NUS protests against tuition fees

Prior to the elections, the Liberal democrats promised to stop tuition fees rising, the conservatives muttered something about unpopular cuts that needed to be made and Labour were too busy trying to keep up. Fast forward six months and the Lib Dem formed a new government with the Tories leaving Labour out in the cold. Since then a lot of spending cuts have been made, making the new government not very popular. As well as cuts, a rise university tuition fees has been proposed by the Tories and backed by the Lib Dems – the very same party that vowed to oppose the rise in higher education fees. So it is understandable that the people that voted for them feel cheated and betrayed.

Students unions across England have been protesting since the fee increases were announced with the first official NUS demo taking place back on November 10th. The news channels went all out with the coverage and what started out as a valid protest, unfortunately turned violent towards the end which was not the intention of the students union. The chaos was directed at the headquarters for the Tory party (Millbank Tower) and MI6. Students were subjected to being hit by batons and kettling techniques (I learnt a new term, although kettles do eventually boil so maybe not such a good use of word). Thinking about it if kettling is used to contain protesters whilst baton’s are used to disperse crowds... erm, well is anyone else seeing a problem here? Surely using both techniques on the same crowd at the same is a pointless exercise as neither method is working successfully.

Although the few people that initiated the rioting were not thought to be genuine students, it still didn’t stop some of the media from describing ALL students at the protest, as an unruly, violent, uncontrollable mob. One of those news people happened to be Sky News presenter Kay Burley, who is excellent at scary people unnecessarily and I think my favourite exchange has to be between her and an office worker from Millbank Tower.

Kay Burley: *an an overly dramatic voice* YOU must be terrified with the all that chaos going on outside? What are you going to do?!?!

Worker: *in a completely normal voice* Err, no I’m fine. I’m going to finish work soon and then go home as usual.

After a lot of fighting within the political parties and numerous student protests, this Thursday the government officially approved the rise in tuition fees, which in resulted in further protests. Unfortunately some members of the Royal family also got caught up in this, which was very unfortunate and totally uncalled for. I think the new government just weren’t prepared for just how many people would be willing to protest against the unexpected increase in fees. Also it makes me feel kind of proud that people are still willing to stand for what they believe in and not just take it lying down. Hopefully it will all get sorted out for the better soon enough but it shows that the British are still very much alive and willing to fight for what they believe in! Yay for Britain!!! :)

MIMIT Evening

Presenting and I have issues – FACT! Everyone who knows me knows that I really dislike presenting. On the whole, I would say that I am a pretty well composed person. However give me something to present and I turn into a horrible nervous mess. The build up to it is the worst thing; an awful knot appears in the pit of your stomach and won’t shift until the presentation is over and done with. It’s one of the reasons why I can’t eat or drink on the day. I also have a problem with the order of presenting –I don’t like going first as everyone is alert, paying attention thus you run the risk of being shot down with many questions, some of which you may not be able to answer – HORROR! Also going last is bad for me as I feel that I might die from my nerves and overdose of adrenaline for such a sustained period of time. Therefore the middle it is then, I like the middle and the middle is good for me, lol.

Anyway why on earth am I telling you about this? Well because I can and you still chose to read it! – Joking. Back in November I was contacted by my old university (Manchester) about presenting my MSc work one evening at a medical symposium at the university. I know what you’re thinking… If I hate presentations so much, then I should have said no. But here’s how I see it, as I progress through my career (iA), I’m going to have to present my work more often whether I like it or not therefore making this medical symposium a good opportunity to practise. Secondly if I totally messed it up not to worry as I probably won’t see them again and thirdly the email stated that Professor Oldham had suggested that mine was one of the better projects. I know, I know, I am so vain and self centred but what can I say, it is nice to be appreciated :) So I said yes thinking that one of the others i.e. Chris, Dom or Eileen, would also be presenting. I discovered in January that they weren’t and I felt it would be rude and totally unprofessional of me to back out at such short notice. I mean the medical school have been really good to me and very supportive and I feel like I owe them something in return. At the back of my mind I was still contemplating feigning some sort of sickness if I felt I couldn’t go through with it on the day. What?! It’s always good to have a backup plan.

I arranged to meet my supervisor, Maureen, for lunch and she looked through my presentation slides and gave me some feedback... because she is just so lovely and helpful. She already knew I was presenting due to all the posters put up and emails sent out (eek!) and had an idea of how nervous I get. The two copies of my thesis were now fully marked; one copy was safely deposited in the library for future reference and the other was to be sent to the main supervisor. Seen as the university internal mail takes a while, I thought I would personally collect and deliver Maureen’s copy, which she asked me to sign. I’d say it was an odd but funny moment! Maureen wished me the best of luck and over the weekend I practised with mum, Bilal and even Saba who looked quite bored, the poor thing! Eventually the day arrived…

Date: Monday 25th January 2010, 1530 till 1830. (My 15 min slot was at 5.40pm – err the middle is good?)

Venue: Manchester Interdisciplinary Biocentre, Princess Street.

I got there in plenty of time (one less thing to worry about), but unfortunately Zareen couldn’t stay long and left a gift for me with Maureen which was really sweet of her. We entered the lecture theatre and sensing that my nerves beginning to take hold, I tried to keep a lid on them by concentrating on the other presentations, which didn’t really help!... and then by reading through my notes, which may have made it worse. As I was sat at the back, a lot of people snuck in and out of the theatre during the evening but I didn’t really pay any attention until Dr Ardy Bayat sat down next to me. Dr Bayat whose project I had rejected in favour of Maureen’s. Dr Bayat who said that clinical projects can be very misleading and problematic. Of all the people to meet before a major presentation, well it just had to be Dr Bayat didn’t it? Out of the corner of my eye, I saw Maureen glance in my direction and I turned and smiled at Dr Bayat… and then went back to looking at my notes. After a small break, it was my turn to present and Prof Oldham whispered that I only had 10 minutes to present as they were running late. Grr! I had taken the effort to time my presentation perfectly and now I would have to squish it all into 10 minutes.

Thankfully the presentation went well, I spoke clearly, only stumbled on my words once, even cracked a joke (yea me!), answered all questions and made it back to my seat without falling over! Yes! For the first time in the evening I could relax and I had such a buzz from completing the presentation. Prizes were handed out for the best projects and presentations etc. Assuming that all the prize giving was over now, I started to get ready to leave when Professor Oldham announced that there was still one special award left that the recipient didn’t know about it and talked a bit about the intended recipient. As I was tired, I sort of zoned out and didn’t realise that Professor Oldham had announced my name at the end. As it didn’t register at first, Maureen had to nudge me and whisper ‘It’s you, Saima’.

