, with high unity between appointed decision makers. This will result in abolishing the requirement of AT for obtaining a medical license, and introduces some changes to the curriculum for the medical education. So how will the upcoming changes affect the course layout in Swedish medical school? It turns out that while the educational contents and curriculum are decided on the government level, the actual course layout is largely up to the individual universities. “Most of them have already started preparing for the imminent changes”, says André Hermansson, former chairman of the student division of the Swedish Medical Association. The additional

semester is largely intended to be used to increase the time spent in clinical rotations, as a compromise to make up for the loss of the AT. “The goals will be more specifically centered on being able to diagnose and treat common illnesses and severe medical emergencies.”, says André. Further, the new education will likely also include segments on patient safety and the usage of digital tools.

“According to the decision made by the parlaiment, a new education plan is supposed to be in place by the start of the fall semester of 2020.” One issue with the current plan is that the official time frame for implementing the new system is very short. According to the decision made by the parliament, a new education plan is supposed to be in place by the start of the autumn semester of 2020. This has been noted as unrealistic, and may in practice be pushed back for at least one year. Nevertheless, there are many issues with the current system that need to be addressed soon, and the current plans’ basis in longstanding discussions and a broad unity within the profession, bodes well for the future. •

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Presidents’ Word

Dear Students, 2019 has just begun and we in the Presidium of Medicinska Föreningen are very excited for this year. A good start is half the work done and thanks to the work last year by Iris Peña Arriarán, Laura Andersson, the board and other enthusiastic members of MF, we have been left with a promising starting position and lot of opportunities to continue the work during 2019. This year, we are happy to lead the newly elected board and we hope to achieve what we have set out to do. But before we get to our plans, let us introduce ourselves: “ I am a former student at Karolinska Institutet’s programme for medical laboratory scientists and currently a PhD student in medicine at KI. I have worked with various tasks at MF before but have mainly worked as a student union representative at KI and have been actively involved in the work done by the sections BAS and DSA. I am currently finishing my thesis but decided that I wanted to completely dedicate this year to MF.” ~Leif Karlsson “ I am currently finishing my third semester at the nursing programme at KI and I am very excited to start the work ahead. My involvement in MF started my first semester when I joined the Nursing Section´s event comitté Festis and just a few months later I found myself applying for the position of Chairperson of the section! This is where I really started to see the charm and importance of MF. Little did I know that my initial curiosity would lead to this grand assignment and exciting future. ” ~Josefine Andersson This year Leif will be the one responsible for working with student representation at KI, to ensure that our influence is respected and voices are heard throughout the new organization of KI. Josefine will be focusing on the internal relationships between our union bodies and also the renovation of the union house. Speaking of which, the work regarding the project 28

Photo: Milja Miettinen

FKH (Framtidens kårhus) is moving along swiftly and together with the people involved in the project we both hope that we may continue the renovation of our Union house this year.

“...there is a completely new organization within KI…” We hope to look back at a very productive year by the end of our period, and we already have two main focuses. First of all, there is a completely new organization within KI, which we need to adapt to and this includes a major increase in student representative positions at the department level. To manage this increased workload, a new position will be implemented at MF where the elected person will work closely together with us, and future president’s, to make life for our representatives a little bit easier. Second of all, as previously mentioned, FKH will be a big project with which we hope to make big strides with this year.

To be able to do all that we want to achieve this year, we are very happy to have the most amazing board filled to the brim with experienced and enthusiastic members of MF. This fantastic group is made up of Hanna Eklund, Pinja Ruuhinen, Alice Weréen, Ylva Jörsäter, Robert Lilford, Max Kynning, Anne Östholm, Jessica Härtell and last, but not least, Puck Norell as secretary.

