When the Dust Settles
Photo Credit: Elizabeth Hu
Welcome to the 54th Volume of the AMSA Panacea - an annual magazine
celebrating the diversity of medical student talents across the country.
'Panacea' is defined as 'a solution or remedy for all difficulties' and this year
has certainly presented us with some unique challenges. Fittingly, the 2020
Panacea is themed: 'When the Dust Settles: Reflection and Renewal in a
Before we let you peruse the artworks, poems, and features of this edition we
would like to thank all the students who submitted to this issue, as well as
the 2020 publications team, and sponsorship officers whom without this
beautiful magazine would not be possible.
So go ahead, turn the page and prepare to be inspired by the phenomenal
talents, resilience, and accompishments of the medical students of 2020.
Truth in a Time of Covid-19: Carpe Diem!
A letter to pre-COVID me
I Wonder- To the Ones that Never Got a Chance
Generation Z, BLM, and What it Means for Medicine
Things to do in Lockdown
From COVID to the Coral Sea: An Echo Through Time
How has medicine and the world changed and how will it 14
Ichange after the pandemic is over?
Medicine at the Movies D18
Recovering Medical School
Minds of Medicine
Ars longa, vita brevis
The Lost Magic of Lockdown
The Fight Against Gender Based Violence
Truth in a Time of COVID-19
Carpe diem (Latin)- Seize the day!
Popular phrase drawn from an ode written by the famous 1st century Roman poet, Horace.
You should not ask, it is wrong to know, what end the
gods will have given to me or to you, O Leuconoe, and do not try
Babylonian calculations. How much better it is to endure whatever will be,
whether Jupiter has allotted more winters or the last,
which now weakens the Tyrrhenian Sea against opposing rocks:
be wise. Strain your wines, and because of brief life
cut short long-term hopes. While we are speaking, envious life
will have fled: seize the day, trusting the future as little as possible.
Dear pre-COVID-19 Me,
I’m here to warn you: brace yourself.
I know you’re already imagining a clichéd start to your first year
of medical school, complete with exciting hospital visits, mindblowing
lectures taught by renowned professors and, naturally,
exciting adventures involving exploring Sydney with your new
friends. Unfortunately, though you don’t know it just yet, this
isn’t the way your first year will ultimately pan out. Let me tell
you that when people say that sometimes expectations don’t match
up to the reality of things, they really know what they’re talking
Before you know it, COVID-19 will have hit you hard and you’ll be
in lockdown for the foreseeable future, forcing you to put a pin
on all those exploring Sydney adventures. Then by April all your
classes will be transitioned fully online, so you’ll have to give
up those hopes of interacting face-to-face with professors and
Perhaps even more disappointing is the fact that COVID-19 will put
a real dampener on your dream of finally fulfilling the archetype
of a messy and disorganised first-year university student. The
virus will be infectious and easily transmitted meaning that
you’ll probably have to spend hours disinfecting every fruit,
vegetable and juice carton you buy from the supermarket- there’ll
be no room for messiness. Not to mention masks will mean life-ordeath
for you on public transport and you’ll want to keep that
bottle of hand sanitiser that your MedSoc gave you during O-Week
nice and safe. Trust me when I say this: you’ll never take
handwashing lightly after the next few months of your life.
I’m sorry to have to be the one to tell you this but your social
life will also most likely not live up to all the hype. Since most
of your classes will be transitioned online from very early on in
the year, you’ll probably have maybe around a hundred friends,
sorry Facebook friends. Don’t worry though, you’ll soon start
recognising people by their Zoom name and standard blank Zoom
screen; you’ll get used to the feeling of knowing people but not
knowing people at the same time. All jokes aside, just promise me
that you’ll attend all the Zoom parties and Facetime calls you’re
invited to because it will probably be all the social interaction
you will get.
While this might sound very daunting and a little stressful, I can
assure you that it’s not all going to be bad. Okay, so maybe your
fantasies of a clichéd first year of university might not come to
fruition but change is not always a bad thing. In fact, change
inspires resilience. You’ll find yourself getting stronger over
the coming months and you’ll pick up hobbies and skills that will,
if nothing else, make for cool party tricks in the future. You’ll
be able to spend more time on the things you love like reading and
playing the piano. You’ll find out just how strong your selfdiscipline
is when it comes to exercise (unfortunately, not very
strong) and you’ll definitely improve your cooking skills
infinitely. In fact, you might be able to get by on your second
year of university just by eating all the banana bread that you
will bake this year.
When you’re feeling down because you think you’ve missed out on
key medical student experiences like visiting the hospital and
observing live practicals, know that you will gain plenty of
unique experiences too. For instance, you will find yourself
having the opportunity to meet with simulated patients online and
conduct a tele-health-type consultation. Let me just tell you,
this is a skill that you’ll want to have under your belt
especially since it has gained in popularity tremendously this
year. You should also remember that learning never stops in
medicine and, even if you do miss out on some experiences, you’ll
have five more years of your medical degree and the rest of your
career to learn.
In short, the next year will totally be different to what you
imagine- but different is not always bad. Just think about it:
without difference, you would not have discovered the true joy of
being able to attend lectures all snuggled up in your pajamas.
Your first year might not be what you expected but it will most
certainly be unique!
Present day Me xx
Photo Credit: Gabrielle magalski
Surfing at Kirra. Shot on 35mm film
Photo Credit: Frank Lee
Photo Credit: Elizabeth Hu
The dynamic and timeless Australian landscapes reflects our resilience through turbulent and challenging periods
I wonder - To the ones that never got a chance
I wonder if, looking through these encounters, I would know:
The vaccination schedules,
The GP appointments,
The growth milestones,
As little steps,
Each carrying you further through that life of yours.
I wonder if, I would know that when time moved,
Just as the way it carried you through that life of yours,
Would put you closer to the inevitable:
The ambulance call,
The head scans,
The things we did that couldn’t stop you from leaving.
Carrying you further away from us.
I wonder if there was anything we could have done differently,
To stop you from leaving us.
Lying here thinking of you,
wondering if time could have frozen,
Transcending you to moments where you were most happy,
Untouched by the horrors of this world.
I wonder if they knew, it would be the final time they saw you,
And gave you the most loving of hugs,
Most generous of kisses,
And told you that you made a difference in their lives
With the brief time you were here.
Here we are,
Wondering if you know,
That you’ve made a difference in our lives.
And here you lie,
Safely in the midst of our memories,
Never to be forgotten by the ones whose lives you’ve changed.
Wai Chung Tse
Generation Z, BLM, and What it
Means for Medicine
2020 has so far been an unprecedented year.
Whether it was the US killing an Iranian
military general and almost sparking WWIII in
January or COVID-19 exposing compromised
healthcare systems, supply lines and social
security we have all witnessed just how easily
everything we take for granted can be
changed. However, what was perhaps even
more remarkable was the explosion of Black
Lives Matter (BLM) protests all over the
world which were unparalleled in their scale
even before considering they were occurring
in the context of a global pandemic. What
stood out about BLM was, unlike COVID-19 or
the US actions against Iran, these disruptions
were not caused by a chance zoonosis or the
decision of a few politicians and military
generals but was led by an extraordinarily
large number of young people. People like
Nupol Kiazolu – only 19 years old – led
protests near Times Square as President of
BLM Greater New York (Ballan, 2020).
Kiazolu belongs to Generation Z, generally
consisting of people born after 1996 who now
make up the younger portion of our medical
student cohorts and the very youngest junior
doctors. Full disclosure: I too am a member of
Generation Z. Our childhood was spent in the
post-9/11 internet age. We saw the impact of
the global financial crisis on our parents and
got our first smartphones in high school.
Floppy discs, cassette players, and MS-DOS are
as foreign to us as horse-drawn carriages
and gramophones. We are comfortable with
coordinating our lives through Facebook,
SnapChat and other social media apps and are
aware of the algorithms and influences that
underpin what we see.
What was remarkable about the BLM protests was
their urgency. A global pandemic limiting mass
gatherings was not enough to deter young people
from the call to action. Racism and its side effects
like policy brutality are not new foes but despite
being young, Generation Z has seen is how little
progress we have made on racism. However, unlike
many generations before us, Generation Z has the
capacity to spread its message like never before.
Within hours, most of the world could easily
access information about the death of George
Floyd in Minneapolis and within days protests had
to spread to countries as far afield as Australia,
Japan, the UK and Denmark. BLM represents how
Generation Z will not only refuse to accept
inaction in the face of injustice but will also use
tools at their disposal to incite change in a way
that the generations before did not or were not
able to. One of the rallying cries of BLM was to
‘defund the police’ in order to fund social
programs that address issues like mental health
and homelessness. Now, less than 2 months later,
numerous cities across the US have scrapped
planned funding increases and even cut police
Beyond protesting, Generation Z has leveraged
social media to agitate those unwilling to change.
