Gazette
GKT
MERRY CHRISTMAS!
NOV - DEC
2014
Volume 128:4, Est. 1872
FREE at King’s College
London Campuses at
Guy’s, King’s
College and St
Thomas’ Hospitals
Electives abroad
for medics, nurses and
bioscientists
Sir Robert Lechler
Villainised Professor
interviewed
Christmas show
What it was like in 1973
Inside: Campus news in brief - Lucy
Webb interviews 1973 Christmas
Show cast - Keats’ corner is back nearby art galleries - and much more
Match reports
from GKT teams
GKT
GAZETTE
Established as the
Guy’s Hospital Gazette in 1872
Vol. 128, Issue 4, Number 258
ISSN: 0017-5870
Website: www.gktgazette.org.uk
Email: [email protected]
GKT Gazette, Room 3.7,
Henriette Raphael House, Guy’s Campus,
King’s College London, SE1 1UL
All opinions expressed within are those of the
authors and do not neccessarily represent the views
of the Hospitals, the University, or the Gazette.
All rights reserved.
Front cover drawing courtesy of F Kirham.
Front cover photo credits: Joshua Gety, Teona
Serafimova, Charlie Ding and Anya Suppermpool.
Inside cover photo credits: Anya Suppermpool and
King’s College London
Contents
4
Editorial
It’s Christmas!
5
News in brief
Exam results leaked | Security increase | Atul Gawande | Marking boycott
6
Letters
Thoughts from a humanist
8
Features
Prof Lechler interview| Plans for NHS | Summer electives | Mental health awareness
32
Arts & Culture
Winter music recommedation | Art on your doorstep | Electra
38
Keats’ Corner
The First Dissection
44
Dental
Retention fees raises | Dental fresher’s experience
48
Nursing & Midwifery
Trade unions | Wernicke-Korsakoff Syndrome
54
Book Reviews
Alcohol and Health | More than skin deep
56
History
Keats the medical student | Charles Grandville Rob | Christmas show �73
66
Research
Stillbirths | UKCAT
72
Careers
Palliative Care
74
Sport
Hockey Girls round up | UH VIIs | GKTWRFC | LSE RFC in memorium
EDITORIAL
Merry Christmas
GKT! Have a
great holiday
Fi Kirkham
Editor
Exclusive interview
C
hristmas is coming. It gets harder to ignore
that fact every year with some shops stocking Christmas cards before August ends.
Despite this excessively prolonged run up I love
Christmas at GKT. Yes many of us have exams
as early as January 3rd and it seems to rain from
early November up until the end of term but it is
still a special time.
From the moment the tree goes up in front of the
arches of the colonnade (artfully depicted on the
cover of this issue), Christmas spirit seems to arrive and preparations for end of term festivities
begin. Many religions have their own unique versions of this celebratory period and they happen
throughout the year but whether Christmas is a
religious occasion for you, or just a chance to eat
lots of chocolate, I hope that you will at least take
some time off to relax after a long term. What
better way to unwind than read the jottings of
GKT students and alumni?
A personal thank you to all who have sent messages of congratulations on my appointment as
Editor of the Gazette; it is both the п¬Ѓnest and oldest hospital journal in the world (on the п¬Ѓrst I am
a little biased). I am immensely grateful for your
support and I will endeavour to have earned it by
the end of my time.
Whatever you are intending to do with your
break I hope it is a happy one; I wish you a Merry
Christmas.
4
GKT Gazette
Electives abroad
for medics, nurses and
bioscientists. p18
Nov - Dec 2014
Prof Sir Robert Lechler. p10
Christmas show
What it was like in 1973
at St Thomas’. p 58
Match reports
from GKT teams. p74
NEWS
News in brief
Medical School exam results leaked
On 11 November a spreadsheet containing the summer exam
results of all students from MBBS 1-4 was mistakenly sent to 21
students on the intercalated BSc Surgical Science module by the
Anatomy admin. The list gave details on exact rank within the year
as well as details on students who deferred or failed individual
components. The College has instigated a full investigation into
the release of this data in accordance with the Data Protection
Act.
Security increases at King’s
Since the beginning of this academic year, security measures at
King’s College London have been heightened in response to the
increased terror threat level in London. These new measures
require students to swipe in, or to be able to show student ID
cards,when entering university buildings. While this may seem
inconvenient the College believes that these measures will allow
all staff and students to remain safe.
Atul Gawande gives visiting lecture
On 4 November Atul Gawande, 2014 Reith lecturer, Professor of
Surgery at Harvard Medical School, and an eminent writer gave
a lecture at Guy’s campus on the subject �Being mortal: ageing,
illness, medicine and what matters in the end’. He gave an
overview of working with the dying through his own experiences
as part of a talk that was accessible for all.
Marking boycott over pensions
From 6 November 2014, Universities and Colleges Union (UCU)
members will be boycotting student assessment and examination
activity. UCU members voted to take action following reductions
in Universities Superannuation Scheme pension plans. Prof Karen
O’Brien, Vice-Principal for Education at King’s told students: “the
university will be open as usual. Also students should hand in
assignments, attend classes and sit exams.”
Nov - Dec 2014
GKT Gazette
5
LETTERS
A Christian chaplaincy is not
representative of beliefs of
students
A
s a former honorary
humanist
chaplain
to
Greenwich
Hospital
and former Clinical Nurse
Specialist at Guy’s & St
Thomas’ I was interested to
read your feature on the work
of chaplains (GKT Gazette
Sep-Oct 2014). Keith Riglin
writes, “We look after all
the religious provision ... we
encourage the diversity and
plurality of King’s making
sure it is an inclusive place”.
What about those with no
religion? Various surveys,
and the 2011 census, showed
the �no religion’ category as
second only to �Christian’;
young people and students
scored higher than their
elders as non-religious.
Keith adds, “Everyone has
beliefs
and
spirituality
of some kind even if it is
an atheist belief”. As a
humanist I don’t regard
atheism as a belief in itself;
it is a philosophical stance.
But humanists do believe
in the social construct of
doing as you would be done
by. In some form this idea
is incorporated into the text
of all religions. However,
it arises from living as
human communities, not
as a supernatural edict.
It is a �human construct’;
humanists live �for the one
life we have’, or at least
of which we have certain
knowledge. I am aware that
the works of atheists such
as Sam Harris and Alain de
Botton* have confused the
discussion of �spirituality’;
however,
non-believers
need no patronising from
those of �faith’. Aren’t
secular counsellors likely to
give better assurance than
a chaplain who inevitably
brings notions of faith to a
student, however tolerant
the approach?
I know King’s is a Church
of England foundation;
in contrast with UCL sometimes known as the
�Godless of Gower Street’!
While
the
�reverend
gentlemen’ Stephen & Keith
are college chaplains, I
Right: Results of
an unofficial poll on
the Gazette website
(faith or otherwise
of chaplains was
unspecified).
6
GKT Gazette
Nov - Dec 2014
presume they have links
with the hospital chaplaincy
service?
A
humanist
colleague of mine, who
trained alongside clergy
as a chaplain, was rejected
as a humanist at her
local hospital, Guy’s & St
Thomas’, some years ago;
she was accepted at Chelsea
& Westminster Hospital,
with proper access to rooms
reserved
for
chaplains.
It seems humanists have
to be grateful for crumbs
of comfort doled out by
Anglicans in an otherwise
publicly funded service.
Some years ago I was invited
to officiate at a Humanist
Memorial for a King’s
professor in Guy’s chapel,
but only after the Anglican
Chaplain gave permission
and a welcome.
Denis Cobell
Nursing correspondent, GKT
Gazette 1987-2005, Member
of Guy’s & St Thomas’
Veterans
* �Waking Up, a guide to
spirituality without religion’
- Sam Harris (2014) and
�Religion for Atheists’ - Alain
de Botton (2012)
EBOLA EMERGENCY APPEAL
LETTERS
Dear GKT Gazette readers,
As the worst Ebola outbreak on record shows no sign of abating in Sierra Leone, King’s
College London is turning to friends like you with this very special emergency appeal, on
behalf of our volunteer medics.
Sierra Leone is already one of the poorest countries in the world, ill equipped to deal
with such a contagious, deadly disease. With no known cure for Ebola, the risk to the
community and health professionals is enormous. Ebola can kill up to 90% of people who
contract the virus, rapidly and painfully. Symptoms include vomiting, diarrhoea, internal
and external bleeding.
The King’s Sierra Leone Partnership (KSLP) has been working in Sierra Leone for two
years to improve and strengthen the health system. But as one of the only organisations still
on the ground, we’ve had to step up our role to help stop Ebola from spreading.
Our team is made up of highly trained staff and volunteers from King’s, Guy’s and St
Thomas’, King’s College Hospital and South London and Maudsley. Along with our brave
Sierra Leonean colleagues we've already helped to set up a 13-bed isolation unit at the
Connaught Hospital in Freetown, and trained staff in 29 hospitals across the capital. KSLP
has access to highly qualified infectious disease specialists, whose skills and knowledge are
vital in preparing hospitals, training staff, isolating patients and treating them.
If you can make a donation, you can help us bring six more specialists to the area, and
cover basic costs such as flights and accommodation. The cost of a one way flight has
increased threefold to ВЈ1,000 as transport links to the area are being cut. Most importantly,
you can help provide essential supplies. A donation of ВЈ50 could help pay for personal
protection suits, gloves and chlorine which will help protect staff from the virus or ВЈ10 can
buy soap and blankets for patients on the Ebola Ward.
Please, donate now and help King’s stay where they are needed most – on the ground in
Sierra Leone.
With warmest regards and gratitude,
Dr Oliver Johnson
KSLP Programme Director
Donate online by visiting: alumni.kcl.ac.uk/ebola-emergency-appeal
Or text “KSLP88” followed by an amount (£1, £2, £3, £4, £5, £10) to 70070.
The alumni fundraising campaign can also be reached by ringing 0207 848 3053.
FEATURES
A bold future for the NHS?
Thomas Bowhay MBBS5
T
he foreword of the 41-page document
called Five Year Forward View, published on the 23rd of October, starts
by stating that the NHS was �founded in 1948
in place of fear’. This all seems rather ironic
to us here in 2014 when fear appears to be
omnipresent in the discussion of the NHS,
from Daily Mail headlines to speeches by politicians. In this context the document presents itself as a rational and pragmatic plan
for the future of the NHS. This is unsurprising given the history of the man behind it,
the new NHS England Chief Executive Simon
Photo courtesy of Zoe Rodgers
8
GKT Gazette
Nov - Dec 2014
Stevens. Having spent time as a healthcare
manager both here at Guy’s and St. Thomas’ and abroad, and having advised the Blair
government, he has gained a broad basis of
experience on which to formulate one of the
most radical visions for the NHS.
What does this plan involve and how has it
been received by various aspects of society?
Well п¬Ѓrst of all it calls for an end to top-down
reorganisations and to the concept of one
size п¬Ѓts all. Each region should have much
greater power to design and organise its own
FEATURES
services. The barriers between GPs and hospitals will be removed. For example, nurses,
hospital specialists, GPs, and mental health
and social care providers could be integrated
into an out-of-hospital unit called a Multispecialty Community Provider. Alternatively, if in some areas GP surgeries are hardpressed, local hospitals would be encouraged
to open up their own GP services. The rush
for further centralisation may be slowed as
smaller hospitals could be given a new lease
of life by linking the �back offices’ of similarly
sized units, creating �hospital chains’. Bigger
hospitals could be allowed to open smaller
subsidiaries at different sites as Moorfields
Eye Hospital has done in London and the
South East. These are all ideas that local areas would be allowed to explore in order to
п¬Ѓnd the best way of delivering care to those
areas.
The demand for the NHS has increased
seemingly exponentially since it was created. Mr. Stevens’ plan puts forward ideas in
preventative healthcare to try and stem this
increase and also to tackle some of the gross
health inequalities seen in different areas of
the country. These include incentivising and
supporting healthier behaviour and allowing local democratic leadership to have enhanced powers in health issues, such as the
ability to limit junk food outlets near schools.
The plan also supports legislation that would
reduce the amount of fats and sugars in food
and calls for companies to implement health
work programmes for employees.
The plan does contain some rather sobering
news. According to the number crunching
carried out by the health regulator Monitor,
by 2020/21 there will be a ВЈ30billion shortfall for the NHS based on current funding.
This will have developed due to a growing
demand, no further increase in efficiency
and flat terms funding. To close this gap in
funding the plan calls for the delivery of the
transformational changes that it has set out,
which would result in an increase in annual
efficiency and staged increases in funding
as the economy allows. Both of these things
are very ambitious. The increase in efficiency would be unprecedented and in the current austerity-dominated political climate
an increase in funding seems remote. This is
despite the fact that the UK spends less on
healthcare as a proportion of GDP than most
western countries and almost half as much as
the US.
The response by politicians has been somewhat muted. Andy Burnham, Labour’s shadow health secretary, reiterated Labour’s commitment to increase spending on the NHS by
an extra ВЈ2.5billion and to bring social care
under the NHS, a proposal put forward in
Mr. Stevens’ plan. This increase in funding
looks woefully inadequate. The Health Secretary Jeremy Hunt gave no п¬Ѓrm guarantees,
just that the Conservatives were committed
to �protecting and increasing’ funding in real
terms depending on economic п¬Ѓgures. The
Liberal Democrats also have said that they
will make sure the budget rises above inflation.
The Five Year Forward View presents a vision of the future for the NHS in which the
distinction between primary and secondary
care is blurred, services are designed to п¬Ѓt the
local area, and the NHS plays a much more
active role in preventative healthcare. All
this needs to be achieved whilst budget constraints and efficiency savings loom. The status quo is clearly not an option and the plan
states that its ideas would lead to a �far better
future for the NHS, its patients, its staff and
those who support them’. Now it is down to
the managers and politicians to deliver. As
for how much can be achieved, we will have
to wait and see.
Nov - Dec 2014
GKT Gazette
9
FEATURES
Interview: Professor Sir Robert Lechler
In early October I received an email from Professor Stuart Carney, Dean of Medical Education, asking if the GKT Gazette had ever considered interviewing Professor Sir Robert
Lechler. I must admit that he is a man I knew little about beyond his involvement in the
highly controversial health schools redundancies. The media have often made Professor
Lechler into a villain and so I was interested to п¬Ѓnd out more about the man I struggled
to picture, a man who has previously left many student questions unanswered. A promise
was made that I could ask any questions I chose and Professor Lechler would endeavour to
answer them:
Fi Kirkham: What do you do at King’s?
Can you give me an overview of a �day
in the life’ of the Vice Principal?
Robert Lechler: My
job is to lead and
oversee the, what
are
now,
four
faculties:
the faculty of life sciences and medicine,
the institute of psychology, psychiatry and
neuroscience, the faculty of nursing and the
institute of dentistry. I line manage the Deans
of those four faculties and that means I have
an overarching responsibility for strategy,
for managing the п¬Ѓnance, for managing the
education portfolio and the second job that I
have is as executive director of King’s Health
Partners and that means that I have a lot to
do with the three partner trusts: Guy’s and
St Thomas’, King’s College Hospital,
South London and the Maudsley.
FK: So tell me about your
training starting with your
time
at
Manchester
University?
RL:
Trained
at
Manchester, I got
ambitious
late:
I
wasn’t a distinguished
undergraduate and
I didn’t really work
until my п¬Ѓnal year.
FK: Is that a
strategy
you’d
advise for medical
students?
10
GKT Gazette
Nov - Dec 2014
FEATURES
RL: (laughing) Well I went up to Manchester
to receive an outstanding alumnus award a
few weeks ago and was asked to say something
to the students, so I said this to them, “If you
are someone who has got ambitious late,”
this was a graduation ceremony, “don’t
worry, it can all still happen”. But I wouldn’t
recommend it as a strategy! So I did well at
п¬Ѓnals and then I decided that I needed to
get down to London so I then came down to
London as an SHO and then decided that I
wanted to get a research training, so I got an
MRC training fellowship and that is what has
ultimately led me here.
FK: Why did you choose to come to King’s?
RL: I spent most of my postgraduate life at
Imperial, spent a spell in the United States
doing research at NIH and then I’d risen
to be head of the division of medicine at
Imperial and started to enjoy leadership
roles and I was sitting in the Alhambra, about
to go round that wonderful place in Southern
Spain when I got a phone call sitting in a
restaurant with a glass of Rioja from a head
hunter who said there’s a job within the
faculty of medicine at King’s.
FK: So it was a glass of wine that led you
here?
RL: (Laughing) Yes, it could well have been…
I thought it was just a fantastic opportunity
because my view at the time was that King’s
was a bit of a sleeping giant in terms of its
performance overall and I saw an opportunity
to help it improve.
FK: What would you say has been your
greatest single achievement while here?
RL: If I say that in the Times’ Higher
National League table the health schools
have risen to eleventh in the world, I forget
where they were, I forget when the Times’
Higher League table started actually but
what I can tell you is that in the last п¬Ѓve years
it has gone 27, 22, 20, 13, 11, where it started
before five years ago I can’t remember.
I suppose I regard that as my greatest
achievement because that is exactly what I
came here to do. We can come on to domestic
League tables, we might in a moment, but I
think I just wanted to drive the quality and
the reputation of King’s forwards and I think
that is, perhaps, what I have helped to do.
FK: What are you hoping to achieve in the
rest of your time here?
RL: If you were to say to me do I really believe
we are eleventh in the world the answer is I
don’t, I think that is a generous league table.
