SURGO

Issue 83.18/09/2013

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Surgo March Edition

Contents
1
James Tadjkarimi Assistant Editor

Editors note Medical news Glasgow effect New South Glasgow Hospital NHS after Yes An FY1 in London Surgo Research: Results Ig Nobel Prize FAQ awards Medical News Quiz A Scots English dictionary

2 3 5 7

Tom Baddeley Finance Editor

10 11
12

13
Josh Nielsen Production Editor

15 16

David Boyle Arts Editor

Trung Ton Cover Boy

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Surgo March Edition

Editorial
So here we are again at the beginning of another glossy Surgo edition, brimming with hope and promise; the sun is almost shining, taps aff is becoming ever more appropriate, and the world and his wife are stuck indoors taking no make-up selfies before accidentally donating to Unicef. This issue endeavours to conquer the somewhat ambitious task of trying to make Glasgows public health issues interesting. For those of you who have yet to encounter the med schools very own God of public health, Phil Hanlon, youll know that this is no mean feat. The reasons behind Glaswegian supremacy when it comes to low life expectancy, poor mental health and premature aging is something that Profs everywhere have long been trying to explain. How Glasgow, unlike any other European city, manages to turn even its wealthiest citizens into patients unlikely to live past 40 remains a mystery. Finance editor Tom Baddeley attempts to get to the bottom of this and asks Dr David Morrison whether hosting the Commonwealth Games will have any impact at all. Contributing writer Jamie Henderson then pays a visit to the mammoth New South General Hospital to play a game of should the fourth years stay in Glasgow, or should they escape while they still can. To make this decision even more difficult, Dan Taylor-Sweet has a look at how independence will affect the NHS: for better or for worse. If the idea of working in the new super hospital, treating UBIs (see medical news) in an independent Scotland leaves you feeling a little anxious, send prof. an FAQ or alternatively, read former Glasgow student Sheelagh Harwells account of her experiences as an FY1 in London. Once youve got through all of this it gets a little more trivial Cast your minds back to the distant memory of Surgos November edition and our first foray into the world of clinical research. Assistant editor James Tajkarimi brings you the results of this much acclaimed trial, proving once and for all which hangover cures work and which most certainly do not. To continue this disconcertingly positive trend, arts editor David Boyle gives you a snapshot into the fantastic world of the Ig Nobel prize, somehow managing to shoehorn both fly fishing and shrews into one article. This brings us nicely on to some humour from within Wolfsons own walls, with of a compilation of the years best FAQs and a few words from Prof. Walters himself. Last but not least, Jane Hamilton explores the world outside of facebook with an impossibly difficult quiz and Josh Hughes gives us a way into the world of Glaswegian slang.

And with that all thats left to say is, Let Surgo Flourish. Ella Bennett Editor in Chief.

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News News

Medical News
A collection of the latest medical news ranging from the semi-relevant to entirely ridiculous (credit goes to the Daily Mails health pages for the latter)

Doctors slang is dying out

Dr Adam Fox, a paediatrician in London has spent the last 4 years compiling as list of medicines most colourful codes used in notes to describe the most unspeakable truths about patients. Due to increasing rates of legal action against doctors however, the risk of being asked to explain one of these inventive acronyms is ever higher and thus, they are falling out of use. One of Dr Foxs finest compilations is of terms used to describe patients of err lesser intelligence: examples include LOBNH (lights on but nobody home), CNS-QNS(CNS quality not sufficient) and the charming, pumpkin positive, which refers to the suggestion that a patients brain is so small that upon shining a light in his or her mouth, the whole head would light up. There are a few examples of doctors being called up on these phrases, a notable example was where a surgeon was asked to explain TTFO(told to F off). He dodged the bullet smoothly, with to take fluids orally. For preservations sake, Ill leave you with a selection of the rest... NFN(normal for Norfolk), CTD (circling the drain), UBI (unexplained beer injury) and last but not least, TEETH (tried everything else, try homeopathy).

Sleep loss, brain loss

We have all had days after a lack of sleep where trying to produce a comprehensible sentence can be almost impossible and you would swear to some sort of brain loss. Well now scientists at the University of Pennsylvania think this may actually be the case. In a study carried out on mice in which they were only allowed 4/5 hours of sleep per day, after just three days there was a 25% decrease in the number of locus coeruleus neurons. It remains to be seen if this is true in humans, with the next stage of research involving looking at shift workers brains after death. The hope is that protective medication from these adverse affects may be developed, much to the delight of students everywhere.

Giant virus could signal return of small pox

Russian and French Scientists have found a virus that has been frozen in the permafrost of the Arctic Circle for 30, 000 years. Found in samples of frozen soil, 30m below ground in the far North East of Russia, the Pithovirus can only infect single cell organisms so is harmless to humans and animals. It does beg the question though, of what else may be lurking out there. The Pithovirus is similar to smallpox in the way that it replicates, leaving the possibility of a return of the smallpox virus. This may be bad news for Russia as it may mean increased regulations on drilling activities to ensure that we dont have a return of the eradicated small pox virus.

Ever wanted to look like cancer?

American Professor Jacqueline Firkins has designed a range of ball gowns based on photographs of microscopic cancer cells. The ten dresses form part of an exhibition called Fashioning Cancer: The Correlation between Destruction and Beauty, and are intended to prompt a discussion surrounding beauty, body image and disease. Whether of not you have a burning desire to look like a cancer cell, these are infinitely more interesting (a great deal weirder) than a thousand no make up selfies...