This was exemplified by the sabotaging of Donald
Trump’s rally in Tulsa, Oklahoma by K-pop fans and
Tik Tok users. They ran a sophisticated campaign
on Tik Tok and Twitter that cleverly worked the
algorithms to publicly reach large audiences
while simultaneously avoiding being found out by
Trump’s campaign. Their message was simple:
reserve free tickets to the Donald Trump rally and
don’t attend. The campaign was expecting in excess
of 1 million people to attend and only 6 000
attended, simultaneously destroying his
credibility but also highlighting the power of
Generation Z to use social media to
surreptitiously subvert those in power (Sakzewski,
The medical field is not likely to be exempt from Generation Z, despite coming of age during
these forces. The BLM movement is highlighting uncertain times, are rallying against injustices in
Aboriginal and Torres Strait Islander health ways that appear to be swifter and more effective
inequalities and continued failures of
than past movements. While living through a
government to ‘close the gap’ (Rix & Rotumah, global pandemic undoubtedly presents new
2020). Unconscious biases are rife in the medical challenges to progress, it also amplifies and
professional, even in those whom we trust to
highlights inequalities and injustices. It is hard
teach us. These biases result in poorer pain
to predict what the impacts of Generation Z-led
movements like BLM will have on history but it is
treatment and overall health outcomes in BIPOC.
clear that young people will not accept ‘all talk
Additionally, issues like bullying and harassment
and no action’ from society’s leaders and
in hospitals overwhelmingly impact junior
institutions or having to wait to gain positions
doctors causing untold impacts on the mental
of power to incite change. It is clear that young
health of the future leaders of the profession
people want to see action in addressing the
(Srivastava, 2018). Social media has created an
myriad problems afflicting society and they will
environment where Generation Z are not only hold those in charge accountable for it.
exposed to these issues but can actively incite
change and monitor the progress of those in
charge. The BLM protests have exemplified that
Generation Z do not tolerate an unjust status quo
and are willing to push for radical changes (like
defunding the police) to do what it takes to
address inequalities and poor treatmentṀ
Ballan, R. (2020, June 12). Gen Z Leads The Black Lives Matter Movement, On And Off Social Media. Retrieved from
Rix, L., & Rotumah, D. (2020, June 19). Black Lives Matter in health care too. But convincing tomorrow’s health
workers is tough. Retrieved from The Conversation: https://theconversation.com/black-lives-matter-in-healthcare-too-but-convincing-tomorrows-health-workers-is-tough-140631
Sakzewski, E. (2020, June 22). Were TikTok users and K-pop fans really behind the poor turnout at Trump's Tulsa
rally? Retrieved from ABC News: https://www.abc.net.au/news/2020-06-22/did-tiktok-users-kpop-fans-reallytroll-donald-trump-tulsa-rally/12378768
Srivastava, R. (2018, October 30). When doctors are bullied, all of society is harmed. Retrieved from The
to do in
Artwork Credit: Jessica Teoh
Question marks at the end of statements can lead to beautiful
things! Being curious and questioning the way we do things is
essential. It allows for growth
Photo Credit: Gabrielle magalski
leaning over a cliff on Nusa Penidashot on DSLR Sony A7ii
Do something productive. Use this time to leave something behind, to leave a mark, a reminder of your existence
and presence in 2020. When was the last time you painted something or have you ever tried painting? Have a
little paint and sip session with a canvas, brush, paint, a glass (or two) of your favourite drink on the side and
your favourite tunes blasting in the background. productively de-stressing ! If you can’t be bothered with the
setup, really even a pen and paper (or if you are more technically inclined an iPad and an Apple pencil) is all you
need to unleash your creativity.
Read a novel... when was the last time you read something that wasn’t news, the textbook, the lecture slides or
study notes? Take some time away from the digital screen: Whether it is watching netflix, scrolling through
social media to check up on the latest med school memes or watching online classes, our eyes are glued to some
sort of screen for the majority of the day. Your eyes are probably feeling the strain and would appreciate a
break from the blue light.
Go ahead and write a journal. A paper one is even better as you reflect and consider each word more carefully.
You never know, a couple decades down your journal may contribute significantly to record of the influenza
With the lack of in person classes, socialising opportunities have equally been diminished. sadly no more inbetween-class
breaks to catch up on the latest goss. Arranging online simultaneous Netflix sessions or gaming
sessions or video call sessions might be a good way to stay connected !
Why not use this time to develop your cooking skills? Become the next Masterchef or culinary artist and
impress your friends, family and even yourself. Honestly one of the most useful life skill to develop.
Being at home all day, it’s easy to spend hours sitting, lying down or lounging. Take some time to get your heart
rate up and prevent your muscles from atrophying. There are so many online workouts and exercise resources
available - it’s just all about finding motivation to get started. Pump some music and some weights. raise those
energy levels. You might be surprised to find your productivity levels to have increased afterwards ! Why
endure a workout alone when you can share the burn with your mates? Schedule in that online workout
session with friends!
It’s been a rough, roller coaster of a year. Everyone’s been affected in some way, and things have definitely
changed. Mindfulness is important. Take time to mediate or just pause, reflect and re-evaluate. Looking after
your mental health is just as important as your physical health. Also look out and check in with your friends
and family as well.
When was the last time you did a full declutter of your room/house? Embrace your inner Marie Kondo and use
this time to reorganise your space which you are spending majority of your time in. Use this opportunity to add
some creative and unique flair to your space, after all it’s your living, eating, studying and working area.
Changing up the atmosphere can have dramatic impacts on your mood and productivity ! Take my word for it.
it’s time to catch up on all the films and tv shows that you haven’t been able to watch whilst attending uni in
person. Or even re-watch some good old classics if you’ve been keeping up to date with the latest shows despite
uni, classes and
From COVID to the Coral Sea;
An Echo Through Time
n the 18th of April 1942, my grandfather reluctantly left his medical studies and reported for
duty to the Royal Australian Navy. The crisis of World War II would take him away from his
medical studies for three years until the war ended in 1945. Three quarters of a century later
on the 16th of March 2020, I was sent home from medical school due to concern over the
growing COVID-19 crisis. As we mark the 75th anniversary of the end of World War II, I
cannot help but reflect on the similarities between our two stories; two future doctors
forced out of the hospital as the world descends into crisis. Whilst I do not expect to be
away from my studies for three years, with no prospect of imminent return the five months I
have spent away from the hospital already seem like an eternity.
During my grandfather’s three years in the navy he went from ordinary seaman, to
midshipman and finally to sub-lieutenant. He served most of his time on the HMAS
Shropshire, an 820-man heavy cruiser equipped with 38 gun towers and eight torpedo tubes.
During their service in the pacific, the crew of the Shropshire supported 15 landings and
carried out 56 bombardments. They received battle honours five times between 1941 and 1945. I
cannot imagine how it must have felt to go from studying to save lives, to operating a gun
tower in the midst of an ocean battle. Unlike six of his crew members who died on active
service, my grandfather returned home in 1945 and finished his medical training. He went on
to become one of Australia’s pioneering specialists in drug and alcohol addiction, receiving
an OBE in 1981 for his services to the medical field. Although Dr John Moon died before I was
born, he continues to be a source of inspiration to me as I go through my medical training.
Throughout the COVID-19 crisis people have tweeted and posted about how our
grandparents survived so much worse; about how they lived through wars when all we have
to do is stay at home and endure lockdown. This is supposed to be easy compared to what
they lived through. Yet every day the news tells us that more people have died in the United
Kingdom from COVID-19 than died during the Blitz, while deaths in the United States have
well surpassed the total number of American soldiers killed in the First World War, Korean
War and Vietnam War combined. During a brief return to work in the hospital I saw an
elderly man struggling to breathe with suspected COVID-19 and thought ‘this fight is not
easy.’ In war, deaths are gruesome and vivid; out in the open. In a pandemic, the deaths are
behind closed doors; in empty hospital rooms or hushed intensive care units. No matter how
they come about, they are still deaths. Families still grieve. The world still reels, failing to
comprehend the sheer volume of people suffering and dying. Even those whom Covid has not
personally visited suffer at home, their mental health declining as they are denied access to
their family and friends. Here in Victoria as I write this, we are enduring another hard
lockdown while the rest of the country reopens. All of this considered I think that we
should hesitate to label any of this as easy, because it is not easy. It is hard. Maybe objectively
our grandparents did live through worse; I know that I would rather be enduring lockdown
in my comfortable home than manning a gun in the Pacific Ocean, but their suffering does
not negate our own.
Like the war, this crisis will eventually end. Like my grandfather, I will eventually return to
my medical studies and hopefully become at least a fraction of the doctor that he was. Until
then, it is okay for this to be hard. Until then, we need to continue to support each other as
much as we can and together, we will come out the other side.
How has medicine and the world changed
and how will it change after the pandemic is over?
Farah Joy Hawila
I write this piece whilst in the throes of a throbbing headache. Going on 19
consecutive years of academia, such a situation is no news to write home about.
However, never have my run-of-the-mill ‘uh-oh I’m getting sick’ head pains been
aggravated by patrolling helicopters with their bright spotlights and
dreadfully loud racket pouring through my bedroom window.
