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OXFORD HIGH SCHOOL
VOLUME TWO | MEDICINE AND DENTISTRY
Packed full of:
Q&A's
Days in the Life of
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SHREYA VERMA AND
GABRIELLA YEJU KIM
Q&A
p ro j e ct. On fi n i sh i n g th i s I re -
e n te re d th e 3 rd ye a r o f me d i ca l
sch o o l a n d co mp l e te d my me d i ca l
d e g re e i n 2 0 1 1 . I a p p l i e d fo r
WRITTEN BY SPECIALIST a ca d e mi c fo u n d a ti o n p ro g ra mme s a s
REGISTRAR IN GERIATRIC I w a n te d to g a i n mo re e xp e ri e n ce o f
MEDICINE AND OHS ALUMNA me d i ca l re se a rch , a n d so I a cce p te d
DR JESSICA RUDNAY
a j o b i n Oxfo rd fo r my fo u n d a ti o n
Q: WHY DID YOU CHOOSE ye a rs. Afte r d o i n g va ri o u s cl i n i ca l
MEDICINE?
ro ta ti o n s i n cl u d i n g g e n e ra l me d i ci n e ,
g e n e ra l su rg e ry a n d A&E, I sta rte d a
I h a v e a l w a ys w a n te d to w o r k w i th
l a b re se a rch p ro j e ct a t th e Oxfo rd
p e o p l e a n d d o s o m e th i n g th a t w o u l d
C e n tre fo r D i a b e te s a n d
a l l o w m e to m a k e a m e a n i n g fu l
En d o cri n o l o g y i n my fi n a l ro ta ti o n o f
c o n tr i b u ti o n to o th e r s ’ l i ve s . I a l s o
FY2 . R a th e r th a n a p p l y fo r my n e xt
w a n te d to b e c h a l l e n g e d
tra i n i n g j o b a fte r FY2 I to o k a ye a r
a c a d e m i c a l l y/i n te l l e ctu a l l y , a n d to
o u t to co n ti n u e so me re se a rch a n d
h a v e a l e v e l o f r e s p o n si b i l i ty w h i l st
d o l o cu m w o rk. I a l so to o k a mu ch -
h a v i n g th e o p p o r tu n i ty to w o r k i n a
n e e d e d b re a k a n d w e n t tra ve l l i n g fo r
te a m a n d l e a r n fr o m o th e r s . I w a n te d
3 mo n th s! I th e n to o k u p a se n i o r
a ca r e e r th a t w o u l d o p e n d o o r s to a
h o u se o ffi ce r j o b a s a co re me d i ci n e
m u l ti tu d e o f o p p o r tu n i ti e s a n d
tra i n e e w o rki n g i n h o sp i ta l me d i ci n e .
d i ffe r e n t p a th s , w h e r e n o tw o d a ys
Afte r co mp l e ti n g 2 ye a rs o f th i s I
w e r e th e s a m e . M e d i ci n e s e e m e d to
a p p l i e d fo r a sp e ci a l i st p o st a n d I
fi t th e b i l l !
a m n o w i n my 4 th ye a r o f b e i n g a
Q:WHAT STEPS DID YOU TAKE TO
me d i ca l re g i stra r ro ta ti n g a ro u n d
GET TO WHERE YOU ARE NOW? h o sp i ta l s i n th e Th a me s Va l l e y a re a .
I s ta r te d m e d i c a l s ch o o l a t th e Q: WHAT DID YOU CHOOSE TO
U n i v e r s i ty o f Ed i n b u r g h i n 2 0 0 5 SPECIALISE IN AND WHY?
s tr a i g h t a fte r fi n i s h i n g s ch o o l th a t
y e a r . I d i d 2 ye a r s o f m a i n l y I ch o se to sp e ci a l i se i n Ge ri a tri c
p r e c l i n i c a l m e d i ci n e i n te g r a te d w i th Me d i ci n e w i th Ge n e ra l Me d i ci n e . I
s o m e b a s i c c l i n i c a l l e a r n i n g b e fo r e a l w a ys kn e w I w a n te d to w o rk i n a
d o i n g a n i n te r c a l a te d d e g r e e i n me d i ca l sp e ci a l ty ra th e r th a n a n y
Ph y s i o l o g y . Th i s i n vo l v e d j o i n i n g o th e r a re a su ch a s su rg e ry o r
u n d e r g r a d u a te b i o l o g i ca l s ci e n ce s g e n e ra l p ra cti ce fo r e xa mp l e . I l o ve
s tu d e n ts i n th e i r fi n a l ye a r a n d my sp e ci a l ty a s i t p u ts th e p a ti e n t
u n d e r ta k i n g sc i e n ti fi c m o d u l e s ri g h t a t th e ce n tre o f tru l y h o l i sti c
fo l l o w e d b y a d i ss e r ta ti o n r e se a r ch ca re a n d re q u i re s u s to u n d e rsta n d
01e xa ctl y w h a t o u r p a ti e n ts’ p ri o ri ti e s Q: WHAT HAVE BEEN SOME OF
a re . Ou r p a ti e n ts a re e xtre me l y YOUR WORST EXPERIENCES AS A
co mp l e x w h i ch cre a te s ch a l l e n g e s i n DOCTOR?
d i a g n o si s a n d ma n a g e me n t, b u t th i s
Th e p re ssu re a n d stre ss I h a ve b e e n
ma ke s i t a l l th e mo re re w a rd i n g .
p u t u n d e r h a s b e e n h a rd to co p e
Th e re a re a l so ma n y ca re e r p a th s to
wi th a t ti me s. Th e re h a ve b e e n
ta ke a s i t i s a b ro a d sp e ci a l ty
sh i fts a t wo rk wh e re I’ ve h a d to try
e n co mp a ssi n g se ve ra l
to j u g g l e se ve ra l e me rg e n ci e s a t
su b sp e ci a l ti e s w h i ch ma ke s fo r a n
o n ce a n d th e re h a ve b e e n ti me s
i n te re sti n g a n d va ri e d ca re e r.
