The Leeds Medical School Magazine

December 2012
In this issue: - Christmas Elves Occupational Health - The Media & Eating Disorders - Spice Up Your Life!

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Letter From The Editors

Welcome back to a new academic year and to a new and improved REGURG magazine! We hope you like our new format. Christmas is just around the corner, so this issue has a bit of a christmassy theme. Hope you enjoy the articles ! Were always looking for writers and people to help out, so please get in touch! Team Regurg x /RegurgMagazine @regurgmagazine
regurg_magazine@hotmail.com

In This Issue
4. 5. 7. 11. 14. 15. 17. 18. 20. 22. Regurg Committee Occupational Health amongst Father Christmas Elves Does the Media Provoke Eating Disorders? Is Surgery for You? Book Review 3rd Year Placement in Airedale Christmas as a Medic Blunders in The Lab / Spice Up Your Life I Think My Lung Has Collapsed Doctor Profile: Elizabeth Garrett Anderson
3

Regurg Committee
Emma Gees | Editor James Gupta | Editor

Hannah Panayiototou | Advertising Steph Harrison | Advertising

Alison Hallett | Publicity Rep Tom Wilson | Publicity Rep

Our Writers
Nicholas Smith, Sook Cheng Chin, Simon Biart, Dahlia Abdul-Rahman, Lizzie Walsh and Emily Amandi
4

Occupational Stress and Health Among Father Christmas Elves

While the success and proliferation of Christmas continues to grow year on year globally, the effect this success has on the industry behind the event have never before been studied. This study is the first of its kind to access the effects the exponential growth of product consumption during Christmas has had on the elf workers of Father Nicholas Smith Christmas factory in the North Pole. Introduction The increasing commercialisation of all Christian festivals seems to be a popular trend in our modern world. Whilst the environmental impact of such vast consumption has been studied extensively (The Grinch et al Where shall I throw this USB humping dog) the impact this has had on the workforce that produces all these gifts, that of Father Christmas elves, has never before been quantified. Methods Whilst visiting the factory itself proved difficult, we managed to access the workforces physical and mental health with the use of questionnaires. The questionnaire assessed both the physical and mental health of the elves and examined whether work was a factor in or caused any decline in health. Discussion Investigation into the detrimental effect of employment at Father Christmas toy factory was somewhat complicated by the fact that elves are magical creatures and so dont concord with modern medicine applied to homo-sapiens. Despite their extra-terrestrial origin, elves still experience a decline in their definition of health due to occupational hazards in the human world. Due to the quantity of products Father Christmas staff

Feature Occupational Stress and Health Among Father Christmas Elves

Solvent abuse is rife as a result of high stress

produce, meal times are tight and so snacking is a common problem. With abundant supply of candy canes, toffee apples and sugared almonds obesity and diabe
5

tes-like symptoms were observed. to experience eclectic highs and crippling lows. Employees in this Other injuries include standing state are often isolated and desperon Lego without adequate foot ate. Occupational stress caused by protection, hearing issues from producing millions of different toys testing glockenspiels and visual in merely 25 days effected all quesacuity problems resulting from tioned Elves, with most serious painting the eyes of My Little Po- cases reported from makers of subnies. While physical health issues buteo games, who stated always such as these were widely preva- getting Rooneys new hair wrong. lent, it was mental health that em- Solvent abuse is rife as a result of ployment in the Greenland factory high stress, as is alcohol dependhad the greatest impact. Manic de- ency specifically brandy from Fapression was the most significant ther Christmas off season stores. mental health problem reported in

Feature Occupational Stress and Health Among Father Christmas Elves

Caption

December overtime: Are christmas elves facing significant unreported occupational health risks?

the elves. Its thought that the deliriously happy atmosphere radiated unrelentingly in the factory causes many of Father Christmas staff

Conclusion The findings of this study clearly highlight the burden of Christmas on Father Christmas and his staff.

Debate Does the Media Provoke Eating Disorders?