I would say that perhaps we are somewhere
between twentieth and thirtieth in
reality; I would like to get us into
the top twenty comfortably
because the league tables vary.
I think there is more work to
be done in consolidating our
strengths and I think there
is undoubtedly more to be
done in extracting value and
making the academic health
sciences centre work. I want
the medical school at King’s to
be the most highly regarded
medical school with the most
satisfied students of any
medical school in
the UK.
Left: Prof
Lechler,
Right:
Fi Kirkham
Photos:
Neethu
Varghese
FEATURES
FK: That brings us nicely onto student
satisfaction, what do you think is going
wrong?
RL: My own diagnosis is that a series of things
went wrong which collectively caused a very
dissatisfied student body. I would probably
suggest four things. One was a cultural issue
where research was valued excessively more
than education and I think that balance
just got a bit out of kilter. I think secondly
we reached a point where there wasn’t a
collective sense of ownership of delivering
the medical curriculum. Third issue is that we
did under invest in the infrastructure and a
lot of cracks were papered
over in the past, I think by
some very conscientious
people
who
were
compensating for that.
Fourthly the immediate
partner hospitals within
King’s health partners
came under increasing
п¬Ѓnancial pressure and
so there is a tendency for
consultants’ job plans to
say you’ve got to deliver
this clinical service target
and so on and so on so you can’t afford to take
time out to teach. I think all of this happened
collectively and they led to a series of things
breaking down in a way that understandably,
caused a degree of unrest.
inappropriate to delegate it to someone else.
Fortunately it is complete, п¬Ѓnished, and
just in case anybody doubts it we’ve paid
enormous attention to education throughout
that, so our Deans were central to the
process and actions we took and we took
as much care as we possibly could to avoid
any damage to education, that’s something I
hope is self-evident. One or two members of
staff at risk of redundancy, but that are key
to teaching, have been asked to stay on to see
through the transition period to help make
sure these gaps are effectively п¬Ѓlled. We have
simultaneously invested in infrastructure for
the institution despite the redundancies.
“having concluded
that I believed it had
to happen I felt it
was inappropriate
to delegate it to
someone else.”
FK: So you’ve spoken there of infrastructure
and the need to invest which in my mind
leads us on to talk of the job cuts and
their relationship to the need to invest in
infrastructure, what can you tell me about
this?
RL: Talking about the recent redundancy
exercise which I presided over, and take
very personally because having concluded
that I believed it had to happen I felt it was
12
GKT Gazette
Nov - Dec 2014
FK: So you think it is
more important to have
infrastructure
over
teaching staff?
RL: I don’t think I accept
those as alternatives,
they are both important.
What I said was, in
terms of causes of the
dissatisfaction, I think
one key cause was that
we had neglected, to some
extent the infrastructure so things were
going wrong which just shouldn’t have gone
wrong, and that was partly lack of investment
in infrastructure. In terms of the number
of people contributing to teaching, the big
drive which I have been pushing for a few
years now, is to make sure that everybody,
and I mean everybody, is contributing to
teaching, including myself. I think that if
we mobilise as we need to, particularly the
clinical academics but not only them, we
will more than compensate for the loss of
teaching hours and staff caused through the
redundancies.
FK: Do you think King’s is preparing students
to be doctors within the NHS?
FEATURES
RL: I think broadly speaking yes we are and
I have obviously followed surveys of �how
ready do you feel?’ and that has been up and
down a bit but the interesting thing is that
the trainers think that our graduates are
more ready than our graduates think they
are.
in our level of ignorance is very important
but I think self confidence, in terms of
thinking �yes, I am equipped to do what I am
being asked to do’, that’s important because
it actually makes you function better so if you
were to ask me how would you like to change
the King’s graduate…
FK: Is that normal across all medical
schools?
FK: How would you like to change the
King’s graduate?
RL: Well it is more true of King’s than in
other cohorts of graduates so what that tells
me is that we aren’t breeding graduates that
have the level of self confidence that they
may benefit from having.
RL: (laughing) I think, as you know, there
is a process underway now led by Stuart
[Carney] to revise the curriculum and I think
there are a number of aims that we would
share behind that process. One is that we
create really scientifically literary graduates
and we are discussing the possibility of
making the BSc mandatory for our standard
entry students and that’s a discussion that
will go on over the next little while. I’m not
saying that’s necessary in order to be a good
doctor but I think given the riches of King’s
FK: Do you think that is a bad thing?
RL: That’s a good question. I think to a
degree it’s a bad thing, when I give graduation
speeches one of the things I say is please do
have modesty because I think that modesty
Villainised: Student
protestors wore “Prof
Lechler” masks whilst
demonstrating against
health schools job cuts
in Summer 2014.
Photo: Teona Serafimova
Nov - Dec 2014
GKT Gazette
13
FEATURES
research environment that it is sensible for
King’s to think about positioning itself at
the slightly more scientifically rich medical
training than may be true for Plymouth, for
example, which doesn’t have the same riches
or depth. I’m excited about the potential
the new curriculum has to create a better
integrated training; at the moment the
science is largely in the п¬Ѓrst couple of years.
I can remember when I п¬Ѓrst started seeing
patients with Systemic lupus erythematosus
I had forgotten the immunology that I was
taught; I think it would be great if we could
go a little bit more to and fro so have clinical
training a little bit more impregnated with
science and saying how it is relevant.
FK: Are you concerned about the cost
implications on the students of bringing in a
mandatory BSc?
RL: I think that is an issue we need to
address. I think its Nottingham that manages
to do a BSc within a п¬Ѓve year program so I
think we will need to look at what the cost
implications will be.
FK: You’re rumoured to hate the identifier
of GKT, is that fair?
RL: (laughing). No its not. I think when I
п¬Ѓrst came here I commented on the GKT
thing, and said does it imply a coherent
future, or a fragmented past and secondly I
said is it not at risk of getting confused with
an alcoholic cocktail or a pharmaceutical
company? I said would it not make sense
to call it King’s College London School of
Medicine. What has been made clear to me
is how strongly people feel about this issue
and how attached they feel to GKT and on
that basis I personally circulated the news
that I am very happy to support GKT for
sports clubs and student societies and so
forth. I don’t have strong views about this is
the short answer and if this is still an issue
14
GKT Gazette
Nov - Dec 2014
that the student body doesn’t feel has been
resolved adequately then I am absolutely
open to further discussion.
FK: The merger of biomedicine and
medicine has been hugely contentious
between both groups of students. What was
the logic behind the merger?
RL: Logic behind the merger was essentially
two fold. In the School of Biomedical
Science the matrix between research and
teaching was really well developed. So the
line management structures were divisions
which were research led and the teaching
departments running across those divisions
were all in place and pretty much everybody
in BMS had a nice mix of research and
teaching in their job plan. Then in the School
of Medicine the research portfolios were very
similar but there were many more people
escaping from their teaching responsibilities
by saying, �well look my research is so
wonderful and I am doing so well that I
don’t need to be burdened with teaching, it
will distract me’. That was unsatisfactory so
while I was saying in meetings that everyone
should be doing a sort of baseline of 20%
teaching it wasn’t quite happening. One of
the drivers for bringing these two things
together was to get a common culture,
which was a really well defined research
and teaching matrix and that is happening.
The second driver was that in terms of our
research the concept that I am very attracted
by is what I call research continuum that
goes all the way from fundamental discovery
science that might be in fruit flies through to
clinical trials and I think that is something
that is particularly well developed at King’s
and I think that merging these two schools
into one faculty just brings that research
continuum to life. I think that there was no
rational for two separate research portfolios
so bringing them together just made sense.
FEATURES
FK: So there is no truth in the rumour
that the two schools were brought together
to improve student satisfaction in league
tables?
FK: Do you go to the GKT games?
RL: None whatsoever. I’ve never even heard
that suggestion.
FK: Did we win?
FK: You were knighted in 2012, what was
this for?
RL: I would think it is in recognition of my
contributions to academic medicine in the
UK. So in part what I have done here; in part
in recognition for my contribution to the
London scene.
FK: Do you ask your students to call you
Sir?
RL: No... absolutely not. I
don’t ask anyone to call me
Sir. It will be a bad day if I
п¬Ѓnd myself in any moment
of frustration in a queue in
an airport or being turned
away from a restaurant
and saying, “Do you know
who I am?” I have never said it and I hope I
never will.
RL: I went to a hockey match earlier this
year.
RL: We won some we lost some. I will
endeavour to get to more matches.
FK: What’s your favourite sock colour?
RL:
(laughing)
Gosh,
I’m
really
unimaginative with sock colour. I’m wearing
black today and it is normally black or blue.
FK: If we were to get you some in GKT
colours would you wear them?
“Absolutely not.
I don’t ask anyone
to call me Sir.”
FK: Questions from the readers now. Would
you rank these sports: hockey, rugby and
football?
RL: Rugby, football and then hockey.
FK: Do you follow the GKT teams in that
order too?
RL: Rugby is just my favourite sport. The
reason I put Hockey last is because I played
in the 2nd XI at Prep school and I wasn’t
particularly good.
RL: If you gave me some
socks I would wear them.
FK: Which is your
favourite
PokГ©mon?
Please tell me you know
who PokГ©mon are?
RL: Oh Lord. I remember
my kids playing PokГ©mon on a little handheld
so I remember them growing up with it. I
think I would have to go with Squirtle.
FK: Finally, what piece of advice would you
give to your younger self?
RL: I would say almost never accept that
something is impossible if it is something
you believe should really happen. If it is
something you believe should happen, what
life has taught me is that you can almost
always make it happen. If you are smart and
get a coalition of people on your side. I think
that it is possible.
Nov - Dec 2014
GKT Gazette
15
FEATURES
Electives abroad
Each year, students throughout the Health Schools travel far and wide in search of
rewarding educational experiences, embarking on electives and other placements in
hospitals, clinics and academic departments around the world. Hundreds get the chance
to witness and engage in healthcare quite different from their experience in the British
system. Others spend their time in research, targeting novel solutions to old problems
alongside some of the world’s finest academics. Here are accounts of some of those
experiences.
Pokhara, Nepal
Green Pastures Hospital and
Rehabilitation Centre
March – April 2014
Sarah Cleary
Adult Nursing BSc (3rd Year)
L
ast spring I went on a nursing elective
to Pokhara, Nepal. Organised through
BMS World Mission, I spent four
weeks working at a hospital and rehabilitation centre that predominantly specialises in
caring for patients with leprosy, spinal cord
injuries, amputations and strokes. The hospital is run by the International Nepal Fellowship (INF), a Non-Government Organisation, funded mainly through charities and
individual donations (http://www.inf.org/).
A quarter of the population of Nepal live below the poverty line of 74p a day and government healthcare is expensive. It was therefore great to go to a hospital where the poor
and marginalised were receiving care irrespective of their ability to pay.
It was particularly eye opening to learn more
about leprosy, a condition that many believe
has been eradicated. An effective multidrug
therapy means that leprosy is a curable disease. Yet, due to limited infrastructure and
education in Nepal, as well as stigmatisation
of the condition, many people still do not
have access to treatment. It was wonderful to
be a part of a community of people who were
trying to change this.
Many people have heard of medical electives
but are surprised to hear that nursing students also have this opportunity. At King’s
we are privileged to have the chance to do
an elective during our course and I would
strongly encourage all nursing students to
embrace the opportunity. My advice would
be to persevere through the slog of planning
and paperwork, because the experience you
will have on your elective will make it completely worth it. An elective provides a unique
learning experience and a great excuse to visit a beautiful country, eat delicious food and
make amazing friends!
Sarah Cleary at the Peace Pagoda, Pokhara, Nepal. Photo: Jo Warren
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Nov - Dec 2014
FEATURES
Photo courtesy of Jo Warren
Rebecca Trenear at Machu Piccu. Photo: Rebecca Trenear
Huancayo, Peru
July - September 2014
Rebecca Trenear MBBS5
T
u quieres mas comida?” “Uhhhhmm…”
“Tu. Quieres. Mas. Comida?!”
“Uhhhmmm...oh right um yes please.
Oh. I mean si por favor! Gracias!!”.
I probably should have known more Spanish
before embarking on my elective in the city of
Huancayo in the Peruvian Andes. Especially
as I was staying with the grandmother of the
charity’s administrator who spoke a combination of Spanish and the Incan language of
Quechuan all through her bottom lip. And
she had a stick that was angrily gestured
every time I didn’t understand something.
Which was about four times during each brief
conversation. I am also so tall by comparison
that I had to sit in the foetal position on buses
as my legs didn’t fit in the nonexistent space
between chairs. Being the token family giant
had its advantages though, as I was invited to
dance through the streets with all the women
in traditional clothing at the annual town fiesta to the sounds of the family’s men playing
endless rounds of Peruvian big band tunes.
Who knew such a genre existed?!
The placement itself involved hanging out
at a free clinic, and seeing endless teenage
pregnancies and very poor, potentially very
ill people. Sadly we would never know how
sick they were as there was no money for
tests and a prescription of antibiotics was the
treatment for everything. There was also the
optional addition of teaching orphan children п¬Ѓrst aid and doing development checks
on nursery children, both of which were
amazing fun and completely heart-wrenching in equal measure. I’d highly recommend
spending part of an elective somewhere like
the Andes, living in a family environment,
witnessing how the other half of the world
live. Not least because returning to well
stocked, well п¬Ѓnanced hospitals is paradise
by comparison.
Nov - Dec 2014
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17
FEATURES
Borneo, Malaysia
July - September 2014
Lewis Moore MBBS5
I
n addition to my main placements on
elective this summer, in hospitals in Malaysian Borneo, I spent two very memorable weekends volunteering for MERCY
Malaysia, a medical relief NGO. Aside from
their work in disaster zones worldwide, and
efforts to produce sustainable health-related
development in Malaysia, MERCY launches monthly missions to provide healthcare
to isolated communities living many hours
from the nearest government health services
and even the nearest paved roads.
I volunteered on two of these missions alongside local doctors, nurses, dentists, pharmacists and drivers: we loaded up multiple 4x4s
with our equipment and set off from the state
capital, Kota Kinabalu, for hours of driving
both on- and off-road to reach the communities we were to serve. Small wooden huts
were provided for us to set up the doctors,
dentists, pharmacists, the facility to distribute reading glasses and hygiene kits, and a
health promotion kiosk. The majority of the
patients were suffering with coughs, dyspepsia and backache but one gentleman presented in full-blown sepsis and another had recently suffered a stroke and required a home
visit.
My Malay language skills were unfortunately
not developed enough for me to take histories and manage patients, but proved sufficient to dispense medication, and I made
myself at home in the pharmacy team. The
expeditions were a great opportunity to observe healthcare delivery outside a traditional setting but also to get out of the city and to
work with other young health professionals,
some of whom I would later travel with even
further into the wild.
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Nov - Dec 2014
The most memorable moment of this experience was the gratefulness of the communities
that we treated; this was expressed by their
invitation to participate in their traditional drinking ceremony. With a cacophony of
gongs banging we were �encouraged’ to drink
still-fermenting potato wine from massive
earthenware jars. I was later ushered into
traditional clothing and then swiftly into a
�purely ceremonial’ wedding with two Malaysian women. I signed nothing, but oh how we
danced.
My time with MERCY was a highlight of my
elective experience and I would recommend
this or similar projects when your elective
comes around.
FEATURES
National University of Singapore
July - September 2014
Anya Suppermpool
Neuroscience BSc (3rd Year)
F
or biomedical students, the closest
thing to the medics’ exotic electives
would be a studentship abroad. This
summer, I was lucky enough to be a part of
the Santander Undergraduate Research Exchange (SURE) program at the National University of Singapore.
I got involved with the program through
checking my email – the University sends
us circulated emails daily and not everyone
looks through them carefully. One day in
March, I got an email saying there were places for two King’s students for an 8 to 10-week
paid summer project at NUS. And I thought,
“why not?!”
During the time there I investigated the role
of divalent metal transporter (DMT1) and
its implication in Parkinson’s disease. In
addition to that, as an intern I helped out
other members of the lab with their work,
preparing solutions, gels and Western Blots.
In return, the electrophysiology lab taught
me fluorescent microscopy, cell culture and
transfection, animal handling, and the patch
clamp technique. Working on a specific project really gave me insights on what it is like to
be a researcher: the flexibility and independence, the frustrations of unusable results,
and the thrills and sense of accomplishment
in obtaining good data.
The perks of doing summer research placements abroad is the ability to travel, make
new friends, learn about new cultures and
earn work experience at the same time! My
advice is to check your emails regularly – you
never know when a great opportunity might
come up!
Anya and friends at Gardens by the Bay, Singapore. Photo: Jordan Seo
Nov - Dec 2014
GKT Gazette
19
FEATURES
Freetown, Sierra Leone
September 2013
Sneha Baljekar
A
lex (pictured below left) and I discovered the King's Sierra Leone
Partnership (KSLP) after attending
their roadshow in London. KSLP is a capacity-building initiative, whose team works with
local staff to strengthen health infrastructure, education and practice. We worked
clinically and on projects tackling current
difficulties within the healthcare system at
Connaught Hospital, such as infection control procedures, the management of hospital
п¬Ѓnances, and the structure of nursing education. It was a challenging month on many
levels – resources and equipment are scarce
in Freetown. As all care is chargeable, those
who cannot afford it go without.
However, the combination of becoming part
of the team at Connaught, Freetown life, and
getting to know a host of wonderful, dedicated staff and students, made for an unforgettable month.
