An Uncomfortable Truth

By Natasha Rasaratnam 

I was lucky. I was lucky that my grandparents left Sri Lanka to seek a better, more hopeful future for their children. I was lucky that I did not have to grow up in a war-torn country whose scars are only beginning to heal. Yet for those who lived through the 25-year civil war, the trauma is everlasting, hiding under the facade of a country that wants to forget the legacy of its conflicts. It is no surprise that after these decades of violence, mental health issues have risen dramatically in Sri Lanka. Yet this spike has not been adequately met with appropriate treatment and education. At its core, this crisis is underpinned by an entrenched cultural stigma towards mental health conditions.

Stigma is when there is a negative perception of someone based soley on them experiencing a mental health issue. More often than not, stigmas aren’t born from malicious intent rather due to a lack of understanding yet nonetheless they create a barrier for people to seek help. In Sri Lanka, it can sometimes be thought that having a mental illness or being associated with someone who does, negatively affects your employment and marital opportunities. This is exacerbated by a lack of mental health workers and information that is not readily available to the public. As a result, particularly in rural areas, it is more common to take people to faith healers or temples rather than seeking professional help. There are also cultural associations that link these illnesses with the notion of ‘karma’ and resulting in them being considered as fate with blame being laid on the person themselves. There are also some views that mental illness simply doesn’t exist and people “just need to get on with it”. This dismissive perception associated with mental illness is deep-rooted and spreads beyond South Asia to immigrant communities worldwide.

Closer to home, despite all the ‘R U OK days’ and mental health awareness events, there are still communities in Australia in which mental health is a stigma. Although we’ve made vast improvement to tackling the stigma surrounding mental health conditions, we must not be complacent in thinking we have completely solved the problem.

Growing up in a migrant community has its ups and downs. Everyone is friendly and wants to know about you… maybe too much at times. Coming from a Sri Lankan background, it is not unusual to hear older members of the community dismiss depression as a weakness of character and not a valid health condition. Similarly, suicide is often mentioned in hushed tones, more a source of shame rather than the tragedy it is. Of course, these attitudes cannot be generalised to all members of the community and I am lucky to be surrounded by a family that understands and values the importance of mental wellbeing.

Yet the consequence of this underlying stigma can have devastating effects on those already isolated due to their mental health. A friend was told to “just pray it away” by family members as a cure for her severe depression. Although faith can be a healing force, the dismissiveness of these comments resulted in a toxic environment at home of further isolation and distrust. Mental health stigmas not only stop people from speaking out about their health but can also worsen the situation perpetuating a vicious cycle.

These perceptions are so ingrained in the older generations of migrant communities it’s difficult to weed them out. Unlike Sri Lanka, Australia has the resources and educational tools to reform and erode taboos such as these. However, despite their admirable aims events run by organisations such as Beyond Blue and Headspace can have little reach to address older members of the community.

To an extent this is also a generational problem rather than a cultural one. Hence, it falls upon us as the next generation to strive to engage in a conversation with our parents, grandparents, aunts and uncles about mental health.  For all their flaws, migrant communities are tight knit, and it is this support which can be utilised to help those struggling the most rather than demonising them. Cultural leaders have the power to make change and it is only through our conversations with them that we can start to see this stigma being overcome. We’re the lucky ones – we have resources and information at our fingertips. Our communities’ ignorance can no longer be an excuse.

 

Kicking Goals for Mental Health

By Kit Ming Foo

March: the time of year when footy fans around Australia rejoice after 6 months in the wilderness finding creative ways to spend their weekend. However, when the first bounce occurs, all eyes are on the players. Every little thing that they do is examined under a microscope. Every goal is celebrated but also every dropped mark or skewed kick is met with sighs of disgust and for some, even boos. Such is the life of an AFL player, where everything they do is in the spotlight, good or bad. Everything gets scrutinised and what the fans and media fail to realise is that at the end of the day, there is still a human being behind these athletes, someone who has put in so much to end up where they are now.