“...we believe it will be an exciting and fun new challenge for the both of us.” This year we look forward to leading our beloved student union forward, we believe it will be an exciting and fun new challenge for the both of us. We hope that we will further develop the union and improve upon our existing functions so that we may step down as president’s in december leaving an even better organization for our successors to inherit. Best wishes from your presidents, Leif Karlsson and Josefine Andersson

medicor MF

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CULTURE

The Realm of Dreams

Every single person dreams for at least one hour each night. Sometimes, the dreams are straightforward: a tropical beach that you’ve previously visited beckons with falling coconuts. Or maybe those impatient customers that you’ve once served at the restaurant complain and demand. However, sometimes, dreams don’t always tell a simple story. The broad definition of a dream may be described as a series of images, ideas, and emotions, which occur involuntarily in the mind during sleep. Furthermore, the content and purpose of dreams have left many curious and been a topic of scientific, philosophical, and religious debate. by Yolanda Rao

Interpretations about the meaning of dreams have varied through time and culture. The Freudian theory of

dreams states that dreams reveal one’s hidden desires and emotions. Other theories suggest that dreams are involved in memory formation or problem solving. Sigmund Freud, who developed the psychological discipline of psychoanalysis, actively discussed dream theories and their underlying messages in his works in the early 1900s. He explained that dreams are manifestations of one’s deepest desires and anxieties, often stemming from repressed childhood memories or obsessions. However, despite the criticism of Freud’s outrageous theories that seem to lack scientific validity, the fascination surrounding what exactly are the common grounds of dreams shared by every person continues to grow.

According to a database known as DreamsCloud, there are a few common images being reported and posted by dreamers. Following analysis and interpretation, the possible hidden meanings have been summarized below for our curiosity’s sake: 1. Being Chased: This is one of the most commonly reported dreams. Perhaps due to the anxiety one feels in the dream and the vivid remnant of this discomfort making it easier for us to remember them. Often, the reasons for these dreams arise not from the fear of actually being chased, but rather, from what we’re escaping from. Thus, chasing dreams help highlight the fact that we may not be addressing something that requires our thorough attention.

Water frequently represents our emotions or our unconscious minds. 2. Water: Water frequently represents our emotions or our unconscious minds. The quality of the water, such as being either clear or cloudy, or state, such as either calm or turbulent, often provides insight into how effectively we are balancing our emotions. Could our inner desire be full of contradicting feelings? Or are we currently residing in a peaceful state of mind

that reflects our satisfaction with our environment? 3. Vehicles: Whether a car, airplane, train, or ship, these vehicles can reflect what direction we feel our life is progressing, how much control we think we have over the road ahead of us, or the future direction toward which we are trying to steer. Vehicles can give us the power to make a transition and envision ourselves getting to our destination -- or highlight the obstacles we think we are facing and need to work through. 4. School or Classroom: It’s very prevalent for people in dreams to find themselves in a school or classroom, often confronted with a test that they have been trying to avoid and are not prepared to take. This is an example of a “dream pun” -- the mind using a concept and giving it a different definition. The “lesson” or “test” we were faced inside the school or classroom is frequently one we need to learn from our past and had been long completed -- which is one reason these dreams are often reported by people who have long since finished school. 5. Paralysis: Shocking to many people, the body is actually in a state of paralysis during dreaming, being restrained from physically performing the actions occurring in their dreams. Therefore, dreaming about paralysis frequently represents the

CULTURE overlap between the REM stage and waking stage of sleep. A common bad dream could be something along the images of running on the spot with uncoordinated limbs or being confined in a small space full of other individuals. However, dreaming about paralysis can also indicate that the dreamer feels he or she lacks life control. 6. Death: Although death is often perceived as dark and negative, it’s more directly related to dramatic changes happening for the dreamer. This could represent the end of one event and the fresh start to a new beginning. However, a transition, in order to make room for this new experience, must first take place, and thus, could be manifested in the form of a tragic nightmare before the shock jolts us awake.

8. Falling: Not all falling dreams are scary and negative. Some people claim a type of slow, smooth fall with waves of serenity and the after-thought of letting go. On the contrary, falling uncontrollably with great speed from a peak indicates the lack of control and urgent need to find firm footing on the ground for assured stability. 9. Houses: Houses frequently symbolize the dreamer’s mind. Different levels or spaces of various interior design may relate to different personality aspects and values of the dreamer. The basement often represents what has been neglected, or what the dreamer is not aware of in his or her waking life, while bedrooms relate to intimate features, or those most significant to the dreamer’s core principles.