We felt that a capacity-building elective
trumped the traditional format. You get to
observe and work amongst clinical problems
on the ground, and then contribute to long
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GKT Gazette
Nov - Dec 2014
term projects that the King’s Team are working on with Connaught staff and the College
of Medicine and Allied Health Sciences (COMAHS) students, to try and address these.
This makes it so much more than an elective
where you see challenging things, take a few
pictures and return home. We are still involved with the KSLP a year later, attending
regular meetings on their current projects.
The focus is now, of course, on their crucial
part in the Ebola response.
My tips for organising your elective: attend
as many global health talks as possible, and
follow up with the people you meet. Don't
use elective companies – they are a waste
of money! Look for capacity-building electives – you're bound to get much more out
of the experience. My time in Freetown will
stay with me forever, and I hope your elective
does too!
For more information on the King's Sierra
Leone Partnership, or to donate to the Ebola
appeal, please visit www.kslp.org.uk or text
KSLP88 followed by an amount (ВЈ1, ВЈ2, ВЈ3,
ВЈ4, ВЈ5, ВЈ10) to 70070.
For general advice on electives, please contact [email protected] or alexandra.
[email protected]
Nov - Dec 2014
GKT Gazette
21
FEATURES
Parity of esteem between mental
and physical health
Mayowa Oyesanya MBBS5
I
t seems like such a simple idea. Mental
health problems should be regarded as
seriously as their physical counterparts,
and they should receive funding that is more
commensurate with the burden that they impose on people. Such an aspiration has been
referred to as seeking �parity of esteem’ between mental and physical health, which of
course is a soundbite-ready slogan for politicians and policy wonks to associate themselves with. Indeed, Nick Clegg has pledged
waiting targets for receiving mental health
treatments as well as an extra ВЈ120million to
ease the process. Apart from Mr. Clegg’s past
confusion concerning the meaning of a political pledge and the practical consequences of
making one, this new proposal is very much
welcome. The Royal College of Psychiatrists
in its manifesto titled �Making Parity a Reality’ proposes an 18-week target for receiving mental health treatment, if there is an
evidence-based treatment available. Such a
target makes sense considering that mental
health problems cost the UK economy ВЈ100
billion a year according to Sally Davies, the
Chief Medical Officer, but are treated less often and in a less timely fashion than physical
health problems.
Proposals made by the medical and political
professions, concerning mental health service reform, seem to suggest that they are of
one mind concerning parity of esteem and
its desirability. But the current proposals
do not go far enough and they suffer from a
limited scope. Parity of esteem does not just
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GKT Gazette
Nov - Dec 2014
entail a parity of funding. It is an ideological
commitment to treating mental health problems as seriously as physical health problems
that impose a similar burden to individuals
and the economy. The current plans do not
reflect this commitment; rather they seem to
be a temporary analgesic to an underfunded
mental health service which has undergone
real term cuts in expenditure in the last few
years, and is therefore writhing in agony.
The current problems with UK mental health
services will be compounded by demographic ageing which will produce a dementia epidemic that the NHS is not equipped to deal
with. Elderly populations do not suffer from
discrete mental and physical health problems
but problems that interact and compound
one another. If parity of esteem is to have any
meaning, then it must entail an integration
of mental and physical health services to deal
with this upcoming burden and to provide
better care to medical inpatients right now.
A small multi-disciplinary mental health
team in City Hospital in Birmingham has
shown that by addressing the mental health
needs of inpatients who are mostly elderly,
days can be shaved off inpatient staying periods and millions of pounds can be saved
every year. The service has made waves
amongst healthcare commissioners as a
funding model that achieves the holy grail of
health service reform: higher quality at a lower cost. However whilst creating equivalent
services across the NHS will most likely be
FEATURES
Discussing mental health as part of the Elephant in the Room campaign.
Photo: Zoe Rodgers
cost saving in the long term, recruiting new
staff, performing service evaluations and remodelling the way mental health and acute
trusts interact will cost considerably more
than ВЈ120 million pounds and will also take
time. Rather than making media friendly
slogans, politicians must now engage in the
hard work of making the case for a broader
health service reform that integrates mental
and physical healthcare.
The way that we conceive of mental health
problems must also change if there is to be
parity of esteem between mental and physical health. Mental health problems are
misunderstood and stigmatised and are not
perceived to be as serious as physical health
problems. Misperceptions concerning mental health problems have poisoned the public
debate on mental health services which has
undeniably contributed to the inadequate
funding that these services receive. Anti-stigma campaigns such as �Time To Change’ have
had some moderate success in changing atti-
tudes according to health service researchers
at the Institute of Psychiatry; but more needs
to be done to shift attitudes. Ideally in time
the somewhat arbitrary distinction made between mental and physical health problems
will be replaced by a paradigm that emphasises holistic care. Closer integration of mental and physical health services will help to
achieve this if carried out properly.
Overall, the debate concerning mental health
services needs to be more ambitious and
should be infused with a clarity of purpose.
This will require cross-party consensus in
order to create a coherent long-term plan
for mental and physical health service integration. The scale of reform required, which
should take place as part of a broader debate
about the cost of healthcare within the NHS,
needs to be communicated to the public. If
this can be achieved, then not only will parity
of esteem become a reality, the NHS will also
be more efficient and more sustainable.
Nov - Dec 2014
GKT Gazette
23
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Nov - Dec 2014
Nov - Dec 2014
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25
FEATURES
Election turnout п¬Ѓgures: need for KCLSU
to engage with Nursing and Midwifery
Simon Cleary, PhD Student
In the annual student council
elections, students at King’s
College
London
decide
which 50 fellow students to
elect as their representatives
on the student council. These
elected students consist of
45 volunteer councillors who
continue with their studies,
and 5 student officers who
go on sabbatical to work fulltime at the students’ union
(KCLSU) for the benefit
of King’s students - and a
ВЈ22,500 salary. Together the
council make decisions that
affect the student experience
and the reputation of
students at King’s.
The 2014 elections were the
п¬Ѓrst in which students could
elect a sabbatical officer
with the title Vice-President
for Health. This sabbatical
officer will work for students
in the health schools, many
of whom have very different
needs from non-clinical
students,
particularly
regarding their placements,
26
GKT Gazette
and are under-represented
in the student council (see
“The case for a GKTSU”
GKT Gazette, November
2011). Election turnout data
broken down by school were
requested from KCLSU with
the aim to use the п¬Ѓgures as
an index of engagement with
KCLSU politics in the health
schools.
“one pattern that
is clear is one
of variation in
turnout across
the College”
KCLSU could only provide
data from the last 4 elections,
but the п¬Ѓgures that they
could п¬Ѓnd show that turnout
has been consistently low for
the last 4 years - very much
the norm in student union
elections.
The low turnout numbers,
together with a number of
factors – potential errors in
estimations of school sizes
Nov - Dec 2014
from the previous year’s
headcount,
mergers
of
schools, changes in the way
students are registered and
the cheating which marred
the 2012 elections – render
analysis of trends over time
fairly meaningless.
However, one pattern that
is clear is one of variation in
turnout across the College.
Fairly consistently, a larger
proportion of students in
the large schools of Social
Science & Public Policy, Arts
& Humanities and Medicine
(respectively 18%, 18% and
14% of all students at the last
count), have turned out to
vote relative to other schools.
One school with a relatively
low percentage of voters
year-on-year is Nursing &
Midwifery, which is also
large, containing 11% of
King’s students, more of
whom are mature students
than in other parts of
King’s, with most students
spending a lot of their time
on clinical placements. The
FEATURES
school has had to rapidly
adapt since a degree became
a requirement for all new
nurses in 2013.
The GKT Gazette asked
Sophia Koumi, who was
elected in 2014 as the п¬Ѓrst
KCLSU Vice-President for
Health and п¬Ѓttingly a former
Mental Health Nursing
student, what she was doing
to get Nursing & Midwifery
students more interested in
KCLSU politics.
of what KCLSU has to offer
them.“
She said: “I work closely
with the Nightingale Student
Council and KCLSU Student
Councillors to ensure they
feel supported and able to
make the changes they want
to see. Where possible, I
work with students within
the School to ensure they
feel listened to and are aware
“I am currently working on
a campaign to reduce the
п¬Ѓnancial pressure on NHS
funded students. As Nursing
and Midwifery students are
solely NHS funded, I feel
they will be able to get on
board with this campaign
and see that KCLSU is doing
something for them.”
KCLSU student council election turnout varies by school:
Percentage of eligible students voting in KCLSU student council elections broken down by
school. Based on data provided by KCLSU via their election managers MSL and KCL annual
headcounts. �Institutes & Centres’ and �Other’ have been excluded due to incomplete data.
* In 2014, neuroscience students previously in the School of Biomedical Sciences (now Bioscience Education) were moved into the Institute of Psychiatry, Psychology & Neuroscience
(formerly Institute of Psychiatry).
Nov - Dec 2014
GKT Gazette
27
FEATURES
Modern medicine, policy and the
pursuit of public health
Ellis Onwordi MBBS5
T
he ever-changing relationship between
doctors and the British public is expressed distinctly today from all previous incarnations. For a start, the universal
right to healthcare has been enshrined for
a mere 66 years; a citizen alive at any time
prior to 1948 would п¬Ѓnd no such protection,
not even the most basic guarantee of being
seen by a doctor at any point in life. These
are rights we have come to take for granted. Gone are the days when comprehensive
medical care was the preserve of the elite. But
with the achievement of this right, has there
been a neglect of others that lead to the ultimate goal of health and wellbeing?
Over the years, we have witnessed in the
NHS the profound medical and social rewards that a well-resourced, efficient and
universally accessible health system has to
offer. These include the eradication of polio,
falls in infant mortality (from around 1 in 20
to 1 in 250), and enormous strides in life expectancy (from national averages of 71.2 and
66.4 years in 1948 for females and males respectively, to today’s figures of 82.7 and 78.9
years).
And yet, despite the levelling effect of welcoming the public to benefit from universal
medical care, the UK is nonetheless beset by
glaring health inequalities. Consider again
life expectancy, but look beneath the headline п¬Ѓgures: in Glasgow, the female and male
28
GKT Gazette
Nov - Dec 2014
expectancies are 78.5 and 72.6 years – the
lowest figures nationally – versus the peak
п¬Ѓgures of 86.6 (Purbeck) and 82.9 (both East
Dorset and Hart).
The mentality that the establishment of the
National Health Service addresses the majority – even all – of our national health issues
is all too pervasive. Whilst the NHS is an essential tool in protecting the public from the
effects of disease and aiding the pursuit of
health, we are perhaps over-reliant on it, often uncritically regarding it – or at least some
ideal, well-resourced version of it – as the
definitive guarantor of health.Yet we neglect
to recognise how the pursuit of public health
can be limited by some of the deficiencies of
modern medical practice within the NHS and
of health policy more generally.
This misperception is variously manifested in
the flawed approaches to health of members
of the public, political and medical classes.
The NHS is useful at managing and reversing
disease, but to suggest that it follows that the
NHS secures public health is surely mistaken.
Of course the NHS is remarkably supportive
of public health, but it must be acknowledged
that disease management is not equivalent to
health achievement.
Neither the simplicity nor the reputability
of this principle precludes us from behaving
FEATURES
as though health and the absence of disease
were one and the same. When we think of
sickness and health, we are prone to consider ourselves as patients, when in reality the
time we spend presenting our various complaints and receiving our various treatments
generally fades into relative insignificance in
the full scope of our lives, throughout which
sickness and health are essential features.
For too many people, accessing care within
the NHS comprises the majority of our time
spent considering our medical wellbeing.
Healthcare means seeing your GP, going to
a hospital, getting prescriptions or having an
operation. Rarely are the more mundane but
modifiable day-to-day activities considered a
feature of this. Patients too often approach
doctors with preventable illnesses, anticipating a miracle cure but having given little
thought as to the simple measures they can
undertake to preserve their own health.
Of course, we medics must accept a measure
of responsibility for this erroneous approach.
Medical achievements, profound as they
have been, have for the best part of human
history seemed nothing short of miraculous.
This unscientific perception of miracle work
is surely the product of a lay misunderstanding – one which in our professional hubris
we have done little to revise. Whilst immeasurably broadening our own knowledge base,
efforts to keep the public informed have been
many steps behind. The intricate functions
of the human body, and the myriad effects of
environmental and therapeutic agents on it,
are not self-evident truths, awaiting discovery through mere contemplation. Extensive
training is required, and a public lack thereof
inevitably produces differences of comprehension between medical professionals and
everyone else.
It is in this profound informational gap – between medic and layperson – that all sorts
of notions regarding what medicine can and
cannot achieve have been allowed to thrive.
Why, then, in light of the inescapability of
Nov - Dec 2014
GKT Gazette
29
FEATURES
the imbalanced distribution of knowledge
and skills, ascribe responsibility to the clinician? Well, that would be because the clinician not only has the ability to disperse that
information, but also, I would suggest, has a
professional need and social duty to do so;
and furthermore, the clinician has not simply
allowed this gulf to organically arise, but has
also absent-mindedly aided its expansion.
clinicians. The simplified public image of the
doctor as the miracle-working healer stems
from a poverty of understanding, which in
turn stems from joint poverties in information and opportunity. The generalised dispersal of both is required for us to understand how to pursue one of our principal
human desires, namely health.
Perhaps dazzled by our own ability to “save”
Hierarchical structures take root: the gap in lives, we have neglected that old adage on
understanding leads to, and is thereafter sus- prevention’s supremacy over cure. We will
tained and exacerbated by, a gap in authori- always require the intervention of docty. Rather than the patient, it is this mystical tors in extremis, but one would hope that
doctor – possessor of private but compel- health-driven interventions would be emlingly effective knowledge and skills – who ployed not only at the point of severe physbecomes the principal authority on matters ical and mental decline. This approach to
health is often founded on
pertaining to the patient’s
our high expectations of
health and wellbeing. The
existing medical therapies
regrettable consequences
“Do we need to
rather than on what they
of this power play include
can realistically achieve.
the sidelining of the patient
fundamentally
Preventative medicine, in
and her views; the assumprevise the role
light of our aims towards
tion of full responsibility
wellbeing, demands that
for patient health on the
of medicine in
we engage positively and
part of the doctor (albeit
peoples’ lives?”
pre-emptively to avoid illfor the relatively brief time
ness where we can.
in which she is under the
doctor’s care); and the conBe honest: how many times
sequent establishment of a
paradigm in which the patient devolves her have you elicited from patients that they
smoke tobacco, and for what proportion of
health concerns to the doctor.
these have you offered the informational
Do we need to fundamentally revise the role impetus by which to cut down? With how
of medicine in people’s lives? The twinning many of those who drink to excess have you
of baffling methodology with frequently pro- discussed recommended weekly allowances?
found implications, in the absence of clear We should be in the business of empowerexplanation, has ensured the near-religious ing people to take charge of their own health
reverence our line of work commands. We where they can – facilitating thereby our
must surely do away with the mysticism that efforts to preserve health and reducing the
surrounds it, pursue a higher level of public burden of disease – whilst being prepared to
understanding, and clarify that health is an offer critical supportive and restorative care
ongoing pursuit, rather than one extreme of when it comes to it.
a binary relationship with disease, preserved
through brief and discrete interactions with All doctors must engage actively in prob-
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GKT Gazette
Nov - Dec 2014
FEATURES
lems of public health, and promote public
understanding with renewed urgency. This
requires them to act as effective communicators, not only of medical ideas, but also of the
role of medicine itself. There is a critical need
to bring all medics into the collective mission
of guiding the public onto a rational path towards health. But responsibility for this task
should not be dumped wholesale on doctors
by a state that wishes to shirk its own.
The universalisation of the means by which
health can be realistically pursued is yet to be
achieved. This should not be limited to access
to medical care, but must also include the
universalisation of access to healthy meals,
gyms, playing п¬Ѓelds, and swimming pools,
amongst other health promoters that are
currently readily available to those who have
the capacity to pay. The founding principle of
the NHS was that access to healthcare should
never again be determined by п¬Ѓnancial status, but the right to healthcare cannot be our
society’s solitary positive liberty associated
with health if national health is to qualify as
a realistic goal. This principle should be extended to unveil further liberties contributing to that common purpose.
In ongoing attempts to demonstrate that
public health remains a state priority, the
government repeatedly trumpets its investments in the NHS. At the same time,
it oversees the sale of school playing п¬Ѓelds,
vacillates over the merits of plain cigarette
packaging, and rejects minimum unit alcohol pricing. Furthermore, it presides over the
п¬Ѓrst nationwide food aid campaign launched
by the British Red Cross since the Second
World War. The Health and Social Care Information Centre reports a 19% rise in hospital admissions for malnutrition in England
and Wales over the last year, and the Trussell
Trust says its food banks have handed out
163% more parcels than in 2013 (the п¬Ѓgure
now stands at 913,000). The Faculty of Public Health notes the re-emergence of rickets,
driven by a boom in food poverty.
These are but a few of the many areas in which
the state must flex its muscles in defence of
public health. Any realistic pursuit of health
relies both upon the individual’s knowledge
of and access to key health promoters, and
knowledge and avoidance of agents deleterious to health. Without empowering the
individual with the relevant knowledge and
opportunities, the pursuit of public health is
a mere pipe dream, no matter the quality of
the health service.
