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Romanticizing Tubercolosis

21 Mar, 17 | by amcfarlane

Radu Jude (Director of ‘Scarred hearts’) and the Screening Room Editor of Medical Humanities, Khalid Ali, met at the London Film Festival, October 2016.

Our screening editor, Dr Khalid Ali (Khalid.ali@bsuh.nhs.uk), here writes about the importance of Romanian director Radu Jude’s new film Scarred Hearts (Romania, 2016) and interviews him at the London Film Festival in the podcast included below.

Each year on the 24th of March, several organizations around the world celebrate ‘International Tuberculosis Day’. It serves as a timely reminder that TB still remains an international epidemic claiming the lives of an estimated 1.4 million people, making TB one of the top 10 fatal diseases, and the emergence of 480,000 multidrug-resistant TB cases annually according to the Global Health Observatory data report- 2015. Before ‘Streptomycin’ was discovered as an effective anti-tuberculous drug in 1944, TB was a devastating disease with an inevitable death sentence. Radu Jude, award winning Romanian film director, revisits the TB epidemic in the early twentieth century in Scarred Hearts. The film is based on the life of Max Blecher (1909-1938), a Romanian writer who wrote the book Inimi Cicatrizate based on his own affliction with TB.

Scarred Hearts is a close examination of the life of Emanuel (Lucian Tedor), a Jewish Romanian young man in his twenties from a privileged background in the turbulent times of WWII, who falls ill with Pott’s disease (TB of the spine). Emanuel is admitted to a sanatorium, were he spends years bed-ridden, contemplating life, love, and illness. While meditating and writing his books and essays, Emanuel meets and befriends fellow patients and nurses. His encounters with the sanatorium’s resident doctor are short and traumatic; one such encounter happens when the doctor evacuates an abscess from his back with little analgesia, if any. The days go by slowly in his confined solitary world, while some nights are livened by ‘carnal activities’ with a young, female nurse, and another patient affected by TB. With the war exploding outside, boredom and melancholy set in in the dark corners of the sanatorium. The budding companionship and friendly exchanges with other inpatients over smoking, drinking alcohol, and playing cards, make the sanatorium a safe refuge for creativity in writing literature and composing essays, human interactions, friendships, and love. Some patients even decide to stay in the hospital indefinitely, and take up voluntary roles caring for other patients, showing altruism and human sacrifice. Self-management in chronic conditions is a relatively new concept in medical literature; however, Emanuel in 1930s Romania embodied the essence of self-management in ‘surviving a bed-bound existence with resilience and hope’. The socio-economic dimension of TB in today’s world plays an important factor in making it a universal public health and social challenge. Co-ordinated health and social interventions are as much needed today as they were in the mid 1930s.

Throughout history, TB has been given several names:  consumption disease, The White plague (a seventeenth-century TB epidemic in Europe and North America), Phthisis (a term which appeared in Greek literature around 460 BC, and was used by Hippocrates), Scrofula (TB of the lymph glands), and Pott’s disease. It was also referred to as the ‘Romantic disease’ as a lot of its sufferers were young adults at the time of the Romantic movement in European art, literature, and philosophy. Throughout history several notable literary figures suffered from TB; Jane Austen, Emily Bronte, John Keats, Anton Chekov, Franz Kafka, Khalil Gibran, and George Orwell are some examples. However, Max Blecher stands out in documenting his journey with TB in Inimi Cicatrizate.

It is interesting to note that Max Blecher was studying medicine in Paris when he had spinal TB. He was forced to abandon studying medicine, and become institutionalised in hospital settings until his untimely death at the age of 28. As a medical student and a writer, he had several qualities which are essential in both vocations; keen observation, building a rapport with those around him by actively listening to them, and transforming all those interactions and experience into a coherent form of story-telling. It goes without question that ‘empathy’ was a driving force in his analysis of the physical and emotional facets of illness. He was indeed bed-bound, but his eyes and ears were wide-open to the suffering and misery around him. Documenting his thoughts and philosophy in writing might have helped him stay sane, hanging on to some form of well-being in the bleakest of circumstances. Mother Theresa once said ‘The biggest disease today is not leprosy or tuberculosis, but rather the feeling of being unwanted’. Reminding ourselves on Friday 24th March 2017 of the global impact of TB, its sufferers are no longer alone or unwanted.

