SPHINCTER

How is it march already? I hear you say,

well at least for the next few moments
you can switch off and enjoy the quality
content provided by your peers in this spring issue. We have the talented
Tamara Al Bahri to thank for the beautiful tulips gracing our front page. A
stellar work of photography! Our featured article this issue is by
Shabariesha Kethees, it takes a passionate and inspirational tone as it
explores self­acceptance. We have a hard hitting polemic on "Bad pharma"
with Rob Gittings and a personal examination of Britain's care crisis with
Aneeshka Nagpaul. With our Welfare and Diversity officer Lauren Battey we
tackle thieving housemates, the single life and ward
worries In her advice column. Want to explore the
great outdoors? Take Vicki Simpson's great advice
for walks, water and parks. We also have a return
of Hamish Baxter’s take on rush hour crush for
some much needed humour. Don’t miss our arty
section of reviews, poetry and of course our
Crossword. If you are inspired by any of the
content or are just a budding writer/illustrator/
poet/artist feel free to contact me on the
SPHINCTER Facebook page.

Contents Opinion Culture

With thanks to: 3.Editors Letter 19.Brexit: The uncivil war­
Illustrator: Tamara Al Bahri 5.Quirks and All review
Contributors:Shabariesha Kethees
Rob Gittings,Victoria Simpson,
8.No Rep for drugs 20.Poetry Corner
Lauren Battey, Hamish 10.Cost of Carers 22.Hate U Give­review
Baxter,Aneeshka Nagpaul
Matthew Antwi ,Pooja Patel, Dr Lifestyle 23.Calender
David Seargent 24.Crossword
12.Dear Lauren…
Advertisers: Elsevier 14.QRS Complexes
The LMSS Committee,
15.Come Hill or the Highway
Officers and Trustees.
18.Resilience is not enough
From the
Editor
When I was in first year, I didn’t expect to find
myself on the LMSS committee. Having attended
my first ordinary meeting in year 1 replete with
LMSS traditions I wasn’t sure if that was my
kind of thing? Yet here I am.

I’m a great believer in trying things out: As my

one time violin teacher; orange belt in karate and
an uncompleted provisional driving test can
attest. I’ve made my peace with the fact that I may not always have great stick­to­itiveness. But
trying in my mind counts for a lot.

The chance to edit the Sphincter magazine as publications secretary wasn’t an opportunity to be
missed. So I applied the great LMSS maxim Don’t be shy and I rocked up at the meeting that
takes place towards the end of Term 2. I made a brief speech and won the close vote against RON
to become the Editor of the Sphincter.

This year I’ve spent time reading funny, serious and touching articles. Advising and editing great
contributors' work whilst learning how to do graphic design has been challenging. Negotiating
with our generous sponsors has taught me that print journalism isn’t a big money spinner (buy
newspapers folks). Yet the support from the LMSS officers and former editors has made it a joy.

The LMSS has gone through great changes and is set to embark on another as reaffiliation with the
School of medicine is on the horizon. In the work of the officers and the comittee, I've seen the
capacity of society to organise great things for its members. Memorable night outs ; revision
sessions; charity fundrasing numbering in the thousands and even a not too shabby magazine.

If you are unsure as you see the Facebook adverts about different LMSS positions If this is for you.
Apply. If this hesitancy is driven by your feeling that the society could better cater to someone like
you the opportunity to change that is yours. This society is its members and its future direction is
set by those who do the work. Just go and do it. Talk to any of the current committee members and
they'll be happy to chat through any queries you have.

I expected to just add this to my list of false starts alongside karate or playing the violin but the
opposite happened. Look out for more information from the start of March.

Don’t be shy

Tinaye Mapako
QuIRkS
aNd
aLL
“You can ask
forgiveness of others ,
but in the end the real
forgiveness is in one's
own self...

My friend Jack has Asperger’s syndrome and every time he mentions this to
someone new, he always hears the same thing. “Oh really? I couldn’t tell”. Over the
years, he developed a way of being ‘invisible’ so people wouldn’t notice his
Asperger’s. He worked so hard, through many therapies, to produce these
‘acceptable behaviours’. Why did he do this? Well at the age of 14, he struggled
significantly to be ‘part of society’. For so long, he just wanted to be ‘normal’.

