AURICLE
January 2024-April 2024
January 2024-April 2024
E D I T O R ' S L E T T E R
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H U M A N S O F M E D I C I N E : D R R O S E M A R Y N I X O N . . . . . . 4
M U M U S S O C I A L U P D A T E
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I N T R O D U C I N G T H E O S S I C L E
P I R A T E S O F T H E P E R I T O N E U M
W H A T W E A R E R E A D I N G
M U M U S T B H U P D A T E
A M S A U P D A T E
L E S S O N S F R O M O N C O L O G Y
N O S O U L , N O C R I M E .
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Dear readers,
It’s so lovely to finally meet you ! My name is Angelica and I’m the 2024 Publications Officer and current editor of the Auricle magazine and host of the Ossicle Podcast
I am so excited to present to you the Auricle’s first issue for 2024 In this issue, you’ll find an interview with Professor Rosemary Nixon for our Humans of Medicine panel Dr Rosemary is a renowned dermatologist who has won membership of the Order of Australia (AM) for her contributions to Occupational Dermatology, and is the only person in Australia to have qualifications in both Dermatology and Occupational Medicine and she is also a Monash Medicine Alumna! It was an honour to be able to meet with her and learn from her many years of experience, and I hope you find her words of wisdom as inspiring and compelling as I do
This issue also contains evocative creative and retrospective pieces from many talented members of our cohort These pieces are often an outlet for our student body to express themselves through the medium of fiction, or to dissect deeper feelings about placements that have left long-lasting impressions
Our magazine also explores and celebrates other aspects of Medicine, such as upcoming events (look out for MedRevue’s upcoming production!) and social gatherings that we ’ re so hyped for
Angelica is a 3B student currently completing her endocrine placement
If there is ever anything that you wish to share with the student body, be it a memory from placement, an artwork, or recipe you can ’ t stop cooking, or even an anonymous essay exploring feelings after a particularly interesting or heavy placement, I implore you to reach out to our publications team at publications@mumusorg to share it in our next issue
I’m looking forward to hearing your thoughts about this issue, and hopefully meeting you at one of our many events this year!
Enjoy our first issue for 2024!
Happy reading,
Angelica Haskins Auricle Editor in Chief and MUMUS Publications OfficerYash here, and I am so honoured to have been elected to represent such an extraordinary group of people this year Our Monash Medicine community is truly special, a place that must be experienced to be fully appreciated One of the most significant highlights of the year has been the relationships we ' ve built, both within our committee and with the broader student body These connections are ones I will cherish long into the future
Now, without further ado, here's our halfway update! (this isn ’ t everything, but I hope to recap some of our key wins)
Our Commitment: Approachability, Advocacy, and Accountability
These were the promises our committee made at the start of the year, and we ' ve worked tirelessly to keep them Here’s a recap of what we ’ ve achieved over the past few months:
We pushed for changes to the Year A Anatomy program and initiated monthly meetings with our faculty executive to address student concerns We aim to formalise this process soon
Renewed our relationship with WILDFIRE to mplement a semesterly survey addressing shortfalls iin our rural health program
Yash is the 2024 MUMUS President
Maximising Student Funding:
Secured more SSAF funding than ever before, allowing us to enhance the Monash medical student experience
Financial Revitalisation:
Strengthened MUMUS' financial standing, providing a robust platform for our social initiatives
Developed resources to demystify the internship application process for final-year students, including webinars in collaboration with other Victorian medical societies
Reviving the Social Scene:
Organised fantastic events such as Clinical Drinks, the 5D + Preclinical MedCruise, Year A/Year 1 MedCamps, and Mixed Netball tournaments for Preclinical and Year A students
Increased our social media presence, especially on Instagram Follow us @yourmumus for the latest updates!
Looking ahead, expect a new and functional MUMUS website, more advocacy surveys to improve your course experience, and an exciting lineup of social events, including MedBall!