 

On the 17thof December 2018, news broke that one of North Melbourne’s players Majak Daw, had an incident on the Bolte bridge where he fell and sustained serious injuries. Suddenly there was an immense focus on not only Majak’s well-being but also that of the wider AFL population. In the months leading up to this incident, many other players such as Richmond superstar Dustin Martin discussed their battles with mental health, yet many felt that not enough was being done by the central administrative body to look after the wellbeing of the players. This all changed in the aftermath of Majak’s bridge fall as the CEO Gillion McLachlan introduced a mental health manager for the league and highlighted that mental health was the “No 1 issue for the playing groups”.  Whilst the AFL has taken some encouraging steps in addressing this issue, it is unfortunate that the catalyst for change from the status quo was such a devastating event.

 

Now some of you may be thinking, this is the Auricle, a medical student journal so why is AFL being mentioned? Taking a closer look, you can draw many similarities between being a player in the AFL and a member of the medical profession. Many of the things that were mentioned above apply to medicine too. Both professions require high levels of dedication to be successful. Both come under heavy scrutiny when things go wrong. Both have the capacity to place massive amounts of pressure on players and practitioners alike. Finally, both have started the long journey to make mental health a priority.

 

In recent years, prominent doctors have started social movements such as Crazy Socks for Docs. With this, medical student mental wellbeing has also been brought into the spotlight and this is something that needs to be taken seriously. For many of us, this is a topic that we have all heard about but until we personally have to confront it, either through our own                    experiences or a friend’s, it is in a way something that is hard to relate to. Problems with mental health are actually more common than we think. A study published by BeyondBlue in 2013 involved the responses of 1,811 medical students and revealed that around 10% had very high levels of psychological distress. This is three times as much as the general population, so why do we not hear more people in the medical profession talking about their struggles with mental health?

 

Much like AFL players, few medical students ever share their stories publicly, meaning that countless more go through these battles in secret. Admitting to one’s own mental health struggles to the world is not easy, let alone telling the people closest to you. As a result, like many footy players, medical students try to hold it together whilst they are in the eye of the public, whether it is on the hospital wards or in tutorials. Because of this, a facade is put up, tricking everyone into thinking that everything is fine, when in reality the opposite is true. If a star player like Dustin Martin can do it, so can many medical students.

 

The aim of piece is not to say everyone should have the courage to tell the world everything, but rather to try and make having a conversation with trusted friends easier. We as a profession need to improve the way that we all think about mental health. We need to accept that it is a problem that all of us have a responsibility to deal with. Breaking down the barriers to seeking help is one way to start and to do so we need to remove the stigma that many of us associate with doctors asking for help. Our profession is built on being empathetic towards our patients but why are we not the same towards our colleagues when they are in times of need? If we do not change our response to this, the topic of talking about mental health will never be made easier. People will continue to avoid seeking help and this problem will continue to grow. Such changes in mentality obviously take time to transpire and it is unrealistic to expect a change overnight amongst the medical profession. However, much like how we have begun to see shifts against bullying in the workplace and safer working conditions, everything needs to start somewhere and we all can have a role in championing a change to make talking about mental health easier.

 

Medicine is a team game and much like being on the footy field, we need to look out for our mates. Battling issues with mental health can make a person feel isolated and often the onus is on them to make the first move and talk to someone about it. At the end of the day there is truth to this as it really is up to the individual and whether they want to share their experiences. Sometimes though, people are just waiting for an opportunity to open up. Simple questions such as “are you alright” or “is there something that you want to talk about” may be all they need. Let’s all make sure that we look after our friends and get through this season together.

 

