Tuesday, November 27, 2007

Medical Musings: Sacrificial Ceremony

(Note: names have been changed to protect identities)

Whilst my patient was being prepped on the operating table, Shaun (the Upper GI surgical registrar) and I had an honest chat. It started with a simple “Oh, why did you decide on surgery as a speciality?”, but soon developed into a complexed discussional affair that interestingly touched on topics such as kids, art history and pangs of guilt. Small, little, minutely-built Shaun, wrapped up in sterile drapes, masked, gloved, fingers on the ready, told me what I wouldn’t dream to hear anyone who has walked down that path say - “Your life, Diyana, is already consumed by Medicine and you know it.”

Even after scrubbing-in, Shaun’s mind was not cleansed of the filthy guilt that stealthily plagued him all his life. The soapy antibacterial suds that dripped from his fingers, forming a trail that marked the path from sink to prep table to operating table, carving the circumference of the little area that we both were standing in - if only it were not reality; that it was just a small, sterile corner where the truth can’t puncture into. “My wife did the right thing.” Shaun added. “She refused to embark on a career as demanding as this. I can only live life once my work has reached its end. I can only silently watch as she lives hers.”

And just. Like. That; the short digression ended, the conversation’s heels turned. We reverted to lighter topics: on Asian food, cooking equipment, the cultural mixture in Singapore, even the prerequisite filler of weather and the warm Australian sun. Within the walls of the medium-sized operating theatre, for what felt like minutes, our attentions deviated away from the medical machinery that surrounded us, the patient that lay by our side, roaming freely into the outside world where we longed to unleash our imaginations that have been locked in too tight.

Toby, the senior registrar, called on Shaun as he made a long slit on my patient’s abdomen. It was an incisional hernia; the patient insisted that it be must be acted on for cosmetic reason. As the diathermy blitzed its way through layers of skin, fat, subcutaneous tissue, vessels, peritoneum and then the inflammatory mess a previous mesh had left behind (for this was not the patient’s first attempt), I thought to myself as my guilt too prodded deeper still - what have I given up and what for?

My patient lying motionless, unaware of his surroundings; his legs and hands spread out like a sacrificial offering. He must have known that it will not be the last time that his bowels will lay splayed out in the open, gasping for breath. It will become progressively rebellious; the operations more risky. No amount of vanity can hide it all in; no synthetic covering can blind you from what you’ve already seen.

Despite standing there in my scrubs - covered mostly from head to toe - I have never felt more emotionally naked, never more vulnerable as if placed on an altar. Life is not long enough to live with complete satisfication, or perhaps no human being can settle comfortably with what they already have.

One has to sacrifice a bit of himself, unfortunately, to be who he wants to be.

Medical Poetry evening

The Medical Humanities Society / Purple Coat Club is hosting a medical poetry evening on Thursday 6 December at 8 pm in the Humanities Department, level 3, Sherfield Building, Imperial College London. Our guest will be poet Carole Satyamurti, whose works include 'Stitching the Dark' and 'Love and Variations'. Her most overtly medical poetry is in the anthology 'Changing the Subject'. This include a cycle of poems about breast cancer which forms an astute commentary on so many of the themes which preoccupy the medical humanities: the doctor-patient relationship, the experience of the hospital environment, and the transition from person to patient and back again. In spite of dealing with complex themes, the poems are very accessible. I love the way they are reflexive about how the illness experience transforms the acts of seeing and saying. Flowers are congratulatory at the bedside stage, applauding the successful adoption of the role of patient, yet they also seem harbingers of doom -- what happened to the prior occupant of the bed? In the poem 'How are you?' the ritualistic phrase has its meaning rearranged in the context of serious illness.

Do come and join us for a pre-Christmas celebration of medical poetry. Everyone is welcome and there is no charge. Please e-mail me if you plan to come so that I can send details of access and directions (and it helps with the catering!).

Monday, November 19, 2007

Review of Jonathon Kaplan's talk

Posted on behalf of Anjali Chandra:

I thought the talk was very enlightening. For me personally my family life was affected by the Gulf War so it was nice to medicalise it and see how Dr Kaplan and others helped out there.

He had lots of stories as you can imagine and most of the audience were non-medical students it seemed. The organiser seemed to be trying to glorify Dr Kaplan's career more than Dr Kaplan himself.

He was much more humble and explained the difficulty with adjusting back to life in UK after such missions.

It was funny to learn that in the UK he just locums as a surgeon and how he is happy that his career is now being made into a speciality that students can consider as a career option.

I appreciate that my take-home message was very different to others as the discussion in the pub afterwards revealed! Of course I bought both his books and got his autograph too!

Friday, November 16, 2007

'Must' is a must!

Work by the Clod Ensemble always defies glib genre assignment, and their new performance piece ‘Must’ is no exception. It’s probably best described as a confrontational monologue, delivered by the gender-ambiguous Peggy Shaw, with some parts set to images and live music. Shaw’s theme is bones: the skeletons of animals, the sucking and crunching of chicken bones, and her own bones – redolent with memories both innate and acquired. Shaw addresses us, in the small space of the Wellcome Collection’s forum, as if we are, at first, strangers and then lovers. She is De Neroesque in more than her looks, with a hypnotic stage presence enhanced by the choreographed lighting effects. The result is unnerving and energising. 'I have 13 bodies and this is just one of them,' says Shaw, utterly plausibly.

'Must' was ably complemented by the first part of a new series of performances called 'Under Glass'. Sachi Kimura 'dances' in a large glass jar which suggests both womb and scientific specimen. There are six more vessels to come in the series which has been commissioned by Sadler's Wells.

The second showing of 'Fantastic Voyage' at the Wellcome Collection on 22 November is sold out, but it's worth being on the lookout for other opportunities to see this and future installments in the series.

Tuesday, November 13, 2007

CPS Open Seminars Series

Thought some of you might be interested in one or two of these seminars at Essex.

UNIVERSITY OF ESSEX
Centre for Psychoanalytic Studies
Open Seminars Series 2007-8

The Centre for Psychoanalytic Studies (CPS) has offered a series of Open Seminars for many years. The seminars are open to all current and past students and staff of CPS, members of the University at any level, and scholars and mental health professionals in the locality.

The seminars take place on the third, sixth and ninth Wednesdays in Terms One and Two and Three in room 4N.6.1. Time: 5pm-6-30pm.

November 14th Dr Alan Cardew: 'Politics, Paranoia, and Psychoanalysis in the United States'

December 5th Dr John Walshe: 'Space, Communication and Therapy'

January 30th Dr Nikolai Sakharov: 'The Idea of Personhood in Modern Russian Thought'

February 20th Mrs Marie Bridge: 'Psychoanalysis and Literature'

March 12th Professor Martin Stanton: 'Alienation in Psychoanalytic Work'

May 7th Professor Rachel Blass: 'From Seduction Phantasy to Faith: Freud's Struggle with Doubt and Conviction in the Truth of his Ideas as the Grounds of a Psychoanalytic Approach to Knowledge'

May 28th Dr Mary James: 'Jean-Martin Charcot and the Art of the Clinic – A Visual Approach to the Study of Hysteria in Belle Epoque Paris

June 18th Professor Les Lancaster: 'Kabbalistic Psychology and the Cognitive Neuroscience of Consciousness'

For more information email cpsadmin@essex.ac.uk
or visit here

Thursday, November 08, 2007

Invitation to special screening

Posted on behalf of Robert Sternberg:

I would like to invite you to a film show next month. As some of you may know, I was a friend of Miriam Hyman, one of those killed on the No30 bus on July 7th 2005. Later that year Miriam's parents and friends established the Miriam Hyman Memorial Fund which has financed young eye doctors from the developing world to come to London for training in specialist techniques. Every year they try to organise some events for further fund raising and this year, on the 9th December we are organising a charity screening of In The Shadow of the Moon at the Tricycle Cinema in North London. The film was co-produced by Chris Riley, a friend and colleague of Miriam. It has already won several prestigious awards in the USA and you can find out more about it here: http://www.miriam-hyman.com/shadow_moon.asp

I do hope you you might be able to attend and if so, please do buy tickets in advance so we know how many people to expect. This is very much a word of mouth promotion so please encourage your friends also. The film is beautiful and the fund is doing important work.