A dazed me got up and made my way to the front. From what I gather I received the best student award for achieving the highest marks in my year for which I received a certificate and the best student project for which I received a cash prize. During all that, I do remember having my picture taken and praying it turned out ok and also fretting that I had taken my suit jacket off and forget to put it back on as I made my way to the front. What can I say, it’s the little things that get to me :P I was still feeling a little dazed as I was congratulated by the senior medics during the MIMIT ‘meet and greet’ in the atrium afterwards. Feeling a little drained (tired/hungry after a long day) I didn’t stick around too long and offered to take Maureen to the train station as it was getting quite late. I smiled and thanked everyone and made my way to the exit, which took a while as I kept getting stopped every few steps. I was pleasantly surprised to find that my course administrator, the lovely Sue Cooper had especially come to the MIMIT evening to see me after seeing my name on the posters. I can’t explain how nice it is to have your work appreciated by so many people and after the initial embarrassment, I felt quite proud of the recognition from the university and senior medics.

Maureen had missed her train so I offered to drive her home and to be honest it was nice to have the company and just discuss the evening’s events. Maureen told me how proud she was of me and how I really deserved it after working so hard at university and at the hospital with all the patients. Upon arriving home, I shared the news with mum and auntie Naseem who were both really pleased and proud. So the lesson learnt – conquering my nerves was totally worth it!!!

Update:

Woo! I’m on the MIMIT website! Damn, I knew I should have put my jacket back on. Also looking at the picture, I’ve just realised that the silk black tie thing that was supposed to be tied around the waist of my purple shirt, must have come undone after my presentation at some point during the evening. Looking through my wardrobe I still can’t find it! Losing clothing at a conference... what am I? 5 years old?

Graduation day

So the day finally arrived. A year of meticulous preparation/planning, many applications, plenty of hard work and even a good dose of panic at times… after all that and more; I am pleased to say that I have successfully complete my MSc with the additional accolade of securing the position of the student with the highest marks within my medical year. It sounds sort of weird but I felt that everything in my life was linked to Aishi, which is true to a certain extent. I also felt that everything good that had happened was because she was with me. She was like my good luck charm and with her gone, I thought everything would come crashing down around my ears. It was a relief when that did not happen and in my mind I still feel that wherever Aishi is, she’s still looking down from above, praying and looking out for us (iA). So yes I am pleased that I was fortunate enough to reach such a level but someone who is doubly thrilled is my mother who has had a huge smile on her face (mA) since the day my marks were released. I’m pleased with my marks but I’m more pleased with fact that my mum is happy and that I am the reason for her happiness and she’s proud of me. Um, does that make sense? Lol.

On graduation day, my ceremony was a morning one, which normally would have been fine except this time, there were a number of reasons which would make it more difficult…

a) I had stayed up late last night making sure everything was ready i.e. everyone’s outfits ironed, tickets were printed etc, which is why I was a bit low on sleep. But not to worry though as the adrenaline soon kicked in!

b) Dad decided he was going to nip into work before heading over to the university, which meant that I would have to print off instructions for him. And because I was travelling in earlier I wouldn’t physically be in the car with him therefore I KNOW to except phone calls everything 15 to 20 minutes from dad informing me he was either lost or late.

c) The car journey from Yorkshire to Manchester with my mum and brother, at peak rush hour. I hate traffic plus Bilal took longer than I did getting ready (!) and because it was absolutely freezing, my car decided it would take longer to heat up. Grrr!

Despite all that, I still made it to Manchester University on time and went straight to the robing room with my mum and Bilal in tow. After making sure everything fit (my cap always feels really weird as I often think it’s about to fall off!), I took mum and Billy over to the Whitworth Hall, which was only a short walk across Oxford Road.

As you can see Whitworth Hall is a fantastic looking building

It was absolutely freezing today and as it was my graduation day I had decided that sense of style ranked higher than practical clothing. Therefore I had a smart but thin trouser suit on (which is why I was dangerously close to hypothermia!) and a lovely pair of court shoes that weren’t really made for running (or walking for that matter :P). But you know it was big day for me and I wanted to make an effort, plus once I had my gown on (thank god!) I didn’t feel as cold. Honest! Lol.

The entrance for the graduating students, where some ceremony took place before we were let in. Plus the inside of the hall is pretty spectacular too :)

After queuing up outside for what felt like an eternity, the graduating students (graduands?) were allowed into the main hall and directed to our seats. Flipping through the programmes that were on our seats, I noticed that that they were very few medics in this ceremony and soon realised we had been split into two separate batches as they were that many of us graduating. Also the ceremony that was due to start at 10.30am was delayed – a good thing for my family as it meant that my dad who was significantly late was still allowed to enter the hall. The ceremony went well (see me at [time] in this video link) and thankfully I didn’t trip up at any point – (it’s an insane fear of mine!). After the ceremony and exiting through different doors, I went to join my parents and was pleasantly surprised to find my supervisor and her post doc; Zareen, had also attended my graduation. I took a few photo’s with Maureen and Zareen and they had a little chat with my parents and cooed over what a cute boy Billy was. Ah, if only they knew him better, lol. I also met up with Chris (my fellow sidekick during my hospital placement :)), took a few pictures with Dad (who had to go to work soon after) and then I went to get some paperwork sorted whilst my family sat and chatted in Muse Cafe. I joined Bilal and mum afterwards. We took some more pictures outside and then we headed home as it was freezing!!!

Cafe Muse provided my parents with their much needed cup of tea :)

On our way home, Bilal decided he wanted to celebrate the occasion further by going out to eat, however mum didn’t feel right as Dad was at work and not able to make it. After a bit of discussion we ended up at Mumtaz and got table by the window. It was a lovely to be able to take my mum somewhere nice where she could sit and relax whilst someone else tended to her. We placed out orders and whilst waiting for the food to arrive, we saw the first few flakes of snow fall. Strangely the road outside the restaurant was rather quiet as opposed to the usual hustle and bustle we had become accustomed to in this part of town. Bilal started to panic about getting home as he felt that because my car wasn’t a huge 4X4, we would end up stranded on our way home. I tried explaining that this was highly unlikely but Billy wouldn’t have any of it and even wanted to cancel our food order. FYI, if Bilal ever rejects the opportunity to have food, you know something is seriously wrong. Mum thankfully calmed him down and they resumed their chitchat whilst I turned my attention back to the window.