The Cannula Volume One

Editor: Idew Wokefield

BMedSci Insight

New research by medical students determined the optimal free food to faculty disciplinary meeting ratio. The non-blinded non-randomised ‘randomised control trial’ was held over 8 weeks and involved a cohort of 100 third year medical student participants at [De-identified] Hospital. Participants were given the choice to grab a slice of pizza, fruit or ‘whatever they could get their hands on’ from a ward meeting or conference. In total the experimental group had participants ranging from obtaining 1 slice of pizza a week to 2 whole pizzas, 3 sandwiches and a slice of garlic bread. Side effects experienced by the experimental group included 5 participants forced into a research paper seminar, 6 roasted by consultants and 12 experiencing faculty disciplinary meetings. Side effects experienced by the control group included 20 experiencing FOMO for missing free food and 1 unfortunate participant that was roasted by an intern for standing within 1 metre of a tray of chicken nuggies. The results show that there is an exponential relationship between ‘amount of food obtained’ and ‘number of faculty disciplinary meetings’ but there were a few outliers from the experimental group that had escaped the notice of faculty. Comparing ‘number of faculty disciplinary meetings’ against ‘general wellbeing/ number of nights drunk, there was no correlation. Therefore, the results of the experiment can be summed up by the words of one participant, ‘Faculty disciplinary meetings are a small price to pay when you get provided three meals a day at the hospital’. Shortly after the statement, he was expelled from the hospital after ‘accidentally’ eating the Clinical School Dean’s lunch.

[De-identified] Hospital In-focus

A new report has found [De-identified] Hospital productivity has decreased by 50% after the introduction of PebblePad. We have an exclusive breakdown of the situation from one doctor that did not want to be named, ‘It was 12pm and I had just finished up the ward round when I was accosted by a gang of medical students after a cannula. After multiple successful attempts of acupuncture and one successful cannula, I was getting ready to head off to lunch when they pulled out their phones on me. I waited through my lunch break, my unit meeting and a MET call for the students to get PebblePad ready and in my haste, I accidently closed the browser. I left the hospital in the dark that day’. An emergency hospital executive meeting was called to discuss how to deal with the threat of increasing use of Pebblepad by medical students. The most popular agreed option was the ‘pretend they don’t exist’ solution which is practised by 20% of doctors and 80% of neurosurgeons. This option is also known as the ‘neurosurgery triad’ where medical students are never spoken to, looked at or acknowledged to exist. Other solutions discussed included the expulsion of all medical students including students that have never used Pebblepad and the introduction of ‘Safe Pebblepad Use Rooms’ where Pebblepad use by medical students is supervised.

If you are a writer, fan, hater or corporate lawyer for [De-identified] Hospital, please send your ideas, money, hate mail or cease and desist letter to xxx1.spam.1xxx@gmail.com!

 

“So tell us, why do you want to become a doctor?”

In the months of my final year of school, the question of ‘Why’, of ‘Why medicine’ occupied my mind with an almost irritating intensity. I was in two minds regarding this question, seeing it as both deeply important and as yet another obstacle during that frenetic period, something for which an appropriately polished response had to be crafted. From the paranoid searching on annoyingly cheery sites with titles such as ‘What med schools love to see in applicants?’ to a final medentry ‘workshop’ before the impending interview, I’d formed a rigid notion of what the ideal reasons ought to be. Perhaps mistakenly, although I would say not uniquely, medicine seemed akin to a fortress of sorts, to which admission was reserved for the near saintly, those of faultless moral character, to those fuelled by purely unselfish motives, in short to those among us for whom this was a vocation, an intense, abiding calling.

 

In the face of these rarefied ideals, I felt the sharp sting of unworthiness, the feeling that I was an alloy of jostling motivations that couldn’t possibly be allowed entry. As I look back now, I think that arriving at the decision to really pursue medicine was, at least in the beginning more of a process of subtraction and elimination rather than one arising out of a deep-seated conviction. I knew what subjects I enjoyed and tended to do well in, and those, to put it charitably, in which my aptitude left a little to be desired. Considering this, I knew I had little interest in pursuing a math heavy field such as engineering or something similar. My passions and perhaps just as importantly, my strengths (I hope your eyes haven’t just glazed over) resided in the bio-chemical domain, in that ‘soft machine’ of the human body. It was this fascination, part scientific and part motivated by a certain paranoia about the inevitable propensity of cogs within this machine to malfunction that impelled me, to commit to the path of medicine. However, this interest was the original impetus, by choosing medicine, I wanted this nascent passion to intersect with humanity. To use the little knowledge I had or perhaps I should say still have, and build upon it, in hopes that ultimately it may be of some use to someone, that it may ease their suffering or sickness, in hopes that perhaps it may make – and I use this well-worn phrase unashamedly- a difference.

