Book Review – Why We Believe in God(s) by J. Anderson, Jr.

 

After listening to a lecture about whether Evolution is fact or theory I decided to explore other people’s beliefs about how the world was created. I have recently read the book Why We Believe in God(s) by J.Anderson, Jr., with Clare Aukofer, from which I have learned about human behaviour that leads to the survival of religion from generation to generation.
The book begins with an introduction by Dawkins, explaining that the ‘cost of a mistake is high’ (being proven wrong is embarrassing) so therefore as humans we often turn to religion even though it is ‘statistically unlikely’. Why We Believe in God(s) explains that living in groups may be beneficial to survival as it ‘helps solve specific social and interpersonal problems’. Perhaps the well known phrase “strength in numbers” is proven here – humans feel safer in groups and this may be due to the fact that it was a survival technique of the past. This is further proven by the fact that there are still three tribes around the world, including the Aborigines of Australia, that live in small communities in extreme climates but continue to survive and thrive. This shows that it is a natural instinct within us to consider those in our group as ‘in’ and those in other groups as ‘out’. We feel naturally competitive when put into groups and feel prepared to ‘fight’ other groups for survival.
The book also goes into detail about the link between craving and pleasure, and how, if we enjoy something, our brain rewards us and therefore we will crave this enjoyment from the same action again repetitively in the future. Anderson compares a craving for fast food to religion in ‘just because we crave something, doesn’t mean that it is necessarily good for us’ and this explains extremist views, such as those of Daesh, and their reasoning for committing inhumane attacks on other humans.
Religion may be an answer to our human ‘Attachment System’ which is our craving to rely on someone else. This system is natural in humans from birth as shown through our connection as a baby with our mothers due to the release of oxytocin, then later in life through connection with romantic lovers and best friends. Religion may particularly appeal to people as it provides a being for people to rely on, that will never pass away or fade, unlike human life. Religion has the ability to ‘shield us from fear, assure our salvation and provide an afterlife’. These positive feelings of security are enjoyable and therefore we crave experiencing them again, and therefore search deeper for religion, relying on it even more.
The ‘mind can be tricked into belief’ as shown by the creation of ‘imaginary friends’ by young children. If something is enjoyable and rewarding we may ‘trick’ our brains into believing it is fact. After receiving many rewards from God, people are bound to believe that God definitely exists.
Religion may also be for ‘sociability’ as humans are united in their beliefs. If someone else is a believer, this may justify ones own beliefs. It may also be for ‘sociability’ with God. Some people imagine God as someone who they have previously had a relationship with so that it is a more personal and closer relationship.
Anderson Jr. also writes about Hyperactive Agency Detection Device which is a belief that beings ‘can alter or affect what happens to us’. This links to religion as people believe that God genuinely dictates a better or worse future for the rest of their lives. People also assume that God is similar to man so that they can relate more easily to Him.
We assume that all people of the same faith may have different opinions about their religion. However, this was not the case during the religion-fuelled 9/11 attack, showing that some people are prepared to cause harm to other members of the human race for proof of their faith. This is an example of a terrorist attack caused by extremist views.
Furthermore, people believe in God because we, as man-kind require a complete story for everything – including how the Earth was created. From a young age we question ‘why?’ – always curious about purpose. Perhaps religion was created in order to provide an answer to those who felt obliged to know, and then the word was spread by all those who thought that this was a good idea.
My favourite part of Why We Believe in God(s) is when Anderson talks about justification of acts of terrorism as examples of extremist views leading to violence. From a young age we are aware of the sense of kin – why we favour blood relatives to friends and friends to strangers. Religion uses this idea of kin to let people feel involved in groups, using God as the closest and most relatable being to man. Terrorist leaders often create an imaginary kin in order to encourage mistreatment of someone’s actual kin, for the promise of everlasting rewards – for example, the fantasy of many virgins and ‘the chance to send this kin to eternal paradise’.
Religion is extremely powerful – even encouraging ‘emotional sacrifice’ in order to get approval from a higher being, and receive eternal rewards. Oxford University has proven that being part of a group for an activity can increase pain threshold. I believe this may be the principal which entices suicide bombers to detonate their bombs – they may truly believe that blowing themselves up will be painless and will gain them great rewards in heaven. Human-kind crave this feeling of reward through being loved and therefore terrorist leaders can influence lonely, vulnerable people with promises of ‘being married in heaven’. We crave a person to support us through life.
Anderson focuses the last couple of chapters of this book on religious ritual and its potential to stimulate the release of key reward hormones and impulses. Singing and dancing release serotonin and dopamine which ‘regulate our self-esteem’ and stimulate ‘uncontrollable repetition’ of rewarding actions, respectively. Adrenaline and noradrenaline allow ‘fight or flight’ by giving ‘temporary bursts of strength’. Oxytocin has a key role in religion as it stimulates our feeling of attachment to God whilst Endorphins ‘facilitate social bonds’. The release of these hormones and impulses through religious practice and rituals leads us to feel happy and assured, encouraging us and the people around us to follow religion.