From the welcome warmth of restaurant, I watched as the brilliant white flakes of snow fell against a perfect backdrop of the inky blue evening sky. I’m not an overly soppy person but it just was so beautiful. It was mesmerising watching the flecks of pure white float gracefully towards the ground. Slow at first but soon picking up the pace, the snowflakes were falling thick and fast, arranging themselves together to form a faultless white layer over everything in sight. The area surrounding the restaurant was definitely no countryside picture, but the deserted street coupled with the fresh snowfall and the dark navy sky managed to make the area outside the restaurant look picture perfect.

Our driveway being covered snow... and it's sticking! Yay!

The remainder of the evening was spent teasing Bilal, chatting with mum and enjoying our meal. Eventually we made our way home safely despite Bilal’s dire predictions (!) and I’m currently sat at my bedroom window watching the snow fall which hasn’t let up since we arrived home. The back garden is now covered a thick blanket of snow, as is the driveway and it seems a shame to disturb it at all. But it inevitably will be as everyone rushes around trying to get jobs done before the Christmas winding down begins. Hmm, looks like it will be white Christmas this year after all :)

The last login

The last time I will ever log into my Manchester University account. I don't why I felt the need to share this, but I just did :)

Besides I think I left just in time. They've changed the portal colours from a nice blue to shocking pink. Not my colour really to be honest, more Sara or Iram's thing really ;)

Phew! I have no outstanding loans/fines or books borrowed. No more modules that require me to enrol and my exam timetable cheerfully announces that all exams are now finished :D

Medicine and Health Conference

The first conference of the new academic year; held at Weetwood hall, which is a beautiful place. I wanted to wander around the grounds after the conference to wind down and take some snaps. But unfortunately the weather had others ideas as it was freezing and beginning to rain :( The conference itself was very interesting and the research was divided into either clinical, lab based or health interventions. The poster room was slightly cramped but I still made my way around the room and catch a glimpse of all of them. Point to note – I’m pretty sure that at conferences etc, all posters are suppose to be a standard size, but in this case the sizes varied wildly starting from the usual A1 size right to an A4 poster. Some huge were but very simplistic and easy to follow whilst others were much smaller but crammed with so much text that it made your eyes hurt. I can understand people wanting to get across as much of their information as possible but sometimes you just need to know when to stop.

In terms of the oral presentations on the day, despite being on the clinical team, I enjoyed all of them equally. More to the point I understood most of them but whilst talking to people during breaks I was surprised at how many people were confused by say the lab based talks. A bit worrying seen as the room was full of medics or medical researchers. Actually to be honest, towards the end of the day I started drifted off a little bit on certain topics such as genetics – something you do need to be alert for. I did feel bad about it but to fair it had been a long day. Another thing that surprised me was that this conference was suppose to be a way for the junior medics/researchers to get some conference practice and therefore it was very informal to put everyone as ease. Some audience members however took the whole thing very seriously and completely laid into the presenters during question time. I felt this was very unfair as it was hardly helping to build up their confidence. Other conferences in the future will be much tougher and more critical of their work which is why this conference was meant to be an ‘easy one’ – one where they could get some practice and gain some confidence. So I say shame on the meaner audience members.
Anyway to conclude, we had to pick three posters/ talks each for the prize session at the end. Below is a selection of the topics that I found interesting and voted for as the best in my opinion.

POSTERS:
1) Gwen Powel – “Lives not worth living”: an exploration of how healthcare professionals make decisions about serious handicap. #3
A model that describes how medics make life and death decisions. Very intesreting talk by the researcher.
2) Jayne Hutchinson – Do women who take supplements have a greater risk of cancer? #23 *
Clear easy to follow poster and an interesting hypothesis.
3) Nicola Kingswell – Mend your own teeth. #32 *
Development of a protein paint that can applied to a patients tooth which in turn stimulates replacement/growth and the build of healthy enamel.

TALKS:
1) Juile Burke – Injectable, biomimetic self-assembling peptides for skeletal tissue engineering. #7 *
A fun, lively and engaging talk on some very promising research.
2) Huiru Zou – Switching on dental pulp stem cells to rebuild teeth. #12 *
Using pulp cells to rebuild teeth naturally.
3) Yamuna Mohanram – Can dental pulp stromal cells repair bone under favourable microenvironments? #13
Using the pulp cells to stimulate and provide material for the growth of other bones.

All in all an interesting conference where much was learnt, well for me anyway.

* Indicates some of actual prize winners on the day. And yes the dentistry group are a pretty sly bunch :P

And so it begins...

Another year :) It's only been a month and I'm already amassing a collection of manuals, handbooks, readings lists and so forth .

Samia - who is Samia? I think you'll find it's SAIMA! :P

Honestly I'm not having a rant but personally, I reckon my name is pretty easy to remember. Part of me loves the different versions of my name (in terms of spelling/pronouncation) that people come up with; it makes for an interesting conversation. Just for future reference people, Saima/Sam/Simi/Saims is fine, Samantha/Susan is pushing it, Simon is a huge no, no. Are we all good now? lol :)

The best days of my life - I totally agree! :D
I can't decide whether the new uni logo (on the white envelope) looks better or the old one (on the brown envelope)?Caught unprepared on a visit to the library resulted in me having to get a library bag... in neon green! lol. And I had to pay... :(

Also it seems that the postgraduate society is keen to play matchmaker with fellow medics in the faculty. Here are a few excepts from some Facebook emails that I received, lol
Email 1:
We now have over 80 members, and are excited about the events to come! Which brings me to item 2: our next event, a Speed Dating/Meeting evening on 15 October. Come along to have a drink, and meet other postgrads for a quick flirt or friendly chat...Email 2:
We're getting a hot reply for the speed-dating, which is excellent, and thanks to everyone who has gotten back to us so far. I don't want to alarm the girls, but the RSVP count is unfairly balanced towards the fairer sex. So guys, the girls are up for it: what say you?...
Email 3:
Our next event, the Speed Dating/Meeting, will be held tomorrow, Thursday 15 Oct, at the Faversham Pub (on the rear side of campus), at 7pm until 10pm. Those of you who RSVPed before Monday will be given priority for the speed dating, but anyone else who would like to can (and should!) still come along for a drink just to meet others.
I know societies are pretty eager about keeping everyone well informed but it seems kind of pushy seen as I got the aforementioned emails (as well as few extra ones!) within a relatively short space of time. Also the excerpt from email 2, did make me laugh – “I don't want to alarm the girls, but the RSVP count is unfairly balanced towards the fairer sex”... Yea I totally believe that the organiser was having a minor panic attack when they realised that, lol. And just in case you're wondering - No I did not go ;)

Other good news, my external hard drive has finally arrived! Woohoo! I love getting packages from Amazon, lol. Also it'll avoid the whole 'Oh-my-god-my-laptop-has-had-a-meltdown-and-I-think-I-have-lost-all-my-data' drama. Usually accompanied by me having a minor panic attack a few months into my dissertation madness, closely followed by me running over to my cousins house clutching my laptop with a sad sad look on my face. I'm glad we can all laugh about it now though eh? :P

Leeds university logo changes –

The University of Leeds has always featured in my life in one way of another...

