The Adventures of Pen

By Rav Gaddam

There are many things that bind the medical student community together; our love of stealing food, the ability to still be bamboozled by an ECG, and of course, our innate skill to lose pens at a rate that Ebola has got nothing on.

But have you ever truly wondered what happens to a pen? Where does it go? What adventures does it have? Ever wonder about the people and things it sees?

Well, if you’re reading this article, you can guess that I have.

My pen’s journey began last year, when I lent it to my consultant who snapped their fingers at me and gestured to my pen as they were on the phone. “Do you also have some paper?” I was also asked, while begrudgingly handing over my favourite black pen.

I was unfortunately called away by a registrar, lured away with the promise of being able to cannulate the next patient. As you can expect, I never did get that pen back, and I assumed it had been lost in the depths of the pen blackhole that is a hospital.

At the same time though, I also imagined that my pen saw many exciting things in its life. It would likely have been used to draw up a drug chart to save a patient from a DVT, or sign path forms for a renal patient on dialysis. It could have been used to write down obs on a glove in ED, or provided comfort to that paeds patient who had left their mark on the hospital (likely on the walls, possibly on the bed covers). It could have also vacationed in world of hospital administration, and heard all the juicy gossip about the number of beds that were not available that week. Who knows what the pen could have done; the possibilities are endless!

Well, in some exciting, awe-striking news, I found the pen.

Nearly a year later, as I rocked up to the first day of my new rotation, I found “pen”, as I affectionately now call it, sitting innocuously in a surgical theatre. “It couldn’t be,” I thought to myself. “After all this time?”

Now, I can imagine some of you scoffing at this story, and some perhaps even accusing me of stealing a pen that perhaps did not even belong to me anymore, for it now belonged to the hospital. Pish-posh, I say. This event was a reunion that would have put The Notebook to shame, and made you weep like the time Mufasa died (it’s been 24 years, and I still cry. Every. Single. Time.)

It would have been a reunion story for the ages, a tale so splendid that David Attenborough would have wanted to make a documentary about it.

That is until the consultant snapped their fingers, and off my pen went on an adventure again.


Featured image from user FP Network on The Fountain Pen Network

Dating Medicine

By Ning Yih Kam

My relationship with Medicine has been a tumultuous one. It is very much like I’m dating medicine…

My love for Medicine started with an infatuation – a crush, as some might say. I was attracted to the prospects Medicine offered me. ‘He’ appeared reliable, strong, caring and sometimes even mesmerising. But that is all I know about Medicine. I was attracted to the security he provided me with, the respect everyone seemed to have for him, and his seemingly endless intellect. But that’s not why Medicine was attracted to me. He seemed to respect my diligence, my willingness to make sacrifices for the things I wanted. He appreciated the fact that I could hold my own against him.

Then Medicine asked me out. I vividly remember the day he did so – it was nearly 3 years ago now. Even the fact that he bothered to ask me out seemed like such an honour – people were practically throwing themselves at him – and here I was, a plain Jane, that Medicine asked out. I was elated to say the least. On our first date, he woke me up at 8am in the morning, with a call – telling me not to worry, the first few months of a relationship he said, were always the best – the Honeymoon period, or so he called it. And he was right, Medicine for those months, never ceased to be charming, provocative and ultimately seductive. He could’ve seduced those who were at first, totally uninterested in him, and put off by his demanding attitude. I did not just want to be with him, I wanted to be him.

And then we celebrated our first anniversary. The first of many, I would’ve hoped. He gave me a utilitarian, digital watch and says, ‘I don’t want you to miss any of our appointments – they’re all important’. I was so pleased at the gift – I hadn’t expected any, but at the same time, I was profoundly confused – surely, we will have some time outside of each other?

It was by third year that the cracks in our relationship started to appear. At first, the thought of spending all my time with him had made me so happy, but all of a sudden, as I watched my friends enjoy their social lives, I realised how restrictive our relationship had become. And that wasn’t all. There were stories. People who had dated him before told me to beware of the initial allure, of his initial charms. ‘He doesn’t work out for everyone, you know’, said a friend.