Such global production of a vast array of products on this scale is simply not replicated anywhere else in the world, let alone in Greenland. This unprecedented manufacturing industry, while deeply successful, has serious health implications for many of its employees. While elves benefit from the protective effects of being magical creatures, they are still vulnerable like the rest of us to occupationally acquired disease. This study reveals the shortfall of medical knowledge about elves and their treatment during the festive period. Father Christmas must do more for his employees, both

ther Christmas elf toy factory, as rumours of abusive conditions have so far not been confirmed.

Father Christmas must do more for his employees

in terms of prevention and management of health issues linked to occupation. We recommend the implementation of a National Elf Service (NES) to address these health inequalities in Greenland as well as palliative care centres for retired elves, who otherwise find themselves forced into gaining walk on parts in fantasy films to pay for expensive private care homes. Further investigation needs to be done into the conditions of Fa-

Yes! We live in a world where we are constantly bombarded by the media; it is hard to go a single day without using some form of it. This heavy reliance upon social media, along with the current celebrity culture, seems to be a boiling pot of potential problems. If you look at a magazine stand, most of the covers are adorned with pictures of celebrities, mocking their love handles and commenting upon how they have let themselves go. These celebrities tend to be slimmer than the average person anyway and their flaws are greatly exaggerated. Individuals who look up to these celebrities may want to emulate them, trying to be as thin as them in the hope that it will make them prettier. There is also worry that individuals reading them may become more dissatisfied with
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Does the Media Provoke Eating Disorders?Emma Gees

their own bodies, reducing their self esteem. Research suggests that low self esteem can make an individual more vulnerable to developing an eating disorder. Incidentally, there is a strong positive correlation between increased magazine readership and eating disorders.

the token curvy girl (usually a size 10, when the average UK dress size for women is 14) does anything to aid the situation. The eating disorder charity Beat has voiced its opinions stating: The media is a powerful influence and we know how vulnerable some people at risk of eating disorders can be to The media also glamorises thin- its visual images in particular. ness. Look at the catwalks of Europe where emaciated models Furthermore, psychiatrists have saunter. Flick through a copy of concerns that many articles promote unbalanced and unsustainable diets, without warning of the perils of extreme dieting. The internet allows an individual to have the whole world at its finger tips...this includes a whole host of pro-ana websites where you can find thinspiration and tips and commandments to staying thin. Unfortunately, there are very few controls available to monitor the content of these sites... No! Eating disorders are a multifactoral condition, caused by a culmination of biological, psychological, behavioural and environmental factors. You cannot pinpoint one factor and claim that it has caused an eating disorder.
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Debate Does the Media Provoke Eating Disorders?

Debate: Is the media really responsible for eating disorders?

Vogue or Vanity Fair and it is hard to find a model that isnt more than a size six. Airbrushing obliterates any blemishes, leaving goddess-like perfection. This unrealistic ideal creates a standard that the average woman falls woefully below. The magazines claim to be doing more but I dont think that

Eating disorders have been around since before the dawn of mass media, the earliest medical description was by Richard Morton in 1689. Whilst statistics show that eating disorders have increased as magazine readership has increased, it doesnt mean that this is causation, merely an association.

Debate Does the Media Provoke Eating Disorders?

has suffered from an eating disorder is far more likely to develop it themselves. From a young age they may have noticed their parents strange behaviour towards food (e.g. binging, playing with food) and have developed habits because of this.

Research has shown that certain personality types are more vulnerOur society has an obsession with able to developing the condition. body image and beauty and since High-achievers and individuals

the media is a reflection of the beliefs of a society it is no wonder that beauty and body shape feature so frequently in it. We live in a world where many people feel naughty for eating chocolate or head to the gym obsessively to stay in shape. If you look through history, societys perception of feminine beauty has changed from curvaceous Tudors, to Victorian corsets and bussels, then to 50s curves. Women change the way they dress and their body shape to meet with societys approval. Is it any surprise that so many people have issues with their body image when it is permanently on the societys psyche? An individual who has a parent who

This unrealistic ideal creates a standard that the average woman falls woefully below

who strive for perfection may find comfort in controlling their eating. This along with peer pressure may be reasons why eating disorders seem to have a worryingly high frequency in boarding and single sex schools. Being thin and pretty almost becomes a competition

Eating Disorders: A multifactorial disease?

