Coca Cola | Time Capsule Log 💊

I hope you’ve all enjoyed the Six-Word Stories I’ve been putting out! I’m now beginning a new segment called “Time Capsule Log”, which I’m extremely excited about. I’ll be exploring inventions & breakthroughs with weird origin stories, whether it be failed pharmaceutical drugs eventually fated for non-clinical use or accidental products that have ended up medically successful. Curiosity is one of the great virtues of mankind, and it just goes to show purpose doesn’t have to be born out of intention. Alrighty, enough introduction – onto the fun!

The History of Coca-Cola

What? Coca-Cola was initially formulated as a cure for morphine addiction. What!?

Who? John Pemberton was a pharmacist and “the most noted physician Atlanta ever had” according to Atlanta newspapers1, but he was also a Confederate veteran of the Civil War.

John_Pemberton.jpg
John Pemberton. Source: https://en.wikipedia.org/wiki/John_Pemberton

Why? He was almost killed fighting in the Battle of Columbus in April 1865, and with his background as a pharmacist, his access to morphine and need to appease the pain from his war injuries lead to a strong morphine addiction2.

How? In 1884, Pemberton began experimenting to create opium-free medication as an attempt to cure his addiction, and along the way, another doctor claimed coca (cocaine) had the ability to do so. Thus, Pemberton devised “French Wine Coca”, a concoction containing coca leaves, caffeine-containing kola nuts, and wine. The product was advertised dramatically as seen on the label below (well I’ll be; it cures heart disease!). However, the city of Atlanta enacted legislation bringing about local prohibition in 1886, and Pemberton was forced to remove the alcoholic element from his formula, despite selling it as a medicine. Thus, he had to revise his to-be popular beverage by using sugar syrup to replace the wine’s sweetness and carbonating the mixture, eventually marketing it as the Coca-Cola we all know and love today. This new drink was advertised as “delicious, exhilarating, refreshing and invigorating” whilst retaining “the valuable tonic and nerve stimulant properties of the coca plant and cola nuts.” The cocaine ingredient persisted, however, only until the beginning of the 1900s because a series of stories spread throughout the South that black men were getting high on cocaine before raping white women (yikes!)3.

In such devastating irony, despite claims made about Coca-Cola’s restorative powers, Pemberton remained addicted to morphine; he never realised the long-potential of the beverage he created, slowly selling off the company in pieces to various partners before dying of stomach cancer in 1888.4 It is said that on the day of Pemberton’s funeral, the owners of all the drug stores in Atlanta attended the services as a tribute of respect, and “not one drop of Coca-Cola was dispensed in the entire city.”5

I’ve always admired how Coca-Cola holds these joyful campaigns that celebrate authentic, genuine moments in life. Perhaps Pemberton couldn’t cure his own morphine addiction, but he created something pretty beautiful out of it. Lest we forget, let’s clink together a couple of Cokes and say cheers.

Sources:

1: http://www.georgiaencyclopedia.org/articles/business-economy/john-stith-pemberton-1831-1888

2, 3: https://books.google.co.th/books?id=dFRd2MMrtiUC&pg=PA152&lpg=PA152&redir_esc=y&hl=en#v=onepage&q&f=false

4: https://www.amazon.com/God-Country-Coca-Cola-Mark-Pendergrast/dp/0465054684/ref=sr_1_1?s=books&ie=UTF8&qid=1388434759&sr=1-1&keywords=0465054684&tag=bisafetynet-20

5: http://www.georgiaencyclopedia.org/articles/business-economy/john-stith-pemberton-1831-1888

©TMK

I Wore A Heart Monitor For 24 Hours

Spoiler: I’m okay for now.

Approximately three weeks ago, I went for my regular health-checkup routine. There was nothing spectacularly negative about my results – my total cholesterol level increased compared to last year, but it was due to an elevation in good ol’ HDL; my TSH level was 1.960 uIU/mL, smack-bam in the middle of the hospital’s normal range; my hematocrit percentage, usually presented with a taunting “L”, was surprisingly normal for the first time in years. It’s safe to say, living on my own in Bristol the past year has made me much healthier on the micro scale.

Ah, but the results came with a little more excitement than anticipated.