Third year, the relationship had become a chore. He wanted more and more. He was insatiable. My time, my intellect, my life: everything was not enough for him. Nothing was ever enough. Maybe our shabby foundation had started to rattle us. We decided, or rather, I decided, that I needed time away from him – time to do what I loved to do, without him intruding. I just didn’t feel like me anymore – I felt like my life was overrun with assignments, OSCEs, hospital placements and more.

During our time away from each other, I realised how shallow my reasons were for dating Medicine. What had attracted me to Medicine? Was it the unattainability? Was it the glamour? Was it the constant challenge? Was it the allure of making a difference? Perhaps it had been the strange amalgamation of all of the above.

As I contemplated my return to Medicine, I knew I would have to confront all I had learnt in the past 3 years. The reasons that had drawn me to Medicine initially, now appeared feeble – or even slightly repulsive. A return to Medicine would require stronger foundations. I needed to be able to justify the long hours, the years of less than desirable working conditions, the intellectual rigour and the physical exhaustion.

At the end of my deliberation, I decided to return to Medicine. In my cynical moments, I thought I was returning to him because I had nowhere to go. In my moments of positivity, I felt I was returning because of a faith that things would work out between us. But ultimately, the appeal of either of these extremes never lasted. I didn’t want to return to Medicine cynical or hopeful. What I did want to do however, was to return to Medicine not in a way that consumed me; but in a way that allowed me to retain who I was.

This is why we couldn’t date anymore. I look at Medicine now, as an equal. I’m not exhilarated by his presence, and I am no longer ignorant to his flaws. I want Medicine to be part of my life, not my whole life.


Featured image from Four Seasons Hotels and Resorts

 

How it is to be labelled crazy

By Anonymous

We have all met Borderline patients on the ward. We are told they are manipulative; “Don’t trust them,” we’re told.  I nod along, agreeing with the words my superiors say. However, I do wonder how they would respond if I turned to them and said “ I have Borderline”. I imagine the responses would be varied; some may laugh me off, thinking I am telling a funny joke. Maybe others would get defensive, tell me that my psychiatrist got it wrong. They struggle to understand how the medical student in front of them, the one that has been keenly asking questions, can be the same as the “crazies” they see. Finally, some may respond by shutting down the conversation and avoiding eye gaze. To them I will be the odd story that they tell their partners when they go home. However, I don’t plan on telling those above me about my diagnosis; instead, I will continue to nod with each word they say.

I feel that many of you are questioning the truth of this article. How could one of the “crazies” infiltrate our ranks? How could we not know this person? Who knows; maybe some of you are looking around at your colleagues trying to see if a neon sign appears above my head? But here I am, sitting in your tutorials and laughing at your jokes. This is not supposed to make you distrust those around you or make you fight your superiors when you hear them make a derogatory comment. Instead, it is to make you realise that we are people too.

Sometimes I wonder if I should have become an actor. To those around me I am full of life and happy. I am confident and appear to have my life in order. However this is not the true me. Instead, I am flat. I feel nothing. My emotions are so supressed that even I struggle to identify as to when I am deteriorating until it’s too late. I used to be labelled as volatile and unpredictable. Now I have become so good at suppressing my feelings that even I don’t feel them. Anxiety takes over my dreams and I have nightmares about everyday situations. However, I have been told so often not to be anxious that I now dismiss my nerves as an over-reaction. Relationships are hard. The last thing I want to do is burden others with my issues. Instead, I isolate myself and hide myself from the world.

My diagnosis is only made worse by that fact that my treating team has told me not to share my diagnosis with others. What job prospects would I have if the wider community knew about my condition? I would be ridiculed and judged from afar by those who don’t know me. Very few individuals know that I was hospitalised over the semester break. Suffering from a major depressive episode, I was hospitalised for four weeks. Walking around the private psychiatric hospital I experienced life on the other side. The stares when I would leave the clinic with my wristband on, the looks of disbelief when I finally let the nurses into my dark mind. Even now whilst the rest of my cohort is studying hard for our final exams, I am in hospital. Getting my treatment early in the morning so I can run to placement. I can’t fail this year because of attendance. However, on Monday when my peers ask me what I did over my weekend, I will respond with a smile on my face and say that I just studied.