Saturday, October 27, 2007

Events at the Wellcome Collection

Materials Library presents: Flesh
Friday 9 November, 20.00-22.00
If butchering joints and life drawing catch your fancy this is the event for you. Demand has been high for tickets to our late-night spectacular investigating flesh in all its guises, so book now or miss out!

The Clod Ensemble's Fantastic Voyage (particularly recommended: directed by Suzy Wilson)
Thursdays 15 and 22 November, 20.00-21.00
Have you ever wondered what you look like on the inside? Join the acclaimed music theatre company Clod Ensemble as they take you on an adventure deep inside your body.

Blood Guts, Children and Power
Saturdays 17 and 24 November, 11.00-13.00
Sundays 18 and 25 November, 11.00-13.00
Join the events team as we head off-site for a revealing walk around Bloomsbury and Holborn's chequered medical past. Walks start at Holborn station and finish at Wellcome Collection.

Something Somatic
Thursday 29 November, 19.30-21.00
Saturday 1 December, 15.00-16.30
Sunday 2 December, 15.00-16.30
How often do you get the chance to see ground-breaking new theatre in London for free? This exciting play about the relationships all of us have with our bodies and their uninvited guests will be on for three nights only. We recommend early booking.

NEW EXHIBITION OPENS ...
Sleeping & Dreaming
29 November 2007 -9 March 2008
Exploring the mysterious state we inhabit for a third of our lives. Keep warm this winter and come and investigate the mythology and popular culture surrounding sleeping and dreaming during these dark winter nights. 'Sleeping & Dreaming' is free and tours will be available. Opens on Thursday 29 November.

Monday, October 22, 2007

Jonathan Kaplan speaks at UCL

Witnessing and Working in War: An evening with Dr Jonathan Kaplan - October 23 @ 7.00pm - UCL

Jonathan Kaplan, war surgeon, film maker, photographer and best-selling author of "Contact Wounds" and "The Dressing Station", will be speaking on his experiences of being a surgeon in war zones across the world, from Burma to Iraq, Eritrea to Angola. This is a rare opportunity to hear a highly prestigious war surgeon speak honestly about his experiences. The lecture is free to all and after the talk Dr Kaplan will also be signing discounted copies of his books.

Lecture Theatre G03, Bedford Way Building, 26 Bedford Way

Facebook event

Also see a related interview.

Thursday, October 11, 2007

Medics on TV

Thanks a stack to Ghostwriter for putting up all these amazing looking events! When you've exhausted yourself participating in all of those, put your feet up and watch 'Trust me I'm a Doctor: Medics in the Movies', scheduled to be screened on Monday 15th October at 22.25 on BBC4. The lovely docs-on-screen expert, Brain Glasser, will be featured.

In fact, BBC4 is running a Docs-on-the-Box season. Click here for full listings for next week. One of the highlights is 'Doctors To Be: Twenty Years On...' at 21.00, following a group of doctors who were filmed at the start of their careers.

Wednesday, October 10, 2007

The Wellcome's October Events

Rebound: two decades of notes on HIV in LondonThursday 11 October-Sunday 28 October Combining sketches, diary notes and wall drawings, Paul Ryan's exhibition sheds light on the changing perception of HIV in London over a period of 20 years.

Rebound TalkSaturday 27 October 15.00-16.30Join Paul Ryan and guests for a discussion about how lives, treatments and feelings have changed towards HIV over the last two decades.


Back by popular demand: Live SurgeryThursday 1 November 19.00-21.30If you missed this fully booked spectacular in July here is your chance to catch Independent described as: 'quite literally a heart-stopping moment... the gift of life and the miracle of science."


FREE GUIDED TOURS THROUGHOUT THE MONTH:Perspectives ToursJoin the curators and other experts for their personal insight into Medicine Man.Behind-the-scenes TourFriday 5 October, 13.30Medicine Man ToursEvery Saturday at 11.30Medicine Now ToursEvery Sunday at 14.30


COMING SOON... Materials Library presents:'FLESH', A SPECIAL FRIDAY LATE NIGHTFriday 9 November 18.30-22.00Touch, feel, smell, cut, drill and even taste flesh at this Friday night late for the curious. Full details available online soon.

London Arts is Health Forum



This autumn, LAHF has organised a series of events focusing on the impact the arts can have in strengthening the health of communities.
Events in October and November will focus on the role of the arts in cultivating healthy lifestyles and in tackling health inequalities. These events will also examine the issues facing architects and designers looking to use the arts to help develop effective community healthcare facilities. Alongside these events, they hope to organise a seminar to debate some of the issues involved in promoting arts events in community settings. Look here for further details.

Bromley by Bow Tour
On Thursday 8 November, LAHF is co-ordinating a tour of the ground-breaking Bromley by Bow Centre. Over the past twenty years, the Bromley by Bow Centre has stood as a beacon of good practice in using an integrated approach to the arts in community healthcare settings. The Centre offers a huge range of arts based activities as well as providing workshop space for artists and including a diverse selection of integrated art throughout the premises.
Buildings and the Arts
On Thursday 29 November, LAHF is presenting a forum entitled "Building the arts into community healthcare provision". Speakers will include clinical teams, design consultants and architects involved in developing some of the newest community health facilities in London and the event promises to be a lively and dynamic exploration of the challenges involved in integrating the arts into new buildings. Keep the date free and look out for more information in future newsletters or, to register your interest, email: Damian@lahf.org.uk
Well London Update
A meeting has been scheduled for Thursday 18 October 2-4pm at Arts Council England, London, to unveil further details about the arts and cultural strand of Well London.
As previously reported in LAHF's newsletter, Well London is a new, £9.46m pan-London programme that will invest in community led projects over three years to promote health and mental wellbeing. Well London partners will work with communities to design and implement creative projects that can meet their needs and aspirations, developing relationships between them and arts organisations and artists which will then deliver projects.

Writing Heals
A national conference focusing on creative writing and wellbeing will take place in Salisbury on 14 November. For more information, t: 01722 321744
London Arts in Health Forum,Floor 1, The Menier Chocolate Factory,51 Southwark Street, London SE1 1RUTelephone/fax number: 0845 602 0825E-mail: info@lahf.org.uk

Experiment Marathon


This coming weekend (13-14 October 2007) sees the return of the Experiment Marathon at the Serpentine Gallery. Steven Pinker and other leading scientists join artists at the gallery's 24 hour Experiment Marathon featuring robots, three-way kissing booths and out-of-body experiences! Check it out here.

Last year’s, now legendary, 24- Hour Interview Marathon has been expanded in scope. The 24-Hour Serpentine Gallery Experiment Marathon, introduced by Julia Peyton-Jones and presented by Olafur Eliasson and Hans Ulrich Obrist, will take place in the Serpentine Gallery Pavilion 2007 and will feature experiments performed by leading artists, architects and scientists.Featuring: Marina Abramovic; Simon Baron-Cohen; John Brockman; Peter Cook; Tim Etchells; Sophie Fiennes; Armand Leroi; Gustav Metzger; Steven Pinker; Pedro Reyes; Matthew Ritchie; Israel Rosenfield; Tomas Saraceno; Angela Sirigu; Andreas Slominski; Luc Steels; and Lewis Wolpert.The experiments will explore ideas of time, space and of reality through models, vibrations and perception, investigating Eliasson's assertion that 'What we have in common is that we are different.'


Tickets available on the door on a first-come-first-served basisSerpentine Gallery Lobby Desk: 020 7402 6075


For full listings please visit:http://www.serpentinegallery.org/


All events take place at the Serpentine Gallery, Kensington Gardens, London W2 3XA.Nearest Tube: South Kensington or Lancaster Gate.10am – 6pm daily, Fridays 10am – 10pm. Admission free.Recorded information: 020 7298 1515

Paintings in Hospitals


There will be a fundraising evening and art auction in aid of Paintings in Hospitals on 13 November at the Institute of Contemporary Arts in London. Check out the Paintings in Hospitals website here for more information on the work they do. It is an extremely worthwhile charity that loans works of art to hospitals and other healthcare sites across the UK. They have quite an impressive collection. More details of the auction itself can be found here. This event should be a really good evening, and they have some very impressive auction lots. MAybe I'll see you there!

