Unmasking the Fashion of Masks | Covid-19

It has been over a month of lockdown in Thailand, and yesterday marked the cautious resumption of some businesses and re-opening of local parks. Though the number of new Covid-19 cases each day have dwindled down to single digits, looking towards a post-pandemic society still feels wearily distant, and the uncertainty will most certainly pollute our minds for much longer after that. I somehow fantastically managed to acquire runner’s knee during my 14-day quarantine (in my room, may I add), but it meant a rare opportunity to leave the house and explore Bangkok’s streets from the car window. Indeed, there is no doubt Covid-19 has transformed the way the world looks, and yet, much has remained the same. The local coconut shop has stayed open, supermarket queues trail all the way to the frozen section, Bangkok road rage is still a thing, and the nation’s addictive usage of Line has only increasingly stoked Thai people’s notorious social insecurities the more isolated we have to be (more from where that came from). Yes, the tourist traps are eerily empty and you’ll see the oddly heartwarming sight of Grab delivery motorcyclists making smalltalk in-store, but the biggest visual change? That would have to be the masks.

…a common site in many gardens here…

Masks everywhere, on everyone. Devoid of smiles, an abundance of expression. And as with any wearable item humans deem fit or have to tolerate, I’ve watched the inevitable emergence of something from the humble breath-catcher: fashion.

Masks now boast extensive diversity — from rugged motorcyclists adorning cartoon animal masks, to AirPod-wearing users boasting sophisticated minimalist designs that flatteringly pronounce their jawline, to young girls prancing around in pastel-coloured flower masks. (Also, what is it with so many people still not wearing a mask properly? I swear if you cross paths with me and I can see your nose I will not hesitate to SPRAY BOTH YOUR EYES WITH ISOPROPYL ALCOHOL, VERY LIBERALLY)

Mask-wearing isn’t a new practice in Asia, and since masks do claim dibs on a fair share of our face, the demand for more aesthetically appealing designs is pretty reasonable. However, I can imagine that masks becoming a mainstay item in the foreseeable future in Western cultures is an unfamiliar and radically different practice. It’ll become a “popular accessory” — and though I feel a bit uncomfortable about using that phrase in the wake of Covid-19’s devastating destruction, there is no dying that the demand for masks is more than just its efficacy.

Here’s a quick story. One time during residential back in Year 6, a classmate gasped when she saw me, and proceeded to exclaim in front of the entire year: “Oh my gosh I can’t believe you’re wearing patterned shorts with a patterned shirt! Everybody knows that’s wrong!”

People sniggered at me. I guess I was meant to be embarrassed, but alas, you can’t really care about something you put zero thought into. Plus, looking back, that statement definitely does not seem like something your average 11-year-old would say, but hey-ho. Not to brag but present-day me now harbours some fashion sense — you know, the fantastic clothes that’ll make you win “Best Dressed Delegate” at yet another overseas MUN conference (I’ve never won), all-black attire for concerts and performances that specifically have no shoulder restrictions (!!! very important !!!), and the increasingly popular all-in-one “Clerk @ 5, Club @ 11” outfit.

…sigh. Help me catch some of that pitiful despair, now would you?

Point being, despite my disturbingly limited sense of style, I do know that fashion is all about fitting in and standing out. It is an outlet of self-expression and personal value; a snapshot statement of individuality. Like wearing a poppy badge for Remembrance Day or adorning NHS rainbow badges on your lanyard, wearing a mask is not just about being the right thing to do but also being seen doing it. “Hello, it is I, pledging my allegiance to citizenship, and you should too.” The self-consciousness of mask-wearing has flipped its polarity from the embarrassment of wearing one to the embarrassment of an exposed chin.

At first I thought, great. Of course the characteristic nature of people is to extrapolate the phrase “high-in-demand” plastered all over the news as “a trendy opportunity”, a way to ride out this viral storm whilst desperately trying to stay relevant, stand out, look cool, versus the stark kind of desperate call from frontline workers for surgical masks and N-95s to simply feel a bit safer; aren’t fashionable masks a mockery, expressing sympathy for those at high-risk to our followers on Twitter from the comfort of our couch, basking in the affordable luxury to wring out the celebrity angle of this “popular” item?

But after much thought and mildly frustrated confusion, I’ve concluded this: 仕様がない. Just, 仕様がない*. Because yes, it is indeed the typical fashion of humans to take advantage of a situation, but lets at least put the “fun” in functional, because life goes on. There’s no denying the age of coronavirus is indeed dire, and the stats are more than horrendous; one can complain that ordinary people wearing fancy designer masks are not taking the situation seriously, but maybe those same people are simply getting on with life’s new normal. Don’t get me wrong, I find it digusting that some ‘social influencers’ and ‘celebrities’ purposefully exploit their audience with hiked prices for less-than-mediocire quality (that’s a whole other topic in itself) — all I ask is that if you’re going to make masks, you better do your homework, do it right, and if you will, sell it reasonably. And if we scoot past that, regardless of whatever intention you may have in mask-wearing, at least it still sends a very clear message of hygiene and safety to both yourself and everybody around you.

So if it is a coping mechanism for your feelings of helplessness to post numerous #maskies, so be it. If your post-pandemic routine before leaving the house becomes “Keys, wallet, phone, mask”, then you proudly whack on that (questionable) plague doctor bird mask, you do you. As long as they’re CDC-approved and not useless self-proclaimed “PPE” (looking at you, Boohoo), I think a little bit of colour is exactly what we need. Don’t you think?

©TMK

Music: “Stand Out Fit In” by ONE OK ROCK

*A Japanese phrase that basically means “can’t be helped” with all sorts of nuances (at least, that’s how I’ve interpreted it from living in Japan for a while!).

So…About Intercalation Year

You’d expect that after several months of radio (blog) silence, I should make up for it with quality content. Well, strap in, boys — here is a real saucy reflection on how intercalation year went for me…

Starting off ~wild~ with a quick heads-up: this is entirely my personal experience and should in no way be extrapolated to what yours is/will be like (I chose to do BSc Physiological Sciences, so that in itself will be different in both the degree you’ll choose, where you choose to do it, and even the units you pick).

So intercalation had its awesome bits, which I’ll dip into, but a lot of my friends have mentioned feeling this sort of ‘intellectual shock‘ — feeling misinformed, and almost even a sense of betrayal, from the people we’ve spoken to before beginning intercalation, who never told us it’d be like how we found it to be. So, I hope to give an honest account of how I found the year, which I wasn’t aware of when making my decision to intercalate.

Also, my creative writing has severely regressed due to the lack of leisure reading in the past term, so forgive my usage of simple terminology. I mean…I can quote a paper pensively speculating the role of aquaporins in the urothelium? Aren’t pathetic redemptions great? Anyway. Enough of me faffing about, and onto the main body.

Let’s start positive.

Intercalation year brutally forced me to learn tedious skills I would’ve never dreamt to sit down and teach myself. Reading scientific papers, then scrutinising their approach? Learning how to use SPSS, a statistics software, to analyse dreary data-sets? If it sounds dry, it definitely felt like that on several (all) occasions; however, they are skills I’m honestly so grateful to have learnt, and can now execute, albeit mediocrely.

When the relief of submitting dissertation is vastly greater than the distress of how awful it probably turned out (yes, that is a mini snickers you see at the side)

So this next pro is highly subjective, but I tremendously enjoyed how much time alone I had. Because my last lectures ended late January, I essentially had no more scheduled teaching for the rest of the academic year, unless you count the revision seminars before exam period. Of course, there were all these tiny niggly things to deal with (like a little something called a dissertation that determines, oh, I don’t know — 33.4% of your entire degree as an intercalator).