We hope you ’ ve noticed our increased presence on campus, and I’ve personally enjoyed meeting so many of you in person
It has been a pleasure and a privilege so far, MUMUS 2024 ����
The following is a transcript of an audio interview with Prof Nixon on the Auricle’s accompanying podcast, The Ossicle. Interview conducted by Angelica Haskins.
Hello and welcome to the first 2024 edition of the Auricle and its accompanying podcast, the Ossicle! Today, I'm interviewing Associate Professor Rosemary Nixon , who has practised in general dermatology for over 30 years and is the only person to have Australian qualifications in both dermatology and occupational medicine An alumni of Monash , she completed all of her university degrees here and was Unit Head of Dermatology at Monash Medical Centre from 1991 to 2001 , and continued as a visiting dermatologist at Monash Health until 2017 Rosemary has published over 150 scientific papers and frequently lectures on occupational dermatitis
In 2017 , she was made a member of the Order of Australia (AM) for significant service to community health in the field of occupational dermatology, as an academic and researcher , and to professional standards
She divides her time between her research group, the Occupational Dermatology Research and Education Centre (ODREC), the Occupational Dermatology Clinic both at the Skin Health Institute; and her practice in general dermatology
Hi Doctor Ro it's really nice to finally meet We have got quite a few questions prepared today but first we ' re going to start off with a really basic question:
What inspired you to pursue medicine?
Well thanks, it's great to meet in person after so long and I'm flattered that you ' re interested
So, I was quite young at school: I turned 17 during the year 12 exams and I was really not sure what I wanted to do so I decided to take a year off the term gap year hadn't been invented then so I deferred Quite a few people deferred in 1973 because Gough Whitlam had come in and made university free
I really didn't know what I wanted to do but I’d done some science subjects at school and I thought that was probably where I was going I wasn't that A S S O C I A T E P R O F E S S O R R O S E M A R Y N I X O N , A M has practised in general dermatology for over 30 years and is the only person to attain Australian qualifications in both dermatology and occupational medicine.
H U M A N S O F M E D I C I N
interested in medicine mainly because when you go to the doctor you ' re sick and it didn’t really appeal to me, but then I got a job at the Prince Henry's department of Medicine, a hospital on St Kilda Road that became part of the formation of Monash Medical Centre in 1991, when it moved There, I was employed as a junior research technical assistant for these folks doing PHDs in medicine and thought ‘ wow this has really opened my eyes to research and academic medicine,’ and I was hooked!
I thought I'd get into medicine but I didn't, because I'd done pure and applied math and that affected my score So then, I was on a bit of a treadmill to get into med and I'm sure many people have been through that process; it's always been tricky So, eventually, I ended up doing honours biochemistry before I transferred Monash had a programme called the combined year where you did a combination of second year and third year medicine, plus the three clinical years, so that was another four years to finish but that was great and having that experience with science was very important because I learned a bit about chemicals, which subsequently became quite important in contact dermatitis
That’s a really interesting journey and I'm sure lots of people relate to taking a gap year or deferring a few years before starting
So, you gave us a little bit of an intro in regards to your journey to medicine but what led you to pick dermatology in particular?
I always liked dermatology as a student and used to go with a friend to additional dermatology clinics at Queen Vic and Prince Henry’s and we would go to the dermatology outpatient clinic, which was on Monday morning at Prince Henry’s remember the dermatologists talking about the
football and what movies they’d seen and I remember thinking these aren ’ t are real doctors, you know, it's life and death in intensive care; I was interested in other things
But then, in those days you worked very hard In fact; I was the poster girl for an AMA campaign to reduce doctors working hours and at that stage I was a resident in oncology at Prince Henrys and I think I added up about 100 hours of work a week, so you worked very hard My overwhelming impression of medicine was that, in those days, the culture of the hospitals was so different in then Everyone was working very hard, a lot of the consultant staff, would you believe were having affairs with junior staff because their work was their life! And I remember thinking this is not a good way to live you need to have a bit more work-life-balance What about those dermatologists who used to talk about the football? So then, I went back to the dermatology clinic and then I ended up being the first person to actually do a research year prior to starting dermatology training
At that stage you had to do a first part exam in dermatology and I knew that the demands of the hospital jobs were so great that you would not have time to study so I did a research year with Robin Marks who eventually became the first professor of dermatology at The Alfred and then that year I was able to study for the first part and got into dermatology
Amazing ! That's an interesting career pathway
So, what are some of the best and worst things about dermatology for you?
