Surgo March Edition 2014

5/27/2018 Surgo March Edition 2014

1/20SURGO Issue 83.18/09/2013


2/20SURGO


3/20SURGO

Surgo March Edion

1 Editors note

2 Medical news

3 Glasgow effect

5 New South Glasgow Hospital

7 NHS after Yes

10 An FY1 in London

11 Surgo Research: Results

12 Ig Nobel Prize

13 FAQ awards

15 Medical News Quiz

16 A Scots English dictionary

Contents

James Tadjkarimi

Assistant Editor

Josh Nielsen

Production Editor

Tom Baddeley

Finance Editor

David Boyle

Arts Editor

Trung Ton

Cover Boy


4/20SURGO

Surgo March Edion

1

So here we are again at the beginning of another glossy Surgo edition, brimming

with hope and promise; the sun is almost shining, taps aff is becoming ever more

appropriate, and the world and his wife are stuck indoors taking no make-up

selfies before accidentally donating to Unicef.

This issue endeavours to conquer the somewhat ambitious task of trying to make

Glasgows public health issues interesting. For those of you who have yet to

encounter the med schools very own God of public health, Phil Hanlon, youll

know that this is no mean feat. The reasons behind Glaswegian supremacy when

it comes to low life expectancy, poor mental health and premature aging is

something that Profs everywhere have long been trying to explain. How Glasgow,

unlike any other European city, manages to turn even its wealthiest citizens into

patients unlikely to live past 40 remains a mystery. Finance editor Tom Baddeley

attempts to get to the bottom of this and asks Dr David Morrison whether hosting

the Commonwealth Games will have any impact at all.

Contributing writer Jamie Henderson then pays a visit to the mammoth New

South General Hospital to play a game of should the fourth years stay in Glasgow,

or should they escape while they still can. To make this decision even more

difficult, Dan Taylor-Sweet has a look at how independence will affect the NHS:

for better or for worse. If the idea of working in the new super hospital, treating

UBIs (see medical news) in an independent Scotland leaves you feeling a little

anxious, send prof. an FAQ or alternatively, read former Glasgow student

Sheelagh Harwells account of her experiences as an FY1 in London. Once

youve got through all of this it gets a little more trivial

Cast your minds back to the distant memory of Surgos November edition and our

first foray into the world of clinical research. Assistant editor James Tajkarimi

brings you the results of this much acclaimed trial, proving once and for all which

hangover cures work and which most certainly do not. To continue this

disconcertingly positive trend, arts editor David Boyle gives you a snapshot into

the fantastic world of the Ig Nobel prize, somehow managing to shoehorn both fly

fishing and shrews into one article. This brings us nicely on to some humour from

within Wolfsons own walls, with of a compilation of the years best FAQs and a

few words from Prof. Walters himself. Last but not least, Jane Hamilton explores

the world outside of facebook with an impossibly difficult quiz and Josh Hughes

gives us a way into the world of Glaswegian slang.

And with that all thats left to say is, Let Surgo Flourish.

Ella Bennett

Editor in Chief.

Editorial


5/20SURGO

News

2

NewsNews

Giant virus could signal return of

small pox

Russian and French Scientists have found a virus that has beenfrozen in the permafrost of the Arctic Circle for 30, 000 years.

Found in samples of frozen soil, 30m below ground in the far

North East of Russia, the Pithovirus can only infect single cell

organisms so is harmless to humans and animals. It does beg

the question though, of what else may be lurking out there. The

Pithovirus is similar to smallpox in the way that it replicates,

leaving the possibility of a return of the smallpox virus. This

may be bad news for Russia as it may mean increased regula-

tions on drilling activities to ensure that we dont have a return

of the eradicated small pox virus.

Medical NewsA collection of the latest medical news ranging

from the semi-relevant to entirely ridiculous (credit

goes to the Daily Mails health pages for the

latter)

New phone case that monitors

vital signs

Due to be released later this year is the Wello, an iPhone

case that can monitor your BP, ECG, lung function, O2

levels and temperature. Azoi, the company behind this say

that they hope it will allow for earlier detection of health

problems. Akin to the tricorder seen in Star Trek the device

allows you to upload your data to the internet (on your sup-

plied URL) and sync with other apps to give an overall view

of your health. Available to pre-order in the UK for 120

though, it is by no means the cheapest phone case around.

While the concept seems like a good idea, there are fears that

it may be more suited to hypochondriacs than actual patients.

Sleep loss, brain loss

We have all had days after a lack of sleep where trying to pro-

duce a comprehensible sentence can be almost impossible and

you would swear to some sort of brain loss. Well now scien-

tists at the University of Pennsylvania think this may actually

be the case. In a study carried out on mice in which they were

only allowed 4/5 hours of sleep per day, after just three daysthere was a 25% decrease in the number of locus coeruleus

neurons. It remains to be seen if this is true in humans, with the

next stage of research involving looking at shift workers brains

after death. The hope is that protective medication from these

adverse affects may be developed, much to the delight of stu-

dents everywhere.

Ever wanted to look like cancer?

American Professor Jacqueline Firkins has designed a

range of ball gowns based on photographs of microscopic

cancer cells. The ten dresses form part of an exhibition

called Fashioning Cancer: The Correlation between

Destruction and Beauty, and are intended to prompt a

discussion surrounding beauty, body image and disease.

Whether of not you have a burning desire to look like a

cancer cell, these are infinitely more interesting (a great

deal weirder) than a thousand no make up selfies...

Guess the cancer: 5th right is brain, 4th, cervical?

Doctors slang is dying out

Dr Adam Fox, a paediatrician in London has spent the last 4

years compiling as list of medicines most colourful codes

used in notes to describe the most unspeakable truths about

patients. Due to increasing rates of legal action against

doctors however, the risk of being asked to explain one of

these inventive acronyms is ever higher and thus, they are

falling out of use. One of Dr Foxs finest compilations is of

terms used to describe patients of err lesser intelligence:

examples include LOBNH (lights on but nobody home),

CNS-QNS(CNS quality not sufficient) and the charming,

pumpkin positive, which refers to the suggestion that a

patients brain is so small that upon shining a light in his or

her mouth, the whole head would light up.