Listen to the interview with Radu Jude, director of Scarred Hearts:

The European Doctors Orchestra and the Irish Medical Choir

24 Feb, 17 | by cquigley

 

Professor Des O’Neill

One of the pleasures of medicine is the frequent sense of a shared vision of how enmeshed it is with the humanities. As a group, doctors tend to have a high level of cultural engagement: for example, our own studies show that over 50% of medical students play, or have played an instrument http://mh.bmj.com/content/42/2/109.long.  Yet we rarely celebrate our cultural participation in a collegial manner, and perhaps it is time that we more openly acknowledged this shared portal to the bigger picture in life and medicine.

These elements came to life vividly at a remarkable workshop in Belfast in early February for the nascent Irish Medical Choir. It arose because the very talented European Doctors Orchestra https://www.europeandoctorsorchestra.com/ has decided to scale new heights with a concert in Belfast in November featuring Mahler’s mighty 2nd symphony, the Resurrection Symphony https://www.europeandoctorsorchestra.com/next-concerts/.

As the work has an extensive choral finale (as well as the chill-inducing Urlicht in the fourth movement http://onlinelibrary.wiley.com/doi/10.1196/annals.1360.041/abstract ), a bright idea was to recruit a chorus drawn from medical practitioners and students across the island of Ireland.

The take-up has been fantastic, with a waiting list of highly qualified sopranos and altos, albeit some space yet for tenors, a constant for choral societies around the world! The introductory workshop was an intense pleasure at many levels, with virtually all specialties represented, and ranging from medical students to those retired for many years, a very intergenerational project.

Having expected a direct exposure to the Mahler, we were initially surprised by the list of works provided by the expert and engaging choir master, Brian MacKay http://www.zezerearts.com/brian-mackay-artistic-director. In the event it was a brilliantly constructed voyage around Mahler, proving as ever that the elliptical beats the direct approach every time.

Our choral journey allowed us to engage with historical and contemporary contexts for Mahler’s music, preparing the soil for future rehearsals. The first work was an eighteenth century hymn by Graun based on a Klopstock poem on the resurrection. It is this piece, played at the funeral of the celebrated conductor Han von Bülow, which inspired Mahler to use the poem in the symphony and it was both simple and affecting.

A perspective of late-romantic German choral music was provided by Josef Rheinberger’s Abendlied, a truly beautiful piece which was a fantastic discovery for most of us (and do watch out for his (and Reger’s) brilliant re-working of the Goldberg Variations for piano four-hands http://www.tal-groethuysen.de/cds/bach-goldberg-variations.html!).

We then immersed ourselves in another avenue of spiritual music, the potent and deep Rejoice, O Virgin, from Rachmaninov’s Vespers. It was a visceral shock to be a part of this extraordinary music, a further intensification of the feelings arising from my recent exploration of choral singing http://blogs.bmj.com/bmj/2017/01/03/desmond-oneill-singing-in-the-new-year/.

Friendships and connections were forged over lunch, and I was in awe at the wide range of pursuits and achievements of those present, and sense of shared pleasure and purpose.  After some business arrangements for upcoming rehearsals, we then sight read twice through the first movement of Brahms German Requiem, further extending our aesthetic, communal, pleasurable and spiritual journey.

For a group dealing with illness and death throughout our working lives, there is something extraordinary reassuring and quietly energizing about this participation in music probing mortality, resurrection and a deep sense of consolation. All of these composers had more extensive personal exposure to death than we do http://blogs.bmj.com/bmj/2011/05/24/des-oneill-death-and-transfiguration/ and their music provides an extra layer of opportunities to see the bigger picture, echoing and providing a more positive spin to Milan Kundera’s dictum that all we can do in the face of that ineluctable defeat called life is to try to understand it.

The coda to the meeting was a clear desire to continue an Irish Medical Choir after the Mahler, a testament to the organizers, our choir master, and those positive elements in medical life which make it such an interesting and satisfying career. If you are a Mahler fan, do consider joining us in the Ulster Hall on Sunday, the 26th of November: all proceeds will go to music and health charities.