But that was what my Term 2 was like: a solid 4 months of however you decided to use your time. Don’t get me wrong — you can most definitely take this time to travel or indulge in other fun social shenanigans. But I’d enjoy early evenings on Brandon Hill wearing out the Irozuku Sekai no Ashita Kara soundtrack, try out little hippie restaurant hideouts for Sunday brunch, and unintentionally act as the most suspicious Geocacher ever. I probably attended a grand total of 2.5 actual social gatherings, but hey, if it counts for anything, hundreds of minutes worth of FaceTiming occurred (time differences still stress me out). So, that’s just my outlook, but it’s totally up to you in the end.

Okay, now onto things that aren’t necessarily negatives, but just general comments to bust in some real-talk.

Intercalation passed by like slime that a kid dumped way too much Borax in. Earlier in September, I volunteered at New Scientist Live and had the privilege of monitoring “The Great Slime Race” attraction (an unfortunate test of resilience. Troves and troves of kids…and me, not a fan of kids. Nor slime). Anyway, one of the games included plopping your personalised slime into a tiny mesh container, and timed to see whose slime would withstand gravity the longest. There were some which splatted down like bird poo in the first 2 seconds (then the dismaying OHhHhh’s from the parents, as they see that dreaded quiver of their child’s lips). Then there was slime which hardly made it past the metal rungs of the container itself — barely moving, barely indented, barely going anywhere. I can’t believe my duty was to stare at this stupidly sparkly amorphous blob for 20 minutes; my contact lenses were absolutely screeching.

I mean, good on you, kiddo – you’re winning the game. But it sure doesn’t feel like it, does it?

That was how intercalation felt to me: an absurdly never-ending, Borax-crazy slime. You’re giving it your absolute all and more, but progress seems microscopic at best. And you ‘win’ by simply sticking it through.

Admittedly mesmerising if they’ve got that Goldilocks’s ratio right, though…

Of course it feels like ‘time flies by’ when I’m comparing this current state of post-cortisol submersion, proportionately greater >10,000 lux days, and shockingly empty seats in Beacon House, to the drawl of introductory “Why are you even here BSc” lectures, 8-month early pep talks (thank you, but not yet), and being the weirdo at Fresher’s Fair who knew way too much about where the freebies were. But it felt begrudgingly slow throughout the year for me, and it was the first time I’ve ever had so many recallable moments of “When will this ever end?” in an academic setting.

Be smart about your revision; you cannot cover everything. “Do not put all your eggs in one basket!” was the prevailing message hammered into us during revision period. So I thought, duh — I’m the kind of person who never wants to leave things untouched anyway; why would I not go through everything!?

…because, sadly, we’re no Spider-Man. Sigh. Teach us, Tom.

It’s really not the same as high school. See, everybody is incredibly bright, but it is utterly unfeasible to cover all the bases in the context of the university’s caliber, and then having to go above & beyond for a higher mark. This, of course, is unsettling if you have a similar mindset to me — having to gamble on topics that will come up in the exam, and selectively revising only half of an entire unit!? What a recipe for anxiety.

I’m so sorry olfaction, but it was an easy decision to selectively avoid you, there’s just way too much content already okay 😦

But you have to trust yourself. It’s not that I hated the topics I didn’t revise, but you’d be fooling yourself to go over absolutely everything and not feel alarmingly overwhelmed. With a bit of deduction, instinct, and hints from the unit structure/lecturers, you can somewhat predict the essay questions. For example, it was an offhand remark by the unit head, “…so because each lecturer set a question…”, that clued us into conducting smarter revision by just looking at the content of 3 out of 5 lecturers, because you’re bound to hit at least one of them even in the worst case scenario. But then other units are not as predictable, so once again, every exam is different even if they’re set-up the same — your revision approach will vary with each test.

It’s a break — from medicine. Not a break in general. So, know why you are doing it. It isn’t an easy year, and everybody has different motivations starting out. You are told to drive by passion, and indeed what you choose to do ultimately stems from some sort of inkling interest — but why intercalate? The reasons vary. Some want the experience of research, some just want a year out before starting clinical years, others find the idea “pretty cool”, or one person told me “I’m not *physically* ready” (yeah, whatever that means). There are obviously discrepancies between courses, with some coming out feeling absolutely lush (I’m looking at you, Childhood Studies — we get you had a great year, okay!?), and some…some looking like they need help.

Nah, but all in all, everybody gets through it one way or the other; the main take-home message is that intercalation is not a break, though how close you lie to this statement on the spectrum will obviously depend on your personal experience. I chose to intercalate for a few reasons, the main one being the challenge it posed and the subsequent experience of resilience. So, just figure out why you’re intercalating and know it isn’t close-my-eyes easy — but not to disregard everything else you get from it.

You become a ‘normal’ student for a year. Initially, I wasn’t entirely sure what this meant when a lot of my fellow intercalating pals cited this to be a positive reason. I assumed maybe this was because of the minimal contact hours per week compared to medicine and the workload flexibility (it boggles my mind that my Thursdays & Fridays were empty during Term 1, albeit meant for dissertation research). But, now having come to the end of this 5-week transition hospital training where I’ve reunited with familiar faces from pre-clinical years, I sort of now realise what this ‘being a normal student’ means: the false pretence in posing as a final year undergraduate student gives you a greater connection to the rest of the university, from the irks of submitting our dissertations in the wee hours of the morning, to the rushing sense of finality stepping out of Coombe Dingle for (what I hope to be) the last time. But, medical school does something different, secondary to this well-established subject isolation when we longingly wave our non-medics good-bye: fostering a strong sense of community in its entirely own misunderstood entity, to feel like a family, because we’re in it for the long-run. Ugh, I know, so wholesome!

Anyhow, here I am, having finished the last day of hospital training. The ratio of panini press to smoothie blender usage has considerably plummeted in the last couple weeks since the weather melted into humidity; the town has gotten as arm-y and leg-y as I’ve ever seen it. Ah, it finally feels like *real* summer has officially begun.

Oh, and about graduation. Well, results were released on Monday…and I’m glad to report that I didn’t order that £45 graduation gown for nothing.

©TMK

The Introvert (or Extrovert) ‘Hangover’

“Go hard or go home!”

I definitely go home.

In these past couple weeks, I have never felt much more blatantly aware of my introverted self. Having begun my intercalation year in physiological sciences, I’ve essentially become a fresher again, but not without an unattractively scornful attitude. It’s highly likely to have arisen from the premise of “This may be my third year here, but I still want the privileges of a fresher to justify my lack of boldness with”, but boy has it made me ponder. 

The introvert hangover makes such profound sense as to why I feel utterly drained and exhausted after any kind of context involving people, but it’s upon the assumption I’m an introvert myself. I’ve taken those 4-hour long personality tests every Asian tutoring school seems to offer up to the ubiquitously crude Buzzfeed-style quizzes that have tried to bedazzle by defining who I am. Like a ping-pong match, the results cast me back and forth — you’re an introvert! You’re an extrovert! “You are such an extrovert!” “Are you an introvert, too?” And it’s only gotten much more absurdly complex: in parade the ambiverts, the extroverted introverts, the social ambiverts. Typical perennial human obsession flaunting to the world a justification for their attributes.