wh e n I’ ve n o t kn o wn a l l th e a n swe rs
a n d n o t h a d so me o n e mo re se n i o r
Q: HOW IS YOUR WORK-LIFE
BALANCE? o n si te to h e l p me . As I h a ve g a i n e d
mo re e xp e ri e n ce I h a ve l e a rn t to
Th e n a tu re o f th e ca re e r me a n s th a t ma n a g e th e se si tu a ti o n s b e tte r, b u t
th e re w i l l b e ma n y ti me s w h e n w o rk wi th th i s e xp e ri e n ce co me s mo re
co me s b e fo re yo u r p e rso n a l l i fe . re sp o n si b i l i ty wh i ch p re se n ts n e w
Th e re w i l l b e mi sse d C h ri stma se s, ch a l l e n g e s. Wh e n p a ti e n ts d o n ’ t g e t
b i rth d a ys, w e d d i n g s e tc. It ca n b e b e tte r i t ca n b e e a sy to ru mi n a te
h a rd to l e a ve o n ti me a n d i t ca n b e o ve r wh a t yo u co u l d h a ve d o n e
d i ffi cu l t to l e a ve w o rk a t w o rk. d i ffe re n tl y, o r wh e th e r so me th i n g
I h a ve a cce p te d th a t th i s i s a p a rt o f yo u d i d o r d i d n ’ t d o co n tri b u te d to a
th e j o b , b u t o ve r th e ye a rs I h a ve d e a th o r a b a d o u tco me . I d o n ’ t th i n k
l e a rn t h o w to p ri o ri ti se w h i l st a t w o rk yo u ’ d b e a g o o d d o cto r i f yo u d i d n ’ t
a n d h a n d o ve r to co l l e a g u e s w h a t I h a ve th e se th o u g h t p ro ce sse s, b u t i t
ca n n o t d o myse l f. A ca re e r i n ca n b e h a rd a t ti me s n o t to l e t th e m
co n su me yo u r ti me a wa y fro m wo rk.
me d i ci n e me a n s a cce p ti n g th a t th e re
It’ s i mp o rta n t to h a ve p e o p l e cl o se
w i l l b e co n ti n u o u s l e a rn i n g a n d
to yo u to d e b ri e f wi th – l u cki l y, I
e xa ms. Th i s me a n s stu d yi n g d u ri n g
h a ve so me b ri l l i a n t co l l e a g u e s wh o
fre e ti me a n d so me p e ri o d s o f
a re a l so g re a t fri e n d s a n d I kn o w I
i n te n se l y h a rd w o rk. I h a ve a l w a ys
ca n a l wa ys co u n t o n th e m, ta l k
kn o w n th a t I h a ve u n d e rta ke n a
th ro u g h a n y wo rri e s o r d i ffi cu l t
vo ca ti o n a n d I ca n n o t si mp l y “cl o ck
experiences I have.
i n a n d cl o ck o u t” o f w o rk. L u cki l y my
fri e n d s a n d fa mi l y u n d e rsta n d th i s,
Th e NHS h a s b e e n u n d e r si g n i fi ca n t
a n d w o rki n g h a rd ma ke s me
stra i n o ve r th e l a st fe w ye a rs wh i ch
a p p re ci a te th e ti me I d o sp e n d w i th
h a s me a n t th e re h a ve b e e n ti me s
th e m.
wh e n I’ ve fe l t u n a b l e to p ro vi d e th e
sta n d a rd o f ca re I’ d l i ke to p ro vi d e .
Wo rki n g wi th i n a syste m l i ke th i s
02a n d b e i n g u n a b l e to ch a n g e i t h a s m e d i c i n e a n d m a ki n g su r e th a t y o u
b e e n i n cre d i b l y h a rd a t ti me s. ca n sh o w yo u p o sse ss th e se
th r o u g h yo u r e x tr a - cu r r i cu l a r
Q: WHAT HAVE BEEN SOME OF a cti vi ti e s, w o r k e xp e r i e n ce a n d so
YOUR BEST EXPERIENCES AS A o n i s k e y. Evi d e n ce e ve r y c l a i m yo u
DOCTOR? m a ke a b o u t yo u r se l f. Yo u r
e xp e r i e n ce s d o n o t h a ve to b e
Ofte n th e mo st re w a rd i n g th i n g s a re e xtr a o r d i n a r y , th e y j u st h a v e to
th e sma l l e st th i n g s. H a vi n g a l o n g d e m o n s tr a te co m m i tm e n t a n d
co n ve rsa ti o n w i th a p a ti e n t o r th e i r su i ta b i l i ty to th e c a r e e r p a th th a t
fa mi l y to i n vo l ve th e m a n d u p d a te yo u a r e ch o o si n g .
th e m o n th e i r ca re , w o rki n g
cl o se l y w i th d i ffe re n t h e a l th ca re Q· WHAT IS ONE PIECE OF ADVICE
p ro fe ssi o n a l s to sa fe l y d i sch a rg e a YOU WOULD GIVE TO ASPIRING
p a ti e n t h o me , ma ki n g a d j u stme n ts MEDICS AROUND THE SCHOOL?
a n d re fe rra l s to co mmu n i ty se rvi ce s
to e n a b l e a n e l d e rl y p a ti e n t to sta y M a ke su r e yo u fi n d o u t a s m u ch a s
l i vi n g i n th e i r o w n h o me . Al th o u g h i t yo u ca n a b o u t a ca r e e r i n m e d i ci n e
ma y so u n d o d d , o n e o f th e mo st a n d b e tr u e to yo u r se l f w h e n
re w a rd i n g th i n g s i s ma ki n g su re d e ci d i n g i f i t i s th e p a th fo r yo u .
p a ti e n ts w h o a re d yi n g h a ve a D o n ’ t d o i t b e ca u s e yo u fe e l yo u
d i g n i fi e d a n d co mfo rta b l e d e a th . I o u g h t to o r b e c a u se th e i d e a
h a ve b e e n th a n ke d b y fa mi l i e s fo r a p p e a l s – k n o w th e r e a l i ti e s! On ce
th i s ma n y mo re ti me s th a n I h a ve yo u a r e su r e o f yo u r d e ci si o n , d o n ’ t
b e e n th a n ke d fo r sa vi n g l i ve s. b e a fr a i d to g o a fte r w h a t yo u w a n t.