Moreover, every twinge of pain is accompanied by a spike in anxiety. Suddenly,
microscopic germs manifest to form a chilling vision before my eyes, exploiting
innocuous exchanges with my family and friends to make a home of those I love
the most. Meanwhile, life is expected to continue as per the ‘new normal’ with
the unrelenting march towards academic and work deadlines. Such is the
condition of over 5 million Australians who have endured the uneasy wait for
basically forever (actually 2-3 days) for the results of a COVID-19 swab. With
restrictions easing and flu-season fast approaching, that number will only
multiply over the months ahead. Years may even pass before Australians can hear
a random sneeze without flinching.
On the subject of scars on our collective psyches, as a Lebanese-Australian
born in the oh-so-great US of A, disillusionment is a central feature of my
political outlook. Reaffirming this notion, the manner in which different world
leaders navigated this pandemic has revealed a sea of unfortunate truths that
had previously lain dormant under the surface of peace-time governing.
In my first years of medical school, medicine was a safe-haven from the shades
of grey that coloured my life and the world at large – one follows best
practice as judged by the established literature base. There was a heavy
responsibility that weighed upon each of us to ensure all we advise is
begetting benefit and avoiding harm, especially when the most commonplace of
drugs can be perfectly safe for some and fatal for others. So goes the humble
motto when asked almost anything by almost anyone at hospital: ‘I’m just a
medical student,’ and part of the answer to most every examination question:
‘Seek senior help and reference to the relevant evidence-based guidelines.’
Recognition of one’s limits in defiance of their ego and henceforth knowing how
to seek suitable assistance in a timely manner is key as a medical student.
Arguably, this principle is even more pertinent after graduation regardless of
how much knowledge and experience one amasses.
Similarly, if any group of individuals were to comprehend the burden of making
judicious decisions when lives hang in the balance, it ought to be world
leaders. As such, I could never help but be somewhat mistrustful of those in
office without a single white hair or wrinkle to be found. So, being forced to
stand by and watch powerlessly as the medicine I once revered for its
scientific purity is muddied and misrepresented in the name of egotism and
national interest by individuals in indisputably sociopathic ways feels like a
strange and unusual punishment.
For the nations who have now been forced to implement the necessary strategies
after actively ignoring the relevant specialist advice – we will remember.
For those who dare to gloat about superlative testing and treating when the
former is an actual farce and the latter consists of criminally negligent,
unilateral presidential advice featuring the injection of caustic materials –
humanity would be stupid to forget.
For the powerful few who shot down the ‘canary(ies) in the mine’ thus
endangering hundreds of millions of innocents across the globe – No worldly
punishment could even come close, although regrettably I don’t envisage one
coming at all.
Moving forward past the coronavirus, I would be naïve to suggest that the
world’s ‘war-time’ leaders will have changed in the slightest. For many, what
is right and what is politically convenient overlap occasionally, but are often
separate concepts. For instance, it just so happens that a dictatorial state
with mass surveillance and established channels for government messaging turned
out to be exceedingly effective in limiting infection control and saving lives.
Even so, whatever good is accrued is quickly followed by exploitative
misconduct as many such countries have taken advantage of the present temporary
situation as an opportunity to instate permanent infringements on personal
privacy. To make matters worse, this then muddies the waters for any members of
the international community to attempt to implement measured, short-term
digital surveillance as a useful tool without the baggage of its typical overreaching
dictatorial packaging. Political conundrums such as these will surely
continue to feature in our post-COVID-19 world, but for my wellbeing’s sake, I
selfishly hope they leave medicine out of it.
After the first wave of the coronavirus, what worries me more than the
politicians is the state of desperation of the people they govern. Staggering
proportions of Australians, Americans and Lebanese alike have been afflicted
with economic struggles in a way they could never have otherwise predicted.
Unsurprisingly, no-one had factored in ‘pandemic’ into their estimations of job
security. So, we find ourselves in a position where newly heightened emotions
of anxiety and hopelessness have fanned the flames of mistrust in conventional
medicine and ‘big pharma.’ People have been forced to choose between the
potential, invisible threat of a respiratory infection and the immediate,
tangible threat of losing their homes or their children starving. If I weren’t
a doctor, I may have been seduced by the black-and-white nature of this
argument. I mean: it’s not even cancer, the C-word which we avoid even saying
due to the heft the mere word carries – so how bad can it be?
Analogous to the issue of vaccine hesitancy, the degree of difficulty is
compounded by the fact that the more well-controlled the disease spread is, the
more one can mistakenly argue it wasn’t a concern in the first place.
Subsequently, if restrictions aren’t followed, and eventual vaccination isn’t
widely taken up, I fear there is no foreseeing a world after the coronavirus;
not for a long time anyway. The issue of an intangible and distant enemy is far
more benign than a malignant enemy which has ravaged through every suburb,
workplace and household. With the second wave spreading through Melbourne and
creeping up on Sydney, restrictions notwithstanding, I fear it will not be long
before ‘coronavirus’ becomes the newly dreaded C-word. As such, I hope for the
opportunity for the masses who dismiss COVID-19’s true potential for harm to
never have that harm reach them or their loved ones. I deeply hope they are
educated by theory and statistics so they may prevent the lesson becoming
imprinted through personal tragedy.
With all this happening on an international, societal, professional and
personal level, it is incredibly difficult to think of the future in terms of
life post-COVID-19. To be honest, even thinking about next week in any certain
terms personally triggers an impulse towards prayer rather than prediction. So,
I pray for relief for our world on fire and that we come out of the flames on
the other end as a global community (citizens and governments alike) taking a
page out of medical ethics textbooks by collectively working a little harder
towards upholding justice, beneficence and non-malevolence.
A virus with a face, marred by the scars of devastation,
It shackles us as we try to reach out to each other,
1.5 metres, loneliness quantified,
We are fighting a battle everyday,
Armed not with swords, but sanitisers and masks,
The new and frightening reality,
It’s as if we’re stuck at the door of socialisation,
Straining our necks passed the stern face of social distancing,
Searching for our friends, but barred from joining them,
The value of human connection was learnt in quarantine,
Even the most introverted felt the weight of isolation,
Being alone was not easy,
But we adapted,
Zoom, Netflix Party, what have you,
Connections flourished from the thorn of COVID-19,
Technology bridged the 1.5 metre gap,
Now the wait begins for The Great Escape, a vaccine,
When shall it come, when shall we be free?
Dr Peter McLaren
Most of us, I guess, are a bit cynical about movies on medical topics; the patient in a coma who
still looks immaculate, the implausible plot lines, too many machines in the room for a
conscious patient, not enough machines in the room for an unconscious patient, the faintly
ridiculous dialogue; you get the picture?
But there are some movies, documentaries and docudramas that get the medical concepts
and moral issues across better than any textbook.
On that basis, I decided to look at movies that I feel should be essential viewing for anyone in
medical school. I have reduced them to the top 10 but have found it difficult to place them in
any particular order, so I present them from old to most recent. I have taken into account
their medical authenticity, the relevance of the topics they tackle, the quality of the
writing, directing and acting, and awards given. I have also striven for variety. I apologize if
some are old but greatness doesn’t come along that often!
The Doctor (1991)
The story of an arrogant surgeon who becomes a patient and gets a taste of his own medicine? It could
have been that simple but thanks to good writing, a strong caste and the talents of William Hurt, it
transcends this scenario and shows an insightful view into the hospital environment.
The plot and dialogue are credible and the acting and directing, subtle. Hurt plays Jack McKee, a
successful surgeon who develops throat cancer. The experience that follows causes him to review his
approach to life, his family and the practice of medicine. Janet Maslin from the NY Times made a
perceptive assessment, writing: "...a charming, cocksure doctor who specializes not only in difficult
surgical procedures but also in careful, deceptively breezy intimidation." Sometimes it takes an
outsider to identify a behaviour we often brush off as simply male bravado.
The director was Randa Haines who had previously teamed up with
Hurt on ‘Children of a Lesser God’, another fine movie. The script
was written by Robert Caswell and based on a book by Ed Rosenbaum,
'A Taste of My Own Medicine'. It was only a modest box office
success with few awards. Still, IMDB gave it 6.9/10 and Rotten
So why include it as a must-see for medical students? Well,
firstly for the presence of William Hurt, another of the
outstanding actors of our time. It will also introduce students to
the music of Jimmy Buffett. As an anaesthetist, I can't deny there
might have been a little schadenfreude involved, though, in
reality, it could have focussed on any specialty. But the main
reason is that watching this film could replace all of the medical
school activities exploring empathy in medical practice (of
course, with the compulsory group discussion afterwards, as I
wouldn't want to put anyone out of work!).