Monday, September 24, 2007

Special medical writing programme at Festival

This year's The Times Cheltenham Literature Festival is featuring a programme on 'Writing Medicine', a series of events that aim to explore the interaction between literature and medicine.
Wellcome Trust 'Writing Medicine' events

Sebastian Faulks and Steve Jones
Sat 6 Oct/14.15-15.15/Town Hall/£7
Sebastian Faulks' bestselling novel 'Human Traces' draws on five years' research in medical libraries, while Steve Jones' 'Coral' used the amazing power of the electronic Web of Science to mine the world for information. They discuss the pleasures and challenges of the research process, and the fascinating and often unpredictable ways it shapes their work.

Medics
Sun 7 Oct/14.15-15.15/Town Hall/£6
From 'Dr Finlay's Casebook' to 'ER', portrayal of the medical world has undergone a seismic shift. Ambulanceman Tom Reynolds, author of the award-winning blog 'Blood, Sweat and Tea', joins former doctor Jed Mercurio, creator of 'Bodies and Cardiac Arrest', and The Times' Thomas Stuttaford to explore whether fact matches up to fiction.

The Only Boy in the World
Mon 8 Oct/14.00-15.00/Town Hall/£6
Michael Blastland has written powerfully about his son's autism. He joins Simon Baron-Cohen, Director of the Autism Research Centre, and Marti Leimbach, author of 'Daniel Isn't Talking', to talk about their own experiences, how autism is reflected on the page and how this relates to the latest medical thinking.

In Sickness and in Health
Wed 10 Oct/16.00-1700/Town Hall/£6
How do authors write about illness and recovery? Poet and non-fiction writer Gwyneth Lewis and author Jeremy Thomas have both written powerfully about depression and illness. They join Brian Hurwitz to discuss reading, writing and recovery.

Ian McEwan and Steven Pinker
Sat 13 Oct/12.00-13.00/Everyman Theatre/£7
How does language shape who we are? Booker-winning novelist Ian McEwan and bestselling psychologist Steven Pinker share a fascination for the way language can offer a window into the depths of human nature. They make an unmissable rare joint appearance.

Seizures
Sun 14 Oct/ 15.00-16.00/Town Hall/£6
Neuropsychologist Paul Broks' 'Into the Silent Land' is a haunting meditation on the relationship between mind and body, while The Times' Erica Wagner's debut novel 'Seizure' uses epilepsy to explore similar terrain. They discuss the portrayal of epilepsy in literature and drama and its power as a fictional device.

The Times Cheltenham Literature Festival runs from 5 to 14 of October. To book tickets please call the credit card hotline on 01242 227979. For full programme details see The Times Cheltenham Literature Festival website.

New source of Medical Humanities funding

The Wellcome Trust has just announced Strategic Awards in the Medical Humanities which will promote multidisciplinary research collaborations. This is good news for the field. More details here.

Thursday, September 20, 2007

Back To Work 1: shades of nights past

I have now been well and truly blooded in the deep-immersion technique of returning to surgery, feet first, into the deep end. In fact, I exaggerate. It felt, for the months leading up to this entry, that it would be extremely deep and extremely bloody, but this is not a war zone. The denizens of my particular corner of the city seem to be maintaining a truce in the gun and stabbing battles that can so excite those of us employed to clean up afterwards. Either that, or they have got better at finishing off their victims, and bypassed us altogether for the more direct line to the morgue. My nights have involved so far the usual grist to the surgical mill of appendices inflamed and not inflamed along with abscesses - hundreds of years of lancing the spectacular things. One has to treasure the operations that necessarily bring you thanks. Most of our interventions hurt and need explaining. However there are a few that bring instant relief: relieving your buttock abscess of an acre of pus; catheterising a man in acute retention of urine, though messy and now, one would hope, rather below me after years of it. All lead to effusive gratitude. Of course, now that they have deprived our wards of all doctors except me, I will again be catheterizing when it is beyond the capabilities of the excellent, yet often hassled nurses (now "clinical site managers").

So this is what has changed: as a houseman, now 13 years ago (wince), I was the sole mistress of the wards. In charge at night of all wards and all admissions with only some tetchy and off-putting seniors to call and woe betide if my story wasn't good, and my investigations done. As an SHO, the next level up in the recently-replaced system, the housemen began to be put to bed and once again, I was the doctor in charge at night. Going round, sorting out the serious and the bog-standard annoying. Admitting and sitting on those not serious enough to wake my tetchy and demanding senior about.
I now return to active service, only to find that the SHOs, too, are in bed now. At the elevated role of Registrar, I would, once have been the tetchy one in bed but am now wandering around the wards keen to find someone to incise and drain or laparotomise to give me an excuse to avoid the drudgery they are so keen to thrust upon me.
It makes me worry slightly about the next leap up, should I make it thus far: the ultimate goal of consultant, the "attending" of the US hierarchy. When we started, they were noble figures, rarely glimpsed and obsequiously bowed-before. The yearly party hosted by them at their pads were more a chance to show off the prizes of sticking the middle years - swimming pool, racing cars, luxurious space and wine. It was supposed to be your inspiration. The standards have been slipping recently, one must admit. More likely a semi in Muswell Hill than Hampstead splendour. But now, having worked this system and expected their last twenty years to be of semi-retired elective advice as the generation before them, they are in supervising a rusty surgical girl sharpening up her knives for a measly little appendix.

What's come back? Oh the tying of knots, the laying on of hands. What's decayed? Memory, my once ace card, now a little frayed at the edges; non-surgical know-how. My, how it's moved on in my absence!
Part 2: But what about the kids?

Tuesday, August 28, 2007

The Woman Surgeon and the Pea

It's just a question, really. Does any one of you artistic souls out there have an idea for the logo of the new women in surgery committee of the royal college of surgeons of england? I can't face capitalising them all as is their due, but the WinS committee goes like that and is going to be a new dynamic force for equality in surgery. Possibly. No, definitely! Only logos are a bit of a debatable issue, post-Olympics. In fact, for women in surgery or women generally, how do you get a defining image of a woman that is not also insulting or reductionist? Well, answers on a post card in a week... They have tried an initial one: a woman's eyes looking over what appears to be the top of a mask on top of the "W" like a lid (I'd love to copy it but would be breaking a few rules) . When shown to some great and good at the college, it was said to look like a woman with fangs, or screaming. Perhaps this describes better the male surgeon's fear of women in the job?

This has been a welcome distraction from the organising of kids and the freezer and the dry cleaning of suits in mothballs (I wish they had been in mothballs - a chosen few eaten happily by generations of the little buggers since I last donned a suit and tried to look serious) which have been my lot of the last few weeks. Going back to work coincides neatly with school and the "Back to School" cheery adverts in shop windows have the same day-dulling effect on me as they did in school days. As they do indeed on my son. Is it no coincidence that they have created an academic year that starts as the nights draw in, the last hopes for summer fade, and we bed down for a long, wet winter. Do they enjoy school more in Australia?

The distraction of suits and summer's last days has in turn helped me avoid the concept of actually revising some facts after my long sojourn in mummy-land. Well, have arrived at the concept but not really acquired any of the facts. So I have persuaded myself that only option is to treat this with more retail therapy - buy some books with the fast-dwindling capital and somehow sleeping with them under my pillow will give me confidence to face out my first day at work. Perhaps.

A logo for the women surgeons? A princess and the pea-like image but with the woman sleeping soundly on a great pile of books and surgical instruments under the mattresses.

Saturday, August 25, 2007

Oncology multidisciplinary meeting

“Mr Jones…”, someone drones.
The consultants are the only ones consulted,
Although the ENT surgeons keep cutting in.
“This one’s not healing. Transfer to Ealing.”
The anatomist may do the body of the work
But it is the pathologist who focuses on the details.
“Mrs Ryder: intermittent stridor.”
The radiologists show everyone the bigger picture
Although the nurses, now sitting silent, might be more qualified to do so.
“White cells seem low. Stop the chemo.”
Similarly, the speech and language therapists say nothing
And the physios don’t move a muscle.
“Tumour’s enlarging.” “Where’s the margin?”
Some doctors are called away, leaving when they have nothing more to offer,
But the palliative carers stay until the end.
“Mr Brady." "So, consider radio?”
And for three hours, at the back of the room,
The students study the insides of their eyelids.