 

Emily Buchanan

Dementia Summary

 

My reading of this week’s New Scientist magazine has inspired me to create a quick summary of Dementia which I thought I would like to share on my blog. I formulated this as a Microsoft Word document as a mind map so that it will be accessible to me in the future.

Symptoms

  • Problems with short-term memory
  • Lack of ability to focus
  • Poor visual perception
  • Poor communication
  • Difficulty in multitasking

Causes

  • Myelin sheaths around neurones erode
  • Arteries narrow
  • Memory and function parts of brain shrink
  • Gene variants (eg APOE gene that codes for clearing of beta-amyloid)
  • Alzheimer’s: hard plaques called beta-amyloid between brain cells = inflammation

Prevention

  • Challenge brain during education
  • Keep on top of cardiovascular health – eg blood pressure, diabetes
  • Social connection
  • Healthy diet
  • Exercise
  • Good sleeping habits
  • ‘An hour-long walk a few times a week’

Types

Alzheimer’s: 62% – memory, language and reasoning problems, usually develops in older age 65+

Vascular Dementia: 17% – impaired judgement, difficulty with motor skills and balance, heart disease/strokes increase likelihood

Mixed Dementia: 10% – several types lead to many different symptoms, usually develops in much older age 85+

Dementia with Lewy body proteins: 4% – hallucinations, disordered sleep

Frontotemporal Dementia: 2% – personality and language change, usually develops in middle age 45-60

Parkinson’s Disease: 2% – dementia symptoms as condition progression

Other: 3% – Creutzfeld-Jacob disease, depression, multiple sclerosis

Why are most cases now?

  • More people living longer due to advances in medical knowledge and medication

 

Emily Buchanan

Medical Physics Talks

 

Last Tuesday evening I visited a local university to watch presentations about application of Physics in Medicine. Although I do not study Physics at school myself, I understand the importance of all specialties of science working together for the most successful healthcare team. I found the evening extremely insightful as I learned about imaging and technology to improve diagnoses.

Evidence of pneumonia shown on an X-ray.

The first speaker did a presentation about X-rays, explaining their history with the first X-ray unit being set up in 1896 by Wilhelm Conrad Roentgen. I learned that X-rays work by material with larger atomic mass attenuating the beam more and therefore leaving a thicker shadow. X-rays are extremely important to see internal structures as before they were discovered, doctors would make incisions in the body even though there were no antibiotics and therefore a high risk of catching a disease. X-rays are most commonly used to image fractures, chest diseases, mammography and dental imaging.

The speaker also talked about Computed Tomography (more commonly known as ‘CT’) scans and that it is a 3D scan made up of many combined images. In the future, contrast agents will be used to target specific cell types to locate tumours and to determine whether they are benign or cancerous.

Images from a CT scan of the brain which are combined to make a 3D image.

The second speaker talked about nanoparticles for cancer treatment and the balance between giving a lethal dose of radiation to tumour cells whilst sparing healthy tissues. I learned how radiation can lead to formation of tumours. If someone’s cancer is caused by radiation, energy is absorbed by the area that will be affected, the cells are ionised and free radicals are formed which are extremely reactive (H+ and -OH) and cause DNA, chromosome or cell cycle damage, causing a tumour. The speaker’s own research was into fluorescent-labeled antibodies to locate and quantify breaks in the DNA double strand – a very helpful tool that could be used to find a cure for cancers caused by breakage of DNA.