One Flew Over the Cuckoo's Nest (1975)
Most would agree that this is a great movie;
after all, it received 5 Academy Awards! Best
actor (Jack Nicholson), best actress (Louise
Fletcher), best movie, best screenplay (Laurence
Hauben/Bo Goldman) and best director (Milos
Forman). Only two other movies have achieved
that: “It Happened One Night” and “Silence of
the Lambs”. However, is it a great medical
Most psychiatrists would disagree. This was the
era of the anti-psychiatry movement. There were
other spokesmen for the movement; Foucault,
Laing, Szasz, but a movie is intrinsically more
persuasive. Much damage was done, not only to
the profession but to patients who were
persuaded to stop their treatment. The movie was
based on the book by Ken Kesey, a figure in the
60's counter-culture who had worked as a janitor
at a Veterans Hospital in California. The
characters were perhaps not typical psychiatric
inpatients. However, psychiatry was not entirely
blameless at the time; the concept of the
'therapeutic community' had been misused, ECT
and psychosurgery were hardly evidence-based and
over the centuries, treatments have been used on
occasion to solve social problems.
Getting back to the movie; it follows Randle
McMurphy (Nicholson) who, looking for the easy
path, opts to serve his prison sentence in a
mental hospital. He is unaware of two factors;
the head ward nurse, Nurse Ratched (Louise
Fletcher) likes to run the ward her way and the
length of his sentence is based on him showing
improvement in his behaviour while in the
hospital. Some viewed it as an allegory of the
social conflict at the time between conservative
and alternate cultures.
It was a showcase for the prodigious talent of Jack Nicholson. This was coming off his scene-stealing
performance in Easy Rider in '69', Five Easy Pieces in ‘70 and Chinatown in ‘74. The true strength of the
movie is that he does not overshadow the rest of the cast and the directing skills of Forman. This was
Forman's US debut following his success with the Czech movie, 'The Firemen's Ball'. Michael Douglas was the
producer together with Saul Zaentz. He had been gifted the rights from his father, Kirk, who had played the
lead in a short-running Broadway adaptation.
As an aside, it is good to see Danny de Vito before he lost his hair and Christopher Lloyd before he grew his
and built a de Lorean time machine!
Why should medical students see this movie? Hopefully it may help them recognise when power politics intrude
on the rights of the individual and it may make them less likely to stereotype or dehumanise those with
But lastly, just to appreciate art and how powerful it can be at disseminating ideas; whether you agree with
them or not.
The Elephant Man (1980)
David Lynch, the director, chose to film this in black and white which was a great choice but does make it
look older than its years. Despite his initial surrealist film effort, Eraserhead, he manages mostly to
keep his renown 'weirdness' under control. The cinematography was by Freddie Francis and enhanced the
period look of the sets. The writers were Lynch, Christopher De Vore and Eric Bergren. Production was by
Jonathan Sanger and Mel Brooks who declined to be credited so as to avoid the expectation of a comedy.
It is based on the true story of Joseph Merrick, born with a still unknown congenital disorder which caused
progressive disfigurement. One of the few options for him in Victorian times was to appear in a travelling
circus, until a curious surgeon, Frederick Treves (Anthony Hopkins), shows an interest, initially in his
disorder and later in him as a person. It is to be noted that Hopkins’ Hollywood career did not really take
off till “Silence of the Lambs” 11 years later, in 1991.
To this day, in some societies, disfigurement is still taken as a sign of evil, either committed in this
life, or perhaps, a previous one. This attitude still persisted in Victorian England. Although, writers,
journalists and politicians had their role to play, it was the medicalisation of these disorders and the
personalisation of those who suffer from them that was pivotal in changing community attitudes.
Despite layers of make-up, the amount of expression that John Hurt conveys in his role is astounding.
Apparently the make-up took 7-8 hours to apply and 2 hours to gently remove! Christopher Tucker, the makeup
artist, used original casts taken from Merrick's body for greater veracity. With him on screen are a
young Anthony Hopkins, Anne Bancroft, John Gielgud and Freddy Jones, all supplying thoughtful performances.
Despite being nominated for 8 Academy Awards, it received none, losing out largely to Robert de Niro in
Raging Bull. So upset were some by the result that it caused the Academy to list a future award for film
make-up and hairstyling. It did score well at the BAFTAs though and also at the box office. IMDb gives it
8.2/10 and Rotten Tomatoes a 90% rating.
The reasons I feel that it should be seen by all medical students?
It will certainly make them hesitant about complaining of their lot in life. It may hopefully make them
look beyond the superficial when dealing with patients. They can be proud of the role that the medical
community had in changing community attitudes and it may spur them to uphold this tradition. In these more
enlightened times, it will caution them to the xenophobic trait still embedded in the human psyche.
But my lasting impression, and I theirs, is that it is one of the ultimate film portrayals of human
This Irish movie is based on the autobiography of Christy Brown, who grew up with cerebral palsy in
a poor but supportive Irish family. He was initially thought to be of subnormal intellect, however,
at the age of nine, he wrote his first word using his left foot. He was then taught by a succession
of therapists, coalesced into one character in the movie. He later went on to become a successful
artist and author. The screenplay was a joint effort by Shane Connaughton and the director, Jim
The film was nominated for 5 academy awards and won best actor ((Daniel Day-Lewis) and best
supporting actress (Brenda Fricker). ('Driving Miss Daisy' carried off the best film in 1990.) They
also achieved the same distinction at the BAFTAs. IMDb gives it 7.9/10 and Rotten Tomatoes a
The role played by Daniel Day-Lewis is an epic performance, even judged by those with the disorder.
Not only does he nail the cerebral palsy, his portrayal of Christy Brown's complexity is even more
impressive as he was known to be cantankerous and a heavy drinker. In one scene he portrays him, as
described by one reviewer, as "cussed, frustrated, indulged, immature".
Day-Lewis was motivated to take on the role, as he doubted it could be done. In a sense, he was
right, as he was only able to control his right foot adequately and the filming of those scenes
required a mirror. He often remained in character while off camera, which apparently upset his
agent on one visit to the set!
As well as Barbara Fricker, who was suitably awarded for her role as Christy's mother, the rest of
the supporting cast was excellent. In his acceptance speech at the Academy Awards, Day-Lewis made a
special mention of Hugh O'Conor, who played the younger Christy, as well as paying credit to the
tenacity and talent of Christy Brown himself.
Daniel Day-Lewis's performance alone is
enough to make it a 'must see' for
medical students. It is ultimately a
feel-good movie; it does demonstrate
triumph over adversity. It demonstrates
the advantages of community services; it
champions diversity and it demonstrates
the value of the disabled in communities.
But I also like the way it doesn't sugar
coat disability. The disabled aren’t
homogeneous; they don't always act like
saints; and nor should they be expected
My Left Foot
Wow! What a movie! What an ending! What a story and what
good performances! Often criticised for its sentimentality,
I personally find it restrained in its presentation of what
is an incredibly sad situation. Directed by Penny Marshall.
Screenplay by Steven Zaillian.
It is based on a book of the same name by the neurologist,
Oliver Sacks. It was released in 1973 and based on his
experience treating patients institutionalised due to
encephalitis lethargica. The movie received three academy
award nominations but unfortunately no awards. (Best picture
that year - 1991 - went to Dances with Wolves.)
Still, it manages a Rotten Tomatoes score of 88%, an IMDb
score of 7.8/10 and a Metacritic score of 74.
Oliver Sacks, the author, oversaw some aspects of the
production and said he was mostly pleased. Robin Williams’
serious role as the neurologist is solid and nuanced but it
is Robert de Niro's immersion in his role as a patient with
a Parkinsonian-like illness that is an acting tour de force.
Sacks commented that even after filming ceased, he could
still detect these mannerisms when conversing with de Niro.
Many top actors, those who do not merely play versions of
themselves in each performance, often seem to reach the
pinnacle of their acting when playing those with
disabilities. viz. Dustin Hoffman in 'Rain Man', Daniel Day-
Lewis in 'My Left Foot' and Sean Penn in 'I am Sam'. Care
must be taken not to overact and make it cartoonish but I
think de Niro nails it.As a medical history of institutions,
diseases and how we treated them, it scores; as a depiction
of a disease process it scores and as at treatise on how we
should not only treat our patients but care for them as
well, it is wins a spot on my top ten movies for medical
This was the first medical movie that grabbed my
intention. 'Contagion' follows the evolution of a
pandemic. It embraces the science so well that it feels
like a docudrama. It starts with a star-laden cast that
give pretty authentic if not exactly riveting
performances. (Matt Damon, Gwyneth Paltrow, Jude Law, Kate
Winslet, Marion Cotillard, Laurence Fishburne, Bryan
Cranston) It moves at a good pace but avoids over
dramatisation.. It obviously had good medical input from
experts in infectious disease. Director - Steven
Soderbergh. Writer - Scott Z Burns.
However, it only received a few nominations and two
awards. David and Margaret gave it 4.5 and 4/5, IMDb
6.6/10, Rotten Tomatoes 84%. Interestingly, the LA Times
reviewer invited three infectious disease experts to
critique it. They did think that it massaged the science a
little for greater dramatic effect but they said that the
movie 'mostly got it right'. One did comment that it
should be seen by all medical students!
Why do I like it? I like the fact that it looks at the
personal and sociological elements of a pandemic. It
doesn't talk down to you, perhaps a reason it wasn't more
appreciated by the general audience. It also mentions our
own Nobel prize winner in medicine, Barry Marshall!