There are a few examples of doctors being called up on

these phrases, a notable example was where a surgeon was

asked to explain TTFO(told to F off). He dodged the bullet

smoothly, with to take fluids orally. For preservations

sake, Ill leave you with a selection of the rest...

NFN(normal for Norfolk), CTD (circling the drain), UBI

(unexplained beer injury) and last but not least, TEETH

(tried everything else, try homeopathy).


6/20SURGO

Surgo March Edion

As Glasgow medical students, youll

have heard a lot about the Glasgow

effect; a phrase used as the ultimate

get out of jail free card for everything

from Glasgows appallingly low life

expectancy to the drug habit that affords

us the title of heroin capital of Europe.

The question of why Glasgow manages

to achieve the Europe-wide dominance in

pretty much every chronic disease is a bit

of a mystery. Public health is something

that tends to divide medical students;

those that have fallen in love with Prof

Hanlon, and those that have yet to make

it to one of his lectures. Whichever side

of the fence you are currently on, the

Glasgow effect is undoubtedly some-

thing that we could do with getting to the

bottom of, particularly if we succeed

from the UK.

No one really knows why the Glasgow

effect exists. Despite having a

deprivation score similar to Manchester

or Liverpool, certain statistics just dont

fit the trend. A prime example of that is

premature death rates which are 30%

higher in Glasgow across men and

women of all ages, and people from both

deprived and affluent neighbourhoods.

This is pretty shocking, particularly

when the childhood health of a

population (premature deaths, infant

mortality child poverty) are arguably

some of the best indicators of a

populations health. To look for the

source of this discrepancy, you have to

look into the past. In its hay day,

Glasgow was known as the second city

of the British Empire, a hub of industry

and trade. People flocked from the

highlands and Ireland looking for jobs.

This triggered the birth of one of

Glasgows most distinctive features; the

sandstone tenements.

Majestic as they are now, these were

overcrowded, poorly maintained with

dubious sanitation which unsurprisingly

resulted in a surge in health problems to

the extent that life expectancy became as

low as 27 in some areas. This situation

was not unique to Glasgow however,

cities such as London, Manchester and

Liverpool were experiencing similar

problems. It was not until the

deindustrialisation period during the

1950s-1980s that the gap began to

appear. Something happened during

this period which changed the very

constitution of the city, something that

affected not only Glasgows physical

health but also the Glaswegian psyche.

Glaswegian life expectancy was, and still

is, the lowest in Western Europe. Whats

odd is that when you look at healthstatistics, the perception this is down to

Glaswegians love of deep fried mars bar

washed down with 18 cans of tenants

just doesnt make sense; yes, there are

too many heart attacks and cancer cases

but these figures are not sufficient to

account for Glasgows supremacy in

achieving early death.

Weve established that poverty cant

really be the answer, with Liverpool and

Manchester managing to cling on for

substantially more years than

Glaswegian despite achieving similar

levels of depravation. Glasgow beats

these cities in a few other places too; we

have far greater deaths from suicide,

violence, drug and alcohol abuse and

traffic accidents and have far poorermental health. Glaswegians seem to be,

for whatever reason, more prone to

despair and hopelessness than others.

It isnt just Glasgows poorest that are

affected by this; even the most affluent

weegies die much younger than their

English counterparts. Its a wonder really

why Salmond hasnt used this in his

independence campaign, someone should

really give #bettertogether a ring.

Over the years the health and crime rates

in Glasgow have improved, but still at a

slower rate than the rest of the country.

3

Deprivation, depression and premature death: The

Glasgow Effect

Glaswegians seem to be more

prone to hopelessness and

despair than people from other

cities.

Finance editor, Tom Baddeley investigates the mystery behind Glasgows health problems, with a little help

from Dr Morrison, head of the West of Scotland cancer surveillance unit


7/20SURGO4

Something provokes these self-

destructive behaviours. Theories such as

vitamin D deficiency, the hedonistic

culture of getting mad wi it or even

the bad weather and prolonged, cold win-

ters have all been considered, but no gen-eral conclusion reached.

The reason seems to go deeper than that.

Epigenetics is the heritablechanges in

gene activity which are notcaused by

changes in the DNA sequence.

Essentially certain genes are expressed

inappropriately, and this alters the DNA

methylation status. This enables the

effects of parents experiences to be

passed down to subsequent generations.

A study undertaken here at the

University of Glasgow found that

insufficient maternal care or poor diet, or

even low maternal mood during

pregnancy can all lead to an inherited

sensitivity to stress in the child,

predisposing them to development of

obesity, diabetes and atherosclerosis.

Additionally, a link was found between

global epigenetic changes (due to smok-

ing, diet, deprivation etc) and increased

biomarkers for inflammation such as

IL-6 and fibrinogen resulting in a general

inflammatory state in the

individual for the rest of their life.

While these results are not the be all and

end all, they are a step into understanding

why this situation exists, and hopefully

what can be done to fix it.

(Glasgow is still an amazing city despite

these problems, and it is a privilege for

us to study and hopefully practise

medicine here in the future. The current

health problems here are like a glimpse

into the past, with exposure to extremely

sick patients, and diseases that are not

present in many other parts of the UK.

We should therefore use this opportunity

to better our knowledge of these andbecome hopefully become better doctors

in the process.)

We asked David Morrison, a reader in

Cancer Epidemiology based at the West

of Scotland Cancer Surveillance Unit for

his opinion on what effect if any the

commonwealth games would have of the

health of Glasgows denizens. Over to

you David.