The fascination surrounding what exactly are the common grounds of dreams shared by every person continues to grow. 7. Flying: Flying or floating in a dream, and how it’s done, relates to how much control we feel we have in our lives. Are we confident about achieving our goals? While flying high, fortunately, is one of the most euphoric and inspiring dreams imaginable, flying or “skimming” low to the ground and being caught in thorn bushes can be frustrating and reflects our current struggle with daily distractions.

Of course, the purpose of this short summary was not to explain for anyone’s personal dreams. Every person, with his or her own identity, will live a completely different life from the other, dream a vivid story unique from the other, and wake up to remember that realm like no other. • Reference: www.dreamscloud.com

“

Yesterday is but today’s memory, tomorrow is today’s dream.

“

- Kahlil Gibran, poet

“

There is only one thing that makes a dream impossible to achieve: the fear of failure.

“

- Paulo Coelho, novelist

“

The key to realizing a dream is to focus not on success but significance – and then even the small steps and little victories along your path will take on greater meaning.

“

- Oprah Winfery, businesswoman

CULTURE

Opinion: The Stalemate in Swedish Politics by Emmanuel Zavalis

To say democracy is slowly making its sortie would be an overstatement. But the international developments have made one question the very essence of democracy and whether or not real democracy is practiced in the majority of the countries. Different election systems Now the undemocratic nature of the electoral college isn’t really a new revelation, let’s scythe through the nonsense every losing party whines all year after they have been gotten by the electoral college and come midterms they have forgotten about it. Yes, Hillary Clinton had the most votes, but she didn’t win, and especially Hillary should be void of grievances, because she simply has had the power and positions before to change the wretched system the US uses for elections and she didn’t. She played and lost, there’s nothing more to talk about. But the system is problematic I’ll admit and even more problematic is the two-party system which limits the options and also is proven to yield a lower voter turnout. Then we have countries like Britain that have a voting system that gives the winner all mandates the voting districts have at their disposal. Finally, we have France where the ones working in the departments are untouchables and don’t change with the political changes, as well as a two round runoff voting system for the presidential election, which is a ´fairer´ type of two-party system but still in the end troubling because there is one person that is elected for the highest mandate, who doesn’t necessarily have to share ideologies with the rest of the senate or the equivalent of the House of Commons.

The Swedish system is very different. It is complex but very Swedish and very fair (probably the closest to a real democracy one can get without having to make all state issues a poll on Facebook). Parties have to have at the very least 4% of the votes to be allowed mandates. First all the votes are divided by 1.2 and the party with the largest number gets the first mandate. After that the number of the party that won the last mandate has its number divided by three and if it is still the largest number it’ll get the mandate. This goes on until all the mandates have been handed out. And then the mandates that were supposed to go to a party that did not make the 4% cut are divided fairly among the other parties using a similar system.

This system - whilst not being completely fair to small parties - is probably the closest to fairness one can get in dividing the mandates. Compare that to Britain, where the winner gets all the mandates, or the US, this is as the Greeks would have said “VERY DEMOCRATIC”.

“Parties need to have at least 4% of the votes to be allowed mandates” And this democratic process is what has led us to the predicament Sweden is in right now. Everybody is taking it very calmly which is very Swedish and very good but there is a stalemate in Swedish politics which has to be resolved. ‘Alliansen’ Sweden Democrats (SD), the party consisting of stealthy racists, whilst not technically in ‘Alliansen’ is splitting it up. There are the conservative parties in ‘Al-