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Article Is Surgery For You?

between them, with huge pressure being placed upon the girls! TV programmes in the last 10 years have featured story lines where characters have had eating problems, which has raised awareness of the conditions and often shown them in a frank way. In conclusion, eating disorders are complicated conditions, which the media may have helped exacerbate. However, the real root of the problem is within our society and until we change our attitudes towards body image it looks unlikely to change.

It is my third night in Airedale General Hospital, and for the third time, I wake up shivering. Now, it could be the seasonal chill, or it could be that my accommodations diminutive radiator has once again reverted to its much maligned economy setting. But, I have a sneaking suspicion that it has something to do with my recurring dream: A tall, foreboding figure dressed head to toe in blue strides towards me, wreathed in the smoke of cau-

Is Surgery For You? Simon Biart

terisation. His hands are stained brown from the iodine, and his mask is spattered with the gory innards of the anaesthetised figure on the table to his rear. The spectre slowly, deliberately, removes his mask and I see my own face glaring back at me, as I am hauled back into consciousness. ...I do not want to be a surgeon! Television dictates to us that to be a surgeon is to be like that bloke from Nip Tuck: rich, content and with features sculpted by Michelangelo. Fantastic if you happen to be a plastic surgeon in Miami, but transport that bleached white smile to the dark, dingy corridors of the LGIs urology ward and something seems amiss. Secretly, finding out that practising medicine in the UK isnt glamorous, is worse than finding out the truth about Santa. I would give my right kidney to look as good in scrubs as the TV surgeons or spend similar amounts of time driving a Ferrari! However, for the vast, vast majority of us, this isnt going to be the case. It can be a hard pill to swallow but to work in the NHS we must search for job satisfaction elsewhere.
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When disputing the attraction of surgery the accusation of squeamishness is often used as a potent counter. Its true, that if I was superman, then broken bones would be my kryptonite, neither does brutally ripping out a varicose vein appeal. But who in their right mind longs for the time in their life when every day consists of removing different pieces of ischaemic bowel? Of course, the bravado of being at the cutting edge of the medical profession appeals, and in a way I can see why: the super surgeon who in a matter of minutes can achieve what no manner of medicines can do, be it through neurosurgery, an appendicectomy or fitting a pacemaker. The truth is though, that in modern medicine, surgeons perhaps, more than anyone have to become massively specialised as they advance along their chosen career paths. Sacrificing the variation and diversity that is so satisfying for a bigger pay check and a few more capitals after their name. Realistically, instead of mixing and matching exotic operations with futuristic sounding acronyms, try a Monday morning timetabled with three toe nail avulsions, or alternatively a Wednesday afternoon

Article Is Surgery For You?

with four consecutive prostate reductions. Before setting your heart on surgery, imagine doing this for a week, a month or thirty years A few weeks ago we had an orthopaedic surgeon give us a lecture on how he goes about his day. Instead of marrying together examinations and investigations, administering he simply said you have to Look, Touch, Move and Listen, then get out the tools. Is that why you are committing five years of your life to the Worsley building? Prometheus and Sun? A hard pill to swallow. Gut feeling about it. If this isnt why you committed to five years of medical school, then we are thinking in the same vein...

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Oxford Handbook of Medical Sciences Sook Cheng Chin

RRP: 24.99 ISBN: 978-0199588442 Oxford University

Review Oxford Handbook of Medical Sciences

Following in the style of the Oxford Handbook series, this book aims to provide concise information on anatomy, physiology, biochemistry, pathology and pharmacology. The book has managed to cover all the body systems in its 15 chapters. Each chapter contains clear visual aid and bullet-point information for easy understanding. It also cross references with the Oxford Handbook of Clinical Medicine, Oxford Handbook of Clinical Specialties and Oxford HandbookofPracticalDrugTherapy. This book will not replace your traditional textbooks, as the information it provides is too superficial for a student who has not studied the topics before. Also, I thought the books coverage of patholo-

gy and pharmacology is definitely too brief (compared to their coverage of the anatomy, physiology and biochemistry), but I appreciate the fact that it is quite impossible to cram all these information in a book this small and thats probably the reason for all the cross referencing! Despite this, I have to admit its a good book to use for quick revision. It also gets extra brownie points for covering laboratory techniques in the last chapter. The chapter provides the reader with an adequate explanation on techniques like ELISA, FACS and cytology, without confusing them with too detailed information. Although this book is mainly aimed at 1st and 2nd year medical students, as a current 4th year, I found myself using this book to quickly refresh my knowledge on anatomy, physiology and biochemistry. Im sure Ill continue using it well into my foundation training years; therefore it certainly earns a spot in my bookshelf.

