The Role of The Doctor in 'Pan's Labyrinth'

Last night I watched this rather bizarre arthouse film from Director Del Toro. The film portrays the escapism of a young girl in the midst of the Spanish Civil War: her father, a tailor, is dead. Her mother is expecting the child of an Army Captain (for whom the tailor once worked). Mother and daughter travel to the Captain's outpost - where skirmishes take place with local insurgents in the wooded hills - in order for the mother to give birth with the father present (he eagerly awaits the birth of the son he is convinced he will have).
Nearby, there is an old labyrinth which the girl explores. Here, she meets a Faun who explains that she is in fact a Princess, and if she can complete three tasks before the full moon, she can open the last remaining portal to her kingdom.

***Spoiler alert***

The Captain is so driven that he ultimately sacrifices everything for his cause; the girl's mother dies in childbirth, he slays innocents in the woods, he horrendously tortures one of the rebels he finds.
Throughout all of this, he has a local doctor by his side, tending to his men, but more importantly to his wife, for whom pregnancy has not been easy. What the Captain doesn't know is that he is also working for the rebels, treating their injuries and supplying them with antibiotics.
This leads to the interesting insight into the role of the doctor, who ends up euthanatising the tortured rebel. When the Captain discovers this, he shoots the doctor. Of course, directly afterwards, his wife's condition deteriorates rapidly, and the paramedic has to be called, seeing as the doctor is dead.
The doctor appeared not to take sides; he treated all to the best of his ability - it was those who he was treating that expected a level of loyalty greater than he could provide. Obviously, the question of euthanasia is a debate by itself, but it brings into question the difficulties faced by military doctors today, with limited equipment and casualties on both sides requiring treatment. For this doctor, his compassion results in his own death, perhaps a noble option.

Sadly, in the end, the Captain's unfaltering obsession with his cause leads to the girl's death. She finds happiness in the fantasy world created from the dark surroundings in her final moments, but the futility strikes the viewer's emotions, as we realise that the Narnia-esque world we have been subject to was pure escapism, and nothing more. This film is depressing, sinister and almost certainly not for children as one might have imagined! However, I found it thought-provoking, and felt the Spanish language with accompanying subtitles helped to create an alien feeling of a blinkered version of reality.

Review: A Special Relationship

Call it prejudice, but I question a male author's ability to write convincingly about postnatal depression. My being able to buy a hardback copy on Amazon marketplace for 99p didn't bode well either for the quality of the novel. However, having escaped dreaded PND myself, I feel unqualified to judge the adequacy of descriptive detail of the illness and I'll trust the author to have done his homework.

What Douglas Kennedy has attempted in this novel is to show the devastating consequences of serious illness on a impulsive marriage. Sally (American) meets Tony (Brit) in the line of duty, which for both of them means as foreign correspondents on newspapers. When Sally becomes pregnant, they marry and move to London. Our city does not come off well in this account, it's portrayed as grimy, gloomy and socially constipated. The middle part of the book details Sally's PND. She's admitted to a psych ward and threatened with ECT (do they really do that to depressed women?). While Sally is recovering, Tony is plotting... Will Sally ever recover her son, or her sanity? And how many lawyers will it take to screw her husband over?

It sounds a depressing tale from the plot synopsis, but the writing style is wry and laconic: sort of desperation-lite. It's told in the first person from Sally's point of view. The fluency and jauntiness of the narrative detracts from the credibility of the depression scenario. There are no memory blanks, few moments of real self doubt, and once Sally feels herself 'recovered' there are no real setbacks in relation to her illness. When Sally finds herself without a single friend after 6 months in London, I was inwardly shouting 'Surely someone told you about the National Childbirth Trust!'

Medical professionals get a mixed press in the story. The male consultant, of course, is an arrogant twat. The women are treated more sympathetically with a health visitor breaking off her Canadian holiday to send a witness statement.

Amazon reviewers are divided on their attitudes to the novel, and I found myself mirroring their ambiguity. The book is a page-turner - I did find myself drawn in to the plot in spite of being a cynical about the detail. I think it shows a very extreme version of reactions to PND. Sufferers may feel this helps boost awareness of a serious illness that is often played down. On the other hand, Sally's treatment at the hands of the medical profession and her husband might make women wary of admitting to the symptoms of PND.

Surgical Society Prize Night - Call for Abstracts

The ICSM Surgical Society is inviting abstracts for its inaugural students prize evening to be held on Thursday 22nd March 2007 at the Drewe Lecture Theatre.

Pre-clinical students are invited to take part in a poster presentation.

Please write a 250 word abstract on the topic:
‘Describe the most important medical advance in the last 25 years’.

Send a copy of your abstract, together with details of your name, year group and medical school to surgical.soc@imperial.ac.uk by Friday 16th February 2007. The best 8 abstracts, as judged by our expert panel, will be invited to prepare a full poster presentation for the prize evening.

Clinical year students are invited to compete for an oral presentation prize.

Please write a 250 word abstract of an interesting clinical case, medical or surgical, seen in the last 12 months.

Send a copy of your abstract, together with details of your name, year group and medical school to surgical.soc@imperial.ac.uk by Friday 16th February 2007.

Once you have submitted your abstract, prepare a 10 minute power point presentation for the prize evening in March. The best 6 abstracts, as judged by our expert panel, will be asked to present their case at the prize evening.