- When I was 18 years old, being interviewed for my undergraduate degree at different universities. I came to Leeds University, had a great day and got slightly nervous during one my interviews as my interviewer was an extremely good looking professor!

- Attending lectures with my other fellow medical students at Leeds University.

- Popping in and out of the adjacent hospitals near Leeds university, when Aishi was ill

- Now I’m back here doing my doctorate :)

We all change over time and so has the university over the past few years. Whilst searching for a logo to put onto my work, I found a number of the old logos, the various changes it underwent and the final product.

They’re phasing out the individual school logo’s now; good and bad.

I honestly can’t decide which I prefer.

Dementia

This is just quick overview summarising the current ongoing work in the area of neurosciences, specifically dementia. Dementia (meaning ‘deprived of mind’) is a serious cognitive disorder which affects areas such as memory, attention, language and problem solving. It can be a result of a single brain injury or of a progressive long term illness. As we age, we will all experience some form of change in our cognitive ability which a normal sign of ageing. However it is when these changes seem to increase more than the expected level, that dementia is diagnosed.

Neurological disorders including dementia are set to rise in the future due to an ageing population.

Types:
The type of dementia is dependent on the pathophysiology. The different forms can be dependent on;
- Age (often the same illness can be given different names as they arise in different age groups)
- Gender (some types of dementia seem to be higher in women than in men)
- Pathology (the change in size and shape of the cells i.e. plaques, neurofibrillary tangles, lesions and the location of the changed area i.e. frontal lobe, temporal lobe.
Consequently the pathology in turn determines the symptoms that characterise the illness.

Diagnosis:
When a person is suffering from dementia, the clinician will usually take a clinical history to see if there is a familial link within the family. This will involve enquiring about the patient’s diet, sleep patterns, medications and a history recent illnesses such as stroke, heart disease, cholesterol, blood pressure and diabetes. A mini-mental state examination (MMSE) is also carried out to test the level of cognitive impairment in combination with other clinical diagnostic tests.

It is common practice to also conduct psychological tests and blood tests to exclude other possible causes. The clinical tests may involve scans and neuroimaging techniques (MRI, CAT) as well as an electroencephalography (EEG), analysis of the cerebrospinal fluid (CSF), tissue biopsies, genetic testing. When all other possible clinical causes have been eliminated then further testing of the cognitive domain is conducted to determine the type of dementia.

There are a number of different scales and assessment methods used to test the cognitive domain however used on their own they are not sufficient, as there is large variation between guidelines and thus the potential for misdiagnosis is possible. Often the histological examination of the brain post mortem is used confirm the diagnosis.

Treatment:
Something to bear in mind is that certain types of dementia are multifactorial meaning that they have numerous causes. For this section if we look specifically at Alzheimer’s and the treatments associated with this disease.

Prevention:
Prevention is the best course of treatment and a number of risk factors have been identified for Alzheimer’s disease;
- A diet that is healthy, low fat, rich in B vitamins and avoidance of alcohol and smoking
- Cognitive fitness - maintaining intellectual and physical activity is a protective risk factor against cognitive decline
- Reducing cardiovascular risk factors is beneficial i.e. hypercholesterolemia, hypertension, hyperhomocysteinemia, dietary saturate fats, cholesterol, antioxidants,diabetes mellitus, cardiovascular disease and cerebrovascular disease.
- the presence of the ε4 allele of the apolipoprotein E (apoE) gene has been identified as a strong genetic risk factor

Pharmaceutiacal:
Although there is no actual cure as this moment in time, there drugs avaliable to help alleviate the symptoms.
- Cardiovascular risk factors can be controlled by the use of antiplatelet drugs such as aspirin to decrease platelet aggregation and statins such as Atorvastatin to reduce serum cholesterol.
- The use of acetylcholinesterase inhibitors such as galantamine, donepezil and rivastigmine. It is thought that the degradation of acetylcholine is a contributing factor and so these drugs slow down the degradation, allowing levels to remain elevated and prevent further neuronal damage.
- Other drugs include the regulation of neurotransmitters using glutamate, NSAIDS and statins.
- Pharmaceutical intervention such as antidepressants, neuroleptics and mood-stabilizers help alleviate the behavioral changes.

The future:
There are numerous groups working on different theories and possible treatments; selections of which are described below.
- Improvements in diagnostic criteria to allow earlier detection thus leading to more positive outcomes.
- Numerous pharmaceutical drugs such as Protollin, Dimebon, Rember are currently undergoing clinical trials.
- Recent work at the University of Manchester has shown that the herpes simplex virus (usually found in cold sores) may be linked to the build of plaques associated with Alzheimer’s. If this is the case then anti viral agents may be used to treat Alzheimer’s.
- To reduced the levels of amyloid protein that cause plaques by using immunotherapy or the development of a vaccine.
- Using the brain’s own neuroprotective strategies to protect against possible causes such as stroke. This novel approach is called ischemic ‘postconditioning’ that involves the activation of the protein kinase Akt, may go onto to produce a suitable treatment.
- the role of metals such as aluminium and spices such as tumeric have also been highlighted in recent work.

Rather than give up on life as so many dementia patients do, I discovered that a few people I know, regularly keep journals throughout their illness. The purpose of this is sort of two fold; firstly it helps the person keep track of their thoughts thus giving their mental capacity a workout and secondly it may help give carers an insight into how the patient is feeling and try and solve some of the problems that they may be facing. During my research, I also found that quite a few people who suffer from dementia or have loved ones living with this illness have set up online blogs.