However, I’m no exception. During middle school, I unashamedly went through an addictive phase of doing online quizzes – but beyond visionary extrapolation, vanity and harmless fun, I was a superbly low self-esteem teen much too worried and much too serious about the future. Personality quizzes were a fork-lift out of the rubble of imploding thoughts; they’d get me out of my own head. See whether my experiences levelled with how others perceived me. And funnily enough, there was almost this sense of awe and wonder to every buffered result – this psychological need for self-reflection, a paralleled OASIS avatar of everything I can be.

Because there, you are assigned an identity, and everybody’s a winner. ESTJ? The performer. INFJ? The advocate. An inborn sense of morality and idealism,” 16personalities.com writes. Hogwarts House: Slytherin. “You possess a remarkably unique blend of imagination and reliability,” some random job recruitment service site spews. Because there, everybody wants to believe they possess some remarkable personality trait, as if it grants them VIP access to unlocking the secrets of society and reality.

Because there, you bask in a sense of innate superiority, in which the world simply must acknowledge and validate. It’s flattering, but probably more to do with the Barnum effect.

So here I am, after a whirlwind of several taster sessions, social events, and meeting new course-mates, and I quickly realised how great of a proportion I spent my 5-month summer engaging in serene, single-player activities. And I’ve also become consciously aware of what a convincing pretence I can muster up in the headlight moment somebody catches me cautiously roaming the room’s perimeter to ask if I’m enjoying the party. Too many introvert hangovers have I experienced from the over-stimulation of social environments (and the only kind of hangover I can relate to, for that matter).

But in jarring contrast, I’m a big fan of initiating conversations with total strangers outside of lecture theatres – I despise small-talk, but because I crave authenticity, I’ll tolerate it and can most certainly conjure small-talk with genuine enjoyment when it’s expected of me. At a totally different birthday party, you can find me wildly busting out the dance sequence to “We’re All In This Together” in front of people I just met. And possibly the most convincing example of extraversion for you Bristol medics out there, I auditioned for CLIC last year (and proud to say I did not get in; 10/10 will definitely go again this year).

That being said, I’ve always known myself to be more of an introvert at heart. And despite everything I’ve said, whatever the consensus on the whole introvert/extrovert faff, I experience introvert hangovers all the time. At the end of the day (quite literally), I’d much rather be doing laundry whilst listening to the “Horizon Zero Dawn” soundtrack instead of clubbing with Nick Grimshaw on a Thursday night. Oddly specific? That’s because it is precisely what I did.

Like a brick-load of things in life, ambiversion is a spectrum. I can’t deny having binged on Buzzfeed quizzes, because let’s admit we’re all a little bit narcissistic and need nonsense in this stupidly stressed life; my issue lies with those quizzes or tests claiming they’re the real deal with a prediction of your future career, relationships and goals. We’re all wired to seek out ways to reflect on who we are — and fair enough, yet this vulnerability is exactly what those companies, tuition centres and other organisations exploit. There’s no denying the very real need people seek to figure out the mess of who they are, but who I am is not a calculation, nor is it a summation of what we know. You don’t need some overpriced test result to articulate your own identity as if you were hearing about if for the first time. The way quizzes guide you through with a nurturing hand, as if a momentous self-discovery process?  It’s an illusion of truth; a botched pseudo-science that rarely tells you anything you didn’t know before, but simply articulates who you know yourself to be. 

You know yourself better than anybody, and more importantly, you know exactly what you don’t know. So, Heaven forbid you sincerely believe your complexity of an existence can be contained by four tiny letters, but please, by all means go right ahead and make a pizza to decide if you’d survive a zombie apocalypse.

©TMK

Year 2 Bristol Med School | Summer Exams

It has only been a few days since completing the final summer exams, and you bet your sweet bippy I’m still experiencing severe withdrawal symptoms. These episodes are of an unfortunate recurrence after every exam season, and leave me chaotically conflicted. I’m gonna call it…post-exam subjection trauma (PEST). You know what I mean; how every little ordinary detail in daily life triggers this automatic all-out regurgitation of lecture knowledge where you completely blackout, before snapping back into reality dry-heaving “May 16th please be kind to me”.

*sees a mother breastfeeding her baby in public*

Okay oestrogen = ductal system, progesterone = secretory system? Ooooo but don’t be fooled since progesterone & oestrogen actually inhibit lactation. Nice one. And then, what was it? Oh, dopamine inhibition due to suckling relieves restraint on PRH, prolactin release causes milk production, oxytocin causes that weird “milk ejection reflex”…that reminds me of the “viscous fingering” mechanism in the parietal cells of the stomach, omg that lecture was kinda weird, ha ha ha *still staring at the breastfeeding*

Sigh. This is what PEST does to you – you only see science, not people. 

Anyways, I did a similar review last year of the Year 1 summer exams. Thus, as a sucker for continuity, here’s another.

Systems of the Body 2: Paper 1 (April 23rd)

Structure: 70 best-of-five questions | 1 hour 45 mins

What: Gastrointestinal, respiratory, renal

Remarks: Because we had January mocks on Systems 2, this was just a smidge less terrifying than the others. I have to say, it was much more clinical than I prepared for, but I was definitely expecting it. There was one question where it said a man came in with fever, diarrhoea, etc. and we had to figure out which bacteria he is most likely to be infected with. At this point, it could be any of the options. But then, the vital bit of information is that upon history-taking, it is learned he works in a lab…with lizards.

…so, okay. I get medical school is all about lateral thinking, but the lizard thing was just a little bizarre. Can’t get over it. Lizards.

With drug names, I can safely say this on behalf on all of us: we don’t remember them entirely, and just commit the first syllable to memory. It’s best-of-five, after all. For example, one of the cysteine leukotriene antagonists for asthma is montelukast, but I just think its that Monte Carlo drug, or the synthetic analogue of PGE1 protecting the stomach mucosa for peptic ulcers is misoprostol but I remember miso soup. And then, we all have our idiotic tactics of remembering a list of drugs. Anti-emetics, for example: the 5-HT receptor antagonists. One of them is Nabilone, which sounds like Naboo, that planet in the Star Wars universe, so extraordinarily picturesque it’s almost euphoric (one of the side-effects of the drug). Or furosemide is a loop diuretic; I remember this by the thinking “fur” = dogs, one of my favourite dog breeds are shiba inus, and they have curly tails (“loop” diuretics)…

A lot of the tactics used are incredibly crude, linking up selective information required for exam purposes only in a strange way. And then for others, you go over and over them again, until they just suddenly give way. Like, for me, I didn’t want to just accept the definitions of SaO2, CaO2 & PaO2 – we’re told it’s saturation, content and partial pressure, respectively. I never really properly understood this in relation to the equations given, but one day, it just randomly fell into place for me: SaO2 = the oxygen binding to Hb, PaO2 = the oxygen actually dissolved in plasma, and CaO2 = summation of SaO2 & PaO2. Highly likely I’m just really slow, but I never really got it until I kept staring at it.

Systems of the Body 2 & 3: Anatomy & Histology Spot Test (April 25th)

Structure: 80 MCQ questions | 45 seconds per station (1 hour exam) | Includes topographical anatomy, case scenarios, pathology cases, clinical examinations, radiology, and histology

What: Gastrointestinal, respiratory, renal (Systems 2); nervous system, endocrine & reproduction (Systems 3)

Remarks: Right, so this was the exam I was more disappointed at myself in compared to the others. Anatomy tends to be the slightly (better subject for me than the written papers (keyword: slightly), but I walked out feeling absolute dismay; it didn’t feel like the dozens of hours spent revising, especially on the topics you make an extra effort to understand, paid off. Things that we spent a lot of time in the DR learning (“You need to know this!”), like the various strictures of the oesophagus & its multi blood supply or the lumbosacral plexus roots, didn’t even come up. We had a whole practical dedicated to ears & eyes, and only 2 questions max came up in total for both. My friend said she only knew the answer to another question because she happened to overhear someone directly ask the demos; so unless prompted, there would be no explicit answer that wasn’t even in the booklet (but apparently on the exam).

