BY NEBULA CHOWDHURY

Initially, one may think that the only links between ‘surgery’ and ‘social media’ is that they both start with the letter ‘S’ and that they are two things that an average middle-aged person may not completely understand. However, upon deeper reflection, one would realise that we have been using social media to benefit the surgical world in many ways.

Social media is increasingly playing a role in surgical education. Relying on books and lecturers alone is an obsolete concept as students are perpetually utilizing the Internet to complement their studies. In her editorial, “Using social media effectively in surgical practice”, Texas cardiac surgeon Dr Mara Antonoff writes her experience of supervising an intern who was placing a central line for the first time. She recalls watching in awe as the intern did the process flawlessly. When Dr Antonoff asked the intern who had taught her, she clarified that she learnt it through ‘Youtube’ and had only physically gone to one simulation class. This highlights the changing nature of the way education is being delivered to the next generation of surgeons. Various social media sites contain vast amounts of credible content. On ‘Youtube’ alone, there exist numerous medical education channels such as John Gilmore M.D, Dr. Najeeb Lectures and many more. Education through social media is not limited to medical professionals – certain content is created for the prospective patient. A leading Sydney Plastic Surgeon, Dr Eddy Dona, live-streams entire uncensored cosmetic procedures on his Snapchat channel. Though controversial, Dr Dona believes that this strategy successfully provides people with complete medical details so that they can look past the ‘glitz and glamour’ of plastic surgery in order to make a holistic decision on whether to undertake a cosmetic procedure.

Social media is also a prodigious platform for information sharing and discussion. This is due to its ability to bring large numbers of like-minded people together. For example, The Royal Australasian College of Surgeons regularly updates their Facebook page to keep surgeons and medical students updated on the happenings of the surgical world. Social events, important journal articles and many other relevant information are all conveniently curated in one place, providing a highly accessible medium for health professionals to keep up with the important knowledge. Additionally, the fact that social media allows for the easy gathering of people from all over the world enables health professionals to engage in scholarly discussions with colleagues that they might not have been able to reach otherwise. For example, there exists an “International General Surgery” journal club on Twitter, which goes by the name of “Int Gen Surg J Club”. This club connects thousands of medical professionals who meet online monthly to discuss new articles related to general surgery. The many contributions of people from 69 nations allow for a more sophisticated discussion- and it would have been impossible to maintain such monthly meetings if they were to do them in person.

The fact that social media enables widespread reach also renders it an attractive realm for advertisement and publicity. Both surgeons and hospitals use their social media pages to share success stories and promote their practice. Dr Simon Ourian, the Kardashians’ plastic surgeon, has posted hundreds of pictures on his Instagram account ‘simonourianmd1’ showcasing the various dermatological cosmetic procedures that he has done. Recently, on their Facebook page, the Royal Children’s Hospital also posted a video of a young girl going through her cancer treatment. 5-year-old Christy was diagnosed with aggressive neuroblastoma and the video shows the cycles of radiation therapy, chemotherapy, stem cell transplant and other procedures that the little girl went through until she was finally in remission. The posting of success stories and procedures confers credibility and experience onto the business, incentivizing prospective patients to choose them over other services.

There are also patient-specific services empowered by social media – such as financial services and support services. It goes against the fundamental nature of surgery to cost patients an arm and a leg but that happens to be the case for many procedures. For patients in need of financial aid, there are many crowdfunding websites around the world which allow them to raise the money required. A prominent local example is mycause.com.auwhere surgical patients or their families can start an online campaign by posting the amount that they need to raise, accompanied by pictures and a brief medical story. Patients would then continuously update their treatment progress and donors would comment the amount that they gift along with a message for the patient. These sites are accessible worldwide, connecting patients with almost anyone around the world. This makes it more likely that the patient would encounter someone that would sympathize with them, increasing their chances of receiving a donation. In terms of support services, there exist many online support groups for patients that have undergone various procedures or are experiencing a certain condition. The global website inspire.comcontains hundreds of these in one place. Patients can join an online community and talk to other members, benefiting from the company of people that can empathize with them.

However, there are certain disadvantages to having social media linked to the surgical world. The notorious doctor-rating websites such as RateMDsand Vitalsare a good example. The fact that many patients ‘google’ their surgeon places too heavy an emphasis on such platforms and their ratings which have a possibility of being misleading. These sites allow for anonymous reviews and have features where doctors can pay to have reviews hidden or have banner advertisements on the pages of other non-paying doctors. These ‘tactics’ reduce the integrity of these websites, not making them an honest provider of surgeon information, instead fostering a toxic sense of competition.