Such measures – targeted towards the universalisation of both information and opportunity – are focussed on redistributing some
of the responsibility for personal wellbeing
back to the public. For who can be more essential in matters of individual health than
the individual in question? Only by recognising the primacy of personhood over patienthood – that is, collaborating with an involved
and valued individual rather than a detached
collection of clinical problems – can we
make greater strides in public health and its
far-reaching social effects, not least its impact on productivity, employability, the п¬Ѓnancial security of dependents, its burden on
NHS resources and overall cost to the state.
Perhaps we need to reflect on and return to
the original great reforming mission that underpinned the founding of the NHS: one that
recognised and challenged public health deficiencies and inequalities as lethal enemies of
social progress, limiting the prospects of the
individual and squandering human potential. It is time for the clinician and the state to
renew their vows to the public at large.
Nov - Dec 2014
GKT Gazette
31
ARTS & CULTURE
New Music: Autumn-Winter Playlist
Rolake Segun-Ojo MBBS5
2014 is drawing to a close, but now is not the time to get musically nostalgic when
you can see the year out with these exciting new artists.
Sye Elaine Spence
HOLYCHILD
Written during what she describes as a time
for �uncluttering’, the EP �Bloom’ shows
Spence going back to basics artistically as
she travels through Georgia and Florida, far
from her hometown of New York. When it
comes to musically packing light, few are as
captivating as this sojourning singer.
The �brat pop’ genre is at odds with the image
�HOLYCHILD’ initially brings to mind, but
after one listen to their debut single �Happy
With Me’, it’s easy to imagine the sweater of
lead singer Nistico, that gave the band it’s
name, as a bright jewel-encrusted affair.
Accompanied only by the subtle twang of
her banjo, her nude vocals take centre stage,
warmly blending elements of folk and soul,
she covers Bob Marley’s �Is This Love’ with
all the sentiments of an old photograph.
Authenticity like this is hard to come by,
so savour Spence’s stripped back style with
�Long Live The Summer’.
32
GKT Gazette
Nov - Dec 2014
The visually evocative sound of the LA duo
blurs the line between bubblegum pop and
indie, with silvery synth punctuated by a bold
steady rhythm.
The debut album is set to land early next
year, so in the meantime listen to the vibrant
offerings of their EP �Mindspeak’.
Little May
Seinabo Sey
Arresting
vocalists,
intriguing
instrumentalists and engaging storytellers;
this indie folk trio represents a triple threat
in more ways than one. Embellishing their
vivid narrative with ethereal harmonies,
Little May has had no trouble capturing the
imagination of large crowds as they make
their way around the Australian festival
circuit.
Scandinavia and soul music are two entities
rarely mentioned in the same sentence,
but Sey has a knack for bringing together
disparate themes. Being a self proclaimed
outcast as a child growing up in Sweden
and Gambia, she now knows that standing
out at school and standing out in the music
industry mean very different things. With
plenty of life experience to draw upon, Sey
combines her atmospheric writing style with
richly textured vocals and genre challenging
breaks.
Far from spinning a yarn around the
campfire, the darkly alluring �Hide’ embodies
their dramatic flair. Including the standout
tracks �Dust’ and �Boardwalks’, their selftitled debut EP, makes for an absorbing
listen.
�Younger’ is a thrilling introduction to Sey’s
fresh take on popular music, now featuring
on her debut EP �For Madeleine’.
Nov - Dec 2014
GKT Gazette
33
ARTS & CULTURE
Art on your Doorstep
Lewis Moore MBBS5
C
ontrary to popular belief, the Tate Modern is not the only art gallery in walking distance of Guy’s Campus. Here I
take a look at a few local galleries that aren’t
full of French tourists, or indeed French impressionism, which just might perk you up on
a dark winter’s evening. All listed exhibitions
are free of charge.
White Cube Gallery
As this issue hits the press, the White Cube
will just be closing an exhibition by the leviathan that is Tracey Emin (of unmade bed
fame), giving you an idea of the significance
of the artists that may be found here. Opening on November 26th, the next offering at
the White Cube, will be of the work of
Liza Lou, a series of duo coloured �canvases’
created from small beads, imitation of Zulu
bead work from South Africa. The work ex-
34
GKT Gazette
Nov - Dec 2014
plores the distinction between painting and
sculpture, the texture created by the beads
brings a dynamic relationship to the position
of the lighting and the viewer. (The coffee
shop across the street from the gallery is also
well worth a visit, as are Bermondsey Street’s
cool pubs and bar’s. A welcome escape from
the old Borough High Street haunts.)
144-152 Bermondsey Street, London SE1
3TQ
Open: Tuesday – Saturday: 10am – 6pm,
Sunday: 12pm – 6pm, Closed Monday
Menier Gallery
Situated in an old chocolate factory on
Southwark Street, the Menier Gallery has a
quick turnover of widely varying exhibitions,
notable shows this month include:
• GFEST – 10th to 22nd Nov. This collection of art works, new and old, come as part
ARTS & CULTURE
of the GFEST LGBT art festival, this year exploring the theme of urban myths in LGBT
culture.
• The Dogs of War Unleashed – 26th to
29th Nov. This collection of wartime propaganda maps explores the way different countries used public information campaigns
to inspire and influence their populations
during the First World war.
51 Southwark Street, London, SE1 1RU
Open: Sunday – Thursday: 11am – 6pm,
Friday: 11am – 8pm.
Jerwood Space
If you prefer a multimedia experience to
hung canvas, then head down to the Jerwood
Space on Union Street. The gallery itself has
several exhibits on at any one time, currently in the �Project Space’ or café, is an experimental piece by Rhys Coren. Four screens
display looped animations of scribbled patterns while a pair of headphones deliver
music from DJs Bahamian Moor. The animations and music both move with an intrinsic rhythm of 120 bpm but their movements
are not rigidly choreographed to the music,
meaning that their �dance’ is only at times
appropriate. When I п¬Ѓrst sat down in front
of the screens I felt rather let down but by the
end of my coffee I was loathe to take off the
headphones and end the experience. Coren is
making a point that the images and music are
not actually created together, it is a mixture
of chance and the viewer’s observations that
make this a reality. Schrödinger’s cat style.
�If We Can Dance Together’ is open until December 12th, with a live performance by the
artist and DJs on the closing night.
Free tickets available at http://www.jerwoodvisualarts.org/. Jerwood Space, 171
Union Street, Bankside, London SE1 0LN
Open: Monday – Friday: 10am – 5pm, Saturday & Sunday: 10am – 3pm
This information was Curated using southlondonartmap.com and their
excellent app: �SL(APP)’ currently only available on iPhone.
Nov - Dec 2014
GKT Gazette
35
ARTS & CULTURE
Electra at the Old Vic
Fahad Malik MBBS1
W
ith her cropped, straggly hair
and thin robe, a painfully thin
and deathly pale Kristin ScottThomas emerges from the imposing gates of
the palace at Mycenae, delving the audience
into twhe story of Electra and her physical
anguish.
Currently playing to packed audiences
at the Old Vic, Electra has been enticing
audience members for the past few weeks
with its remarkable acting and unforgettable
storyline. A reunion of director Ian Rickson
and actress Kristin Scott-Thomas, Electra
36
GKT Gazette
Nov - Dec 2014
follows the daughter of King Agamemnon
and Queen Clytemnestra on her long and
treacherous road to vengeance.
The theatre’s small size provides the audience
with an intimacy, which is necessary to see
the raw emotional power that Scott-Thomas
is capable of delivering. This adaptation of the
classic tale by playwright Frank McGuinness
sees the set relocated to just outside the
family home, with the large imposing doors
of the palace dominating the set alongside a
lone tree. The anachronistic placement of a
very modern looking tap in the centre is all
ARTS & CULTURE
that breaks the illusion of travelling back to
Grecian times.
Kristin Scott-Thomas, is the star of the show,
she shines in her portrayal of Electra, whose
immeasurable anger flows forth in every
scene with her never wavering need for
revenge against her mother. The lead expertly
walks the thin line between being slightly
neurotic and highly obsessive, highlighting
Electra’s heavy burden of grief.
The supporting cast is equally excellent, in
particular, Diana Quick as Electra’s mother,
Clytemnestra brings real internal conflict to
the stage as she portrays a woman driven by
a thirst for justice. Meanwhile, Jack Lowden
makes the returning Orestes seem naively
innocent in his quest while the chorus, which
includes Julia Dearden, Golda Rosheuvel
and Thalissa Teixeira, provides much needed
order and narration for every scene.
It is a remarkable production put on by a
very talented cast, however Scott-Thomas’s
performance is what makes the evening
unforgettable. The painfully raw, human
intensity to it will leave the audience wanting
more. Alas the final gesture must suffice,
suggesting that even revenge is accompanied
by remorse and regret.
About tickets at the Old Vic:
Electra is set to play at the Old Vic until the
20th of December, with performances at
7:30pm daily, Monday to Saturday. Tickets
range from ВЈ21-ВЈ60, with under 25 tickets
for only ВЈ12.
Nov - Dec 2014
GKT Gazette
37
KEATS’ CORNER
Don’t you love the smell of
formaldehyde in the morning?
9 am, we huddle,
Freshly lab-coated, gloved, and shoved
Into a room where the ceiling is a little too low;
The heating a little too high;
And the décor left over from Hannibal Lecter’s last
Christmas party
All but the bold hover: iron filings between magnetic poles that match
Instinctively and exactly equidistant from each chrome case
And he makes us wait – not in the way you wait for a bus But the way you wait to go onstage with hundreds in the auditorium
(Nervous doesn’t even cover it)
We are not yet used to this - as everyone assures us we will become
We act, not embody, the role of clinician
We are still startled by mortality
With a click-crash of ten reveals and the rustle of wrappings that caress
The cases are cracked, halved like Christmas walnuts
And it is
Underwhelming
The earth does not move
The flesh too different from our own to compare,
Saturated with preservatives,
We handle her carefully, delicately,
Jitters becoming pride
(Well at least I didn’t faint)
Coat and gloves can be shed
The smell of formaldehyde, on the other hand,
And my gratitude
Lingers
Published Anonymously
(MBBS1)
38
GKT Gazette
Nov - Dec 2014
Photo: Zoe Rodgers
EBOLA EMERGENCY APPEAL
Dear GKT Gazette readers,
As the worst Ebola outbreak on record shows no sign of abating in Sierra Leone, King’s
College London is turning to friends like you with this very special emergency appeal, on
behalf of our volunteer medics.
Sierra Leone is already one of the poorest countries in the world, ill equipped to deal
with such a contagious, deadly disease. With no known cure for Ebola, the risk to the
community and health professionals is enormous. Ebola can kill up to 90% of people who
contract the virus, rapidly and painfully. Symptoms include vomiting, diarrhoea, internal
and external bleeding.
The King’s Sierra Leone Partnership (KSLP) has been working in Sierra Leone for two
years to improve and strengthen the health system. But as one of the only organisations still
on the ground, we’ve had to step up our role to help stop Ebola from spreading.
Our team is made up of highly trained staff and volunteers from King’s, Guy’s and St
Thomas’, King’s College Hospital and South London and Maudsley. Along with our brave
Sierra Leonean colleagues we've already helped to set up a 13-bed isolation unit at the
Connaught Hospital in Freetown, and trained staff in 29 hospitals across the capital. KSLP
has access to highly qualified infectious disease specialists, whose skills and knowledge are
vital in preparing hospitals, training staff, isolating patients and treating them.
If you can make a donation, you can help us bring six more specialists to the area, and
cover basic costs such as flights and accommodation. The cost of a one way flight has
increased threefold to ВЈ1,000 as transport links to the area are being cut. Most importantly,
you can help provide essential supplies. A donation of ВЈ50 could help pay for personal
protection suits, gloves and chlorine which will help protect staff from the virus or ВЈ10 can
buy soap and blankets for patients on the Ebola Ward.
Please, donate now and help King’s stay where they are needed most – on the ground in
Sierra Leone.
With warmest regards and gratitude,
Dr Oliver Johnson
KSLP Programme Director
Donate online by visiting: alumni.kcl.ac.uk/ebola-emergency-appeal
Or text “KSLP88” followed by an amount (£1, £2, £3, £4, £5, £10) to 70070.
The alumni fundraising campaign can also be reached by ringing 0207 848 3053.
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GKT Gazette
43
DENTAL
Annual retention fee rises
Pippasha Khan BDS1
A
s a budding dentist,
it is imperative that
you keep up to date
with the legal requirements
you are expected to meet,
and the politics that often
surrounds these. The most
recent news in the whirlwind
world of dentistry was the
announcement by the General Dental Council (GDC), of a
rise in the annual retention
fee (ARF) for dentists. This
fee is something required by
law from every dental professional and is paid every
year around Christmas. If
you do not pay the ARF fee
you are unable to practice.
Herein lies the problem.
After п¬Ѓrst hearing this news
on the 30th June, much action has been taken in the
form of social media, proving
a useful tool in uniting many
dental professionals in the
UK. The main opposition to
the fee increases has been led
by the British Dental Association (BDA), which п¬Ѓghts for
the interests of dentists as
the main association. The
previous fee cost was ВЈ576,
and has now been confirmed
from the 30th October in a
decision by the GDC to rise
to ВЈ890 (though originally
44
GKT Gazette
it was to rise to ВЈ945). This
is nearly a grand to register as a general dentist for
a year. The given reasons
for this rise include the increase in court hearings due
to the massive rise in complaints against dentists over
the last couple of years. The
GDC claim they will need
ВЈ18,000,000 to allow for this
increase in Fitness to Prac-
“The GDC claim
they will need
ВЈ18,000,000 to
allow for this
increase in Fitness
to Practice
hearings.”
tice hearings. This change
has also been, in part, driven by campaigns from the
GDC encouraging the public
to take action against dentists. Of course it is essential
that badly practicing dentists are reported, however,
is it useful to actively push
for an increase in the litigation of dentists? As it stands,
many dentists have written
furiously against these rises, looking at the considerable expenditures the GDC
has made towards those
Nov - Dec 2014
such campaigns, the London premises it keeps and to
the ever evolving hearings.
When the ARF increase was
п¬Ѓrst proposed, the GDC gave
an opportunity to consult
with them but even with the
results of the consultation
they continued to back their
rises, giving the reason of
110% rise in complaints and
the fact the fee hasn’t risen
for a few years. Alongside this
consultation an e-petition
against the ARF rises was
started and has so far generated over 15,000 signatures.
Due to the large response,
the Department of Health
gave commentary that the
GDC is an independent body
to set its own fees however
it should only increase these
fees with due evidence. This
means it should not be set
beyond a reasonable cost.
The decision by the GDC
to go ahead with its fee rise
has meant that the BDA is
now looking to go to court
with the GDC and set about
a judicial review. They have
released a video explaining
the ins and outs of this judicial review and the outcomes they expect from this
very large decision they have
made. The BDA, of course,
depends on the income of its
DENTAL
members’ association fees
and so are calling for the
joining of more members
and even students to help
with the costs it will incur
as they await to go to court
with the GDC over the ARF
consultation. It is claimed
that the consultation was
botched and so KPMG were
commissioned to look over
its results, however, the paperwork behind this has not
been released. All these supposed misgivings, and the
behavior that the BDA has
described as unprofessional,
along with the numerous delays in the response to BDA
complaints and requests for
information, have meant
that the BDA has now fast
tracked its judicial hearing
in order to get a possible
turnaround before the ARF
fees are due in the new year.
Controversy such as this is
an example of politics in action and shows you just how
the actions taken by dental
organizations such as the
GDC, BDA and Dental Defense Union all have a say
against each other. It is important that you know what
each organization is doing
for you, and that you have
your own stance and opinion
over each legal proceeding
occurring in the professional dental world. If you do
not use your voice you may
have to make changes to
your practice without having your say on how this will
impact on you. You should
get involved from this point
onwards, and have a hand in
your future. To learn more
about the outcome of the judicial review and the BDA’s
progress, go to www.bda.
org. The results from this
enquiry will prove whether
the BDA can actually take
action when needed, and will
also show the direction our
lives as dentists will be taking in the next few of years.
Nov - Dec 2014
GKT Gazette
45
Dropped in at
the teeth end
Onkar Mudhar BDS1
T
aking a gap year, I expected to walk
into university feeling more revived
and relaxed than ever before. I hoped
I would be able to deal with the pressures
that university would throw at me through
the skills I learnt on a �gap yah’ (and no
I didn’t travel, or ride elephants in Asia).
Eight weeks in and I can say that although
I’m truly drained, I’m having the best time.
Being unsuccessful the п¬Ѓrst time I applied to
Dental School, I was forced to go through the
nightmare of the admissions process again
- sleepless nights preparing a personal statement, where trying to sell yourself without
sounding egocentric is quite possibly one the
hardest things I have ever done. Additionally,
retaking the UKCAT was another nightmare,
46
GKT Gazette
Nov - Dec 2014
looking blankly at a screen full of shapes and
forming a relationship between them was beyond me. Each of us must’ve once thought how
solving codes and matching shapes would
help us become good dentists? Little did we
know, we’d have to sit a Situational Judgment Test soon after the start of first year...
Fast forward to September 2014, I was
packing up the contents of my room and
moving into halls where, like most, I was
living on my �own’ for the first time. Freshers week was one big blur: countless names,
new rooms, dental jargon, and introductory lectures that seemed to go on forever.
What’s interesting, is that during my time at
school there were always certain subjects that
never really appealed to me. At dental school,
DENTAL
I’ve honestly been interested in what is being
taught. From anatomical systems to physiology, studying doesn’t seem to be as much of a
chore as it was during my A-Levels. Being able
to get on the clinics super early, around four
weeks into our п¬Ѓrst term, has also helped fuel
everyone’s ambition to succeed at the course.