Last year, my EKG result stated: “Sinus bradycardia with sinus arrhythmia; borderline prolonged QT interval; otherwise no pathological findings”. It wasn’t necessarily denial, but an unimpressive knowledge about ECG/EKG interpretation that allowed me to shrug nonchalantly about the situation. But this year, my EKG result stated: “Sinus bradycardia with junctional escape beat and bigeminy premature ventricular complexes”, and after having crammed an outrageous amount of information about various cardiovascular system abnormalities (I’m panicking as the phrase “Quick lids flecking at amiable dilettantes” scrolls across my vision), well, what can I say…I still shrugged nonchalantly about the situation.

fullsizeoutput_93f
14/06/17 EKG Results (For You Keeners Out There)

A follow-up was required a couple weeks later. I was *this* close to napping face-down all day listening to the ironically motivational movie soundtracks of Rupert Gregson-Williams, but thankfully dragged my lazy bum off the bed due to post-exam hopelessness (I hope today all you IB kids got the results you wanted – remember, there’s always a pathway for you!). So there I was, in the doctor’s office – not to be worried about at all, she said. It’s common for people under 40, and it’s very rare for it to be serious. Two things would happen: I’d get an echocardiogram done, and then wear a Holter monitor for 24 hours.

I remember watching one of the demos talk about echocardiography during an anatomy session, and this image was put up:

echocardiogram
Source: http://www.cardiachealth.org/sites/default/files/2011/echocardiogram.jpg

Um. I mean, what a truly wondrous photo. Find a person who’ll look at you the same way the patient and sonographer look at each other, am I right? (I swear I learn in anatomy sessions).

Anyways, that didn’t happen in my case (painfully grateful); I faced away from the sonographer and counted the number of vertical stripes per coloured block on the wallpaper (seven, if you wanted to know), and there was barely any talking. Despite being half-nude and having this transducer basically kneading my left boob, it all felt incredibly systematic. I almost fell asleep. But by hearing sudden spitfire beatboxing by my heart, occasionally being asked to hold my breath, and catching a glimpse of the Doppler echocardiography’s explosion of pretty colours, I just managed to stay awake.

After swiping away the ultrasound gel, I was then suited up with the Holter monitor: five electrodes plastered on, and a little pouch that held the ambulatory device itself. It’s basically just a piece of tech that records heart activity continuously for 24 hours (or 48, depending on the doctor’s suspicions of the final diagnosis) – since ECG/EKGs are performed only within a short snapshot of time and abnormal heart rhythms/cardiac symptoms come and go, the monitors are pretty great for doctors to evaluate irregularities, severity and patterns over an extended period.

I left the hospital feeling like an amateur espionage agent (watch out Agent Cody Banks!1!!). Here are a couple of images to show the Holter monitor itself and where the electrodes were placed – the former displays a countdown of the exact amount of time I had left of the 24 hours, and shut down once it reached zero; it was like a microcosm of every dystopian novel ever. 

So comes the next day, after having slept as still as a log (subconsciously afraid I’ll roll onto the Holter monitor and suffer the pricey consequences), and they go analyse the data. Here are my results in brief.

Echocardiography Summary: function and anatomy normal albeit mild tricuspid regurgitation (TR). Seeing the real-time videos of my heart beating made me oddly vulnerable – I mean, if you think about it, nobody will ever have the privilege to set eyes on your beating heart (with the exception of those lucky enough to partake in open heart surgery). I’d feel more naked posting a snippet of the echocardiogram than a revealing swimsuit photo of myself.

Holter Monitor Summary: The doctor said if I had 10% or more ventricular ectopic beats in the total number of heartbeats in the 24 hours, I would be sent for treatment. If it was 5% or below, I’d be alright. Luckily, I only had 4.1% – whilst she did appease my mother by stating there was nothing to worry about (“All you need to hear is that her heart is completely normal”), she turned to me and asked me to be more aware of my body. That is, if my palpitations become more frequent or if the tight squeezes I feel in my chest increase in severity, I am to go back to see her.

“How many hours of sleep do you get?” she asked in the middle of history-taking.

“Well, 7 hours on average, now that it’s summer.” I think back to how my heart rate was only 48BPM just before the appointment; that armchair was really quite comfortable…

With a small smile, she casually said, “Ah, wonderful – when you get to clinical years of medical school, you won’t get nearly as much!”

Honestly, I really like this doctor.

Anyways, I got this incredibly exciting full report with an hour-by-hour analysis (I can sense what a funky, wild Friday night I’ll be having).

You can see how the number of PVCs vary during various times of the day; a few examples of the activities I was engaged in included:

8:00PM = delicious dinner at MK with the family + a McDonalds cone (the simple pleasures of life)

10:00AM = extremely fervent Kyle Landry piano-playing; I even got a cramp in my left hand (watch this space for a cover…)

3:00PM = serious car talks in traffic

It’s extraordinary to actually see the direct play between the physical environment and the electrical activity of my heart – the times with high PVC frequencies correlated with some form of intense emotion; “Strike fear into the hearts of your enemies” “With a sinking heart” “Eat your heart out” idioms suddenly became exceptionally reasonable to me. It should be blatantly obvious that everything you do cascades upon your inner mechanics, but I previously could only resonate so much so as if watching a devastating BBC News segment from the comfort of my own home. It just further highlighted the stark opposition of medicine being both routine practice and blindly grasping in the dark.