New phone case that monitors vital signs

Due to be released later this year is the Wello, an iPhone case that can monitor your BP, ECG, lung function, O2 levels and temperature. Azoi, the company behind this say that they hope it will allow for earlier detection of health problems. Akin to the tricorder seen in Star Trek the device allows you to upload your data to the internet (on your supplied URL) and sync with other apps to give an overall view of your health. Available to pre-order in the UK for 120 though, it is by no means the cheapest phone case around. While the concept seems like a good idea, there are fears that it may be more suited to hypochondriacs than actual patients.

Guess the cancer: 5th right is brain, 4th, cervical?

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Surgo March Edition

Deprivation, depression and premature death: The Glasgow Effect

Finance editor, Tom Baddeley investigates the mystery behind Glasgows health problems, with a little help from Dr Morrison, head of the West of Scotland cancer surveillance unit
As Glasgow medical students, youll have heard a lot about the Glasgow effect; a phrase used as the ultimate get out of jail free card for everything from Glasgows appallingly low life expectancy to the drug habit that affords us the title of heroin capital of Europe. The question of why Glasgow manages to achieve the Europe-wide dominance in pretty much every chronic disease is a bit of a mystery. Public health is something that tends to divide medical students; those that have fallen in love with Prof Hanlon, and those that have yet to make it to one of his lectures. Whichever side of the fence you are currently on, the Glasgow effect is undoubtedly something that we could do with getting to the bottom of, particularly if we succeed from the UK. No one really knows why the Glasgow effect exists. Despite having a deprivation score similar to Manchester or Liverpool, certain statistics just dont fit the trend. A prime example of that is premature death rates which are 30% higher in Glasgow across men and women of all ages, and people from both deprived and affluent neighbourhoods. This is pretty shocking, particularly when the childhood health of a population (premature deaths, infant mortality child poverty) are arguably some of the best indicators of a populations health. To look for the

and trade. People flocked from the highlands and Ireland looking for jobs. This triggered the birth of one of Glasgows most distinctive features; the sandstone tenements. Majestic as they are now, these were overcrowded, poorly maintained with dubious sanitation which unsurprisingly resulted in a surge in health problems to the extent that life expectancy became as low as 27 in some areas. This situation was not unique to Glasgow however, cities such as London, Manchester and Liverpool were experiencing similar problems. It was not until the deindustrialisation period during the 1950s-1980s that the gap began to appear. Something happened during this period which changed the very constitution of the city, something that affected not only Glasgows physical health but also the Glaswegian psyche.

just doesnt make sense; yes, there are too many heart attacks and cancer cases but these figures are not sufficient to account for Glasgows supremacy in achieving early death. Weve established that poverty cant really be the answer, with Liverpool and Manchester managing to cling on for substantially more years than Glaswegian despite achieving similar levels of depravation. Glasgow beats these cities in a few other places too; we have far greater deaths from suicide, violence, drug and alcohol abuse and traffic accidents and have far poorer mental health. Glaswegians seem to be, for whatever reason, more prone to despair and hopelessness than others.

Glaswegians seem to be more prone to hopelessness and despair than people from other cities.
source of this discrepancy, you have to look into the past. In its hay day, Glasgow was known as the second city of the British Empire, a hub of industry

It isnt just Glasgows poorest that are affected by this; even the most affluent weegies die much younger than their English counterparts. Its a wonder really why Salmond hasnt used this in his Glaswegian life expectancy was, and still independence campaign, someone should is, the lowest in Western Europe. Whats really give #bettertogether a ring. odd is that when you look at health Over the years the health and crime rates statistics, the perception this is down to Glaswegians love of deep fried mars bar in Glasgow have improved, but still at a slower rate than the rest of the country. washed down with 18 cans of tenants

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Something provokes these selfdestructive behaviours. Theories such as vitamin D deficiency, the hedonistic culture of getting mad wi it or even the bad weather and prolonged, cold winters have all been considered, but no general conclusion reached. The reason seems to go deeper than that. Epigenetics is the heritable changes in gene activity which are not caused by changes in the DNA sequence. Essentially certain genes are expressed inappropriately, and this alters the DNA methylation status. This enables the effects of parents experiences to be passed down to subsequent generations. A study undertaken here at the At best, according to the epidemiologists' calculations, deprivation accounts for less University of Glasgow found that than half (around 40%) of Glasgow's insufficient maternal care or poor diet, or mortality gap"compared with the rest of the " even low maternal mood during UK. The other causes are still unknown. pregnancy can all lead to an inherited sensitivity to stress in the child, global epigenetic changes (due to smokpredisposing them to development of ing, diet, deprivation etc) and increased obesity, diabetes and atherosclerosis. biomarkers for inflammation such as Additionally, a link was found between IL-6 and fibrinogen resulting in a general

inflammatory state in the individual for the rest of their life. While these results are not the be all and end all, they are a step into understanding why this situation exists, and hopefully what can be done to fix it. (Glasgow is still an amazing city despite these problems, and it is a privilege for us to study and hopefully practise medicine here in the future. The current health problems here are like a glimpse into the past, with exposure to extremely sick patients, and diseases that are not present in many other parts of the UK. We should therefore use this opportunity to better our knowledge of these and become hopefully become better doctors in the process.) We asked David Morrison, a reader in Cancer Epidemiology based at the West of Scotland Cancer Surveillance Unit for his opinion on what effect if any the commonwealth games would have of the health of Glasgows denizens. Over to you David.