Well, it ’ s hard to find a worst thing! Dermatology is fantastic I think the variety of patients, as it ’ s said that there are over 3000 dermatological conditions
The fact that you see elderly people but you also see young people, you see babies, you see teenagers with acne, and the fact that you can help people Itch is the second worst symptom after breathlessness, so if you see itchy people, they are really upset, their quality of life is terrible but you can help those people If people have spots or skin cancers, you can help them One reason that I joined dermatology is that you can do stuff! If someone comes in with a spot, you can just take it off at the time
“Dermatology is very satisfying”
I think this is probably disappearing, but my generation were always very hands-on so rather than send people away to come back another day you just did it on the spot And so, it has been very sad to see the decline in the amount of dermatology teaching When I was the head of Monash we had 13 hours of dermatology lectures and it is gradually being whittled away because they couldn't fit them in anymore, so that that means you ' ve got a lot of doctors and particularly GPs who haven't done much dermatology, so the patients are very pleased to see you Dermatology is very satisfying
Can you tell us about a typical day for you?
I've evolved into doing a number of different areas, so I really have three jobs I have a patch testing clinic at the Skin Health Institute in Carlton The Skin Health Institute is like a private tertiary referral dermatology outpatient centre which was
started by the dermatologists of Melbourne in 1987 in response to the fact that the public hospitals are never going to expend any significant resources in dermatology We don't have operating sessions, we don't have many inpatients they barely tolerate our existence, so it was really up to the dermatologists to set up our own purpose-built centre by the model of donating our time and charging the patients, so this organisation has now thrived for over 35 years since 1987 I’ve recently become the president for four years, and I run an occupational dermatology clinic, which is a patch testing clinic and so people come in with suspected occupational dermatitis three times a week in the same week: Monday, Wednesday, Friday for patch testing
In the other times that I'm at Skin Health, I have a small research group In occupational dermatology, weve had a great data base since 1993 when I actually started the clinic initially at Monash Medical Centre
I also have a long day of private practice once a week So, to answer your question, a typical day means when I wake up, I have to think what day it is and then I know what I'm doing, whether it's a patch testing day, research day or a private patient day
That sounds like a very busy week
It's wonderful actually, it's a real privilege Ever since I've done dermatology, I've had to think what day it is because that's because when we were registrars, you go to different hospitals on different days, it ’ s a terrific programme although, albeit, logistically quite tricky, so it's a real plus of my life that I've always had variety in my week
You’ve obviously made a huge impact on the world , particularly in regards to your work in contact dermatitis , patch testing and occupational dermatology
Are there any other changes you'd like to see brought about in the dermatology world or even outside of that in terms of medicine?
Just in the dermatology area, one issue that I'm often confronted with is when we see people for patch testing Sometimes, they have had suspected occupational dermatitis, sometimes, they’ve had suspected contact dermatitis from cosmetics I'm amazed, if not appalled, by how much stuff people buy for their skin I think that big business is out to sell things to people, be it cigarettes, be it sugar, be it alcohol, be it unnecessary skin care items It would not be unusual to see people with suitcases of skin care products with often very expensive plastic bottles which are harming the environment So, if I have one area of dermatology which I think is inappropriate, it is over consumption of products that concerns me a great deal
Going on with that, I think the sort of increasing trend for young people, particularly young women to invest money in cosmetic procedures at a young age is of great concern to me Women are always going to end up with less superannuation than men and to see them getting on a treadmill of spending money on cosmetic procedures concerns me Plus, some young women don't realise the advances that feminism has made over the last 40 years and I'm just astounded when I see young colleagues who change their name when they get married but I guess you can't rant and rave, it ’ s just a personal thing I could go on but we’ll leave it
I think that's a really good topic of discussion We were just talking about the book , ‘Lessons in Chemistry’ and discussing how treatment of women particularly in sciences has evolved over the years,
but it seems that discrimination and discrepancies between men and women still persist even now , and this is not isolated to STEM , which is really sad
Yes, exactly
I have noticed right now , on TikTok and Instagram, it's a trend for really young girls in particular to go into all the big makeup stores and buy lots of products
It’s just terrible I don't do social media, I guess that's one of my other bugbears, is where people get information from, but I think selling skin care products to tweens is just horrible and I think people just have to understand that they're being exploited
It is definitely an important area to tackle
One of Dr Rosemary’s most recent reads
Moving on from that , are there any moments in medicine that you ' ve experienced which have made a long-lasting impression on your life?