 

However, this doesn’t represent my motivations in their entirety, it would be wrong of me to cut out the less lofty reasons for my decision; in this case let us not separate the wheat from the chaff. To admit that one might in some small part be driven by the likelihood of a monetarily rewarding profession (eventually) or by the prospect of healthy career options, although after an ominous lecture concerning the internship crisis I am not so sure, was close to profane. Yet I recognise motivations such as these along with a subtle familial encouragement did play a role, a junior one but a role nonetheless and I would venture to say that these more material considerations may have in part influenced others too, at least judging by the number of biomedical memes we make. However, I don’t mean this as criticism, we as medical students or as prospective medical students do not live in a vacuum. Instead we’re shaped by the environment around us, by familial expectations: hopes that their children might enter a few select professions are so common in certain families, perhaps in some of those from a migrant background that they border on sociological phenomenon, by professional aspirations, by financial prospects, these can all seep into us via a sort of osmosis as we decide what it is we want to do with our lives.

 

Yes, it’s true that being solely or largely motivated by more worldly reasons, those of security or prosperity would be unwise in the long term as the path to and of medicine is lengthy one. A path of training followed by more training, of assessments succeeded by more assessments, in short, one of ultimate deferred gratification and if someone doesn’t feel a degree of passion for the material and its application in aiding others in their time of need then they’re at risk of deep dissatisfaction. A worrying prospect for both the individual and especially their patients.  However, I maintain to ask that we completely void ourselves of those prior concerns is requiring, in my opinion, the impossible. It is asking us to be a little more than human.

 

On a final note, I would add that although I still hold the core of those same motivations, I did prior to beginning medicine, in the months since then, something else has been added into that original foundation. Through seeing and interacting with patients if only in a rather limited capacity, I am at times filled with a terrible, and I don’t mean that in the pejorative, sense of responsibility at what will be expected of me in the future. That I will be privy to individuals at their most vulnerable, through sickness and malady and that they will place a dizzying amount of trust in my and the profession’s ability to steer them through their illness. It is the knowledge that at this moment there are people, some well and some ill, some young and some old and some who are as yet unborn, none of whom are known to me but whose paths may one day cross with mine that impels me to continue. It may be a brief encounter or a more prolonged liaison, however in that time I will have to honour and live up to the trust that has been placed upon me.

 

 

 

 

 

 

 

 

 

Some unexpected lessons on exercise

I have a body that was ideally designed for sitting on the couch. My legs are not all that long, my reflexes are subpar, my cardiovascular capacity is below average, and my muscles are equivalent to Steve Rogers’ prior to his Captain America transformation. Physical education classes at high school consistently resulted in my lowest grades. By Year 11 they had become more of an occasion to gossip with friends, rather than engage in ‘sport.’ So, it’s really by some sort of miracle that I stumbled upon an exercise regime that works for me – and yes, it actually does involve moving.

 

For me the key to starting to enjoy exercise was to completely change my attitude towards it. Sport and exercise have typically been something I was not naturally adept at, and thus typically avoided (subsequent to the fear of failure so often present in perfectionist medical students). My fear of failure had to be overcome. I started viewing the mere attempt to exercise as success. If I was aiming to run five kilometres but only made it to the corner of my block, then I congratulated myself on at least leaving the house in my activewear. My perspective on sport and exercise evolved. I realise now that the only prerequisite to exercise is to move your body – no actual skill or talent is required.

 

After coming to the revelation that yes, we can all in fact exercise, I have gained a few more insights into physical activity.

 

Firstly, exercise is integral to maintaining my mental wellbeing. While many had told me of the benefits of endorphins and the mythical ‘runner’s high,’ I started believing that they weren’t talking rubbish when I regularly started exercising myself. Or more accurately, I realised it when I stopped exercising regularly. An injury had halted my routine for a couple of weeks. Soon enough, my weekly running mileage was being made up for by anxious thoughts running through my head, rather than my feet striking the pavement. Furthermore, it was noted that I was more consistently in a bad mood. I felt wound up and on edge, with an excess of energy manifesting itself through unproductive emotions. As soon as I recommenced exercise this all went away. It was then I realised I needed to exercise to stay sane.