Undoubtedly, meeting so many like-minded individuals has been one of the highlights. Everyone loves teeth and everything to do with them... just like me.
Additionally, we’re all closet nerds who’ve
been branded �the hardest working freshers yet’- a back handed compliment?!
Not only is Guy’s Campus in one of the best
locations but the facilities are outstanding, with some of the best teaching in the
world- and who can forget the amazing
coffee at Keats CafГ© in New Hunts House?
Although the workload is colossal, university
so far has taught me that there is more to life
than �studying’. A-levels made it seem that
nothing else existed except my four subject
options. Dentistry has thrown more material
at me in eight weeks than my entire two years
of A-levels, but the cheeky Wednesday afternoons off have helped show me that п¬Ѓrst year
is a crucial time to enjoy yourself, explore
different societies and get your head around
the process of being a student at university.
I wouldn’t change my freshers experience for
the world. King’s College is most definitely
the perfect balance of work and play, and although the lift journey to the Tower Lecture
Theatre is often busier than the Central Line
in rush hour, things can only get better...
Onkar’s fresher photos
Nov - Dec 2014
GKT Gazette
47
NURSING & MIDWIFERY
Wernicke’s and Korsakoff’s
explained
Em Johnson PGDip Adult Nursing (2nd Year)
You may not be familiar with either Wernicke’s or Korsakoff’s; and this is not unusual
– as despite (Wernicke’s in particular) being present in 2% of the general population
(Alzheimer's Society, 2012) they are both
relatively unknown conditions. Korsakoff
syndrome and Wernicke’s encephalopathy
are both brain conditions and are both associated with alcoholics or those consuming
significantly large amounts of alcohol over a
long period.
However, because both Wernicke’s and Korsakoff’s are conditions which respond positively to effective treatment intervention,
I feel it is important to raise awareness of
these to ensure people are treated. It is unacceptable to me that many diagnoses are only
made post-mortem. As an Adult Nursing
Student I have been surprised by the distinct
lack of awareness of both these conditions
within Nursing and Medicine on the wards. A
lack of knowledge and therefore the non-implementation of simple treatment or prophylaxis could lead to fatality.
What are Wernicke’s and Korsakoff’s?
Wernicke’s or Korsakoff’s are both brain
conditions which are caused by Thiamine
Deficiency which can be caused by alcohol
impacting on vitamin absorption and poor
dietary intake. As mentioned, both conditions are common in alcoholics; although
Wernicke’s can also be seen in people who
have suffered severe malnutrition with risk
factors for those with eating disorders, or
48
GKT Gazette
Nov - Dec 2014
people undergoing medical treatment like
dialysis or chemotherapy. One of the main
differentiation factors is the speed of onset
- the initial disorder of Wernicke's encephalopathy usually develops suddenly with Korsakoff's syndrome being more progressive..
In relative terms the factors causing the development of Wernicke's encephalopathy
and Korsakoff’s are simple to avoid and also
treat if damage has already occurred. These
conditions develop due to a deficiency of
vitamin B1 (Thiamine). There is strong evidence to support interventions to administer
high potency vitamins to those at risk, as a
way of reducing Korsakoff's syndrome within
the population, halting existing Korsakoff’s
progression, and reversing Wernicke's encephalopathy in its initial stages.
However, despite the causes of Korsakoff’s
being avoidable and treatment intervention
straightforward, it seems that its prevalence
is increasing as alcohol consumption goes up
and effective nutrition goes down. Diagnosis
is important as Korsakoff’s syndrome is often
mistaken for dementia due to it causing issues with short-term memory. The important
difference between Korsakoff’s and dementia
is that, unlike for example Alzheimer's disease, Korsakoff’s progression can in most
cases be halted with effective treatment.
This increase of both condition’s risk factors
means that more attention needs to be drawn
to them in order to avoid further develop-
SECTION
HISTORY
Abnormal hyperintense signal in the mesial dorsal thalami indicative of
Wernicke Encephalopathy. Photography courtesy of Wikipedia.
ment within the population. I recently spent
time on a Ward where a patient was being
given an Alcohol detox by a prescribing Physician with no awareness of the risks of either
condition. This patient was therefore not being given treatment to avoid developing these
conditions despite being a heavy drinker with
likely vitamin B deficiency due to poor diet. I
п¬Ѓnd this unacceptable and I hope to improve
awareness of both the conditions and interventions through my practice.
Disease Development
A lack of intake of Vitamin B1 (Thiamine)
can lead quickly to a deficiency as the human body itself cannot produce thiamine but
must ingest it through diet. Persons with adequate intake but high alcohol consumption
may still develop deficiency due to the way
alcohol prevents effective absorption. It is an
essential nutrient and is a required component of maintain function within the body; it
is required by all tissues but most observably
within the brain where damage is observed
within Korsakoff's. In particular B vitamins
are required for the nervous system to be effectively developed and maintained as well as
for the modification of pyruvate - which is a
by-product from the breakdown of carbohydrates, fats and amino acids in the body. A
lack of B vitamins allows for pyruvate to accumulate in the body and cell damage occurs.
B vitamin deficiency is linked to damage to
the medial thalamus, the posterior hypothalamus and reduction in overall brain size
(cerebral atrophy). The impact of neuronal
loss and damage overall can lead to Korsakoff’s syndrome and eventually death which
presents with slower onset than Wernicke's
encephalopathy.
Disease (Wernicke's Encephalopathy) is
more sudden in development although diagnosis is often missed due to poor symptom
expression. It is thought that only 10% of patients afflicted by Wernicke's exhibit all three
of the common features of eye muscle weakness, confusion, and uncoordinated movements from poor muscle control (Ataxia).
This poor expression means diagnosis is often missed although prophylactic treatment
with high dose thiamine to those in at risk
groups can be used to reverse its effects.
Nov - Dec 2014
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49
NURSING & MIDWIFERY
Preventing
One place where steps are being taken to
counteract development of Wernicke's Encephalopathy is Accident and Emergency.
It is thought that 20% percent of presentations to Accident and Emergency are alcohol
related so targeting of this population with
prophylactic administration of vitamins is
considered to be a positive step to reducing
future instances of both Wernicke's and Korsakoff’s.
If you were to take a wander through the Accident and Emergency Department any given
Saturday Night, you’d be forgiven for thinking we were secretly turning our drunken
attendees radioactive. Those attending A&E
alcohol intoxicated will be treated to a lurid
yellow intravenous infusion. This odd little
bag of (not so) mellow yellow is Pabrinex a yellow injectable drug used for correcting
severe depletion or malabsorption of Vitamins B and C. This is given in A&E as an intravenous infusion for those presenting with
severe alcohol intoxication or showing signs
of alcoholism. Pabrinex contains vitamins C
(ascorbic acid), B1 (thiamine), B2 (riboflavin), B3 (nicotinamide) and B6 (pyridoxine).
Pabrinex should also be prescribed as part of
Alcohol Detox programmes.
The administration of Pabrinex is relatively
cheap but may help to reduce development of
Wernicke’s and Korsakoff thereby saving not
only lives but the cost to the NHS of treating
these conditions. However, this is just one
small intervention which is only being given
to those attending A&E which means that
thousands of other at risk people are receiving no help or treatment at all.
I would urge all people within the health
and social care п¬Ѓelds to educate themselves
on Wernicke’s and Korsakoff’s and spread
awareness of these conditions. If you are
working with people who have alcohol issues
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or poor diet, encourage them to see their GP
with a view to getting vitamin supplements
including thiamine. It is a sad fact that many
health and social care workers shy away from
working with alcohol dependent patients
and feel there is nothing they can do to help
them. However, reducing someone’s risk of
developing serious brain injury is exactly the
opposite of nothing.
For more information:
http://www.alzheimers.org.uk/
https://www.drinkaware.co.uk/
NURSING & MIDWIFERY
Trade unions and
why we need them
Picket line outside of St Thomas’. Photo: Sam Evbuomwan
A
Amy Silver Adult Nursing Year 3
s sources begin to report that only
one in ten health care workers took
action during the planned walk out
on October 13th , unions are still as vital as
ever to give a voice to nurses and midwives.
But what are they and why do we need them?
What’s a Trade Union?
In a nut shell, a trade union consists of a
group of employees working together to
maintain and improve the quality of their
workplace, their pay and pensions, and support members to take industrial action, such
as the strikes and work-to-rule action seen
over the past few weeks. Trade unions support all sorts of public sector workers, including nurses and midwives. Currently, over 7
million people are members of unions.
At present, there are four predominant health
service unions for nurses and midwives; The
Royal College of Midwives, The Royal College of Nursing, Unison and Unite. All four
unions also support health care assistants,
porters, doctors and whomever else from the
health service wishes to join.
Why do I need a trade union?
All four of the unions mentioned above offer
legal advice and support. Although as a student, you are protected to an extent by the
university, it is always worth knowing that
there is access to support if you need it. Furthermore, some unions including the RCN,
offer indemnity insurance, which is essential
for undertaking your elective, as this allows
you to practice outside of your host trust.
TUs are committed to the improvement and
further education of their members; both the
RCN and the RCM offer e-learning portals
and access to journals in the terms of their
Nov - Dec 2014
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51
NURSING & MIDWIFERY
support campaigns such as those for safer
staffing levels; the overall aim is to provide a
safe and fair working world for all health care
professionals, so in turn we can deliver the
best possible care.
How do I decide which union to join?
All unions offer student memberships, which
can be renewed annually, so it really just
depends on what you are looking for from
a union. Browse their websites to п¬Ѓnd out
what each can offer. All hospitals will have an
RCN, RCM and Unison representative who
are always willing to talk about what they can
offer you when you join; furthermore, every
fresher’s week, all three unions visit universities to talk to students about membership
(and they bring great freebies too!).
The choice is yours; make your voice count!
Photo: Zoe Rodgers
membership, which can be invaluable when
you’ve got a tricky essay to write and you
can’t access something via the library. The
RCN also has four physical libraries located
around the country, including its newly renovated library in Cavendish Square, and the
RCM has a library in Sussex Place; both hold
a huge collection of journals and books.
As a union member, you are united with other members of your profession and therefore,
have a larger voice with which to speak out
on issues that affect your practice and- very
importantly- your livelihood. Pay and pensions remain two huge issues for health care
professionals, as has been shown this month
by the NHS walk out on the 13th October and
the �Britain Needs a Pay Rise’ rally on the
18th October, but unions will support and
advocate for its members to have safe working hours and conditions, protect them from
discrimination and unfair dismissal, and
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Nov - Dec 2014
GKT Gazette
53
BOOK REVIEWS
Book Review:
Alcohol and Health
Title: Alcohol and Health
Authors: Marsha Y Morgan and E.B. Ritson
ISBN: 978-0956355300
Price: ВЈ14.99
Reviewer: Maria Chicco MBBS4
A
�
lcohol and Health' by Marsha Y Morgan and E Bruce Ritson contains a
wealth of information, organised and
presented in a clear and structured manner,
that will come in handy to medical students
throughout their university years and beyond.
Chapters such as 'Alcohol, its Metabolism
and Consumption' will help pre-clinical students get their heads around Dr Paterson's
dreaded pharmacology lectures on the metabolism of alcohol and on the physical and
psychological effects expected at reference
alcohol blood concentrations.
One of the п¬Ѓrst clinical achievements and
rare moments of self-satisfaction for third
year medical students, freshly brought into
the wards from the comfort of the Greenwood, is to identify the physical symptoms
and signs of alcohol abuse. This, unfortunately, will lose its exciting novelty as soon
as students start spending more time on the
wards. Nevertheless, reading chapters such
as 'Alcohol-related physical harm' will facilitate that thrilling moment when students
п¬Ѓnally spot their п¬Ѓrst spider naevus.
Further down the line, 'Detection and assessment of Alcohol misuse' should provide
a useful tool for OSCEs and, in conjunction
with 'Management of Alcohol misuse', will
benefit the newly responsibility-stricken
Foundation doctor.
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Nov - Dec 2014
One of the book’s advantages is that it gathers information which would otherwise have
to be sought in different chapters from different books, thus potentially saving the reader
from spending a long day at the library, shuffling frantically through shelves.
The book's clearly-stated aim is to help medical students (as well as other healthcare professionals) master the subject; this objective
is consistently achieved. The authors include
a variety of illustrations, diagrams and appendices which in turn contain many resources and links, such as alcohol-screening
questionnaires and a section dealing specifically with legal aspects of alcohol consumption and abuse.
A bonus, which the artsy medical student will
not fail to appreciate, is the book's distinctive
cover: pictorial satirist William Hogarth's
engraving 'Gin Lane'. It represents a scene
from an 18th century gin-soaked alley, where
death and squalor are only too apparent. The
engraving constitutes an early attempt at
encouraging London's population to restrict
their favourite tipple's intake; prompting
them to drink beer instead (the 'Beer Lane'
engraving by the same author depicts, in fact,
a joyful and healthy population savouring
their pints of bitter): a surprising ancestor of
our current public health campaigns.
BOOK REVIEWS
Book Review:
Lecture Notes:
Dermatology
Title: Lecture Notes: Dermatology
Authors: Robin Graham-Brown and Tony Burns
ISBN: 978-1-4051-9571-3
Price: ВЈ24.99
Reviewer: Samuel Evbuomwan MBBS4
T
here is unlikely to be another specialty
that polarises medical students to the
extent that dermatology does. Whether they are ardent supporters of the п¬Ѓeld or
they struggle to differentiate between pemphigus and pemphigoid bullae, there is one
thing they do agree on; to truly grasp this
subject you need pictures!
This is something Lectures Notes: Dermatology provides in abundance. This textbook
displays the numerous and diverse conditions in colourful photographic glory. The
images allow the reader to understand the
ways in which dermatological conditions
present and appreciate the characteristic lesions these patients may suffer from.
The initial chapters of this text introduce the
basic anatomy and physiology of skin, hair
and nails. It then provides a clear approach
to investigating and diagnosing dermatological disease whilst outlining the various tools
the treating clinician may have at their disposal.
The chapters in this book comprehensively
cover many of the common skin conditions
from bacterial and viral infections, to cutaneous drug reactions; all of which have images
and illustrations to facilitate learning. The
standout sections on emergency dermatology
and skin and the psyche not only emphasise
the importance of detecting these conditions
early but also give the reader a greater insight
into the psychosocial burden dermatological
disease can have.
The case studies and multiple choice questions add particular value, not only do they
give the reader a chance to consolidate their
learning, but they also allow for greater understanding of the importance of a concise,
clinical approach to dermatology.
Lecture Notes: Dermatology goes far beyond
being just a picture book for the specialty, it
provides a guide to learning often quite difficult concepts and presents the most salient
points. This textbook is not only of benefit to
those trying to clarify the many lesions seen
in dermatology clinic but it is also for those
who require a concise, structured and holistic
approach to managing these patients.
Nov - Dec 2014
GKT Gazette
55
HISTORY
Ode
to
Keats
Nathan Hodson iBSc Medical Ethics and Law
I
t was a sunny spring day as I arrived at
Guy’s campus for my iBSc interview.
Walking from London Bridge through
campus to the Hodgkin Building I was
surprised to п¬Ѓnd a statue of a famous
poet. Coming from a small, new medical
school I saw the London medical schools
as amazing historic institutions, which had
produced centuries of great doctors. John
Keats is possibly Guys’ most famous past
student but he was never a great doctor, he didn’t even complete medical school.
Some weeks later, after receiving an invitation to study here and arranging accommodation in London, I was reminded of the statue of the young poet in the medical school. I
was googling Kanye West lyrics because, well,
do I need to explain? One reviewer had drawn
a comparison between Kanye’s professed addiction to money, girls and weed and Keats’
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GKT Gazette
Nov - Dec 2014
trinity. I’d never heard of this before but it
led me to his poem Give me women, wine and
snuff:
Give me women, wine, and snuff
Until I cry out “hold, enough!”
You may do so sans objection
Till the day of resurrection:
For, bless my beard, they aye shall be
My beloved Trinity.
Keats was a medical student when he
wrote this poem, it was before he dropped
out to focus on writing and having tuberculosis. Frozen in the typically pompous
Keatsian lines is some timeless truth about
life at medical school, sentiments I think
a lot of us would recognise. I can’t help but
imagine Keats scratching these words into
the soft wood of a battered desk, perhaps having just п¬Ѓnished the last exam
HISTORY
of the year, gazing out of the window into
the summer afternoon. The need to escape from work is something any medical
student can appreciate. His verse is just an
elongated sigh: “What a day. I need a drink.”
However, he’s not just talking about a quiet
one, he wasn’t a single pint kind of guy. In
a letter to his sister, Keats wrote “give me
books, fruit and wine” which doesn’t sound
like a night at Guys’ Bar, however he went
on to change his mind because “one is sure
to get into so
me mess before evening”: it’s gonna be a
messy one. In the poem Keats wants things to
get out of control, he has no objection to that.
He’s going hard tonight. This makes it
disconcerting that he employs such religious language: “resurrection”, “bless my
beard”, “trinity”. In this context it emphasises the fervour with which he is partying
and perhaps the regularity or routine to his
partaking of alcohol and snuff. However,
there’s another picture here. The broken
poet praying in the darkest pew at the back
of the church; sometimes religion is about
admitting brokenness or wanting to escape.