Dr David Morrison on the potential impact of Glasgow hosting the Commonwealth games
We carried out a systematic review to look for evidence about the health effects of major sporting events, such as the Commonwealth Games. While there are short-term economic benefits, there is little evidence to suggest that there are long-term economic or health benefits. While absence of evidence is not evidence of absence of an effect, do I think that the Commonwealth Village is likely to lead to measurable improvements in health? It may do, but if it does, it may be more to do with the fact that people who move into new housing are likely to be healthier (and wealthier) than the rest of the population rather than because chronic health problems can be quickly ameliorated by housing improvements alone . None of which is to say that the redevelopment of the east end with sustainable, energy efficient housing is not a good thing. Similarly, building modern new sports facilities providing they are affordable and accessible to everyone is a good thing, but is it the most effective way of improving health? Well, the single biggest thing that would improve health would be to stop people smoking. The effects of that would be greater than any amount of additional exercise. More broadly, finding ways of getting the majority of the population gainfully employed would have far-reaching and long-lasting benefits on their health. But improvements in public health are achieved through a range of activities and they are all important. Some problems are more difficult to fix than others. So while were working on ways of further reducing the prevalence of smoking, obesity, alcohol abuse and other health problems, provision of better sports facilities is a welcome contribution to improving public health.

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Surgo March Edition

The New South

A step in the right direction for Glasgows healthcare or a medical monstrosity? Contributing writer Jamie Henderson finds out all about Glasgows new super hospital. Lets just hope everyone can get through the Clyde tunnel in time for the next big emergency
As Im sure you'll be at least vaguely aware, a New South Glasgow Hospital Campus is currently being built on the site of the current Southern General Hospital. This will contain a massive 1109 bed adult hospital and 256 bed childrens hospital. To put that into perspective, thats equivalent to 3 Western Infirmarys with Yorkhill stuck on the side. The Sothern's existing neurosurgical, pathology and maternity departments will continue to be based there. As if embarking on one of the largest hospital developments in Europe wasnt enough, a new learning and teaching facility for us medics is also under construction.

Front entrance of the New South Glasgow Hospital

Just a small change from making the depressing pilgrimage from a rammed WILT to an even more soul-destroying Boyd Orr then

The new hospital is equivalent to 3 Western Infirmarys with Yorkhill stuck on the side.

So, what else is new?

A few key changes are being made to the hospital layout; gone are large general wards favoured by the likes of Florence Nightingale. Instead, wards will consist of 28 en-suite single bedrooms. This has been done less out of a desire to compete with Holiday Inn and more in an attempt to improve patient satisfaction and infection control. On a logistical level, it makes barrier nursing much easier and eliminates the problem of mixed sex wards. Some lucky patients will even be offered a fantastic view of the Clyde, sewage works included, through large windows in every room.

infamous portacabin; it will be replaced by an atrium that would not look out of place in a Merchant City office block. A central hub of the shiny new Hospital filling the alcohol-gel laden air with the much loved aroma of hospital cuisine. Hopefully there'll be windows.

Yorkhill to go

The new hospital, which has already begun to tower over Glasgow, will be completed during the first quarter of 2015. Many of the services currently provided by the Victoria and Western Infirmaries will move at this time and it is hoped that the hospital will be fully operational by the summer of 2015. Thats just in time for our current fourth years to start their FY1 jobs. This is also exciting for those of us in the pre-clinical These new style wards will surround a years as our initial clinical experience, central space housing shops, a caf and and much of our teaching, will be in a the hospital canteen. Gone is the brand new, state of the art hospital.

Architects impression of the atrium

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Surgo March Edition

Glasgow Hospital
The Royal Hospital for Sick Children at Yorkhill will provide specialist services only available in Glasgow to the rest of the West of Scotland. The linking of this with the existing specialist maternity unit will mean that all specialties are completely centralised. Whilst the childrens hospital will be attached to the adult hospital it will have its own identity, much like Yorkhill has today. Unlike in the adult hospital, wards will be a mixture of four bedded bays and single rooms as it was evidence suggests that many children have better outcomes when surrounded by others. hospital. As the facility is shared with the NHS the medical school will only have official use of 50% of its capacity, though this will apparently remain flexible. Within the building itself there will be a 500-seat lecture theatre, a caf with good coffee Im assured, clinical training facilities Architects drawing of the multi-story car park and a library space. It is envisaged that the facility will be staffed Clinical Skills from 8am to 8pm allowing NHS staff to Alna Robbs dream home has finally use the facilities outwith their normal been built. With a new clinical skills working hours. It also aims to take some New Learning and suite, mirroring the layout of patient of the burden off the SL, during times of bedrooms within the new hospital, there Teaching Building great need such as when four of the hunwill be more scope within Glasgow for dred light bulbs spontaneously combust. Along with these new hospitals the mediclinical training. It will consist of a 12 cal school and NHS Greater Glasgow Somewhat conspicuously, I couldnt find bedded area, 8 of which will have live and Clyde are making a any pictures of this snazzy new medical oxygen and suction, and a prep area. All significant investment in medical school offshoot so I thought Id stick in areas of which will be covered by education. Construction has already an equally snazzy, not at all CGI-ed cameras with the ability to pan, tilt and begun on a Learning and Teaching picture of New Souths multi-story zoom, allowing Alna to monitor your Facility that will be shared with car-park. Further proof that a world every move from the comfort of her inNHSGGC, and will be linked to the new where car headlights are red and the sky built throne. The cameras will also give is purple is altogether a tutors the ability to record and feedback better one. on student performance from an adjacent control room. Students will be able to The majority of pre-clinical training book time within this facility to practice will remain on campus; with older their clinical skills, just like in the students who are attending Wolfson. placements, within Glasgow using this facility for the majority of their clinical teaching. With all these facilities arriving in Glasgow over the next few years we Access to the library, something I have no excuse for poor clinical skills. think we are all dying to know Trips to Govan will become a daily about, will hopefully be 24 hours occurrence rather making that once a for students as well as staff year scrubby trip significantly less novel. although the practicalities of this You never know, perhaps some of us have yet to be worked out. will be tempted to make Brechans our local.