Shabariesha Kethees 2nd Year

 I think that young
men and women are
so caught by the way
they see themselves.
Now mind you...
So why am I telling you this story? I feel many
people, more than we realise, feel the same way as
my friend did. Wanting to be ‘normal’. Conflicted
by ‘what is an acceptable behaviour’. Many find it
hard to be themselves, particularly considering
how much pressure there is from society
(especially with the use of social media) to be a
certain way. Causing one to lose their sense of
self. I feel we forget that we’re just people at the
end of the day. I see people disrespect themselves
or not believe in themselves: I hear ‘that’s weird
of me’;‘I’m so stupid’; ‘I’m ugly’; ‘I’m not good
enough’; ‘I’m not worthy’ and the list goes on. It
always makes me sad to hear that, when they are
so much more. We have become accustomed to
being unkind to ourselves & that it’s ok to do that,
when it’s not. Would you say those things to a
friend? No. So why do we say these things about
ourselves?
Going back to the story, Jack, who is now 21, has
finally accepted himself and knows that his
Asperger’s doesn’t define him. He even made a
film, which will be shown in several film festivals,
called Undertow (About what it is truly like to
have Asperger’s) and said that this film was the
peak manifestation of his own self­acceptance. It
is a loud celebration of the autistic spectrum,
treating people with it not as empty vessels who
can sometimes be good at maths, but as a
profound niche in human psychology and
behaviour. I asked him for some advice for the
public on self­acceptance and said, “I suppose my
two cents on self­acceptance is that I can’t
really say I believe in a solid idea of ‘self ’.
I see it as more of a sequence of
behaviours. You can judge those behaviours
and not accept them, but they aren’t you.
Merely your actions and you can always
change your future actions for the better. So,
I accept myself in that my mistakes are
mine, but they are not who I am, they are a
by­product of me and I can always move on
from them”. I’ve also asked several friends to
share their views on self­acceptance:
Rochelle L.Ellis, a founder of the ‘S’ Word
Sisterhood (an empowerment programme giving
women a safe space to reclaim their sexual self &
rewrite their sexual script), told me “We must
When a larger society
sees them as
unattractive, as threats,
as too black or too
white or too poor or
too fat or too thin or
too sexual or too
asexual, that's rough...
take a radical approach to self­acceptance
and self­love. Self­acceptance is just the
beginning, it is only through experiencing
acceptance that we can begin to truly fulfil
our potential. But whether it’s self­
acceptance or even the full, positive regard
of being accepted by others, this is the very
foundation of lasting empowerment”.
  At East Carolina University in the USA, my especially we, as a society, sometimes forget
friend Marina, who has started a fast­ that mental health is important, and we are
growing movement (on individuality & to so busy focusing on other things in our life.
fight injustices) called ‘I Exist’, said “It is
important we all start to acknowledge the So, remember self­acceptance is a journey.
importance of the individual person. It is Truly accepting yourself doesn’t happen
not necessarily similarities that unite us but overnight. It takes time. Remember to be
differences. Although our common patient with yourself and you’ll get there. At
similarity is being human beings, our times it may be hard, but it’ll be worth it. If
differences make us even more human and you want to improve on yourself, do it for
even more connectable”. I couldn’t agree only yourself. You don’t need to prove to
with them more. anyone else that you’re worthy because
you’re already are. If you’re finding yourself
Self­acceptance for me is to truly embrace being harsh on yourself, write the things you
who you are. But so much more. To know like about yourself or what you did that made
that you are more than enough, and your you feel good. Do this regularly and you will
flaws don’t define you, they are just part of see a positive change in how you view
you. To know that you are not defined by yourself. 
society. To know that you don’t need to be
someone else to be ‘part of society’. Self­
acceptance is when you don’t apologise for The real difficulty is
who you are.
to overcome how you
So why talk about self­acceptance? Many
people have self­conflicts, and this can lead to
think about yourself.
anxiety, low self­esteem and depression.
Sadly, mental health is still an issue. With
If we don't have
6,213 suicides in UK and Republic of Ireland
in 2017, suicide is the leading cause of death
that we never grow,
among young people age 20­34 years in the we never learn, and
UK, and men are three times more likely to
take their own lives than women. Enough is sure as hell we
enough. No one deserves to feel ashamed
about who they are. No one deserves to feel
should never teach.”
they don’t exist.  I feel it’s important to speak
up about these things so we can let those,
­ Maya Angelou
who are suffering, know that they aren’t
alone. What they are feeling is important,
understandable and they matter. Therefore, it
is essential we keep promoting self­care and
 The Real
cost of
caring
In the UK today, 6.5 million people are carers,
that is 1 in 8 adults. In addition, approximately
700,000 children and young people are carers in
the UK. Carers are defined as people caring
unpaid for loved ones who, due to illness,
disability or mental health problems cannot
manage or cope without their help and support.
Dedicating their
whole lives to their
loved ones
Carers save the NHS £100b a year, equivalent to
the entire current NHS budget, they make an
enormous contribution to society. With people
living longer; suffering from illnesses and
disabilities as they get older and requiring more
care and support this is making the role of carers
more crucial.Care may be a few hours a week or
twenty­four hours a day and often has a huge
impact on carers’ lives. Many carers try to juggle
employment, family life as well as meeting their
obligations. Carers may be older with their own
health issues or are under 18 and growing up
themselves.
Aneeshka Nagpaul 3rd Year
Becoming a carer can be a gradual process,
often creeping up unnoticed, e.g. looking
after parents who can no longer manage on
their own, whose condition gets worse, such
as dementia or heart failure. Whilst, some
Byline
people literally become carers overnight,
Secretary
e.g. caring for a child born with a disability
Anna
Griffin
or for someone who has suffered a life­
changing road traffic accident. For carers,
this can lead to loneliness, depression,
exhaustion, stress and other health and
social issues.
I decided to work in the community to
grasp the challenges faced by carers. I
worked closely with doctors in a GP
practice in North London. Using their
computer system, I identified and selected
the practice’s carers. Having contacted the
carers and gained consent I visited them in
their homes. It was more convenient for me
to go on home visits, given the carers
Carers save the NHS
£100b a year,
equivalent to the entire
NHS budget
needed to be available at home for the
person they were caring for. I signed a
confidentiality agreement reassuring carers
that the conversations would be for my
learning and would be kept anonymous. I
carried out research to identify support
services to support these carers to improve
their quality of life and then signposted the
carers accordingly.
Some have talked about human nature as
justified biologically the concept of ‘the
selfish gene’. Yet meeting carers you come
to the opposite conclusion. Selflessly
dedicating their whole lives to their loved
ones and making permanent sacrifices in
their lives are just some of the inspiring
They see the outside
world and their friends
moving forward yet
they themselves are stuck
qualities carers portray, whilst not being
paid. I was deeply moved when carers
expressed that they see the outside world
and their friends moving forward yet they
themselves are in the same previous
position, unable to focus on their own lives.
The love between carers and their loved
ones is one I will never forget, with carers
wanting full responsibility for their care
instead of sending them to a nursing
home.  Visiting the carers put a smile on
their face, I was able to build good
trustworthy relationships with them
giving them the opportunity to finally
focus entirely on their lives.
I hope to visit these carers again to assess
any improvement in their quality of living
having signposted them to different
resources such as ‘Age UK’ and ‘Carers UK’.
I would love to visit them regularly to be a
part of their journey by personally
supporting them (even by having regular
chats) whilst they support their loved ones.
 The Problem
with Drug
reps