Be p r o a c ti ve a n d a sk fo r
Q: WHAT WOULD YOUR TOP TIPS o p p o r tu n i ti e s . Th e w o r s t th a t ca n
FOR THE APPLICATION PROCESS h a p p e n i s s o m e o n e sa ys n o !
BE?
Yo u r a p p l i ca ti o n sh o u l d b e
u n d e rp i n n e d b y a g e n u i n e d e si re to
u n d e rsta n d th e re a l i ti e s o f w o rki n g
a s a d o cto r a n d h o w th e N H S,
me d i ca l re se a rch , e th i cs, p u b l i c
h e a l th e tc w o rks. If yo u d o th i s a s
o p p o se d to tryi n g to “ti ck b o xe s”, i t
w i l l sta n d o u t o n yo u r p e rso n a l
sta te me n t a n d a t th e i n te rvi e w .
Id e n ti fyi n g th e ke y a ttri b u te s a n d
ski l l s re q u i re d fo r a ca re e r i n
03progeria: a consequence of
protein accumulation
WRITTEN BY YEAR 12 STUDENT SHREYA VERMA
Th e n a me Pro g e ri a w a s d e ri ve d fro m th e Gre e k w o rd ‘ p ro ’
me a n i n g b e fo re a n d ‘ g e ra s’ me a n i n g o l d a g e , w h i ch p e rfe ctl y
su ms u p th i s d i se a se . It’ s a ra re g e n e ti c d i so rd e r, a l so
kn o w n a s H u tch i n so n Gi l fo rd syn d ro me , a n d ca u se s th e
p re ma tu re a g e i n g o f ch i l d re n , o fte n sta rti n g w i th i n th e fi rst
tw o ye a rs o f th e i r l i ve s a n d p ro g re ssi ve l y w o rse n i n g .
Th e re fo re , th e se ch i l d re n fa ce ma n y p ro b l e ms i n cl u d i n g
o ste o p o ro si s a n d ca rd i o va scu l a r d i se a se s a t a ve ry yo u n g
a g e , typ i ca l l y d yi n g a t th e a g e o f 1 3 .
Si mi l a r to o th e r p ro g re ssi ve d i se a se s su ch a s Al zh e i me r’ s, Pro g e ri a i s
ca u se d d u e to th e a ccu mu l a ti o n o f a sp e ci fi c p ro te i n . Th i s p ro te i n i n th e
ca se o f Pro g e ri a i s ca l l e d p ro g e ri n a n d g a th e rs o n th e n u cl e a r e n ve l o p e ,
w h i ch i s a ca si n g th a t su rro u n d s o u r ma i n g e n e ti c i n fo rma ti o n i n th e
n u cl e u s o f th e ce l l a n d i s e sse n ti a l to su p p o rt i t. Acco rd i n g l y, w h e n p ro te i n
b u i l d s u p th e re , th e n u cl e a r e n ve l o p e i s u n a b l e to ma i n ta i n th e ce l l ca u si n g
i t to d i e p re ma tu re l y. Th i s p ro ce ss i s ca l l e d n u cl e a r b l e b b i n g . Al th o u g h
sci e n ti sts sti l l h a ve n ’ t d i sco ve re d w h y th i s l e a d s to p re ma tu re a g e i n g , a
p a tte rn i s ce rta i n l y p re se n t b e tw e e n d e g e n e ra ti ve d i se a se s a n d th e
a ccu mu l a ti o n o f a p ro te i n a s th e ro o t p ro b l e m. Th e ca u se o f th i s p ro te i n
g a th e ri n g i n Pro g e ri a i s a mu ta ti o n i n th e L MN A g e n e w h i ch se q u e n ce s fo r
p ro g e ri n i n ste a d o f a p ro te i n ca l l e d l a mi n A. Th i s me a n s th a t th e e n zyme
th a t w o u l d u su a l l y fa ci l i ta te th e p ro d u cti o n o f th e l a mi n A p ro te i n ca n n o
l o n g e r re co g n i se i t, so p ro g e ri n a ccu mu l a te s i n i ts p l a ce .
As th e d i se a se i s ca u se d b y a mu ta ti o n , th e mo st e ffe cti ve cu re fo r i t w o u l d
b e th e u se o f a g e n e e d i ti n g to o l , su ch a s C R ISPR -ca s9 to ch a n g e th e
g e n e se q u e n ce . Th i s h a s b e e n te ste d i n mi ce w i th Pro g e ri a , a n d i t re su l te d
i n i n cre a se d l o n g e vi ty, b u t i s fa r fro m b e i n g a p p ro ve d fo r u se i n h u ma n s.
H o w e ve r, a d ru g fo r Pro g e ri a ca l l e d L o n a fa rn i b h a s b e e n a p p ro ve d ve ry
re ce n tl y a n d cl a i ms to sl o w th e p ro g re ssi o n o f th e d i se a se . It w o rks b y
i n h i b i ti n g th e e n zyme th a t fa ci l i ta te s th e p ro d u cti o n o f th e p ro te i n p ro g e ri n
a n d so p o te n ti a l l y p re ve n ti n g th e p ro te i n fro m b u i l d i n g u p a l o n g th e n u cl e a r
e n ve l o p e . U n fo rtu n a te l y, th i s d ru g i s n o t a cu re b u t co u l d ce rta i n l y a ct a s a
p o ssi b l e ste p to w a rd s fi n d i n g o n e .
04Living the life a l l o f th e d i ffe re n t fa ce ts o f
Me d i ci n e a n d i t i s i mp o rta n t to n o t
of a cl o se yo u rse l f o ff to th e se to o so o n .
It a l so l e d to so me sl e e p l e ss n i g h ts
neurologist a s w h e n a l l yo u r fri e n d s kn o w th a t
yo u w a n t to b e a N e u ro l o g i st, yo u
re a l l y d o n e e d to e n su re yo u
WRITTEN BY CONSULTANT b e co me o n e !