So what does he mean by “the day of resurrection”? Perhaps he’s suggesting he’ll drink
until he dies. Perhaps he hopes the women
will change him, resurrect something lost
in him. Or could it be that by “resurrection” he is referring to getting up, he’ll have
a good time, but when he has to get out of
bed the next morning he’ll just get on with
medical student life.
about medicine, dropping outafter completing his apothecary exams. When Keats cries
out for hedonic pleasure in this
poem he is asking for a break, for a change,
for an escape. This must be the only medical
school in the country where there are statues
and rooms dedicated to a man who was no
natural clinician or scientist and was never
really that interested in the subject. Keats
was a medical student who sometimes felt
down, sometimes didn’t really enjoy medicine, and sometimes just wanted to drink
and shag. His medical school experience is
not so far-removed from our own so I love
that he is forever to remain chillaxing on the
grass outside Boland House.
“When old age shall this generation waste,
Thou shalt remain, in midst of other woe
than ours,
A friend to man” (from Ode on a Grecian
Urn - Keats)
The difficulty in separating his outward
wildness from his internal wilderness is
what makes Keats a particularly interesting mascot for the medical school. Much of
Keats’ later poetry is infused by a profound
melancholy and many medical students
experience such dark times. He certainly doesn’t seem to have been passionate
Nov - Dec 2014
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57
HISTORY
Interview: St Thomas’
Christmas show cast 1973
Having found the program for the 1973 St Thomas’ Christmas Show, White
Tiles, in a box of Thomas Mans from the �70s, the GKT Gazette contacted Mr
Paul Baskerville and Dr Alan Maryon-Davis who kindly agreed to give current
Christmas Show producer Lucy Webb an interview about their time in the show.
Lucy Webb: Tell me a little about your
time at medical school and what you
do now.
Alan Maryon-Davis: I was a medical
student from 1965 to ’69 at St Thomas’
Hospital. I had done my preclinical at
Cambridge, and I did Christmas Shows all
the way through all of those years. The п¬Ѓrst
one was in ’65 and I kept on doing Christmas
Shows even after I qualified because I
enjoyed it hugely. Now, I’m basically semiretired. I was the Director of Public Health
for Southwark, and I’m currently honorary
professor of Public Health here at KCL. I give
my annual lecture to year 2 on Prevention
and I run an SSC on Medicine and the Media
for year 4.
Paul Baskerville: I’m much, much younger
than Alan, and I was at Thomas’ from April
’72, having done my preclinical at Oxford,
until beginning of ’75. I was in the Christmas
Show all those years, including White Tiles
[in 1973].
AMD: Great dancer, by the way.
nimble.
Very
PB: Thanks, Alan. And now I’m a vascular
surgeon and I’ve been working at King’s
College since 1988. I have just left my clinical
post there, six weeks ago, but I’m still working
in the West End as a private surgeon. I started
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GKT Gazette
Nov - Dec 2014
the day surgical programme at GKT and I
still go back there to teach on management
courses for people who are about to become
consultants.
LW:
Back in your time with the
Christmas Show, did either of you hold
any committee positions?
PB: Only in one. I was the director/producer/
semi-scriptwriter/semi-songwriter – the
hirer and п¬Ѓrer for White Tiles; for the others,
I was just a participant.
LW: Producer and director must have
been very stressful.
PB: I was doing obs and gobs at the time
so you sort of live round the clock really. It
was stressful in the sense that I was quite
old because I did languages before I did
medicine, and at that advanced age of 24, I
started smoking, so we can blame my lung
problems on the Christmas Show!
AMD: They would never give me the
producer job, because they knew it would all
fall to pieces if they did! They gave me the
producer job for the Summer Play, actually,
and I got as far as casting, and there we were,
reading the script as the set was being painted
behind us and suddenly the lead person
playing the key part in The Birthday Party
suddenly said �I’m sorry, I can’t go through
HISTORY
From left to right: Paul Baskerville, Lucy Webb and
Alan Maryon-Davis. Photo credit: Charlie Ding
with this, I’m going to
pack it in’ – �cos he just
got a job as a repetiteur
at Covent Garden!
Well, he’s now a worldfamous conductor, so I
gave him a bit of a step
up in his career. It did
mean the Summer Play
completely collapsed
and it’s never been
revived since! It was
very much an annual
tradition; went back
hundreds of years… But
anyway, all I did for the
Christmas Show was
to write a few sketches
and do a bit of acting.
I like comedy acting,
that was my forte, and
I did that for a long
time – until it became
indecent to be doing
it. Actually, the show
itself did become a bit
indecent – in the early
days, it was a good,
clean show you could
take your granny to;
it was very funny, but
there weren’t any nasty
words!
PB:
Well, we had
a censor. The week
before you were due
to start, we did a dress
rehearsal in front of
a censor, who was
appointed by the Dean,
and he had the right
to strike out whatever
he didn’t like. So you
made pretty sure that
you weren’t going to
Nov - Dec 2014
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59
HISTORY
cause huge offence – you were allowed to
take the p*ss out of senior consultants but
that was about it.
AMD:
The nearest we got was very
discreetly, with two characters having it away
behind a screen.
AMD: Mind the language. But yes, very
gentle stuff like that. It got much raunchier
after our time, but it was all good clean fun;
the other good thing about it was the music
was excellent as well. A lot of work went into
the band, and into the writing of the songs
and writing the tunes and the words of the
songs – it was really quite professional stuff.
PB: In White Tiles, we had exactly the same
thing; it was left to your imagination.
LW:
That’s fantastic because we
no longer have an orchestra; we do
everything using tracks as parodies. A
lot of the song numbers are still some
of our more popular sketches. I’ve got
to say, �good, clean fun’ has never quite
been my experience. Do you remember
any controversy happening?
PB: The only controversy I remember was
the title, calling it �white tiles’ because of the
then-new Thomas’ building covered in white
tiles – Gassiot House. People thought it was
the most disgusting building in the world,
and it was revolting to call the Christmas
Show after it – so our controversies were
slightly less.
AMD: I don’t think that there were any real
problems with the censor.
LW:
Nowadays, groups of third
year boys and girls perform a
choreographed dance for the audience
and it ends up being a comedic strip
tease – I’m not sure if you would have
gotten away with doing that?
AMD: We’re talking subtlety. It was all
understated.
PB: You’ve also got to be very good, if you’re
going to be blatant. If you look slightly
amateurish, it’s not going to work. I’m not
sure that I necessarily want to see my students
taking their clothes off, either. But if they’re
doing it in a way that’s funny, then of course
you’ve immediately turned the tables on it;
you’ve made it sharp and it’s okay.
AMD: It might be worth just mentioning
the show that has spawned – well, at least
one group – because I appeared in an early
show in 1965, as I mentioned, and two other
key members of that cast were Peter Christie
and David Barlow. We were all in the show
together, and at a New Year’s Eve party
[1966/67] and the cabaret act went down
with gastric flu, and the organisers were
desperate. So we put together a few numbers,
and we put on a little 20 minute cabaret at
New Year’s Eve. We all felt great of course,
and that would have been the end of it except
a girl came up to us afterwards and asked if
we could do her 21st birthday party! We put
the whole thing together again, and we called
ourselves Instant Sunshine – and we are still
together as a cabaret group to this very day.
We had a series on the BBC, been all around
the world, performed for the Royal Family…
all because of that Christmas Show!
LW: Yes, usually.
LW: You’ve clearly gone on to an
incredible amount of success with
them. How often do you still do shows?
PB: Well, we certainly wouldn’t have gotten
away with that.
AMD: We still do a show every п¬Ѓve or six
weeks, mainly around the Home Counties.
PB: Do they do the full Monty?
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Paul Baskerville (left) and Alan Maryon-Davis (right) with the “White Tiles”
soundtrack. Photo credit: Charlie Ding
And we still go up to the [Edinburgh] Fringe
every other year, which we have been doing
since 1975.
LW: And after the show, did you ever
get involved with anything else, Mr
Baskerville?
PB: It was the highlight of my whole life;
it’s been a complete downhill disaster ever
since. But no, I’ve never been involved since.
I eventually had to do some work.
LW: How long has it actually been
since you two last saw each other?
PB: Probably not for ten, twelve years?
AMD: Of course, we are in very different
worlds.
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61
HISTORY
LW: So to bring it back to the absolute
start: how did each of you п¬Ѓrst get
involved with the Christmas Show?
AMD: In October ’65, they had the Dean’s
Sherry Party and there was a fair amount of
sherry, and it just so happened that it was the
same evening that they were doing auditions
for the Christmas Show. I hadn’t considered
it at all because I hadn’t done any comedy
stuff. But I had had a drink, and somebody
said �go on, have a go’, and I was eventually
persuaded to go up to the audition room. I
did a good audition and they said �we’ll have
him’. I was in the chorus line in that first
year, and learnt to dance like Paul!
Dean, and at this stage, the Dean physically
signed the cheques for all of it. So I sat down,
and I said to the Dean, �Do you want a four in
the Visitors’ Cup at Henley or are you going
to give that up?’ And I got to leave straight
away! The answer to your question is, it was
several months to prepare it because it ran
for two weeks. How long’s your run for?
LW: We have three days – Wednesday
until Friday of the same week and a
matter of all hands on deck. For us it
tends to be that ten days before the start
of the show, without fail, everything
will go out of the window! Somehow
though, it either runs well on the night
or the audience are
too drunk to care!
PB:
I always like to
“Do they do the full
think I was headhunted
AMD:
I think they
for the Christmas Show
Monty?”
certainly laugh at the
because I’d done quite
mistakes, as well.
a bit of acting at school
“Yes, usually.”
and at Oxford. When I
LW: In your day, was it
came down to Thomas’,
more of a pantomime
I thought �I need to turn
“Well, we certainly
or sketches?
over a new leaf and start
wouldn’t have gotten
working without doing
AMD:
It used to
anything else’ but there
away with that.”
alternate.
were people who’d seen
me. I mean, they were
senior and so I didn’t have a choice, really – I PB: The pantomimes were great but they
could drag, although there was a theme
just got nominated and pushed in.
running through. It was easier to make a
LW: In terms of the lead up to the sketch work, because if it’s rubbish, you were
off in three minutes anyway.
show, how did it all work?
AMD: A lot of preparation went into it; the
whole autumn term wiped out, really. It was
really hard work – dance sequences, learning
new songs, learning the moves.
PB: We did very little medicine in those
days, you know, if you did the Christmas
Show and, like me, you did a sport [rowing]
and things…I was actually reported to the
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Nov - Dec 2014
LW: And how did rehearsals work?
PB: The band rehearsed separately in the
music rooms. Then we had lighting people,
and we knew a bit about lighting and a bit
about sound. And then you taught the next
generation as you went along.
AMD: The good thing about having a two-
HISTORY
week run was that it tightened up hugely as
you went through. As a performer, you also
began to know where the laughs were, so you
could pace it better, and you could react off
the audience a lot more, so by the time you
got to the last nightPB: -it was really, very sleek. It was one of
the most fun things that I’ve ever done on
stage, I think. They’ve got a huge auditorium
now, they actually do it at the Greenwood
Theatre.
AMD: Oh, that’s very big. Instant Sunshine
have played there.
LW: It’s about 450 per night, really.
PB: For our Christmas Show, at St Thomas’
Bar, 136 rings a bell. Well, the Bar wouldn’t
always close, which is really bad news
because you could hear the clink of glasses
within the auditorium, people falling over –
although they didn’t ever come in and spoil
the punchline!
LW: Nowadays we run the Christmas
Show as a subcommittee of the Medical
Students’ Association here, and all of
our profits go back to the GKT Raising
and Giving Society. Where did you
source money from, and where did the
profits go in those days?
PB: We had to pay the expenses – including
hiring in the lights and this and that – but
anything over and above that went to either
the Medical & Physical Society or maybe
Friends of St Thomas’. It did go to a charity,
for sure.
AMD: It’s a pity you can’t do a longer a run;
that’s a real shame because of the amount of
work that goes into it.
LW: I’m meant to be in A&E during the
Christmas Show so I’m trying to swap
all my shifts!
PB: Or else go and talk to the Dean!
AMD: I also think it has a wonderful
broadening effect. It moulds a more rounded
person as you can develop other sides to your
life – you become a much broader person,
and I think that’s terribly important.
PB: If you look at the people in White Tiles,
there are now п¬Ѓve professors, and most of
the rest are teaching hospital consultants –
they’ve all done extremely well in Medicine,
so taking a few weeks out doesn’t make a
huge amount of difference! You will certainly
remember this more than you remember the
Krebs cycle. You will look back on it and
think it was a great thing to do – you’ll get
dug out, in 41 years’ time.
LW: And п¬Ѓnally, do you have any
advice for this today’s Cast & Crew?
AMD: Enjoy it! Throw yourselves at
it wholeheartedly and thoroughly enjoy
yourselves.
PB: It’s perfect practice for a medical career.
You practice, practice, practice until you’re
really good – I think that summarizes the
medical career, really. I always saw it as very
good practice for what I spent the next forty
years doing.
AMD: And it’s all about teamwork!
PB: So have a great time!
LW: Mr Baskerville and Dr MaryonDavis, it was an absolute pleasure.
Nov - Dec 2014
GKT Gazette
63
HISTORY
Charles Granville Rob
of St.Thomas’
Hospital
Allyn May MD
I
n 1960 Charles Granville Rob, chief of
surgery at St. Mary’s Hospital, London,
agreed to assume the leadership of the
department of surgery of the University of
Rochester in the United States. During his
seventeen year tenure he proved to be an outstanding teacher, scientist, and leader. This
short biography is offered in gratitude to the
institutions and culture that fostered him.
Early Years
Charles Rob was born in 1913 in Weybridge,
his father, Joseph William Rob, was a general
practitioner who had trained at St. Thomas’s
Hospital. Charles matriculated at St. John’s
College, Cambridge, and completed his studies with honors in the Natural Sciences Tripos in 1934. During those years he learned to
fly in the Royal Air Force Reserve, ascended
many mountains of Europe as a member of
its Alpine and Climbers Clubs, and, to the
distress of college dignitaries, affixed on successive nights an umbrella, then a chamber
pot, to two high pinnacles of King’s College
Chapel.
St. Thomas’s Hospital
He went to St. Thomas’s Hospital for the
clinical phase of his medical studies. He
mentions little in his memoirs of the medical
curriculum, but instead records nonmedical
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GKT Gazette
Nov - Dec 2014
events, such as an attempt made by MI5 to
recruit him, seeing the destruction by п¬Ѓre
of the Crystal Palace, and giving emergency
assistance at a disaster in the underground
railway. In 1938 he began to train with the
surgeons of St. Thomas’s while London prepared for war (Figure 1). Of the first bombs to
fall, one struck St. Thomas’s Hospital three
days after war had been declared. Six members of staff died.
Before the Blitz had exhausted itself, St.
Thomas’s had come close to total destruction, but it remained open throughout the
war, and never ceased to have the confidence
of the people it served. On 4 May 1941, six
days before the Blitz ended, Charles met
Nurse Probationer Mary Dorothy Elaine Beazley, the girl he would marry. The marriage
cost Mary her position in the Nightingale
School of Nursing, but Charles was granted
permission to п¬Ѓnish his surgical training, the
first house officer to receive that privilege.
Parachutist in the Royal Army Medical Corps
From 1942, Charles Rob spent four years in
the Royal Army Medical Corps as a parachute
surgeon (Figure 2). His first “drop” in action
occurred in North Africa. In spite of an injury, he operated on 162 wounded soldiers,
earning the Military Cross. During a three
HISTORY
year period, he followed the frontline as it
moved up the Italian peninsula to Trieste.
St. Mary’s Hospital
After the war, St. Mary’s Hospital in London
invited him to become its chief of surgery.
Rob was among the п¬Ѓrst clinical scientists
to realize the nature of the gross anatomy of
atherosclerosis, that it caused disease as often by a local lesion as by a diffuse one. In
order to investigate the pathogenesis of atherosclerosis, he established St. Mary’s first
surgical research laboratory, and in order to
treat the disease, he founded a tissue bank
and a transplantation service.
On a round-the-world tour in 1952 he visited
the Peter Bent Brigham Hospital in Boston,
Massachusetts, where he performed as Visiting Professor and Surgeon-in-Chief. This experience brought him to the attention of the
Department of Surgery at the University of
Rochester, where he became chairman.
University of Rochester, New York
State, USA
He was a healthy influence on the University
of Rochester: By his example, not by edict,
he tightened discipline and punctuality, im-
Charles Rob, on the far side of the operating
table, working to accomplish an appendicectomy
during an air attack in St. Thomas’s “temporary”
wartime operating room.
proved the operating room, and inspired accomplishment in the clinic and laboratory.
In Rochester, Rob developed the term, Critical Arterial Stenosis, with a series of papers
correlating mathematically arterial blood
flow with arterial stenosis. He published an
operative technique by which the abdominal
aorta could be exposed without opening the
peritoneal cavity, anticipating peritoneoscopic surgery by decades.
Retirement
After he reached mandatory retirement
age he took positions at the North Carolina
School of Medicine (1978) and the Uniformed
Services University of the Health Sciences in
Bethesda, Maryland (1983). At those institutions he became a consistent source of good
advice, a model of humility, and the ultimate
raconteur. He died in 2001 of the effects of
his anathema, atherosclerosis.
(This article is based on a biography of
Charles Rob, “The Joyful Life of Charles
Granville Rob, Surgeon, Soldier, Scientist”,
Mustang, Oklahoma, Tate Publishing and
Enterprises, LLC, 2013)
Major Charles Granville Rob, RAMC
Nov - Dec 2014
GKT Gazette
65
Photo courtesy of Zoe Rodgers
Is the UKCAT really worth it?