At the end of the day, the treatment literally stated “reassurance” – drink lots of water, sleep for a minimum of 6 hours per day, no caffeine, stress less. Such basic courses of action to take, and yet so subconsciously overlooked by the generation of today. Anyways, I think as a medical student, having the opportunity to personally experience particular examinations/procedures you see portrayed via cringe-worthy stock photo compilations in lectures provokes the same level of excitement you have as you are about to watch one of the most anticipated block-buster films of the year (I am at this very minute on the way to watch Spider-Man Homecoming). And that’s probably the very reason I documented it all…I guess I’m just young at heart.

©TMK

 

Addiction: A Six-Word Story

YOUng cARelessnEss –

Married mY sweetHEart, heROin.

Explanation:

Often depicted negatively, addiction is a very serious condition – people with addiction are heavily stigmatized against, seen as “crackheads” with a lack of “willpower…or a moral compass”1. I wanted to show the interaction between a patient who requires help for their addiction and somebody willing to understand, whether it be a family member, friend, or doctor. From the perspective of the patient, whilst their addictive behaviour may cause conflict in various aspects of their life, underneath they may harbour vast gratitude for those who stay by their side to help battle their condition as revealed by the hidden message, “YOU ARE MY HERO”. I simply wanted to highlight the importance of not leaving somebody in their times of struggle and need, even if they may not express appreciation immediately, because a support system is incredibly vital for recovery.

Sources:

  1. Villa, L. Shaming the Sick: Addiction and Stigma. [online]. Available at: http://drugabuse.com/library/addiction-stigma/.

©TMK

Microaggressions: You’ve Been Victimised

“Ni hao!” says the random white, middle-aged man, grinning profusely as he leans in much too closely for your liking whilst you’re walking down the street. Sigh.

Hands up if this has ever happened to you.

This scenario has happened to me multiple times whilst I was abroad – I can guarantee you, every Asian friend you have has probably experienced this if not once, but more than they can count. I mean, wow! What a great way to mark you as an ignorant, presumptuous jerk, right? Blurting out the first Asian-language phrase you think of just because we look vaguely East Asian; I honestly have always wanted to know, do you really think we’re going to be impressed by your poorly pronounced two syllables? Don’t get me wrong – I have nothing against Mandarin or the people who speak it, and I’d be totally cool with it if it happened to me somewhere where Mandarin is actually the official language. But every single time, it’s always been in a Western city. If you wanted to be friendly, a simple “hi” would’ve been more than enough. I’m always down for a conversation, but not when you’re randomly throwing around “ni hao” to every Asian you see – it’s quite extraordinary, and quite peculiar, to speculate what goes through their sad little minds.

It was only until I attended a Discrimination & Harassment Workshop on May 7th that I finally could put a word to what I had experienced: microaggression. The term was coined by psychiatrist Dr. Chester Pierce in the 1970s, and Columbia professor Dr. Derald Wing Sue1 borrowed the term, referring to it as “the everyday verbal, nonverbal, and environmental slights, snubs, or insults, whether intentional or unintentional, which communicate hostile, derogatory, or negative messages to target persons based solely upon their marginalized group membership. In many cases, these hidden messages may invalidate the group identity or experiential reality of target persons, demean them on a personal or group level, communicate they are lesser human beings, suggest they do not belong with the majority group, threaten and intimidate, or relegate them to inferior status and treatment”2.