But to cap it off, with the ubiquity of modern jet travel
and the fact that some cultures still live in close
proximity to animals, pandemics will continue to be a
concern for future doctors and the world they live in.
SARS, Ebola and now, Covid-19 are reminders of this. In
the words of George Satayana: “Those who cannot remember
the past are condemned to repeat it.”
And the Band Played On (1993)
We just had to have a movie about the AIDS
epidemic, the greatest medical crisis since
the ‘Spanish ‘flu’. You could not have
invented the plot; an epidemic starts among
derided minority groups (gays and I.V. drug
users), then spills over into other sections
of society while it is also ravaging the
developing world. This all happens to the
background of emerging gay activism.
‘And the Band Played On’ was made as a
television docudrama and plays out like a
thriller. Researchers, doctors, bureaucrats,
politicians, AIDS victims; and many don't
come out smelling like roses.
Directed by Roger Spottiswoode. Teleplay by
Arnold Schulman. It is based on the 1987
bestselling non-fiction book by Randy
Shilts, a reporter on the San Francisco
Chronicle at the time of the epidemic. Randy
was diagnosed with HIV shortly after
completing the book and succumbed to the
complications of AIDS in 1994. It was a
monstrous book, packed with research that
attempted to encompass the many strands of
the unfolding of the epidemic in the U.S.
The fact that most of the activism and
research was in the U.S. is an explanation
and solace for its North American centrism.
Making the book into a movie was always going to be a tall order. It has been criticised for its
irregular pace and occasional disjointed plot, not helped by the sudden appearance of famous actors in
supporting roles. To critics of its chaotic approach to the epidemic, I feel comes the old refrain; 'You
had to be there!'. The main role goes to Matthew Modine, playing an epidemiologist, Don Francis. A good
performance but the writers gave him little in the way of character development. The familiar faces
include: Ian McKeller, Alan Alda, Lilly Tomlin, Phil Collins, Steve Martin, Angelica Huston and Richard
Gere who all apparently only collected actors’ union rates. Gere was supposedly the first to join the
project, an act which encouraged some of the others. Still, it garnered 3 Emmys. Rotten Tomatoes gave it
100% and an 88% audience rating. IMDb gave it 7.8/10.
The AIDS epidemic not only stretched health services in research, epidemiology, infection control,
manpower and finances; it also stressed the system morally and ethically and strengthened it in the long
term. It has messages for the medical profession, not only in the management of pandemics but also in the
profession's involvement with minority groups.
The power of this telemovie about the AIDS epidemic, I feel, is summed up by an anonymous on-line
reviewer who said: '......- it isn't a quick-fix wallow or a time-filler....it is a serious, frustrating,
angry movie with no easy answers. And that is as it should be.'
This American, made for television, movie was based on the book and Pulitzer Prize winning play by
Margaret Edson. The director, Mike Nicholls and the star, Emma Thompson tweaked the dialogue but
largely it remains true to the play. This includes the theatrical technique called ‘breaking the
fourth wall’, where the actor addresses the audience directly.
It is a cancer movie; you know we had to have one; and I feel that this is the best. It has no
clichés, it isn’t maudlin nor are there any miracles. It involves the eight months of aggressive
treatment of advanced ovarian cancer in a 50 y.o. professor of English literature. Vivian (Emma
Thompson) has no partner, no children, no religious affiliation and few friends. Her life revolved
around her study of the poetry of John Donne. This is a recurring theme throughout the movie.
Although the lack of social support is not typical of life or the cancer movie genre, the focus on
one’s career is a situation that other professionals can empathise with and it does allow a more
intimate relationship with the audience.
Emma Thompson is perfect in the role,
perhaps aided by her university
degree in English literature. She is
ably assisted by Christopher Lloyd,
Jonathon M Woodward and Audra
McDonald all providing authentic
Awards included two Emmys for best
movie for television and best
directing of a movie for television.
Rotten Tomatoes give it 83%.
So, why is this movie a must-see for
medical students? Firstly, to note
the communication skills and agenda
of the medical staff. Secondly, to
see what some of our therapies put
patients through. Thirdly, to see
that the subjects enrolled in
research projects are real people.
Fourthly, to join the main character
in realising that all the learning in
the world can never make up for a
lack of kindness.
In searching online, I noted that
there was an article in the BMJ
outlining the use of excerpts from
Wit as an entree to the discussion of
communication in medical practice.
Though I do applaud that initiative,
my stance would be to make them watch
the entire movie; to place the
conversations in context and make
them appreciate the beauty and power
of great art!
anks 37th in the world on health outcomes!
It is, with deliberation, I include this documentary by Michael Moore in my ten top movies. It has
flaws but tells an important story with power and humour.
Moore takes on the U.S. health industry, in a laid-back style for him, letting his interviewees get
their messages across. They are just average people with their many stories that chip away at the
image of the American health system. He looks at the health care systems in other countries and
then makes his point by using the plight of those with health problems who helped in the aftermath
of 9/11 to make a comparison with Cuba. The ultimate message is that this is not a country where
one would like to be sick and poor. As Moore points out in the documentary, the U.S. has 4 health
care lobbyists for each congressman and the largest per capita spending on health care, but only
It did get an Academy Award nomination. The Rotten Tomatoes score is 93%, Metacritic 74/100 and
IMDb 8/10. Moore shows less bombast and refrains from his usually aggressive interview technique,
that's true, but parts of it are sloppy, superficial and overly dramatic. There is little in the
way of investigative reporting and few topics are nuanced.
So, why would I want all medical students to see this?
Our public health system has problems; limited resources, inefficiencies, waiting lists, waiting
lists to get on waiting lists, health departments with large media departments, multiple levels of
bureaucracy, bureaucrats who are more interested in preserving their jobs and way of life than
caring for the sick, etc. But, behind every national health care system there are essential values
that define us as citizens and humans. This documentary shows the impact of not having a
functioning system for supporting society’s most vulnerable members.
I feel that it is a little like Winston Churchill's comment on democracy: a public health system is
the worst form of health care; apart from all the other forms of health care that we have tried.
Vera Drake (2004)
Vera is a well-meaning, in the parlance
of the day, ‘kindly’, working-class
woman in London in the 1950’s who likes
to help others. Amongst her helpful
duties, she performs abortions on young
woman who have ‘got themselves in
trouble’. She accepts no payment but her
friend, Lily, who organises the service,
does charge and in turn, makes sure Vera
is looked after with occasional gifts of
black market goods. Like in real life,
the plot then goes on to show that bad
things can happen.
Vera is played by Imelda Staunton in an
exquisite performance. In fact, it is
the audience’s belief in Vera that helps
paper over inconsistencies in the plot.
The rest of the British cast are all
authentic characters from that era. Mike
Leigh was both writer and director and
used his trademark approach of immersing
the cast in the milieu of the times and
circumstances. The dialogue is
convincing and the sets embody the
nostalgia of the 50’s without
trespassing on the twee.
The movie won a Golden Lion at Venice,
was denied screening at Cannes for some
reason, lifted three BAFTAs (including
best leading actress) and was nominated
for three Academy Awards. Metacritic
give it 83/100, Rotten Tomatoes 92% and
If all, or any illegal abortionists, were as well-meaning as Vera they would not have been held in
as much disrepute. The reality was that it was highly dangerous both for the woman and the
abortionist and often carried out with poor preparation, poor counselling, poor knowledge, poor
technique and poor equipment. Some criticism was directed at the lethality of the actual technique
that Vera uses; however, until abortion was legalised in the late 60’s, it was estimated that there
were approximately 250,000 illegal abortions performed each year in the U.K. Those comments were
perhaps based on only seeing the tip of the iceberg: those that went wrong.
Well, if it is not a fair and accurate portrayal of backyard abortionists, why should it be seen by
Well, for starters, it raises the topic.
Secondly, it authentically depicts situations that they might be exposed to in their medical
career. Pregnancy will still continue to have a possible negative effect on a woman’s future.
Abortion has persisted through the ages and even in these enlightened times will continue to be an
option. It does illustrate the contrasting options for rich and poor.
We only need to go back to the life and campaigning of Dr Bertram Wainer in Melbourne to conjure up
the rather similar situation that existed here in Australia. Seeing this movie may deter some of
those who would be tempted to revisit the past and make it a criminal offence.
Photo Credit: Gabrielle magalski
unknown woman on Gili Trawangan
Photo Credit: Karen Lee
My medical school, like many, was forced by
COVID-19 to send students home to study
online. During lockdown, I kept coming across
articles about other people’s experiences of
lockdown, raving about how it gave them
space- space they hadn’t had for a long time or
even realised they needed- to reflect on the
way they were leading their lives, and maybe
consider ways they could better align
their daily practices with their values.