I think that sometimes, one area I would choose is that sometimes you see difficult patients and that's tricky but I would make the observation that you often don't know what's going on in people's lives Sometimes, I've had some very memorable discussions when you spend time with people, such as when you cut out a skin cancer and you can talk to them and you realise that some people have pretty terrible lives
If you look at statistics, the rate of sexual abuse of children hovers around as high as 10% and higher in some studies and some people have had very difficult lives and while you can't excuse bad behaviour, you never really know what goes on in peoples’ lives So, sometimes I've had patients who have been difficult and you just put up with it and then find out actually they've got a really good reason for being difficult as they’ve had a very hard life, so I think that you always have to keep that in mind
A very important lesson
What are some of the biggest challenges you ' ve had to deal with?
Well, my husband died when I was 60 He died of mesothelioma He was quite a famous architect and so you don’t expect to be widowed at 60, so dealing with that's probably the biggest thing for me
I'm sorry to hear that You have my sympathy ---
What was the biggest surprise in your career journey?
I think just the fact that it's been so enjoyable! I think that the fact is it's funny having a niche like occupational dermatology but it's just been really interesting to be able to work in the area to know all the interesting folks overseas It’s been such a niche area that there haven't really been many other people that have been interested in it and it's been wonderful to have a career like that, in such a niche
In a way, I have a bit of a generalist approach to life: I'm a lumper not a splitter, but to sort of hone into a particular area and be the main expert, your life is fun!
That must be great!
What's one thing that you think everybody should know about skin?
The most important thing about skin is downloading the SunSmart app and understanding that at certain times of the year, from late August in Melbourne to the end of April, there will be times where you need to sun protect
So, for Caucasian skin, you need to sun protect if the UV index is 3 or more For darker skin, there are slightly different guidelines, however, you also need to get your Vitamin D
I think this is something that's really emerged in recent years: ever since a dermatologist, about 20 years ago fell over on a golf course and fractured his leg because of osteoporosis, most of us have had a much greater awareness of the importance of actually getting vitamin D appropriately from the sun I think having the SunSmart app which tells you the UV levels, is a very good way to monitor how much vitamin D you are getting and so the message is nuanced; it's not just protect yourself from the sun, it ’ s get appropriate vitamin D, as well
I have never even considered that! That's really cool So to clarify, if the index is less than three ?
If the index is less than three, you don't need sun protection, so that's when you need to go out and get some UV So, you can base your sun protection on the UV index
Now, I'm always going to use my sunscreen on my face because you want to get your vitamin D through other areas and obviously if you expose a lot of skin it's very good if you were having a swim in winter time, and you were wearing your bathers, you can expose a lot of skin to the sun Of course, you'll absorb the vitamin D quite slowly in winter in southern latitudes because there's not much UVB around, but getting that balance is really important and I'm very proud of my high vitamin D levels As you ’ ve seen I’ve just had a great weekend climbing mountains and kayaking!
Amazing lots of vitamin D! That was really interesting I'm excited to go home and download that app
Is there anything that you miss about other specialties in medicine?