This piece isn’t supposed to change the minds of my peers. Instead it is to give me a place to say to those that are struggling with a diagnosis that you are not alone. There are others in this world that are not a “stereotype” and are trying their best just to get through. However there are some battles we cannot win. Do not be ashamed to just nod your head when your superiors judge a person based on their illness. We cannot all be advocates (high five to those who are); it’s okay to just focus on your own survival. 

Indicators of a successful clinical year

By Tiffany Tie

In medical school, we are constantly assessed through various modalities including assignments, examinations, OSCEs and MCRs.  However, there is a growing body of research which suggests that certain experiences on the ward are highly predictive of students developing strong clinical acumen. This list can be used to formatively self-assess your progress throughout the course.   

1. Unwittingly following your registrar to the bathroom

You trail after your registrar like a lost puppy, from ward to ward, clinic to clinic.  You follow them down the corridor that doesn’t seem to lead anywhere… and then they enter the bathroom.  A good registrar is someone who signposts when they are going to the toilet.

2. Fainting in hospital

This can happen on the wards, in theatre or in clinic.  It is not a sign of weakness; rather, it is a true sign of commitment to medicine.  Just remember to faint away from the patient, especially if you are scrubbed.

3. Deciphering a drug chart

The scribbles on drug charts resemble the trail of a spider that tap-danced across the page.  Deciphering this brings into play the pattern-recognition skills from section 3 of the UMAT. Hospitals that use electronic prescribing systems fail to provide this exceptional educational opportunity.     

4. Meeting the MET call criteria for low urine output

A wise registrar once told me that the hospital systems just would not function if not for the hidden workforce of unpaid medical students.  As a consequence, you build stamina to go through days with early starts, no food, no water, no opportunity to void and mild AKI

5. Anxiously awaiting or sending a fax

Healthcare in Australia is amazing in its ability to provide universal care and to single-handedly support both the historic pager and fax industries.  A device on which you can receive but not send messages is essential for maximising efficiency.

6. Substituting meals with coffee

An average small flat white with regular milk contains all three macros: 7 g fat, 8.8 g carbohydrates and 6.2 g protein.  If you have a nice intern, registrar or consultant, then who says there is no such thing as a free lunch? Or maybe that was payment for the 10 discharge summaries you did yesterday afternoon.  Wait, coffee doesn’t count as lunch…. Or does it?

7. Getting conned into a research project

When a seemingly innocent clinician pitches their idea to you, beware of phrases such as “it’ll look good on your CV” and “it won’t take much time.”  Trawling through medical records to extract data for “only a few patients” is a similar experience to repeatedly banging your head against a brick wall.

8. Obstructing the hallway

Physicians think, surgeons cut, medical students obstruct.  

Lessons on Leadership: NLDS 2018

By Rose Liu

Earlier this semester alongside 9 other Monash Medical Students, I had the wonderful opportunity of attending the AMSA National Leadership Development Seminar (NLDS). I’m writing this piece to share the thought provoking and inspiring lessons shared by the presenters: including what it means to be a good leader, how to be politically engaged and mental health in medicine. Thank you to the NLDS team for their hard work putting together this wonderful event, and to MUMUS and the Monash Medicine Faculty for their generous financial support.

The NLDS brought together a variety of speakers with diverse backgrounds to share their opinion on what makes a good leader. A universal theme carried across all the presentations was the importance of character – namely having integrity, being kind and being humble. Other traits which came up again and again included the ability to build a team and empower team members, being persistent and resilient, creating a safe culture of trust, and being approachable. It was particularly interesting to note how many of the skills required as a leader differed according to context. For example, many of the political leaders emphasised the importance of not blindly accepting the status quo and being able to motivate team members, as the process of advocating for and passing a policy can be very arduous and faced with many roadblocks. Contrastingly, leaders with a more entrepreneurial background emphasised the importance of resourceful problem solving, identifying how problems are formed from first principles, and knowing which problems are viable to solve. It seems like the technical skills required for leadership differ depending on the context, but the foundation of leadership lies in one’s character and ability to work well with others.