 

Furthermore, exercise provides the perfect opportunity to create a sense of achievement. Since starting medical school, I have found that I more often feel I am sinking under the course content, struggling to keep abreast with the fire hydrant that is medicine. Instead, I have started setting physical goals such as running a certain distance or going to the gym a certain number of days a week. When I achieve these goals, it gives me a meaningful sense of satisfaction that feeds into and nourishes the academic aspect of my life.

 

Finally, starting to exercise has helped me appreciate the importance of taking care of my body and my health. At times, I think we can take our health for granted. I, at least, didn’t realise the strength of the human body, and its incredible ability to adapt to new activities. This is what makes exercise and sport so enjoyable, and this is what can be easily taken away with sickness and ill health. So, beginning exercise has emphasised to me the importance of taking care of my body, to ensure that it can perform to the best of its ability.

 

I can’t pinpoint a reason why I decided to get my body off of the couch and force it to do physical activity, but I am incredibly glad I did. I have learnt about the strength of the human body, the link between physical and mental health, and how one can find a sense of achievement outside of their normal activities. So, while not everyone has the perfect athlete’s physique, I certainly cannot claim to, I believe the benefits and lessons one can learn from physical activity and sports are far deeper and richer than what we may imagine at first glance.

Fifty-Four Years Ago

By: Bowen Xia 

For: The Auricle Writing Competition 2018

Prompt: ‘What is a piece of advice you wish you hadn’t taken and why?’

In a small house, a year 6 student sits in a dimly lit room studying hard all day to prepare in the hopes of entering a prestigious selective school. Surrounding him are boxes of certificates, medals and trophies of various competitions and outside that, on a patchwork couch, his parents and siblings huddle together watching the latest episode of the ‘Simpsons’ on an old box TV. They ask him to join but he has more important things to do. Ha! His family’s periodic bursts of laughter mix over the TV static and he blocks his ears. One day my hard work will pay off and then I’ll be truly happy.

6 years later…

In a prestigious high school, a year 12 student sits in an empty classroom studying hard all day, to prepare for his VCE exams, in the hopes of studying medicine at a prestigious university. His blazer is adorned with numerous academic and leadership badges and his brow is furrowed and beaded with sweat whilst gazing at the citric acid cycle. Bam! A ball hits the window and shouts of his friends playing outside fill the room he shuts the window and closes the blind. One day my hard work will pay off and then I’ll be truly happy.

4 years later…

In a prestigious university, a fourth-year medical student sits in the medicine building foyer silently studying hard all day, to prepare for his end of year exams, in the hopes of gaining an internship at a prestigious hospital. In his bag sits his Netter’s flashcards, four medicine textbooks and his trusty Classic III stethoscope. Slam! The silence is broken as his peers leave the building for their weekly pilgrimage to the ‘Nott’. He stares back at his Anki cards. One day my hard work will pay off and then I’ll be truly happy.

3 years later…

In a prestigious hospital, an RMO sits in the staff breakroom revising hard all day, when he is not on shift, to prepare for his eventual registrar exams in the hopes of joining a prestigious speciality. On the table sits his fourth cup of coffee, a Cardiology III stethoscope, two patient files and a model of the brain. Creak…! Some colleagues leave the room and head off to Zoukis for a well-deserved break, but he resolutely refocuses on his studying. One day my hard work will pay off and then I’ll be truly happy.

9 years later…

At a recently founded clinic, a neurosurgeon sits in a consulting room working hard at night. It has been a long day chock full of patients and paperwork but hopefully, he will be finished soon. On his desk sits a framed picture of his family, a pile of bills, a neatly drafted cover letter and a brochure titled ‘AMA Nominations Opening Now!’. Click…! He opens the main door to his house. All the lights are turned off except a small night light in the lounge room where it shines dimly on the couch and two small sleeping figures are illuminated. He picks up a piece of paper lying next to them and inspects it. A squiggly drawing of his family is on it and underneath is scrawled ‘please come home soon Dad!’. A tear rolls down his eye. One day my hard work will pay off and then my family will be truly happy.