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Surgo March Edition

NHS after
Our contributing writer; Mr Daniel Taylor-Sweet explores what may happen to our health service following the Independence vote taking place later this year
On the 18th of September this year the future of Scotland, as we know it, will be placed into your hands. Salmond and the SNP are putting the question of independence to the people of Scotland and inevitably, this will have some effect on the NHS. the lack of prescription charges, by providing free car parking at hospitals, and in having managed to avoid Andrew Lansleys controversial Health and Social Care Bill. already in place allowing UK nationals to get treatment in the EU. Its argued that the impact of this newly formed, highly complicated relationship would be seen predominantly in highly Aneurin Bevans brainchild is taking a niche areas of certain specialisms such as very different path on each side of the paediatrics, cancer care and Regardless of your political and cultural border, a gulf that is likely to continue to transplantation services. views, a vote for an independent widen in an independent Scotland. If the One of the most frequent examples of Scotland would have a drastic impact on current state of affairs were to continue, cross boarder cooperation is seen in the day to day life of everyone in this it is likely that the South will head down transplantation cases. Currently any country. A deluge of changes would be the path to greater privatisation, with the patient requiring a lung or heart-lung implicated across the public and private North likely to become even more transplant in Scotland has to be sent to sectors and these changes will not go dependant on public funding. the transplant unit in the Freeman unnoticed. An NHS in an independent Scotland Hospital, Newcastle upon Tyne. Better The NHS in Scotland has been devolved would face less drastic changes than Together argue that this special since 1999 giving Holyrood a large other sectors such as the military and relationship with the Freeman and other amount of control over the spending of intelligence agencies, but changes would specialist units could be affected by its health care budget. Since this time, be seen in several other areas that may independence. This would directly several major differences have developed affect patient care. impact on the healthcare of Scottish in the NHS above and below the border. people, leading them to receive a lower Currently any patient in Scotland NHS Scotland currently differs from its standard of care than their Southern requiring treatment in England (or vice Southern brother in three principle areas; neighbours. Margaret Watt, chairwoman versa) is able to do so as part of a longof the Scotland Patients Association, standing agreement with NHS England. said: Whatever the outcome of the This creates an interdependent relationreferendum, there is already pressure on ship between the NHS in Scotland and patients when it comes to travelling for the NHS south of the border. medical treatment and the system for The No campaign reminds us that the treatment south of the Border is relationship between NHS Scotland and complicated enough. We wouldnt want NHS England following a Yes vote to see patients placed with any additional would be a very different one. Better burdens. Together claim that the simple internal Several high profile health charities have relationship between what are effectively also spoken out on the issue of two governmental organisations will be international cross border care, with replaced with a complex international Macmillan Cancer Support even going relationship with all the associated as far as recommending that patients do bureaucracy. not seek treatment abroad as they say They also claim that any patient treatment in other EU countries (as Aneurin Bevan was the MP who drafted the requiring treatment across the newly England would be) can take a number bill that lead to the implementation of the NHS formed international border would need of weeks, possibly months, which is in England, Scotland, Wales and Northern Island in 1948. to follow a similar process to the one likely to be detrimental to patient care.

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Surgo March Edition

When speaking to a consultant at Glasgows Western Infirmary, he highlighted the general feeling of uncertainty that is crossing doctors and patients minds. On the other hand, proponents of the Yes campaign are quick to refute this claim. They argue that the NHS in a newly independent Scotland would remain much the same as it already is. They point out that health care spending was devolved in 1999 meaning that the Scottish government already has control over the Scottish health care system, meaning that regardless of the result of the referendum Holyrood has and always control of spending, a Scottish will have total control of the NHS. government would be able to reduce The Yes campaign claim that by having inequality and thus improve the health of full independence from the UK would the Scottish people. Although this is not allow a newly formed government to directly connected with the NHS, it increase the health of the Scottish would have a direct impact on the health population because they would be free to of the residents of Scotland. increase public spending. It is well Whatever the outcome of the referendum known that life outcomes and health are on the 18th of September Scotlands directly correlated with poverty. The Yes NHS will continue to look after the campaign point out that with greater

people of Scotland and will prove that free healthcare is critical, and it is here to stay, leaving the fine details that outline specialist treatment to be confirmed and finalised after a Yes vote. Therefore the situation of the NHS is left to the voters, with the understanding that there will be some changes that are detrimental, and also some changes that are beneficial for the Scottish people.

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Surgo Review

An FY1 in London
I moved down to London in the wake of my accountant boyfriend who was attracted to the big smoke like a moth to the flame. I am now in month two of FY1. This article lays out some of my experiences so far, with the view to help any other Glasgow medical students interested in FY1 in London.