I found the third and final talk the most interesting, where the speaker talked about nanoparticles in tissue engineering, for example for growing organs. This would be extremely useful as there is a shortage of donors of organs so by engineering organs from our own cells we could reduce demand and the problem of matching tissue types. She talked about the five things needed to grow a tissue culture; isolating a cell from a patient by biopsy, allowing the cell to multiply, in a scaffold, allowing it to grow into the scaffold, then inserting it as an organ into a patient. The part of her talk that particularly interested me was about Carbon Nanotubules – a synthetic material that is a scaffold used to house a growing tissue culture before being inserted into a patient as an organ. It is an extremely lightweight, strong and highly conductive material allowing it to stimulate cells to contract and expand and letting blood flow. The fact that it is so strong may mean it can be used to reconstruct bones in the future. This is an extremely exciting discovery that may be used in the near future to build organs from one cell of a human body.

 

Emily Buchanan

The Menopause

 

Every female knows the physical and mental difficulty of menstruation, having to experience it once a month most commonly, starting during teenage years. Every child in the UK who sits GCSEs is taught basic reproduction and the 28-day reproductive cycle of a woman, including the roles of two key hormones; oestrogen and progesterone. However, only those going through or those who have already experienced the menopause are completely aware of what it is and its symptoms.

The menopause is ‘when a woman stops having periods and is no longer able to get pregnant naturally’, as described by the NHS and usually happens between the age of 45 and 55 but can happen prematurely, or after breast cancer treatment or an oophorectomy.

Low mood, sweats and vaginal dryness are all common symptoms of the menopause caused by significant fluctuation in release of oestrogen and progesterone, and the stopping of ovulationThe reduction of oestrogen and progesterone is due to the decreasing responsiveness of ovaries to the hormones FSH, which causes ova to mature in the ovary and controls release of oestrogen, and LH which stimulates release of the ovum. The menopause worsens quality of life as women sweat more so feel that they may not wear long sleeves, cannot wear makeup without it coming off and have to wear their hair up to be comfortable (as written in the Daily Telegraph on 10.4.17).

Both female and male gametes are required for reproduction in humans as we produce sexually, as opposed to asexually so once ovulation stops (the release of the female gamete), women are no longer able to have a child. Humans stop reproducing far sooner than other mammals and this is said to be an evolutionary advantage as reproducing late in life has various risks for the child, such as developing Down’s syndrome or a cleft palate, and for the mother, if they are in a less able physical state to give birth.

In the news lately there has been talk of a new drug called MLE4901which relieves the symptoms of the menopause – in particular sweats, with a lower risk than the most commonly used drug HRT which can lead to breast and ovarian cancer, and blood clots which can lead to strokes. The drug is said to improve many more lives as it would be available for far more people as HRT cannot be given to people who have previously had breast or ovarian cancer or high blood pressure for obvious reasons. MLE4901 does not increase oestrogen release like HRT, but works by preventing Neurokinin B (a hormone) being released. Neurokinin B is an important hormone shown by its increase in release during falling oestrogen levels so by decreasing Neurokinin B levels, decline in oestrogen level can be stopped. Neurokinin B also activates the metabolic pathway of thermoregulation, so by controlling its release, hot flushes are reduced.

A clinical trial was taken out by Imperial College London where people spoke about their moods during a four-week trial period of taking the drug and feedback was very successful. However, it is extremely hard to compare MLE4901 to HLE as emotion is a qualitative value so should be used with caution.

 

Emily Buchanan

Book Review: Trust Me I’m a Junior Doctor by Max Pemberton

 

Trust Me I’m a Junior Doctor is a diary of Dr Pemberton’s first year as a junior doctor in which he reveals the truth about what it is to be a doctor and how his work makes him feel  through description of real patients’ conditions which he had to face in his first foundation year.

“Competent”, “confident” and “loves the pressure” are three phrases which describe the qualities needed to be a successful and inspiring healthcare professional, showing that the qualities of a doctor are partly natural, with increased resilience being taught through five or six years at medical school. Following my hospital work experience, this book reminded me about the fact that doctors must not become emotionally attached to their patients, and that there must be a differentiation between the doctor and their patient – “usually good at being detached; clinical”, “everything moves on” and “not carrying any drama of the previous one”. The book also proved that being a doctor is far from easy and showed that even after the training at medical school, you will not know everything about every condition (“I felt out of my depth at times”) as there is such a large variation in presentation of conditions, in different people.