We carried out a systematic review to

look for evidence about the health effects

of major sporting events, such as the

Commonwealth Games. While there are

short-term economic benefits, there is

little evidence to suggest that there are

long-term economic or health

benefits. While absence of evidence is

not evidence of absence of an effect, do I

think that the Commonwealth Village is

likely to lead to measurable

improvements in health? It may do, but

if it does, it may be more to do with the

fact that people who move into new

housing are likely to be healthier (and

wealthier) than the rest of the population

rather than because chronic health

problems can be quickly ameliorated by

housing improvements alone .None of

which is to say that the redevelopment of

the east end with sustainable, energy

efficient housing is not a good thing.

Similarly, building modern new sports

facilities providing they are affordable

and accessible to everyone is a good

thing, but is it the most effective way of

improving health? Well, the single big-

gest thing that would improve health

would be to stop people smoking. The

effects of that would be greater than

any amount of additional

exercise. More broadly, finding ways of

getting the majority of the population

gainfully employed would have

far-reaching and long-lasting benefits on

their health. But improvements in public

health are achieved through a range of

activities and they are all

important. Some problems are more

difficult to fix than others. So while

were working on ways of further

reducing the prevalence of smoking,

obesity, alcohol abuse and other health

problems, provision of better sports

facilities is a welcome contribution to

improving public health.

Dr David Morrison on the potential impactof Glasgow hosting the Commonwealth games

At best, according to the epidemiologists'

calculations, deprivation accounts for less

than half (around 40%) of Glasgow's

"mortality gap"compared with the rest of the

UK. The other causes are still unknown.
http://theses.gla.ac.uk/846/01/2008reidjamesphd.pdfhttp://theses.gla.ac.uk/846/01/2008reidjamesphd.pdfhttp://theses.gla.ac.uk/846/01/2008reidjamesphd.pdf


8/20SURGO

Surgo March Edion

The New South

5

As Im sure you'll be at least

vaguely aware, a New South

Glasgow Hospital Campus is

currently being built on the

site of the current Southern

General Hospital. This will

contain a massive 1109 bed

adult hospital and 256 bed

childrens hospital. To put

that into perspective, thats

equivalent to 3 Western

Infirmarys with Yorkhill

stuck on the side. The

Sothern's existing

neurosurgical, pathology and

maternity departments will continue to

be based there. As if

embarking on one of the largest hospital

developments in Europe wasnt enough,

a new learning and teaching facility for

us medics is also under construction.

The new hospital, which has alreadybegun to tower over Glasgow, will be

completed during the first quarter of

2015. Many of the services currently

provided by the Victoria and Western

Infirmaries will move at this time and it

is hoped that the hospital will be fully

operational by the summer of 2015.

Thats just in time for our current fourth

years to start their FY1 jobs. This is also

exciting for those of us in the pre-clinical

years as our initial clinical experience,and much of our teaching, will be in a

brand new, state of the art hospital.

Just a small change from making the

depressing pilgrimage from a rammed

WILT to an even more soul-destroying

Boyd Orr then

So, what else is new?

A few key changes are being made to the

hospital layout; gone are large general

wards favoured by the likes of Florence

Nightingale. Instead, wards will consist

of 28 en-suite single bedrooms. This has

been done less out of a desire to compete

with Holiday Inn and more in an attempt

to improve patient satisfaction and infec-

tion control. On a logistical level, it

makes barrier nursing much easier and

eliminates the problem of mixed sex

wards. Some lucky patients will even be

offered a fantastic view of the Clyde,

sewage works included, through large

windows in every room.

These new style wards will surround acentral space housing shops, a caf and

the hospital canteen. Gone is the

infamous portacabin; it will be replaced

by an atrium that would not look out of

place in a Merchant City office block. A

central hub of the shiny new Hospital

filling the alcohol-gel laden air with the

much loved aroma of hospital cuisine.

Hopefully there'll be windows.

Yorkhill to go

A step in the right direction for Glasgows healthcare or a medical monstrosity? Contributing writer

Jamie Henderson finds out all about Glasgows new super hospital. Lets just hope everyone can get

through the Clyde tunnel in time for the next big emergency

The new hospital is

equivalent to 3 Western

Infirmarys with Yorkhill

stuck on the side.

Architects impression of the atrium

Front entrance of the New South Glasgow Hospital


9/20SURGO

Surgo March Edion

6

The Royal Hospital for Sick Children at

Yorkhill will provide specialist services

only available in Glasgow to the rest of

the West of Scotland. The linking of this

with the existing specialist maternity unit

will mean that all specialties are

completely centralised. Whilst the

childrens hospital will be attached to the

adult hospital it will have its own

identity, much like Yorkhill has today.

Unlike in the adult hospital, wards will

be a mixture of four bedded bays and

single rooms as it was evidence suggests

that many children have better

outcomes when surrounded by others.

New Learning and

Teaching Building

Along with these new hospitals the medi-

cal school and NHS Greater Glasgow

and Clyde are making a

significant investment in medical

education. Construction has already

begun on a Learning and Teaching

Facility that will be shared with

NHSGGC, and will be linked to the new

hospital.

As the facility is shared

with the NHS the medical

school will only have

official use of 50% of its

capacity, though this will

apparently remain flexible.

Within the building itself

there will be a 500-seat

lecture theatre, a caf withgood coffee Im assured,

clinical training facilities

and a library space. It is

envisaged that the facility will be staffed

from 8am to 8pm allowing NHS staff to

use the facilities outwith their normal

working hours. It also aims to take some

of the burden off the SL, during times of

great need such as when four of the hun-

dred light bulbs spontaneously combust.

Somewhat conspicuously, I couldnt find

any pictures of this snazzy new medical

school offshoot so I thought Id stick in

an equally snazzy, not at all CGI-ed

picture of New Souths multi-story

car-park. Further proof that a world

where car headlights are red and the sky

is purple is altogether a

better one.

The majority of pre-clinical training

will remain on campus; with olderstudents who are attending

placements, within Glasgow using

this facility for the majority of their

clinical teaching.