 

Des O’Neill is a professor of geriatric medicine and co-chair of the Medical and Health Humanities Initiative at Trinity College Dublin https://www.tcd.ie/trinitylongroomhub/medical-humanities/

Editor-in-Chief post at Medical Humanities

25 Jan, 17 | by cquigley

 

The Institute of Medical Ethics and BMJ are looking for the next Editor-in-Chief who can continue to shape Medical Humanities into a dynamic resource for a rapidly evolving field. Candidates should be active in the field, keen to facilitate international perspectives and maintain an awareness of trends and hot topics. The successful candidate will act as an ambassador for the journal supporting both pioneering authors and academics publishing their first papers. The candidate will also actively promote and strengthen the journal whilst upholding the highest ethical standards of professional practice. International and joint applications are welcomed.

Interviews will be held on 24th March 2017.

Term of office is 5 years; the role will take 12-15 hours a week.

Contact Kelly Horwood (khorwood@bmj.com) for more information and to apply with your CV and cover letter outlining your interest and your vision for future development of the journal.

Application deadline: 24th February 2017.

Start date: June 2017

Further information here.

Blog Curator and Books Editor Opportunity

18 Jan, 17 | by cquigley

Blog Curator and Books Editor Opportunity

 

We have a vacancy for a Blog Curator and Books Editor at Medical Humanities. It is a single, combined role as all book reviews are published on the Blog.

The role involves:

·         Commissioning and editing content, including reviews, for the Medical Humanities Blog;

·         Maintaining the Medical Humanities Blog and updating it regularly (currently on a weekly schedule, but this could be flexible within reason);

·         Liaising with publishers to receive new titles and organise reviews of relevant books for the Blog;

·         Contributing to the editorial team (comprising the editor-in-chief, associate editors and BMJ Publishing staff) that leads and manages both the journal and Blog, including attending the annual editorial team meeting;

·         Curating the content of the Blog to reflect the journal’s identity, priorities and interests;

·         Working with social media platforms to provide a coherent online presence for Medical Humanities

 

The role is flexible and can be adapted according to the successful applicant’s interests and availability. On average, the role takes approximately 4-6 hours per week. It is an exciting and creative opportunity to join a diverse and well-supported editorial team.

If you are interested in the role, you are welcome to contact the Editor-in-Chief, Prof. Deborah Bowman, for an informal and confidential discussion. Her email address is dbowman@sgul.ac.uk.

Applications, comprising a letter setting out a) the reasons for applying and b) suitability for the role and a curriculum vitae, should be submitted to Deborah Bowman at the above email address

Institute of Medical Ethics Conference 2017: Call for Papers

19 Dec, 16 | by cquigley

4th IME Summer Conference, June 2017

 

Building on the success of three previous conferences held in Edinburgh, Newcastle and London, the 4th Institute of Medical Ethics (IME) Summer Conference will take place on the 15th and 16th of June in Liverpool. Two changes have been made to the conference format for 2017. First, the Research Committee will accept proposals for both individual papers as well as for panels. The latter will be allocated 75mins and the time can be used for traditional presentations of 15-20 mins or for more collaborative and discursive interactions. Second, there is a specific call for contributions from the medical humanities. The IME’s Research Committee hopes to include a stream of medical humanities papers across both days of the conference.

Confirmed Keynote Speakers are Prof Rosamund Scott (KCL) and Prof. Stephen Wilkinson (Lancaster).

Further information can be found here: http://ime.datawareonline.co.uk/Event-Booking/EventId/1023 and both the IME (@IMEweb) and various members of the IME’s Research Committee can be found on twitter if you want to get in touch.

Finally, the location and date of this year’s conference have been coordinated with the annual conference of the UK Clinical Ethics Network (UKCEN). Themed ‘Family Matters’ this will be their 17th Annual Conference. It takes place on the 14th June 2017 and there will be a short IME/ UKCEN crossover session on the morning of the 15th. For further details about UKCEN’s conference see: http://www.ukcen.net/

 

Politics and Medicine

9 Dec, 16 | by cquigley

Clinicians should understand how they can use the ballot box to advance their patients’ health interests.