12 years later…

In the nation’s capital, a high-ranking member of the AMA studies some documents in his empty boardroom. When he is not attending meetings all day, he prepares his family’s finances. In his wallet sits a real-estate business card, a prescription for Xanax and a well-worn photo of his children. Ding! A message appears on screen ‘where are you dad? I can’t see you in the audience from the graduation balcony’. As the Prime Minister and his panoply of staff enter the room, the text message is dismissed with a sigh. One day my hard work will pay off and then my family will be truly happy.

20 years later…

In an inviting, large, well-kept house no one enters except for the occasional cleaning staff. On the balcony, a recent retiree idles all day on a sunchair waiting for the clock to strike 5:30 pm. In a bin next to him sit two empty pill boxes, one bisphosphonates and the other NSAIDs, and a torn brochure titled ‘Europe travel guide’. Beep… beep… beep! He unsteadily gets out of the chair and shambles towards his phone. Every movement seems to be painful but made with determination as he stops the alarm. His daily ritual has begun as he calls the two people that matter the most to him. Both go to voicemail but not without him sending two text messages that are left on seen. As the sun begins to set and the darkness approaches, he begins writing a letter.

My dearest angels,

I am truly sorry that I could not make you happy, but I hope this letter can. Fifty-four years ago, I a young, eager boy promised myself that I would not stop pushing forward into the world until the right moment to enjoy life to its fullest arose.  Alas, that day arose too late and I an elderly frail man will bountiful time and material can make neither you nor me happy.

 I blame this on ill-disciplined motivation and determination and insufficient time. If only, my promise was made when I was younger, and I tried working harder, today’s grief would be avoided. Our past conflicts were due to our different outlook on life but as your father, I cannot let you continue making the same mistakes as me. I implore that you resist being complacent and discontinue your premature enjoyment of life. If you do not stop working hard for the future, you may be happy in the end.

 

With Love,

A Sorry Old Man

A study in inter-faculty relations

By Natalie E Evans 

It was upon a midnight clear when the three discovered each other. Awakened from their slumber by the whispers of wind which breathed their way through the fronds of palm trees. The one with the stethoscope round her neck awoke first – or so she thought.

Her last memory had been of playing hangman in Active Learning – but suddenly she had sand beneath her feet and night’s cool embrace upon her skin. In front of her lay another – an individual whose face was hidden from view by the cloak of night. She tentatively took a step closer when she felt someone push from behind. Suddenly her face was in the sand and a foot was planted firmly on her back.

A voice came out of the dark.

‘State your name – whoever you are.’

The one with the stethoscope wriggled out from the foot, heaved herself up and said with a salute,

‘My name is Laura Jacobs and I’m a first year medical student at Monash University. I don’t know why I’m here but I was probably asked by a GP to take your medical history or perform an examination or jab you with a needle. Don’t worry though, everything we discuss will be between yourself and myself and your doctor –’

‘Spare me the spiel.’ said the disembodied voice. ‘I thought you might have been the one who dumped me here but obviously we’re in the same boat.’

‘And who are you?’ said Laura.

The other stepped into the light.

‘I’m a law student.’ Silence, then –

‘Need I say more.’

Laura let him have his moment of significance and then interrupted it with an obsequious flourish of her hand,

‘Perhaps your name my lord?’

‘Paul.’

Laura noticed the Paul wore something strange.

‘What’s that?

‘Oh – this?’ Paul touched his head, ‘It’s a wig. I sometimes wear it when I’m at home studying to make me feel more motivated.’

The two students fell into stilted silence as they surveyed what was visible of their landscape in the darkness.

‘What do we do about –it?’ said the Paul eventually.

‘The one still asleep?’ said Laura, turning around.

‘Well was,’

The third one had disappeared.

‘Where did they go?’ said Laura

‘Well I don’t think it’s in our jurisdiction now to do anything about it.’ said Paul,  ‘The – individual – has moved off to where it’s someone else’s problem.’

‘Like whose?’ asked Laura.

Before the two could begin an argument ripe with the fruit of bitter conflict they heard a shout and then a thump.

‘Quick, we’d better help.’ said Laura.

‘No – not our problem any more, remember?’ replied Paul.