The major theme of the conference was political engagement. I’ve always been intimidated by the prospect of being politically engaged after watching Question Time on national television (and much more intimidated after watching Question Time in person). The conference brought in influential political leaders and policy makers whose talks elucidated an empowering message that we as medical students are not just idle observers of policy changes. Rather, medical students can influence policy change through political engagement, such as being involved in advocacy groups, writing to your MP and organising a meeting with your MP. Our efforts can influence issues as diverse as abortion laws, asylum seeker rights and medical workforce policy. It was interesting to hear multiple presenters talk about the unique role of doctors as one of the most trusted community members whose opinions have great influence: one speaker commented that her most successful advocacy campaigns have been when medical students and doctors have been involved, and likewise a former politician explained how politicians love to work with doctors and often try to recruit them. With the immense trust society places in the medical profession, we are in a unique position to influence policy in the best interest of our patients both as doctors and as medical students. 

A confronting topic which recurred throughout the conference was mental health in medicine. The Beyond Blue National Mental Health Survey of Doctors and Medical Students found that 1 in 5 medical students had suicidal thoughts in the past year, and more than 4 in 10 medical students were highly likely to have a minor psychiatric disorder. Several speakers emphasised the importance of being honest, not just about our strengths but also our vulnerabilities. Too often in medicine, because of both the culture and the type of personality that medical schools inadvertently select for within candidates, medical students and doctors hesitate to reach out for help. To create widespread improvements in the mental health status of medical students, a systemic culture change needs to be implemented: by making it easier to report bullying and harassment, enforcing safe working hours for doctors, and creating avenues of seeking help. A message that really stuck with me is that ‘the behaviour you walk past is the behaviour you accept’: a leader leads by example, and that means confronting and calling out unacceptable behaviour when it occurs and not being a passive bystander. When we progress into senior leadership roles in hospitals it is our responsibility to ensure that we enforce a safe culture for junior doctors and medical students to feel comfortable asking for help and reporting distressing behaviour.

The most exciting take home message from this conference was the idea that as medical students, we do have the ability to have a positive impact in our communities and we are not just passive bystanders to the status quo. This can be through many mediums like political advocacy and entrepreneurship. In my opinion the simplest and most important way we can all be leaders in our everyday lives is through having the character of a leader: one of integrity, kindness and humility.

A Day in the Life of a BMedSc Student

By Steph Davies

Sometimes I feel like I’ve fallen off the face of the earth. Not quite a med student, not quite an honours student. I don’t quite fit into any category, which I have learnt makes it very easy to be forgotten. What’s more is that nobody understands what on earth we spend an entire year doing. Not only is our year very different from medicine and other courses, no two BMedSc students do the same thing. It can be very hard for someone on the outside to understand what a BMedSc is like. Research projects are notorious for things going wrong. Unlike in a medical degree where if you follow all the directions everything will probably be fine, research projects almost always have a part that doesn’t turn out as planned. And like I have learnt all too well, mistakes happen. In a way, this year has been more challenging than any other year in medicine.

So here’s a sneak peek into one of my days, in the hopes that us BMedSc students will be a little better understood and a little less forgotten.

7am: Today is the big day, I’ve spent two weeks culturing patient samples to generate an immune response. For some context, my project is on adverse drug reactions to anti-epileptics and characterising the patient’s reaction at a cellular level. This is the part where I get to see the results of two weeks of work. I would be more excited but I am still practically fast asleep. I’ve done this a number of times so I work with my supervisor like clockwork, each taking different jobs. I’m finally at a stage where I am trusted to do most of this by myself without my supervisor watching my every move. The first step is to count the cells I prepared a day earlier. 1, 2, 3, 4, is that a cell? Looks like it might be dead. I’ll count it anyway, I could use the extra numbers. 5, 6, 7. You get the picture. Alright, onto the next step. Count some cells. What’s after that? Count some more cells. Over and over again until I am really, really sick of counting cells.