one of them asserting gather: such as at hospital

What’s the big deal? ‘I don’t think skin Grand Rounds; conferences and

If big pharma cream really goes with

cheese sandwich’. She
indeed lunchtime meetings at a
GP surgery. They often come
wants to pay for our took down the email bearing gifts of food and free

lunch, then let them addresses of the

doctors to sign them up
samples, and sometimes
evidence and papers of the

right? for a new app, before

thanking us for
wonders of their new drug.
Now you may think that
listening and leaving the promoting a new drug which
They arrived at the GP
meeting armed with a lunch
meeting. This was the
first time I had ever Big pharma pumps
buffet made up of cheeses,
meats, bread, salads, crisps, and
encountered a drug rep so much money into
cakes ‘which are soft in the
during my time in
medical school, but by the having drug reps
around the hospital
middle!’. I was half­way through
time I’d realised what had
scoffing my cake down when
happened, her cake was
she introduced herself as the
‘rep from GlaxoSmithKline’ and
already deep in my
stomach.
because it works !
was promoting a new non­
Drug reps are people who have has evidence supporting it is a
steroidal skin cream. To
been hired by pharmaceutical good thing, after­all doctors
demonstrate the effectiveness
companies to promote the should know if there’s a new,
of her skin cream, she proposed
company’s latest medication. more effective treatment
that everyone in the room try it
You may find them at any place available for them to prescribe.
out. The GP's all declined, with
healthcare professionals will
Rob Gittings 3rd Year