You will only be informed if you are presenting your case at the prize evening itself

The winner in each category will be awarded a cash prize of £250 and free entry to the annual conference of the Association of Surgeons in Training (ASiT)

Competition Entry Costs:
ICSM Surgical Society members - Free
Non Members and Non Imperial College London Students - £5
For further details of the prize night and guidelines for abstract submission, please visit http://www.surgicalsociety.org or email surgical.soc@imperial.ac.uk

This event is sponsored by: Prentis Pharmacy Ltd, John Bell and Croyden Ltd, MPS/ASiT

Why Nobody Likes Surgery

PorcelainCowlickBoy doesn't like surgery. In fact, he hates surgery so much that he's posted a film about it for all to see. Exploring patients' experiences in theatre through a series of images and sounds that highlight the invasiveness of operations, we have a powerful sense of why many people would rather not be put under the knife.

What do you think?

NB This video contains images of blood and invasive procedures which you may find disturbing.

Beyond the Veil: The Adventures of an American Doctor in Saudi Arabia

Saudi Arabia is the world’s largest exporter of oil and arguably one of the most powerful economic and political players in the Middle East. The “War on Terror” has led to an explosion of interest in the Arabian Peninsula, often focussed on religion and extremism.

Seymour Gray's Beyond the Veil offers a refreshing and astonishing insight into the medical culture in Saudi Arabia. It explores how an American doctor and his wife settle into a way of life very different to their own and the difficulties and surprises they encounter along the way. Based primarily at the King Faisal Hospital in Riyadh, the first flirtations of Western traditions with young Saudi minds are set against a backdrop of efficient medical secretaries, private medical jets and demanding but very charismatic patients.

We discover how a state of the art hospital contributed to the spread of knowledge and medical education amongst a once largely nomadic people, and how demand for the best medical care in the world led sometimes to unjust treatment of the ex-pat healthcare workforce.

This book digs deep into Saudi morality, exploring sex and relationships, religion, business, partying, oil, and how a young royal family like to spend their money. Gray is very good at making us see how a Saudi assumes his position in the world. A turbulent shift is taking place in the minds of Saudis trying to cling onto religious values that are not fully compatible with the cultural, technological and political development that is stirring.

Published almost two decades prior to 9/11, it is refreshing to come across a narrative that takes an objective view at a country that was virtually unchanged for a thousand years before the discovery of black gold. Beyond the Veil is an easy read, and through Dr Gray’s experiences we learn a great deal about a country that is thought to be on the verge of a social revolution.

The Waiting Room

There was a marvellous play on R4 this afternoon, 'The Waiting Room', based on the web diary of poet Julia Darling. Julia died last year of cancer, but she has left a legacy of wry and insightful poems and plays. You can listen again here for 7 days (click on Tuesday).

Wellcome Medical Photographic Library

I received an email recently with details of the Wellcome Medical Photgraphic Library. You can find it here. It's a wonderful resource full of images from across the centuries. Images are catagorized as follows - Anatomy, Circulation, Disease, Genetics, Pregnancy and Birth, Plants in Medicine. You may already be familiar with this resouce but if not then do take a look. It's full of all sorts of gems. I particularly liked this image (above) by Thomas Rowlandson of A midwife going to a labour (1811).

Last Chance To View An Interesting Blog

In the author’s words:

“I am 33 years old. Two years ago - in the midst of trying to conceive my first child with my husband of two and a half years - I was diagnosed with ovarian cancer. Through surgery and chemotherapy, I reached remission several months later. However, my cancer recurred in April of 2005.

This blog chronicles my cancer experience and my infertility. If I'm lucky enough to somehow beat the odds, it will also one day chronicle my journey to motherhood, ovaries be damned.”

Sadly on May 12^th 2006 the author passed away. Her blog is due to be removed from the internet shortly so have a read whilst you still can.

A particular favourite of mine was the author’s ‘Reflections on a Yellow Jersey’ in which she considers Lance Armstrong’s portrayal of his ‘fight against cancer’ and debates how helpful this actually is to a public where one in ten people already believe that "all you need to beat cancer is a positive attitude".

Moving over to the new version of Blogger

We've taken the plunge and upgraded. Contributors will please need to launch a Google account (you'll be prompted when you log in to Blogger -- you can use the same details as you had for Blogger and it only takes a second). Apologies for the inconvenience, but we gotta move with the times.

Medical Blog Awards 2006

There is a week left to vote for the 2006 Medical Blog Awards. There are seven categories:

Best Medical Weblog 2006
Best New Medical Weblog (established in 2006)
Best Literary Medical Weblog 2006
Best Clinical Sciences Weblog 2006
Best Health Policies/Ethics Weblog 2006
Best Medical Technologies/Informatics Weblog 2006
Best Patient's Weblog 2006

I'm pleased to see Emergiblog leading the polls for Best Medical Weblog.

A comic take on cancer?!

The rise of graphic art means cartoons for adults are back in fashion, more literally than most in the case of Maris Acocella Marchetto. A cartoonist for the New Yorker and New York Times, Marchetto has produced a book called Cancer Vixen in which she 'puts on her five-inch heels to kick cancer's butt'. An extract is in today's Guardian's magazine -- which includes a curiously unflattering wedding picture, considering Marchetto's status as arch-fashionista. The book is being made into a film starring Cate Blanchett. See here for an article from the Observer.

In June I reviewed Brian Fies's excellent Mom's Cancer here. It still gets my vote for top pathographic memoir around.

Green Wing Special

Green Wing is back for a one-off special tonight at 10pm on Channel 4. It promises to be its usual hilarious self. Check it out here.