I don't, but I have to say my colleagues and I from the Monash year of 1981, we feel very privileged because we really were given a terrific education and even to this day there's lots of things I'm not up with but when relatives or friends have medical issues, I am always surprised that we have a good grounding I think in those days, you could sort of learn about every disease Since then, there's been a knowledge explosion and it's the job of universities to teach you how to think and how to look up information but we had a terrific
“It’s been wonderful to have a career like [this], in such a niche”
education, we really learned a lot about other conditions, so I've always felt that I've had a bit more knowledge about other areas and that's really helped me over the years; I've made some quite good diagnoses in areas outside my specialty
I think it's really great that all these years of school have helped us to be able to have the skills to understand things; even if there's a topic about a specialty or something we haven't yet studied , we have the privilege to be able to read a research paper and understand what's happening which I'm really grateful for
Yes, I think gratitude is actually really important
This might be a difficult question, what is your biggest regret in medicine?
I think my biggest regret is when I see people doing the wrong thing So, there's been instances of overservicing I think some of the skin cancer clinics these days provide a good service but in very early days there were bulk billing skin cancer clinics that practised unethically by excising things that didn't need to be excised It's very easy to be unethical in skin I once referred a patient for removal of skin cancer by a plastic surgeon who then cut out 16 solar keratoses, as well as the skin cancer, so when I see over-servicing and particularly overcharging sometimes, it breaks my heart There are some very hungry practitioners out there and it does concern me greatly
That concludes most of our medicine-related topics. Now, we ’ ve got a few more questions which hope to give an insight about you as a human outside of medicine. So, what are some hobbies that you enjoy?
Well, I've always liked keeping fit, so I have always liked things like bushwalking and skiing I go to a regular choir once a week, that’s been fantastic;
I think singing is great I've always been a bit of a volunteer, so I volunteer as Treasurer of a local friend’s group, I was a scout leader for ten years; I still volunteer; I do first aid; something called the Melbourne gang show which is a scout musical theatre event, and I'm quite involved in Rotary, so I'm just a bit of a volunteering type!
Do you often spend your weekends doing thes things?
Yes I always like to spend time in nature I think that nature is incredibly restorative and I think being outside is really important for the human soul Just on the weekend, I heard something I've never heard before: there are two doctors that can help you doctor time and doctor green!
I was going to write that down like let's go look them up, that's funny
A friend told me that; nature does heal
I actually have a friend who recently completed an honours project which was comparing people looking at pictures of nature on a screen in comparison to actually walking through nature and the effects on their mental wellbeing and I know I think , oh yeah going out in nature , I feel happy, but there's actual science to prove this now!
There’s lots, and the Japanese are right into this They call it shinrin-yoku and it's really really important
“Nature does heal”
There’s a very good website that folks might be interested in: the American Association of Landscape Architects; if you Google their website, they have a whole list of the health benefits of nature and they have all these different medical conditions and they list scientific articles how being in nature can help diabetes or Alzheimers or whatever It's really good and there's a lot of literature about it
What kind of advice would you give to your younger self ?
‘Nothing ventured, nothing gained’ has always been my philosophy I think you ' ve got to try stuff, you ' ve got to take advantage of opportunities I think the most important things I would say, in your life, are keeping socially connected: so, putting a priority on social relationships I feel for your generation who was so impacted by covid and I think phones and social media communicate in a different way and that some people have, as a consequence of all of that, don't perhaps catch up in person as much as our generation did Remember, our generation grew up talking on the phone, that was how we communicated with our friends
So, social connectedness and health and I think the most important thing is that you have got to look after your fitness and look after your health You know, as a doctor, on the first day you graduate, the patient will say don't get old and you know that bad things are going to happen So, putting a priority on your social connectedness and health I think are the most important things
“’Nothing ventured , nothing gained,’ has always been my personal philosophy”
Good advice!
What's the purchase under $100 that has most positively impacted your life?