Some examples3 of microaggression would be asking the Asian guy how to solve a difficult mathematical problem, asking a black person if you can touch their hair, or the “ni hao” situation above. I’ve had my fair share of microaggressions, being told “You act different from other Asians, y’know?”, friends being in disbelief I dislike playing classical music on the piano, or people bluntly assuming my parents forced me to study medicine. I’ve moved around my entire life from a very young age, so I’m used to these types of interactions – I don’t feel threated, I don’t feel intimidated, and I definitely don’t feel relegated to an inferior status. Instead of taking extreme offense from somebody remarking “Your English is so good for somebody from Thailand!”, I take it as a sort of educating moment, and I somewhat enjoy it, because chances are, most people don’t have malicious intentions behind their words. I don’t believe they’re trying to “aggress” me in any way, and it’s just a sincere comment from somebody who maybe doesn’t mingle much with Asians. It sprouts from their upbringing; perhaps they’ve lived in only one place their entire lives. I once asked a lecturer a question about their presentation, only for her to slowly repeat the exact same phrase she used in her lecture, when it was the specific meaning behind it I was interested in. The issue here was she spontaneously assumed this Asian student couldn’t understand her British accent during the lecture, rather than wanting to delve into the science – but this lady is not a racist at all, and I felt completely fine. I didn’t see that encounter as a microaggression until I discovered the concept itself. Plus, who’s to say it doesn’t go the other way around? I’ve definitely displayed my fair share of microaggressions (e.g. saying to my Asian friends “That’s such a White thing to do” or even asking “But where are your parents from? Where are you ethnically from?”). Leave a comment down below of what microaggressions you’ve ever faced or dished out yourself without knowing – this is a non-judgemental zone (I’ll make sure of it)!

So during the workshop I attended, when the presenter introduced this whole microaggression concept, I thought, Man! This is incredibly relatable, preach!” But the more I thought about it, the more I wondered, where does one draw the line? Am I supposed to be more offended? When does this sort of “oh, poor me” stuff stop? Because given the nature of microaggressions – subtle messages slipped into casual conversation – I don’t believe they will ever cease to exist completely. But there is definitely benefit to fostering this awareness surrounding microaggressions; the change is evident. In fact, during my first year of university, I spent more time correcting people saying I was actually from Thailand when they assumed I was from America or Canada. This evolution in assumption is a tell-tale sign we’re at least on our way to eradicating the binary name-calling and formal exclusion (i.e. Asian people are solely from Asia! White people cannot be from Asia!). And on the other end of the stick, I know people aren’t asking about my nationality in order to oppress me, but out of genuine curiosity – diversity is fascinating, and when something’s fascinating, we speak the unintentional dialect of awe.

This interested me. Because when I walk up the steps in the lecture theatre to find a seat, I definitely have this feeling I can’t quite put my finger on – a sort of quiet, “Hm, is she going to sit next to me? I don’t know what to say because she’s Asian” vibe. Like I’m a bit of an outsider, because that’s what we’re programmed to think in a country dominated by white people, whether we’re conscious about it or not. And now I know it’s called microaggression, but why has it only erupted in recent years, and should I even do anything about it except recognize when it happens? Jonathan Haidt4, social psychologist at New York University’s Stern School of Business, signposted a fascinating article in September 2015 titled “Microaggression and Moral Cultures”5 published in the journal Comparative Sociology. Written by sociologists Bradley Campbell and Jason Manning, the article may help explain the dynamics currently manifesting in the U.S. society and why concerns of microaggressions have erupted on many American college campuses in the past few years (which I think definitely applies to other countries, too). So, what exactly does it argue?

In brief, we are undergoing a second major transition in moral culture6. Prior to the 18th & 19th century, most Western societies were cultures of honour, existing where the rule of law was weak. People had to avenge offenses, insults and violation of rights on their own via self-help violence (a reputation of rapid brutality and vengeance was thus important back in the day); failure to do so resulted in loss of social respect and status. The first major transition then occurred during the 19th century as the West became cultures of dignity, in which “people are assumed to have dignity and don’t need to earn it. They foreswear violence, turn to courts or administrative bodies to respond to major transitions, and for minor transgressions they either ignore them or attempt to resolve them by social means.  There’s no more duelling”.7 All citizens were legally endowed with equal rights, practicing tolerance that resulted in much more peaceful societies than those embodying the honour culture. Basically, it was the whole “sticks and stones may break my bones, but words will never hurt me” gist.

Campbell and Manning now describe societies currently undergoing a second major culture transition: the culture of dignity into the culture of victimhood. It hybridises both the honour culture’s quickness to respond even to the slightest unintentional offense, with the dignity culture’s appeal for the help of third parties to whom they must make the case they have been victimized, so these administrative bodies or powerful authorities can police and punish transgressions. The result? People are urged to think of themselves as weak, marginalized and oppressed; everybody seeks to become a “victim”8. Within the broader context of the highly egalitarian & diverse culture we live in due to college campuses popping up all over the place and the rise in administrative bodies & regulations, the intensity of identifying oneself as a fragile & aggrieved victim is extreme. Here, the equation triggers an explosion of microaggression.