Wednesday, August 08, 2007

There's a blog blocking me up like a constipated stool..watch out, it's been a long time. Complete bowel obstruction about to ensue. The problem is, the time is so rapidly approaching for my return to the world of full-time work, that there has been no time to record the changes bearing down on me. From planning the minutiae of my children's after-school care to worrying about only having joke shoes and glasses bent back by a toddler and held together with sellotape. Once fetching in a Pulp or Morrissey sort of way, this look is hardly inspiring in a surgeon. One of my bosses (for someone who works only one measly day, I seem to have acquired a fair number of bosses) commented that my clothes didn't match. There are downsides to female bosses. I didn't want to admit that I'd got dressed in the dark. Anyhow, defence seemed pointless. Another said, "you'll have to lose the hippy look". Oh, for a suit and a tie and be done with it. Haven't we enough to worry about without the whole thing of what goes with what. I shall spend as much of the day in blue pyjamas as possible. It saves on dry cleaning bills, for a start.

I've noticed that colonoscoping has got easier. I mean, at about the pace of watching a child grow. Almost visible, yet not. Only when someone hasn't seen them for a few weeks, then they say, ooh he's taller and I think yes, I thought he was taller. Been detecting it in extra gap at the ankle - note: needs new trousers - and yet can't see it. My improvements are a combination of confidence and practice. Interesting to see that the boss (one of em) doesn't intervene now when I'm stuck. I'm kind of left to it. I don't whizz round them all in 3 minutes, but I do whizz round some in 3 minutes. There are always the ego-deflating (mine) and colon-inflating (theirs) depressingly difficult ones. We had a list of them last week. Possibly the most depressing week I'd had in what is now 2 and a half years of this job. Each and every patient was either poorly prepared (bowels covered in poo - like we all are. What a lowering thought. I shall look at the next mean member of officialdom I meet with my X-ray eyes and see through to his poo-covered gut), or hopelessly difficult or both. And worst of all, we didn't achieve anything. No one was saved. A hiatus at the beginning, at 9, when no one arrived for an hour left us hopelessly late at the end, finally drooping out of there resentfully at 7. At least it rained cheerlessly all day, matching our mood.
This week, though, buoyed by the sun we succeeded. We still finished late, but it somehow felt different. I searched carefully for a polyp to have the satisfaction of finding one, hiding in the very last place I looked. You don't want to find cancers. They are big and scary and life-changing, life-threatening bits of news to see round a bend - an intake of breath, somehow the patient is alerted and looks: what's that? of course they ask. Yet how can you have a serious discussion about what it might be, with someone dosed up on benzodiazepines, in the least equable position at patient can be, at the mercy of your scope? Of course it is always better that it was found now rather than later. But the recriminations begin immediately - why did the GP sit on it, the patient not complain more, the husband not notice something? Finding a polyp is usually without these implications. Just all good. Meant the decision to scope was correct. Potential future cancer can be avoided. And you get all the fun of zapping it. Finding ten polyps, when there are 4 people waiting is not good - too much pressure to be fast. So there it is, the is the tiny rectangle of pleasure that keeps you coming back: despite the wrist ache, the excruciatingly dull paperwork, the possibility always of doing it wrong in many many ways, the satisfaction of buzzing off a little polyp in someone's gut. My old boss said you were of surgical intent if you used to squeeze other people's spots as a teenager. I should have stuck to that.

Wednesday, August 01, 2007

Filmmaking opportunity

MA Film/Media Postgraduate Scholarship National Institute for Excellence in the Creative Industries, Bangor University & MIND

Commencing October 2007

We aim to recruit a student who will work on a weekly basis with mental health service users in Anglesey, undertaking the following innovative film project:
• Overseeing a practical film-making project from pre- to post- production.
• Familiarizing service users with use of industry standard cameras, lighting and editing equipment.
• Working along with other professionals from NIECI facilitating scriptwriting and storyboarding workshops for the purpose of the film.
• Producing a significant piece of high-quality and original critical and/or creative research of publishable standard.

The student will be registered for an MA with the National Institute in 2007-2008 and their postgraduate fees will be paid.

Applications close: August 24th. Applicants can obtain further details from n.abrams@bangor.ac.uk or graeme.harper@bangor.ac.uk. Applications should take the form of a CV, including degree results and any relevant experience, along with a letter of interest.

Tuesday, July 24, 2007

Handsome Young Doctor

Thanks to Anenta for bringing this exhibition to my attention, it looks well worth a visit.

6 July – 26 August Exhibition – Rannvá Kunoy

Works by Faroese artist Rannvá Kunoy are on show for the first time in London. They form part of a group exhibition titled “Handsome Young Doctor – A show about Trust” and curated by Tom Morton. Rather than focusing on pills, scalpels and other objects from the universe of the doctor, the exhibition questions the idea of ‘Trust’ as a general concept. The London bases artist’s paintings draw on the tradition from high modernism and sci-fi illustration and depict ephemeral figures in a state of coming into being. The fragile state of these figures may question the overall idea about being confident and having faith in the uncertainty of life.

The exhibition is supported by the Representation of the Faroes in London, Arts Council England and Institut Francais. Wednesday-Sunday 12-6 pm

CUBITT Gallery & Studios 8 Angel Mews London N1 9HH Tel. 020 7278 8226 info@cubittartists.org.uk

Monday, July 23, 2007

Changing the Subject

I recently came across the work of poet Carole Satyamurti. This London-based writer does not shy away from difficult subjects. The seriousness of cancer is dealt with with a mixture of wit and courage in Changing the Subject. This collection of her work was published in 1990 and the title refers to a sequence of fourteen poems about a woman cancer patient's experience of discovery, diagnosis and treatment. In Out-Patients, she tells us, the doctor "reads my breasts like Braille, finding the lump I knew was there." And Diagnosis is sensitively handled, "He said/ cancer with a small c/ - the stuff of routine -/ yet his manner showed/ he knew it couldn't be ordinary for me." Satyamurti is a new discovery for me and I look forward to exploring her work further. You can find out more about her and her work here.






Sunday, July 01, 2007

Poetic Medication

The nature of this bunch of people I am associated with has painted a grainy picture in society's mind. For they have labelled us nerds, adroit androids and cookie-cutter bookworms; we apparently define our existence by the number of pages of a medical text that we have read (and/or memorised) and of how many accomplishments we have achieved (and how much money we have earned) as we fast-track our journey to Consultancy from that first step into our careers.

Why is it so difficult to equate medical students with the Arts; the anti-Science? Perhaps culture, lack of creativity and the pressures of performing (amongst others) has led many of us to not pursue this as a hobby, but to handle it as an obstacle to what little time we have left for studying. Here in Australia it seems a little more natural to pick up a footy ball and have a match between mates, rather than conjuring paintbrush strokes or rhyming words to ease the stresses of medical school. Lately, blogging has become a formidable phenomenon, engulfing the interest of all genres - medical students included, posing as a platform for a sudden spillage of life stories that allow the common people glimpses into someone else's day-to-day activities. Perhaps this could be the gentle ripple that may someday overtake the stereotypical beliefs that most medical students are devoid of inbuilt empathy, dependent on rehashed formulas that worked well for an OSCE ethics station.

Alfian Sa'at has defied convention, stringent Asian conventions to be exact, in a different way. He has embarked on a career as a successful playwright in his home country Singapore. Storing his stethoscope away for good, he decided to leave the art of medicine to peruse the art of life. His plays have been staged to critical acclaim in countries as far displaced as Sweden. Despite his insistence that his life will not revolve around ward rounds and patient care, little semblances of his experiences as a medical student has somewhat shaped his identity as an artist, evidencing the simple fact that while one can leave Medicine, Medicine will not leave him.

Here is a poem he wrote in medical school. Extracted from his anthology A History of Amnesia, which was published when he was a fourth-year, it describes his feelings in an anatomy class. I hope you will enjoy it as much as I do.

Dissection Class by Alfian Sa'at

Peel the drenched cotton
From his stony face. Some
Wisps will stick to his
Stubble, like love-grass
There is nothing to fear.
Death is its own death mask.