The job of a doctor is not only in a surgery or hospital, but in all of society as shown through the quote “‘I’m on holiday’ I felt like screaming” when someone fell under a train, Dr Pemberton realised that he was expected to attend to this casualty even though he was on his way home after a very long and tiring shift at work.

It is important to remember that your own health is just as important as your patients’ health. I believe that this is often forgotten by doctors as they work endless hours, making them extremely tired and therefore dwelling on the negatives of their job. This can be seen through the fact that he could tell that his colleague felt “inadequate” and like a “failure” and exclaimed that he often felt the same way as a junior doctor. The feelings as a junior doctor are often negative due to the extensive hours of extremely concentrated work leading to many people quitting the job – “spent the weekend backtracking on all her career plans”. ‘She’ did not end up quitting due to her love for the job and satisfaction that she gets out of her job. This shows that many doctors realise the positive impact they have on people, further reiterated in “I don’t do it for the glory, I do it for the love of seeing my patients’ faces when they are well.”

Many qualities of a doctor cannot be taught like kindness and bedside manner, supported by the quote “there’s no assessment of whether someone will hold your hand and stay with you when you’re upset”. This highlights the importance of the interview in medical school applications to show your natural love and care for people.

A love for being busy is also very important and being able to stay organised as shown through the quote “constantly having to think ahead, juggle and plan the jobs that have to be done while moving effortlessly between patients”. In addition, this quote reminded me of what I saw at my hospital work experience where I noticed that however stressed and busy the doctors were, they always made time to speak to their patients and comfort them – not letting them know how truly stressed they are. Doctors are prepared to sacrifice their social life for their patients as they spend any time off “recovering from working”.

Problems in the NHS are highlighted in this book as Dr Pemberton explains about the strong emphasis on reaching NHS targets, taking over medical professionals’ ability to care for their patients – shown through an ambulance driver not being able to drive a man home when there were many ambulances not in use, “the mountain of paperwork and protocols means there is less and less time to spend with the actual patients”. Furthermore, we must provide better care for discharged patients in the future as many people, such as the elderly and homeless are extremely vulnerable once released from the safety of a hospital as shown through “Domestic violence is not medical. A head injury is. But teasing the two apart is incredibly difficult to do.” This leads to reoccurring patients in hospitals who use lots of the NHS’ resources. Dr Pemberton suggests that neglect may not be a case of poor healthcare assistants but of the NHS system due to its focus on meeting targets as “nurses’ time is increasingly taken up with reams of paper work rather than the job of actual nursing.” I found it extremely interesting that Dr Pemberton believes that nurses cannot prescribe medicine due to “cutting corners to reduce waiting times, to meet targets” “at no extra cost” rather than due to “clinical ability.”

I was reminded that getting into medical school is such an enormous challenge due to the fact it is impossible to be completely prepared for the interviews as there is “no set formula that can be easily copied” in approach to interaction with people. People must be understood in their “entirety” in order for a doctor to completely understand their medical condition, and to get them to open up to and trust them. Making a patient feel comfortable enough to speak to a doctor whom they may be meeting for the first time takes incredible “people skills”.

I learned so much from this book and would recommend it to anyone interested in finding out the true feelings of a doctor when treating patients.  It is easy to read as is written day by day in very short chapters and is very funny.

 

Emily Buchanan

MRI – magnetic resonance imaging

 

This week I went to a Physics talk at my school where a teacher spoke about MRI scans, their uses and the images produced.

Scans are mainly used in order to monitor or diagnose neurological, brain or muscular conditions. At this talk I noted the interdisciplinary skills used to create and use an MRI scanner including physicists for the mechanism, electricians for the servicing, mathematicians for quantitive analysis, radiologists for running the machine and doctors for overall analysis of pictures, before patients receive their results and prognosis.

I noted that MRI scans show up areas that are ‘soft’ as light grey and ‘hard’ materials in black eg. the brain looks light grey whilst the skull looks black. This directly contrasts images of X-Rays and CT scans which are lighter shades where ‘hard’ material is found in the body. The reason for MRI showing lighter colours in ‘soft’ areas is due to it highlighting areas of the body containing water and fat. The image is made by shooting low frequency and long wavelength radio waves at the cells – those containing water (H2O) absorb some energy due to the proton in each nuclei of H-atoms, and then reemit the waves at the same wavelength.