‘It’s not in my code of ethics to leave someone to die,’ Laura continued, ‘Beneficence, justice, non-maleficence, those are my divinities.’

Laura tore through the undergrowth, stumbling over ferny tendrils and occasionally splashing through black pools of water. Paul reluctantly followed, slapping at any stray vines that attempted to mess with his wig. In a small clearing lay the third – the moon illuminating her curled up silhouette.

Laura stopped about a metre away – Paul nearly crashing into her.

‘Well? Aren’t you going to fix her? What’s the diagnosis?’

Laura’s fists unconsciously curled up.

‘You think I can treat her? I don’t know anything about anything!’

‘But you do med,’ Paul snapped back, ‘therefore you’re basically already a doctor.’

‘I can recite the contents of the femoral triangle and the popliteal fossa but that’s not going to help us here!’

‘But you have a stethoscope around your neck.’ pointed out Paul.

‘I only used it once in a vital signs assessment but the assessor was so busy trying to get the Wi-Fi to work she didn’t even see I was doing it right!’

‘Help!’ said the one sprawled on the sand.

‘What brought you in to see the G- I mean, what happened?’ said Laura.

‘Well, I was fake sleeping before, and heard you two plotting against me so I ran off. Then I ran into this palm tree here because I couldn’t see.’

‘So you didn’t dump us here either.’ said Paul, stroking his chin in contemplation, ‘How curious. I wonder who did.’

‘Can’t you just help me?’ said the one on the ground.

‘Of course.’ said Laura, bending down. The other slowly sat up, and rested against the offending trunk of the palm tree.

‘I do arts. What about you two?’

‘Law,’ said Paul, ‘she does med, hence the stethoscope.’

Laura started palpating a few anatomical landmarks.

‘I don’t suppose anyone knows how we got here?’ said the arts student.

‘Nope.’

‘Well then – I might just head to the beach and write a distress message in the sand. I’ll do it in the phonetic alphabet too – put that linguistics to good use.’

‘What’s your name?’ cried Laura, hurrying after the arts student.

‘Name’s are of trifle importance at a time like this,’ called back the arts student. A wind rippled through the trees, ‘what matters are our values, our talents – our creative enterprise which shall save us from this dystopian land.’

‘Have it your way then,’ mumbled Paul as he struggled to keep up.

‘But,’ continued the arts student, her words tossed about in the air as if they were ships upon an ocean, ‘if you wish to refer to me by name, Theodora de la Roule is the one to use.’

Once Laura and Paul caught up with Theodora she had already scrawled a number of messages in the sand. Her handwriting was curiously elegant and loopy.

‘Are you sure any would-be rescuers would be able to read that?’ said Laura, peering at the cursive script.

‘I don’t know, but I love it. I squish all my university commitments into two days so I do lots of random stuff the other five days of the week. Calligraphy is one of my hobbies.’

‘Hobby. Maybe I should get one of those.’ said Laura.

But her thoughts were cruelly tossed aside as a horde of helicopters descended overhead and landed on the churned up sand. Bright yellow lights winked and sparkled as three individuals came striding towards the sorry party of students.

They were the three heads of faculty – each wore a steely glare.

‘You have failed us.’ boomed the first.

‘I am especially disappointed in you,’ the medicine faculty head (that would be me) exclaimed to Laura, ‘I assumed a medical student would be able to foster good interfaculty relations. But no – you stand back and critique handwriting!’

Laura hung her head in shame.

‘And you forgot to palpate the tibial tuberosity!’

‘Hey, wait a second,’ said Paul, pointing to the cowering arts student, ‘I think you are to blame for this after all! You’ve been acting strangely this whole time! I bet your name isn’t even Theodora de la Roule!’

The arts student broke down.

‘They told me I had to participate, and feign ignorance! They threatened to cut arts funding again!’

“This Monash University experiment is deemed a failure.” said the law faculty head.

‘And you’re right about the name,’ said the arts student between sobs, ‘I’m really Jessica Smith.’

 

 

 

 

 

 

Are surgery and Social Media Compatible?

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.

Straight

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.

An Issue that should be addressed

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.