Planning
Firstly, I did not make the decision rashly; I chose to do my second elective in London, an academic psychiatry placement at the Maudsley hospital, to test the water. I thoroughly enjoyed my 4 weeks there and would recommend a placement before applying as its a different beast altogether from other cities in the UK.

door of the hospital in 25 minutes. Friends say this is an amazing commute, so be prepared for worse. Surgery is the toughest as shifts can start as early as 6am.

Money
London is expensive. My rent and travel are half my monthly salary. To get a nice flat in a very nice area, we had to put an offer in that day and the estate agents fees were 380 to get us both references and hand us a set of keys. The London weighting is roughly 1000 a year, but seeing as the tube is 200 a month, this doesnt really cut it. My rent is over double my Glasgow rent.

The hospital
For FY1 I am placed in Kingston hospital, a small district general 20 minutes south of the Thames. Its a very affluent area near Richmond Park (where the famous Fenton the dog is walked) with yummy mummy Wimbledon next door. The hospital itself employs 38 FY1s, and there is a doctors mess with free toast and coffee (essential for on calls). The hospital just became its own trust, which apparently means its reaching the targets that are so important to the management team but all I know is that its a really friendly, clean and modern hospital. All the FY1s are good. And I mean lumbar puncturing-in-their-first-week good.

Opportunities
Having said goodbye to your social life and most of your wages you will, hopefully, look around and realise that London is brimming with opportunity. I once presented a patient at a neuro-oncology MDT and afterwards someone said Ill do her pituitary if her notes are on my desk on Monday. I was so scared I scuttled off without asking his name (turned out it was Mr Henry Marsh Wikipedia him). Im currently being forced to do 4 audits. Literally forced. Its like youre a freak if you say no. There are lots of academic meetings and grand rounds to present interesting patients at. We also have compulsory prescribing exams and ABG training, not to mention 2 hours bleep-free teaching a week. Having said that, I wouldnt say its particularly different to Glasgow; those that seek these extra opportunities anywhere will get the same exposure.

The job
I am currently on Neurology, which involves me working across 3 hospitals, one of which is a specialist neuro-rehab centre. This has meant that Ive experienced 3 different systems but has made has made it more difficult to meet other FY1s as they lunch together and I can only join twice a week. My neurology exam has become my main competency as I do it at least 10 times a day. Even fundoscopy is now my friend.

FY2
For all FY1s in London, it is important to realise you will do one year centrally and one year peripherally. And that can be We do one long on-call day a week until 10pm and one week- very peripherally. Like further away than Edinburgh. I decided end in eight. This is when you roam 8 wards alone, prescribing to do my central year first as there is a very active FY2 Swap warfarin and gentamicin, running away from nurses and Shop run by South Thames Foundation School, so I thought praying no one gets ill. It is on-call that Ive cannulated a foot, Id at least have a little more autonomy over my placements. catheterised, sedated, started the sepsis 6, spoken to relatives, Its worked out, so far. You dont find out what youre doing interpreted x-rays, pronounced death, pulled out drains, called in FY2 (not in South Thames anyway), but almost everyone the crash team and generally sweated all over. If in doubt, page does A&E. the FY2.

On-call

The commute
Something that all Londoners endure; even at the weekend, trying to traverse through the population of 12 million can reduce you to tears. I live in Pimlico and can get to the front

Hopefully this brief account of my experiences will help some poor souls going through the FPAS process next year. If you would like any advice, please email me on Sheelagh.Harwell@kingstonhospital.nhs.uk

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Surgo Research

The relative effectiveness of interventions intended to treat alcohol hangover: results

Tadjkarimi J, Bennett E, Neilsen J et al. the other drunk people...
Some of you may remember our botched attempt to enter the world of scientific academia in our last issue. What follows is a jumbled effort to pick out any trends in how effective one so called hangover cure maybe over another. A quick word of warning; dont take any of it as gospel. Its somewhat impossible to remember everything from one night 3 months ago, and no one could quite be bothered to take notes. Understandable really, as we were all hanging pretty badly...

Results
To recap: participants were randomly allocated to one of seven treatment groups and instructed to consume an average Saturday nights worth of alcohol. The seven treatment groups were: 1. Paracetamol/ibruprofen with Irn Bru 2. 5k run to Maryhill Tesco's and back 3. Full Scottish breakfast 4. Hair of the dog (drink of choice) 5. Milk Thistle tablets 6. 0.9% saline 7. Wallowing in self pity (control group).

Participants were asked to rate on a scale of one to ten, how they felt when they woke up in the morning, and 2 hours after their allocated hangover cure. On waking, far too early thanks in part to haphazard sleeping arrangements and also to a certain ex editor insisting on opening the curtains, our guinea pig subjects certainly felt a little worse for wear. A large proportion experienced fatigue or general tiredness, with only 2 saying that this feeling was minimal. Many also scored 10 out of 10 for apathy or a lack of concern. However as this remained largely unchanged following treatment, this may have been skewed by the cynical nature of most Surgo contributors. Concentration problems had a relatively normal distribution throughout the population, with clumsiness and confusion scoring quite low. It was proposed that in future studies, a rubix cube could be introduced to further asses these parameters but due to financial constraints, this did not materialise. Thirst scored extremely highly as most people couldnt quite make it to the kitchen for a glass of water for fear of triggering another pounding headache, or worse, a not -so-tactical chunder. People experienced little to no shivering or shakes, stomach pain or palpations. There were however, scatterings of dizziness and nausea seen in isolated pockets of the population. Following ingestion of the allocated cure, and once the two poor souls who had to run to Maryhill Tesco in order to procure readily fry-able foods had returned, subjects lounged around for a number of hours before they could summon the will to return to their respective homes. They once again took the questionnaire posed to them earlier, at which point I was left to discern what effect, if any, these therapies had had on their hangover status. Results were largely inconclusive though there was a slight global shift to a drop in severity of symptoms for all areas tested; except that of apathy. Thanks guys.

