Archive for the ‘medicine’ Category

Podcast plug – Dr Aust live (ish)

September 30, 2010

In which Dr Aust does some heavy breathing into a headset.

A week or so back, thanks to the wonders of internet-based communication technology (aka Skype) I joined the guys from Greater Manchester Skeptics for their podcast Just Skeptics (Episode 12, apparently). It is now out – if you’re interested, you can listen to it here, or here, or even download it (free, of course) from the iTunes store.

You’ll have to excuse the heavy breathing, which I’m embarrassed to say was me. I’d never used a microphone headset before – I’d only installed Skype a day or two earlier – and I think the microphone distance needs adjusting. Or perhaps I’m just a heavy breather.

Anyway, if you do fancy checking it out, you can first hear us talking about “Charity mugging”, the phenomenon whereby you can’t walk twenty metres in a British town centre in the daytime without being accosted by someone trying to sign you up as a charity (direct debit) donor. Until the podcast I hadn’t heard that these “Chuggers” are often out-of-work actors.

We also discuss mad chemists, that hardy stereotype of the man in the white coat with the mad staring eyes. This was inspired by the UK Government’s “Crazy Chemist” anti-drug campaign – the one that got the Royal Society of Chemistry so hot under the collar.

And finally, at 24 minutes in, you can hear me having my “Soapbox” where I poke fun at Alternative Medicine. It’s not terribly original stuff, and will probably be fairly familiar to regular readers, but hopefully you might find some of it amusing.  This segment is followed by a discussion of similar themes, which runs for most of the rest of the podcast. It  concludes with the Richard Feynman reflexology story that you may remember from here.

Anyway, let me know what you think, especially if you stick it out all the way through.

PS Listening to the podcast I now notice a couple of minor factual inaccuracies on my part, notably giving the wrong name for something… ah well. Shows that talking off the cuff is not as easy as one might think. Try to spot the slip(s), if you like.

Advertisements

Stress, fighter pilots and medical students

August 31, 2010

In which Dr Aust offers, instead of bad science, a rather meandering anecdote.  Sorry.

En route back to Britain last week from our rather damp annual holiday, I couldn’t help noticing all the media coverage of the 70th anniversary of the Battle of Britain.

Like all children growing up in Britain in the 60s and 70s, I guess, I became familiar early on with the story of the Battle as it has passed into British folklore (or history).  I remember my mum taking my little brother and I to see the 1969 film version during a rainy holiday (another one!) on the Isle of Wight. At the time (the tail end of the 1960s) Winston Churchill was not long dead, and we children could all recite by heart his famous line about the Battle:

“Never, in the field of human conflict, was so much owed by so many to so few”

So the picture of young RAF fighter pilots pushing themselves to the limit to keep the Luftwaffe (the German air force) at bay in a knife-edge struggle against the odds was a very potent one in those days – and of course, there were many people still alive then who had been part of the battle. The struggle and the bravery of “The Few” seemed to embody what British people felt were “the British virtues”. Perhaps that is still true – though I was interested to find, reading the modern Wiki entry on the Battle, that the historians nowadays debate the version of it that I grew up with.

Anyway, the coverage this Summer reminded me of learning about the Battle of Britain some forty years ago – but also about another context in which I have come across the story being used.

Let me fill in this other context for you.

One of the things you get used to dealing with over the years, if you are a University teacher, is students who feel under pressure. Now, for people of my vintage there is a definite tendency, I think, to see University in hindsight as a right old lark. From the perspective of ten or twenty or thirty years spent earning a living, and dealing with all of life’s other vicissitudes, it is rather difficult to see the University years as a time of stress and pressure. Indeed, I think this view is common among most people looking back at their student years. When I learnt, rather late, to drive, I had a driving instructor who used to describe his one year at University before dropping out as “the best year’s state-sponsored drinking I ever had”. And I had a good laugh at this very funny David Mitchell piece from the Guardian last week.

Now, it is fair to say that things have changed in more recent years. The state in Britain is not sponsoring students nearly as much as it used to, and nothing like it was when I was young. Many of our students now have to have part-time jobs to help with their finances – though this seems to be far less common in “vocational” degrees, like medicine, that have more fixed time commitments during the week. We set a lot more formal assignments for students to do then when I was a student, and we set students exams far more often too. And many of our students are certainly worried about getting a degree results good enough to ensure they will be competitive in the employment market. So it is, I freely admit, not like it was when I was twenty years old.

