World Mental Health Day

BY NICHOLAS WILKES

When someone tell you they are sick, what’s the first thought coming across your mind? Even as a medical student, many of us may automatically think of a physical illness, like a flu, a stomachache, a broken arm, something that is visible to the naked eye that you are more likely to notice and understand how it can impact someone’s activities and life. But there’s more to health than just the physical health that we all refer to when we wish someone good health, that is the health of our minds – our mental health.


World Mental Health Day is coming up on October 10th and occurs every year to raise awareness of mental health issues and promote greater support for mental wellbeing on both an individual level as well as on a larger scale. While the significance of physical health to one’s life quality and expectancy is increasingly appreciated, unfortunately, we tend to pay less attention to our mental wellbeing, which is undoubtedly becoming more important than ever in this pandemic. The detrimental impact of physical isolation and countless disruptions to normal life may have different impacts on each of us, but one certain thing among all these undesirable uncertainties is that we all have to experience this to some degree, and our mental health is all potentially at higher risk of being compromised during these difficult times.


This time of the year when exams are imminent, even without the presence of the COVID situation, it is undeniably stressful for everyone no matter what year levels you are in, and it can be hard to avoid feeling down, overwhelmed, worried or anxious all the time, but remember that you are not lonely. As how we will never judge our patients or loved ones because they are having a hard time with their mental issues, we all can support others who are in need, as well as reach out for help when we need to. Mental problems should never be stigmatized, it is not a sign of weakness, and it applies to everyone including us, who are expected to be the professional carers for our future patients. We do not have to be perfectly
healthy mentally and physically to fulfil this job, but we need to understand that our own wellbeing should always be the first priority over anything else.


Just as how throughout the course of medicine, we have been taught that prevention is always better than treatment, make sure to take steps from this very minute to give yourself a moment to think about your current mental state, and what you can do to prevent it from getting worse, because every day should be a day when you care about your mental wellbeing. Try all the self-help advice to adjust yourself to this current pandemic situation, establish a routine schedule to optimize your productivity and sense of self-control, find a friend or family member when you are feeling blue, but don’t forget that sometimes even with your best efforts, there are things which can still be out of your control, and that’s totally OK. Take one step at a time, things may be very tough now no matter how you look at it, but looking back on
the paths you have been through to realize how far you have come to this point, and one day these difficult times can be another past that your future self will be so proud of. Please do not hesitate to seek for professional help when you need to, just like how you would hope you future patients to look for your help when they are really in need. I wish you all to be healthy today and every day, mentally and physically and best of luck with your exams.

Know Right

BY MICHELLE XIN

The following piece was part of the Writing (Clinical) section of The Auricle’s 2021 Writing and Visual Art Competition and is responding to the prompt “The pursuit of knowledge is a quintessential part of medicine, but the benefits and risks sometimes balance treacherously“.

We do not know what we do not know.

Does this unsettle you?

To chase the tails of knowledge, relentlessly.

To walk the roads of answers, endlessly.

To mine the gems of truth, tirelessly.

What do we know when we know?

When we know, a door is closed.

“Unfortunately, the tests did not show what we were hoping for.”

When we know, another door is opened.

“Doctor, how long do I have left?”

We do not know.

Our work is scaffolded by ladders and stairwells – up, up and up. We work to learn more, feel more, understand more, give more. To know more; this forms the foundations of our abilities. Each step is cushioned by knowing, trying to know, or at the very least, the illusion of knowing. We are reassured by answers, by the concrete of our schemas, our evidence-based guidelines, our research. We want to know because it makes sense to know.

We know that once we know, we can synthesise and process and generate. Differentials, management plans, approaches, teaching points. We know this is important. We know that the answers to the questions we pose help us and help them. We know it is harder for us and them when they are unable to answer our questions.

For how important knowing is to us and our profession, it is incredible how fickle it all is. How fallible we are when it comes to knowing. We need to know right. We need to know well. We need to know, without being told what or how to know. We need to know, even when no one does.

Chasing knowledge can be a place of comfort, but only when we want to know, and we are willing to face the consequences that come from doing so. When our landings are blanketed by foresight and the privilege of being the one asking the questions, knowing does not seem so difficult, or surprising, or shocking.

For those at the receiving end of our interrogations, our prods, our palpations, our auscultations – they undergo these without knowing, with compliance, with blind trust. Often without knowing the outcome, emerging uncertain and waiting. They trust us to know, and to know what is best for them.

Sometimes, knowing changes everything. We know what to do. They know what to expect. They know what to do. This pushes us to ask, to seek, to test, to scan, to biopsy, to re-scan, to re-test, to find the answers, without end.

The universe knows better than to give mortals this book of answers; and yet we are tantalised by the possibility of omniscience; by the power that comes with knowing. It is bold of us to assume we know, and that we know best.

Because we do not know what is best. Let alone know what is.

We are grounded by dissonance between the biochemical results and the presentations, the holes in research and the management plans being drafted. We are bound by the preconceived, traditional notions of how things should be, and thinking we know because our predecessors seemed to know, and that is enough, right?

When you next chase the tails of knowledge, have a look at the creature whose tails you are chasing. What would you like to know? Its tails? Or itself? Or the reason for your chase?

When you next walk the roads of answers, ponder where the paths lead, and who forged these beaten tracks before yourself? Where are you headed? Why are you walking? Or running? Or running away?

When you next mine the gems of truth, consider the weight of the tools in your hands, the darkness that surrounds you, and the bright shimmers beneath. What are you looking for? What will these gems become when they are unearthed?

Find comfort in not only knowing, but also the process of doing so, and in understanding how we come to know that we want to know. 

And find solace in not knowing, for we are beautifully human when we have the courage to continue, to strive, to believe, despite not knowing.

“I don’t know.”

“That’s okay. Thank you for your honesty. I can’t expect you to know everything – you’re only human after all!”

See Wisely to Treat Entirely

BY MATTHEW LIM

The following piece received an honourable mention the Visual Art section of The Auricle’s 2021 Writing and Visual Art Competition and is responding to the prompt “ ‘The value of experience is not in seeing much, but in seeing wisely.‘ William Osler

My visual piece has been influenced by the dehumanisation of patients in medicine. William Osler has also said: “It is much more important to know what sort of a patient has a disease than what sort of a disease a patient has.” My visual portrays the value of experience as the ability to take a holistic approach to medicine and personalise medical treatment by placing more emphasis upon patients’ own personal desires when deciding treatment options. This message is displayed through the depiction of faint
silhouettes of people visible within the words on the computer screen – in order to see these silhouettes, you need to “[see] wisely” rather than “[see] much” (if you zoom in close enough to read the words, you will not be able to see the silhouettes). The words on the screen relate to ‘the medical interview’, and choosing to see patients solely as this set of information (rather than as people) will result in dehumanisation. The large stack of books is reflective of the ease at which medical students can sometimes reduce a patient into a set of symptoms to be diagnosed, especially when studying the signs
and symptoms for a variety of medical conditions.