Access to the library, something I

think we are all dying to know

about, will hopefully be 24 hours

for students as well as staff

although the practicalities of this

have yet to be worked out.

Clinical Skills

Alna Robbs dream home has finally

been built. With a new clinical skills

suite, mirroring the layout of patient

bedrooms within the new hospital, there

will be more scope within Glasgow for

clinical training. It will consist of a 12

bedded area, 8 of which will have live

oxygen and suction, and a prep area. All

areas of which will be covered by

cameras with the ability to pan, tilt and

zoom, allowing Alna to monitor your

every move from the comfort of her in-

built throne. The cameras will also give

tutors the ability to record and feedback

on student performance from an adjacent

control room. Students will be able to

book time within this facility to practice

their clinical skills, just like in the

Wolfson.

With all these facilities arriving in

Glasgow over the next few years we

have no excuse for poor clinical skills.

Trips to Govan will become a daily

occurrence rather making that once a

year scrubby trip significantly less novel.

You never know, perhaps some of us

will be tempted to make Brechans our

local.

Architects drawing of the multi-story car park

Glasgow Hospital


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Surgo March Edion

NHS afterOn the 18

thof September this year the

future of Scotland, as we know it, will be

placed into your hands. Salmond and the

SNP are putting the question of

independence to the people of Scotland

and inevitably, this will have some effect

on the NHS.

Regardless of your political and cultural

views, a vote for an independent

Scotland would have a drastic impact on

the day to day life of everyone in this

country. A deluge of changes would be

implicated across the public and private

sectors and these changes will not go

unnoticed.

The NHS in Scotland has been devolved

since 1999 giving Holyrood a largeamount of control over the spending of

its health care budget. Since this time,

several major differences have developed

in the NHS above and below the border.

NHS Scotland currently differs from its

Southern brother in three principle areas;

the lack of prescription charges, by

providing free car parking at hospitals,

and in having managed to avoid Andrew

Lansleys controversial Health and

Social Care Bill.

Aneurin Bevans brainchild is taking a

very different path on each side of the

border, a gulf that is likely to continue to

widen in an independent Scotland. If the

current state of affairs were to continue,

it is likely that the South will head down

the path to greater privatisation, with the

North likely to become even more

dependant on public funding.

An NHS in an independent Scotland

would face less drastic changes than

other sectors such as the military andintelligence agencies, but changes would

be seen in several other areas that may

affect patient care.

Currently any patient in Scotland

requiring treatment in England (or vice

versa) is able to do so as part of a long -

standing agreement with NHS England.

This creates an interdependent relation-

ship between the NHS in Scotland and

the NHS south of the border.

The No campaign reminds us that the

relationship between NHS Scotland and

NHS England following a Yes vote

would be a very different one.Better

Togetherclaim that the simple internal

relationship between what are effectively

two governmental organisations will be

replaced with a complex international

relationship with all the associated

bureaucracy.

They also claim that any patient

requiring treatment across the newly

formed international border would need

to follow a similar process to the one

already in place allowing UK nationals

to get treatment in the EU.

Its argued that the impact of this newly

formed, highly complicated relationship

would be seen predominantly in highly

niche areas of certain specialisms such as

paediatrics, cancer care and

transplantation services.

One of the most frequent examples of

cross boarder cooperation is seen in

transplantation cases. Currently any

patient requiring a lung or heart-lung

transplant in Scotland has to be sent to

the transplant unit in the Freeman

Hospital, Newcastle upon Tyne.Better

Togetherargue that this special

relationship with the Freeman and otherspecialist units could be affected by

independence. This would directly

impact on the healthcare of Scottish

people, leading them to receive a lower

standard of care than their Southern

neighbours. Margaret Watt, chairwoman

of the Scotland Patients Association,

said: Whatever the outcome of the

referendum, there is already pressure on

patients when it comes to travelling for

medical treatment and the system fortreatment south of the Border is

complicated enough. We wouldnt want

to see patients placed with any additional

burdens.

Several high profile health charities have

also spoken out on the issue of

international cross border care, with

Macmillan Cancer Supporteven going

as far as recommending that patients do

not seek treatment abroad as they say

treatment in other EU countries (as

England would be) can take a number

of weeks, possibly months, which is

likely to be detrimental to patient care.

Aneurin Bevan was the MP who drafted thebill that lead to the implementation of the NHSin England, Scotland, Wales and NorthernIsland in 1948.

Our contributing writer Mr Daniel TaylorSweet explores what may happen to ourhealth service following the Independence vote taking place later this year


11/20SURGO8

Surgo March EdionWhen speaking to a consultant at

Glasgows Western Infirmary, he high-

lighted the general feeling of uncertainty

that is crossing doctors and patients

minds.

On the other hand, proponents of the Yescampaign are quick to refute this claim.

They argue that the NHS in a newly

independent Scotland would remain

much the same as it already is. They

point out that health care spending was

devolved in 1999 meaning that the

Scottish government already has control

over the Scottish health care system,

meaning that regardless of the result of

the referendum Holyrood has and always

will have total control of the NHS.

The Yescampaign claim that by having

full independence from the UK would

allow a newly formed government to

increase the health of the Scottish

population because they would be free to

increase public spending. It is well

known that life outcomes and health are

directly correlated with poverty. The Yes

campaign point out that with greater

control of spending, a Scottishgovernment would be able to reduce

inequality and thus improve the health of

the Scottish people. Although this is not

directly connected with the NHS, it

would have a direct impact on the health

of the residents of Scotland.

Whatever the outcome of the referendum

on the 18thof September Scotlands

NHS will continue to look after the

people of Scotland and will prove thatfree healthcare is critical, and it is here to

stay, leaving the fine details that

outline specialist treatment to be

confirmed and finalised after a Yes

vote. Therefore the situation of the NHS

is left to the voters, with the understand-

ing that there will be some changes that

are detrimental, and also some changes

that are beneficial for the Scottish

people.