This is a good one, I think So once, I had a trigger finger My ring finger got sort of stuck and fortunately, one of my friends, a plastic surgeon, said, during a corridor consultation, ‘yeah, I can just inject that with steroids,’ because what happens is that the tendon gets stuck on a little loop and that made it better And then, after about four months, it came back again so she injected it again I said ‘ great, ’ and it was better but then it came back Then I thought, maybe there's another way of dealing with this, and so then I went to see a hand therapist and she made me little splint, which was less than $100 and I wore it every night for about a year until it broke and then the problem went away
So, the lesson was: there's different ways of doing things and it's also a plea to respect allied health All of those areas have so much to offer: I think physiotherapists are terrific because of my interest in health; when you get various injuries I just love the way they diagnose you and then they give you exercises and it's up to you to make it better I've recently had a knee replacement and the rehabilitation was fantastic, so I think that made a difference to me, and respect to allied health
There's a good lesson in that
This is a very vague big question: what brings you joy?
I think I'd have to say our daughters I have daughters aged 32 and 29 and I think growing independent adults has been a fantastic journey and I'm just so, so proud of them You see people with young babies and it's very easy to sort of helicopter around them I think we were always fly-in, fly-out parents and it's just great to see them make their way
Thats lovely
What is a book that has changed your perspective of the world?
When I had to think about all the books, I thought about Arundhati Roy’s The God of Small Things’ I remember really liking that and I've always enjoyed India and Sri Lanka My first trip overseas was to India and Nepal by myself years ago and I recently did a self-driving trip across Southern India which was fun
So, I was going to talk about that, but just before ‘Lessons in Chemistry,’ I read this book called ‘The Glucose Revolution’ by Jessie Inchauspé and it's all about ordering the food that you eat So, you have to eat foods in certain combinations and certain orders to reduce glucose spikes I found it fascinating, particularly for older folks and so many people developing type 2 diabetes, so: ‘The Glucose Revolution,’ I thought it was very interesting
Yes , and that would definitely change your perspective of the world
Leading on from that, what book do you give most as a gift?
This is a funny one because you tend to just give what's popular or new, but years ago when I was going to a lot of weddings, I used to give an atlas because atlases are really nice You know, when you are solving arguments over the dinner table, there's something about seeing a map You can probably see in my house here, I have lots of maps and as it was, I met my husband car rallying and would you believe I've navigated in over 200 car rallies, so I have quite a history of map reading and enjoying maps, so giving people atlases was something I always used to do
I feel like it must be a good thing to pick out a place and go one day after this argument is fixed , we’ll go here ”
Because you ' re a dermatologist I thought I might ask this: what sunscreens do you like?
So, I've always enjoyed Ego products; Ego’s a local company that’s made good formulations Propaira is another local company which is doing well, and La Roche Posay Fortunately, I don't want for sunscreens I think the most important thing with sunscreens is finding one you like and of course, if I could have a dollar for every time a patient asked me, ‘what skin care do you use, doctor?’ I’d be very very rich But the most important thing about all of these skin care products is just finding something that you like and therefore, you enjoy it
One tip for folks who may get irritated by sunscreen is if you use your lip balm around your eyes, that can help stop the sunscreen getting in your eyes, so that's a useful thing because sometimes it can be quite irritating to the eyes But the most important sunscreen is the one you like to use
“The most important sunscreen is the one you like to use ”
Okay I have snuck in one extra question: do you have a favourite Monash memory?
Look, we used to have a lot of fun because in those days we lived in So, in fifth year med, we had five weeks of medicine and five weeks of surgery, living in at Prince Henry's We had ten weeks of paeds and ten weeks of obstetrics, living in at Queen Vic, so it was really, really very different because you were there in the hospitals and you spent all that extra time seeing patients They had student quarters and we just used to have some terrific parties They were fantastic Doctor Sally Cockburn, who is now also a radio presenter, she was famous at our medical student parties, she was a great singer, back at the Chevron at The Alfred We just had some great parties!
Yeah , that’s what we want to hear! So , I think that's all the questions that I have for you, Doctor Rosemary Is there anything else you would like to say to readers?
No, I'm flattered and I think you ’ ve done a great job and thanks very much
Thank you so much for your time That was a really interesting and informative interview and we hope to maybe hear back from you later in the year to perhaps see how the derm world is going
Thank you!
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