The questions came at obscure angles, like the innervation of the ureter (only PSNS, only SNS, both PSNS & SNS, etc.) – not even joking when I say it’s this tiny, vague statement at the bottom of the renal booklet “Nerve supply via autonomic plexuses”. There was one station displaying a radiograph of the thorax, and the right lung clearly showed pleural effusion. The question was, “What is the pathology in the left lung?”, in which the correct answer was simply “Normal”, which I didn’t even realise was a trick question until somebody asked me after the exam, “Hey, that trick question though, right?!” I think what irks me is that the formative spot questions in the sessions give the wrong impression of the style of questions that actually came up. But then again, this was just my experience; a lot of people came out feeling pretty good, and that it went better than expected, so I could just be an unpopular opinion (story of my life).

Systems of the Body 3: Paper 2 (April 27th)

Structure: 70 best-of-five questions | 1 hour 45 mins

What: Nervous system, endocrine & reproduction

Remarks: Held in the grandiose Will’s Memorial Great Hall, it was a pretty adorable way to finish the gruelling pre-clinical years. Most of us were tremendously jittery beforehand, because of the fact we have handbooks the length of your average 3.5/5 Goodreads YA novel and tedious 9-5 lectures that happily shoved us off the cliff into anxiety. So, it was a shocker to say the paper went much better than anticipated for the majority of us. Once again, a rather clinical paper – there were quite a few questions on contraception applying theory to legitimate context useful in practice, which I appreciated (though mind-boggling at points). The first question threw everybody off – “How does alcohol cross the blood-brain barrier?” For some reason, I thought drawing the molecule for ethanol would help me decipher the answer (it didn’t). Ask us about the basal ganglia pathways in relation to Parkinson’s disease, and we’ll give you this immaculate answer all backed up with Vancouver referencing. But a stupidly easy question about alcohol’s solubility properties? Well-played, examiners, you’ve caught 228 med students off-guard. My favourite question asked how a patient with mania would present at the GP – one of the options had convoluted SAT words with way too many vowels, but the real star answer was “Staring at the wall and counting”. Not the right answer, but just…right.

There were other little bits I picked up on, like how there were equations the lecturers specifically said to commit to memory, like % ionised, that they just straight up gave in the paper anyway. Then various pathways, including the motor & sensory tracts, auditory & optic pathway, or the spermatogenesis & oogenesis processes, barely made appearances, if not at all. Embryology was absent. It was a little frustrating, because with those topics,  it actually took a substantial amount of time to methodically learn them step-by-step. Then there were those one-off questions, like what the uterus fundal height is by 20 weeks – it’s this tiny sub-bullet point on a slide amongst 37 others, let alone in a booklet of 225 pages. Or which condition can cause increased feet width; intuitively, most would choose acromegaly anyway, but this information was in a video the lecturer showed, not on the actual lecture slides given.

••••••••••

I know a lot of this was nit-picking and complaining about parts of the paper, but overall, I understand exams will always be like this. The really wishy-washy, extremely unpredictable questions that you’ll feel are unfair, but you gotta play the game whether you like it or not. What I’m basically saying is, no matter how much you revise, it’ll never be enough – the learning isn’t necessarily harder than IB or A-levels, but probably down to the sheer quantity and conceptualisation of certain ideas (e.g. the reticular formation or the basal ganglia). It’s learning how to cover everything effectively (but not beating yourself up if you don’t, either), preparing to accept there isn’t always a correct answer, but most importantly, being able to not always want to know why. I say this with a conviction suitable only in this context; this is a mindset that our high school curriculums set us up to think, that there is always some kind of explanation for every question-mark – it’s the whole “big fish small pond” syndrome shaking up the high-achieving kids who tumble down the pyramid. Falling isn’t the issue, but trying to climb to the top again purely out of familiarity, most definitely is. Whether you agree or disagree, hopefully it’s something to think about.

©TMK

Term 1 • Year 2 Bristol Med School | Reflection

 

So, I don’t do these much – a solid year has passed since the last one. Well, here I am, giving you my less-than-wise perspective on how I found the last few months. So, it’s rumoured Term 1 of Year 2 is objectively the most leisurely time of your entire medical school experience in Bristol, to which is a statement I do not object – but it’s not saying much compared to everything else.

Let’s skip over explaining all that standard lecture curriculum stuff you can read on the website; what’s differed from Year 1 is that after finishing a lecture-based teaching block studying a particular system in the body (i.e. respiratory, gastrointestinal, renal) lasting between two to three weeks, we all get placed into a hospital in or around Bristol. Our stethoscopes slung proudly around our necks (£90 worth of the hypocritical attitude “Just don’t ask us to properly use it”), it’s the ultimate committal point-of-no-return investment.

I’d really like to point out how it positively warms my heart to watch my medic colleagues take a history and do clinical examinations on actual patients – everybody slowly emerges with their little personality quirks. Like that intimidatingly buff dude who got in Clicendales last year who is actually adorably soft-spoken and displays great open body language. Or that girl always rocking denim overalls you’ve never really properly talked to who unconsciously leans very far forward, engaging far more with the patient. Or the legend card guy on nights out, who consistently makes sure to repeat back the information to put the patient at ease she/he is being actively understood. I’ll even say it’s humbling to being a part of the beginnings of my peers’ medical career – sappy? Yep.

Aside from that, you’d think medical students would find the clinical environment extremely exciting; and don’t get me wrong, we did desperately yearn for those hospital placements after living in E29 (groggily waiting as the clock ticks a few minutes after the scheduled hour before somebody shouts “LECTURE CANCELLED, CHECK YO EMAILS!” which unfortunately happened far too often). However, there was a surprising collective thought a few of my fellow colleagues had about the 3-day formalities:

“I’ve realised people are just…so tiring. Is that bad?”

We’re still figuring it out. Even myself, I found the weekend leading up to ICS Placement was a bit of a dreaded countdown – it’s the culmination of having not finished going through the Respiratory Element and then we’re expected to know Gastrointestinal pathologies for the following Monday; exhaustion from everything else in our lives not medically-related; fear of the much-too-real insight into the lives we will lead in the many years ahead…

I guess it’s some mild form of empathetic burnout – honestly, actually sitting down with patients is always incredibly humbling and we would never be insincere about it. And yet, at the end of the day, you flop onto your bed in bare-below-the-elbows attire with the lanyard uneven around your neck, utterly exhausted. And I swear, if I met somebody new during that period, I would’ve immediately blurted out the preprogrammed “Hi-my-name-is-Holly-I’m-a-second-year-medical-student-etc-etc-etc”

Anatomy was chill as always. Top tip: no matter how weird your question, ask. Really. As long as you use anatomical terms, you can practically ask anything whilst sounding vaguely intellectual – the demonstrators will possibly be the more openminded people you’ll meet, given the niche nature of their job. And even though your friends (you know who you are) are cackling at your sincere curiosity of the science behind certain, ahem, activities, you’ll certainly thank yourself for not needing to do an uncomfortable Google deep-dive without UV protection from the bare exposure to everything but the science.