This I feel is a great idea because for the sufferers it is a way to maintain their intellectual ability as I mentioned before and for the carers it is a way to release some of those feelings of frustration and helplessness. The fact that their journals are online mean that anyone can read them and know that they are not alone with this illness, that they have someone to share their thoughts and feelings with. Personally from the patients that I've seen that is one of the key things; the fear/feeling of isolation and to alleviate some of those fears can only be a positive step forward.

Err, the IP belongs to me? No?

So I finally made a decision about where to go for my doctoral studies and have been sent my contracts in the post. That’s right – contracts. Not university forms to fill in but contracts that need to be signed, which makes it sound all so scary. I mean contracts are not a new thing for you, I’ve had to sign them for jobs etc but never for a place of study. An agreement to the code of conduct at university – yes; a contract at university – err, no. This contract in particular had clauses such as;

i) Your must agree to assign Intellectual Property arising from the projects to the University. Full details of this are explained in the assignment letter (see below).
I cannot be bothered copying the rather wordy and legal sounding assignment letter. Sorry! But I mean really? My intellect or more specifically the intellectual property that I may or may not develop does NOT belong to me? I really don’t get some type of ownership over this? Oh no wait I do... just a passing comment perhaps, but mostly it’s all the university. Which in fairness is ok I guess, seen as they are paying for me via my scholarship. It just feels a bit weird that’s all.

ii) During the tenure of the studentship you may undertake teaching and demonstrating duties in the university provided that the total demand made on your time, including preparation time, does not exceed six hours in any one week. You may not, however, retain or accept other employment or an appointment, which involves substantial calls upon your time without written consent of the Head of the School in which you are registered.

Ah yes lecturing, which I conveniently forgot about, eek! I’ve done like odd lectures here and there, filling in for people etc but teaching a regular class – again scary stuff! Ah well I guess I’ll deal with it when I get there, lol.

Ok, SO maybe I’m making it sound a bit scary as it is not all harsh and I will learn a lot from some really knowledgeable people. Also I got a really lovely accompanying letter of which included; congratulating me on getting the studentship (Why, thank you), the faculty hoped that I would accept the offer (which I have done) and wished that my time at the university is rewarding and enjoyable (well I hope so too).

Anyhow I now have two whole weeks off. Neither Saba or I have had much of a break this year so these two weeks really mean a lot to us. Eid is coming up and I have a lot of things to sort out before the new university semester begins again. Two whole weeks!!! Woohoo!!!

My Dissertation...

The core basics of my research project...
Title: “Investigation of combined cerebral oximetry and transcranial Doppler cerebral blood flow measurements in the common dementias.”
Location: The University of Manchester (course admin) and Wythenshawe hospital later renamed University Hospital South Manchester (study location).
Area: Department of Academic Surgery and the Vascular Studies Unit (VSU) at UHSM.
Duration: The MSc officially ran from September 2008 and September 2009. This time period also included my clinical study.
Supervisor: Dr Maureen Thorniley
Other people of interest: Numerous helpful associates but a few that I’d like to mention are Professor C. McCollum (Head of academic surgery), Dr V. Sekar (PhD Student), Dr Z. Bashir (Post doc), Miss J. Mercer (Researcher), Mr T. Kelly (Student), Mrs S. Cooper (MSc course administrator), Dr J. Oldham and Dr P. Gardener (Course directors) and finally C. Slinger, D. Anglin and E. Greenwood (fellow 2009 scholarship students).

The techniques/technology used:
Transcranial Doppler (TCD) – Measures the cerebral circulation parameters such as speed, direction, resistance, presence of emboli and so on. The middle cerebral artery (MCA) was the prefered vessel for insonation.
Near infrared spectroscopy (NIRS) – Measures the levels of oxygenation in the cerebral circulation.
Cambridge (CANTAB) – A total of 22 computerised cognitive tests that focus on different areas of the brain and aid in the diagnosis of different neurological conditions.
Mini-mental state examinations (MMSE) – A quick cognitive test (usually under 5 minutes) used to test the mental acuity of an individual.
CAMCOG/ CAMDEX – Other types of cognitive testing procedures commonly used in patient assessments.
Atorvastatin – Medication; statin used to break down plaques in arteries used formed from cholesterol.
Clopidogrel – Medication; anticoagulant used to disperse blot clots.

Hypothesis:
Premise – The process of embolisation is thought to be an early indicator for the onset of dementia. Tiny atherosclerotic plaques give rise to tiny break off particles (named emboli) which travel around in the cerebral circulation. In some cases, these tiny emboli can become lodged in narrow vessels thus decreasing the blood flow and oxygen to certain areas. The decline in cerebral parameters is thought to contribute to the memory decline associated with dementia.
Aims and Objectives – Based on the above hypothesis my project had a number of aims and objectives to fulfil, which were as follows;
- 1st – To screen patients and if they were emboli positive, then the participants underwent further testing where cerebral oxygenation levels (NIRS) and blood flow velocities (TCD) were analysed to see if there was a change in parameters associated with the presence of emboli.
- 2nd – Compare the cerebral parameters of the patients with dementia in the study to normal healthy volunteers of a similar age to see if there were any significant differences between the two groups, which may help to answer some of the questions linked to this area.
- 3rd – To evaluate potential therapies for dementia by analysing TCD and NIRS parameters on a monthly basis. Prior to this the patients were randomised to receive each of the following drug phases, Atorvastatin, Clopidogrel or a no treatment phase.

Methods:
My study had two protocols:
Protocol 1 – Testing normal subjects and patients with dementia.
The aim was to recruit 20 normal and 20 patients with dementia. We ended up with a total of 43 participants - 23 normal subjects and 20 patients with dementia. Both groups of participants (normal and dementia) underwent just a single test session with identical testing procedures. The session involved using TCD and NIRS probes to measure the cerebral parameters whilst the participants underwent the CANTAB test method followed by the MMSE and a full medical history. The results from both groups were analysed to see if any differences could be detected. From all the participants tested, 10 normal subjects were age and sex matched to 10 of the patients with dementia and their results were analysed in greater detail to see if age and gender had any affect on the cerebral circulation. The pictures below show the typical output from each of the methods used (TCD, NIRS, CANTAB).