Having said all of that, the first couple of years at University must still be, I think, one of the least stressful times work-wise in most people’s lives. In most UK Universities and courses, you merely need to pass the 1st year exams. You don’t have to get 80% – or even 60%.  In the 2nd year of UK science degree courses, the exams typically count in part towards the final degree grade (classification), but usually only a bit (often contributing something like 20-25% of the final mark). Meanwhile, in professional degrees, the 2nd year is another “you simply have to pass” deal. Depending on the particular degree, the pass mark for the year (or its component units) will typically vary between around 40 and 55%. There are sometimes “Distinction Points” for those who record the top marks, but mostly it is pass/fail.

Given all this, you would not think students in this part of their University course (the early years) would be that stressed.

Some of them, however, are.  Or they certainly feel, and tell us, that they are.

Medical students are a special example in some ways, partly for the following reason. People who reach medical school are typically those who have been used to being the top, or near the top, of the class throughout their years in the school system. Conversely, they are not used to failing things. But obviously, the step up from school to University is a significant one. And now you are in a group where everyone has been selected as being from the top echelon at school. Anyway, there is a top of the medical school class, and a bottom. And some people do fail medical school exams in the 1st year.

The good news for them is that they get another chance.

Further good news is that, if you are going to fail one set of exams in medical school, the best ones to fail are probably the first lot that you do. Everyone knows there may be an “adjustment”, both for academic or personal reasons, in the transition from school to University. Away from home for the first time, for instance. Busy socialising, for another. Getting used to working without teachers and parents prodding you along for a third. As a result of this, you typically get cut a little slack if you are a student having a few bumps. You have to pass the resit exam, but the initial failure does not get you written off as a no-hoper, or even a problem case.

But some students take any failure very personally. And each year, at least a couple of those that have failed the first Semester exams fetch up in the Faculty offices complaining that they are having problems with stress.

Now, views on how to approach discussing this with students differ. Back in the 1950s, in the era of the Dirk Bogarde Doctor movies, such a student would no doubt be told to “Pull your socks up, work harder and stop talking such utter nonsense.”

We don’t do that any more.

We are sympathetic. Really, we are.

Indeed, we in the University are rather more sympathetic than some in the medical profession itself might be. Hardliners in medicine (which might at times include Mrs Dr Aust, for instance if she has had a bad week in the medical trenches) have been known to offer the view that if a person can’t cope with failing their 1st year medical student exams and having to resit, then they are going to be about as much use as a junior doctor (a job that undoubtedly is stressful) as the proverbial udders on a bull.

So one take on the stressed 1st year student who failed their exams is that they perhaps benefit from being gently reminded that it is a minor setback that they can hopefully address and overcome, regroup and move forward, worse things happen at sea etc etc.

So, sympathy, but also a gentle steer that failing an exam isn’t the end of the world, or really that stressful in the greater scheme of things, and you need to get things in some perspective.

Which brings me back to where I started – with the Battle of Britain.

You will see why in a minute.

At a medical school where I worked, the person who for many years saw the students having “difficulties” (including those who were feeling stressed) was called the Senior Tutor for Students. The occupant of this role was a slightly crusty (but actually very wise) Yorkshireman, honed by many years of teaching gross anatomy whilst also working as a GP in a local health centre. By the time I met him, this chap, who was one of the best medical teachers I have ever come across, was in his 50s and already a legendary figure among generations of undergraduates.

One of his more celebrated routines for talking to 1st year students who were complaining of stress problems went something like the following.

————————————————————————————-

(Fixing student with deep hooded gaze over his glasses)

” Yes… well, How to look at this.”

A pause.

“Consider, if you will, A Battle of Britain fighter pilot in the Summer of 1940, fresh from training school. Solo flying hours on a Spitfire… perhaps a handful. Sleep in the last week… perhaps 20 hours in all. Chance of returning from the next day’s sorties against the German fighters, perhaps two out of three…”

Longer pause.

That (word very slightly emphasised) would be stress, I’m sure we could agree”

Another pause.

“Now…. you are a first year medical student…..”

————————————————————————–

Which is, I hope you will agree, the stuff of legends. I have certainly met doctors who could still remember, a dozen or more years later, themselves or their friends being on the receiving end of  this spiel.