Next, we move the scalpel
Across the chest, gradually
Down the arms, like a zipper.
This, to your untrained eye,
Can be considered beautiful,
Even if it is only skin deep.

Expose the path of the tendons.
Observe the nerves' many detours.
The arm is like yours, these fingers.
Consider this a new instrument:
A microscope working through mirrors.

The muscles ooze sighs under your touch.
The sliced arteries uncover blood clots
Like broken wax crayons.
And bone is bone: the final resistance
Knocking against blade or teeth.

Marvel at the lungs, pyramids of air.
Weigh the liver like a moonrock in your hands.
The hollowed ribcage in a swamp of formalin.
Yes, to hold an organ up like a trophy
Makes this less desecration, more archaeology.

But this is no fossil. No history, only
Biography. Yet even palmistry fails us now;
There is nothing written on
The papyrus of this skin. No echoes
Of past lives, or a sense of deja vu:

Memory entering the head like a knife.
A girl's hands slicing the heart in two.

Thursday, June 28, 2007

Heartening new exhibition at the Wellcome

I thoroughly enjoyed visiting the new Wellcome galleries today. There are three exhibition spaces: a temporary space, 'Medicine Man' and 'Medicine Now'. The temporary exhibition space is currently devoted to the heart. Here you can see ancient Egyptian papyrus illustrating separate hieroglyphs for the physical heart and the spiritual one. There's an amazing pair of 17th century anatomical tables -- huge slabs of cedar wood on which is mounted actual venal and arterial material. Galen, da Vinci and Harvey all receive attention in the exhibition.

The middle section of the exhibition is devoted to technology, with explanations of the first heart transplant and a recently-retired heart/lung machine on display. An interesting portion looks at the symbolic power of the heart, including the sacrificial rituals of the Aztecs, and the concept of the 'sacred heart' as the seat of the soul. The art in the exhibition is fascinating, from traditional portraits to more contemporary work. I was particularly drawn to a large-scale work mounted on the wall called 'Le Coeur II' by Annette Messager. It consists of soft toys that have been 'operated on' so that they are reconstructed in new and disturbing ways. They are hung in the shape of a heart. The work sets up a tension between the apparently 'heartless' toys and the emotional resonance that soft toys automatically set up with the overtones of children and illness... It is very affective.

Other interesting objects include a piece of tattooed human skin (somehow more fascinating when it's detached from the rest of the body), a pig's heart stuck with nails and thorns recovered from a chimney in Somerset in the 19th century, and the dried heart of a whale.

There are various points in the gallery where you can listen to heart-themed songs. I like that it is not strictly chronologically arranged. The art and science permeate each other. Poems are displayed on X-rays. I am less sure about the 'porthole' type windows in the gallery that are eye-piercingly bright compared with the dim interior. Who needs to see Euston Road traffic anyway? The exhibition continues till 16 September.

I'll review the other exhibitions in the building soon.

Wednesday, June 27, 2007

Art in a tent...

...but it's not Tracey Emin. The Royal College of Art's 'Great Exhibition' takes place in a giant marquee in Hyde Park (technically Kensington Gardens) next to the Albert Memorial. This is really to be recommended. I was pleasantly surprised by the heady mix of aesthetically pleasing objects and the ingenuity evident in so many of the projects. There is a fair sprinkling of medicine-related design. I do wish I'd gone round the tent in an anti-clockwise direction because by the time I reached the concentration of medical design (in the industrial design engineering and design interactions section), I had gallery fatigue and didn't give them the attention they deserved. A second visit is in order. Sabine Fakete designed an intelligent knee brace and easily changeable stoma bags. Michael Korn's work also focuses on the patient experience and includes a device to reduce needlestick injuries. I particularly liked Chris Hand's ideas about social sensors (pictured on the right). Susana Soares designed bushy fingernails for collecting DNA (pictured left) as part of her project which looked at what extra organs might prove useful in future.

Congratulations to all the RCA students for such innovative and exciting ideas. The Exhibition continues until 28 June.

Monday, June 25, 2007

'Signal' misses target

I do so wish I could say something more positive about 'Signal', a film directed by Simon Tegala. I went with a friend to see it at the Prince Charles Cinema last week where its screening was accompanied by a lived performance of the score and, somewhat disastrously, a discussion with Dr Kevin Rigley, an immunologist who mentored Tegala.

The film, which was three years in the making but lasts just 15 minutes, is set in the British Library's iconic reading room. A cast of four female characters perform in the space -- some collecting parts of puzzles, others striding about or lying on the desks. A sparkly glimmery 'thing' appears which interacts somehow with the characters. Okay, so I didn't understand what was happening while watching the film, so I eagerly looked forward to being enlightened by the discussion. Rigley, who is badly in need of some science communication training, proceeded to give a totally baffling minilecture on how cancer cells recognise 'self' and 'non-self' which seemed to have absolutely nothing to do with what was depicted in the film.

Tegala, prompted by a question from the audience, did eventually explain which cells the 'characters' were meant to represent. The sparkly thing was the antigen or invader and the actresses were all different types of immune cells. Ideally, Rigley would have explained how these cells work in relation to the metaphor of the Reading Room as an organising system.

Tegala wanted to create a film that did not rely on a didactic explanation of the immune system to 'work' as art. I can sympathise with this -- we don't necessarily need everything spelled out for art to be a transformative experience. The problem is that the immune system already abounds with metaphors -- bioinformation, communication, the military metaphor... I was really looking forward to a new system of metaphor being introduced in the film that avoided these cliches and revealed a provocative and novel gaze. But by making our previous frames of reference irrelevant and providing no explanation for the events on screen, the audience was left baffled. It's a question of expectations: the billing promised 'a surreal exploration' -- but the surreal relies on what we know as 'normal' to make sense as a departure from the norm.

I think the film could still work if Tegala is willing to be more upfront about the symbolism. Librarians wear name badges -- it would be a huge help to know what kinds of cells the actors represent from the outset (all we get is a brief glimpse in the credits). In my opinion the musical soundtrack added little to the film. A commentary giving at least an introduction would enhance the narrative intelligibility. Rigley comes across as badly prepared and patronising ('If there's one thing I want you to understand...'). It's not too difficult to explain the rudiments of the immune system to a lay audience in relation to cells depicted in the film. He let down Tegala on the night.

The whole enterprise was clearly well intentioned and I hope it can be rescued. In its current form, though, it sadly seems somewhat pointless.

The National Gallery in London is about to open an exhibition called 'Dutch Portraits: the age of Rembrandt and Frans Hals'. The reason I'm flagging it up here is that it includes one of the most famous medical portraits of all time: The Anatomy Lesson of Professor Nicolaes Tulp. The odious showman anatomist Gunther von Hagens models himself on Tulp. You can read more about the painting here and here. The exhibition runs from 27 June to 16 September 2007.

Friday, June 15, 2007

Gawande gets even 'Better'

Every now and then, I come across an article or a book that I know is just going to be fantastic course material for our Medical Humanities course at Imperial. Reading Atul Gawande's book, Complications: a surgeon's notes on an imperfect science (reviewed by AJ on this blog here) was one of those 'Ah, brilliant' moments. Here is a book that sits on the interface of science and humanities in showing that the practice of medicine is vulnerable to all sorts of biases and unacknowledged 'human' factors. In a particularly eye-opening first chapter, Gawande explains how the 'learning curve', both for inexperienced junior doctors and for new procedures, exacts a toll. This sometimes adversely affects individuals (costing lives in some instances through initially low success rates) but it's for the greater good as skills develop as 'practice makes perfect'.

Some in the medical profession greeted the exposing of these weaknesses in Complications as a betrayal of the profession. But Gawande doesn't merely flag up weaknesses. In his new book, Better: a surgeon's notes on performance, he gives guidelines on learning from experience, good and bad, to improve the success of individual medical professionals but also medicine as a whole -- after all, as James Bryce said, medicine is 'the only profession that labours incessantly to destroy the reason for its own existence'.

Gawande gave a talk at Imperial College on 4 June in which he highlighted some of the issues he explores in his book. He pointed out the discrepancy that exists in the public imagination about the quality of medical performance: it is generally expected to be more consistently good than the reality of the Bell curve in which only a few people or institutions operate in the 'excellence' range. Gawande is in favour of league tables (shock! horror!), because he believes it identifies the excellent few from whom we can then learn how to be better.