But of course, like every piece of literature, there were holes in the research – like, for example, the basic question of how this concept of microaggression should be applied. It’d be interesting to use Sue’s list of microaggressions9 with college students and see if minority students feel offense in the same way Sue and his researchers did. Personally, I didn’t for all the Asian stuff. And of course, they failed to take into account the subjectivity of microaggression; if it is truly in the eye of the beholder, where should the blame be placed (if any) if the beholder knows nothing of the third party? There is so much scope – we could delve into white privilege, marginalized groups, and the uprising of meritocracy. With the evolving culture of victimhood, there is paralleled swiftness in reading negativity into lots of things in life, but let’s call it microaggression when we’re belittled on the basis of stereotypes or with malevolent intent.

I hope you don’t take all of this the wrong way.

Sources:

1, 2, 3, 9. Sue DW, Capodilupo CM, Torino GC, Bucceri JM, Holder A, Nadal KL, Esquilin M. Racial microaggressions in everyday life: implications for clinical practice. American Psychologist. 2007; 62(4): pp. 271-286.

4, 7.  Haidt, J. Where microaggressions really come from: A sociological account. [online]. 2015. [cited June 27th, 2017]. Available at: http://righteousmind.com/where-microaggressions-really-come-from/.

5. Campbell B & Manning J. Microaggression and moral cultures. Comparative Sociology. 2014; 13(6): pp. 692-726.

6, 8. Bailey, R. The Rise of the Culture of Victimhood Explained. [online]. 2015. [cited June 27th, 2017]. Available at: http://reason.com/blog/2015/09/08/the-rise-of-the-culture-of-victimhood-ex.

DeAngelis, T. Unmasking ‘racial micro aggressions’. American Psychological Association. 2009; February: p. 42.

McWhorter, J. ‘Microaggression’ Is the New Racism on Campus. [online]. 2014. [cited June 27th, 2017]. Available at: http://time.com/32618/microaggression-is-the-new-racism-on-campus/.

©TMK

Hypertrophic Cardiomyopathy: A Six-Word Story

Hypertrophic cardiomyopathy hurts;

My heart overflows!

Explanation:

Hypertrophic cardiomyopathy is a condition that causes increased filling pressure due to the thickening of the myocardial wall1 – in a very simplistic way, I depicted this as the heart “overflowing” with blood. The phrase “my heart overflows” is a Biblical inference to Psalm 23:5-62; the original phrase is “…you anoint my head with oil; my cup overflows.” David describes how abundantly the Lord provided for him – a phenomenal picture of how God gives us everything we need and more, placing endless resources in front of us3. Whether readers are religious or not, the message states that whilst life challenges your resources or faith in difficult times, you will always have a wealth of support around you.

Sources:

  1. Shah, S.N. Hypertrophic Cardiomyopathy. [online]. Available at: http://emedicine.medscape.com/article/152913-overview.
  2. The Holy Bible. New International Version. Biblica, Inc. Ò. Psalm 23:5-6.
  3. MacDonald, J. Does Your Cup Overflow? [online]. Available at: http://www.jamesmacdonald.com/teaching/devotionals/2013-07-24/.
  4. Image courtesy: http://signesandelin.deviantart.com

©TMK

A Sense of Entitlement: A Malignant Tumour?

       One sunny April day, I decided to drop into my old high school, and naturally beelined towards the music department. After exchanging all the How Are You’s and the How Has University Been’s and Any New Aspiring Musicians In School’s with my old music teacher & guiding mentor, we began conversing about the evolution of job opportunities and whether millennials should be dubbed the “Me Me Me Generation” (the phrase coined by Times magazine back in 2013). As he furrowed his forehead in concentration and interlaced his fingers, he said, “It’s called a sense of entitlement – you just graduate and suddenly expect to be immediately working in the top ranks. But that’s not how it works; you gotta climb up.”

           From that day onwards, the phrase attracted to my mind like a magnet because I could finally put a title to what I observed so frequently. The rates of entitlement are unsurprisingly high around me – the very fact my parents were able to send my siblings and me to private, international schools around Asia is more than enough to say what kind of cohort I was brushing shoulders with. But don’t get me wrong – everybody contains symptoms of a sense of entitlement (SoE), including myself. An example of why this may be is because we, the millennials, grew up watching reality TV shows, most of which are documentaries about narcissists. I don’t necessarily say this in a negative way, but it somewhat trained us to be “reality TV ready” – that is, we are able to define our personality types when we’re 13 instead of 30, which is a huge evolutionary jump.