CULTURE

liansen’ that don’t see a problem in letting SD have influence over their politics. The party agenda of them do not differ significantly after all and the votes of SD helped the Moderate (M) and Christian Democrat (KD) budget go through. The budget of those two parties wasn’t particularly different than the one the Social Democrats(S) had suggested but most of this story is about symbolic politics. The liberal parties such as Centerpartiet(C) and Liberalerna (L) have both objected to a cabinet that would need approval from the Swedish Democrats, which would be the case if there was a M+KD+C+L government and that is why C has turned to S with demands that S has to meet for them to be allowed another run at office. This ‘mutiny’ has obviously shaken up the political sphere and the demands have been semi-controversial. C wants to lower the income tax and specifically the upper tax brackets significantly, while S wants to only lower taxes for pensioners. C wants to further lower the corporate taxes which S hasn’t intended. C wants to allow for more private healthcare providers and schools, whilst S is against it. C wants to lower the employer costs as well as allow for more leeway when it comes to smaller companies infringing on employment security. S is technically against most of the mentioned demands, but the party has approached C on many issues and is looking at different agreement options for both of the parties to be satisfied. If C is happy then L will likely follow (although L has had its own share of rumors of mutiny within the party).

“This ‘mutiny’ has obviously shaken up the political sphere and the demands have been semicontroversial”

‘Rödgröna’ - the Green Party, the Left Party and the Social Democrats The problem with the approach S took is that they have now alienated V, which now has sent in its own demands. This love for nailing up lists must be a Lutheran vestige. They are strictly against profits in the welfare system and against deregulating the labor market, and if an Scabinet will fight for that, that is nothing they want to support.

“This love for nailing up lists must be a Lutheran vestige” The Green Party has been passive since September, but they have also committed their own treachery on a municipal level,

since which they’ve seemingly become silent: they are in power in the Stockholm Municipality with Alliansen.

support from C+L+V+MP, but with this mess it is indeed anybody’s guess.

This is a mess and there’s probably nobody envying the politicians that have to untangle this, whilst still staying true to what their constituents have demanded. The problem with Swedish democracy right now is that it is too fractioned. There are too many small parties and there are too many allegiances that have to be kept, because for some reason it has become part of what the constituents ask for when they vote. Stefan Löfven will likely have to walk a tightrope, trying to please both the left and the liberals until everything is finished, until there has been a decision made upon which party is going to constitute the administration. My bet is on a collaboration between the Social Democrats together with a passive

“There are too many small parties and there are too many allegiances that have to be kept” I’d rather not finish on a negative note though, this is actually a luxury Sweden has. It has the luxury to take more than 100 days to form a government. This is part of the democratic tradition in Sweden: compromise and communication are both key and need to stay that way. This is democracy at its best: both sides get part of what they want and balance is maintained. •

CULTURE

Snille och Smak

The scandal of the Swedish Academy Photo: Pixabay

by Emmanuel Zavalis

One must be walking around with a blindfold and their ears filled with wax if they have missed it. This year the Swedish academy has managed to be in the spotlight for all the wrong reasons. Protector of the Swedish language The academy was established in 1786 by King Gustav III, who was the king that ended the ‘Age of Liberty’ in Sweden and took the reigns as the Machiavellian enlightened despot, and a patron of the arts. The academy has 18 members that are supposed to uphold and promote the purity and majesty of the Swedish language, endowing eloquent poets with awards and creating a grammatical structure, as well as a dictionary for the Swedish language. Curiously enough, its motto to this day is ‘snille och smak’ , meaning ”talent and taste”. In 1901 it was bestowed the honor of awarding the most excellent writers internationally with the Nobel Prize in Literature, and it has been its main task since then.

Photo: Pixabay

Abuse of power and other allegations What usually happens around this time of the year is that everybody shakes their heads because the Nobel Prize winner was too unreadable, or everybody hands out the author’s works to all their relatives as Christmas gifts or birthday presents. There have always been annoyances about academy members handing themselves the prize (Harry Martinson), but this time the scandal is outrageously problematic: Jean Claude Arnault, husband of a member of the Academy, has been accused by 18 women of sexual assault or harassment and has gotten a 2.5year jail sentence.