12/20SURGO


13/20SURGO

Surgo Review

10

Planning

Firstly, I did not make the decision rashly; I chose to do my

second elective in London, an academic psychiatry placement

at the Maudsley hospital, to test the water. I thoroughly en-

joyed my 4 weeks there and would recommend a placement

before applying as its a different beast altogether from other

cities in the UK.

The hospital

For FY1 I am placed in Kingston hospital, a small district

general 20 minutes south of the Thames. Its a very affluent

area near Richmond Park (where the famous Fenton the dog is

walked) with yummy mummy Wimbledon next door. The

hospital itself employs 38 FY1s, and there is a doctors mess

with free toast and coffee (essential for on calls). The hospital

just became its own trust, which apparently means its reaching

the targets that are so important to the management team but

all I know is that its a really friendly, clean and modern

hospital. All the FY1s are good. And I mean lumbar-

puncturing-in

-their

-first

-week good.

The job

I am currently on Neurology, which involves me working

across 3 hospitals, one of which is a specialist neuro-rehab

centre. This has meant that Ive experienced 3 different

systems but has made has made it more difficult to meet other

FY1s as they lunch together and I can only join twice a week.

My neurology exam has become my main competency as I do

it at least 10 times a day. Even fundoscopy is now my friend.

On-call

We do one long on-call day a week until 10pm and one week-

end in eight. This is when you roam 8 wards alone, prescribing

warfarin and gentamicin, running away from nurses and

praying no one gets ill. It is on-call that Ive cannulated a foot,

catheterised, sedated, started the sepsis 6, spoken to relatives,

interpreted x-rays, pronounced death, pulled out drains, called

the crash team and generally sweated all over. If in doubt, page

the FY2.

The commute

Something that all Londoners endure; even at the weekend,

trying to traverse through the population of 12 million can

reduce you to tears. I live in Pimlico and can get to the front

door of the hospital in 25 minutes. Friends say this is an

amazing commute, so be prepared for worse. Surgery is the

toughest as shifts can start as early as 6am.

Money

London is expensive. My rent and travel are half my monthly

salary. To get a nice flat in a very nice area, we had to put an

offer in that day and the estate agents fees were 380 to get us

both references and hand us a set of keys. The London

weighting is roughly 1000 a year, but seeing as the tube is

200 a month, this doesnt really cut it. My rent is over double

my Glasgow rent.

Opportunities

Having said goodbye to your social life and most of your

wages you will, hopefully, look around and realise that London

is brimming with opportunity. I once presented a patient at a

neuro-oncology MDT and afterwards someone said Ill do her

pituitary if her notes are on my desk on Monday. I was soscared I scuttled off without asking his name (turned out it was

Mr Henry Marsh Wikipedia him). Im currently being forced

to do 4 audits. Literally forced. Its like youre a freak if you

say no. There are lots of academic meetings and grand rounds

to present interesting patients at. We also have compulsory

prescribing exams and ABG training, not to mention 2 hours

bleep-free teaching a week. Having said that, I wouldnt say

its particularly different to Glasgow; those that seek these

extra opportunities anywhere will get the same exposure.

FY2

For all FY1s in London, it is important to realise you will do

one year centrally and one year peripherally. And that can be

very peripherally. Like further away than Edinburgh. I decided

to do my central year first as there is a very active FY2 Swap

Shop run by South Thames Foundation School, so I thought

Id at least have a little more autonomy over my placements.

Its worked out, so far. You dont find out what youre doing

in FY2 (not in South Thames anyway), but almost everyone

does A&E.

Hopefully this brief account of my experiences will help somepoor souls going through the FPAS process next year.

If you would like any advice, please email me on

[email protected]

An FY1 in LondonI moved down to London in the wake of my accountant boyfriend who was attracted to

the big smoke like a moth to the flame. I am now in month two of FY1. This article laysout some of my experiences so far, with the view to help any other Glasgow medical

students interested in FY1 in London.


14/20SURGO

The relative effectiveness of

interventions intended to treat alcohol

hangover: resultsTadjkarimi J, Bennett E, Neilsen J et al. the other drunk people...

Surgo Research

11

Results

To recap: participants were randomly allocated to one of seven treatment groups and instructed to

consume an average Saturday nights worth of alcohol. The seven treatment groups were:

Participants were asked to rate on a scale of one to ten, how they felt when they woke up in the morning, and 2 hours after their

allocated hangover cure. On waking, far too early thanks in part to haphazard sleeping arrangements and also to a certain ex-

editor insisting on opening the curtains, our guinea pig subjects certainly felt a little worse for wear. A large proportion experi-

enced fatigue or general tiredness, with only 2 saying that this feeling was minimal. Many also scored 10 out of 10 for apathy or

a lack of concern. However as this remained largely unchanged following treatment, this may have been skewed by the cynical

nature of most Surgo contributors. Concentration problems had a relatively normal distribution throughout the population, withclumsiness and confusion scoring quite low. It was proposed that in future studies, a rubix cube could be introduced to further

asses these parameters but due to financial constraints, this did not materialise.

Thirst scored extremely highly as most people couldnt quite make it to the kitchen for a glass of water for fear of triggering

another pounding headache, or worse, a not-so-tactical chunder. People experienced little to no shivering or shakes, stomach

pain or palpations. There were however, scatterings of dizziness and nausea seen in isolated pockets of the population.

Following ingestion of the allocated cure, and once the two poor souls who had to run to Maryhill Tesco in order to procure

readily fry-able foods had returned, subjects lounged around for a number of hours before they could summon the will to return

to their respective homes. They once again took the questionnaire posed to them earlier, at which point I was left to discern

what effect, if any, these therapies had had on their hangover status. Results were largely inconclusive though there was a slight

global shift to a drop in severity of symptoms for all areas tested; except that of apathy. Thanks guys.