Discussion
From our results, it appears very difficult to discern which remedy had the most effect in eliminating the toxic effects of alcohol. Clearly, the strictness of scientific protocol wasnt upheld as we all got food envy and ended up joining in on the fry up. In addition to this, a handful of subjects forgot to fill in the questionnaire so had to do so retroactively. Despite these minor short-falls, for our first foray into research it was a fine attempt and although weve learnt pretty much nothing about what works, weve gained extensive experience of what doesnt. Like most of the population when asked, subjects swore their method of getting rid of a hangover was the only effective way of doing so, and, as expected, its probably based on a foggy notion that on that one morning after the night before they felt right as rain. This author swears by two paracetamol and a pint of water before bed (if you can remember to do so, which is hardly ever) but again, cant really back that up with anything more than anecdotal evidence. Our current editor on the other hand, has become recreationally addicted to Milk Thistle. I think its also true to say that in all the years that ethanol has existed, if a magic bullet for treating hangover symptoms existing we would surely have discovered it by now. Before starting this trial, we did find a number of papers out there examining many weird and wonderful treatments, with no clear consensus. The conclusion they reached was much the same as ours; if a 100% certified hangover cure sounds too good to be true, it probably is. Drink in moderation, or otherwise, try curling.

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The Ig Nobel Prize

The Ig Nobel Prize - Pushing the boundaries

of the unnecessary
By arts editor David Boyle (formally known as Druid Boyle)
Many of you wont have heard of the Ig Nobel prize and quite frankly, you are perfectly vindicated in your state of ignorance; the prize will never coat the glossy pages of more reputable publications such as the Lancet, the BMJ or Total Flyfisher. A prize for those researching what we wouldnt deem worthy of a fleeting thought, the Ig Nobel prize has been rewarding those rascals pursuing obscure breakthroughs since 1991. We here at Surgo, as co -founders of the award, have always been very proud of its ability to find pioneers of the modern world. Fields such as Medicine, Physics, Physiology, Nutrition and Peace to name but a few, have been scoured to find the most utterly useless but remarkably humorous pieces of research. Focusing on medicine (and throwing in a few other crackers) I hope to moisten your palette as I walk you through the fantastic world of the Ig Nobel prize. Perhaps it may even lead to an inspired SSC self -proposal and you may find yourself at Harvard University accepting your own Ig Nobel prize. In 2012 a pair of cheeky fruit loops Emmanuel Ben -Soussan and Michel Antonietti from France were rewarded for their research advising doctors who perform colonoscopies how to minimize the chance that their patients will explode. Weve all seen it happen on placement, so its good someone is looking out for the patients. Zut Alors! Ever been caught out by a nasty cause of the hiccups? Been told to hold your breath? Have a glass of water? If not you havent lived. Luckily an American by the name of Francis Fesmire came to the discovery of 2006 by realising that a digital rectal massage causes termination of intractable hiccups. Ive been doing it for years and nobody has believed me. #digitdoesthejob The 2013 recipients of the Medicine prize were a group from Japan assessing the effects of listening to opera on heart transplant patients who were mice Wonder if it was pavaratti? Either way theres no looking Bach for them. (I dont get paid for these puns) Thats enough medicine for me. The Peace prize in 2013 was won by Alexander Lukashenko, president of Belarus, for making it illegal to applaud in public, AND to the Belarus State Police, for arresting a one -armed man for applauding. With the Commonwealth Games coming to Glasgow Ill throw in a sporting discovery from 2011. Four scientists from France and a Dutch bloke discovered why discus throwers become dizzy and why hammer throwers dont! Im not sure why this is a thing either Viagra aids jetlag recovery in hamsters. Personally I think an hour or two on the wheel is going to do a better job than hours and hours of humping sawdust will but Im not winning these prizes for a reason. Finally, youll be glad to know, my personal favourite. Brian Crandall and Peter Stahl from the USA went to the extent of parboiling a dead shrew, and then swallowing the shrew without chewing, and then carefully examining everything excreted during subsequent days all so they could see which bones would dissolve inside the human digestive system, and which bones would not. Apparently that is Archaeology. Astounding.

The day you find yourself swallowing an entire shrew is the day you know you really are making a difference to the world and shaping the future of generations to come. Id like to think you are now looking at your surroundings, questioning them and will strive to change them. What are the effects of Calvin Klein boxers on Sloths with inguinal hernias?! Stay tuned to Surgo and youll be the first to know. Until next time scholars. Science.

