'Wires' - Athlete

I've always liked the album 'Tourist' by the band Athlete. Listening last night I realised the medical theme of their Top 5 hit 'Wires'...

You got wires going in
You got wires coming out of your skin
You got tears making tracks
I've got tears that are scared of the facts

Running down corridors, through automatic doors
Got to get to you, got to see this through
I see hope is here in a plastic box
I've seen Christmas lights reflect in your eyes

You got wires going in
You got wires coming out of your skin
There's dry blood on your wrist
Your dry blood on my fingertip

Running down corridors, through automatic doors
Got to get to you, got to see this through
First night of your life, curled up on your own
Looking at you now you would never know

I see it in your eyes; I see it in your eyes
You'll be alright
I see it in your eyes; I see it in your eyes
You'll be alright
All right

Running down corridors, through automatic doors
Got to get to you, got to see this through
I see hope is here in a plastic box
I've seen Christmas lights reflect in your eyes

Running down corridors, through automatic doors
Got to get to you, got to see this through
First night of your life, curled up on your own
Looking at you now you would never know

I saw another significant case today: a thirteen year-old girl who presented acutely with Diabetic Ketoacidosis. This is an acute presentation of diabetes, whereby the body has begun to metabolise fat and protein, as in starvation. Patients complain of thirst and frequent passing of urine, and smell of pear drops, lose much weight and present with collapse or coma.

After suffering symptoms for only a few days, and having initially put the symptoms down to a urinary tract infection, the girl ended up in A&E, where she was transferred to the Paediatric Intensive Care Unit, where she spent two weeks in a coma. When she came round she was agitated, and thus sedated. She has neurological injury from the high pH (caused by the acidic ketone bodies produced) which has damaged her brain.

Dealing with loss is hard enough, but it seems so unfair when it affects a child, especially in such a dramatic way. I found it difficult to detach myself from the emotion surrounding the issue, and think about the practical multi-disciplinary approach that I ought to be considering. I do hope, like in the song, the girl will be alright.

Great Ormond Street Hospital

I visited Great Ormond St Hospital this afternoon as part of the Paediatrics course. The doctors there received us warmly (they don't normally have students) and taught us at the bedside. The experience made me think of a piece by Edvard Munch (famous for 'The Scream') called 'The Sick Child':


I was surprised that 8 students were taken on bedside teaching in one go, we made for an intimidating bunch for sick children. We visited a dozing child with a vastly distended abdomen. He was alone and one of us examined his tummy. I was saddened to see him awaken (yet remain confused and drowsy) and yelp plaintively during the exercise. The doctor informed us that he was 'a practised patient' and we weren't really hurting him - although his recoil and discomfort made me think otherwise.

We were encouraged to distract him with play - to no effect - but all the while I felt that I was somehow intruding where I shouldn't be. His parents were not there to consent to our presence, and the despondency of his medical condition was heart-wrenching. However, there was a definite air amongst the students - one of quiet respect, compassion, and sadness.

Having spent a reasonably peaceful week on the postnatal wards, I felt I had been exposed to the darker side of Paediatrics. Spending the morning performing baby-checks on newborns was a stark contrast to both the neonatal intensive care unit I later visited, seeing tiny premature babies in respiratory distress, gasping and grunting for breath.

Paediatrics seems an ideal opportunity for students to examine their own ideas about empathy and compassion. I'd be very interested to hear others experiences...

Radio Ballad tackles AIDS

Radio 2 first aired a series of 'radio ballads' in the 1950s and 60s in which the voices of communities are blended with sounds and songs on the topics. 'The Body Blow', first broadcast in 1962, dealt with polio. The ballads have now been updated and are being broadcast from next week on Radio 2 at 9 pm. The one on AIDS, 'Enemy Within', was deemed excellent by a preview panel on 'Front Row'. It is due for broadcast on 6 March, 9 pm.

Jonathan Kaplan on 'Midweek'

Jonathan Kaplan, author of 'The Dressing Station' and now 'Contact Wounds', was interviewed this morning on Midweek on Radio 4. It will be on again at 9.00 pm tonight or you can listen again through the website for a week. 'Contact Wounds' is garnering good reviews, from what I've seen of the press (see here), although the consensus seems to be -- as AJ implied in his review of 'Dressing Station' -- the man still comes across as 'clinically detached' even though he writes autobiographically. There's an interview with him in 'The Times' here.