So, are surgery and social media incompatible? Not at all. Amongst its many other uses, it is already being employed in the educational, informational, promotional, financial and supportive aspects of surgery. Despite the problems, there is a net benefit in employing social media in surgery. It is already enriching our present surgical world and there is no doubt that if managed correctly it will continue to do so in the future.

By Jun Kim

2018 Auricle Writing Competition: Highly Commended

“Mr Hodge-Johns?”

There’s always one. The whole school calls me Hodgey and yet there’s always that one kid every year who takes the extra second to say my tongue-twisting institutionalised name.

Back in 2022, my automatic response to being called Mr Hodge-Johns would have been to exclaim that I wasn’t a surgeon. But none of the kids got it, and it cut me more deeply than I’d bargained for, so I dropped that line into the “never again” basket. It has stayed there for forty years, and it wasn’t about to come out today.

“Mr Hodge-Johns? Can I ask you a question?”

I could sense the irritation in stressed Year 12 girl’s voice. I smile slowly without sound as I swivel around in my wheelie-chair, which groans softly in disapproval of my summer diet of ice-cream and beers. Within seconds, I’m wading my way through another rendition of “you’ll learn it next year if you do maths at uni”. There was once a time when I used to teach beyond the study design, but tenure has capped my efforts at the bare minimum. Is loss of motivation a symptom of burnout? I know burnout is a symptom of burnout, I learnt that much from the mindfulness bloke. Maybe I would have learnt more if I went to lectures.

Am I bitter? I can’t say I haven’t lived a fantastic life; one full of meaningful relationships and enjoyable moments, along with the opportunity to shape young minds. For over forty years, I have been able to consistently generate laughter and confidence and educational satisfaction within my students, whilst also maintaining a good work-life balance and having time for leisure activities.

And yet, despite all that fulfilment and achievement, I can’t help but wonder about the journey I might have had if I’d kept going straight. Back at the start of 2016, it was like I was in a manual car, driving towards my ideal future of being a doctor. I headed off without any help from Google Maps, because the road was long and bumpy but straight – med school, intern, resident, registrar, consultant. But as I continued, I realised that the drive was harder than I thought. Med School Road had far more hills and traffic lights than I’d bargained for, and after passing through primary and secondary school without a hitch, it felt like I’d forgotten how to stop and start the car. Jarring gear changes and unfortunate stalls at intersections made me doubt whether I was on the right path, eventually compelling me to enlist the help of satellite navigation as I barely made it through Third Year OSCEs.

You know when you’re fairly confident about the route you’re meant to take but you turn the navigation on just to be sure? It was like that for me when I said, “Ok, Google”, and asked to be taken to my future. I was in the left lane expecting to stay straight towards 4C, when Ms Google said, “In 200 metres, make a U-turn”. A questionable pair of lane changes and a vicious U-turn later, I settled into a new route which led me through the Education part of the Clayton campus and eventually back to high school, where I hopped out of my car and have remained ever since.

Did Google Maps make a mistake? Or at least, did my Google Maps make a mistake? Quite possibly, because my Ms Google back then was Blake, a Year 12 student whom I was privately tutoring. He was a high-achieving student and he wanted to get into Medicine at Monash, so I often talked about my experiences of medical school, perhaps with more honesty than I should have. He was more of a listening type with a fairly shy nature, which meant that his words were infrequent unless I prompted him. But after a lesson which combined clear explanations of hypothesis testing with accounts of how difficult I was finding the Gen Med ward rounds, he did have this to say:

“You should just become a maths teacher, Tim.”

…

I do sometimes wish that my pursuit of secondary teaching was a whimsical daydream formed by an apathetic third-year student who’d had enough of feeling like he knew nothing in medicine. I do sometimes believe that the steps of my working life should have been plotted along corridors of wards and labs, not classrooms and lockers. I do sometimes dream about what I could have done if I’d kept going straight.

By Anna Bayfield 

Hello, my name is Anna, and I have an addiction to Australian politics – “the ScoMo express”, “shoegate”, “it’s okay to be white” – I cannot get enough. Through the year I get my fix from the weekly Australian political analysis podcast by ABC Radio National  “The Party Room.” Patricia Karvelas is an ABC political journalist who co-hosts the podcast, and as a fan I quickly became aware of an unfolding media scandal she has been embroiled in late 2018. Ms. Karvelas was instructed to leave Question Time due to “showing too much shoulder”  – the offending piece being a white blouse with capped sleeves deemed “sleeveless”.