Jacob King, Deniz Kaya

Medical Students, Peninsula College of Medicine and Dentistry

 

As a health professional working in a sterile environment one might easily find themselves feeling disparately removed from the slimy world of politics. But sadly we believe that this separation of clinic and state denies the measurable effects they have upon each other. Environmental public health acts, improving access to medical coverage, and taxes on ‘bad behaviours’ have all been platforms for political campaigns, each subsequently having shown powerful health benefits.

We have a duty to patient wellbeing, and some argue that this extends to advising or lobbying government. But in light of recent major democratic exercises, including the EU referendum and junior doctors’ contract votes here in the UK, and the upcoming Trump presidency, the ballot box can frequently become a vessel for enacting changes for patient health. Unfortunately, we fear that health professionals are missing out on this key opportunity to address their patient’s wellbeing from an entirely new angle, one normally out of reach for the individual clinician. In the only study of its kind Grande et al. show that US physicians were significantly less likely to vote than the general public [1]. They suggest that medical training may lead physicians to perceive voting as in conflict with their professional duties. Anecdotally, among our colleagues, we also find disillusionment with the political system, limited understanding of legislative processes and little appreciation of health and social policy impact. The GMC’s ‘Tomorrow’s Doctors’ sets the framework of a medical school curriculum, and simply requires students to “discuss the principles underlying the development of health and health service policy” [2]. This limited criterion for health policy teaching, we believe, fails to adequately prepare health professionals. It follows that if greater awareness was fostered toward the impact and variety of health policy options, health professionals could more readily be able to advance patient health by means of their vote. Supplementary teaching of political systems and health policy could be incorporated into a medical curriculum which recognizes the importance of political decision in healthcare. Initially teaching politics effectively may seem implausible. Yet we have experience of teaching, and being taught medical ethics quite successfully without running into contentious arguments, cries of bias or questioning of practical use. We see no reason why politics should be any different.

There is a broader point here, however. Just as this blog routinely demonstrates, the role that accepting humanities topics (sociology, art, music, anthropology, religious and cultural studies et cetera) into medicine has progresses hidden and tangible clinical benefits – we claim that political science possesses similar potential. “A physician is obligated to consider more than a diseased organ, more even than the whole man, he must view the man in his world.” (-Dr Harvey Cushing). Small “p” politics by any definition must also fall into the category of humanities, concerned with forms of individual thought and behaviour, power structures, interpersonal relations, as a cousin of sociology, psychology and anthropology. But while earlier we suggested that at least some measure of political science education for health professionals might theoretically improve our voting rates, fuel broader discussion of health and social policy or directly lead to effective health outcomes via the ballot box, the hidden side of recognising political belief in oneself and our patients may also (akin to its humanities cousins) result in a greater appreciation of the man in his world.

In this light we wish to make the case that political awareness will on one hand prime clinicians to appreciate on a different level the background and health beliefs of their patients, and on the other, confer a greater idea how voting one way or another may play a role in improving health and wellbeing.

Whether one ultimately does vote in what they deem to be in their patient’s best interests is a personal matter. Individuals of course have other motivations on which to base their decisions. However we reasonably believe that health professionals should have the opportunity, foundation knowledge and confidence to enact change via the ballot if they wish to do so.

 

References

  1. Grande D, Asch DA, Armstrong K. Do doctors vote? J Gen Intern Med, 2007;22(5): 585–589.
  1. General Medical Council. Tomorrow’s Doctors: Outcomes and standards for undergraduate medical education. 2009.

 

Medicine Unboxed: Students 2016

17 May, 16 | by cquigley

 

Deadline: Midnight Sunday 3 July 2016


Medicine Unboxed 2016 is on the theme of Wonder and takes place in Cheltenham on 19-20 November 2016.


Medicine Unboxed: Students brings together students of the arts, health and medicine to present their work and thinking at Medicine Unboxed.

Applications are invited for a 10-minute presentation at Medicine Unboxed: Students 2016.

Applications are open to undergraduate or postgraduate students from all backgrounds, including art, drama, music, medicine, literary studies, philosophy and other health-related subjects. Previous presentations have included conversations and debate, performances, storytelling, dance and comedy, workshops and film.

The application should be around 500 words long and include: i) Title, ii) Format, iii) Presenters names, iv) Contact email & phone number, v) Educational institution and subject being studied.

The advisory group will review all applications and will let you know if you have been selected by 25 July 2016.