NEUROLOGIST DR ARJUNE SEN
Afte r Me d i ca l Sch o o l , I d i d Ju n i o r
A n e u r o l o g i s t’ s l i fe fo r m e ?
Me d i ca l tra i n i n g i n Oxfo rd a n d
'Pe r h a p s th e th i n g th e b r a i n i s Bi rmi n g h a m b e fo re co mp l e ti n g
l e a s t d e s i g n e d to d o i s th i n k h o w ‘ H o u se Jo b s’ i n L o n d o n . I fi rml y
th e b r a i n w o r k s,’ w a s a p h r a s e o n e b e l i e ve th a t i f yo u a re g o i n g to b e
o f m y s u p e r v i so r s, a ce r ta i n Si r g o o d a t a n y su b -sp e ci a l i ty, yo u
C o l i n Bl a k e m o r e , to l d m e v e r y n e e d a n e xce l l e n t g ro u n d i n g i n th e
e a r l y i n m y U n i ve r s i ty l i fe . It h a s b a si cs. In p a rti cu l a r w o rki n g o n th e
s tu ck w i th m e e v e r s i n c e b e c a u se , i n te n si ve ca re u n i t a t St Th o ma s’ s
w h i l e s u r e l y tr u e , th e H o sp i ta l ta u g h t me a l o t a b o u t
c o r o l l a r y ,‘ Wo r k i n g o u t h o w th e cri ti ca l ca re me d i ci n e th a t i s
b r a i n w o r k s i s th e m o st i n te r e s ti n g i n va l u a b l e to d a y. I th e n w e n t o n to
th i n g y o u r b r a i n c a n d o ,’ m u st a l s o co mp l e te a Ph D a t Qu e e n Sq u a re
a p p l y . It i s a p r i n ci p l e th a t s ti l l a n d w o rke d o n tryi n g to u n d e rsta n d
guides me. th e mo l e cu l a r b a si s o f n e u ro n a l l o ss
i n e p i l e p sy. I w a s l u cky a n d th e Ph D
I c o m p l e te d M e d i c a l Sc h o o l w e n t w e l l , l e a d i n g to se ve ra l
tr a i n i n g a t C o r p u s C h r i s ti C o l l e g e , i n te re sti n g o p p o rtu n i ti e s, so me o f
Ox fo r d a n d k n e w b y th e e n d o f m y w h i ch w e re re a l i se d ma n y ye a rs
fi r s t y e a r th a t I w a n te d to b e a n l a te r.
Ac a d e m i c N e u r o l o g i s t. Th i s w a s
m a i n l y o w i n g to a p l a ce m e n t I d i d I sta ye d i n L o n d o n fo r H i g h e r
i n m y fi r s t s u m m e r w i th Pr o fe ss o r N e u ro l o g y tra i n i n g a n d w o rke d a t
Sh o r v o n a n d h i s Ep i l e p sy Th e R o ya l L o n d o n H o sp i ta l , Qu e e n ’ s
R e s e a r c h Gr o u p a t Th e N a ti o n a l H o sp i ta l , R o mfo rd . I th e n w e n t o u t
H o s p i ta l fo r N e u r o l o g y a n d to Syd n e y to co mp l e te a n Ep i l e p sy
N e u r o s u r g e r y , Qu e e n Sq u a r e , Fe l l o w sh i p . Th i s, co u p l e d w i th my
L o n d o n . Wh i l e th i s m e a n t g o a l s e l e cti ve i n Va n u a tu a s a me d i ca l
were very clear, I am not sure I stu d e n t, w a s p e rh a p s th e b e st p a rt
w o u l d r e c o m m e n d d e c i d i n g so o f my e n ti re me d i ca l tra i n i n g .
e a r l y a s th e r e i s h u g e i n te r e s t i n Wo rki n g i n d i ffe re n t h e a l th ca re
05s y s te m s , h a v i n g to e sta b l i sh th o se i n d i vi d u a l s, 8 0 % h a ve n o
y o u r s e l f i n a n o th e r co u n tr y , l e a r n i n g a cce ss to me d i ca ti o n . Ye t, a n ti -
fr o m d i ffe r e n t se ts o f p a ti e n ts i s se i zu re d ru g s ca n co st l e ss th a n
b r i l l i a n t a n d e s se n ti a l . o n e p o u n d p e r mo n th . D i sp a ri ty i n
h e a l th ca re ca n b e sh o cki n g a n d th i s
M y w o r k i n Oxfo r d i s sp l i t b e tw e e n a p p l i e s e ve n i n th e U n i te d Ki n g d o m,
c l i n i c a l c o m m i tm e n ts ( a r o u n d 6 0 % ) so w e a l w a ys try a n d b ri n g l e a rn i n g
a n d a c a d e m i a ( 4 0 % ) . I fo u n d e d a n d h o me to h e l p h a rd -to -re a ch
s ti l l l e a d th e Oxfo r d Ep i l e p s y co mmu n i ti e s h e re a s w e l l .
R e s e a r c h Gr o u p . We a r e a
c o l l e c ti v e o f o v e r 4 0 p e o p l e w i th i n My cl i n i ca l ti me i s sp e n t d o i n g
Ox fo r d a n d a r e b e n e fi tte d b y o u tp a ti e n t cl i n i cs, w a rd ro u n d s,
a m a z i n g i n te r n a ti o n a l p l a n n i n g e p i l e p sy su rg e ry a n d
c o l l a b o r a ti o n s. Th e Gr o u p p u b l i sh e s w o rki n g w i th o u r w o n d e rfu l mu l ti -
w i d e l y a n d h a s w o n m u l ti p l e d i sci p l i n a ry te a m. Pe o p l e u se d to
n a ti o n a l a n d i n te r n a ti o n a l a w a r d s . th i n k th a t n e u ro l o g i sts sp e n t a g e s
We w o r k w i th l o c a l c h a r i ti e s, l e a d a ma ki n g co mp l e x d i a g n o se s a n d th e n
h o s t o f i n te r n a ti o n a l p r o j e c ts a n d w e re n o t a b l e to o ffe r a n y
s e t u p th e C o r o n a v i r u s a n d Ep i l e p s y tre a tme n t. Th a t i s n o t th e ca se n o w .