            For a deep-dive analysis into the heated discussions of whether millennials have higher rates of a sense of entitlement, it’ll have to be saved for another long-winded post. So, just to put my bare opinions out there first: I stand on the middle-ground with the issue. I believe millennials are extremely passionate and optimistic, embrace the system, and are pragmatic visionaries. We are tinkerers more than dreamers; industrious life-hackers. Perhaps our SoE is a result of our adaptation in a world of abundance. Yet simultaneously, our SoE can be extraordinarily tiresome – with social media becoming such an integral, staple part of our lives, so does narcissism and its partner in crime, entitlement. Personally, I think if you’re constantly exploring the curiosities of life rather than demanding so much from it, then that’s what matters. Living life completely free of a SoE is almost impossible.

         Anyhow, during the tedious revision period back in May, I remember going over oncology. All the tumour-suppressor genes, CDKs, and oncogenic viruses just suddenly seemed all metaphorical to me (one of those days), so I crafted this weird link between malignant tumours and the concept of entitlement. As I finally have spare time (and limited knowledge), I decided to try my hand at creating an infographic describing the similarities I was envisioning in my head. Hope you enjoy!

 

Sense of Entitlement Infographic.jpg

©TMK

Sources:

https://www.popsugar.com/news/Why-Millennials-Entitled-42873548

http://time.com/247/millennials-the-me-me-me-generation/

https://qz.com/720456/the-myth-of-millennial-entitlement-was-created-to-hide-their-parents-mistakes/

Seven Emotions That Follow a Sense of Entitlement

http://outofthefog.website/top-100-trait-blog/2015/11/4/sense-of-entitlement

https://lonerwolf.com/sense-of-entitlement/

5 Songs That Helped Me Survive Exams

       Thank goodness for music. Personally, during exam period, I tend to avoid lyrical music because my mind will latch onto the words and I get a plethora of distracting earworms. The same reason applies as to why I have to revise in silence. So when I am running or on a break, I’ll be listening to the most mellow songs, or if I’m feeling really frisky then I’ll listen to the following soundtracks on extremely low volume when doing work. A little odd, I know, but there you go. Here are a few select songs that ease out the wrinkles on my brain:

  1. “Anna (Piano Version)” composed by Takatsugu Muramatsu from “When Marnie Was There” 
  2. “Katherine” composed by Hans Zimmer, Pharrell Williams & Benjamin Wallfisch from “Hidden Figures”
  3. “Pi’s Lullaby” composed by Mychael Danna & Bombay Jayashree from “Life of Pi”
  4. “Spacewalk” composed by Thomas Newman from “Passengers”
  5. “Go To Her” composed by Mike Higham & Matthew Margeson from “Miss Peregrine’s Home for Peculiar Children”

©TMK

Year 1 Bristol Med School | Summer Exams

Wow, I apologise for the unexplained hiatus I took. 2 months! This post is going to be an unofficial breakdown on the summer exams here in Bristol med school and how I found them (they’re finally over for me, now let’s hope I’ve passed </3).

Systems of the Body #1: Anatomy & Histology Spot Test (May 30th)

Structure: 60 MCQ questions (40 anatomy + 20 histology); 45 seconds per station (hence 45 mins long). The anatomy questions are 50:50 between pathology and identifying structures.

What: In Term 2, we began the Systems unit – for first year, we learn about the cardiovascular system and the musculoskeletal system. Each system integrates both the anatomy DR sessions, histology practicals, and the of course, the abundant lectures. Students tend to prefer Systems over MCBoM, because this is actual information we may need to retain as doctors in the future since it’s much more focused on pathology and we begin distinguishing the normal from abnormal. And for this same reason is why students buckle down and revise that little bit more than the January exams, because it’s the real deal.

Top tips:

  1. DO NOT NEGLECT HISTOLOGY. In Term 1, students saw histology as a bit of a joke, thus neglecting it partially or completely, and got away with relying on knowledge retained from the histology lectures in LT 1.4 those few weeks ago. Sorry, but this ain’t gonna work for Systems! I highly recommend going over the virtual microscope slides (no need to remember the names of each slide – they label it in the exam), identifying what things are and functions of certain cells/structures. All you need to know is in the lecture and the VM, so don’t get all worked up with histology, but do not neglect it. People came out of these exams saying “The frikken histology stuff though, not even funny how much I guessed…”
  2. LOOK THROUGH THE RADIOGRAPHY SLIDES. Again, be efficient with your time and don’t dwell extensively on them, but they definitely come up – it’s the only kind of pathology you’re seeing in first year, so whatever slides they use to teach the clinical stuff, focus on those. They won’t give you a random tiny fracture in the 4th metacarpal bone to identify. Sometimes you’d like to rely on your anatomy knowledge of where things are, but there are just things the radiography slides have that can trip you up if you haven’t seen it before.
  3. KNOW OBVIOUS SIGNS OF CERTAIN PATHOLOGIES. Okay, really obvious. But, if the case scenario starts talking about a 63 year-old man complaining of pain radiating to his back, you can almost guarantee the answer will be coarctation of the aorta without having to read the rest of the scenario. Or if there’s an image of splinter haemorrhages or Osler nodes, it’s bacterial infective endocarditis. If you attempt to remember the hundreds of other causes of back pain or splinter haemorrhages, or research the extensive pathophysiology of pericarditis, it’s a waste of your time at this point – to pass the exam, just key points.
  4. NEVER LOOK BACK. It’s so easy to think back 7 stations to that question on the umbilical cord when you’re looking at the brachial plexus, and be tempted to change your answer. Stop! Don’t do that. I was a victim of that in the January exams. Completely derails your focus on what’s currently in front of you. Trust yourself, because knowledge is lingering in that brain of yours and don’t question your instinctive answers.