From the applications received five people will be selected who, in addition to presenting at Medicine Unboxed: Students, will work with Medicine Unboxed as interns for two days helping to set up and support the delivery of Medicine Unboxed: Wonder. Interns are provided with accommodation and travel expenses and are invited to a creative writing workshop with Professor Tiffany Atkinson.


Applications
sam@medicineunboxed.org

Enquiries
lucy@medicineunboxed.org
sarah@medicineunboxed.org

Follow
@MUstudents

Explore https://www.facebook.com/groups/175072369272118/?fref=ts

http://mustudents.wordpress.com 

http://medicineunboxed.org

Khalid Ali: Film review – A political leader declares war on stroke

2 Mar, 16 | by Ayesha Ahmad

A political leader declares war on stroke  

Churchill’s secret- ITV drama- shown on Sunday 28th February 2016

                               Directed by Charles Sturridge 5* 

                                Released on DVD later in 2016

                               

Stroke back in 50’s England was not the well-characterized disease we know so much about today with effective interventions such as thrombolysis that can save lives. In a fascinating account of what the director Charles Sturridge describes as ‘secret history’, the ITV drama tells the story of Winston Churchill’s stroke in the summer of 1953. Churchill’s wife, Lady Clementine, and the Conservative Party conspired to hide the news of his stroke by keeping him out of the public eye for three months to recover. That well-kept secret became public knowledge when his private doctor Lord Moran published his autobiography ‘The struggle for survival’ years later (1). The book was faced by a storm of criticism as a breach of confidentiality and an exploitation of doctor- patient relationship by Lord Moran.

more…

Screening of ‘Radiator’

26 Feb, 16 | by cquigley

 

Described by the Guardian as ‘an absorbing portrait of ageing and unhappiness’, Radiator has been the recipient of a number of nominations and awards at national and international film festivals.

There will be a special screening of the film on March 4th, followed by Q&A with Tom Browne (writer and director) and Daniel Cerqueira (co-writer and actor).

Read a review of Radiator by Dr Khalid Ali on this blog.

 

All welcome.

Friday March 4th, 7.30pm

Venue : POSK, The Polish Culture Centre, 238 King Street, Hammersmith, London W6 ORF

Sapphire Room, 2nd Floor

Nearest Tube Station :Ravenscourt Park

 

 

 

 

 

 

Khalid Ali and Jane Peek: Cinema of splendour: Reporting from Dubai international Film Festival (DIFF) 2015

29 Jan, 16 | by Ayesha Ahmad

Cinema of splendour: Reporting from Dubai international Film Festival (DIFF) 2015

Dr Khalid Ali, Screening Room Editor

When I visited Dubai International Film Festival (DIFF https://www.dubaifilmfest.com/) for the first time in December 2015, I was not expecting to find so many films exploring health and well-being from all over the world. The variety of films on offer explored contemporary issues such as euthanasia and the right to die (Last cab to Darwin, directed by Jeremy Sims, Australia 2015), terminal illness (Dry, hot summers, directed by Sherif El Bendary, Egypt,2015, http://blogs.bmj.com/medical-humanities/2016/01/04/khalid-ali-taxi-ride-to-eternity-review-of-dry-hot-summers/), doctor-patient relationships (Waiting, directed by Anu Menon, India 2015), sports medicine and its ethically challenging medico-legal implications (Concussion, directed by Peter Landesman, USA 2015), and the aftermath of an epidemic of sleeping sickness (Cemetery of splendour, directed by Apichatpong Weerasethakul, Thailand 2015).

Old age and its colourful diversity of frailty alongside resilience, health and disease, creativity and cognitive decline were also present in ‘The lady in the van, directed by Nicholas Hytner, UK 2015’ and ‘Youth, directed by Paolo Sorrentino, Italy 2015’. I was once again reminded that arts and films in particular have a lot more to offer. By portraying artistically the lived experience of human suffering, healthcare professionals can begin to understand the determinants of physical and mental well-being and subsequently deliver dignified compassionate care. Films are no longer entertainment vehicles only; they do have a ‘healing power’. An elegant example of such ground-breaking ability of ‘healing through understanding’ came from the film ’23 Kilometres’ that will be reviewed here.

more…

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