( C OV- E) s tu d y g r o u p to e x a m i n e th e Th e re a re o ve r 3 0 a n ti -se i zu re
d i r e c t a n d i n d i r e c t e ffe cts o f th e me d i ca ti o n s a n d l o ts o f n o n -d ru g
p a n d e m i c o n p e o p l e w i th e p i l e p s y . i n te rve n ti o n s w e ca n co n si d e r.
Th e re h a ve b e e n si mi l a r a d va n ce s
M y p e r s o n a l r e se a r c h i n te r e s ts l i n k i n h e a d a ch e tre a tme n ts, mu l ti p l e
b a c k to w h a t I d i d i n m y d o c to r a te . I scl e ro si s a n d Pa rki n so n ’ s.
s p e c i fi c a l l y l o o k e d a t th e
i n te r s e c ti o n b e tw e e n s e i z u r e s a n d Me d i ci n e , a t i ts h e a rt, re ma i n s a
d e m e n ti a . Fo r e xa m p l e , w e se t u p vo ca ti o n , n o t a j o b . It te n d s to
th e w o r l d ’ s fi r s t tr i a l to se e i f a n a ttra ct l i ke -mi n d e d p e o p l e a n d th e re
a n ti - s e i z u r e d r u g i s a b l e to h e l p i s h u g e ca ma ra d e ri e w i th i n cl i n i ca l
m e m o r y i n p e o p l e w i th Al z h e i m e r ’ s p ra cti ce . We l e a rn w i th o u r p a ti e n ts
d i s e a s e . M o r e r e c e n tl y I h a v e a n d w o rk th ro u g h th i n g s to g e th e r.
b e c o m e v e r y i n vo l v e d i n g l o b a l Th e a ca d e mi c w o rk i n fo rms w h a t w e
h e a l th . Po p u l a ti o n s a r e a g e i n g v e r y d o cl i n i ca l l y a n d , a s d e mo n stra te d
q u i c k l y i n l o w to m i d d l e i n c o m e d u ri n g th e p a n d e mi c, me d i ci n e i s
c o u n tr i e s a n d e p i l e p sy i s m o r e th e ca re e r w h e re yo u w i l l a l w a ys b e
c o m m o n a s yo u b e co m e o l d e r . 8 5 % stu d yi n g , a l w a ys b e l e a rn i n g a n d ,
o f th e 5 0 m i l l i o n p e o p l e w i th h o p e fu l l y, a l w a ys b e ma ki n g a
e p i l e p s y i n th e w o r l d l i v e i n p o si ti ve d i ffe re n ce . So co me o n i n ,
r e s o u r c e p o o r s e tti n g s a n d o f th e co rte x (i n p a rti cu l a r) i s l o ve l y!
06Henrietta
It a cts b y re stri cti n g ch ro mo so me s
fro m sh o rte n i n g th e i r te l o me re s
lacks: the true
a fte r e a ch d i vi si o n o f th e ce l l ;
u l ti ma te l y ma ki n g th e ce l l s i mmo rta l .
unsung hero of Th e re fo re , th e H e L a ce l l l i n e w a s
p e rfe ct fo r sci e n ti sts w h o re q u i re d
science l a rg e sa mp l e si ze s o f g e n e ti ca l l y
i d e n ti ca l ce l l s.
WRITTEN BY YEAR 12 STUDENT Po l i o (p o l i o mye l i ti s) i s a h i g h l y
REBECCA IM
i n fe cti o u s d i se a se w h i ch ca n ca u se
th e d e tri me n ta l co n se q u e n ce o f to ta l
Th e d e fi n i ti o n o f ‘ u n s u n g ’ i s to n o t
p a ra l ysi s, w i th i n a sh o rt sp a n o f
b e ‘ n o ti c e d o r p r a i se d fo r h a r d
work, courage, or great ti me . Th e vi ru s sl o w l y a tta cks
a c h i e v e m e n ts’ . Al th o u g h H e n r i e tta n e rve s i n th e sp i n e a n d b a se o f th e
L a c k s d i d n o t m a ke a c o n s c i o u s b ra i n a n d ca n re su l t i n co mp l e te
c o n tr i b u ti o n , h e r c e l l s p r o ve d to b e i n va si o n o f th e n e rvo u s syste m. In
a h u g e s te p p i n g - s to n e i n to th e 2 0 1 8 , h o w e ve r, th e re w e re o n l y 3 3
g e n e r a ti o n o f m e d i c a l e n d e a v o u r s re p o rte d ca se s o f p o l i o vi ru s, a
th a t e xi s t to d a y . sta g g e ri n g 9 9 % d e cre a se co mp a re d
to 1 9 8 8 . An d w i th j u st 1 i n 2 0 0
In 1 9 5 1 , a t j u st 3 1 ye a r s o l d , i n fe cti o n s ca u si n g i rre ve rsi b l e
H e n r i e tta L a cks , a n Afr i ca n - p a ra l ysi s, th e d i se a se se e ms to b e
Am e r i c a n w o m a n , w a s d i a g n o s e d n e a ri n g co mp l e te e ra d i ca ti o n .
a n d tr e a te d fo r ce r vi c a l ca n ce r a t
th e s e g r e g a te d Jo h n H o p k i n s Th i s n o ti o n sh o u l d b e su rp ri si n g a s
H o s p i ta l . It w a s th e r e th a t d o cto r s th e re i s n o kn o w n tre a tme n t fo r th e
r e m o v e d tw o s a m p l e s o f h e r c e r v i x d i se a se , i n d i ca ti n g th a t th e re w o u l d
w i th o u t h e r co n s e n t, c o m p l e te l y b e a mu ch g re a te r n u mb e r o f ca se s.