And now, January exams have ended (before I hightailed into London – what is it with me escaping to that city after tests?) and Term 2 has begun with the highly anticipated neuro (negatively rumour-drenched from older years). A brief review of Week 1 so far? Let’s just say, I’m seriously enticed to do work rather than celebrate my birthday next week.

’til next time.

©TMK

Once Explorers, Always Explorers | Colin Pillinger Memorial Talk

In typical fashion, I had overslept a nap – rushing up the steps inside Will’s Memorial, I made it inside the Big Hall just in time to attend an event I had been looking forward to for months. Titled “Once Explorers, Always Explorers – Europe’s Role in Space Exploration”, it is part of a lecture series established by the Pillinger family in 2015 in memory of Colin Pillinger. Born in Bristol, he attended Kingswood Grammar school (now King’s Oak Academy), and graduated with a BSc and PhD in Chemistry from University College of Swansea and was a post-doctoral fellow in the University of Bristol School of Chemistry, Organic Geochemistry Unit from 1968 to 1974. A pioneering figure with an illustrious career in instrument development and analysis of extra-terrestrial samples at the University of Cambridge, and later at the Open University where he founded the Planetary and Space Sciences Research Institute, he is probably best known as the leader of the Beagle 2 Mars mission. His legacy lives on, and as Dr David Parker so perfectly summarised, Colin possessed “sheer bloody mindedness”.

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Colin Pillinger. Photo credits: http://www.bbc.co.uk/news/science-environment-27322166

That being said, the main speaker of the night was the fantastic Dr David Parker himself, Director of Human and Robotic Exploration in the European Space Agency. With fervent passion, he delivered such engaging insight into what projects are currently being undertaken, and where we are going in Europe’s space exploration. He began with highlighting the many successes of ESA, including the Cassini-Huygens mission exploring the Saturnian system, the historical Rosetta mission gathering data surrounding the Jupiter-family comet 67P/Churyumov-Gerasimenko, and of course, the huge international collaboration of the ISS itself.  Attempting to be discreet as I hastily scribbled notes in my battered notebook, Dr Parker zoomed ahead to talk about the challenges space exploration still currently presents, analogs here on Earth, and potentially going back to the Moon (build a base, anyone?). My favourite analogy of the night was that if Earth were the size of his hands balled together, the distance to Mars would be the equivalent to the distance between Will’s Memorial and IKEA (1:12,133,333 km scale). Love me some #justbristolthings geography.

Then we got to watch some amazing videos of Tim Peake and Thomas Pesquet, emphasising the overview effect and how “…it takes all of this technology to allow us to understand the simplicity of us.” It was only then appropriate for Dr Parker to now look to the future – more than ever, international cooperation is required for ambitious projects like the ExoMars programme to put the 2020 rover on Mawrth Vallis, planning the first roundtrip to Mars, and hopefully, undertaking the proposed Deep Space Gateway. You should’ve seen number of jaw drops around the room.

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Left to right: ESA’s Director for Human Spaceflight Frank De Winne, Thomas Pesquet and Timothy Peake. Photo Credit: Jacques van Oene / SpaceFlight Insider

After Dr Parker’s compelling talk, there was a Q&A hosted by Tim Gregory – you may know him as the finalist on BBC Two’s riveting program, Astronauts: Do You Have What It Takes?, but he is also currently completing his PhD in cosmochemistry right here at the University of Bristol. The selected audience members had intriguing questions, including the future of planetary protection and how investment into the space program compares with current pressing issues today (e.g. poverty and famine). I especially loved Dr Parker’s answer to the age-old question “Are we alone?”, which was that either way – whether yes, there are other species out there, or no, humans are a unique entity – both answers will be just as extraordinary as the other. Tim ended the event with, “I hope you all have a safe journey back home…and beyond!” and the claps were thunderous.

Before I could talk myself out of it, I beelined towards the front and went up to Dr David Parker – surrounded by a huddle of middle-aged people discussing the technical aspects of spaceflight, I kept thinking to myself, “I am definitely not intelligent enough to talk to these people.” And at that point, Dr Parker looked at me expectantly during a lull in the conversation. So, I thanked him for the awesome talk, introduced myself, and began rambling on about Beth Healey, space medicine and the Concordia Station since he mentioned it during the lecture – he replied with a chuckle, “Oh, you probably know much more about this stuff than I do!” to which I promptly disagreed with a smile. I then quickly asked him, “Do you think one day we’re going to have to genetically modify the perfect astronaut?”, to which Dr Parker threw his head back in laughter, and responded, “Well, isn’t that the question!? I think we’ll all be walking around more cyborg than human, and that’s something I can’t quite wrap my head around!”

I then turned around, and spotted Tim Gregory – we immediately geeked over the lecture for a bit, before I told him I attempted to read his publication “Geochemistry and petrology of howardite Miller Range 11100” (to which I confessed a single sentence took me an unfortunate amount of time to understand). Thirty seconds into the conversation, and I already understood why Tim was nothing short of extraordinary – with such powerful maturity simultaneously coupled with an endearing child-like enthusiasm, he spoke about the psychological impact going through vigorous astronaut training, the importance of keeping up your hobbies, and how Will’s Memorial can be slightly unsettling in the wee hours of the morning (there is no denying the paranormal activity).

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Meeting the lovely Tim Gregory!

I finally asked him, “What’s your motivation when you’re completely down?”, and  without any hesitation, he looked me straight in the eye before replying, “Just always remember why you began in the first place.” Incredibly optimistic, humble and kind-hearted, I cannot wait to see what other fantastic contributions Tim will make for science in the future. And then as we said our goodbyes, he enthused about how we could one day be working together on the Moon, as geologist and doctor – needless to say, describing my elation as ‘over the moon’ seems paradoxically unbefitting.

Throughout the night, I remember feeling a little out of place – bustling with an older generation, it could’ve been mistaken for just another humdrum event. But instead, looking around, I did not just see an audience – I was looking at the spirits of restless kids staying up way past their bedtime; I was looking at the wide-eyed children lying much too closely to the grainy television, chins resting on palms and legs swinging back & forth; I was looking at the generation of children who, united together on that one Sunday evening in 1969, witnessed the history-defining moment when Armstrong stepped down off that pad onto the Moon.

 

And even though I couldn’t join in to fondly chuckle at the memories of “Space: 1999” or reminisce back to collecting Brooke Bond & Company’s “The Race to Space” tea card set  in 1971, there was something universally compelling about the night’s events – this powerful hope that united every single one of us, rooted back in time to the ancient dreamers who looked up at the night-sky all the way to the tinkerers of the future, is what eventually got us from “I wonder…” to “What next?”. We’re going to keep innovating as long as we remain curious, and as Queen perfectly summarises, I don’t want to stop at all.

©TMK

 

 

The Dirt On Clean Eating

“I’m eating clean,” the postgrad says, not for the first time that week. Six of us are crammed around this tiny three-person IKEA table in the Chulalongkorn Biomedical Laboratory, eating a spread of grilled fishballs, red pork covered with gravy, and spicy somtam. I slurp a mouthful of tom yum noodles, briefly tasting the phrase before moving on. She proceeds to enviously eye the others eating blissfully carefree, but not before she pulls out a homemade salad, completely drenched in Caesar salad dressing. The overwhelming stench of mayo made me nauseous; I had to hold back a gag.

“Yeah, you guys should try clean eating,” she says with this smug expression, popping open a can of Diet Coke; it froths over slightly and trickles down lazily. “Like, I feel so much healthier, instead of putting junk in my body.”

Hoo boy.