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The FAQ Awards

Sadly VALE will be shut down next year and with it will be lost a vast archive of learning and wisdom. For the benefit of all future medical students, contributing writer Mike Pretswell has collected some of the very best and saved them for posterity. There are many fine initiatives which have harnessed the power of technology to improve Medical Education. The FAQ website isn't one of them. Over the last couple of years it has degenerated from an academic resource into a conduit for gratuitous abuse, threats of violence and utter, utter nonsense, some of which will be illustrated in the pages of this edition of Surgo. It was Mandell Creighton, 19th century Bishop of London and Inaugural Professor of Ecclesiastical History at Cambridge University who said: "The real object of education is to have a student in the condition of continually asking questions." The following article will prove how very wrong he was... Professor Mathew Walters, (Doctor, Educator and FAQ slave)
In response to a 2009 question on pneumonia Welcome student, Do not be afraid of the sequinned cloak over my tweed onesie, for I am Mystic Matt, Psychic Investigator and spirit guide on your quest for truth. The answers to questions like yours, young man, lie beyond the reach if mortals and can only be found on the ethereal plane. Let us begin. High Priestess Eunice has already inspected the entrails of a freshly-killed medical school applicant (we've had to add a "ritual sacrifice" round to the mini-interviews as the UK-CAT scores were pretty high this year) but the only knowledge we gained was that it's nearly impossible to get bloodstains out if a Hutchie uniform. So let us gaze deep into my crystal ball and the spirits may show us the truths we seek... Yes, yes, I'm getting something....whispers from "beyond"... getting louder... [AT THIS POINT EYES ROLL BACK AND VOICE BECOMES A GUTTERAL DEMONIC SNARL] YOU FOOLS THIS QUESTION CANNOT BE ANSWERED AS ITS TOO VAGUE AND PROBABLY THE WORK OF SOME DODGY LECTURER DOING UNAUTHORISED MEDICAL EDUCATION EXPERIMENTS LATE AT NIGHT IN THE LAB OH AND BY THE WAY, BLOOD TESTS ARE NOT INVASIVE The Night Before Christmas Twas the day before Christmas and all through the SL some 5th years were stirring and complaining of hell. As they sit and revise some paeds, maybe gyn they look forward to dinner of meat from a tin. The 1st years were nestled all snug in their beds While visions of Alna Rob danced in their heads The 3rd years revised at home with some cake But 4th years in the SL much panic did make. The wind outside it made such a clatter So music was turned up, disturbance? No matter. The staff in the med school, a half day were granted And merry thoughts throughout the SL were planted. The lights of the cars on the street wooshed past, Until there was a sound - a resonant blast! Up rushed the 5th years to the atrium with fear, They knew not, what was happening here. There stood a man in a red velvet suit, With a dark brown beard and shiny black boots, He stood by the tree in medical school, To be honest we thought he looked like a fool. He was leaving some gifts all under the tree, Answers to FAQs answers for me. A wink of his eye and a twist of his head, Soon gave me to know I had nothing to dread. He left the building as quick as he came, He left so fast we couldnt ask him his name, But I heard him exclaim, ere he drove out of sight, "Merry Christmas to all, and to all a good-night!"

Prof on the future of medical education Medical educationalists have tried a huge range of initiatives (PBL, CBL, etc) but the potential benefit of a full -on staff/ student fist fight in the car park at the end of a tough five years has been sorely overlooked. In a few years the OSCE will be one 5 minute station consisting of a basket of puppies and a big hug.

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On Pulmonary Embolisms: This young seal presented with pleuritic chest pain and shortness of breath on diving. He had noted a swollen flipper a few days earlier but had not sought medical attention. The CT scan he was undergoing when this picture was taken showed a filling defect in the pulmonary artery. In the absence of obvious risk factors they did a thrombophilia screen which showed he had "protein sea" deficiency. He was treated with "wharf-arin" and you'll be pleased to hear he made a full recovery. The Tale of the 5th Floor Terror For a time in January the SL was plunged into darkness and reports began to filter in that strange happenings were to be seen on the 5th floor. Bloodcurdling screams, flickering lights and even a balding man pacing the shelves and muttering about traction alopecia. It started quietly with an innocuous FAQ about hair loss: Dear Prof, A wee festive EMQ for you that has left us close to tears. 2010 paper 1 EMQ 1.2 Theme: Hair loss. Can you shed some light? (The urgent answer) LISTEN CLOSELY. DO EXACTLY AS I SAY AND EVERYTHING WILL BE FINE! SLOWLY PUT THE QUESTION DOWN. BACK AWAY TOWARDS THE DOOR. KEEP YOUR EYES ON THE QUESTION. NO SUDDEN MOVEMENTS. ONCE OUT OF THE ROOM GENTLY CLOSE THE DOOR. BRICK UP THE DOOR AND NEVER SPEAK OF THIS QUESTION TO ANYONE ELSE. EVER. This is the worst question in the history of finals. We have taken it out of the question bank and had it shot. Later that week, Hi Prof, I did as you asked and walled up a project room) with that alopecia question inside. Unfortunately I can now hear scratching and weeping noises from within. Either the question has grown sentient heralding the start of a follicly challenged apocalypse, or I accidentally sealed a first year in there too. Dear Prof, I unwalled the 5th floor project room as some nutters needed for "OSCE practice". Much to my surprise inside I found the carcass of a now bald 1st year, but the alopecia question was nowhere to be seen. Ive stared patrolling the SL with a shotgun and a can of rogaine Dear Student, Stay vigilant! I fear that rogue alopecia question may have targeted Jesse Dawson, he's in the office next to me writing an IPL scenario about Minoxidil while wearing a baseball hat. Musings on life as a medical student... I suffered a similar fate in 5th year during a block at Inverclyde. Imagine a wet Guantanamo Bay with a chip shop. One of my ultra-keen student colleagues insisted on being given a page so he could be beeped for interesting events out of hours, and to alleviate the terrible boredom we took it in turns to get up overnight and page him from the only phone in the residences, getting him to call the number of that same phone. He never worked out why it was constantly engaged, despite being three o'clock in the morning. Progressively the relentless sleep deprivation took a terrible toll on him. The UN insisted on the closure of those residencies not long after. Q. Hey Prof, thought you might be interested to know you share the same birthday as Elijah Wood. I can certainly see a lot in common, both saviours of the free world and vanquishers of evil dark overlords (a certain he who shall not be named year head) A. Your Lord of the Rings reference is pretty apt: I frequently see the frail, emaciated figure on the left while I'm at work and wonder if he's following me: Do you think they're related?