Protocol 2 – Patients analysed from the drug trial.
These patients were selected from an ongoing clinical trial. 10 patients that had completed the trial in full had their results analysed. Each participant underwent a screening test to see if they were emboli positive of negative, If emboli positive, the participants were randomised to receive the different medications on a monthly basis followed by a month long ‘washout’ period between each drug. At the end of each month (and thus at the end of each different drug phase), the participants underwent 2 x one hour long TCD sessions. Each scan last one hour and each phase requires two scans therefore a minimum of 6 scans per person. A total of 10 patients equals a minimum of 60 scans. These 10 patients also had a monthly MMSE test and a blood sample that was analysed for Interleukin 10, an inflammatory marker.

Results and conclusion: Papers are being written for publication so I will post the link online soon.

Taken by one of the VSU staff. Me working through about a 100 scans (Protocol 1 – 43 scans and protocol 2 – minimum of 60 scans. I look cheerful don’t I?

Further work: Things I would further like to investigate (provided I had the funding and time) would be...
1) Larger patient numbers to increase the validity of my results
2) Validation of CANTAB tests to form part of a diagnostic method
3) Assessment of other neurological defects such as Parkinson’s using the CANTAB method
4) Comparison of other cognitive assessments such as the MMSE, CAM ICU and so on

All in all I enjoyed my project immensely. It was a lot of hard work, long nights and I often felt like packing it all in but I guess I have a strong stubborn streak. And I’m grateful it kicked in because it gave me the fantastic opportunity to learn many things about life in the medical world. Aside from the science/ clinical aspect of the project, from my placement I also learnt many other non-medical stuff.

Two major learning points for me were...
1) Patient responsibility – It seems kind of obvious but some people get so caught up in the end result that they forget everything else. It’s essential to keep patients well informed at all times as they often panic and become anxious very quickly. I learnt that theory and practice are very different in real life. It is VERY hard to recruit people as they can often be very sceptical but mostly scared. Sometimes it’s not even the patients but their carers that are reluctant to some extent. I also learnt very quickly that you must always to be very clear with your aims and what you are doing. Furthermore working with vulnerable populations; especially people with dementia that are often scared/confused, requires the utmost care and attention. Old or young, patients need plenty of patience and need to be constantly reassured. Personally I found those who tried to be a friend and not just their doctor/nurse/researcher or whatever were more successful than those who were strict professionals. I’m not saying that the professional boundaries are not required as they are vital working in such an environment and as part of the clinical team we shouldn’t get too attached but at the same time we should try to be a friend as well, as it helps to break down a lot of barriers.

2) Interdisciplinary teams – Communication is key! Bad communication leads to a lot of infighting between staff and placing blame back and forth as I observed in other departments. It’s bad for staff morale and also for junior staff i.e. students such as me etc. Although I didn’t have any clashes myself – it did show me that sometimes medicine isn’t always about saving lives and includes building on skills that maybe aren’t linked to your scientific and clinical knowledge. Those experiences help make you a good all rounder. I’m sure that all teams go through a few rocky patches but unless they work through it, they’re not doing themselves or their patients any favours. I’m pleased to say that the clinical team I worked with are genuine hard working individuals who are dedicated to their work. I couldn’t have asked for a better place to learn :)

So there you have it... the story of my dissertation. Here’s hoping I get good marks for this past year and for my dissertation (iA). The pictures below show the clinic and work areas, my equipment and patients being tested.

MSc stuff...

Disclaimer – I apologise in advance if anyone dies of boredom reading this post. It wasn’t my intention ;)

All in all, this past year has been dedicated to my MSc in medicine at The University of Manchester. The major focus was my dissertation which involved a lot of long work hours at the hospital, sleepless nights and quite a fair bit of travelling. Seen as it was such as major part in my life for this past year – and at certain moments the ONLY important thing in my life (sadness I know!)... well I thought I should explain what I have been doing for these past twelve months. So here goes....

My MSc kicked off in September where after my initial induction meetings and lectures, I started to attend a number of interesting talks from the MIMIT seminar series that were a part of one of my MSc modules. It was also a good way to get to get to know my fellow students better as we had all come from different med courses. Soon after this we started choosing our preferred tutorial sessions which involved a lot of research, preparing and giving presentations and then submitting written assignments on our chosen topics. All fine so far, just like my undergraduate degree… and then came the difficult part. Who knew choosing a dissertation topic would be so difficult both for the MRes (purely research based) and MSc (partly taught element) students alike.

The great thing (or bad thing, depends on how you look at it) is that at Manchester university, the MSc students were given the option of either carrying out a full 35 week project for the dissertation OR splitting it into a 10 week and a 25 week project which are written up separately and submitted for their dissertation. I initially thought this was a good thing and I was very keen to carry out two projects that were both in different disciplines; one would be clinically based and the other would be lab based. I felt this was a great way to pick up a larger skill set, provide me with a better all round knowledge base and also create a lot more options for my further medical degree. My initial 10 week project was to be lab based as I felt I could get on with this relatively quickly whereas the clinical project would require a lot more planning time etc and so that was allocated to the 25 week project. Also the various project titles indicated the time span that would be required for completion of the project.

I chose the topic of wound and keloid systems for my 10 week lab based project with my supervisor who was a plastic surgeon at one of the Manchester Hospitals. After the initial meeting, my supervisor felt that the keloid system project would be quite hard to complete in the time I had in terms of training and lab set up etc. Therefore I was offered an alternative project which I thought was fair enough. The alternative project was on the topic of breast implants and the adherence and rejection by the fibroblasts that grow around the implants. Basically it was in the area of cosmetic surgery and I’ll be honest, although it may be an interesting topic for others, personally it wasn’t what I quite I had in mind. However despite the niggling feeling, I stuck with it and went away and did some reading on the topic.

A week later, I returned to my future supervisor and told him that I was happy to undertake it for 10 weeks after which I intended to switch to a clinical project for the 25 weeks. My supervisor was initially taken aback and wanted me to stay for the full 35 weeks but I stood firm and a terrified me explained my reasoning about gaining a larger skill set etc. His response was that although my reasons were good, he felt it was more beneficial for me to stick to one project as it would provide me with more in-depth knowledge and also I would be able to publish more papers and attend conferences, which in turn would look better on my CV and future interviews. I thought about it and realised that he was also right and very appreciative of his advice. As a final warning he asked me to reconsider my decisions as “clinical projects are not always what they seem”, but I stood firm and told that my interest in medicine had always been patient orientated. He shook my hand and wished me the best of luck - it was a sort of terrifying but very informative meeting.

I started and successfully completed my clinical project and this was the result...

My dissertation - for which I will hopefully get a decent mark (iA)

The story of my dissertation ... Well that’s dedicated to a separate blog post altogether seen as this post is getting a bit too long :)

DONE!!!