“The Academy was aware of the allegations, but supported Arnault anyway”

Arnault has been awarded several grants from the Academy for running his cultural-elite establishment ‘Forum’, and it is speculated that Arnault used the academy’s name to ‘ease’ the interactions. This led to the Swedish Academy starting an investigation into which members were implicated in this scandal by being aware of his perversion as well as abuse of power and came to the conclusion that the Academy was aware of the allegations, but supported Arnault anyway. His wife wants to step down in exchange for

a financial compensation and multiple members of the academy have stepped down even though this is technically impossible, since one is a lifetime member of the Academy and can only resign from the position by dying. Sara Danius, the academy’s secretary, has stated that this rule will be changed, but due to all this ruckus there has not been any Nobel Prize in Literature this year.

“These things have to matter enough to pose a hindrance for the Nobel Prize in Literature being handed out”

Shaking the dust off In conclusion, this is some of the kicked-up dirt from the Me Too movement that shook Sweden and is still shaking it. It is important that these issues are still discussed, that there is a fuss about a rapist being - even if just passively supported by members of the esteemed Swedish Academy, these things have to matter enough to pose a hindrance for the Nobel Prize in Literature being handed out. If this does not matter, then the academy loses its prestige as it does not adhere to its motto “talent and taste”. The case of Arnault shows that even a country as enlightened as Sweden has its moldy corners, some dusty desks and people that think they don’t answer to anyone. Thankfully, this is slowly changing. •

Event Calendar INTERNATIONAL WOMEN’S DAY

Illustration: Makyzz/Freepik

8th

MAR

ST PATRICK’S DAY Kungsträdgården, Stockholm Join a traditional St Patrick’s Day parade together with the Swedish Irish Society. The event takes place on March 16th, 12 pm. Come and soak up the atmosphere of Irish music and dancing, face painting, green balloons and other fun activities.

17th

MAR

WAFFLE DAY Sweden

25th

MAR

MF SPRING BALL MF, Nobels väg 10, Solna The annual Spring Ball at Medicinska Föreningen includes a 3-course dinner, live string music by Stroket, ballroom dancing and a radiant atmosphere. Get your gown or tailcoat ready as we wait for the date to be announced - you do not want to miss out on the white tie event of the season!

TBA 1st

APR

NOV

Sweden

30th

FÖRSTA MAJ

by Irina Polishchuk

You might want to be a little more sceptical and cautious during this day, since friends and family could fool you with a practical joke or generally being silly.

WALPURGIS’ NIGHT

21st

APR

Internationally known as Labor Day or Worker’s Day, May 1st is the celebration of the working class and the labor movement. If you are into civil rights, you can join one of the many political demonstrations that take place on this day. If not, you can just enjoy the time off work.

Waffle Day is a uniquely Swedsh tradition that originates from the Feast of the Annunciation. Called “Vårfrudagen” in Swedish, which sounds suspiciously similar to “Våffeldagen” if you say it fast, the Christian holiday turned into a waffleeating shindig with little religious meaning.

FÖRSTA APRIL

EASTER DAY Easter holidays in Sweden are celebrated together with the family. Some traditions include children dressing up as witches, birch branches decorated with feathers, weekend in the summer house surrounded by nature, and of course lots of chocolate eggs. If you are lucky, you might even spot the Easter Bunny!

International Women’s Day is the day to show the amazing women in our lives that we care for and appreciate them. Of course, you should do that every other day as well.

1st

The last day of April – Valborg, is celebrated in Sweden traditionally with choral singing, bonfires and fun public events all around the country. Let’s say goodbye to the endless cold and dark winter by greeting the coming spring with warmth, light and positivity. ideas and grab some fika!

MAY

SPEXET PRINSESSAN PEACH

1-5

MAY

MF’s male skit group Spexet Corpus Karrolina debuts their new show Prinsessan Peach, a twisted comedic take on the well-known computer game series Super Mario. Improvisation, audience participation, live music and dance are included as always. 35

WE HAVE TOLD OUR STORY,

COME TELL YOURS.

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