And finally, with another teaching year at the University about to start, with all its inevitable minor vicissitudes – not to mention the uncertain economic future for the University sector –  I shall be taking my own advice.

I shall be doing my very, very best to keep it all in perspective.

Poetry corner – subluxation special

May 15, 2010

In which Dr Aust mourns the loss of an old (imaginary) friend.

Today Zeno’s excellent blog alerts me to the sad loss of the Chiropractic Subluxation, printing an extended and most informative Obituary.

This follows a lengthy investigation by Zeno and other interested parties, notably the Skeptic Barista, into claims that the Subluxation had, in fact, been deceased for many years.

Or, indeed, that it had never existed in the first place – except, perhaps, as a metaphor.

The Chiropractic Subluxation,  you may remember, is the mysterious “functional lesion” (no non-subjective test will actually find it, but chiropractors have insisted it is there) in the vertebral column which chiropractors claim to find, “diagnose” and correct.

Well – they did used to claim this.

That, however,  may be about to change.

The Skeptic Barista informs us that the UK’s General Chiropractic Council has now declared that:

“There is no clinical research base to support claims that the chiropractic vertebral subluxation complex is the cause of disease or health concerns.”

Advice to chiropractors about whether they can continue to make claims for the subluxation complex being:-

“the cause of disease or health concerns”

– and hence, of course, something you should consider paying a chiropractor to correct – is likely to follow shortly.

In the meantime, and following the acclaim for our resident bard’s  recent Memorial Poem on the demise of the Prince’s Foundation for Integrated Health, he has been persuaded to pen something suitable on this new, and solemn, occasion.

———————————————————————————————————

POETRY CORNER

In Memoriam
The Chiropractic Subluxation

So. Farewell
Then. The Chiropractic
Subluxation

A complicated Word
For something that
Does not
Exist.

Or perhaps for what
Was just
A Metaphor.

Or rather –
A Metaphor
Wrapped up inside
An Enigma
Wrapped up inside
A Paradox.
Wrapped up inside
A Huge Invoice.

Which last
Chiropractors have been
Presenting for
At least
A Century

Very Tricky

As a member of
The Public
You would probably
Need X-ray
Vision
to
Get to the
Bottom
Of All This.

Or at least to make
Sure you
Were not being
Manipulated

In memoriam

April 30, 2010

In which Dr Aust gets a bit poetic

Today the Prince of Wales’ Foundation for Integrated Health (FIH) announced that it was to close its doors.

(There is some suggestion that if you look at the logo for long enough the feathers will start to droop.)

The announcement follows recent revelations about the FIH’s finances, sources of income for at least one of their more notorious projects, and the police investigation into allegations of serious fraud at the charity, including the arrest of at least one ex-staffer.

Though the announcement states that the closure of the charity was “already planned”,  it acknowledges that it has been brought forward by the ongoing police investigation.

The story has already attracted coverage in the media – both mainstream and scientific/medical – and on the blogs.  Some links are at the end.

However, as yet, no-one has penned a valedictory poem.

Though I suppose it is possible Poet Laureate Carole Ann Duffy will rise to the challenge in due course, in the meantime I thought I would have a go.

So, with apologies to E.J. Thribb, I give you:

————————————————————————————————————

POETRY CORNER

In Memoriam
Prince of Wales’ Foundation for Integrated Health

So. Farewell
Then. The
Prince of Wales’ Foundation
for Integrated Health

As it so
Happens a
Much disputed term

“Integrated Health”
You said.
“Quack nonsense” said
The scientists.

“Achieve optimal health
and wellbeing”
You said.
“If you buy this Duchy dodgy
Herbal potion
They mocked.

But of course now
That all the
Money has disappeared
It might
Appear rather
Quackademic.

—————————————————————————————————————-

I have also been trying to come up with a suitable epitaph for the FIH

So far my favourite is:

Requiescat in ridiculo

or perhaps:

Requiescat in ridiculo (a)eterno

Which latter version would have the neat acronym – at least for anyone who has ever studied French at school – RIRE.

—————————————————————————————————————-

More coverage:

From Pulse (with quotes from FIH’s Dr Micharl Dixon and Edzard Ernst)
From Nature (with comment from Edzard Ernst)
From David Colquhoun’s blog (with updates promised)
Google collection of news stories