But let’s be perfectly clear: drug reps are promoting. into having drug reps around
Any person who is promoting a Okay, so drug reps come to the hospital is because of one
medication for financial gain is meetings, provide lunch, say reason: they work!
not acting in the interests of something about some sleazy Studies into the effect of drug
patient safety. drug, then leave. What’s the big rep interactions with doctors
Drug reps may flaunt evidence­ deal? If big pharma wants to show that they increase the
based papers and facts, prescribing of their drug
even personal anecdotes
Any person who is by up to thirteen times

promoting a
about the medication in compared with doctors
order to try and convince who had had no
a doctor that it should be
prescribed. However, the
medication for interactions with that
drug rep. This means that
evidence may be biased, financial gain is not these doctors are more
and they may only show
the positive findings for acting in the likely to prescribe a drug
that is more expensive,
the drug. In the studies, interests of patient less researched, and
they may only test the
new drug on healthy safety potentially harmful if
they have interactions
people, who they know with drug reps, even if
will respond well to the drug, or pay for our lunch, then let them they think that they won’t have
compare their drug against right? You may think that drug an impact on their prescribing.
something which is actually reps don’t do any harm by Interactions with drug reps
rubbish. There are very often giving out free cake and that begin in medical school, and
old drugs which are cheaper, doctors aren’t actually affected more exposure you have to
more researched, and equally as by them, but the reason why big them, the more likely you are to
effective as the ‘new’ drugs that pharma pumps so much money prescribe their drug.

So what can you do?

Don’t see drug reps. They will influence your prescribing.

Ask to ban drug reps from your hospital or clinic

Challenge people who are apathetic towards drug reps.

Ensure no pharmaceutical reps sneak their way into lectures at the

University of Liverpool, conferences, or at fresher’s fayres. If they
do, email your year lead to let them know

Educate other people about the dangerous influence drug reps can
have on prescribing and medical practise.
 Dear,
Credit: rolereboot.org
Single for valentines
This year was the first year that I’ve
been single for valentines. It was awful.
All of my friends had plans with their other
halves and I was just sat in the house alone
watching Ghost. I’m really worried that
medicine takes up all my time and that the
same thing will happen next year if I don’t
get a girlfriend soon. What should I do?
Sincerely, budding bachelor
We’ve all had that one exam that’s thrown our
confidence and made us think, why am I doing
this?! But my advice to you would be definitely do
not give up. Whilst it can feel like you have to know
everything in first year, all you need according to
JJ is a ‘good breadth of knowledge across all systems’,
so don’t get bogged down with the fine details. Our
academic rep Bethan will also be putting on some
top­notch teaching sessions to get you all whipped
into shape for the real thing, so keep your eyes
peeled for those! In the meantime? Get out of the
library and get a good nights sleep!
Agony Aunt ­ Lauren Battey
helps LMSS members with
problems of the heart and
h ead
First of all, valentines these days isn’t just for the
loved up couples. I’ve seen Gal­entine’s and Pal­
entine’s galore this year! So next year if you’re
still a single pringle, get on the hunt for some
fellow single friends and make plans to wine and
dine with them instead! If you’re desperate for the
traditional vibe, get in touch with our charity reps
and get down to LMSS take me out* as a
bachelor, I can’t think of a better way to find true
love!
*22.02.19, Arts Club, Seel St.
Mock stress
I thought that I was really
well prepared for the January mock
as I’d worked so hard knowing it was
the first exam I was ever going to sit at
uni. When I got my results and saw that I’d
failed I felt so disheartened. All those nights in
the library just aren’t paying off, should I just
drop out and bore off medicine altogether?!
Sincerely, dissapointed fresher
L auren
Thieving Housemates
Since September I’ve moved in with
a new group of people that I’ve never
lived with before, and it was all going great
until I realised one of them was an absolute
leech! I’m sick of getting into the shower to find
that the shower gel I bought last week is already
gone, and one time I even opened my kitchen
cupboard to find half an unopened packet of
ginger nuts devoured! I need some advice to
make it through the last few months of
our contract without killing him!
Sincerely, poor and smelly
student
A classic predicament that many a student
living in a house share will experience. It
may be best to speak to your housemate
directly and explain that you can’t afford to
buy shower gel every week, and politely
suggest that they go out to get their own.
Failing this? Hide it in the most obscure
place you can think, or fill said empty bottle
with something disgusting ready for a
surprise the next time he decides to steal
it…just don’t forget where you hid them
when you need a shower…or forget what’s
inside it!