Discussion

From our results, it appears very difficult to discern which remedy had the most effect in eliminating the toxic effects of

alcohol. Clearly, the strictness of scientific protocol wasnt upheld as we all got food envy and ended up joining in on the fry

up. In addition to this, a handful of subjects forgot to fill in the questionnaire so had to do so retroactively. Despite these minor

short-falls, for our first foray into research it was a fine attempt and although weve learnt pretty much nothing about what

works, weve gained extensive experience of what doesnt. Like most of the population when asked, subjects swore their

method of getting rid of a hangover was the only effective way of doing so, and, as expected, its probably based on a foggy

notion that on that one morning after the night before they felt right as rain. This author swears by two paracetamol and a pint

of water before bed (if you can remember to do so, which is hardly ever) but again, cant really back that up with anything more

than anecdotal evidence. Our current editor on the other hand, has become recreationally addicted to Milk Thistle. I think its

also true to say that in all the years that ethanol has existed, if a magic bullet for treating hangover symptoms existing we would

surely have discovered it by now. Before starting this trial, we did find a number of papers out there examining many weird and

wonderful treatments, with no clear consensus. The conclusion they reached was much the same as ours; if a 100% certifiedhangover cure sounds too good to be true, it probably is. Drink in moderation, or otherwise, try curling.

1. Paracetamol/ibruprofen with Irn Bru

2. 5k run to Maryhill Tesco's and back

3. Full Scottish breakfast

4. Hair of the dog (drink of choice)

5. Milk Thistle tablets

6. 0.9% saline

7. Wallowing in self pity (control

group).

Some of you may remember our botched attempt to enter the world of scientific academia in our last

issue. What follows is a jumbled effort to pick out any trends in how effective one so called hangover

cure maybe over another. A quick word of warning; dont take any of it as gospel. Its somewhat impossible to remember eve-

rything from one night 3 months ago, and no one could quite be bothered to take notes. Understandable really, as we were all

hanging pretty badly...


15/20SURGO

The Ig Nobel Prize

12

Many of you wont have heard of the Ig Nobel prize and quite frankly, you are perfectly vindicated in your state of ignorance;

the prize will never coat the glossy pages of more reputable publications such as the Lancet, the BMJ or Total Flyfisher. A

prize for those researching what we wouldnt deem worthy of a fleeting thought, the Ig Nobel prize has been rewarding those

rascals pursuing obscure breakthroughs since 1991. We here at Surgo, as co-founders of the award, have always been very

proud of its ability to find pioneers of the modern world. Fields such as Medicine, Physics, Physiology, Nutrition and Peace to

name but a few, have been scoured to find the most utterly useless but remarkably humorous pieces of research. Focusing on

medicine (and throwing in a few other crackers) I hope to moisten your palette as I walk you through the fantastic world of the

Ig Nobel prize. Perhaps it may even lead to an inspired SSC self-proposal and you may find yourself at Harvard University

accepting your own Ig Nobel prize.

In 2012 a pair of cheeky fruit loops Emmanuel Ben-Soussan and Michel Antonietti from France were rewarded for their

research advising doctors who perform colonoscopies how to minimize the chance that their patients will explode.

Weve all seen it happen on placement, so its good someone is looking out for the patients. Zut Alors!

Ever been caught out by a nasty cause of the hiccups? Been told to hold your breath? Have a glass of water? If not you

havent lived. Luckily an American by the name of Francis Fesmire came to the discovery of 2006 by realising that a

digital rectal massage causes termination of intractable hiccups. Ive been doing it for years and nobody has be-

lieved me. #digitdoesthejob

The 2013 recipients of the Medicine prize were a group from Japan assessing the effects of listening to opera on heart

transplant patients who were mice Wonder if it was pavaratti? Either way theres no looking Bach for them. (I dont

get paid for these puns)

Thats enough medicine for me. The Peace prize in 2013 was won by Alexander Lukashenko, president of Belarus, for

making it illegal to applaud in public, AND to the Belarus State Police, for arresting a one -armed man for applauding.

With the Commonwealth Games coming to Glasgow Ill throw in a sporting discovery from 2011. Four scientists from

France and a Dutch bloke discovered why discus throwers become dizzy and why hammer throwers dont! Im not sure

why this is a thing either

Viagra aids jetlag recovery in hamsters. Personally I think an hour or two on the wheel is going to do a better job than

hours and hours of humping sawdust will but Im not winning these prizes for a reason.

Finally, youll be glad to know, my personal favourite. Brian Crandall and Peter Stahl from the USA went to the extent

of parboiling a dead shrew, and then swallowing the shrew without chewing, and then carefully examining everything

excreted during subsequent days all so they could see which bones would dissolve inside the human digestive

system, and which bones would not. Apparently that is Archaeology. Astounding.

The day you find yourself swallowing an entire shrew is the day you know you really are making a difference to the world and

shaping the future of generations to come. Id like to think you are now looking at your surroundings, questioning them and

will strive to change them. What are the effects of Calvin Klein boxers on Sloths with inguinal hernias?! Stay tuned to Surgo

and youll be the first to know. Until next time scholars. Science.

The Ig Nobel Prize -Pushing the boundaries

of the unnecessary

By arts editor David Boyle (formally known as Druid Boyle)


16/20SURGO13

Fun stuf

The FAQ Awards

There are many fine initiatives which have harnessed the power of technology to improve

Medical Education. The FAQ website isn't one of them. Over the last couple of years it has degenerated from an

academic resource into a conduit for gratuitous abuse, threats of violence and utter, utter nonsense, some of which

will be illustrated in the pages of this edition of Surgo. It was Mandell Creighton, 19th century Bishop of London

and Inaugural Professor of Ecclesiastical History at Cambridge University who said: "The real object of education

is to have a student in the condition of continually asking questions." The following article will prove how very

wrong he was...

Professor Mathew Walters, (Doctor, Educator and FAQ slave)

In response to a 2009 question on pneumonia

Welcome student,

Do not be afraid of the sequinned cloak over my tweed onesie, for I

am Mystic Matt, Psychic

Investigator and spirit guide on your quest for truth. The answers to

questions like yours, young man, lie beyond the reach if mortals and

can only befound on the ethereal plane.