This got me thinking - maybe this forced
reflection period could be useful for med
schools too. Maybe there needs to be more
reflection going on about what needs to
I don’t know about your medical school, but
mine often raises this concept of ‘student
wellbeing.’ We receive regular reminders that
we need to be ‘looking after ourselves’ and
should contact faculty if we need help. Over
the years however, I have been increasingly
frustrated by the fact that, despite us
learning in our course that prevention is the
best cure, this hasn’t extended to med school’s
approach to student wellbeing. Sure, they
offer counsellor access when you’ve fallen
apart, but they seem to pay less attention to
preventing the falling apart process from
happening in the first place. Medicine has
never been known as the easiest course to get
through, but I’ve found myself wondering so
many times over the past years how a course
designed by some of the brightest minds in the
world is struggling to educate the next
generation of doctors without damaging
them with stress and anxiety, and
encouraging in them a fear of exposing any
imperfection or vulnerability.
I feel very lucky to get to be taught by some of
the most talented and knowledgeable
physicians and medical professionals in the
country. My admiration for these teachers is
slightly dimmed however, every time I have to
hear the phrase, in response to student
inability to answer a question that has been
posed, ‘You should know this.’ In my more
tempestuous moods, I can’t help but wonder
about the inherent ridiculousness of the
statement. Do our teachers think we enjoy
not knowing the answer? Do they think a
bunch of neurotic perfectionists (guilty as
charged!) need more shame heaped on them?
Do they think they need to have their
impossibly high standards for themselves
raised even more impossibly high? Now of
course the majority of educators are
wonderful humans who, if asked, would no
doubt answer negative to all the above. But I
also think the majority have been educated in
med schools in times when shame and
perfectionism was rampant and encouraged,
and public humiliation used as a weapon to
force med students to study harder. I guess
some habits and ways of thinking die hard.
Another thing that seems to occur regularly
in the lectures and tutorials I attend in
hospital and at university is teacher-led
laughing at wrong answers. I cringe
internally and feel so bad every time I see a
student give an answer, and watch the
lecturer imply that the answer is so wrong, it
is funny, thereby implying the student is a joke
for suggesting it. Ridicule doesn’t have to be
performed by the malicious; sometimes it comes
from a simple inability to remember back to a
time when questions that seem obvious to you
now were anything but. The same lecturers I
see laughing at ‘silly’ answers that have been
offered by well-meaning students are also
ones that complain that students in their
classes don’t seem to want to speak up and
answer questions they pose to the class. Hmm,
I wonder why that could be…
But do we want students to be trained to see
not knowing the answer as a weakness that
must be hidden at all costs? Is it not possible
that such an attitude may lead to issues down
the line in a clinical setting with doctors
feeling unable to admit to their colleagues
that they feel unsure about how to manage a
patient? Medical schools emphasise that
patient safety and wellbeing should be the
priority; maybe for this to be ensured, doctors
need to be comfortable from the time they are
still med students with not knowing the
answer, and be able to be out and proud about
this. Right now, as we think about how to fix
things so that we exit the COVID-19 era better
than we entered it, let’s spare a thought for
how we can help medical schools to recover
from the culture of shame that has gripped
them for far too long.
Minds of Medicine
An interview by Karen Lee
Intervewee Ishwarya Nair
Artwork Credit: Janhavi Suryawanshi
This artwork represents the importance of
mindfulness and positive mental health within in
medical students, especially in a COVID-19 world
covid has impacted each one of us in many diverse ways and medical students have, no doubt,
been uniquely impacted by the adverse circumstances. This interview provides a look into the
impact of COVID to a medical student in their clinical years.
I thank Ishwarya for taking her time to respond to these questions and providing an insight
into her covid experience
Tell me a little bit about yourself.
Hi there! I’m a fourth-year medical student at Griffith University. Outside of medicine, I enjoy
rock climbing, cycling, running, baking (and eating my own baked goods), cooking and
spending time with loved ones.
How were you impacted during the COVID-19 period as a medical student?
When the COVID-19 outbreak first started spreading to other countries in January, I was
completing my elective in London. Looking back, it feels like a different time. People weren’t
wearing masks 24/7, hand sanitiser hadn’t become as valuable as oil and giving hugs didn’t
earn you dirty looks. I also remember how the doctors that I worked with were very
confident that the outbreak wouldn’t hit London as hard as it did (oh how wrong they
were…). I was fortunate enough to do lots of travelling and have a wonderful learning
experience before I returned to Australia. Incidentally, a week after I visited the Louvre in
Paris, France, and returned to Australia, it was closed because the outbreak had spread to
Europe. That was pretty crazy.
Fast forward, as COVID-19 cases started growing in Australia, I was doing my GP placement. I
slowly saw how pharmaceutical reps stopped coming to the GP practice with free food
(something that I very much looked forward to), how the practice had to be dynamic with
taking on patients, the receptionist having to conduct screening questionnaire when they
made an appointment, to almost all face-to-face consults turning into telephone consults.
This meant that physical examinations, one of the key diagnostic tools of medicine, were no
longer being done! You only had a history to rely on when deciding further management for
the patient. I also saw first-hand how patients were exposed to fake news circulating
around on social media or hearsay. As such, I had to remain up-to-date with the latest
information and guidelines regarding COVID-19 in order to give them the most accurate
Following this, I started my anatomy rotation on the Gold Coast which involved me going to
the lab to prepare different dissections, as well as teaching anatomy to the second years
online. Unfortunately, because of Griffith’s COVID-19 restrictions, after week 2, the other
students and I were no longer allowed to enter the lab to work on dissections for the rest
of our rotation. As such, we were only able to fulfill the teaching component of the
rotation. While I was disappointed that I was unable to fulfill this component, one that I was
very much looking to, I was content with the fact that I was still able to continue with
rotations instead of stopping them altogether.
Were there any major learning curves? What was the greatest challenge and how did you
One of the major learning curves I experienced was doing telephone consults and taking a
very thorough history without seeing the patient during my GP placement. I managed this by
going back to the basic frameworks of history-taking such as SOCRATES PP to ensure that I
covered all relevant aspects.
Another challenge was trying to model a real-life anatomy lab with cadavers into an online
lab using pictures and videos. Fortunately, this experience has made me a bit of a tech whiz
using shapes and tacky animations!
How has this experience changed you or your perspective?
This experience has shown me just how integral technology is to our life now and the
importance of being flexible and adaptive to changes that are well beyond our control.
Is there a particular moment that stands out to you or that you were most surprised by and
The past 8 months and counting will be something I will never forget!
What is something positive about your experience?
Reduced time in rotations meant that I took on new hobbies like cycling and practised way
too much of others, like baking. It also meant that I made an effort to connect with friends
via video call. I think in some ways, it has also strengthened my cohort to find innovative
ways to ensure that our learning has not been affected by shortened rotations by sharing
notes etc. I believe that we will make an interesting and resilient bunch of interns next year
(if we graduate!)
Is there anything you are proud of?
I am very proud of the way that GUMS has been advocating for all cohorts of our medical
school to ensure that our learning remains as undisrupted as possible. I am also very proud
of how Queensland has managed the COVID-19 situation so that we haven’t experienced much
of a second wave.
How did you feel about it all?
Mixed feelings of frustration and shock at how a microscopic organism has brought to the
world to a stand-still preventing travel and limiting social interaction. However, I am also
very grateful to be safe and healthy and to have mostly had the opportunity to continue
with all my rotations according to plan. I am also very fortunate to live in a state which
isn’t quite as badly hit by the pandemic and to have a close group of family and friends to
support me through these unprecedented times!
Where to from here?
Would you care to share a word of wisdom to fellow med students?
Make sure that you don’t leave all major socials to final year! You never know when a global
pandemic might hit!
Ars longa, vita brevis
In clinical medicine ‘ars longa, vita brevis’, medical
professionals must always be prepared for the unexpected. This
reflective piece will describe a highly unexpected Advanced Life
Support experience I had as a 3rd year medical student whilst
aboard a train carriage. It also includes my introspection and
insights gained following the medical emergency, while
contemplating the significance of the words uttered by ancient
Greek physician Hippocrates, which especially resonate now in the
midst of the COVID-19 pandemic.
I would like to extend my thanks to Dr Stephen Teo and Dr Karina
Hochholzer for your advice and feedback. Your support and
encouragement has been invaluable.
Most medical students don’t expect their first Advanced Life Support (ALS) experience to occur in the middle of a
train carriage. I certainly didn’t.
It was almost 6pm; the train was emerging from the underground tunnel, beginning to decelerate before pulling
into the platform. I had just risen from my seat and turned to face the train doors, anticipating my arrival home
after having spent the day at my first clinical placement as a 3rd year medical student in the Emergency Department.
All of a sudden, there was a thud, punctuated by raised voices and cries of alarm from the surrounding passengers.
The person sitting a mere two seats away from me had collapsed.
Various thoughts and emotions raced through my head in a split second. I thought of syncope, a transient and
abrupt loss of consciousness and began considering possible differentials. His face had gained a purple hue,
signalling cyanosis. He wasn’t breathing normally, instead making abnormal gasping sounds, alerting me to
something much more urgent and dire. This jolted me to recall my ALS training session, which had coincidentally
taken place that morning. Could those sounds actually be classified as agonal breathing? Was it a cardiac arrest?