Snakes on the ward

I’m at the end of my tether. I’m really
stressed about getting my DOPS signed
It can be difficult to find the balance in hospital
off in hospital and have been arranging to
when it comes to helping the rest of the group
meet with doctors and nurses on the ward to get
out from time to time versus being left with
them filled in. Every time my hospital partner and I
nothing for your e­portfolio when everyone else
get there, another member of my group is always
got a CPAD and 15 venepunctures signed. Again
there too, and always takes all the cannulas and
this is a situation where it may be best to
fluid lines so there’s none left for us to do! He’s
confront the offending group member directly
not even meant to be on our ward, what
and explain your concerns regarding the
should I do?
upcoming DOPS requirements for the next AA
Sincerely, stressed student
meeting. If you’ve tried all other options and
nothing changes, rearrange the lift to go in an
hour early for the sub cuts and leave them
waiting on Smithdown none the wiser.
 Hamish Baxter 5th Year

QRS Complexes
Tachycardia, Diaphoresis, Mydriasis,Dopaminergeic Surge. Query LOVE ???
Hello and welcome to the valentine’s day special of the QRS Complex. For some, valentine’s day is an
opportunity to show their other­half how much they love and appreciate them. However, not
everyone receives beautiful bouquets of red roses or large assortments of chocolate; and for some,
valentine’s day can be difficult. So with the looming possibility of spending valentine’s day alone, the
people of Liverpool have been working even harder looking for the Yin to their Yang . However, I
will say, that in a couple of entries boundaries have been crossed and I have had no choice but to
notify the authorities. Despite this set back, love waits for no man, or woman; and the seeds of love
must be sewn! I hope this edition will quench your thirst for romance.

To the cute Asian guy who I keep bumping into To the short haired cashier at my local Ann
outside the gender neutral toilets. If you hadn’t Summers. I have no idea what an ‘Orgasmatron
have pissed all­over the toilet seat, I would have 3000’ does, or what I am going to do with it, but
asked you on a date. I’m running out of new things to buy just so I can
Girl with huge polkadot handbag talk to you.
. Curvy blonde who can’t stay away.

To the vet who lives upstairs. I have known To the devilishly attractive, bespectacled man who
you for 5 months now and your beauty still sits opposite me every morning on the 47 from
stuns me into silence. So, I have decided to set Bootle to Liverpool one. We deserve better than
pen to paper and have written you this love Bootle. Lets elope together and make a life in
poem. Allerton. We can buy a pug and walk it round
“Roses are red Calderstones park.
Violets are blue Long haired blonde with sexy grey suit.
Sheep go bah
And cows go Moo.” To the frizzy haired guy playing the piano in the
From your loving admirer guild. You tickle those ivories so beautifully, why
p.s. I hope this helps you with your veterinary don’t you come round tomorrow night and tickle
exams. my ivories?
Chopsticks fan
To the blonde haired beauty who assisted in
my cryotherapy clinic last week. The filiform
If you would like to have your love
warts wouldn’t have frozen off without you. It
message in the next edition of the
was a real learning experience and I can’t wait
Sphincter, then
to work with you again.
message Hamish Baxter on FB.
Handsome beardy Medic
Confidentiality will be maintained.
Treat Symptomatically
Or d e r C X R
Arrange Date ....
 Gate to Princes Park Credit Rodhullandemu

Come Hill or
High Water
Sometimes those claustrophobic hospital wards, lifeless libraries and cramped students digs can get
on top of you and the only cure is an injection of fresh air. Our routines can so easily become
mundane when our lives revolve around long days and commuting As the days are getting longer,
that means more daylight to make the most of the great outdoors. Whether you want to run, walk
or slowly explore, I’ve tried to gather some suggestions that will hopefully appeal to all, from just
stepping outside your front door to going further afield while enjoying what Liverpool is handily
placed for. Some are a personal recommendation, and some by word of mouth, but hopefully they’ll
provide some inspiration for you if you’ve been feeling cooped up lately.

Victoria Simpson 4th Year

 Hilbre Island( not a proper island) and check
out its famous lighthouse.

The Wirral Way

The Wirral is home to a lot of the beaches
and cool spots that we neglect to think of.
Birkenhead is home to a park that was the
inspiration for Central Park in New York. The
Park life
100 acres of Eastham country park looks out
It’s no secret that Liverpool is abundant in
on to the Mersey, Garston and Speke Hall and
lush green spaces (some less dodgy than
boasts two pubs from which the views can be
others). Sefton, Calderstones, Greenbank
enjoyed. A thirteen­mile trail known as the
parks and Otterspool promenade are all within
Wirral way exists between West Kirby and
a couple of miles of where most of us live and
Hooton and is a smart way to tick off several
are great for walkers, cyclists and runners
of the South Mersey beaches and views in a
alike. They make perfect retreats for those of
day( take your bike to do it in a few hours
us with little time on our hands for escapism
).nto the woods
and who want to see as many pet dogs in a
small radius as possible. Take some cash to
grab a snack at the food vendors or try and
catch park run on princes park or pop up
events and concerts at the Sefton Park Palm
House.