Perhaps my mind was completely enraptured on my lovely E. coli battlefields holding little wars between the awesome antioxidants and the feisty free radicals, but I didn’t realise at the time “clean eating” would soon be taking over the minds of millennials in years to come. Fast forward, shall we?

***

Year 2 has begun, and consequently, so have the diets.

Besides all the How Was Your Summer?’s, It’s So Nice To See You!’s, Did You Do Anything Cool?’s talk that becomes heavily saturated between lectures, I see a bunch of loaded veggie wraps, skinny lattes, and quivering self-control. And if this was the scenario a few months ago, my mind would’ve crumbled from the toxicity my relationship with food was creating.

I’m all for eating clean. I’m happy that people are striving to nourish their bodies with nutritious ingredients and are spending a little longer looking at supermarket food labels. This is an awareness I admire, but “clean eating” is a little different from your quack conspiracy-theory-like diets; it has challenged mainstream ways of eating, powered by the ever so convenient social media, and has become absolutist in its claims.

The phrase “clean eating” must’ve began with good intentions; to eat fresh, natural, whole foods minimally processed – vegetables, fruits, whole-grains, animal & plant-based protein, oils, nuts, pulses. Eating as close to nature as possible; cooking at home and seeking high-quality ingredients for your own health. This healthy approach towards nutrition is fantastic. Eating clean sounds modest, almost like Mum’s cooking – no calorie calculators, but simply eating as much nutritious home-cooked substances as possible.

So, #eatingclean, #eatclean, #clean – what the heck happened?

This definition has become incredibly misguided and misconstrued. It’s clear “clean eating” is more than a diet; it’s a belief system. That if you’re not “eating clean”, you’re the very opposite – sloppy, careless, and damaging your body. And that’s when this becomes a dangerous game to play. It’s morphed into a beneficial sense of awareness of food into this diet-driven caste system. Not only is “clean eating” establishing a hierarchical model for eating healthily, but it is yet another bolstering means for food-shaming. And just to make it all worse, its taking over the entire Instagram platform, shovelled into the mouths of millennials, resulting in a heightened paranoia about the foods we eat consequently falling onto an obsession with the way we look. It’s the latest fad to prompt nationwide lack of self-acceptance in this millennial generation. I miss the days when “eating clean” simply meant not getting nachos down your front (napkin, miss?).

What I realised from my personal experience – the hours and hours of searching up vegan burrito bowls on Pinterest and anxiously scrolling through the infinite #cleaneatinginspo thread – is that this whole “eat clean” culture disregards the lack of access, both in time AND money. Not all of us can find the little organic farmer’s market; not all of us can afford dried gogi berries, a kilo of coconut sugar and cacao nibs on the daily. The surge in #avocadotoast aesthetic, Amazon searches for spiralisers and cauliflower pizza bases. Frankly, it’s elitist – this isn’t food education or nutritional economic awareness. This is buying into the attempt to be, let’s face it, media-skinny; the fat-burning green juice, protein powder lovin’ pictures of health. This isn’t the “eating clean” I signed up for, but a movement I unfortunately became a part of.

In addition, the phrase “clean eating” misrepresents scientific evidence of food ingredients – more and more food products begin boasting a “clean ingredient” label. But how could it be, if your product is mostly filled with a trendier version of oil and not providing consumers with educated choices? Kale is no better than good ol’ spinach; coconut oil is high in LDL cholesterol; commericalized cold-pressed juice is essentially a bottle of expensive sugar. And like with any revolution, “clean eating” has its hardcore leaders. I know you know them.

The trend claims to be easy, but just like every YouTuber who attempts the Pinterest Challenge, it is always much more complicated than that. The rules are endless, and you have the power to choose which one to adhere to – you can begin with the vegetarian diet, pescatarian diet or vegan diet. Pretty harmless, huh? Well, let’s go further – the Atkins diet, juice cleanse diet, paleo diet, carb-free diet, gluten-free diet, dairy-free diet, or the sugar-free diet. Oh, but it doesn’t even stop there – how about the anything-cooked-above-a-certain-temperature diet, or the raw food diet? What’s next, food-free diet? Breathing-free diet? If that sounds extremist, you bet your fancy pants it is.

Unsurprisingly, this philosophy birthed unrealistic, guilt-inducing fads – and falling down to our knees, we pursue its promised attractive outcome despite its disguise as an instructional guide to becoming unhealthy obsessive and/or feeling ultimately terrible about ourselves with failure. If any kind of diet whispers into your ear, “Hey, food is the enemy. Take it down.”, drop the weapons of restriction, because there is something very wrong. Don’t you ever view your food choices as sources of guilt and shame. This war makes you delusional, and it has consequences.

©TMK

 

 

Laughing Gas | Time Capsule Log 💊

I’ve never tried laughing gas. Just never felt the need to; I’ve seen some of my friends intoxicated with the substance, and that’s enough entertainment in itself. But, the history of this party drug is a pretty incredible one – you’ll realise a lot of great inventors are elite masters of self-experimentation (yeah, not me) and this guy is no exception. Let’s get to it.

It began in 1772, when Joseph Priestly first discovered nitrous oxide, and he successfully synthesised it in 1775. Then came along young English chemist and inventor (plus, future president of the Royal Society), Humphry Davy. In October 1798, he joined the Pneumatic Institution in Bristol as the laboratory operator, and for you Bristolians out there, you’ll be extremely proud to know it was there where Davy played around with stoichiometry and delivered the laughing gas of your parties today! Oh, and just for your interest, this organisation was formed to exploit usage of recently discovered respiratory gases for medical practice – thus, the date 1798 is a pretty vital marker for the rapid progress in the discovery of respiratory gas for times to come.

***A lot of the quotes and information below comes from Davy’s “Researches, chemical and philosophical chiefly concerning nitrous oxide, or diphlogisticated nitrous air, and its respiration” (1800). 

Davy was dead keen on determining the effects of inhaling nitrous oxide (“…I resolved to breathe the gas for such a time and in such quantities, as to produce excitement equal in duration and superior in intensity to that occasioned by high intoxication from opium or alcohol.”) With the aid of his assistant, Dr Kinglake, during his first few experiments, he described “a slight degree of giddiness”, “pleasurable feelings” and “sublime emotions connected with highly vivid ideas”. So, Davy began increasing both the dosage and the frequency of the experiments over the next couple months, and he does allude to a potential medical use of nitrous oxide, “The power of the immediate operation of the gas in removing intense physical pain, I had a very good opportunity of ascertaining.” 

Ya boi began inhaling the gas in out-of-work hours by December, and “felt very great pleasure when breathing it alone, in darkness and silence, occupied only by ideal existence”, though remained incredibly diligent in logging his scientific entries. Ugh, nothing sounds more tempting than a long session of optimistic nihilism, ammirite?

Later, he constructed an “air-tight breathing box” where he would sit for hours and hours, inhaling way too much of that addicting gas, and nearly died on several occasions. He began allowing others to partake (what a selfless man) and I highly recommend you read all the entertaining experiences of his acquaintances, friends & family getting high on this hippy crack. All for science, of course. For example, you know talented poet Robert Southney? Dude who wrote “Goldilocks and the Three Bears”, and the epic 1796 poem “Joan of Arc”? Oh yes, he tried out this gas and stated it “excites all possible mental and muscular energy and induces almost a delirium of pleasurable sensations without any subsequent dejection”.  Ayyy, a delirium of pleasurable sensations leading to talking bears who eat porridge! (Jk I don’t want to assume anything, but who knows…)

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Pleasure was so cheap back then

I know I’m making it sound like Davy was a sneak who used the excuse of science as a coverup to enjoy the bouts of pleasure – but honestly, he really did bear medical intentions in mind and was an intelligent guy. Davy was close to recognizing that inhaled nitrous oxide could be valuable for anaesthesia; however, the usage of nitrous oxide at upper class parties and fairs only increased its reputation as a novelty and decreased its respectability as a medical tool. 