10am: Three hours later and the experiment is finally set up. Now I’ve got two hours to kill until I have to do anything else. Time for that magical time of day. Coffee. Then, back to the office for some ‘light’ reading for my literature review. By light reading I mean that I’ve read over 100 papers in two months; although by the end of the two months, reading tends to constitute a quick ‘control + F’ to find whatever it is I’m really looking for. Despite being tedious, this process has helped me to develop a specialised knowledge in immunology, specifically in relation to the interaction between T cell receptors and human leukocyte antigen molecules. A BMedSc provides a unique opportunity to learn in depth about a niche area of medicine. Something we don’t normally get the opportunity to do in medicine.

I am lucky to be in a lab where there are seven other research students in my office, each working on a slightly different project. Whenever I have a question (which is often) there is always someone around to help out. This can involve anything from locating papers on the structure of T cell receptors to letting me use their free printing.

12pm: Five hours since I started and it’s finally time for step two. I calculate how much of the reagent I need and add it to every single well of the four plates. Then back into the incubator it goes for another four hours. This project involves a lot more killing time than I expected. Luckily, it also involves a lot of multitasking. At this stage of the year I can be juggling 6 different patient samples at various stages. I spend this break learning how to perform PCRs (polymerase chain reactions) with my supervisor. I have been really lucky to learn a variety of skills during this year. Ranging from cell culture to flow cytometry and analysis of T cell receptor sequencing (this is still very much a work in progress). I have been quick to learn that lab work requires fine hand eye coordination as well as the ability to work quickly and accurately. With more and more practice my fine motor skills have picked up although my gross motor skills have unfortunately not improved. Luckily, my supervisor has been there to catch anything I happen to knock over, like a full measuring cylinder, before disaster ensues.

4pm: Another four hours and it’s time for step three. I promise, despite the long hours lab work is actually fun. This time I make up a stain consisting of antibodies bound to fluorochromes so that I can identify what sort of T cells are causing the reaction (and whether they’re still alive). This is the part of the day when I know I’ve nearly made it because after this there are only two steps left. At this time of day there are usually quite a few people still left in the lab so there’s always someone to hang out with during the incubation periods. Usually they are also avoiding doing any work. Soon enough though I’m back in the lab for the next step. This is probably the only time when I cut my breaks short because the later I run, the later I get to leave.

6pm: Fast forward to the last step which involves washing off the previous addition and spinning the plates in the centrifuge. It’s also at this stage that I forget to turn on the centrifuge and come back to find it hasn’t even started. Provided that everything goes to plan and I don’t perform the last two steps in the wrong order (this has happened, killing all my cells and rendering the day’s work useless) I usually finish by 6pm. I’ll have to wait until tomorrow to find out if the experiment has actually worked.

An open letter to Greg Hunt MP; Tobacco Tax is a smoking gun

By Grace Scolyer

Dear Greg Hunt MP,

Stop taking money from my cousin.

When I think of the people who should be paying the most tax proportional to their income, I think of the big earners, with their multiple properties and multiple cars, their children in private schools, whose assistants make reservations at fancy restaurants for them. But I’m not writing to you about tax cuts for large and small businesses and the adjustments made to tax brackets. I’m writing to you about my cousin.

My cousin Anthony is a gorgeous thirty-three-year-old man who loves the NBA, magic cards, playing guitar, and painting. In high school he was social, popular, loved acting and playing sports, and was a prefect. Since the age of eighteen though, he has been battling severe schizophrenia.

Anthony is unable to support himself financially. He has struggled to keep a job. He struggles to make his government income last the fortnight. It is through the support of his family that he is able to survive, and often, survive is all he can do.

Survive, that is, and smoke.

Anthony smokes a pack a day, and has done for many years. When he smokes, he is focused, mindful, yet between puffs, he is lost in his internal whirlwind of chaotic thoughts and voices. He takes another puff; he is back, and the cycle continues. It calms him; he remembers to breathe.

My family often refer to smoking as a part of his treatment. As a medical student myself, who is fully aware of the risks associated with smoking, it seems almost paradoxical to call it therapeutic, but it is hard to deny. His medication changes, as do his moods, as do the volume and rhythm of the voices that control him. But this never changes: he will always find himself on his balcony holding a cigarette to his lips.

