Soundings Competition Winners

Thanks to everyone who entered our soundings competition. After much deliberation and debate, here are the four winners and examples of their work...

The global war on the overlooked terrorist

As the United States twitches at the mere sniff of a terrorist threat, some observers may note a dark irony in the fact that most of the weapons it is particularly afraid of have been developed by its own department of "defense."

Weapons research, however, still goes on. It is a simple logic that says "Hey boys, if we don't invent it the baddies can't steal it," but none the less one that seems to have escaped the world's leading military minds.

Perhaps unsurprising then, that while President Bush pours billions into a missile defence system to protect himself from the misuse of his predecessors' legacy, he refuses to close the door on a much more intimate threat to his countrymen.

There is a terrorist that is threatening the fabric not only of the United States but of humanity as a whole. A terrorist that enters its host silently and lies, inconspicuously consolidating its position, for 10 or more years, before launching its attack. By targeting the body's immune system, HIV performs the microbiological equivalent of flying hijacked aircraft into the Pentagon, destroying the very machinery that we have developed to counter such attacks.

No weapon yet exists to defeat this discreet invader, and the Centers for Disease Control and Prevention in Atlanta estimates that almost one million people in the United States alone may already be infected. By this calculation HIV could exact a death toll over 300 times greater than that of September's attacks on the World Trade Center.

This chilling statistic includes only those victims in the United States and only those who are already infected. The big picture is much, much worse.

Along with Somalia, which doesn't officially have a government, the United States is the only country in the world not to have ratified the United Nations convention on the rights of the child. Why? Because its clause regarding the provision of reproductive health services and sex education is deemed immoral by those bastions of integrity on Capitol Hill.

It is considered necessary to learn of the dangers of using an automobile and how those dangers may be minimised before a licence to operate one can be issued. Surely then education regarding safe and appropriate use of the machine we were all born within, our own bodies, is a basic human right. A right that America, along with the rest of us, can ill afford to ignore.

And so it is that every day in classrooms across America children pledge allegiance to their flag, while their government persists in denying them access to a treaty designed to guarantee them the liberty and justice for which that flag is supposed to stand. Americans, as Bill Bryson wittily informs us, do not get irony. Perhaps its time someone gave their leaders a lesson.

Ben Lawton
groovybenji@yahoo.com

Competitive streak...

Now I, as much as the next medical student, love a good bit of healthy competition--it's part and parcel of medical student life. It does not surprise me that this trend continues into the professional world. A recent experience made me realise, however, that such interdoctor competition can be something much more sinister indeed.

My student rotation was invited to a multidisciplinary case review meeting. I have to be perfectly honest and admit I filtered out most of what was being said--the retro 1960s light fittings on the roof proving to be too much of a distraction. When the floor was opened for questioning my attention was quickly snapped back as the room erupted into a frenzy of outwitting put downs and insults. There seemed to be some unspoken rule that the aim was to make every colleague look as completely inept and stupid as possible. Ten points for a clinical flaw, 20 for having a paper to contradict an opinion, 30 points if you could outdo someone senior to you, and 100 points if blood was shed. To make matters worse a group of specialist registrars who had formed a splinter faction at the back of the room quite audibly generated a stream of insults about the various contributors. Instead of a group of trained professionals, I felt I had woken up in some sort of bad reality TV show that drove people to annihilate each other for the grand prize of academic superiority--"Jerry, I'm smarter than my boss and not afraid to tell him!"

I pride myself in being part of a reasonably amicable year, and the very thought that some day I may have to be downright nasty all for the sake of a patient centred case review is very disturbing. I feel I'm not quite prepared to exit this merry world in a blazing row over a "query lumbar puncture." If so, I may as well just cut off all friendships now and stock up on ammo.

How then do we find a balance between healthy professional competition and nuclear fallout? Surely, we very progressive medical students can redress this problem? Group hug at the end of the meeting? All sit in a circle and hold hands? No, surely just generate an environment where everyone has a bit of mutual respect for one another. Take a step back and realise that there is a bad academic place where you can take yourself just a bit too seriously.

Thomas Hanna fourth year medical student, Queen's University, Belfast
thomas2910@hotmail.com

What do nurses really think of medical students?