Making waves
Liverpool’s geography means that there’s no
shortage of beaches to retreat to. At the
slightest sign of temperatures rising into the
Everything is just a little bit sweeter over in
twenties, everyone seems to flock to the
Cheshire and that’s equally true when it comes
beaches with portable BBQs and instax minis,
to the great outdoors. Cheshire boasts over
but this doesn’t mean that they aren’t
176 miles of its own cycleway, making it a
accessible all year round. A cheap train
great place to get out on two wheels.
journey will land you in the grand houses of
Delamere forest is Cheshire’s largest area of
Formby, where you can check out the squirrel
woodland and boasts many routes to meander
park and coastline there, or in Crosby, where
along, as well as being a Go Ape venue for
Anthony’s Gormley’s intriguingly endowed
those who want to splash some cash. A quick
statues ( “another place”) are waiting to be
google search can reveal many great, easy
posed with. The Wirral also has beaches on
walks in the area like the Gritstone trail and
offer, such as Thurstaton, Hoylake and West
Alderley Edge, all you need to start rambling
Kirby. If the tides is right you can walk to
is to hop across the Mersey.
 many people of many abilities, assuming you
can get there through the Stockport traffic in
the first place.

As you Lake it
The world­renowned Lake District might
seem worlds away, but within about two hours
by car you can land yourself in most of its
popular spots. It’s definitely a top national
park to tick off for those of you who’ve
moved from afar to come to study in
Croeso I Gymru Liverpool and boasts my personal favourite
Liverpool often boasts being a gateway city to
ranges that can be appreciated by anybody. A
Snowdonia. The reality is, it’s not the most
good day can be spent appreciated in
accessible without a car or a lot of patience
Ambleside and Windermere but there’s no
and planning with the public transport
shortage of walks of different levels to
system. Still, the pay off for your planning is
choose from (again, with some not being
the stunning views. Whether you hit up some
recommended for the average tourist). A
of the Welsh hill walks like Tal­Y­Fan or
quick look on the national park website, or
Great Orme, venture to stunning sites like
researching in to what “Wainwrights” are, can
Aber Falls or take to the mountains, there’s
both be good places to start with this.
plenty to see for all levels of daring­ness.
Also, it’s worth a scramble up Tryfan or a trip
With any luck, if you aren’t already a lover of
to Carnedd Llewelyn.
wide­open spaces, I might have been able to
In Peak Form convince you to break out of your bedroom­
An often­overlooked national park within
shaped­box, change out of your dressing gown
convenient driving distance is the Peak
and do some exploring! Happy trails…
District. Although not as dramatic as
Snowdonia, few routes are as fun to drive
along as the Snakestone pass and it cuts out
the annoying tolls. Home to some grand
houses and halls to mooch around, old­world
towns like Bakewell and Buxton, as well as
namesake peaks like Mam Tor and Kinder
Scout. The Peaks boasts being a “miles
without stiles” national park and as such it’s
filled with highly accessible moorland
expanses and dales that can be enjoyed by
 Resilience is
not enough
In material science, they talk
about the resilience of stuff. We
are being constantly asked by the
world around us if we are
resilient? If we can handle it? Are
we tough enough? Have we got
the bottle?
The scientists in their
underground labs, measure stress
and elasticity and they say that
resilience is the maximum energy
that can be absorbed up to the
elastic limit, without creating a
permanent distortion. The
challenge in medical school and
when we are doctors is can we do
all of this without getting bent
out of shape? Becoming not too
cynical or breaking down? We
still even in this age valorise
difficulty, stress and pressure like
they are badges to achieve rather
than considering them as just a
part of life as a medic to manage.
And now with occupational
health knocking at the door; with
doctor’s knocking off for early
retirement; people leaving the
profession; with almost 70% of
foundation doctors taking an F3
year and without looking at the
mental illness data we know
something is awry.
Some say the solution in an
underfunded and under­doctored
health service is resilience
training, apparently. This is to
burnout what statins are to CVD.
Resilience is the
process of adapting
well in the face of
adversity, trauma,
tragedy, threats or
stress
The problems of burnout, low
wellbeing and poor mental and
physical health are associated
with poor patient outcomes. So,
there is a desire amongst various
medical institutions to promote a
solution to these stressors and
their effects (particularly one that
is cheap).
Resilience training often refers to
programs which focus on
practical skills for individuals to
reduce and recognise stress and
to improve their ability to cope
with stress. This can form part of
wellbeing days, seminars or
online programs. If done
properly resilience training can
work (a bit). Of course, providing
the tools to cope with stressors in
our lives is valuable and there is
some research to back it up.
Though when it comes to
resilience training especially for
medics the evidence is limited and
the outcomes are modest. That is
worth repeating.
Resilience if reduced to just
making doctors “mentally tough”
only enables the workplace
cultures which are disastrous to
doctor’s wellbeing. Building our
B
Burn­out is a
prolonged response
to chronic emotional
and interpersonal
stresses on the job.
Only 3 studies
showed just
modest benifits
due to resilience
training
personal psychological reserves
is only part of the answer to the
challenges that the sector faces,
in terms of us its future
workers.
Resilience training has a long
way to go, its definition is
unclear and we are unsure of the
most effective strategies to
pursue. I worry that it could be
used to take the onus away from
the responsibility that managers
and government have in dealing
with the problem at hand.
Mindfulness and relaxation
techniques are not to be mocked
but they don’t fill the 1/10 empty
doctor posts. Being able to
manage our emotions is
necessary but doesn’t negate
policy which deals with bullying
and harassment. In a perfectly
funded well­managed hospital we
would still need resilience but
let’s not forget to aim for those
other things too.
BREXIT:The Uncivil War
A Film Reviw
Matthew Antwi 3rd Year
“
Everyone knows who won, but
not everyone knows how” is the
first line uttered by Dominic
Cummings the unknown
hero/villain of the EU
referendum. Channel 4’s explosive
Brexit drama follows the
‘mastermind’ and campaign
director behind Vote Leave.
Played by non­other than
Benedict Cumberbatch in this
role he seems to draw from his
‘Sherlock’ Character’s arrogance
and behaviour with classic
‘sherlockisms’ like drawing mind
maps on walls. As David
don’t need MPs and their
conventional thinking” stated by
Cummings as he unveils a highly
advanced, highly secretive data
analytics team. He uses this team
to target millions of voters that
remain didn’t even know existed
using personal data from social
media. In one scene the infamous
“Everyone knows
who won, but not
everyone knows
doomed to fail traditional route.
Bogged down by bureaucracy and
outclassed in tactics the remain
campaign loses steam early on to
a vastly less polished and
organised Vote Leave campaign.
Cummings leaves the more
controversial campaigning about
immigration to the Nigel Farage
backed Leave.EU campaign.
Whilst Cummings tries to keep
his hands clean by focusing on
“taking back control” message but
as the time to decision day counts
down the line between the two
campaigns becomes blurred.
The drama takes a huge
emotional swing as the murder of
Jo Cox is plastered on all the
campaigns TVs. This is the first
time that the standard Cummings
arrogance is stripped back
revealing something more akin
to sullenness as he has to reckon
with opening a political
Pandora’s box. The most
poignant part of the drama
comes towards the end as

