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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
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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
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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).
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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
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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.pdf5/27/2018 Surgo March Edition 2014
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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
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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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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
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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.
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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
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.
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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...
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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)
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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.
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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?
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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?
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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
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