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3rd Year Placement in Airedale Dahlia Rahman

Article 3rd Year Placement in Airedale

Placement in third year has been an entire other experience from that in years one and two. Not least because youre in placement for four consecutive days ov v f the week, but also, due to the sudden drop in the amount of university teaching, leaving you hanging somewhat irresolutely. Independent learning is very much the new emphasis; youre behind if you havent checked the VLE that day. Ive just started placement in Airedale General Hospital. For those of you who havent been, its in the beautiful countryside near a place called Keighley...right amongst the sheep, quite literally! The hospital itself is made up of a complex configuration of corridors where, when walking down a long corridor, you could end up being a level up from when you started! It takes a while to become accustomed to the set-up, but there are helpful volunteers dotted around, who are keen to point you in the right direction.

On arriving, we were inducted at the clinical skills centre. We were given packs, timetables and, uniquely in Airedale, assigned a personal tutor, who was a consultant in the specialty we were on placement in. I was assigned a lovely geriatrician whos planned to teach various examinations every week. Though there is timetabled teaching here and there, the rest of time you are free-reign to spend your days as you like, be it on the wards or in clinics. Ive found that foundation doctors are particularly keen to teach us and to sign off our practical skills. The consultants, on the other hand, constantly challenge you and bombard you with questions...as to be expected really! Today I heard mitral regurgitation, my first ever murmur! So far, Ive had a really good time and, despite my previously negative preconceptions of Elderly Medicine, I think Im really going to enjoy it. The elderly are, generally very cooperative, especially when it comes to taking bloods and they are always ready to impart their wisdom on you. It is placements like these which inspire me and make me wish my years would fast forward more quickly!

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Since the dawn of medical school, Christmas seems to have become synonymous with two things: exams and deadlines. Whilst the rest of the university winds down once the calendar page is turned to December, medics carry on with placement or revision right up until the middle of December. I remember sitting at home in first year attempting to revise for the BMS exam (now rechristened as IMS), staring glumly out of the window at snow revelers, wishing I didnt have to spend as much time inside as I did. In second and third years, the shortened Christmas break was made slightly sweeter by RESS fortnight, where we spent time studying something outside of medicine. However, it soon became apparent that the level of work required varied from very little contact time in spirituality with a tiny amount of work, to contact and assessment heavy language courses. Dont get me wrong, there is time for friends, family and frivolity over Christmas (and of course,

Christmas as a Medic

Article Christmas as a Medic

thats what it should be about), but there is always that small, niggling worry at the back of your mind that you should be doing work! This year, as an intercalater, I was looking forward to four blissful weeks off, with no work and no exams in January. But, as it draws nearer, I have realized that I still have lots of work to do and umpteen deadlines for January. Some of my friends are in a worse position, with deadlines and exams! I think many of us have been surprised by the workload. Nevertheless, Im sure we will find time to recharge and get into the Christmas spirit over the coming weeks. Christmas should be about seeing those you love and putting work to the back of your mind- it can be done another day. Now, can someone please pass me a mince pie and my Santa hat

17

Over the summer holidays, as part of the Leeds Undergraduate Research Enterprise scheme, I undertook a seven week research project on removing cells from a pigs carotid artery. By removing the cells, we removed the part of the artery that gave it, its identity. Why would we do this, you may ask? Well, after removing the cells, a scaffold remains and this has promising implications in the field of ischaemic heart disease. For those of you whove come to medical school straight from sixth form, you will probably all agree with me when I say that our experience in the lab thus far has been highly limited. I remember at the beginning of second year being intrigued by one of the modules, LSM; it supposedly stood for Laboratory and Scientific Medicine. I later came to realise when revising, that not once did we see a lab in the 15 weeks of that module. So, unsurprisingly, this summer started with a wide selection of blunders which, thankfully, as the weeks wore on, subsided in frequency. From screwing the lids of