Let us begin. High Priestess Eunice has already inspected the en-

trails of a freshly-killed medical school applicant (we've had to add

a "ritual sacrifice" round to the mini-interviews as the UK-CAT

scores were pretty high this year) but the only knowledge we gained

was that it's nearly impossible to get bloodstains out if a Hutchie

uniform.

So let us gaze deep into my crystal ball and the spirits may show us

the truths we seek...

Yes, yes, I'm getting something....whispers from "beyond"... getting

louder...

[AT THIS POINT EYES ROLL BACK AND VOICE BECOMES

A GUTTERAL DEMONIC SNARL]

YOU FOOLS THIS QUESTION CANNOT BE ANSWERED AS ITS TOO VAGUE AND

PROBABLY THE WORK OF SOME DODGY LECTURER DOING UNAUTHORISED MEDI-

CAL EDUCATION EXPERIMENTS LATE AT NIGHT IN THE LAB

OH AND BY THE WAY, BLOOD TESTS ARE NOT INVASIVE

The Night Before Christmas

Twas the day before Christmas and all through the SL

some 5th years were stirring and complaining of hell.

As they sit and revise some paeds, maybe gyn

they look forward to dinner of meat from a tin.

The 1st years were nestled all snug in their beds

While visions of Alna Rob danced in their heads

The 3rd years revised at home with some cake

But 4th years in the SL much panic did make.

The wind outside it made such a clatter

So music was turned up, disturbance? No matter.

The staff in the med school, a half day were granted

And merry thoughts throughout the SL were planted.

The lights of the cars on the street wooshed past,

Until there was a sound -a resonant blast!

Up rushed the 5th years to the atrium with fear,

They knew not, what was happening here.

There stood a man in a red velvet suit,With a dark brown beard and shiny black boots,

He stood by the tree in medical school,

To be honest we thought he looked like a fool.

He was leaving some gifts all under the tree,

Answers to FAQs answers for me.

A wink of his eye and a twist of his head,

Soon gave me to know I had nothing to dread.

He left the building as quick as he came,

He left so fast we couldnt ask him his name,

But I heard him exclaim, ere he drove out of sight,

"Merry Christmas to all, and to all a good -night!"

Prof on the future of medical education

Medical educationalists have tried a huge range of

initiatives (PBL, CBL, etc) but the potential benefit of a full-on staff/

student fist fight in the car park at the end of a tough five years has

been sorely overlooked.

In a few years the OSCE will be one 5 minute station consisting of

a basket of puppies and abig hug.

Sadly VALE will be shut down next year and with it will be lost a vast archive of learning and wisdom. For the

benefit of all future medical students, contributing writer Mike Pretswell has collected some of the very best andsaved them for posterity.


17/20SURGO

Fun stuf

14

The Tale of the 5th Floor Terror

For a time in January the SL was plunged into darkness and reports

began to filter in that strange happenings were to be seen on the

5th floor. Bloodcurdling screams, flickering lights and even a

balding man pacing the shelves and muttering about traction

alopecia. It started quietly with an innocuous FAQ about hair loss:

Dear Prof, A wee festive EMQ for you that has left us close to

tears. 2010 paper 1 EMQ 1.2 Theme: Hair loss. Can you shed

some light?

(The urgent answer)

LISTEN CLOSELY. DO EXACTLY AS I SAY AND

EVERYTHING WILL BE FINE! SLOWLY PUT THEQUESTION DOWN.BACK AWAY TOWARDS THE DOOR.

KEEP YOUR EYES ON THE QUESTION. NO SUDDEN

MOVEMENTS. ONCE OUT OF THE ROOM GENTLY CLOSE

THE DOOR. BRICK UP THE DOOR AND NEVER SPEAK OF

THIS QUESTION TO ANYONE ELSE. EVER.

This is the worst question in the history of finals. We have taken it

out of the question bank and had it shot.

Later that week,

Hi Prof, I did as you asked and walled up a project room) withthat alopecia question inside. Unfortunately I can now hear

scratching and weeping noises from within. Either the question has

grown sentient heralding the start of a follicly challenged apoca-

lypse, or I accidentally sealed a first year in there too.

Dear Prof, I unwalled the 5th floor project room as some nutters

needed for "OSCE practice". Much to my surprise inside I found

the carcass of a now bald 1st year, but the alopecia question was

nowhere to be seen. Ive stared patrolling the SL with a shotgun

and a can of rogaine

Dear Student, Stay vigilant! I fear that rogue alopecia questionmay have targeted Jesse Dawson, he's in the office next to me

writing an IPL scenario about Minoxidil while wearing a baseball

hat.Give us our daddy back please

Musings on life as a medical student...

I suffered a similar fate in5th year during a block at In-

verclyde.Imagine a wet Guantanamo Bay with a chip

shop. One of my ultra-keen student colleaguesinsisted

on being given apage so he could be beeped for

interesting events out of hours, and to alleviate theterrible boredomwe took it in turns to get up overnight

and page him from the onlyphone in theresidences, get-

ting him to call the number of that same phone. He never

worked out why it was constantly engaged, despitebeing

three o'clock in the morning.Progressively the relent-

lesssleep deprivation took a terrible toll on him. The UN

insisted on the closure of those residencies not long after.

On Pulmonary Embolisms:

This young seal presented with

pleuritic chest pain and shortness

of breath on diving. He had noted

a swollen flipper a few days

earlier but had not soughtmedical attention. The CT scan

he was undergoing when this

picture was taken showed a filling defect in the pulmonary artery.

In the absence of obvious risk factors they did a thrombophilia

screen which showed he had "protein sea" deficiency. He was

treated with "wharf-arin" and you'll be pleased to hear he made a

full recovery.