The MRI scanner looks like a large donut with a bed which slides in and out of the central hole. Along the bed is a very strong uniform magnetic field, like that of a coil, which must overcome the thermal limit of the body to magnetise the body (it is never turned off). The current flowing through the machine is very high, in order to significantly increase the magnetic field and create a ‘superconductor’ (a metal which does not have any electrical resistance), so liquid helium is used to ensure the scanner does not overheat.

The loud sound during an MRI is due to the magnetic field and fast flowing current making a loudspeaker. Ear muffs must be worn to protect eardrums from permanent damage. Magnetic objects must never be bought near to the machine due to the extremely strong magnetic field of around 1.5 teslas (on earth the average background magnetic field strength is 50 microteslas), which would attract them into the machine, where the person is lying, at a very high speed.

Current research using MRIs includes its potential use in monitoring neurological conditions associated with losing muscle function due to fat coating the muscles. Researchers are looking for ways to monitor this condition using numbers (quantitive analysis) to get a more accurate representation of improvement or deterioration, as opposed to making a judgement using the less informative black and white pictures (qualitative data). They are looking at finding a way to count protons in the nuclei of fat molecules by monitoring the amount of radio waves reemitted from the body.

 

Emily Buchanan

 

Down’s Syndrome

 

Down’s syndrome is a learning disability caused by an extra copy of chromosome 21, making total chromosome count 47 instead of the ‘regular’ human count of 46. Physical characteristics are very recognisable of a broader, flatter face, smaller ears and nose and more space between the eyes whilst an associated medical issue is an increased risk of heart problems.

There are three ways in which Down’s syndrome can occur; through non-disjunction of chromosome 21 (94% of cases), by translocation (4% of cases) or mosaicism (2% of cases). Non-disjunction of chromosome 21 is when chromosomes do not separate properly during the anaphase stage of the cell cycle, translocation is when a part of a chromosome breaks off and attaches to another chromosome, and mosaicism is when people’s cells vary in number of specific chromosomes.

Translocation occurs specifically with the breaking off of part of chromosome 21 and it attaching to a different chromosome in the parent. After receiving two copies of chromosome 21 (one from mother and one from father) and an extra chromosome 21 attached to another chromosome by translocation, total count of chromosome 21 equals three in the offspring, causing Down’s syndrome. People with translocation do not always show Down’s syndrome characteristics but do pass on translocation, giving their child the extra chromosome 21. Translocation can also occur during meiosis, when the parents do not have translocation themselves.

Mosaicism occurs either by the fertilised ovum having three copies of chromosome 21 and losing one during mitosis, or when the ovum originally has cells with two copies of chromosome 21 and during mitosis gains an extra copy of this chromosome by mistake. If the ratio of cells containing three chromosome 21s to cells containing two chromosome 21s is large then Down’s syndrome is likely, and if the ratio is small, Down’s syndrome is less affective, shown by the person having fewer of the characteristics linked to Down’s syndrome.

The biggest risk factor of conceiving a child with Down’s syndrome is a women’s age with risk increasing with age. Figures by the NHS currently stage that maternal age of 20 gives you a risk factor of 1 in 1500, age 30 of 1 in 800, age 35 of 1 in 270 and age 40 of 1 in 100. Risk is also increased if the person has already conceived a baby with Down’s syndrome and further increased (up to 1 in 10) if one of the parents has translocated genes.

In today’s NHS, foetuses are tested for Down’s syndrome by amniocentesis and ultrasounds. Amniocentesis is the removal of some amniotic fluid which is taken to a laboratory to be stained and looked at under a microscope to look for extra copies of chromosome 21. However, some women choose not to have this test as it increases chance of miscarriage so other less invasive tests are taken first such as ultrasounds and blood tests, before referral for amniocentesis.

Ultrasound is high-frequency sound waves to create a moving image in order to see thickness of fluid between skin and foetal neck (taken between weeks 14 and 22), with a thickness greater than 3mm likely to imply chromosome abnormality. Taking a blood sample from a pregnant mother is another less invasive and therefore less risky test, from which alpha-fetoprotein concentration can be measured. If the mother’s concentration is 25% less than normal, it is significantly more likely that their child will have Down’s syndrome so will be referred for an amniocentesis for a more reliable test.