Blunders in the Dahlia Rahman Lab

Article Blunders in the Lab

bijous (small cylindrical containers) too tight in the freeze dryer, preventing the arteries in them from drying out, to accidentally losing the arteries when placing them in the cryomill due to vacuously placing them in a perforated tube! The cryomill was a nifty piece of equipment; it used an electromagnetic current to grind arteries. It was insightful to be using techniques wed briefly studied like sectioning, western blotting and electrophoresis. I learnt not to leave a gel electrophoresis overnight or all the proteins leak out. Oh the practicalities! You can tell that, all in all, I used a lot of arteries!

Spice Up Your Life! Emily Amadi ...People of the world spice up

your life. Hai ci ja. Hold Tight!! I cant be the only one who grew up singing along to the lyrics of the spice girls. You know who you are!

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Food Spice Up Your Life

Now that introduction seamlessly takes us on to the topic of super spices, of a different variety. Easily picked up in your local supermarket, these spices not only give your otherwise boring dinner a kick but also have scientifically proven antioxidant properties. One teaspoon of cinnamon has the same measure of anti-oxidants as a cup of pomegranate juice. So look out for them when you are

Antioxidants, also found in fruit and vegetables, protect the cells of the body against free radicals. Free radicals are molecules produced when the body is exposed to environmental stresses like tobacco smoke and radiation. But the body also makes them during the normal breakdown of food. Research has suggested that antioxidants can protect against heart disease and cancer. Beta-carotene, lutein, lycopene, selenium and vitamins A, C, and E are all antioxidants.

Anecdotal evidence suggests that spices may boost the metabolism and aid satiety. Currently researchers are investigating anti-inflammatory potential of super spices. Their use in chronic inflammatory conditions like heart disease, allerTop Spices: How many of these do you gies and Alzheimers could prove to use regularly? be invaluable. down the supermarket aisles next: The top seven are: 1.Cinnamon 2.Oregano 3.Ginger 4.Dried Red Peppers 5.Rosemary 6.Thyme 7.Turmeric

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I Think My Lung Has Collapsed

One morning I woke up in pain, and as any student would do, I took it as a sign that the universe didnt want me to go to lectures that morning, assumed I had pulled a muscle and took it upon myself to stay in bed for a few hours. At midday I was still in pain: a sharp pain radiating across my right side and along my shoulder. It was a struggle but I eventually managed to get out of bed at which point I realised I was not only in pain, but also incredibly breathless. I could inhale what felt like a quarter of my usual capacity, at which point I could not take in any more air even if I managed to break through the pain barrier this presented. As an otherwise healthy 21 year old with an incredibly uninteresting past medical history, I couldnt really believe that there was actually something wrong with me: I still thought I had pulled a muscle, badly, and this was somehow interfering with my breathing, but it would get better in a few minutes. But just in case, I did what any medical student would do, and pulled out my stethoscope. I have had minimal experience

Article I Think My Lung Has Collapsed

listening to chest sounds, but I thought Id give it a go: mainly out of curiosity, Left side: a thin rush of air, I think. Right side: nothing. I must be doing it wrong, lets try a bit higher: nothing. Lower? Nothing. I tried the left side again just to compare the difference between the two, I was sure I was doing something wrong but every time the results were the same: I could hear air moving in and out of my left lung, but on my right lung there was absolutely no noise. Spontaneous pneumothorax, my right lung had collapsed. I was fairly alarmed but, to be honest, mainly excited we try to hide

James Gupta

it but I dont know many medical students today who dont secretly know what I mean here. I was still breathless, but surprisingly calm as I started gathering my wallet, keys and phone. Here is where I probably, in hindsight, should have phoned an ambulance, but instead I
20