He has tried to stop countless times, because he cannot afford a pack a day. He spends half his pension on tobacco. But there is no hope in him stopping, not in the foreseeable future. It is undeniable though that the biggest impact smoking has on his life, aside from the positives, is financial.

Mr Hunt, this is not a health promotion issue. I care about rates of lung, throat, mouth and bladder cancers. I care about COPD and asthma and heart disease. But I also don’t think this tactic is working. If it were, with the taxation of cigarettes rising 12.5% every year, we would not be seeing the first increase in tobacco use in decades. If this were an effective health promotion measure, Australia would not have the smoking rates it does. If this were an effective health promotion approach, those facing financial hardship would have significantly lower rates of smoking than the rest of the population.

This is a financial issue. My question is how the government can justify benefiting from the most vulnerable members of our society. Because that is who is impacted by tobacco tax, and it benefits no one – except you. With tobacco tax rising at the rate it is, the financially disadvantaged are taxed more heavily, proportional to their income, than the richest people in the country. And that might sit alright with you, Mr Hunt, but I can see the impact it is having on people, and it is not alright with me.

I would like my cousin to stop smoking Mr Hunt. I would like us to find a way to make that happen together. In the meantime, I would like his life to be just a little bit easier. And I can think of one easy way to make that happen.

Kind regards,

Grace Scolyer

Bingo, you’re a medical student!

By Fraser Tankel

The hospital grind getting you down? Have you snuck off for an extended toilet break and already browsed all the dank memes? Are you wondering what life will be like once you’ve finished the VIA? Introducing….

Medical Bingo for Bored Students (MBBS)

Consultant unaware of student’s existence

“Hi, my name’s ___ and I’m one of the med students…” Misses easy cannula Gets kicked out of room because there’s ‘too many people’ Orders 10 coffees on the reg’s BOQ Specialist card

Turns up to rounds incredibly hungover

Follows reg to the toilet Friend/family asks for medical advice Wears RM Williams boots

Can’t find patient’s chart or file

“Uh, I have a tute I need to go to…”

“So, are you going to specialise, or just be a GP?”

Free

Grand Rounds

Space

Lunch

Obs not actually stable

Gets stuck talking to patient for >1 hour

Reg borrows pen and never returns it

“Can you sign my log book?” Ward round lasts >6 hours

No swipe access to important area of hospital

Actually asks about patient’s concerns

“Sorry, I’m just the student, so I’m not allowed to do that…”

Best hand hygiene despite least patient contact

Follows multiple dank medical meme pages Requires antibiotics for conventionitis

Contaminates sterile field

A letter to the AMA: Mandatory sentencing

By Seamus Horan

In 2014 the Victorian Liberal government instituted six-month mandatory minimum jail sentences for people who assault emergency service workers, except where there are “special reasons” not to impose it. In December last year two women were found guilty in the Magistrates Court of assaulting a paramedic and, as per the mandatory laws, were sentenced to prison. On appeal this month, the County Court overturned this decision on the basis of the “special reasons” exemption.  Those reasons related to difficult backgrounds, mental health and dependent children. This prompted an outcry from Ambulance Victoria paramedics, who have called for the mandatory minimum sentencing laws to be tightened, with “It’s not OK to assault paramedics” painted onto ambulances across the state. In response, the Victorian Premier Daniel Andrews has promised to tighten mandatory sentencing laws.

In a newsletter from 17 May 2018, the AMA conveyed their “profound disappointment” in the removed jail sentence for the two women, and called upon the government to send a “strong message” that “such acts [should] be met with the mandated penalty”. In response, Seamus Horan wrote the following letter exploring the effect of mandatory sentencing.

I refer to your email newsletter from 17 May 2018 regarding penalties for attacking healthcare workers, specifically discussing the recent assaults against paramedics. I was surprised to read that the AMA is supportive of mandatory sentencing.

Healthcare workers have a right to be safe at work, and often this right is not met. Tragedies in the last year alone have shown us the devastation that attacks on healthcare workers can have. As the peak body representing medical practitioners and students in Australia, the AMA has a responsibility to advocate for change that will make us safer. Advocating for mandatory sentencing does not achieve this.