So lets just skip ahead and head across the pond to meet our next figure, Horace Wells, who saw the gas as a way of reliving the pain of dentistry in 1844. In fact, he had such great success he got a chance to perform it for a crowd at Harvard Medical School…and no, they weren’t a friendly bunch. Wells extracted the tooth of a complying patient, and there definitely was a lot less pain than usual, but the patient mentioned still feeling some pain – this was enough for the judgemental physicians to boo Wells off the stage, and Wells committed suicide a few years later. Wow, doctors, way to go – what’s the purpose of your occupation, again?

Two more decades until nitrous oxide was used again publicly. Two! Okay, we’re almost there. Well, its reintroduction around 1870 was somewhat permanent, and remained the golden dental anaesthesia until the 1960s. It kept its position in anaesthetics, though not at the forefront; although plenty of physicians use it in their practice to this day, it isn’t really something anyone would admit to because even medical grade nitrous oxide can leave people anaemic and are potentially lethal even in the right amounts. Eek.

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MySafetyLabels.com

Nitrous gas has its iffy reputation, but the fact euphoria is mentioned on labels today endures its original recreational usage from over 200 years ago. So, next time, when you’re buying a canister of this stuff at some awesome party, give thanks to your 20-year-old pal Davy doing exactly the same thing 219 years ago.

Sources:

https://eic.rsc.org/feature/nitrous-oxide-are-you-having-a-laugh/2020202.article

https://io9.gizmodo.com/5934877/the-strictly-non-medical-history-of-laughing-gas

https://en.wikipedia.org/wiki/Pneumatic_Institution

http://www.independent.co.uk/news/uk/home-news/how-dangerous-is-laughing-gas-legal-highs-hippy-crack-nitrous-oxide-safety-facts-explained-a7088226.html

http://justsayn2o.com/nitrous.history.html

http://publicdomainreview.org/collections/the-nitrous-oxide-experiments-of-humphry-davy/

http://www.smithsonianmag.com/smart-news/heres-what-it-was-discover-laughing-gas-180950289/

©TMK

Listerine | Time Capsule Log 💊

Listerine did not invent bad breath. Human mouths have stunk for millennia, and there are ancient breath fresheners out there you can read up about. But here’s a nice little story of how Listerine advertisements transformed bad breath from an ordinary albeit awkward personal circumstance into an embarrassing medical condition with heavy implications of social suicide. Treatment that very conveniently was sold by the company themselves.

The History Of Listerine

What: Listerine was invented originally as a surgical disinfectant.

Who: Doctor Joseph Lawrence, inspired by the research of Sir Joseph Lister. Oh, who was Joseph Lister? Well, back in the nineteenth century, “hospital disease” (now known as post-operative sepsis infection) was prevalent; that is, mortality rates post-operation were high despite successful surgical procedures. For example, Lister reported in the Male Accident Ward in the Glasgow Royal Infirmary, between 45-50% of amputation cases died from sepsis between 1861 and 1865. It was in this ward he did his experiments – in line with his earlier research on the coagulation of blood and role of blood vessels in the first stage of inflammation, he had already formulated theories and disregarded the concept of miasma (popular, but not obsolete medical concept, stating diseases were caused by “bad air”). By that time, bacteriologist Louis Pasteur had arrived at his theory microorganisms caused fermentation and disease; thus, Lister’s education and speculations that sepsis could be caused by pollen-like dust compelled him to accept Pasteur’s theory. An amalgamation of his previous research and Pasteur’s theory, he began conducting experiments; he soaked dressings with carbolic acid to cover wounds (an effective antiseptic already used as a means of cleansing foul-smelling sewers). The results were dramatic: surgical mortality rates decreased from 45 to 15% between 1865 and 1869 in the Male Accident Ward. And in 1865, Lister was the first surgeon to carry out an operation in a chamber sterilised by pulverising antiseptic into a fine mist of carbolic acid into the air around the operation. 

Why: So, here comes in an inspired Joseph Lawrence, who made a unique formulation of surgical antiseptic himself in 1879…and in honour of Sir Joseph Lister, called it LISTERINE®. He formed a partnership with pharmacist Jordan Wheat Lambert, creating Lambert Pharmaceutical Company, producing & selling this disinfectant in operating theatres and bathing wounds.

How: …but it was pretty small market. So, to increase sales, its advertised use became extremely varied: a cure for dandruff, a floor cleaner, a hair tonic, a deodorant, and even a cure for diseases ranging from dysentery to gonorrhoea. Okay, so this did put up company revenues. But the Lamberts had another idea in the 1920s. 

They began putting the vaguely medical-sounding term “halitosis” in their advertisements, framing it as a health condition hindering people from being their best. During that era of time, a lot of companies were offering products that could cure every known illness, including catering to the emerging middle class’s social anxieties. I mean, look at this ad below – the sad, unmarried Edna doomed to be a bridesmaid but never a bride just because she has this condition “halitosis”.

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This marketing campaign was incredibly successful, and over 7 years, revenues skyrocketed to $8 million. And now, we all know Listerine primarily as the antiseptic for oral health & hygiene. This must be one of the best iterations in history of the modern advertising industry creating a problem to sell its solution. Well played, Lamberts.

Sources:

http://www.sciencemuseum.org.uk/broughttolife/people/josephlister

https://www.listerine.co.uk/about

Listerine Was Once Sold as Floor Cleaner

Click to access listerine.pdf

©TMK

Vibrators | Time Capsule Log 💊

I just came back from the 13th International Conference on Thai Studies titled “Globalized Thailand? Connectivity, Conflict, and Conundrums of Thai Studies” in Chiang Mai – my amazing sister presented her LSE dissertation, Thai Youth Sexual Culture: Exploring Representations of Gender and Sexuality in the Thai Controversial Series, Hormones (2013).” If you’d like to read the masterpiece, here’s the link (scroll down to Tammarin Dejsupa and press that PDF logo); there were way too many intelligent words coming out of her mouth, and needless to say, I was immensely proud, but also very confused…

The panel was on sexuality, media & commercialisation – and so, to kind of continue on a similar theme, I decided to dedicate this time capsule log to that by writing about…vibrators.

•••••

There’s a tale that goes Egyptian Queen Cleopatra invented the vibrator; she supposedly had the idea to fill a hollow gourd with angry bees, and the violent buzzing caused the gourd to vibrate…and the rest is history. Or is it?

If you do a quick Google search on the history of vibrators, many will state it was invented by Victorian doctors as a prescribed “pelvic massage” treatment for patients with hysteria to induce “hysterical paroxysm” (read: orgasm) because the medical professionals back then complained about the manual labour being tiresome. It’s a great conversational story, huh? Imagine breaking the ice with “Hey! Did you know, the vibrator was invented to treat women with hysteria because Victorian doctors got tired of manually stimulating them?” And then there’d be shared boisterous laughter, suggestive nudges and comments like “Ugh, tell me about it!”

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Source

The story makes the Victorians sound reserved, that they were oblivious to the art of self-pleasure and never saw pelvic massage as anything other than medicinal. And until the 20th century, it was even more so believed women did not experience sexual desire; to be a lady was to lack sex drive, with a duty to put up with their husband’s sexual needs. It would feed directly into the stereotypical connotations I’m sure most of you have about the Victorians – the whole high prudery attitude resulting in shrouding piano legs and a “Lie back and think of England” kind of mentality.