Have you ever wondered what nurses really think of medical students? A senior nurse and I recently had a conversation about this. We realised that the trouble with the two groups is that their relationship is peppered with rumours, lies, and deceit. We hear that they hate us, that they just became nurses so that they could marry us (well the boys, anyway), that the sight of a medical student on their ward ruins their whole day, and so on.

Out of interest, the nurse and I decided that, just for fun, we would carry out a brief questionnaire on the nurses in the hospital in which we were both based. We asked the question: "If I said the words 'medical student' to you, what is the first thing that comes into your head?"

The answers were many and varied. Around 17% related to our remarkable youth (usually the more senior staff) but the vast majority (62%) related to behaviour.

Answers such as "always in the way" and "no common sense," which students might expect, were actually quite rare (2% of responders). More responses related to confidence levels, but no overriding consistency was shown as responses ranged from "shy" to "cocky." Responses concerning enthusiasm were also quite common, but again, the range was vast--everything from "very keen" to "Do they actually want to do anything?"

A few fulfilled the "Nurses are out to marry doctors," stereotype, but this was a mere 3%. Replies in this category included both "gorgeous" and "sexy," but they were counterbalanced with the same percentage commenting that medical students were "stupid."

The responses that I believe are the most amusing are listed below. I'm sure that everyone can relate to these.

• They can never find the consultant
• Obsessed with patient notes
• Always asking where they can put their bags
• Lapdogs to consultants

No one response could have been construed to represent a majority view, although it is obvious that student behaviour is the main factor affecting people's opinions. It's still undeniable that nurses are the people that are in control of the wards, so be nice to them and they will be nice to you (it's like putting in good words with the consultants who will give you better marks and references rather than others).

The most important comment that was made I think should be placed at the end--even though only one person made it: "Just make sure that you don't go through 'the change' when you're a junior doctor. Stay nice--don't turn into a consultant that everyone hates--us, the students, and the patients."

Sonali Dutta fourth year medical student, Newcastle-upon-Tyne
S.T.Dutta@newcastle.ac.uk

The right way to do things?

My name is Marianne, and I'm left handed. "Well, so what?" I hear you ask. "You're unlikely to be burnt at the stake for being a witch these days, and I've heard it can be quite an advantage when playing cricket. Besides, you're only a second year. Surely it doesn't matter which hand you use to write up your biochemistry notes?"

Well you'd be right, up to a point, although I'll have to take your word for it about the cricket, but I am a second year on an all singing, all dancing, all integrated course, which means that just occasionally we are taught to test a few cranial nerves or elicit the odd reflex. And herein lies the problem.

"I don't mind which side you do it from," said the fourth year student teaching us catheterisation. "But lots of consultants will, and anyway, some of the beds are against the wall." Of course. The beds are against the wall. And why are they never against the other wall? Is it some kind of hospital policy? "Yes, I know there's a bed shaped space there, but we couldn't possibly put Mr Smith in it because then he'd be against the wrong wall." Needless to say, my attempt at catheterising the rubber model was not a resounding success--well you try doing it with your hands crossed.

Mention to anyone who is trying to teach you something that you are not, actually, right handed, and they will generally look at you for several seconds in a panicked kind of way, as though you've just announced that, from now on, you will communicate only in medieval French. They will then take the implement they've been using, be it a tennis racket or a tendon hammer, and attempt to use it in their own left hand, while looking rather confused and muttering, "Now if I normally do it like this I need to turn it round and... oh bugger, that's not right." Things can then go one of two ways: your instructor will either say "Well, you get the general idea, I'm sure you can work it out," and disappear in search of some normal people, or will smile sympathetically and say "Gosh, yes, it is awkward, isn't it?"

Of course, I don't know yet how many doctors really mind what side you examine the patient from and how many don't care so long as you don't drop things or bump into the furniture. Obviously I'm hoping that the latter predominate, but if things get too bad I could always start a support group. We are in a minority after all. Alternatively, I'm sure it's not too late to take up cricket.

Marianne Maer second year medical student, St George's Hospital Medical School, London
ms004688@sghms.ac.uk