There have been more than 5 FAQs a day submitted since Christmas, some at 3 in the morning, some in barely intelligible English and most clearly on the edge of despair. But all have been answered with compassion, wit and genuine insight. A big thanks, and SRC teaching award goes to Prof. for undertaking such a mammoth task. In his own words: I do this not for money but because I care. That and the sad fact that my bins get out more often than I do.

Give us our daddy back please

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Medical News Quiz

How much have you been keeping up with whats been going on outside Facebook? Questions: 1. Will you develop dementia - what are scientists looking for in blood that could detect early signs of dementia? Nightmares in childhood what could this lead to? How much was the British Pregnancy Advice Service fined after its website and all confidential information was hacked? How many cases of Malaria were there in 2012? Talking of Malaria, why are a further 3 million more under 15 year olds at risk every year? What did a widow recently win in a legal fight? 10. 7. How old was the giant virus that scientists brought back to life after being found in Siberian Permafrost? 11. What was it called? 12. For the Student BMJ avids: what no longer qualifies for points in the UK Foundation Programme application process? 13. What has happened to the baby born with HIV in LA last April? The NHS is set to trial an Edible Health Sensor what is this? What did a snake recently kill and eat in Queensland Australia? What bill are doctors in Scotland supporting they believe it will complement palliative care, not undermine it? What is the name of the ecstasy tablet that police are warning people not to take? How many people have died from Bird Flu this year already? A hospital in Staffordshire has decided to start a new type of consultation. What is it? And last but not least!! What did the outgoing NHS Chief Sir David Nicholson do to the National Director for Patients and Information? Score: 17/17 Seriously? 12-15/17: Pub quiz team 16. 7-11/17: Good effort! 2-5/17: Fair. 0/17: Ermmmm.. Well as long as youre doing your PBL 14. 15. 16. 11. 17. Answers: 1. 2. 3. 4. 5. 6. 7. 8. 9. 6. Fat! (levels of 10 lipid molecules could predict dementia onset with 90% accuracy!) Psychotic Disorders! (Around 47/1000 children!) 200,000! 207 Million! Temperatures are changing and mosquitos are moving up to higher altitudes! Her husbands frozen sperm! 30,000 years old. Pithovirus sibericum, it belongs to a class of giant viruses that were discovered 10 years ago. Presentations. Oral and Poster, International/National dont matter anymore! Free of HIV after starting treatment in womb and 4 hours after birth! Edible magnesium and copper sensors, attached to pill to be taken, which send an electronic signal to a patch on the abdomen! This enables doctors to ensure medication has been taken! A whole crocodile! Wtf. Bit of non-medical chat there. Apologies. The Assisted Suicide (Scotland) Bill Mortal Kombat 72 (Far more already than in the whole of 2013!) Skype Consultations! Made a spoof Hitler Youtube Video (The scene from Downfall!) taking the piss out of him and his work! He had to apologise later of course.

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Scottish-English Dictionary
All of us non-Glaswegians will remember a time, probably from somewhere towards the beginning of first year, when someone came up to you shouting geiswanoyerfagsahvranoot. Your response to this could mean the difference between hearing Nae bother pal, cheers and am gaunae chib ye (I am going to stab you). So here are a few words and phrases to help decipher this strange, strange language.. English to Scottish Child Wean, bairn, chile, littlin Disgusting/dirty Boggin, clairtie, manky, mingin, houghin Drunk Steamin, mingin, pished, hammered, guttered, blutered, fou, smeekit, roarie, the worse odrink, bleezin fou, pie eyed, mortal, stottin, soople. Excellent/good Guid, braw, grand, rare, barrie Idiot Eejit, galoot, numpty, daftie, bawheid, muppet, neep heid, bampot Shut up/stop talking nonsense Haud yer wheesht, dinnae haver, git awa an bile yer heid, yer aff yer heid! Sick Nae weel, peelie-wallie, seek Scottish to English Words and Phrases Blether Chat, gossip Bonnie Pretty, nice Dour (pronounced door) Glum or miserable Foosty - Mouldy Geesa or geis (pronounced Geez) Give me. E.g. geesa light. Haver To lie or speak nonsense (pronounced Hayvurr) Jag - Injection Jake/jakey Term used in Scotland for those you might regularly see seeking advice from Jeremy Kyle. Also known as a Ned. Jis a few bevvies Just a few drinks. Can mean anything between a thimble of sherry a month, and two bottles of whisky a day. Och! Oh! E.g. Och aye the noo means Oh yes, just now, although no Scottish person has ever said this. Pal A word used to refer to just about anybody in any situation. Common uses (e.g. Yalright pal?) can be friendly, aggressive or anywhere in between, depending on the context. Polis The police. Sair - Sore Taps aff! Tops off! Expect to hear this everywhere on the first sunny day in May. Wee - Small Wheesht! Be quiet!

Do you have an interest in journalism or writing in general? Are you curious about the influence of the wider world on medicine, and vice versa? Do you have an opinion or perspective you think should be heard?

Join the writing team at Surgo!

Awful (- Matthew Walters), Visionary ( - William Shatner) The scalpel-sharp edge of modern medical journalism ( - Ian Swan)

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