A test that may be available in the future is the analysis of a foetus’s DNA from their mother’s placenta by week 10 of pregnancy. It is currently 99% accurate at detection which is not considered high enough to be widely available on the NHS.

Test results give people a choice; to terminate or continue with their pregnancy – an extremely difficult decision for many.

 

Emily Buchanan

Work Experience in a Hospital – day five

 

I shadowed a Consultant on a ward round this morning, noticing their extreme patience when speaking to an ill patient who demanded to leave the hospital, wanting to return home. The Consultant remained calm and collected, explaining the severity of the patient’s condition and  why hospital, surrounded by healthcare professionals, was the best place for the patient until they became stable. The Consultant calmly stated that the move home could easily be arranged, as long as the patient understood that there was an extremely high chance that they would die or be admitted to hospital again in an emergency.

I went on to learn about two predominant types of pneumonia; legionella and mycoplasma. Legionella presents symptoms such as a persistent cough bringing up phlegm and flu-like symptoms which can be cured by erythromycin or clarithromycin. Mycoplasma is very much more serious, presenting itself in a dry cough and fever and it can damage the heart or central nervous system in extreme circumstances. Mycoplasma pneumonia is far more contagious than that of legionella so could cause an epidemic.

I saw that the Junior Doctors were tired, stressed and frustrated as they followed Consultants making accurate recordings of observations, medicines and dosages whilst being questioned by the patient’s families and nurses for help. This in turn frustrated the Consultants as they did not believe the Junior Doctors were completely focused on what was supposed to be written down on the ward round. I believe this is very important for all people going into medicine to see as we must have a realistic understanding of the stressful, and at times frustrating, profession that we are potentially going in to.

During the afternoon I went to a teaching of ‘wellbeing’ to medical students in which a lecturer spoke to students about the role of diet and exercise in maintaining a healthy mind and body. The lecturer spoke of the fact that most medical students are perfectionists so have extremely high expectations of themselves leading to severe burnout. Burnout can lead to depression, heart disease and a weakened immune system which is reflected in patient care, decreasing patient satisfaction and increasing recovery times. The lecturer focused on resilience as an extremely important quality of a doctor saying that it is a natural quality of people which can also be taught throughout time at medical school. I learned about foods containing sugar, caffeine, nitrites and salt and how they affect sleeping routine, perception and increase risk of diseases.

Emily Buchanan

Work Experience in a Hospital – day four

 

I was in a respiratory clinic again this morning with an inspiring Consultant where I learned more about qualities of a doctor. I noticed their reassurance and truthfulness when telling a patient about the severity of their illness – approaching the subject politely and respectfully whilst always reminding the patient the negative consequences of their condition.

I was reminded today of the disastrous impact of smoking when meeting people with extreme reduction of lung capacity – the lowest was 11% (measured using a spirometer). I try to prevent many of my peers from smoking and would love to expand this to the wider community in the future. I noted the patients’ responses to finding out that they have poorly functioning lungs. A particularly interesting response was thinking that they could easily get a new pair of lungs from a donor. This is incorrect as there is a shortage of donors and if there is a donor, the lungs will go to a child with cystic fibrosis due to them having a greater need. I noticed the doctor’s calm response to their patients, explaining clearly the plan for their future relief of breathlessness using medication. Patients often forget about the large risks associated with replacement of vital organs which could completely change their quality of life (for example after the operation they may be bed bound meaning they have a high reliance on other people, or if the organ is rejected they may die in extreme cases).

I found that by using the number (in a percentage) of lung capacity the doctor was able to show the extreme severity of this patient’s lung condition in order to tell them a truthful prognosis so that they completely understood that they were in a bad state.

As a doctor is it extremely important to have a strong relationship with your patients in order to be able to talk to them about anything – even if a little embarrassing in the eyes of the patient. The doctor advised about depression and the effects of being overweight to their patients using knowledge to comfort them whilst telling them about the best medicinal decisions for their future. Telling people they are overweight is sometimes extremely difficult and therefore whether it is acceptable is being debated at the moment within our NHS due to extra bodily weight leading to health conditions in itself, for example type 2 Diabetes.