Final remarks: Dare I say, the most fun exam, since approximately 60 of us are crammed into the DR, madly stressing under the same sky of glaring white lights that illuminate the bags under our eyes. It’s kind of teamwork in the most independent way. I remember seeing some questions that no way came up in the red booklet, like “What does the umbilical cord contain” and then permutations of 1 artery 2 veins/2 arteries 1 vein etc. – don’t freak out about it. Chances are, if you’ve done your revision and this has not come up in the statements, your course mates will feeling equally baffled. And, there will definitely be specimens you’ve never seen before, like how I saw a hand with Dupuytren’s contracture; not a difficult question, but very interesting to see.

MCBoM Element 5-9: Written Paper (May 31st) 

Structure: 120 best of five questions (mind you, different from MCQs – all could be correct but one answer better than the other); 3 hours.

What: Basically, anything could come up based on all the hundreds of lectures you had since the beginning of Term 2. Also, some random questions pertaining to the various practicals, eBiolabs and STAN sessions could come up.

Top tip:

  1. DO WEIGHTED REVISION. What does this mean? The number of questions per element depends entirely on how much content there was in that unit and how much lecture time was dedicated to it. So, I tended to focus a bit more on Element 8  (clearly not enough, judging by the amount of guesswork done on all the hospital acquired infection stuff…).
  2. START EARLY. Even before all the CVS & MS stuff. Just because the amount of content will make your head implode if you begin two weeks before the exam. Just take it slow and let everything pass your eyes at least once through.

Final remarks: Back in high school I was one of those annoying kids who learned everything on the syllabus and beyond. In med school, that ain’t gonna happen. We’ve all gone from “I’m going to get top in my class!” to “I pray I get 50%”, because if you’re attempting to learn ALL the lectures from Element 5-9, you’re crazy. And no, not crazy in the smart way. Be efficient with your time – 12 hours revision per day will do more harm than good. All I can say for this exam is, just do it + repetition.

Systems of the Body #1: Written Paper (June 1st) 

Structure: 60 best of five questions; 1.5 hours.

What: Basically all the theory you learned in Systems that isn’t anatomy or histology.

Top tips:

  1. CUT THE WAFFLE. You know when you’re listening to Mediasite, and then the lecturer begins droning on about their current research project (ahem stem cells)? Yeah, don’t even bother understanding that stuff – no way they can test us on information they can’t even validate yet. Maybe during summer if you’re really keen on their expertise, but for exam purposes, skip that portion of the lecture.
  2. DRUGS DRUGS DRUGS. There are some lecturers who highlight exactly which ones to remember, and then there are ones who give a list longer than your arm. This is where you really have to listen to the lecturers – which one do they mention a lot? For example, the calcium channel blockers do end in -dipine (well, one subset of them), but the one selective for the heart is verapamil. As for learning side-effects, just know the more outstanding ones – like, one of our questions was “Which of the following drugs has a side-effect of rhabdomyolysis?” and a string of foreign words were listed, but the only drug ever mentioned to have that special adverse effect were the fibrates. Just little things like that.

Final remarks: I did a lot of idiotic things. For example, on the exam, they wrote “osteoprotegerin” and my  mind threw a tantrum because for goodness sake I swear I have never seen that in my life why would the examiners do th- oh. OH. It’s…the same thing…as OPG… Also, there was quite a bit on skin and joint infection stuff which I completely neglected (when in doubt, choose S. aureus). And I spent crazy long revising what cytokines and pro-inflammatory mediators were seen in rheumatoid arthritis and osteoarthritis, but none of that came up. 