Anna Harvey MBBS1
T
raditionally, university entrance required substantial volumes of upfront
funds. It has only been throughout the
twentieth century that this precedent has begun to be eroded to the system we have today,
with extensive options for funding. However,
there are still significant economic barriers to
applying for both the most competitive universities and courses – such as medicine and
dentistry – and the UKCAT is one of them.
The UK Clinical Aptitude Test is a cognitive
ability test consisting of п¬Ѓve separate sections, required for application to 23 of the
UK's 33 medical schools. The sections include
verbal, numerical, abstract and decision
analysis – each of which is designed to test
a particular cognitive skill. Verbal skills in-
66
GKT Gazette
Nov - Dec 2014
clude drawing conclusions from a paragraph;
the numerical section consists of simple, but
multi-step calculations. Abstract reasoning
involves choosing the next set of shapes in
the sequence, and decision analysis is most
similar to a 'code cracking' exercise. Each of
these is marked out of 900, with around 600
representing an average score. Newly introduced this year is the �situational judgement’
section, which tests your ability to respond
appropriately to scenarios, most of which will
have a medical slant, although one of mine
involved the most appropriate response to
accidentally killing a neighbour's cat. We appreciate that for many readers the UKCAT
occupies nothing more than a place in their
distant memory, so for understanding's sake
an example question from each section has
RESEARCH
been provided – the answers can be found at
the bottom of the page so have a go.
The University of Birmingham are the most
open with their rejection of the UKCAT, with
a medical admissions tutor telling the BMJ
the school felt there were “ethical problems
with asking candidates to pay for a test with
no proven worth1.” Students are charged
ВЈ65-80 for the privilege of taking a test without which you are limiting your application
choices significantly. Whilst there is a bursary scheme, an investigation revealed that this
option was laborious. It required an abundance of documentary evidence, and involved
very early application to be considered as a
candidate2. Although the test is cognitive, so
cannot be officially 'studied for,' according to
the UKCAT website, familiarising yourself
with question styles is useful. Two full-length
practice tests are available through the UKCAT website, but many candidates will use
additional resources – which will certainly
put them at an advantage. Having completed
both the free practice tests I still felt unprepared, and was lucky enough to have a preparation book bought for me. These books retail
at up to ВЈ30; add this to the cost of the test
and it quickly becomes a less than manageable expense for some. Websites which offer
�2000+ UKCAT Questions!!!’ appear above
the official UKCAT website when searching,
and these questions can only then be accessed via a bank transfer. A brief surf п¬Ѓnds
weeklong UKCAT technique courses costing
more than ВЈ500, which 'guarantee' a certain score across the sections. None of these
courses are approved by or affiliated with the
UKCAT consortium, yet still there is a market
for them, so students must be utilising them
as part of their preparations in order to secure as high a score as possible.
Supporters of the test argue that due to the
nature of the questions the UKCAT provides
more of a level playing п¬Ѓeld than A Level re-
sults. However, a study published in 2014
by the British Medical Council found that
UKCAT scores were statistically significantly higher amongst groups who also perform
better at A Level: hardly levelling the п¬Ѓeld
when both types of testing favour the same
set of people, in this case white males with
English as their п¬Ѓrst language3. This study
is particularly significant as it was a national
study using data from over 8000 candidates
who took the test during the 2009 admission
session, tracking their socioeconomic backgrounds in correlation to their overall and
sectional scores. Data published by UKCAT
consortium in 2014 states that the UKCAT
�modestly’ correlates to final year marks in
the п¬Ѓrst cohort to have taken the test as part
of their entrance criteria4. Furthermore,
there was no research performed on the reliability of the test's predictive mechanism before it was introduced; the п¬Ѓrst studies were
produced four years after the tests' debut in
2006 – one of the key reasons The University of Birmingham rejected the test in the
п¬Ѓrst place5. More recently, both Brighton
and Sussex Medical School and the University of Leeds have switched from using the
UKCAT to the BMAT, with a representative
from Leeds stating that the BMAT was more
'robust and transparent' in discriminating
between high ability candidates6.
So is the 'modest' predictive factor of this test
really worth the money it costs the student to
take it? Or is it just another disincentive to
students who are certainly intellectually, but
perhaps less so п¬Ѓnancially, able to secure a
place on one of the most competitive courses
in terms of applicant to placeholder ratios?
Having just spent ВЈ50 on a compulsory Disclosure and Barring Service check, another
unforeseen expense of studying medicine, I
am inclined to agree with the latter.
See overleaf for a mock-up of a UKCAT
question.
Nov - Dec 2014
GKT Gazette
67
RESEARCH
(Question В designed В by В Fi В Kirkham) В Abstract В Reasoning В Practice В В You В have В two В minutes В to В assess В the В sets В and В decide В which, В if В either, В the В test В shapes В belong В to: В В Set В A В В Set В B В В В В В В В В В В В В В В В В В В В В В В В В В В В 1. В 2. В 3. В В 4. В В В В В В В В В В В В В В В В В В В В В В В В В В В В В В В В В В В В В В В 1) Set В A В В 2) Set В B В В 3) Neither В 1) Set В A В В 2) Set В B В В 3) Neither В 1) Set В A В В 2) Set В B В В 3) Neither В 1) Set В A В В 2) Set В B В В 3) Neither В Answers: В Test В shape В 1: В Set В A; В Test В shape В 2: В Neither; В Test В shape В 3: В Set В B; В Test В shape В 4: В Set В A В В 68
GKT Gazette
Nov - Dec 2014
В RESEARCH
Going Live: Stillbirths under Scrutiny
Ellenor Richards & Alexandra von Guionneau MBBS1
2
.65 million stillbirths occur every year
across the globe1. As a pioneer in fetal
medicine, the fact that the UK came
32nd out of 35 European countries ranked by
their rate of stillbirth is alarming. In 2013,
there were 3,284 stillbirths in England and
Wales, putting the stillbirth rate for the UK at
around 1 in 200 of births3. A stillbirth defines
any birth after 24 weeks gestation when the
baby shows no signs of life. The most common
cause of stillbirth is placental inefficiency;
most often due to compromised uteroplacental circulation and placental hypoperfusion.
The former and latter can cause intrauterine
hypoxia, malnutrition, fetal growth restriction and other complications. The majority of
stillbirths occur in fully formed infants; it is
therefore essential that we identify novel and
more efficient ways to pick up potential signs
of stillbirths in utero. Presently, only 0.33%
of government research funding is invested
in stillbirth related research4.
Current NHS guidelines
Current NHS guidelines for antenatal fetal
monitoring relies primarily on the mother’s
own awareness of fetal movement, particularly during the later stages of pregnancy5.
If, during this time, mothers suspect reduced
fetal movement,
they are advised to
lie on their left side
for two hours. This
reduces pressure
on the uterine
artery, increasing
blood flow to the uterus. If ten fetal movements within this timeframe are not detected,
mothers are advised to contact their midwife
for further assessment and monitoring. The
use of Doppler scans is set out in the 2009
NICE guidelines for fetal monitoring, but
not as a routine assessment for low-risk
mothers6. Similarly, regular fetal movement
counting has not been recommended as routine for low-risk mothers.
Emerging techniques
Professor Jason Gardosi, director at the Perinatal Institute in Birmingham has developed
a 50p-per-pregnancy measure to help monitor the growth of a foetus, using an individually tailored growth chart. This method
has been taken up by several NHS trusts.
During assessments, a midwife uses a simple
tape-measure to calculate the size of the uterus and plots this data on the patient’s graph.
If foetus growth rate has slowed beyond
the expected boundaries estimated for each
baby, the mother is automatically scheduled
for a Doppler scan. A Doppler scan measures
blood flow between the placenta and fetus6.
On the BBC’s Panorama documentary, Professor Gardosi stated, “we are estimating
[that] if everybody picks up this fairly simple,
but
standardised,
evidence-based
method, we can save
1000 stillbirths each
year.”
Nov - Dec 2014
GKT Gazette
69
RESEARCH
Professor Kypros Nicolaides, widely described as the father of fetal medicine, has
pioneered a special methodology in detecting
stillbirths at King’s College Hospital. He offers three Doppler scans to all mothers at 12,
22 and 32 weeks. He told the BBC, “We have
demonstrated through extensive research,
that we can identify more than 90% of those
[potential stillbirth] cases from the 12th week
assessment.” In response to a question asking whether we can avoid more than 50%
of stillbirths in the UK, he replied, “I think
we can easily avoid them, and we can do so
through very simple adjustments in the way
we deliver antenatal care.” Supporting this
premise is Professor Basky Thilaganathan,
a consultant in fetal medicine, at St George’s
Hospital. Professor Thilaganathan maintains
that despite national guidelines indicating
Doppler scans should only be given to highrisk women, many placental failures occur in
apparently healthy pregnancies towards the
end of the gestational period7. Indeed, Professor Thilaganathan affords Doppler scans
to all п¬Ѓrst time mothers, at ВЈ15 per pregnancy
and explained in a BBC Panorama documentary that, “over the last two years, we’ve had
about a 50% drop in stillbirths.” He highlights the arduous task in proving that ultrasound-based interventions pertain to the
drop in stillbirths.
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GKT Gazette
October 2014
Professor Gordon Smith specialises in obstetrics and gynaecology at the University of
Cambridge. His work is part of a ВЈ12 million
pound government research grant and he believes that combining growth, Doppler and
blood tests, will result in being able to identify high-risk babies. Importantly, however, he
acknowledges that there are some 800,000
women giving birth every year in the UK and
the NHS is not going to fund a large-scale intervention that has not been clearly shown to
be safe and effective.
Tommy’s Charity
Looking further afield, and away from Doppler scans, Tommy’s Charity (est. 1992 by
obstetricians at St. Thomas’ Hospital) is currently conducting 18 research projects into
different aspects of stillbirths. Tommy’s aims
include identifying babies at risk to prevent
stillbirths, improve the understanding of the
causes in order to develop new diagnostic
tools and to better inform national guidelines2. A prominent project is focusing on the
use of sildenafil, more commonly known as
Viagra®, to improve fetal outcome in pregnancy. Mechanistically, sildenafil inhibits
phosphodiesterase type 5, thus enhancing
cyclic guanosine monophosphate (cGMP)
levels, ultimately leading to smooth muscle
relaxation and vasodilation8. Trials of this
drug have shown an increase in blood flow
RESEARCH
to the uterus in mice specially bred to exhibit symptoms similar to those experienced by
women suffering from pre-eclampsia and fetal growth restriction2. Furthermore, in vitro
tests on blood vessels taken from human placentae have also shown a marked improvement in blood flow. The use of sildenafil is
now being trialled on a small scale in Canada
to test its efficacy on severe fetal growth deficiencies.
Other studies include the use of MRI scanning to identify fetuses at risk of intrauterine
hypoxia. Currently, it is difficult for doctors
to tell how hypoxic the fetus is, so this test
could be particularly useful2 . Further, in
the AFFIRM study, investigators are testing
whether introducing a package of care for
women with reduced fetal movements can
decrease the incidence of stillbirth2. The
package of care includes educating pregnant women to improve their awareness of
fetal movements and encourage reporting
of any reduced movements2. A standardised
management plan for identification of placental insufficiency with timely delivery in
confirmed cases will then follow. A similar
package was recently introduced in Norway,
with a reduction in stillbirth frequency by
30%2. However, the efficacy of this intervention has not been robustly established in
a randomised trial. As part of the Tommy’s
Charity funding, hospitals in the UK will be
randomised to the timing of introduction of
this care package.
Discomforting prospect?
As was highlighted by Professor Basky
Thilaganathan and Professor Gordon Smith,
promising new methods may very well be the
reason stillbirth rates are dropping in some
UK clinics. The crux of the UK’s stillbirth
issue appears to lie in the paucity of data to
back up these developments. Recently, data
suggesting that Doppler scans afforded to all
women at multiple gestational points, and
not just at-risk mothers is effective, has been
submitted to the Department of Health for
review. Parents may п¬Ѓnd it discomforting to
п¬Ѓnd that although we have data to support
these interventions, the NHS is slow to accept them. The NHS can be sluggish to adapt
to new techniques; evidence-driven medicine
is how British medicine functions and we
can have confidence that the most effective
treatment plans will be rolled out to pregnant
women in the near future.
References:
1. Bhutta, Z. A. et al. Stillbirths: what difference can we make and at what cost? Lancet 377, 1523–38 (2011).
2. Research into stillbirth - Tommy’s. at <http://www.tommys.org/researchintostillbirth> Accessed: 26/10/14
3. Births in England and Wales - Office for National Statistics. at <http://www.wwl.nhs.uk/Library/FOI/Requests/2012_2013/
October_2012/1398_GuidelineObs21_Antenatal_Fetal_Monitoring.pdf Accessed: 22/10/14
4. Interview with Dr Alex Heazell, Director of the Tommy's Stillbirth Research Centre - Tommy's. at <http://www.tommys.
org/research/research-centres-and-teams/interview-with-dr-alex-heazell-director-of-the-tommys-stillbirth-research-centre> Accessed: 22/10/14
5. Davies, J. Antenatal Foetal Monitoring Guidelines Wrightington, Wigan and Leigh NHS trust <http://www.wwl.nhs.uk/
Library/FOI/Requests/2012_2013/October_2012/1398_GuidelineObs21_Antenatal_Fetal_Monitoring.pdf> Accessed:
22/10/14
6. NICE 2009 Guidelines http://pathways.nice.org.uk/pathways/antenatal-care/routine-care-for-all-pregnant-women#content=view-node%3Anodes-antenatal-interventions-not-routinely-recommended Accessed: 22/10/14
7. BBC Panorama "Born Asleep". Accessed 26/10/14
8. Webb, D.J. et al. Sildenafil citrate and blood-pressure-lowering drugs American Journal of Cardiology 4;83(5A):21C28C (1999)
Nov - Dec 2014
GKT Gazette
71
CAREERS
Palliative Care:
“Isn’t that just to do
with dying people?”
Sky Liu iBSc
Dame Cicely Saunders- Founder of the
hospice movement
T
he dreaded “What is Palliative
Care?” is a question uttered by
many,and is one which makes us
think of the feathery hands of the elderly and the compassionate gaze of the nurse
as she leans over to administer that п¬Ѓnal dose of morphine. In reality, however,
how often does this actually happen? The
NHS medical careers site lists symptom
control and effective management of the
psychological and spiritual aspects of patient
care as Palliative Care’s main aims. This extends to offering a support system to help patients live as actively as possible until death,
whether that be at home or in the hospital, a
s well as helping family cope during illness
and bereavement. As it is a niche speciality, Palliative care specialists are likely to
have a high level of autonomy and can be
involved in a variety of different tasks, such
as carrying out п¬Ѓrst assessments of a patient,
providing teaching and implementing var-
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GKT Gazette
Nov - Dec 2014
ious clinical applications; common procedures include pleural aspiration and parac
entesis (sampling of peritoneal fluid).
With between 69 and 82% of those who die
in need of Palliative care, it is no surprise
therefore, that this once overlooked area of
Medicine is rapidly expanding to include
equality of access across all regions, in addition to provision of services for those with
incurable or chronic illnesses. The commitment to providing adequate Palliative care
education in the undergraduate course has
also become a priority in many European
countries where Palliative Care is quickly developing. A medical school in Navarra, Spain recently recounted its experience
of introducing an optional Palliative Care
module into its curriculum amongst students. The overall experience was positive
and students highlighted how learning about
Palliative Medicine helped them to explore
CAREERS
humanistic aspects of their practice and become better doctors. Students found that the
knowledge and skills acquired would be applicable to all patients, even if they were not
looking for a career in Palliative Medicine.
With that said, for those who are interested
in a Palliative Care career, what comes next?
The standard postgraduate training pathway requires a switch to Palliative Medicine
training two years after core medical training
or an acute care common stem in acute medicine, GP anaesthetics or surgery.The route
through General Practice involves starting
Palliative Care training during years 4-7, depending on the nature of the post. For those
interested in working abroad, it is possible
to organise electives in developing countries
like Tanzania, where life-threatening illnesses such as AIDS are rife and often under
treated. A placement like this will offer valuable insight into how the UK model of Palli
ative Care can be effectively adapted to specific traditions, belief and cultures- all of which
vary between communities and countries.
If you would like to п¬Ѓnd out more about Palliative Care, the Cicely Saunders Institute
and Royal Society of Medicine regularly hold
an array of specialist talks and workshops,
which are usually free and explore Palliative
Medicine from a range of different perspectives. Local hospices are also good places to
look at if you’re looking for clinical shadowing or long term volunteering opportunities,
both of which can be invaluable for learning
about what Palliative Care involves on a day
to day basis. These can take place in a clinical
setting or within the wider community,
for
example
in
patient’s
homes.
Changing demographic and societal needs
mean that Palliative Medicine is becoming
more and more necessary in providing holistic care to all patients. However, even if this
isn’t your future career path, there are still
many essential skills and learning opportunities that can be attained through exploring this very niche but growing speciality.