how”
Cummings and Oliver are sat
Cameron’s spin doctor and
down in a pub talking about the
Cummings’ Remain counterpart
tribal discourse that had stirred
Craig Oliver put it: Cummings
is seen by himself as the Dominic Cummings up due to the referendum. After
a comment from Cummings
visionary architect of new
Vote Leave bus in all its glory is about the future Oliver states "Be
world order but seen to the world
featured with £350 million to the careful what you wish for. You
as an egoist with a wrecking ball.
NHS written on its side with its won’t be able to control it either".
Throughout this drama, the two
main MP backers Boris Johnson This show will not change
communication titans of the 2016
and Michael Gove played as a anybody’s opinion on the result of
referendum, Britain Stronger in
deliberately comedic, over­the­top the referendum as that is not its
Europe and Vote Leave, battle it
double act. James Graham goal. Channel 4 provides a
out for the hearts and minds of
(playwright) makes it hard not to, whistle­stop tour on the most
the British people. Cummings
in some way, resonate with interesting parts of the
spends his time trying to hack the
Cummings’ own brand of wacky referendum and shines a spotlight
traditional handbook of politics
anti­establishment insurgency. on a controversial unknown figure
trying to convince the old guard
The Remain campaign headed by that has now shaped UK politics
of Eurosceptics of his
Craig Oliver heads down the forever
unconventional methods. “We
Poetry Corner
Reflections on Psychiatry

Rumination & Release

Silent room but I am deafened
Talking Talking
My voice yet not my words
Faster Faster
Thoughts come
Buzzing Whiring Sawing Choking
Can’t Escape
No No Useless Worthless
Fast Faster
Can’t Stop
Hate and Fear
Muscle Tension
Jaws Tighten
Louder Louder
Piercing Screaming
Heart Races
Make it Stop Stop
Too much too much
Faster Faster
Can’t stop Can’t see Can’t Think
Again Again
Away Away

My lovers steel kiss brings me back.