Gawande identified 'diligence' as an attribute of successful doctors: giving attention to detail to avoid errors. This includes surveillance for failure in a profession in which failure is effortless. He also said that doctors need a moral clarity about their mission. Yes, there are financial and time pressures, but professionals need to be innovative about finding ways round these obstacles to deliver good quality care. His third quality was 'bedside ingenuity': protocols only take you so far -- thinking of new solutions and interrogating failure is vital for improvement.

Although I have not yet had a chance to read it thoroughly, Better looks every bit as good as Complications. Gawande has an enviably accessible writing style, and important things to say. I was thrilled to have the opportunity to hear him speak in person. There is a podcast from NPR of Gawande discussing his book and reading from it here.

Friday, June 08, 2007

Signal



Artprojx & James Putnam present ...

Signal by Simon Tegala

Live musical score by BENDER


A discussion between artist Simon Tegala and Dr. Kevin Rigley, leading immunologist and consultant for Signal, chaired by James Putnam, curator and producer of Signal

Tuesday 19 June 2007

7pm


7 Leicester Place
London WC2
Box Office: 020 7494 3654 (open 1-9pm)


Tickets £7.50 book now
£5 for artists, curators and students

Simon Tegala’s new film, Signal transposes the model of the human immune system onto the architecture of the British Museum Round Reading Room and Great Court. The space becomes a metaphorical cell/organ/body. The four characters within the film play components of the immune system, operating within the space of the Museum, as do the immunological cells within our body. The film is a surreal exploration of micro and macro spaces. The characters mirror the staff and clerks of the reading room, protecting and ordering the knowledge base of books that become analogous to the DNA within our cells. The film has been researched with immunologist, Dr. Kevin Rigley and supported by The Arts Council of England and NESTA.

The soundtrack to Signal was created by the band ... Bender who will play a special live set to accompany the event. Bender are:-Geraldine Swayne: vocals/ guitars/ accordion/ benjo/ piano/ bass/ viola. James Johnston (also a member of Nick Cave & The Bad Seeds): vocals/ guitars/ organ/ harmonica/ autoharp/ viola/ cello/ piano/bass. Steve Gullick: vocals/ guitars/ cello/ organ/ bass/ tonka.

The event will also include a discussion between artist Simon Tegala and Dr. Kevin Rigley, leading immunologist and consultant for Signal, chaired by James Putnam, curator and producer of Signal.

Thursday, June 07, 2007

Arthur Kleinman speaks at Imperial


The lecture is in Lecture Theatre 1, South Kensington campus, Imperial College London, SW7. Drop me a note at medhum@imperial.ac.uk if you can come so I can add you to the guest list. Everyone is welcome!

Friday, May 18, 2007

Purple Coat Club / Medical Humanities Society events


Michele Petrone

I am really sorry to report that Michele Petrone has died. Michele was a wonderful artist, and a caring and altruistic human being. When he was diagnosed with cancer he chronicled his illness in his art. He really believed that painting helped him cope, and he passed his insight on to others. 'Inspirational' doesn't even begin to describe him. I'll miss him so much. Michele's good work lives on through the MAP Foundation.

Wednesday, May 16, 2007

Diagnosis Wenckeback

Recently, those of us with upcoming medical finals exams have had a serious "chat" deficit. Over time, we have come to accept that medicine has become and will always be ingrained in our conversations, our humour and our souls. This is particularly true of group e-mails more recently, with a rather amusing sketch sent over from across the pond.

WARNING: This is somewhat medical in nature and thus may not excite a huge number of people (or their AV nodes for that matter) and for that I apologise.

Tuesday, May 15, 2007

The invention of health

Oh gosh, I wasn't even aware that medical humanities was a 'space of problematisation'... I'm definitely going along to this to find out what's in that space!

The invention of health: creativity and the medical task: a CSISP seminar

Thursday 17 May 4.30-6.30 Warmington Tower, Room 1204
with Monica Greco Sociology Department, Goldsmiths

In recent years, an increasing number of medical educators have explicitly thematised the relevance of 'creativity' to the medical task. While this movement has gone some way towards addressing the relational dimensions of health, illness and medicine, it has tended to leave unchallenged a number of fundamental ontological assumptions. On the other hand, advocates of a 'successor paradigm' in medicine have explicitly addressed the need for a transformed understanding of the material substrate of health and disease processes, in such a way as to suggest that matter itself can be both creative and subjective. Typically, however, they have stopped short of considering relational constraints at the level of interpersonal and societal interaction. This paper will argue that evidence suggesting a link between health, illness, and creative process is abundant and yet 'anecdotal'. The anecdotal character of such evidence is not accidental, but must rather be regarded as symptomatic of the implications that a processual approach to the medical task would have to envisage as a specific challenge.

Monica Greco joined Sociology at Goldsmiths in 1996 after completing herdoctorate at the European University Institute (Florence). She has along standing interest in how mind/body dualism has been problematisedwithin medical discourse. Her book Illness as a Work of Thought(Routledge, 1998) offers a genealogical analysis of psychosomatic medicine. More recently, her work has turned to the emergence of medical humanities as a space of problematisation. She has published articles in Economy and Society, Health, Theory, Culture and Society and Social Science and Medicine.

Friday, May 11, 2007

In praise of the reopened Wellcome library


I want to go to the Wellcome.
They make sure it lives up to its name.
It’s clean and it’s neat
The chairs are a treat,
And it makes the BL look lame.

I want to stay at the Wellcome.
No expense has been spared over there.
They’ve Wi-Fi that works,
There are plenty of perks,
The loo paper’s quilted – I swear!

I want to move in to the Wellcome.
Do you think they would give me a place?
Surrounded by books
In one of their nooks,
I wouldn’t take up too much space.

I want to live at the Wellcome.
The service I can’t get at home,
It's so nice the way
At the end of the day
They will tidy away every tome.

It’s bliss over there at the Wellcome.
No papers in teetering piles,
No sticky marks on my screen
Where the children have been –
Whom I guess I might miss after a while…

Perhaps I won’t move to the Wellcome
The problem is food there is banned,
And everyone knows
That one cannot write prose
Without coffee and chocolate to hand.

Maugham's moment

Somerset Maugham, chronicler of the early 1900s, is in vogue again. One of his short stories, 'The Letter, is on at Wyndham's Theatre in the West End, and the film of another, 'The Painted Veil', is enjoying box-office success. In an afternoon of sheer indulgence yesterday I went to see both. Maugham is of interest because he qualified as a doctor but never practised. His medical training is evident in his writing, particularly in 'Of Human Bondage' which is not about S&M, but about the constraining nature of social obligation. 'Human Bondage' is one of my favourite novels. It's excruciating in places -- the protagonist, Philip Carey is infuriating but fascinating. Like his creator, Philip also spends time as a medical student. Descriptions of stigma (Philip has a club foot) are thought to be informed by bullying Maugham experienced as a result of his stammer.

'The Letter' and 'The Painted Veil' have parallels, aside from a penchant for white linen suits and panama hats. Both are set abroad and deal with issues of adultery, colonialism and corruption. 'The Letter' (Independent review here) stars Jenny Seagrove (of TV's Judge John Deed fame) as a woman accused of murder. Anthony Andrews is absolutely outstanding as her lawyer and friend of her husband. It's an engrossing, if somewhat outmoded, story, sumptuously produced. I was puzzled but the lighting effects which suspended time permanently at dawn in spite of most of the action taking place at night. This minor irritation aside, the sets were stunning.

'The Painted Veil' has landscape to rival 'The English Patient' of which it is faintly reminiscent. This is more obviously medical. The character of Walter Fane (Edward Norton) is a bacteriologist -- now there's a profession that rarely gets an outing in literature. He takes Kitty (Naomi Watts) to Shanghai with him, and then on to deal with a cholera outbreak in the back of beyond. Fane has a touch of Mr Darcy about him and Kitty is capricious society girl who finds herself out of her depth in a politically unstable, disease-wracked community. It's a portrait of a impulsive and ill-advised marriage which matures under desperate circumstances. I really loved this movie. It's worth seeing on the big screen for the cinematographic splendour of the Chinese landscapes.
I have resolved to read more of Maugham's work. He has an enviable talent for characterisation, realised very well in the stage play 'The Letter' and the film 'The Painted Veil'.