This story stuck with me as it occurred just weeks after I had a similar experience on my psychiatry placement as a fourth-year medical student. I was taken aside by a female colleague of the male doctor whom I had been shadowing for the morning, who told me, in a very apologetic way, that her colleague believed the way I was dressed was inappropriate. She tried to throw me a bone to soften the blow – she shrugged her shoulders and gave a sympathetic laugh; she joked that it was “silly” because every other day she would “come into work dressed like a hoe” but that her colleague was “old school” and had felt the need to tell me.

It is interesting, a small repudiation by someone in the workplace on your clothes – it should not be a big deal. If it is simply a matter of professionalism, like washing your hands thoroughly, or examining a patient in an appropriate way, it should sting a little bit as any criticism does to perfectionistic personalities, but ultimately it should not seem personal, or evoke any deep-seated emotion.

Why then, did I spend weeks cringing over this comment? Why did I go through a Kubler-Ross-reminiscent evolution of my attitudes towards it? I began with dismissal; I rolled the comment off my shoulders with an effortless shrug. Fair enough, I thought, I should have known better. Did I think I was dressing inappropriately when I chose my clothes that morning? Of course not, but I guess I was wrong. I would learn from this mistake. Within the minutes it took to walk from the hospital entrance to the car, I shifted to doubt. Was what I was wearing really that inappropriate? I had seen other doctors wearing stilettos before – surely that was more inappropriate if only from a practical perspective? My doubt turned to anger, then to bargaining. Maybe I would not be so annoyed about this if the male doctor in question had just spoken to me himself, instead of asking his female colleague to speak to me. I mean it did not have to be a gendered issue, but he had made it one! And then this female doctor – did she agree with her colleague? If she did, why had she apologised on his behalf? And if she did not, why did she not tell her colleague so and refuse to pass along criticism she did not agree with?

I spoke to a number of friends about my thoughts, but could not quite articulate myself the way I wanted, nor could I quite evoke a response that satisfied me. I did not want sympathy, I wanted validation; affirmation that I was objectively in the clear and had committed no wrongdoing.

After about a week of this I managed to burrow to the roots of my discomfort, and it came down to two essential points unique to the issue of what is deemed “appropriate” workwear for women. Firstly, I was embarrassed because I feared I had made a mistake. I could not find the objective validation I sought, I could not simply look up the correct answer; this was a grey-zone marked by opinion and personal values. My second source of grief was the criticism itself – I had essentially been told I had dressed too provocatively for work and it hurt. It did not sting like any other criticism, it was strangely degrading and humiliating. How could I not know how to put clothes in a respectable way on my own body? How could I fail at this blindingly simple task that nobody else seemed to have a problem with?

At this point many of you may be rolling your eyes and thinking I am over-analysing, and maybe I am. However, that does not change the crux of the problem in this scenario, and that crux is this: fearing you have dressed provocatively for work, and being punished for it, is a uniquely female problem. The fact of the matter is – I cannot think of a male colleague in my life who has ever looked in the mirror before heading off for work, or placement, and thought to himself – “am I dressed provocatively?” Perhaps; “am I dressed inappropriately?” or “am I dressed too casually?”, but never a question of whether his clothes convey an unwanted sexual message.

It is important to note here that I am not saying that this is the male gender’s fault. We are operating in a world of shifting sands. The bedrock values that inform our everyday decisions are evolving rapidly, often without even our noticing. There was a time where it was consistent with our values that women should dress more conservatively. That is certainly still true in some cultures that exist within multicultural Australia, but in many other cultures that value has changed. Women’s bodies are no longer seen as hyper-sexualised objects in need of protection from the world at large. The problem is that, although overtly our values have changed, subvertly – as reflected through the policy that a woman’s shoulders are not permitted in Question Time – the remnants of this anachronistic belief system still persist without our knowing. That is why I have written this article. That is why I think this is an important topic of conversation. That is why we need more women like Patricia Karvelas. We cannot change the things we do not name. Like a slender thread of mercury winding its way down a riverbed from an occult  source upstream, we cannot recognise the significance, and danger of seemingly innocuous comments on dress code policy unless we go looking beneath the surface.

I considered for a long time posting a photo of what I was wearing that day, but decided against it. Posting a photo would only serve to validate my own feelings if you agreed with me. The point, in my view, is not whether or not what I wore was appropriate, but rather, the bigger conservation. Why do we consider some things appropriate, and other things not? Is our rationale behind this distinction fair? If it is fair, is it there a way we can better frame it so as to not humiliate women when criticising them? I do not know the answers to these questions – they exist in the grey zones, shifting sands and murky riverbeds. I hope through writing this, through others reading it, and through leaders in the community openly talking about it, that we can find these answers, so that women such as myself do not have to feel alone or ashamed for the deceptively simple task of choosing a shirt to wear to work.