Seeing the O2 reading on your monitor drop from 92 to 70 is pretty scary

Article I Think My Lung Has Collapsed

called Amber Taxis and asked them for a taxi from my apartment to the A&E at Leeds General Infirmary. I was struggling to complete full sentences at this point, maybe managing about 5 words at a time before having to take another painful breath. As I started to walk to the lift and then to the car park I really realised how breathless I was, but I stuck by my decision not to call an ambulance. Whilst I was fairly confident in my self-diagnosis at this point, I still couldnt quite believe there really was something wrong with me. I can put up with the humiliation of being yet another guy who goes to A&E with nothing wrong with him, and even being yet another medical student who thinks hes developed the disease they were studying recently, but I know how much an ambulance costs the NHS and I really didnt want to risk having called one over nothing. Besides, I was breathless and in pain but I could still walk.

sprayed with some stuff (I assume something antibacterial-y?). The next 30 minutes werent great, and it was only that point where the whole thing stopped being a cool, real-life episode of House for me. I was given morphine and a local anaesthetic in preparation for the chest tube insertion, and at one point I almost passed out because apparently the collapsed lung was compressing the right ventricle of my heart, preventing it from pumping blood effectively. Seeing the O2 reading on your own monitor drop from 92 to 80 then to 70 in a few seconds is pretty scary. The anaesthetic meant that I didnt feel pain when the tube went in but it still pretty uncomfortable. I was expecting my lung to reflate and to feel better almost as soon as it was done so was disappointed to hear that it would take a few hours.

I was in hospital for just under a week overall, and whilst I wouldnt rush to go through the whole exSoon after this the real fun began: perience again, it really was a facwhen in A&E I was put onto a bed, inating week and I probably learnt strategically shaved so ECG leads more in that week than I did for a could be placed on my chest and whole term on placement at BRI, legs, hooked up to an IV, pulse, seeing hospitals as a patient is a blood pressure and O2 monitor truly eye-opening experience. and, this one I wasnt expecting,
21

Most Famous For: Being the first female British doctor

Doctor Profile: Elizabeth Garrett Anderson Lizzie Walsh

Profile Elizabeth Garrett Anderson

derson decided to become a doctor. Controversy: Elizabeth enrolled as a nursing student at Middlesex Hospital, London. After being at the hospital for 6 months she applied to the hospitals medical school. Her application was rejected, but she was allowed to attend some lectures and teaching with the other male medical students. However, Anderson was not a popular addition, and in 1861 her fellow students appealed to the medical school to ban her from any further lectures. She left Middlesex and applied to medical schools inWhere it all began Elizabeth Garrett Anderson was cluding Oxford and Cambridge, born in Whitechapel, London on which were all met with rejection. 9th June 1836. Andersons father built up a successful pawnbroker Eventually, she joined the Society business, and this meant he was of Apothecaries and in 1865 and able to send her to private school. passed her final exam to become Elizabeth was born into a society the first British female to obtain a that expected women to grow up licence from the society. Immedito become wives rather than work ately after, the society changed its for themselves, but this did not sit regulations to stop another womwell with her. She met the famous an obtaining a license. Because of feminist Emily Davis and Elizabeth this, Anderson was still unable to Blackwell, the first female doctor get the job of a doctor in a hospital. qualified in America. With these influential people in her life, An-

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Profile Elizabeth Garrett Anderson

Pioneer Undeterred, Elizabeth opened a dispensary for women in London in 1866, with backing from her father. In her first year she tended to 3,000 patients, but Garret Anderson was still determined to obtain a medical degree. The University of Sorbonne in Paris began accepting women on to their medical course, so for a year, she taught herself French so that she could attend. In 1870, Elizabeth obtained a certified medical degree, nevertheless, the British Medical Register still refused to recognise her qualification. Anderson then founded the New Hospital for Women in London, later named after herself. Finally, after much campaigning, in 1876, an act was passed that permitted women

to enter the medical profession. Life After Medicine: In 1883 Anderson was made Dean of the London School of Medicine for Women. She then retired with her husband, whom she married in 1871, and their three children to the Suffolk coast. Here she became mayor of the town in 1908, the first female mayor in England. In the End: On 17th December 1917, Anderson died and was buried in Suffolk.

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