The GKT Gazette
Invites Companies to Use Our
Advertising Space
For more information, contact
[email protected]
Nov - Dec 2014
GKT Gazette
73
SPORTS
GKT Mens 2nd XV Continue Their
Impressive Start to the Season
GKT 2nds 29-7 Kent 4ths
Phil Mitchell Biomedical Science (3rd Year)
T
he п¬Ѓrst BUCS home game of the season saw the GKT 2nd XV taking on
Kent 4ths at Berrylands. Given the
game was at Berrylands to call it a 'home'
game is perhaps a bit of a stretch, however the boys all made it, eventually. The new
kit seemingly painted on and the warm
up complete the referee spent the briefing spelling out that he might mistakes,
74
GKT Gazette
Nov - Dec 2014
instilling confidence in all those listening.
GKT kicked off and immediately J Jones
clobbered Kent’s man with a hit felt in Aberystwyth, forcing an early scrum. Guys
were soon on the scoreboard after some
good work by the forwards secured quick
ball and after a couple more phases, J Jones
crashed through the Kent lines to score.
SPORTS
GKT continued to create overlaps and line
breaks with a variety of offloads and direct
running. Having seen a number of opportunities spoilt by forward passes or knock-ons
the blue and gold п¬Ѓnally made one stick with
A Macfarlane putting the ball down in the
corner after some quick hands: the touchline conversion duly made by S James. The
one way traffic continued with any move
the opposition tried stopped by some unforgiving hitting from the centre pairing of
Macfarlane and Herry. One п¬Ѓnal score was
the least the boys deserved, Jones again running a good support line to go in behind the
posts unopposed. S James kicked the conversion to make it 19-0 to GKT at the interval.
The 2nd half saw much more pressure on
the GKT try line as the opposition readjusted
their compasses and began to run better lines.
The referee also began to ping GKT at the
rucks, the mauls and generally with alarming
regularity. While there is no doubt the GKT
loose forwards, infamous proponents of the
dark arts of the breakdown, were at work, the
feeling was a number of these calls were a little harsh/mistaken. The eventual reasoning
in the 75th minute from the referee was 'you
have five scores so it doesn't really matter’.
Undeterred, GKT managed to put another
score on the board, with P Pritchard rumbling over. After good phase play Kent then
got their one score leaving the boys feeling a little aggrieved they had spurned the
clean sheet. Straight back up the other end
they went with A Macfarlane eventually going over in the corner again after more good
hands and rucking. GKT kept pushing for
another; Jones went close for his hat trick
only for it to be disallowed for a double
movement. J Branagan also had a score disallowed for a knock-on that went backwards.
This was another dominant performance by
the 2s and the margin of victory could have
been double had the countless opportunities
in the п¬Ѓrst half been put away. The 2s are as yet
unbeaten this season and with the strength
of the current squad, long may it continue.
Trys. Al MacFarlane (2), Jolyon Jones (2),
Pete Pritchard
Conversions. Stuart James (2)
Photograph Sachin Sharma
  1st  XV  BUCs  South  Eastern  2B  Queen  Marys  1sts    19-­‐19    GKT  1sts  GKT  1sts    12-­‐51    UCL  1sts  Canterbury  Christchurch  1sts    32-­‐31    GKT  1sts   Friendlies  Cambridge  U21s  1sts  43-­‐21  GKT  1sts    2nd  XV  Kentmet  Bishops  Finger  League  Beckenham  5ths     22-­‐24    GKT  2nds  GKT  2nds    39-­‐7    Old  Alleynians  5ths  Shooters  Hill  2nds    3-­‐52    GKT  2nds  GKT  2nds    62-­‐10    Westcombe  Park  Gents   BUCS  South  Eastern  5B  University  of  Essex  2nds    8-­‐15    GKT  2nds  GKT  2nds    29-­‐7    University  of  Kent  4ths     Nov - Dec 2014
GKT Gazette
75
SPORTS
Decent Start to the Season for
the GKT Ladies 1st Team
Josie Hogge & Alys Bowen MBBS3
GKT Ladies 2nds
GKT Ladies 2nds 2-2 RVC 1s
GKT Ladies 1s
10-0 St Mary’s 1s
F
or the п¬Ѓrst match of the season the
GKT Ladies 1st team were playing St
Mary’s, the team that moved down
from the league above at the end of last year.
Having never played them before, and with
the knowledge that they used to be in the
league above, GKT thought they had a tough
match ahead of them, even with the new addition of this year’s incredible freshers.
The match started quickly, and within minutes things were looking far better than expected as GKT went 2-0 up. With our solid
four defenders at the back, the one break that
St Mary’s had was quickly repulsed and once
again GKT were on the attack.
By half time GKT had a massive lead of 5-0.
Trying not to think about the score to avoid
complacency, GKT took to the pitch after a
half time chat encouraging everyone to continue as they had started. The second half
progressed as hoped; goals were being scored
left, right and centre, but only by GKT.
When the full time whistle went it was 10-0
to us: an amazing start to the season. The official goal tally is: Laura (2), Alex (2), Lauren
F (2), Gabby (1), Jess (3)
76
GKT Gazette
Nov - Dec 2014
T
he 2nds п¬Ѓrst home game saw the team
continue their excellent start to this
season, with some competitive hockey. With most of the play being in the GKT
half, RVC initially appeared to be the ones
putting on the pressure and testing our defence. With a moment of genius though, it
was GKT who took the п¬Ѓrst goal, scored by
Charlie Devine from a short corner. Despite
being 1-0 up we took our foot off the pedal
slightly, and 2 goals from RVC brought them
swiftly back into the game.
After some orange slices and moving words
at half time we came back to level the score at
2-2, following some fantastic work from Izzi
and TP, and a diving reverse goal from Charlie Devine. Everyone got their heads back
into the game and really stepped up their
performances during the second half with
some great defensive work, successfully defending 10 short corners! Particular mention
goes to Kathy and Becky, the latter playing
in only her second ever hockey match, not to
mention some fantastic saves from our very
own goalie, Nicky. Although forwards, Livvy
and TP tested the Vets’ goalie, and we were
unlucky to not sneak another goal past her;
the game п¬Ѓnished with a fair result of 2-2.
Goals: Charlier Devine (2)
Photo courtesy of Josie Hogge
SPORTS
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SPORTS
United Hospitals 7s
Cup 2014
James Hatfield Biomedical Science 3rd Year
S
unday October 12th saw this year’s UH
7s take place, out of season as usual. As
the best 7s players, and some others,
from each of London's medical schools made
their way towards Teddington (an interesting journey due to a lack of running trains,
another annual occurrence), GKT players
were performing their pre-tournament routine of dropping out. A depleted squad arrived at the ground shortly before the п¬Ѓrst
match was due to start. However, after a
few late-comers showed up, two (nearly) full
squads could be put together.
And so the matches began. It wasn't long before the GKT captains came under scrutiny.
Having been absent from the latter stages of
the tournament for the past few years, suspicion was aroused when both GKT teams
started demolishing opponents left, right and
centre. However, having proven to the judges that they hadn’t recruited New Zealand’s
78
GKT Gazette
Nov - Dec 2014
entire 7s team, the second team were allowed
to play on, and the heavily beaten opposition
were told to grow up and accept the fact that
they lost. The 2s eased past Imperial Medics
2s, George's 2s and Bart's 1s, putting serious
points past each of them. This set up a decider with RUMS 1s to see who topped the
group. With both teams unbeaten, and impressively so, this was sure to be a belter.
Meanwhile, in the other group, the 1st team
were making things look easy. Having had
a typically slow start, conceding two tries to
George's 1s in the п¬Ѓrst half, the dream team
started to click. The second half was a different story, with GKT running in two tries of
their own to level the match. With the п¬Ѓnal
play of the match, clear instructions were given to just get the ball to Harry Davis. Harry
got the ball.... Harry ran.... Harry scored.....
GKT won.
SPORTS
From there, there was no looking back. Bart's
2s (61-0), RUMS 2s and Imperial Medics 1s
(31-0) were all comprehensively thrashed by
a GKT team playing some impressive rugby.
GKT 1st team topped the group convincingly,
and waited to п¬Ѓnd out their opponents for the
semi п¬Ѓnals. A hard-fought match ended in
defeat for the second team, allowing RUMS
1s to top the other group. However, this did
set up a showdown between the two GKT
teams. With fatigue setting in, both teams
pushed hard with the prize of a place in the
п¬Ѓnal up for grabs. The п¬Ѓrst team were eventual winners by three tries to one, but high
praise has to go to the second team for an impressive performance.
standing organisation and п¬Ѓtness. The opposition were able to call on rested players from
their 12 man squad, whilst GKT, having started with a squad of 10, were down to 9 players for the п¬Ѓnal match. RUMS' unbreakable
defence and unanswerable pace meant that
they pulled clear inside the п¬Ѓrst half. There
was no let-up in the second half, although
GKT did pull a try back to ensure the score
remained respectable. RUMS were worthy
winners, but GKT should be pleased with
2nd place, and very proud to have displayed
such a high standard of rugby throughout the
day. This can only leave GKT confident of a
successful season, especially in the 15-a-side
UH Cup.
For the п¬Ѓrst time in many years, GKT had a
team in the п¬Ѓnal of UH 7s. RUMS 1s eased
through the other semi-п¬Ѓnal to take the other
spot. This test proved to be too much for the
team from GKT, with RUMS showing out-
Photograph of courtesy Isaac Parker
Nov - Dec 2014
GKT Gazette
79
SPORTS
Determination and intuition
take GKTWRFC to their п¬Ѓrst
victory of the season
Kriszti SzГЎntГі MBBS1
O
the opposition into a marginal lead but this
did not stop our defence, who held off many
last minute attempts at a try before the sound
of the whistle, marking the end of п¬Ѓrst half.
The п¬Ѓrst half saw GKTWRFC off to a very
good start, with Katie Harries (3) scoring a
try just minutes after kick-off. From the outset, the home team’s attack meant Kent were
unable to even cross the halfway line. Spirits
were high from the outset of the game and
led to dynamic and fast-paced play. Our try
was quickly followed by one from the opposition which they converted. A penalty kick put
In the second half the lines of the opposing
team were already a little broken, as a result
of them losing a few players due to injury.
Malaika Atim (10) took advantage of this and
went on to score another try just under the
goalpost, followed by a fantastic conversion
by our novice kicker, Kimberly Welsh (8).
Kent visibly put their every remaining drop
of energy into their second attempt at scoring another try, which was beautifully heldup by our defensive line. When the last п¬Ѓve
n a relatively sunny Wednesday afternoon, GKT Women’s rugby won their
п¬Ѓrst match of the season, against Kent
University Women’s Rugby with a score of
17-10 in a home game at our very own Honor
Oak Park training grounds.
80
GKT Gazette
Nov - Dec 2014
SPORTS
GKTWRFC. Photo courtesy of a kind member of Kent University WRFC
minutes was announced, GKT made a last
march with the forwards powering through
with the ball, which was rapidly passed to the
agile and speedy Sophie Hughes (12). Having
waited eagerly on the side lines, Sophie put in
some great work in the second half, scoring a
beautiful try jut under the goalposts, minutes
before the referee sounded the whistle.
This game was mainly that of the forwards
although the backs fended off some attacks
brilliantly. Excellent tackles were made by
some of our most novice players, including
our new winger, Sims Bagary (14), pushing
some weighty players out into the touchline.
With little to no injuries and such a magnif-
icent score, this match was definitely a great
one, especially taking into account that the
majority of our players were in fact freshers,
with only one or two matches behind them.
Tries: Katie Harries (1), Malaika Atim (1),
Sophie Huges (1)
Conversions: Kimberly Welsh (1)
Player of the match: Rochelle Findley,
Malaika Atim
Nov - Dec 2014
GKT Gazette
81
Photo courtesy of Sachin Sharma
GKT Hockey Men’s 1st team
win season opener vs Chichester 1s 3-4
Sachin Sharma MBBS4
T
he BUCS game of the season saw a
clash of epic proportions between
Chichester and GKT. Chichester, yet
to take a point away from a п¬Ѓxture, would
do anything to win. GKT wanted to taste the
sweet nectar of glory for the п¬Ѓrst time in 1A.
Which team would prevail? Only time and
fate could decide.
The match began with what ensued being
nothing short of warfare. GKT took an early lead with a sumptuous п¬Ѓnish from Geoff.
Chichester, however, did not so much as wait
for the dust to settle on their beaten keeper's
pads before they responded in kind, bringing
the scores level. As the game progressed, so
did the barrage of abuse from both sides. But
amidst the chaos a light still shone through
and GKT once again pulled ahead. On the
stroke of half time, Chichester were awarded
a short corner and, alas, this offensive play
proved one too many for our valiant defence
to withstand. At half time, there was nothing
to separate the two sides.
82
GKT Gazette
Nov - Dec 2014
The second half was much the same as the
first. Tempers flared, and shots of green and
yellow were п¬Ѓred with no remorse from the
umpires. A further goal came to both sides
from their struggle against each other, bringing the score to 3 goals a-piece. In the п¬Ѓnal
10 minutes there was still no way of telling
which way the game would go. After some
skilled playing the sound of the ball hitting
the backboard was like music to our ears;
GKT now had the lead. Surely the match
was won? In a frantic frenzy, GKT lost two
men to yellow cards and had to face the п¬Ѓnal
few minutes with just nine men. The whistle blew, but not for the end of play: for a
short corner for Chichester. The п¬Ѓnal whistle
sounded; it was the end of the п¬Ѓrst half again.
History would surely repeat itself? But the
GKT defence did not accept fate's offering.
They fought to repel the Chichester attack
and held their lines: the battle had been won.
It may not have been pretty, but GKT had
come away as victors.
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Nov - Dec 2014
GKT Gazette
83
SPORTS
In memoriam:
LSE Men’s
Rugby Club
LSE MEN’S
R.F.C.
Who cares? - 2014
Phil Mitchell Biomedical Science (3rd Year)
I
t is with mixed emotions that we announce the passing of the LSE Men’s
Rugby Club after years of moderate success on the п¬Ѓeld, and apparently a lack of
tack off it. Its passing was sudden and entirely self-inflicted; a leaflet distributed at the
Freshers Fair caused the club to come down
with a sharp bout of �sexist banteritis’. The
infection was traced to a number of passages
in the leaflet which were, without exception,
sexist and misogynistic. When nobody in the
club showed the good grace and decency to
come forward and accept responsibility, the
students put the entire club out of its miserable existence.
This is not the п¬Ѓrst time that the club has been
sick(-ening), as previous bouts of �racist banteritis’ and �urinatus publicus’ show. At GKT
we have long known that the LSE rugby club
men are questionable characters after the attack on the Strand buildings in 2005 caused
84
GKT Gazette
Nov - Dec 2014
ВЈ30,000 worth of damage. It is, therefore, of
some relief that the passing of this institution
was actually quite painful; they cost their
athletics club a ВЈ22,000 KPMG sponsorship
deal. Following the withdrawal of п¬Ѓnancial
support the accountancy firm said “diversity
and inclusion is an issue which KPMG treats
with paramount importance”.
While the club will miraculously resurrect itself in only 12 months, it does leave behind
a �two-fixture-shaped hole’ in the GKT 1st
XV’s season, representative of 6 points and a
healthy points tally.
P.S. Imperial College Men’s Rugby Club
seem to have caught �nakednus publicus’, a
different strain of LSEs disorder this term
as they abandoned all decency (and many
of their clothes) on the District Line during
rush hour. We will keep you updated on their
progress.
SPORTS
Scans of the LSE Rugby
Purple Warrior via Roar News
Nov - Dec 2014
GKT Gazette
85
SPORTS
A scan of the LSE Purple Warrior (via Roar News)
86
GKT Gazette
Nov - Dec 2014
The Gazette Team
Joshua Getty
Deputy Editor
History Editor
Lewis Moore
Deputy Editor
Arts & Culture
Anya Suppermpool
Layout Editor
Kriszti SzГЎntГі
News Editor
Ajay Shah
Research Editor
Pippasha Khan
Dental Editor
Matilda Esan
Careers Editor
Abi Walker-Jacobs
News Editor
Phil Mitchell
Sports Editor
Ellis Onwordi
Features Editor
Hannah Asante
Advertising Officer
Nayaab Abdul Kader
Merchandise Officer
Zoe Rodgers
Photography
Sam Evbuomwan
Book Reviews
Sky Liu
Staff Writer
Rebecca Trenear
Staff Writer
Charlie Ding
Photography
Melissa Hartley
Layout Staff
Simon Cleary
News & Layout
Amy Silver
Nursing & Midwifery
Editor
With special thanks to:
Alexandra von Guionneau - Contributing Writer
Allyn May - Contributing Writer
Alys Bowen - Contributing Writer
Anna Harvey - Contributing Writer
Denis Cobell - Contributing Writer
Ellenor Richards - Contributing Writer
Em Johnson - Contributing Writer
Fahad Malik - Contributing Writer
James Hatfield - Contributing Writer
Josie Hogge - Contributing Writer
Maria Chicco - Contributing Writer
Mayowa Oyesanya - Contributing Writer
Nathan Hodson - Contributing Writer
Onkar Mudhar - Contributing Writer
Rolake Segun-Ojo - Contributing Writer
Sachin Sharma - Contributing Writer
Sarah Cleary - Contributing Writer
Sneha Baljekar - Contributing Writer
Thomas Bowhay - Contributing Writer
Profs Challacombe and Reynolds - Trustees
Margaret Whatley - Administrative Support
William Edwards - For Assistance and guidance
Many thanks also to King’s College London and
our other donors for their generous support
The Guy’s, King’s College
& St Thomas’ Hospitals
(GKT) Gazette
Volume: 128
Issue: 4
ISSN 0017-5870
gktgazette.org.uk
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Photos courtesy of Charlie Ding

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