d i s r e g a r d i n g p a ti e n t a u to n o m y. H o w e ve r, i t i s a s a re su l t o f a n o w
co mmo n p o l i o va cci n e , th a t
M o s t c e l l s , i n c l u d i n g ca n ce r c e l l s, se ve n te e n mi l l i o n w h o a re w a l ki n g
d o n o t s u r v i ve i n vi tr o . Su r p r i s i n g l y , to d a y a re a b l e to d o so .
th e H e L a ( d e r i v e d fr o m H e n r i e tta
L a c k s ) c e l l l i n e h a d th e a b i l i ty to Wh e n th e va cci n e w a s fi rst
th r i v e a n d m u l ti p l y r a p i d l y o u ts i d e d e ve l o p e d b y Jo n a s Sa l k, i n th e
th e b o d y , a s i t w o u l d i n s i d e th e e a rl y 1 9 5 0 ’ s, i t w a s d i ffi cu l t to b e
b o d y . Th i s a n o m a l y w a s d u e to th e te ste d d u e to th e e xce ssi ve p ri ce o f
e n z y m e te l o m e r a se , w h i ch i s th e ce l l cu l tu re o fte n u se d fo r l a rg e -
u s u a l l y fo u n d i n th e h u m a n e m b r yo . sca l e stu d i e s (rh e su s mo n ke y ce l l s).
07An i d e a l c e l l l i n e fo r te s ti n g th e b a si c h e a l th ca re n o r w e re th e y
v i r u s w o u l d b e su s ce p ti b l e to a w a re o f th e re g u l a r u ti l i sa ti o n o f
p o l i o v i r u s b u t b e a b l e w i th s ta n d i t; h e r ce l l s (u n ti l th e 1 9 7 0 s). Th i s p o o r
th e H e L a c e l l cu l tu r e fu l fi l l e d th e se tre a tme n t th u s d i sp l a ys th e a b se n ce
n e c e s s i ti e s p e r fe c tl y. Th e ce l l s o f re sp e ct th e sci e n ti sts h a d fo r th e
w e r e th e r e fo r e p u t i n to m a s s L a cks h o u se h o l d .
p r o d u c ti o n a n d b y 1 9 5 2 , h a d
a l l o w e d Sa l k to fu l l y te st a n d Su rp ri si n g l y, th e re co n ti n u e s to b e
p r o d u c e h i s va cc i n e . a n e xp l o i ta ti o n o f th e i r p ri va cy
e ve n to th i s d a y. In 2 0 1 3 , Ge rma n
In 2 0 1 9 , th e r e se a r c h i n v o l vi n g sci e n ti sts p u b l i sh e d th e se q u e n ce d
H e L a c e l l s h a s r e a ch e d o ve r g e n o me o f H e L a ce l l s i n a p u b l i c
1 1 0 ,0 0 0 s c i e n ti fi c p u b l i c a ti o n s, d a ta b a se , w i th o u t th e p e rmi ssi o n o f
w h i l e a n e s ti m a te d 5 0 m i l l i o n to n n e s a n y o f th e L a cks fa mi l y. Th i s
o f th e c e l l s e x i st. Th e y h a v e a ffe cte d b o th th e p ri va cy o f
c o n tr i b u te d a s th e u n d e r p i n n i n g o f a H e n ri e tta a n d h e r su rvi vi n g fa mi l y
n u m b e r o f N o b e l Pr i z e w i n n i n g me mb e rs, a s i n fo rma ti o n re g a rd i n g
d i sc o v e r i e s, i n c l u d i n g o n e w h i c h th e i r g e n e ti c tra i ts co u l d h a ve b e e n
p r o v e d th a t H PV c a u s e s ce r v i ca l p u b l i ci se d .
cancer.
So , sh o u l d w e i g n o re th e
H e n r i e tta L a c ks h e r s e l f p a s se d i n a p p ro p ri a te u se o f H e L a ce l l s
a w a y i n 1 9 5 1 , u n a w a r e o f th e b e ca u se o f th e sci e n ti fi c
i n va s i ve h a n d l i n g o f h e r ce l l s th a t b re a kth ro u g h s ca u se d b y re se a rch
w o u l d o c c u r a n d c o n ti n u e d to d o s o o n th e ce l l l i n e , a n d co n se q u e n t
fo r o v e r s i x ty ye a r s fo l l o w i n g h e r l i ve s i t h a s sa ve d ?
d e a th . Al th o u g h d u r i n g th e ti m e o f
h e r p a s s i n g , ta k i n g s a m p l e s fo r N o . Ab so l u te l y n o t.
r e se a r c h w i th o u t p e r m i ss i o n d i d n o t
v i o l a te a n y l e g a l g u i d e l i n e s , o n e In th e fu tu re , w e mu st ma ke a
c o u l d a r g u e th a t h e r d o c to r s w e r e
co n si d e ra b l e e ffo rt to a ckn o w l e d g e
n o t fu l fi l l i n g th e e th i ca l p r i n ci p l e o f
th e i mme n se kn o w l e d g e g a i n e d fro m
‘ a u to n o m y ’ ( s h o w i n g r e s p e c t fo r th e
re se a rch o n th e H e L a ce l l s. By
p a ti e n t a n d th e i r r i g h t to m a k e
re i n fo rci n g e th i ca l p ri n ci p l e s, w e
decisions).
mu st stri ve fo r a fu tu re w h e re a
sto ry si mi l a r to H e n ri e tta L a cks’
Fu r th e r m o r e , w h i l e H e L a ce l l s w e r e
ca n n o t o ccu r a g a i n .
fu e l l i n g th e p r o d u c ti o n o f c o u n tl e ss
m e d i c a l i n n o va ti o n s, H e n r i e tta ’ s
fa m i l y c o u l d n o t a ffo r d a c c e ss to
08Medical news:
TOPIC: DIAGNOSING DEPRESSION FROM EARWAX
C u r r e n tl y , s u b j e c ti ve a s se ss m e n ts a r e u se d b y d o cto r s to
d i a g n o s e m e n ta l h e a l th d i s o r d e r s su ch a s d e p r e s si o n o r a n xi e ty ,
a n d th u s d e ci d e w h e n tr e a tm e n ts su ch a s a n ti d e p r e ss a n t o r
th e r a p y a r e n e ce ss a r y . H o w e v e r , p s ych i a tr i c r e s e a r ch e r s h a ve
d i s c o v e r e d th a t e a r w a x o f a l l th i n g s co u l d p r o vi d e a b e tte r fo r m
of diagnosis.