I knew then that I had to act immediately. I just didn’t expect to be the most competent or qualified individual at the
forefront of a situation as tenuous as this. Nor did I imagine that my first exposure to a medical emergency would be
in the middle of a train carriage, without a MET call team or any hospital adjuncts. But there was no room for
hesitation. It was no longer about me, a 3rd year medical student in the first week of my emergency rotation; the
sole focus was on this man caught in a precarious situation between life and death. Appropriate action needed to
taken immediately, especially considering the survival rates for cardiac arrests.1, 2 I found myself saying ‘I’m a
medical student, I can take a look, give me some space’ and nearing the man.
Danger, the first element of Basic Life Support guided by the acronym DRSABCD had been accounted for and I
launched into the next, checking for responsiveness. I asked in rapid succession ‘Hello, can you hear me? What is
your name? Squeeze my hand if you can hear me.’ Nothing. No response. I did the trapezius squeeze. Nothing. No
response. Both the radial and carotid pulses were imperceptible, further supporting my suspicion of a cardiac
arrest. The train doors had been open for a couple of seconds now. I raced to the edge, exclaiming ‘Stop the train!
Medical Emergency! Suspected cardiac arrest!’ After I had sufficiently gained a transport officer’s attention, I
rushed back and checked the airway, there didn’t seem to be anything obstructing and I remembered being advised
against doing a blind search with my fingers. Two transport officers had just entered the carriage and I asked them
to call 000, the emergency number.
By this point, I knew the man required urgent cardiopulmonary resuscitation (CPR). With the help of passengers I
lowered him to the train floor. Unfortunately I had no access to any basic airway adjuncts to maintain the airway
such as with a Guedel’s, so obstruction by the tongue was a concern. There also wasn’t a bag valve mask to provide
ventilation, so the main focus had to be rescue breaths. This highlighted the significance of having access to
hospital adjuncts during a medical emergency and the requirement for adaptability in their absence. I commenced
CPR, interlocking my hands and placing the heel of them at the centre of his chest, aiming to depress one third of the
depth. Fortunately, the transport officer was carrying a plastic barrier as part of his uniform, and administered
the two rescue breaths after 30 compressions. This allowed hypoxia, one of the reversible causes of cardiac arrest,
to be somewhat accounted for. I began the next set of 30, intending on continuing for up to two minutes when the
transport officer stated that he was trained and could effectively perform CPR. This transition enabled me to go to
the head and maintain the airway through the three way head tilt, chin lift, jaw thrust manoeuvre. I had just
completed my two-week anaesthetics rotation, which enabled me to adjust the manoeuvres and prioritise the jaw
thrust due to the man’s size and girth. While performing these manoeuvres, I considered other reversible causes of
cardiac arrest, ruling out hypothermia and hypovolaemia caused by trauma. The other reversible causes were
difficult to assess due to the setting and lack of an adequate history or context. I was also aware that in the
background, there was a police officer on his day off who had started prudently clearing the train carriages.
As we approached two minutes, I asked the other transport officer who was on the call to bring me a defibrillator. I
attached the pads and followed the prompts of the AED, which was slightly different from the device I was familiar
with in hospital. Unfortunately, the defibrillation attempt was not successful and it must have not been a
shockable rhythm. However, I had no definite way of assessing the actual rhythm due the lack of an ECG. This led me
to prioritise chest compressions, getting the transport officers to alternate. We alternated another time.
Then the paramedics arrived, there were three of them. I remained at the head maintaining the airway, explaining
the situation and the steps taken thus far while they set up their equipment. One of the paramedics inserted a Guedel
airway and began bag mask ventilation. Another paramedic attached ECG leads, replacing the defibrillation pads
while the third took over CPR. Now I could clearly identify that the man was in Ventricular Fibrillation, a
shockable rhythm. They applied COACHED – compressions continue, oxygen away, all others away, charging, hands
off, evaluate rhythm and then delivered the charge. Just after the first COACHED two other paramedics had
arrived. They performed COACHED again, then about four or five times subsequently with adrenaline delivered
through the inserted cannula.
The paramedics continued their efforts for approximately 20 minutes, with no return of spontaneous circulation.
Eventually, the paramedics all agreed to unfortunately make the call, ceasing operations, removing all adjuncts,
ventricular fibrillation eventually diminishing to asystole.
Being thrust into such a stark situation exposed me to the harsh reality of medical emergencies. Before the acute
balance between life and death had been a concept that I had only explored through the humanities or vicariously
through others. Never had I been so close to the edge, directly exposed to the precariousness of human existence.
The immediacy of the situation reminded me of the existentialist play Waiting for Godot by Samuel Becket that I had
studied in high school ‘light gleams an instant, then it’s night once more.’3 Our shared fate, encapsulated over 2000
years ago by the Roman poet Horace ‘pulvis et umbra sumus’4 – we are but dust and shadow, remains valid now and
forevermore. I realised that this would be my reality as a medical professional, facing this precipice between life and
death, performing treatment and management interventions and inevitably seeing the patient progress down
The experience emphasised the importance of prioritising patient care, using all your skills and knowledge to secure
the best clinical outcome possible. This is especially relevant when clinically appropriate action can be taken in an
emergency situation, unlike Beckett’s play, which was imbued with a sense of passivity and irresolution from the
first line ‘nothing to be done.’3 It has also emphasised the importance of providing medical students with
interactive and hands on ALS training similar to the session I had attended just that morning, enabling students to
take necessary action. This also extends to members of the public, highlighting the necessity of basic life support
knowledge to improve outcomes for similar medical emergencies1. Further, the current COVID-19 pandemic has
demonstrated the importance of widespread health literacy and education in interrupting the chain of
Overall, being placed in a position where I had to take initiative has made me more observant and attentive during
my clinical placements. It has augmented my desire to learn and to take a more active role, so that when the next
critical moment arises, I can once again take part to help secure the best possible outcome for the patient. The words
uttered by ancient Greek physician Hippocrates still resonate ‘Ars longa, vita brevis, occasio praeceps, experimentum
periculosum, iudicium difficile’ – ‘life is short, the art long, opportunity fleeting, experiment dangerous, judgment
difficult’5, emphasizing the urgency of acute medical emergencies and the importance of being prepared for the
unexpected. This has been exemplified by the unprecedented nature of the COVID-19 pandemic, which has
necessitated rapid action on a clinical and public health front, underlining the significance of contingency
Thank you Dr Stephen Teo and Dr Karina Hochholzer for your advice and feedback. Your support and
encouragement has been invaluable.
Brady WJ, Mattu A, Slovis CM, Lay Responder Care for an Adult with Out-of-Hospital Cardiac Arrest, N Engl J
Med, 2019, 381:2242-51.doi: 10.1056/NEJMra1802529
Myat A, Song KJ, Rea T, Out of hospital cardiac arrest: current concepts, Lancet, 2018, 391(10124): 970-979.doi:
10.1016/S0140-6736 (18) 30472-0
Beckett SB, Waiting for Godot, London, Faber and Faber, 1956
Horace, The Odes of Horace, Book IV, Ode vii, 13BC
Hippocrates, The Aphorisms of Hippocrates, 400BCE
Photo Credit: Gabrielle magalski
The Lost Magic of
On a ferry in the Salish Sea Shot on DLSR Sony A7ii
By Vijendran Jayaveerasingam
On a sweltering summer day in Newcastle, I was trudging through a
park alone. Why you ask? Well in an addition to my growing list of
car mishaps I had punctured my tyre on the highway, and was in the
middle of the painful wait while I waited for my ride to be ready.
“Hey how are you going?” I turned around expecting to see a chance
run in with a friend but instead found a total stranger- a tall
gentleman, dark hair and a welcoming smile. Hold your horses, this
is not another romantic short story! We did however have a great
chat as I eventually made it back to the vicinity of Kmart Auto.
His name was…something Irish…Ciarran? No that’s the Bachelor in
Paradise…character. Instead of his name, what stayed with me was
his story- with no set home yet in Australia he was bouncing
around trying to help people. At that point in time he was
volunteering in a shelter for the homeless and couch-surfing, or
so he claimed, but what’s the value in questioning? At the end of
our chat, I shook…Ciarran’s…hand, we wished each other good luck
for the future and went our separate ways forever.
What was the point of that tale? I met a random guy, can’t
remember his name, and am not even completely sure his wonderfully
selfless story was entirely true. But that interaction- the
spontaneous moment which brightened up my otherwise dull day, is a
pleasure which I took for granted that is hard to come by
nowadays. A conversation with a stranger now is tinged with the
suspicion and worry that they may be infected, and as we progress
through this, will have to be done through masks- removing the
possibility of the welcoming smile that sets the ball rolling.
I’m not questioning the lockdown measures in any sense at all.
Obviously to curb a global pandemic, we need to limit our
interactions. But it would be remiss of me , I feel, to not
discuss the social impacts of this disease, and that does not
diminish the importance of the health impact- the hundreds of
thousands dead worldwide- in doing so.