Creativity and depression

The media's obsession with celebrities and their bodies must surely peak sometime soon, but the BBC health website is featuring an interview with a cerebral celeb, Welsh poet Gwyneth Lewis. She is the author of the biggest poem in the world, featured on the Cardiff Millennium Stadium. It reads 'In these stones horizo

ns sing' and 'Creu gwir fel gwydr o ffwrnais awen' (Creating truth like glass from the furnace of inspiration). The BBC inteview (about her depression) is not all that revealing, but Lewis has an interesting website. Her first book was called 'Sunbathing in the Rain: a cheerful book about depression'. Her anthology 'Keeping Mum: voices from therapy' was also inspired by her illness. I rather liked this poem called 'Nothing Doing'. A full list of her books can be found here.

A View of Life before Birth - RCOG event

On Thursday 26th January 2006 i went along to the RCOG of an evening for medical students and young doctors.

For the first time I had the pleasure of inviting my mother (O+G consultant) to the RCOG as my previous visits had been through invitation from her.

6-7pm We had several student presentations. These were short case studies or research projects that had won various prizes. Each student was presented with a certificate by Lord Winston. Lord Winston then took the opportunity to remind us why he chose medicine and why O+G in particular. He was inspirational and despite the current chaos of the new medical training system he would still recommend this field.

7 - 8pm The highlight of the evening. The don of Fetal medicine - Professor Kypros Nicolaides MRCOG gave a lecture on fetal medicine. He was truly inspiring. He discussed a variety of topics rangin from spina bifida to fetal anaemia. He showed us the immense scope for research and how we can truly make a change in this field. He showed how things have changed in the last 20 years and made us realise we could be the one making the change in the next 20 years...

The evening ended with a drinks and canape reception where we had the opportunity to speak with the prize winners, people in the RCOG and discuss a career in this field. There was a good turn out from the 5th year ICSM medics.

It was wonderful. perfectly timed as I shall be starting O+G on 13th feb and I am filled with excitement and wonder already!

Endoscopy as art?

Nothing like exploring someone's gut for an afternoon's entertainment...

From the blurb:

'The fascinating capsule endoscopy procedure is a completely new technology, for the first time enabling the photographing of the GI passage in its entirety. In a two-part performative demonstration, artist Phillip Warnell will undergo a live capsule endoscopy medical procedure, integrating projected visual material from his project, Host, which makes use of raw material gathered in this way. In part one, and following a period of preparatory fasting, Warnell will ingest an untethered pill sized camera, which will embark on a fantastic voyage through the nine-metre gastro-intestinal tract. In part two, following a period of waiting whilst the capsule progresses via the bodies peristaltic, muscular contractions, the camera’s radio transmissions will be downloaded to a drive and viewed/interpreted by Gastroenterologist Simon Anderson through a unique software interface. '

The project is called ENDO ECTO. It's on 10 February 2006, 3 - 8 pmNash Room, ICA, The Mall, London SW1. Booking essential, limited numbers. £6.00, £4.00 ICAA members
Tickets: 020 7375 3690

Also on at the ICA until 10 February, is a project by MA Birkbeck students called 'The Body Digital: fantasy and function'.

My sister's keeper - Jodi Picoult

I'm so pleased I finally made it to a 'Purple Coat Club' meeting. Although I hadn't read the book that was being discussed I still immensely enjoyed the evening.

I have now read the book! It is a very gripping tale. Lots of cliff hangers and a day off today resulted in my inability to put the book down till 7am! I finally finished it this afternoon. Its no Shakespeare, it has been written for a wider audience to explore the modern advances in genetic engineering and about the long term consequences on a young girl who has been brought into this world genetically perfect to save her sister from a rare leukaemia.

It is very American. This opinion was voiced a few times last night. Some felt it was too forceful. Some completed hated Picoult's style. It is written from many different perspectives but the style of writing does not change significantly. This didn't bother me particularly.

I thoroughly enjoyed the book, I clung to every word through every tear (warning: keep a box of tissues handy!)
I recommend it highly to one and all, medics and non medics. Everyone was a child once, everyone has parents and so everyone can relate with this book.

Going to the meeting last night has renewed my lust for reading. It was interesting to read the book after yesterday's discussion. I could consider people's opinions as I read the book, it felt like I wasn't reading alone!

I'm now looking forward to Plath's 'The Bell Jar'.