Th r o u g h e a r w a x d o c to r s m a y b e a b l e to o b se r ve th e p r e se n ce o f th e str e ss
h o r m o n e , c o r ti so l , i n s te a d o f d o i n g th i s th r o u g h th e s a l i va o r b l o o d . Wh e n
te sts a r e c a r r i e d o u t o n s a l i v a o r b l o o d fo r co r ti so l , th e y g i v e a s n a p sh o t o f
th e l e v e l s o f th e h o r m o n e a t th a t ti m e o n l y a n d th e r e fo r e a r e u n r e l i a b l e to
b a se a n e n ti r e d i a g n o si s o r tr e a tm e n t p l a n o n . H o w e ve r , e a r w a x ca n sh o w
h o w l o n g th e c h e m i c a l h a s b e e n th e r e a n d i ts b u i l d u p , a l l o w i n g d o cto r s to
s e e th e p r o g r e ss i o n o r r e g r e ss i o n o f s tr e s s o ve r ti m e , a n d th u s p r o vi d e th e
m o s t e ffe c ti ve fo r m o f th e r a p y a n d r e l i e f.
TOPIC: CRISPR-CAS9 AS THE MOST EFFICIENT GENE EDITING TOOL
Th e C R ISPR - ca s9 to o l i s su p p o s e d l y th e m o s t u n i q u e a n d e ffi ci e n t
e q u i p m e n t th a t h a s b e e n i n tr o d u c e d to th e w o r l d o f g e n e ti c s. It w o r ks d u e to
i ts tw o m a i n co m p o n e n ts: th e e n zy m e ‘ ca s 9 ’ a n d a p i e ce o f ‘ g u i d e R N A’
w h i ch i s a s m a l l se cti o n o f p r e - se q u e n ce d R N A l o ca te d i n a l o n g e r R N A
sc a ffo l d i n g . Th e e n zym e o p e r a te s a l m o st l i k e a p a i r o f sc i ss o r s , w i th th e
a b i l i ty to c u t tw o str a n d s o f D N A s o th a t a se cti o n ca n b e r e m o ve d o r n e w
D N A se q u e n ce s ca n b e a d d e d . M e a n w h i l e , th e ‘ g u i d e R N A’ a ss i sts th i s b y
g u i d i n g th e e n zym e to th e s p e ci fi c l o c a ti o n i n th e g e n o m e th a t n e e d s to b e
e d i te d . Th u s, th i s p a r t o f th e D N A i s s p l i t a n d a m u ta ti o n ca n b e i n tr o d u c e d .
Th e a d va n ce m e n t o f th e n e w C R ISPR - c a s9 te c h n o l o g y i s a h u g e l e a p
n o t o n l y to w a r d s l e a r n i n g m o r e a b o u t o u r g e n o m e , b u t a l s o cr e a ti n g th e
p o te n ti a l to tr e a t m e d i ca l co n d i ti o n s r a n g i n g fr o m ca n c e r to h i g h ch o l e ste r o l .
In te r e s ti n g l y , th e d e ve l o p m e n t o f th i s to o l s te m m e d fr o m b a c te r i a , w h o h a ve
a b u i l t i n g e n e e d i ti n g to o l l i ke C R ISPR - c a s9 th a t th e y u s e to d e fe n d
th e m se l ve s fr o m p a th o g e n s, su ch a s vi r u s e s . M u ch l i ke o u r a n ti b o d y
r e sp o n s e , b a cte r i a u se th e i r ve r si o n o f th e C R ISPR - ca s 9 to o l to cu t o u t a
se cti o n o f th e vi r u s’ s D N A so th a t th e y a r e a b l e to r e c o g n i s e i t fo r th e
fo l l o w i n g ti m e th e y g e t i n fe cte d . C o n se q u e n tl y , th i s sa m e p r o ce s s w a s
a d a p te d b y s ci e n ti sts to cr e a te C R ISPR - c a s9 .
09Q&A
p e o p l e w h o r e a ch si xth fo r m kn o w
w h a t su b j e c ts th e y e n j o y a n d a r e
g o o d a t b u t a s r e g a r d s to a fu tu r e
ca r e e r , l i ke m e b a c k th e n , th e y
h a v e n o i d e a . I th i n k th a t a s yo u n g
WRITTEN BY A GENERAL DENTIST
AND PARENT DR NICOLA a d u l ts y o u s h o u l d n ’ t p u t to o m u c h
BEARSLEY p r e ssu r e o n yo u r se l ve s a n d l i fe w i l l
u n fo l d yo u r o p p o r tu n i ti e s i n i t’ s o w n
ti m e .
Q: WHAT IS THE MOST
CHALLENGING AND REWARDING
PART OF YOUR JOB?
As I a m th e o w n e r o f th e p r a cti ce
th e n th e b u ck sto p s w i th m e ! Th a t
Q: WHAT IS YOUR MAIN SOURCE m e a n s th e m o st ch a l l e n g i n g si d e o f
OF MOTIVATION IN A DENTAL th e j o b i s n o t th e p a ti e n ts o r th e
CAREER? d e n ti s tr y , i t i s i n fa c t m a n a g i n g a
te a m o f d e n ta l ca r e p r o fe ss i o n a l s,
M y g r a n d a d w a s a w e l l r e sp e cte d r e c e p ti o n i sts, h y g i e n i s ts a n d fe l l o w
c h i r o p o d i s t a n d so v i si ts to h i m , i n d e n ti s ts. We a r e a c l o se k n i t b u n c h
m y c h i l d h o o d , u su a l l y i n vo l v e d b u t a s w e w o r k v e r y cl o s e l y
jumping on his chiropody chair and to g e th e r o u r yo u n g e r sta ff fi n d i t
m a r v e l l i n g a t h i s c h i r o p o d y ‘ to o l s’ h a r d to se p a r a te h o m e l i fe fr o m
w h i c h a r e s u r p r i s i n g l y si m i l a r to p r o fe s si o n a l l i fe . Th i s m e a n s th a t a
d e n ta l i n s tr u m e n ts. Al s o m y fa th e r l o t o f m y j o b ca n b e i n vo l v e d i n
w a s a c h e m i s tr y l e c tu r e r i n L e e d s su p p o r ti n g m y sta ff w i th p e r so n a l
a n d s o y o u c a n se e sc i e n c e a n d str e s s, su ch a s r e l a ti o n sh i p u p s
h e a l th ca r e w e r e p r e tty m u c h i n m y a n d d o w n s, d i ffi c u l t ch i l d r e n e tc
b l o o d . I w e n t to a s ta te s ch o o l i n e tc!