It’s true that some doctors during that time believed the art of self-pleasure was highly dangerous to your health (check out these painful looking anti-masturbation devices – moment of silence for all the teens during 1840 to 1900). However, Michel Foucault famously critiqued these stereotypes, and in his book “The History of Sexuality” explains the repressive hypothesis: “…that Western man has been drawn for three centuries to the task of telling everything concerning his sex; that since the classical age there has been a constant optimization and an increasing valorization of the discourse on sex; and that this carefully analytical discourse was meant to yield multiple effects of displacement, intensification, reorientation, and modification of desire itself.”1 Basically, as readers, we’ve read into the history of the past three centuries assuming sexual repression. Whether or not you accept this hypothesis, Foucault sparked much academic work exploring the various ways Victorians did indeed openly speak of desire; there are a lot of examples. Victorian attitude towards both male and female sexuality can be seen just as expressive and expansive as it is today – a prime example being the glamorous courtesan of Paris, Cora Pearl, who lived a very erotic life. In fact, Victorian women had a healthy interest in protecting their bodies whilst still enjoying a sexual relationship; Annie Besant’s “Fruits of Philosophy”2 published in 1877, was a guide that listed every single possible contraceptive method available to the Victorian reader, becoming so popular it even reached out to 125,000 Brits in the first few months alone.

So, back to that whole women-with-hysteria-treated-with-massage-and-vibrator-was-invented story. In actuality, it was only a hypothesis by Dr. Rachel Maines, famed sex historian and author of seminal 1999 book, The Technology of Orgasm”. She even said so herself, “Well, people just thought this was such a cool idea that people believe it, that it’s like a fact. And I’m like, ‘It’s a hypothesis! It’s a hypothesis!’. But it doesn’t matter, you know? People like it so much they don’t want to hear any doubts about it.”3 Truth! Even when I began researching about the topic, I thought it was a hoot and a half to tell. But now we know – yes, the vibrator was officially invented in Victorian times, but that is definitely not the full story. Number one, doctors were fully aware what they were doing; keep in mind, people thought real sex was only penetration to male orgasm, and sex education was incredibly limited. I just wanted to make clear Victorians weren’t this prude, unaware society. Number two, the vibrator’s history is much more complicated. Hopefully we can get past the party story version.

So, what’s the actual history of the vibrator, then? Well, we definitely know its origin was very much within the medical setting; the earliest vibrators, as stated by Dr. Maines, “…came out of massage, hand technology for massage.” Not with the intention of inducing orgasm. But other than that, there is vast amount of speculation out there, which in turn further deep-dives into a plethora of ancient obstetrics & gynaecology papers. I particularly enjoyed Helen King’s critical analysis of the history behind therapeutic masturbation associated with “hysteria” – it’s 32 pages long, but 32 pages of such splendidly interesting information citing many dated texts (honestly, worth checking out). However, I attempted to comb through the tangles of speculated knowledge so you don’t have to (but there is still so much out there I haven’t mentioned). Here we go.

The History of Vibrators

We begin with Hippocrates, widely regarded as the Father of Western Medicine (we swore the derivative of his medical oath during the promise ceremony first week of uni). Despite his brilliance, there was a lot about the female body Hippocrates did not grasp – he believed the womb was an actively moving organ that even travelled to the trachea during orgasm, contributing to heavy breathing. The label “hysteria” is never used in early texts, but that weird womb-moving theory Hippocrates thought of is mentioned as a condition called “suffocation of/from the womb”. The womb, he believed, was to blame for “nervousness, fluid retention, insomnia, and lack of appetite”4 Later, Greek doctor Galen, most admired for being a brilliant anatomist ahead of his time and a master of medical philosophy5, proclaimed the symptoms were caused by retention of semen and saw widows as a particularly high-risk group. The cure: herbal remedies, pelvic massage, and even getting married6 (can you imagine getting this as your prescription). Mind you, the concept hysteria hasn’t been mentioned yet.

It persisted through the Middle Ages; treatments still included marriage and pelvic massage, but also “irritating suppositories and fragrant salves”7This treatment continued throughout the Renaissance period, and Nathanial Highmore was one of the first doctors to publicly acknowledge the end result of pelvic massage – the hysterical paroxysm8Orgasms became kind of a socially acceptable treatment for this strange condition that hadn’t been named yet. Whatever the condition was, doctors agreed it included a wide variety of symptoms including nervousness, anxiousness, emotional outbursts, hallucinations, “tendency to cause trouble”, fluid retention, and yes, sexual thoughts/frustration. 

In the 1700s, speculated causes of this condition shifted from the womb to the brain, but it wasn’t until the beginning of the 19th century when the condition was finally labelled hysteria (the Greek word for womb) and was something in need of treatment. The treatment was hysterical paroxysm, horse-riding, and even unpleasant blasting of water on the abdomen.9 Doctors apparently dreaded giving hysterical paroxysms because it was time-consuming, taxed physical endurance, and hand fatigue giving the massages meant they couldn’t always produce the desired result. They pushed for an invention to aid them – thus, here enters the very first vibrator: the Tremoussior, a strange wind-up clockwork contraption invented in France, 1734 (mind you, this was before electricity was invented). Then, in 1869, came along the steam-powered vibrator, “The Manipulator”, invented by American physician George Taylor – however, it was this cumbersome, immovable thing that you constantly had to shove coal in.

Finally, an enterprising English physician, Dr. Joseph Mortimer Granville, patented an electromechanical vibrator during the 1880s, which became greatly popularised and was soon a permanent installation in the doctor’s surgery at that time. It became incredibly popular and soon, battery-powered vibrators were introduced as a household appliance; it was a huge commercial success, becoming the fifth electrical appliance to be introduced into households alongside the kettle, sewing machine, fan, and toaster10.

 

But then the vibrator had its debut in pornography and became unacceptable as a household tool to treat hysteria, labelled prurient rather than respectable. Women could no longer disguise their intentions of buying one, and doctors dropped the devices because of their sexual connotations. Vibrator ads disappeared from consumer media, and lips were sealed shut – that is, until the women’s movement in 1970s. Feminists like Betty Dodson11 made it a symbol of female sexuality, and vibrators became just as popular as before.

As for hysteria – being such an amorphous condition, the diagnosis surprisingly only recently fell from medical grace in American Psychiatric Association’s mental disorders in 1952.12

So there you have it. From womb-moving theories to feminism, that is how a medical cure became a female sexual icon.

Sources:

1: https://g.co/kgs/Z5hx6H

2: https://www.gutenberg.org/files/38185/38185-h/38185-h.htm

3: http://bigthink.com/ideas/18073

4: http://women.timesonline.co.uk/tol/life_and_style/women/article4032852.ece

5: http://www.greekmedicine.net/whos_who/Galen.html

6: http://www.vonnaharper.com/history-of-the-vibrator.html

7, 8: http://www.motherjones.com/media/2012/06/hysteria-sex-toy-history-timeline/

9: Cosmacini G.  The long art: the history of medicine from antiquity to the present. 00. Rome: Oxford University Press; 1997.

10: http://www.thedailybeast.com/hysteria-and-the-long-strange-history-of-the-vibrator

11: http://www.abc.net.au/news/2016-10-15/the-history-of-the-vibrator/7925988

12: https://www.scientificamerican.com/article/the-vibrator/

©TMK

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