Woohoo!!! My dissertation - printed, bound and submitted on time – DONE!
And I’m finally heading back to Leeds where I belong!
A friend’s sent me a T-shirt which summed up the past year of my life –

... funny I know :) Please feel free to order it from here if you really want to own one :)

So on Thursday night with my dissertation completed to my satisfaction, printed and nicely bound, I thought I could afford to relax a little the night before my submission deadline. TEDx Leeds on a Thursday evening with my cousins. Ok maybe a little geeky but I was genuinely looking forward to it. I should have been there... but instead I spent the evening surrounded by blank CD's waiting to be filled with study data and statistical analysis spreadsheets. I guess archiving my study data took much longer than I had expected. A little disappointed with not being able to go but at least I had the satisfaction of knowing that work wise everything was done properly.

I was so caught up in the submission of my dissertation (filling in forms and making sure my work was complete) that I completely forgot the date today. Upon my arrival at University, I had noticed an unusual number of people heading in and out of the church nearby but just it didn’t click in my mind. At around midday, the clock tower chimed, which for some unknown reason made me stop in my tracks. Oxford road, which is notoriously busy throughout the day, seemed to standstill as a sudden spell of silence descended upon it. I’m not sure if my mind was just imagining this quiet spell or if it actually was happening. But I’m pretty sure it was real as many of the students nearby stopped what there were doing and just bowed their heads in silence. I didn’t remember being told about this but still I stopped what I was doing and joined in with the two minute silence. There sat in this eerie hush on the steps of the Stopford building, in the heart of Manchester, it dawned on me that today was 9/11.

I thought about the families that had lost loved ones and what their lives must be like and whilst everyone else got up and went about their day; I remained seated on the cold stone steps. For some reason, I felt incredibly bad that I had forgotten and part of me couldn’t understand why. I wasn’t personally connected to any of the 9/11 victims so why this sudden guilt? And then it hit me. Whilst I was going about my daily life, doing what needed to be done, how easy had it been for me to forget those we had lost? I don’t just mean the people associated with this day, but people closer to home - our own loved ones, our family and friends. If I could forget this day that was incredibly well documented and talked about, how easy would it be for me to forgot those people that I love who are no longer in this world. Those people that aren’t well known to the rest of the world but for me they hold a special place in my heart.

In all honesty that scared me; that I may one day forget and I made a promise to myself that I would try and avoid that all costs. However this past year at the hospital has taught me that sometimes it is out of our control. The patients with dementia had no idea that they would be struck down by this terrible illness and in essence they have been stripped of their memories. It has made me appreciate life a lot more and I learnt (from my own patients in fact) that we should cherish every moment as we never know when we may lose it all. And so I believe I owe it to those that have gone; to keep their memory alive. Some people might say that it is unwillingness on my part to let go of the past, which they may deem as unhealthy. However I see it differently. It is those losses that have made me who I am today and taught me some invaluable life lessons. To forget those people would be an ungrateful act on my behalf.

It’s getting there...

• Clinic – done.
• Data collection – done.
• Patient and GP follow up – done.
• Statistical analysis - nearly done. Would have been done earlier if I had stopped making changes from numerous suggestions.
• Reading – being continued.
• Writing up dissertation – slowly but surely getting there. Numerous drafts done so far.

Phew! I cannot wait to hand in my completed dissertation, here’s hoping I will get a good mark (iA).

Following the submission of my work, I have two/three whole weeks off before I go back to university for the start of the next semester. Here’s hoping we have good weather during my time off as my holidays were practically non-existent this year. These past few months, I’ve twittering about my dissertation progress during the final months of my MSc. Rather weirdly I got a tweet from a company offering to analyse my data and write up my dissertation on my behalf. All I have to do is send them the university guidelines, my word limit, how I would like it set out and a copy of all my data collected and so on. Helpful it may be but I didn’t take them up on it as; firstly I wouldn’t have spent any time and effort spent on it and so calling it my work would have been an unfair representation. Consequently the final marks would not have been a true reflection of MY work and in my academic/ professional life to date I’ve have never knowingly submitted something that hasn’t been my own work. Secondly I have major issues about plagiarism – handing over unpublished work to an unknown party (and sometimes even known parties) who may or may not be connected to your work is NOT a particularly smart move. I’m pretty sure most of you will probably say that I’m being paranoid but in my mind it’s better to be safe than sorry.

The reason why I have slowed up on posts lately - people witness my dissertation mess! This is what my room looks like at the moment. I promise you it is a good kind of chaos... organised chaos if you will :P

So yes that’s my dissertation progress and now onto other news...
Aah yes so far then – Independence days for Pakistan and India (14th and 15th respectively), Ali Zafar got married but I’m over it, lol (see cool but bordering on weird here) and probably the most major news the month of fasting (Ramzan) will soon be upon us and I’m in two minds about the whole thing. I will further explain this in a separate post later. Hopefully. Actually to be honest I haven’t had much time to catch up on a lot of news which is probably why I’ve been using twitter a fair bit these past few months. Twitter trend topics is good for catching up on general ‘need to know’ news – however I have a problem with this. I often find that trending topics is just a bunch of people tweeting to find out what it is going on and NOT actually informing me of why it all started in the first place. Not very helpful – maybe they should get someone to put up a little intro for each the current trending topics perhaps? Ok, maybe it’s just me then...

Must get back to some work now...

Clinical mistakes

I don’t really know who I am writing this for but you know me, when I notice something, it has to be said :P Also I thought it best not to mention any names of the people who this is directed at. In any event, it’s very unlikely that the he/she concerned will ever read this blog, but I still believe it is better to be safe than sorry. So what did I learn from my clinical placement...

1) Never argue with a patient. It makes you look very unprofessional plus the patient will think you are an arse no matter how sick they may be. It’s true.

2) Don’t annoy the staff. As a medic try not to annoy everyone else you will have to work with whether it is the nurses, technicians, care workers etc. However if you love making your life as difficult as possible then please fire away with the disrespect!

3) Puctuality. Try and show up on time for shifts/appointments etc. If you’re running late let them know as you are being unprofessional and uncourteous otherwise. Also don’t try to lie about why you are late, because a medic, people will look towards you for trust and honesty. Those same people can also tell when you are lying and totally see through your BS. Result - congrats on making a bad impression.