The AMA supports evidence-based medicine, however it appears this outlook does not extend to the legal system. The evidence indicates that mandatory sentencing fails to produce the desired result of deterring crime, and comes at high social and economic costs. The Law Council of Australia found that mandatory sentencing results in unjust sentences where the punishment does not fit the crime, and that by their very design they disproportionately impact particular groups within society. These groups include Indigenous peoples, juveniles, people with mental illnesses and cognitive impairment, and those who are impoverished. Indeed, in 2000 the United Nations condemned mandatory imprisonment legislation in Western Australia and the Northern Territory for its disproportionate effect on Indigenous Australians, acknowledging the negative health consequences, as well as the social and legal impacts.

If we were to compare the legal system to the medical system for a moment, imagine the medical equivalent of mandatory sentencing. Mandatory clinical guidelines would be unthinkable in medicine. There would be an outcry if they were imposed, particularly if they were imposed by politicians spurred by popular demand. Clinicians would rightly say that the specific circumstances of individual patients should influence which treatment is recommended. This is the job of doctors – if we follow mandatory clinical guidelines, what is the point of having doctors?

Mandatory sentences are unjust because by their design they similarly ignore the circumstances of individuals and lead to unjust results. If we have mandatory sentences, what is the point of judges? Why allow discretionary judgement in any profession? By weakening public confidence in our justice system in this way, we only weaken ourselves.

For further detail of the substantial evidence that mandatory sentencing leads to unjust outcomes and fails to deter crime, I refer you to the article below.

In the era of Fake News and political scepticism, our institutions are under intense pressure. The AMA has the potential to play a moderating role, to champion evidence-based policy and confront populist politics. By supporting mandatory sentencing, the AMA has done the opposite.

Regards,
Seamus Horan

Articles:

Sentencing Matters: Mandatory Sentencing, 2008, Sentencing Advisory Council, Victoria
AMA Media Release


Featured image from WorkSafe Victoria 

A Letter to my Year A Self

Anonymous Author

To My Year A Self,

You’ve just arrived in Churchill and it is not what you expected it to be. When you thought “rural” you pictured rolling hills and gumtrees. You did not picture a somewhat post-apocalyptic landscape marred by a coal mine, and fields bathed in the glow of the power stations. When you thought “country town” you thought of a tight-knit, friendly community. You will be shocked to realise that several med houses have already been robbed.

You’ll walk to the main shopping area, which will take approximately 3 minutes to explore. The dining options are limited, but you’ll comfort yourself with the fact that you’ll spend less energy thinking about what to eat and therefore have more energy to study. It’s kind of like how Obama only had blue or grey suits, so he’d spend less time choosing what to wear and more time making other important decisions. Kind of.

You’ll meet everyone, make some friends and go to your first lecture, only to be told it will be your last. You’ll be hit with the “flipped classroom model” and “lectorials” and be asked far too many times if you’re #medready. The flipped classroom in year A means that you’ll be watching lectures online and coming to tutorials ready to discuss what you’ve learnt- so basically what you did in undergrad when you didn’t feel like physically turning up to lectures. The first few weeks will be spent conducting a complete overhaul of your learning style, resigning yourself to the fact that flashcards are the only way you’re going to be able to memorise all the content they’ve thrown at you.

You took anatomy for a whole semester a couple of years ago, but as you look at the cadaver in the anatomy lab you will question where all the knowledge from your Biomedicine degree has gone. You will mistake a nerve for a tendon and feel your head start to throb, partially from stress and partially because of the formaldehyde.

On some days you will drink your weight in coffee to make up for your lack of sleep. For some godforsaken reason Federation University’s student society has decided to host parties in the building behind your room on Wednesday nights- the night before clinical skills days and hospital placements. Invest in some earplugs and try to go to bed at a reasonable hour. It is your only hope of getting a good night’s sleep and curbing your caffeine addiction.

When you meet your first patient in the hospital your ability to talk to another human being will promptly disappear. It will take a few more clinical encounters for you to realise that you can just talk to patients in the same way you would talk to another adult. You’ll learn how to build rapport and feel like you’re helping them, even though you have no formal role in their care. You’ll feel like you’re helping because they’ll tell you how happy they are to be contributing to your education, and at this point you’ll be taking all the encouragement you can get.