There have been more than 5 FAQs a day submitted since

Christmas, some at 3 in the morning, some in barely

intelligible English and most clearly on the edge of

despair. But all have been answered with compassion, wit

and genuine insight. A big thanks, and SRC teaching

award goes to Prof. for undertaking such a mammoth

task. In his own words:

I do this not for money but because I care. That and the

sad fact that my bins get out more often than I do.

Q.Hey Prof, thought you might be interested to know you

share the same birthday as Elijah Wood. I can certainly

see a lot in common, both saviours of the free world and

vanquishers of evil dark overlords (a certain he who shall

not be named year head)

A. Your Lord of the Rings reference is pretty apt: I

frequently see the frail,

emaciated figureon the

left while I'm atworkand

wonder if he's following

me: Do you think they're

related?


18/20SURGO

Fun Stuf

15

Questions:

1.

Will you develop dementia-

what are scientistslooking for in blood that could detect early signs of

dementia?

2. Nightmares in childhood what could this lead to?

3. How much was the British Pregnancy Advice Service

fined after its website and all confidential information

was hacked?

4. How many cases of Malaria were there in 2012?

5.

Talking of Malaria, why are a further 3 million moreunder 15 year olds at risk every year?

6. What did a widow recently win in a legal fight?

7. How old was the giant virus that scientists brought back

to life after being found in Siberian Permafrost?

8. What was it called?

9. For the Student BMJ avids: what no longer qualifies for

points in the UK Foundation Programmeapplication process?

10. What has happened to the baby born with HIV in LA

last April?

11. The NHS is set to trial an Edible Health Sensor what

is this?

12. What did a snake recently kill and eat in Queensland

Australia?

13. What bill are doctors in Scotland supporting they

believe it will complement palliative care, not

undermine it?

14. What is the name of the ecstasy tablet that police are

warning people not to take?

15. How many people have died from Bird Flu this year

already?

16. A hospital in Staffordshire has decided to start a new

type of consultation. What is it?

17. And last but not least!! What did the outgoing NHS

Chief Sir David Nicholson do to the National Director

for Patients and Information?

Answers:

1.

Fat! (levels of 10 lipid molecules could predictdementia onset with 90% accuracy!)

2. Psychotic Disorders! (Around 47/1000 children!)

3. 200,000!

4. 207 Million!

5. Temperatures are changing and mosquitos are moving

up to higher altitudes!

6. Her husbands frozen sperm!

7. 30,000 years old.

8. Pithovirus sibericum, it belongs to a class of giant

viruses that were discovered 10 years ago.

9. Presentations. Oral and Poster, International/National

dont matter anymore!

10. Free of HIV after starting treatment in womb and 4

hours after birth!

11. Edible magnesium and copper sensors, attached to pill

to be taken, which send an electronic signal to a patch

on the abdomen! This enables doctors to ensure

medication has been taken!

12. A whole crocodile! Wtf. Bit of non-medical chat there.

Apologies.

13. The Assisted Suicide (Scotland) Bill

14. Mortal Kombat

15. 72 (Far more already than in the whole of 2013!)

16. Skype Consultations!

17. Made a spoof Hitler Youtube Video (The scene from

Downfall!) taking the piss out of him and his work! He

had to apologise later of course.

Score:

17/17 Seriously?

12-15/17: Pub quiz team

7-11/17: Good effort!

2-5/17: Fair.

0/17: Ermmmm.. Well as long as youre doing your

PBL

Medical News QuizHow much have you been keeping up with whats been going on outside Facebook?


19/20SURGO

Do you have an interest in journalism or writing in general?

Are you curious about the influence of the wider world on medicine, and vice versa?

Do you have an opinion or perspective you think should be heard?

Join the writing team atSurgo!

Awful (-Matthew Walters), Visionary ( -William Shatner)

The scalpel-sharp edge of modern medical journalism ( -Ian Swan)

Fun stuf

16

All of us non-Glaswegians will remember a time, probably

from somewhere towards the beginning of first year, when

someone came up to you shouting

geiswanoyerfagsahvranoot. Your response to this couldmean the difference between hearing Nae bother pal, cheers

and am gaunae chib ye (I am going to stab you). So here are

a few words and phrases to help decipher this strange, strange

language..

English to Scottish

Child Wean, bairn, chile, littlin

Disgusting/dirty Boggin, clairtie, manky, mingin, hough-

in

Drunk Steamin, mingin, pished, hammered, guttered, blu-

tered, fou, smeekit, roarie, the worse odrink, bleezin fou, pie-

eyed, mortal, stottin, soople.

Excellent/good Guid, braw, grand, rare, barrie

Idiot Eejit, galoot, numpty, daftie, bawheid, muppet, neep-

heid, bampot

Shut up/stop talking nonsense Haud yer wheesht, dinnae

haver, git awa an bile yer heid, yer aff yer heid!

Sick Nae weel, peelie-wallie, seek

Scottish to English Words and Phrases

Blether Chat, gossip

Bonnie Pretty, nice

Dour (pronounced door) Glum or miserable

Foosty -Mouldy

Geesa or geis (pronounced Geez) Give me. E.g. geesalight.

Haver To lie or speak nonsense (pronounced Hayvurr)

Jag -Injection

Jake/jakey Term used in Scotland for those you might

regularly see seeking advice from Jeremy Kyle. Also known as

a Ned.

Jis a few bevvies Just a few drinks. Can mean anything

between a thimble of sherry a month, and two bottles of

whisky a day.

Och! Oh! E.g. Och aye the noo means Oh yes, just now,although no Scottish person has ever said this.

Pal A word used to refer to just about anybody in any

situation. Common uses (e.g. Yalright pal?) can be friendly,

aggressive or anywhere in between, depending on the context.

Polis The police.

Sair-Sore

Taps aff! Tops off! Expect to hear this everywhere on the

first sunny day in May.

Wee-Small

Wheesht! Be quiet!

Scottish-English Dictionary


20/20SURGO

Surgo March Edition 2014

Documents

Transcript of Surgo March Edition 2014