My worry is whether the fear of interaction becomes the ‘new
normal’, even when the virus is finally under control. Will a
seven year old who spent their formative years in primary school
watching their parents turn their head away from people on the
street, be in a position to strike up a conversation at a bus stop
in twenty years? Ultimately society will progress as normal. The
next generation will still be productive whatever happens, as many
businesses can be fully contactless both in payment and
interaction if needed. But where is the magic in that?
I have no idea what happened to my Irish friend. Neither do I have
any idea what happened to the troubled man who I struck up a
conversation walking back to Parramatta Station after he had been
kicked out of Centrelink for swearing at the staff. He was
frustrated- he was trying his best with a poorly dealt hand and
unfortunately sometimes the natural response is anger. We chatted
about what’s wrong with society, and like the Irishman, I never
saw him again. Did he end up getting a job? Is he happily settled
and raising a happy family now? Or did the pent up anger lead him
to commit a crime? I will never know, and in that there is the
magic. Not knowing the ending doesn’t diminish a treasured moment.
So for now, my eyes are turned towards the American Pharma giants
like Pfizer, praying that their brazen confidence that a vaccine
will be ready by early 2021 is true. Because for me one of the
core pleasures of humanity is the chance meeting with a stranger
never to be seen again- let that never not be part of a ‘new
Against Gender Based Violence
For most of us, the idea of eliminating worldwide violence against women is well and truly in the ‘too hard’ basket.
But not for feminist icon Dr Emma Fulu.
Interviewee : Emma Fulu
By Kate Maddams
Dr Fulu is a global leader of research into violence against women as well as the founder and CEO of The Equality
Institute, a Melbourne-based agency focusing on ending violence worldwide.
Good morning Emma, thank you for chatting to me today. I wanted to start by getting some insight into how
and why you started The Equality Institute.
I’m a researcher by background, and have been researching in the field for almost 20 years now. I initially was
doing a degree in International Development Studies at university where I became interested in the gender
dimensions of international development. My family is actually from the Maldives, so when I finished my
honours degree I went to the Maldives to work at the Ministry of Gender. One of the first things they asked me
to do was look into the issue of violence against women. They had anecdotal evidence that the problem existed
but didn’t really know the scale of the problem so they asked if I could try to do some research.
I ended up working with the World Health Organisation (WHO) to do the study – the first national prevalence
study in the Maldives .
From then on I kept working in the space. I’d found my passion. I worked with the United Nations (UN) and then
moved to South Africa to lead another global program on violence prevention. In the midst of that I had 3 kids.
So I was doing a crazy job, travelling a lot, and the truth is I burnt out. I knew I was still passionate about the
work but was struggling to do the career. So I moved back to Australia to be closer to my family and to re-asses,
and that’s when I started the Equality Institute.
I started it with the idea that I wanted to combine research with policy and create a space where there was
nurturing and I could balance my career with my family. It started small but it has grown now to be a global
agency. We’ve worked in more than 20 countries, we have an office in Timor-Leste and I’ve since set up a charity
in New York.
That sounds very exciting. Could you tell me a little bit more about what you do at The Equality Institute?
We’re a global feminist agency and our priority is advancing gender equality and ending violence against
women. We do that through 3 core areas – research, creative communication and policy and advocacy work.
So for example, we do a lot of research to try to understand violence against women and also to evaluate
programs and policies to see what’s working in different settings. We then work with a lot of global
organisations like the UN and Word Bank to help set the policy agenda, and then we also do work on social
media to ignite the conversation around feminism and gender equality and how to end violence.
It sounds like extremely rewarding work yet at the same time the content of the work is also deeply upsetting.
How do you manage the nature of the work?
That’s a good question. The focus of our work is predominantly on primary prevention, so trying to address the
root causes and we take a very positive, strength based, empowerment approach. So even though the content of
the work is very heavy, because we are working to create positive change, that keeps the work positive and
engaging and it feels like you’re doing something meaningful. For me, I feel like I’d be more depressed if I wasn’t
doing anything towards the issue. It’s a deep passion for me and for members of my team so I think as hard as it is
some days, we all feel better for actually trying to do something to end violence against women.
I think we also see change happening, so while from a distance it can look like this issue is overwhelming, that’s
not true, we are actually seeing rates of violence decrease in some countries, we are seeing programs that are
actually having an impact on the ground and we are seeing women and girls all over the world leading that
change which is really inspiring. So most of the time I feel inspired more than I feel upset, but we do have to take
care of yourself as well because it is hard work.
You know when I started in this field about 20 years ago, no one was talking about violence against women and
now it’s on the global agenda. There’s the sustainable development goals which all countries have to report
on. In my career I have seen massive change, and that’s motivating.
There’s been some concerning reports of increased violence in the home during COVID-19 lockdowns around
the world. Can you expand upon this?
Sure. There definitely is, and while we still don’t have all of the data, what we do know is that in Australia
we’re seeing increased rates of reporting around violence against women. We also know that during the
lockdown, unfortunately home isn’t always the safest place for some women and children. It also makes it
harder for these people to seek support. We’re also seeing diversity in the types of violence that women are
experiencing, for example technology facilitated abuse and more controlling behaviour.
The pandemic is also impacting gender equality through risk of catching the virus. In the vast majority of
countries, a higher percentage of front-line workers (health workers for example) are women, putting these
women at a higher risk of being infected with COVID-19.
On top of this there have been interruptions of supply chains for medical products. For example women’s access
to contraception is being impacted because the world’s largest IUD factory has shut down. Shipping
interruptions are also worsening the issue. So there’s a huge number of flow on effects that we’re just starting
to get a better sense of, but we really need to collect more data to get a better understanding of the situation.
At this point, we really need to focus on violence against women, and we also need women to be leading to this
response because they know the issues that they are facing. It’s a really challenging time for many, many people.
Do you think the Government is responding to this appropriately?
I think there is definitely more that could be being done. Importantly, ensuring that response services are well
funded, but also looking at other ways to protect women in vulnerable circumstances.
I think there’s the opportunity for using this time to create long term changes. It’s a complicated issue but we
have some lessons from a humanitarian context, that when things fall apart, as challenging as the situation is,
it also offers opportunities.
In Australia we currently have the chance to think about long term systemic and structural changes, and to
improve gender equality through this process. That could be things like restructuring childcare and thinking
about existing child caring responsibilities as well as norms around men and women’s work. It’s a time when all
of these norms are being disrupted and I would like to see more of that long-term change and investment in
transformation rather than just responding to the crisis. I think we need to be thinking more holistically
about what’s possible to create in the post-COVID world.
As junior doctors and future doctors, is there anything in relation to gender-based violence that you think
we should be aware of?
Violence against women is now defined very clearly as a global public health issue. The evidence is clear that it
has an impact on women’s physical, mental and reproductive health. We also know that in Australia it’s the
greatest heath risk factor for women in their reproductive years - greater than smoking, alcohol and obesity.
What we know is that women who experience violence are engaging with doctors and health professionals
more often. So doctors are inevitably going to be seeing women who have experienced violence. Globally 1/3
women will experience sexual or physical abuse. So you will be seeing those women. The issue is that they don’t
always present as experiencing violence through injuries - they may be presenting with a variety of other
health consequences and concerns.
There’s a lot of work being done globally to help health workers identify and be able to provide the right
treatment for people who are experiencing violence. So I would say it’s being aware.
Alongside this awareness though, there really needs to be a whole health system response. It has one of the
highest health burdens of any health issue facing people in this country.
The WHO has some great guidelines on this for healthcare professionals. And it does really require training.
It’s not just about asking the basic questions, it’s also about noticing the subtle signs and symptoms that might
indicate experiences of violence. It’s also about being able to ask in sensitive and safe ways and then knowing
ways to support women. I think it’s an area that should definitely be introduced into medical training.
As medical students who are passionate about feminism and gender equality, do you have any suggestions for
how young people can advocate in these areas?
A few ways! There’s a public health approach. A lot of the work globally being done in the field of violence
against women is being completed by public health experts who are medically trained. So there’s always the
opportunity to combine being a doctor with a public health focus and then potentially have an influence on
policies and health promotion in that regard.
But I also think it doesn’t necessarily have to be through the health space, it can be through talking about
these issues in your families and communities or finding local organisations working on gender issues. I
recommend trying to identify the space that you’re most passionate about, finding like-minded people and going
from there. We (The Equality Institute) will also be starting to develop more resources and support for people
to engage with these issues.
What’s your vision for The Equality Institute?
Within our organisation, we envision a world where diversity is celebrated, all people are respected and
resources are shared. We recognise that we are one player in a big ecosystem and we’re trying to contribute in
areas that we feel like we can.
Personally, I tend to be a big dreamer. I’ve always been interested in pushing things further. I have a vision of
supporting people to be themselves, because I really feel that everyone benefits from gender equality - it’s really
about people having the freedom to live the lives they want to live. I personally feel like feminism is for everyone
and feminist leadership can help transform the world. So I guess my big vision is expanding the reach of that
type of work and broadening the people who feel engaged in this issue. For us at The Equality Institute, that
manifests in lots of different forms and I’m really open to seeing where that takes us as an organisation.
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