I was rocked!

This time last week an intrepid band of medical students were starting preparations for the third annual '24-Hour Opera'. This is a show prepared and performed over the course of a night and a day. Saturday's show was 'We Will Rock You'. Heaven knows how many cans of Red Bull were consumed during the making of this show, but the performers didn't look as if they were suffering from sleep deprivation. In fact the energy levels rivalled those of my 6-year-old on smarties and Robinson's.

The cast did fantastically. The dance routines were great (well done to our own Tash Wiggins who was the choreographer). Matt Mak revealed talents we would have found ways to exploit on the Medical Humanities course last year had we known he could sing and dance. The band was really amazing -- what a talented bunch of individuals. Did anyone think to invite Brian May? He was spotted in SAFB the other day...

Well done to the directors Claire and Seshi, the backstage crew and everyone else involved. It was a memorable evening, and all for a worthy cause. Funds were raised for Demelza House.

Friday, May 04, 2007

Mozart and the Whale



For everyone that attended the meeting of 'Curious Incident of the Dog in the Night Time', I forgot to mention that there is another book (and film now) that provides more insight into Asperger's Syndrome - particularly the notion that autistic people are drawn together.

The film stars my favourite actress, Radha Mitchell (of 'Neighbours' fame!), and is based on the book by Mary and Jerry Newport. Jerry Newport is an author with Asperger's Syndrome and is also a mathematical savant. The book is a true story of their relationship and has been well received by critics. It is by no means a heavy read and is described more as a "quirky memoir" than anything else.

I am going to get hold of the film asap (since it wasn't actually released in the UK) and will let you know if it is any good. You're more than welcome to come round and watch it with me. Possible future book/film for the Purple Coat Club?

Wednesday, May 02, 2007

Lines written on attending a memorial service for babies and children

The world goes by. Inside
The clocks are stopped.
A passing cyclist in the dappled park
Cannot sense the sadness within.

Along the altar, lights are lit
For all the lights too soon extinguished.
A baby’s voice echoes from a laden pew
As silent cries echo in these leaden hearts.

A hymn, a muted sob, a prayer
Rise to the high walls, where
The sinking sun casts spring leaves’
Lively and playful shadows.

Sunday, April 22, 2007

Stethoscape


Last week saw the opening of Stethoscape, the Medical Humanities art exhibition at Imperial College. I was pleased to attend the opening night although I have to admit a certain degree of scepticism before hand – what should I expect of art works created by medical students? Yet, as I wandered around the exhibition it soon became clear that I need not have worried.

Inevitably, the quality of works on show varied enormously. What impressed me, however, was the quality of the ideas behind them which was consistently high. These works were, without exception, fresh, inventive, engaging and provocative. Some stood out more than others - Leonie Williams' Still Life is a particularly intelligent and accomplished piece - but all displayed a thoughtful engagement with the themes of the course. With more than a passing nod to Foucault, the students produced a body of work which examined the role of the doctor, the patient, the medical student, physical and mental health, power relations, emotional involvement and clinical detachment. The list goes on…

Some students used themselves as the subject of their work, others used the body in different ways, while others absented the body entirely. It was, perhaps, this later group which was most interesting from an art historical perspective. For, it is here we have an opportunity to consider the minds and bodies which are pivotal to the efficacy of the doctor-patient relationship without (re-)subjecting them to the gaze of the beholder. After all, haven’t they been poked and prodded and scrutinized enough all ready? It would seem not, since much of the work reflected on important themes in new ways, revealing new insights and leaving the beholder with much to consider.

The self-reflexive manner in which many of the students worked showed a willingness to be self-critical, an openness to the possibilities offered by medical humanities and perhaps a process of self-discovery which even they themselves did not expect. I don’t know to what extent the students considered affect – they way in which their work might impinge upon the consciousness of the beholder. How might those who visit the exhibition re-evaluate their own medical relationships whether as doctor, patient, relative or anything else? The value of artistic practice is its potential to make people look again at a situation and think, just for a moment, how that situation might be transformed.

On that note, I leave you with Alice Monk’s Statement of Interpreter(above), a piece which grips you with its presence. The brief catalogue entry relays an awful situation, one which makes your stomach churn, but you have to keep on looking...


Stethoscapes continues at the Blyth Gallery, Level 5, Sherfield Building, Imperial College London until 30th April.

Wednesday, April 18, 2007

Keats

Tamzin Cuming has published an interesting piece about Keat's poem 'La Belle Dame Sans Merci' in the British Medical Journal (subscription needed for the full text). Apologies for subjecting you to my holiday snaps (feel free to be 'sans merci'), but I did think of this poem a fortnight ago in Rome when we passed by the house where Keats died. I did not venture in -- or even any closer given the crowds. Also, having two children and a Grandma in tow, eager for the delights of the park at the top of the Spanish steps, was a disincentive, but I plan to visit it some day.

I can't resist plugging Keats House in Hampstead, London. This is a wonderful little museum in a beautiful setting and they have a good programme of events.

Sunday, April 15, 2007

Picasso, the prostitutes and the medical student

Medical Humanities students at Imperial will know that I am very fond of showing the 'Head of the Medical Student', a preparatory sketch for one of Picasso's most famous works, Les Demoiselles d'Avignon (shown above). I've just heard a snippet on Radio 4's 'Pick of the Week' that suggests a possible explanation for the rather curious conjunction of subjects that informed the work. A medical historian has suggested that the painting might be warning of the dangers of syphilis, particularly as three of the women have mask-like faces -- possibly showing ravages of the disease, especially the deformed nose of the figure on the bottom right. Medical students at the time (early 1900s) would have toured wards of syphilitic patients. If Picasso based his paintings on real subjects, it could explain the association with the student. The medical student didn't retain his identity in the final composition -- he became the 'curtain raiser' on the right-hand side of the painting.

In the National Gallery, you can see Bronzino's An Allegory with Venus and Cupid, which is also thought to have a lurking figure suffering from syphilis (on the left of the picture), as a warning of the dangers of illicit love.

Tuesday, April 03, 2007

The Song of Los

I've posted before about the little tidbits the Oxford Handbook of Clinical Medicine contains. A welcome break from the horrors of revising glomerulonephritides was this beautiful picture from William Blake's the Song of Los. It depicts a cloud-borne Los leaning over his hammer, looking down at the sun. The authors of the Oxford Handbook felt this was rather more representative of a 'haemotologist hammering a red cell into shape', based on this quote:
"Every space larger than a red globule of man's blood is visionary, and it is created by the Hammer of Los"
[Los was a mythological character, a fallen god, and his hammer represented creative energy.]

Monday, April 02, 2007

Medical Humanities Society AGM

This Thursday 5th April there is an Annual General Meeting for the Medical Humanities Society. The following positions are available:

President
Responsible for union affairs, liaison with BSc events and overall responsibility
Secretary
Responsible for co-running with President, Fresher's Fair and overall responsibility in the President's absence
Treasurer
Responsible for subs and funding
Finance Officer
Responsible for outside sponsorship
Publicity Officer
Responsible for advertising the schedule and poster production
Social Sec
Responsible for outside events, e.g. theatre trips, exhibitions as well as social gatherings.

The meeting will be held at 7:30pm in room S303A in the new Humanities area, Sherfield Building (3rd floor), Imperial College London, South Kensington Campus.
Directly afterwards we will be watching The Motorcycle Diaries, which chronicles Che Guevara's travels around South America whilst he was a medical student.
If you can't make it on Thursday and would like to stand for a position, you can leave your email address below and I will contact you.