Pain, a single comforting thought.
A moment of exquisite clarity,
Pure white light cleansing the spirit.
Red fury runs from flesh and it is good.
My body unwinds as the tension flees.
Deep, calm breaths escape my lungs.
My cares float away down the scarlet river.

And I remain alone.

With nothing but my guilt and shame.
The Psychiatric Interview
We have an appointment this morning, you and I.
I quickly review my notes in your file,
Check the medications.
Although by now I have a pretty good grasp of things,
I mean, I’ve been working with you since the day you arrived.
I see you walking towards the interview room.
You seem tired, slightly distracted.
Are you sleeping alright?
Are things getting difficult again?
I make a mental note to ask you.
I think about the symptoms you’ve exhibited,
The delusions of grandeur.
The paranoia.
Do you still believe you have the power to heal people?
Do you still think I want to hurt you?
How convinced will you be today?
You thank me for coming to see you.
What’s on your mind?
You seem anxious to speak to me,
Are you ok?
And you begin
“Hi John, its good to see you. Tell me, how have you been?”
“I’m just fine doctor. How are you?”

By Dr David Sergeant
Liverpool Alumi
 THE
HATE
U
GIVE
A Book Review By
Pooja Patel 2nd Year

After picking up this book, it was hard to put it
down. The Hate U Give tackles the problem of
police brutality against the African American
community in the United States. It follows 16­
year­old Starr Carter who is from a poor
neighbourhood troubled by problems of
addiction and gang­related crime. Yet she is
expected to put on a mask when she attends an
elite prep school. Her world comes crumbling
down when she watches an old friend, Khalil,
wrongfully murdered by a police officer. This
compelling story trails Starr’s heartbreak and
anger as she struggles to come to terms with the
death of her friend as well as what it truly means
to be black in America.
This novel opens your eyes to the injustice of
institutional racism and the turmoil that people
who are made vulnerable go through. News of
young black teenagers being shot and killed by
police is frequently in the media, yet sadly it is so
frequent that it is almost overlooked. The Hate U
Give shows how difficult it is to speak out against
a system that is clearly working against you.
Most importantly, it encourages people to carry
on fighting the system and getting justice for
victims of police brutality and racism in America.
If you’re struggling for a new book to read, this
is definitely a must­read. Angie Thomas packs in
anger, sadness, outrage and sympathy for so
many characters in this book: whilst giving us
the readers some food­for­thought about our
views on race in the world today.

blacklivesmatter reading list.

Police Brutality
They Can't Kill Us All: The Story of Black Lives Matter by Wesley Lowery
When They Call You a Terrorist: A Black Lives Matter Memoir by Patrisse Khan­Cullors

Race/ism in the US
I Am Not Your Negro by James Baldwin
The New Jim Crow by Michelle Alexander

Race/ism in the UK
Why I’m No Longer Talking to White People About Race by Reni Eddo­Lodge
Brit(ish): On Race, Identity and Belonging by Afua Hirsch Hardcover
Black and British: A Forgotten History by David Olusoga
Natives: Race and Class in the Ruins of Empire by Akala
 LMSS
Year in Review

A Snapshot of The LMSS. Bus Tour ,

Charity Dinner, Annual Ball ,Grand
ROUND, Charity Talent Show, Deal or
No Deal And Alumni Ball
 Crossword

ACROSS 17.Hospital case DOWN 12.Scouse Nobel prize for

4.Father of Vaccination discussion/ Musical 1.Rods in AML medicine
6.Serena Williams' elbow performance 2.Fainting 13.Man who mistook his
10.Home of the school 18.Used to edit a baby’s 3.Grounded UK airports wife for a ­­­
medicine/ Tree genes 5.The TV show not the 19.As progesterone
11.Greek God with dodgy 20.Relaxing by putting medical textbooks decreases/American Full
ankle things into your head 6.American paracetamol stop
14.Highest of the 3 peaks 24.Didn’t win the Nobel 7.Prehistoric craniotomy 21.Test for Year 6 and
15.Wrong sided heart prize for DNA structure 8.The creator of this rule Common Observation
16. The hospital where "simpler solutions are 22.This going to ­­­­
casualty takes place more likely to be correct 23.Mood disorder
than complex ones" associated with time of
9.One of the four year
humours, cause stones