4) Laziness. Clearly if you’ve made it this far, there must be some hope. Don’t rely on other to do things for you, instead get stuck in and do it yourself. You learn quicker and earn the respect of others around you. By being a slacker, you do the complete opposite and all that time studying in med school goes to waste.

5) Suck up. In the medical world, you respect your seniors; it’s an unwritten rule and there is a hierarchy that is followed and goes something like this... (top) Consultant > SHO > HO > F1> Med student (bottom). To move up this chain, a lot of people suck up to seniors. I get it, I get; it has to be done, but must you do it so blatantly? Urgh!

6) Communication. Not telling other team members (doctor’s/nurses etc) what you have found can lead to problems for the patient and for yourself. If you spot something serious or haven’t relayed vital information back to the appropriate people, then it can lead to some serious hassles.

7) Correct authorisation. Don’t attempt to do things that you have not been assigned or allowed to do. It may cause problems for the patients (legal issues?!) but it will also without a doubt cause problems between you with your supervisor.

8) Fudging it. Don’t make stuff up because it fits in with your study hypothesis or because you forgot to take a patient observation and you need to make up for lost time. Again it makes you look unreliable and incompetent.

9) Know your surroundings. A hospital is a place full of ill people. Obvious I know but when you spend so much time in one place, it easy to forget sometimes. This also applies to your appearance; dress appropriately and smartly – we’re no longer in lecture halls but actually interacting with real patients. Play you part accordingly.

10) Err....

Unfortunately I don’t have a number 10 at this moment in time, but if you think of anymore then please feel free to add them on.

Science debate – economic benefit 17th July 2009

Every med student at some point in their lives will undertake some form of research, whether it is laboratory based or clinical. For some students, research will be just a passing interest and for some it will form a large part of their lives, which is why when issues like these are brought to the forefront, it is a cause for concern in the research world. The people in charge of research (basic and applied) recently introduced a new rule in which everyone that applies to conduct any form of research will now have to fill out an extra section in their application form. This extra section is not time consuming and it asks every researcher to state the social and economic benefit of their research. This may be difficult for some researchers to complete, especially those that conduct basic research, nevertheless the assessors say those researchers that do not have a direct benefit will not be scored negatively. However I feel this statement is a little misleading.

Firstly funders will give preference to research that will provide an economic return for them either in monetary terms or by increasing their profile/reputation in the research world. As funds are limited, research that cannot provide such returns will be pushed to the bottom of the pile to be considered as a last resort thus putting them at a disadvantage. Secondly if the assessors are not concern with the economic benefit, then why would they introduce this new section, why the sudden need? And finally, creativity should not be bound by financial constraints. By placing certain restrictions on researchers, some research may not be able take place which in other circumstances may have proved beneficial. For example, if Messelson and Stahl in 1953, had to provide the economic benefit of their (basic) research, then their work may never had been carried out. To outsiders it may look like a couple of grown men, messing about with test tubes wasting time and money. What they were actually doing was laying the foundation for future work by proving the structure of DNA via a series of logical experiments. The results of their basic research is now used in so many other programmes of work and projects like the Human Genome project may not have taken place.

So in conclusion, this new requirement has irritated the research world, so much so that Professor Allen has now launched a petition in order to have the economic benefit section scrapped in the application forms. I can understand how funders would be reluctant to support work that would not bring them any profitable (economic and social) return but at the same time, these restrictions may stifle researchers and their creativity. Clearly there are both advantages and disadvantages to this debate but I think personally I prefer not state the economic benefit but those that want to state their benefits can do.

http://petitions.number10.gov.uk/honest-discovery/  The petition

http://webarchive.nationalarchives.gov.uk/+/http://www.number10.gov.uk/Page21111  The response

UPDATE:

http://www.timeshighereducation.co.uk/story.asp?storycode=408774  – Scrapping EB, October 2009

Medicine takes over EVERYTHING...

Being part of the medical world doesn’t just include your work life but also causes an outward ripple that also affects your personal life. You may start off thinking you have it all under control but pretty soon, the boundaries begin to blur and your work and professional lives begin to merge into one big mess... sometimes with horrible consequences as I’ve seen for some people.

Don’t get me wrong – being involved in medicine (whether as a doctor, nurse, clinical scientist/researcher or any other profession allied to medicine) is rewarding. As medical students we’ve been chosen out of many thousands of applicants to pursue these careers; it is a privilege and we should appreciate it. In accepting our places, it is no longer just a case of getting good grades as there are many more things that need to be considered. We agreed to be put in positions of trust, to improve other people’s quality of life, the responsibility to humanity – all in all a great honour. So yes it is rewarding and I am appreciative... but at the same time it can sometimes be very stressful. Often patients don’t consent to procedures or treatments as they may be nervous or scared and so it sometimes falls to the med students/doctors to be cruel to be kind. It’s funny how repeating a common procedure can still make you feel like a newbie each time. Sometimes it’s not even the clinical setting that is the cause for concern; it’s your personal life. You find yourself reading science journals as opposed to general newspapers or gossip magazines in your spare time, you correct people by providing scientific explanations, you link certain occurrences back to science in a general conversation between friends and the list goes on.

Joking aside though I recently I found myself getting so caught up in my clinical project that it started to take over my whole life. Eventually my project supervisor had to pull me aside and told me to “take some time out and relax.” She told me that as fantastic as it was that I was so dedicated to my work, I should actually take the time to just switch off and live my own life. When this was relayed back to a PhD student I was working with, it led to certain clashes. The student felt that I should spend as much time at the hospital as possible as this is what he/she had done during their clinical training and they felt that every student after them should do the same too. My supervisor (who had also put in long hours during their clinical training) felt that I should pace myself otherwise I would ‘burn out’ and that wouldn’t be useful to anyone. So the difference in opinions which got me thinking - residents and F1’s have set work limits but do medical students? If you don’t put as many hours in as your fellow colleagues does that indicate that you aren’t as committed? Conversely if you’re working as many hours as you possibly can does that mean you don’t know when to stop and have no clue as to how to obtain a healthy work/life balance?

I’m pleased to say that after a few hiccups, I eventually found my own style of working that seemed to satisfy everyone involved (I think) and didn’t send me over the edge. But this incident was useful as it showed me how work can take over your life without you even realising what has gone on. I think balance is very important. As well as gaining new knowledge and meeting interesting people, it’s important not to get trapped by work. As well as being part of the medical world, you’re still a part of general society just like the people you treat and so you should take the time to break off and relax rather than be blinded by work.