Friday, March 30, 2007

surgical poetry

The Association of Surgeons of Great Britain and Ireland, the ASGBI, is not known for its contribution to medical humanities. Things may change however in this most serious-minded and conservative of organisations. First the "wives' social programme" was changed to the "accompanying persons' social programme" at its Annual General Meeting, which is taking place this year at the old Manchester Central station now re-done as a conference centre. It used to be part scientific update (if you got round to going into the lectures), or part/all a nice social jolly for all the old boys to meet up and boast about their prowess this year. It continues in this vein, with its annual golf competition a prized prize, and the Annual Dinner a famed spot for networking and observing well-known figures undone by the old medical school poison. However, winds of change are slowly whispering. In 2004 an art and photographic display was introduced. By surgeons and their partners. Of course, being surgeons, they had to have a competition. I don't know what happened at that one, but it was dropped for a year. However, the photography competition was reinstated in 06 with a poetry competition which is on again this year.
The winning entries in the poetry were of a rather familiar joke variety, the kind of joke my 4 year old would appreciate, the "Colonoscopy Anthem" and the "Ode to a Pitts S2A"
http://www.asgbi.org.uk/edinburgh/pages/poetrycomp.htm
However, the winning photograph was poignant and beautiful
http://www.asgbi.org.uk/edinburgh/images/siteimages/waitformelarge.jpg
so there is some hope that the poetry will get taken more seriously in time. Perhaps photography is just less embarrassing a prize to win.
Sadly, it is only open to Members of the ASGBI or associated societies, or anyone attending the Annual Meeting (at a cost of approx £200 a day. So fairly exclusive, then) - but it is there. If you are interested and fulfil the above requirements, the closing date is Monday. It would be nice if they opened it to medical students as well. Perhaps the quality of entry would improve...
http://www.asgbi.org.uk/manchester/pages/competitions/photographic.htm
and the poetry http://www.asgbi.org.uk/manchester/pages/competitions/poetry.htm
There is a serious category of entry and a humourous one. I hope for some inspiration over the weekend. Perhaps one should write it first before deciding whether it is funny, or leave that to the judges (who are they? what poetry experts have they hidden in their ranks?) Maybe that is why they have said categories. They wish the author to make that judgement and save them from the excruciating situation of awarding the humourous prize to a serious entrant.

I wonder how many Annual General Meetings we are away from having this collection of surgeons hear some seriously well-written poetry to leaven their/our diet of acrid coffee, hangovers and information overload? Mr Abse, fancy a trip to Manchester?

Dr Freud Will See You Now Mr Hitler

As a bed-wetting, traumatised child, Adolf Hitler was referred by his provincial doctor to a young psychologist specialising in children's traumas in Vienna. His name was Sigmund Freud. Hitler never went. But how different might the history of the 20th century have been if he had?
Laurence Marks and Maurice Gran present this exciting study of the relationship that develops between Freud, his daughter, Anna, and the 20-year-old Hitler. Toby Jones plays Adolf Hitler, with Alan Corduner as Freud and Sophie Winkleman as Anna Freud.

You can listen on Radio 4 at 2.30pm tomorrow

Monday, March 26, 2007

Modern medicine

A friend of mine found this pair of poems in a book on Comm Skills. You'll probably know the first, but the second is obviously inspired by the government's views on how the NHS should be: modern, multi-disciplinary and, most importantly, meeting targets.

WH Auden:
Give me a doctor partridge plump,
Short in the leg and broad in the rump,
An endomorph with gentle hands,
Who'll never make absurd demands,
That I abandon all my vices,
Or pull a long face in a crisis,
But with a twinkle in his eye,
Will tell me that I have to die.

Response by Marie Campkin:
Give me a doctor underweight,
Computerised and up to date,
A businessman who understands,
Accountancy and target bands.
Who demonstrates sincere devotion
To audit and to health promotion -
But when my outlook's for the worse
Refers me to the practice nurse.

Friday, March 23, 2007

Short story competition

The Lancet is running a short story competition for which medicine should be the inspiration. More details here. The deadline is 10 May, and the recommended length is 2,500 words. If you don't get your story published, we'd be happy to feature your entry right here on our blog!

Equus


last night I went to see the highly publicised play 'Equus' currently showing at the Gielgud Theater in London. The play is not for the fainthearted. It concerns the case of a teenage boy, Alan Strang, who savagely and inexplicably blinds six horses. He is sent to the psychiatrist Martin Dysart (widely thought to be based on RD Laing). Dysart is a frustrated Hellenist, dreaming of Ancient Greece and increasingly disillusioned with psychiatry. As Alan gradually reveals the lead-up to the shocking attack on the horses, it becomes that a bewildering conflation of consumerism, iconology, upbringing and a need to worship are implicated in Strang's actions. Dysart envies Strang's passion, and ends up denouncing a profession which seeks to 'cure' emotional extremes of which Dysart is in awe. It's a dark play, but also very funny in places. More ideas about the depiction of psychiatry in the play can be read here.


Much has been made of Daniel Radcliffe (famous for playing Harry Potter) stripping off and (very nearly) simulating sex. Not to mention him smoking on stage! But what about Radcliffe's acting ability? It's good, but not great. He veers between obstreperous teenager and vulnerable kid with not much to offer in between. I think he should have had long hair to lose the clean-cut schoolboy look. Also, his 'stare' is central to the play. Sitting up in the Grand Circle, this was lost on us -- he needed to use his head and neck more to emphasise his gaze. Yet he coped very well with the physically and mentally demanding second act. Richard Griffiths is outstanding as Dysart. The horses, played by dancers in masks and on stilt-like hooves, were excellent. They showed just the right combination of majesty and menace. For anyone with an interest in psychiatry, the play is well worth the ticket price.

Wednesday, March 21, 2007

Women 'left alone during labour'

Thanks to Ruvandhi for this:

The BBC website carries a story regarding women's perceptions of their childbirth experiences within the NHS. Half the three thousand women said they were left alone during labour, prompting us to ask why on earth weren't they accompanied by a medical student? A perfect opportunity to provide support and company, as well as learning and taking some of the burden from midwives, whose numbers the same article claims will need to increase to the tune of ten thousand over the next few years.
Still, this doesn't allow for women not wanting a medical student present during their labour, some of the issues are discussed in this previous post.

Wednesday, March 14, 2007

SCIENCE VERSUS ART!

You may remember me telling you about making new plays with almost a dozen surgeons - it's the first time professional London theatre has attempted such a collaboration. We open at The Old Operating Theatre, Britain's oldest operating theatre, in April. In the face of pressure from funders to make more art from science, we've decided to turn our venture on its head and launch with a debate at The Royal College of Surgeons (followed by a drinks party, natch) at 6.45 pm, 22nd March.

Aren't Science and Art different but equal? Does adding them up only dumb them down? Can the new medium of 'sci-art' produce high art or good science or weaklings that are neither? Author Don McRae ('Every Second Counts' is the story of the race for the first heart transplant), scientific playwright Jack Klaff, TLS editor Michael Caines and philospher Hilary Lawson will argue against the public, surgeons and artists. If you fancy adding your brain to the mix, get tickets at www.metalandbone.org (EVENTS).

Sunday, March 11, 2007

Medical Humanities Society - Get Involved

The Medical Humanities Society is Imperial College School of Medicine's only book and film club. Although not a Union Club, we are recognised by the Medic’s Clubs and Socs Committee. We are an informal free book and film club that meets monthly to watch films and discuss books of medical relevance. We aim to provide access to Medical Humanities for all, whether medical or not.
An AGM will be held on Thursday 5th April along with the Medical Humanities Society’s next film showing, The Motorcycle Diaries. The meeting will be room S303A in the new Humanities area, Sherfield Building, Imperial College London, South Kensington Campus, at 7:30 pm. Refreshments will be provided.
We will decide next year’s committee and any suggestions you have for the Society – please come along!

Wednesday, March 07, 2007

The human touch

An ESRC-funded study called Bodies Online looked at how people access health information on the Internet. The story was covered by BBC News online.
The study found that participants developed trust in web material over several stages and quickly dismissed poorly designed sites, sites with ads and general portals. While people looked for credible and impartial information, they were also highly influenced by personal stories to which they could relate.
In common with other studies, the participants used the Internet to prepare for visits to their GP. Yet the results also suggested that legitimate sources of information - such as NHS sites - were less likely to be used because they were hard to access and lacked input from others sharing similar concerns.
As the Internet is not going to go away, and is likely to be accessed increasingly by those seeking medical advice, I believe this report underlines the importance of providing health information in an understandable way as well as in specialist terms - putting the humanity into medicine, so to speak.