I saw a hernia which was the intestine sticking out due to intense pressure around the lungs – hernias can be found all over the body. I will be writing another blog about a condition called Sarcoidosis as this condition particularly interested me in the clinic today.

Structure and function are the key to understanding every disease. Structure is determined by doing a scan eg. X-Ray, CT scan, MRI and function is determined by tests eg. blood tests, lung capacity test.

I was particularly interested in hearing about a new innovative surgery which allows patients to have less invasive surgery of the heart to fuse arteries by a small incision in the side of the body (a new type of keyhole surgery).

In the afternoon I spent my time in the AMU ward with a Consultant where I saw lots of patients with respiratory problems. I enjoyed looking at and learning how to interpret CT scans and X-Rays and listened to the Consultant advising Junior Doctors about which treatment to use for which patients. Everyone respected the Consultant’s wishes for their patients as the Consultant was leading the way for the chance of a healthier future for everyone.

 

Emily Buchanan

Work Experience in a Hospital – day three

 

This morning as I sat in a respiratory clinic at the hospital, I was greatly inspired by the Consultant that I shadowed. They were intelligent, compassionate and clearly respected by all of their fellow doctors and members of the healthcare team. Junior Doctors constantly came to the Consultant asking questions and for second opinions about treatments and the best plan for their patients, while nurses were extremely happy to support them in any way they could. It appeared that the Consultant made their patients feel comfortable, relaxed and positive even when the prognosis was not so positive. Whilst they always showed that they were in control to their patients, once they leave the room the Consultants were extremely busy answering calls whilst looking at other patients’ test results and giving second opinions for Junior Doctors. I learned that a doctor must be able to multitask to a high enough standard that they can be focusing accurately on more than one patient at the same time. The Consultant approached talking to their patients in a very different way to the two Consultants that I shadowed on Monday as the Consultant today explained what they thought was their current problem and history, allowing the patients to correct them, whereas on Monday the Consultants would let their patients do the talking then prompt with questions. Both methods seemed to please the patients.

As a doctor you must explain everything that you are doing. The Consultant was very empathetic when they delivered less positive news – always concerned about questions that may be in patients’  heads, so the Consultant always explained their decisions of medication to them so that the patient was not concerned or confused. The Consultant attempted to explain patients’ conditions without them feeling awkward, embarrassed or less able, speaking scientifically and empathetically appearing to understand exactly how the patient was feeling. The Consultant also offered them professional psychological help due to their frustration of the disease.

Many illnesses affect peoples’ state of mind due to it causing a lower quality of life. An example of this is when patients are unable to walk due to not having enough energy (from lack of oxygen) when their legs do in fact work perfectly. Patients often explained that this not only had a negative effect on them but also on their families who they were extremely reliant upon to transport them from place to place.

Today I also learned about drugs that may be able to replace antibiotics in the future. These drugs are a much lower dose of antibiotic to boost your own immune system to fight the pathogenic bacteria that has infected your body cells. I hope that more doctors use these drugs as it will reduce antibiotic resistance, although I have to say that I am not educated in the knowledge of their side effects and I was told by the doctor that they currently only work in very select cases.

During the afternoon I shadowed a fourth year medical student in the Acute Medicine ward (AMU). I was interested to hear a heart murmur which was confirmed by a Junior Doctor after the medical student hypothesised the specific type of heart murmur. I noticed how knowledgeable the medical student was when they explained in detail everything about the specific heart condition to the Junior Doctor.

It was interesting to see the dynamic in the ward with students reporting to Junior Doctors and Junior Doctors reporting to Consultants. There was clearly a hierarchy in amount of experience but everyone respected and supported each other, concerned about one another especially about those who were on call last night.

I encountered patients who suffer or have suffered recently from bronchiectasis (had also had had a thoracotomy) causing wheezing and coughing after having a lung tumour removed, lung scars causing nodules to appear on their CT scan,  recurring chest infection, osteoporosis, chronic asthma, polymyalgia rheumatica, exercise induced desaturation causing breathlessness, pulmonary embolism, lung collapse, breast cancer, severe emphysema, low T Killer cell count and a heart murmur.

Emily Buchanan