Although this year is going to be tough, I assure you that there will be time to laugh and enjoy this crazy journey. You’ll join a mixed netball team and realise that you are probably the worst netball player in history, but you’ll love playing all the same. You’re going to make some great friends, who will be there to support you when you’re struggling- academically or otherwise- because they’re all going through the same thing. You’ll motivate each other to study and run marathon OSCE sessions at each other’s houses. After exams are done you’ll play Cards Against Humanity, which will make you laugh until you can hardly breathe and will help you forget the horrendous history you took in station 3.

You’ll realise you must take care of yourself if you want to stay afloat this year, and you’ll realise this somewhere between polishing off a Woolies chocolate mud cake and opening another bottle of wine. Eating breakfast will become part of your morning ritual and will give you enough energy to get through lectorials. Going to the gym will become a daily habit as well, and it will be a welcome break between finishing class and going home to study. You’ll discover the life-changing concept of cooking in bulk and will be thankful for all the time you have saved, especially during exam time.

Although this isn’t what you thought medical school would be like, you’ll be grateful for the people you have met and the knowledge you have gained. As you move into your clinical years you’ll still feel a strange affinity for Churchill, and whenever someone mentions they also did year A there, you’ll exchange a knowing look and swap some funny stories. This year will be one of the most challenging, stressful and rewarding years of your university life. So, unpack your things, call your mum to let her know you’re safe, and take a deep breath. You’re going to be just fine.

 

Rainbow Doctors: The experience of one queer med student

By Chris Hardy

Content warning: harsh language, distressing scenarios

“Oh, look at that cute little baby!” I said, walking through the halls of the hospital. No sooner had the words left my mouth when the guttural cry of a complete stranger snaps me back to reality, with words that I have heard all too often: “Fucking faggot.”

How lovely. Exactly what I wanted to hear on that Wednesday morning, right between ward rounds and my regular morning coffee.

The shock of being called such a name never wears off, no matter how often you have it thrown at you. Whether it is out of a car window, in a club, or just walking down the street holding your partner’s hand, it still leaves a hollow, cold sensation running through you and a fear of what will happen next. Will they just move on? Will they spit on me, throw their drink on me, hit me? In that moment, all possibilities are considered and feared over.

Don’t get me wrong though. We all develop a thick skin, especially as medical students. We are constantly being yelled at, abused, and underappreciated by both patients and colleagues alike. Falling to pieces every time someone is mean to you is just not practical. But to have such an integral part of your identity, a part that you may still be coming to terms with, be attacked is devastating. Some attacks are not as openly hostile, like the double take of people when you walk down the street and the deliberate lack of questions regarding relationships at the dinner table, but are still just as damaging.

I am in the GP clinic, talking with a patient about a mundane issue that was quickly resolved in the first 5 minutes leaving the next 25 for small talk. Same sex marriage comes up, and I cringe internally. The patient’s face crumples into a grimace and the familiar arguments brought forward; what will it lead to, gays are diseased, God doesn’t agree with these choices. The once quite pleasant patient is now a hatred-spewing entity who disagrees with a core part of my being. I look impartial and listen like we are told to do, until the onslaught is over and the patient returns to their normal state. “Now then, what about you? Have you got a special girl?”

People are often shocked when I tell them about what has happened to me just because I am gay. Some don’t believe me and think I am overdramatising things: “Surely that is a thing of the past? No one thinks like that anymore!”

Wouldn’t it be nice if that were true? Wouldn’t it be a much happier world if we just didn’t care about this stuff and let people live? Such a cliché and I legit feel like a dick writing it, but we can all have a dream. I would really just be happy with some more queer representation in the curriculum or a focus on the unique issues surrounding queer health to be honest. It is impossible to change people’s minds, but it is possible for us as future doctors to help make the world just a little bit less shit for those who are different.

Don’t assume someone’s sexuality or gender identity, don’t assume they aren’t struggling, and don’t assume that you will never encounter queer people. We exist, we are your friends and patients and colleagues. Don’t forget about us.


Featured image from Pixabay