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Take all of this with a pinch of salt (because we are the last year in the MB16 program of Bristol; starting next year is the fabulous new MB21). Everybody is vastly different in their revision style and approach to learning, so let me just say: I’m not smart. Honestly. I rely a lot on being hardworking. If you’re one of those who naturally assimilate information from just listening to the lecture once through and have the ability to formulate an intellectual question to ask afterwards as well as retain it in a few weeks, amazing! You are awesome. But I’m definitely not one of those people. So, that’s the direction & perspective I took on these exams; it’s just a little something to be aware of.

©TMK

Sir Paul Nurse: University of Bristol’s New Chancellor!

     On Wednesday, 22nd of March, marked a monumental day. And with most monumental events in Bristol, it took place in the Great Hall of the Will’s Memorial Building. So, after a failed session of attempting to write up notes on heart arrhythmias, I skedaddled down to the post office room, because I forgot my admission ticket was mailed to us personally, and rushed out at approximately 6:35pm.

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     I walk into the foyer, and enter the Great Hall with uttermost shock – there, right in the centre above the audience, hangs a 1:500,000 scale reproduction of the moon’s surface. It’s part the Museum of the Moon exhibit, conceived & created by Bristol-based artist Luke Jerram, happening on the weekend. I mean, outer space. That is my absolute dream, my version of a fairy-tale without the fancy bits of characterisation, the embodiment of every single star-gazing app on my iPhone. Since the event was in honour of Sir Paul Nurse whose work was on fission yeast that eventually led him to win the Nobel Prize of Physiology or Medicine in 2001 (in conjunction with Tim Hunt), there were projected electron microscopic images of Schizosaccharomyces pombe on the walls. Being in that place, surrounded by just raw science rooted in curiosity from the incredibly detailed craters on the moon (I saw Newton’s crater) to the rod-shaped cells swirling around, I might have almost teared up. Almost.

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     I won’t dwell too much on the actual programme details – it was a beautiful ceremony, with great background music by the prestigious Bristol Hornstars (fantastic jazz band that I was so confident about joining back last summer but too intimidated when I heard them play), and the opening ceremony. Let me just say, in the latter, there was a performance by the poetry & creative writing society of Bristol’s SU, and it was this grand poem of the journey and advancements in science. I mean, yes, it was very delightful, but…“like how the microorganisms festered in the library textbooks” and “oh, like yeast, *looks up to a higher power* let my mind grooow…”? I appreciated the science metaphors but it was a tad difficult to take seriously. Hey, wasn’t just me – the professors around me were a choir of collected muffling of laughter.

     Moving on swiftly…the installation itself. Watching the robing of Sir Paul Nurse and presentation of the ceremonial items felt all very royal – one of the items included the key used by King George V to open the Wills Memorial Building in 1925, and the new chancellor made sure the audience could catch a glimpse of it. And then his address. Wow, I’ll just say, I was blown away by the end of it. I’ll admit, initially I found myself zoning out occasionally as he went on about the merits of education and university, but it’s hard to get bored by him, because he is a fantastic speaker. He talked about 9-year-old him in his pyjamas on his front porch watching Sputnik-2 being launched, and the long & lonely walks back from school that allowed him to observe spiderwebs and growth of nature which fuelled his curiosity of science. And to think, just over a year ago, I had been reading about his discovery in the IB Higher Biology textbook in the Nature of Science box, thinking, “Man, just imagine…” With a very subtle lisp and a razor-sharp enunciation of his words, there was only one word I could describe his entire presence: historical.

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     I don’t know. Maybe it was the moon. Maybe it was the Great Hall’s beautiful architecture that dates way back. Maybe it was the spirit of the predecessors, including Winston Churchill, that I felt throughout the ceremony. But to me, it was all history. Sir Paul Nurse’s history of his childhood, the Great Hall’s history, the ceremonial item’s history, science’s history…and suddenly, I had this sudden urge even greater than before, to be part of that. To be part of history. I want to do something great and meaningful. I can only do so much but I’ll try my best as I’ve always done.

     I was in a bit of a daze afterwards – from the Elderflower Champagne at the drink’s reception, meeting my lecturers (pharmacology gang), racing up the stairs with a friend to gaze at the moon again, trespassing up into the high levels via steep winding stairs for better views, silhouette photos against the moon backdrop, sprinting back home at 8:48pm realising I’ve got a pre-practical quiz that I have to do before 9:00pm, getting 100% on said quiz (took literally 4 minutes), and eating a forgotten dinner. It was such a fantastic event, and I am grateful I had the opportunity to go (respond to your emails fast!). Really, I could say more about how inspiring the entire event was and how excited it makes me to know Paul Nurse is Bristol’s new chancellor, but it wouldn’t end if I began. So, here’s to an incredible future of science that I dream to be a part of.

©TMK