Yo r k s h i r e a n d th e ca r e e r s a d vi c e
w a s p r e tty m u c h n o n - e x i ste n t. So I Th e m o st r e w a r d i n g p a r t o f th e j o b
d e c i d e d th a t a s m y b r o th e r w a s i s th e p a ti e n ts . As I h a ve b e e n a t
a p p l y i n g to m e d i ci n e a n d I d i d n ’ t th i s p r a c ti c e fo r 2 5 y e a r s ( h o w
w a n t to c o p y h i m , I p l u m p e d fo r d i d th a t h a p p e n !) m a n y o f m y
d e n ti s tr y ! p a ti e n ts I h a ve k n o w n s i n ce b i r th !
So m e o f m y e l d e r l y p a ti e n ts h a ve
I h a v e to s a y th a t th e r e w a s n e ve r a su ffe r e d l o s s o f a p a r tn e r a n d a s a
b u r n i n g d e s i r e fr o m a y o u n g a g e to d e n ti s t w h o h a s se e n th e m e ve r y 6
b e a d e n ti s t a n d I fe e l th a t m o s t m o n th s I fe e l th a t I h a v e a u n i q u e
10i n s i g h t i n to th e i r l i fe a n d c a n o ffe r ma n a g e me n t a n d u l ti ma te l y ru n n i n g
th e m s o m e fo r m o f s u p p o r t e ve n i f a p ra cti ce o f my o w n . I w a s i n a
i t i s j u s t to r e m i n i sc e a b o u t th e ve ry fo rtu n a te p o si ti o n th a t my
e x p e r i e n c e s th e y h a d to g e th e r . As b o yfri e n d (n o w my h u sb a n d ) w a s
y o u c a n s e e th e r e l a ti o n s h i p w i th a l so a d e n i st. Th i s me a n t th a t w e
th e p a ti e n t i s r e a l l y th e b i g g e s t p a r t co u l d ta ke th e ri sk o f b u yi n g o u r
o f th e j o b a n d th e tr u st i n y o u r o w n p ra cti ce ve ry e a rl y o n a s
p r a c ti c a l s k i l l s o n l y co m e s o n c e y o u h e re ma i n e d i n h i s j o b i n
h a v e g a i n e d th e i r c o n fi d e n ce . N o rth a mp to n e n su ri n g w e h a d a
ste a d y i n co me .
Q: HOW DID YOU GET TO WHERE
YOU ARE NOW? Th e re i s a l w a ys a h u g e ri sk w i th
b u yi n g a p ra cti ce a s th e va l u e o f
I stu d i e d my A l e ve l s a t sch o o l i n
th e p ra cti ce i s n o t o n l y w o rke d o u t
Kn a re sb o ro u g h , N o rth Yo rksh i re .
fro m th e b u i l d i n g a n d co n te n ts b u t
Fro m th e re I w e n t to Bi rmi n g h a m
th e g o o d w i l l o f th e p ra cti ce . Th i s
U n i ve rsi ty to stu d y a Ba ch e l o r i n
me a n s i f th e p a ti e n ts d o n ’ t l i ke yo u
D e n ta l Su rg e ry. Th i s w a s a 5 ye a r
a n d l e a ve th e n yo u r p ra cti ce i s
co u rse a n d u p o n q u a l i fi ca ti o n , b a ck
p re tty mu ch w o rth l e ss. L u cki l y th e y
th e n yo u h a d th e ch o i ce to g o i n to
se e me d to l i ke me a n d n o w o u r
fo u n d a ti o n tra i n i n g (FT) o r stra i g h t
p ra cti ce i n Bo tl e y, Oxfo rd h a s o ve r
i n to a p ra cti ce . I d e ci d e d to g o
8 0 0 0 p a ti e n ts.
stra i g h t i n to p ra cti ce . N o w a d a ys th e
FT e l e me n t i s ma n d a to ry a fte r
q u a l i fi ca ti o n a n d o ffe rs Q: HOW DO YOU MANAGE YOUR
WORK LIFE BALANCE?
p o stg ra d u a te tra i n i n g a s w e l l a s
me n to ri n g d u ri n g yo u r fi rst ye a r o f
I a m i n a ve r y fo r tu n a te p o si ti o n
p ra cti ce .
w h i ch a l l o w s m y w o r k l i fe b a l a n ce
to b e q u i te u n i q u e . Or i g i n a l l y I
My fi rst j o b w a s i n a g e n e ra l
w o r ke d fu l l ti m e a t th e p r a cti ce , b u t
p ra cti ce i n Ba n b u ry. I w a s a t th i s
w h e n I w a s p r e g n a n t w i th m y fi r s t
p ra cti ce fo r 3 ye a rs a n d d u ri n g th a t d a u g h te r m y h u sb a n d d e ci d e d to
ti me I d i d a fu rth e r p o st g ra d u a te l e a ve h i s j o b i n N o r th a m p to n a n d
e xa m w h i ch i n vo l ve d ca se stu d i e s w o r k a t Bo tl e y. Th i s m e a n t th a t h e
a n d sp o tte r te sts (Ye s, I d i d th i s c o ve r e d a l l m y p a ti e n ts d u r i n g m y
vo l u n ta ri l y!). Fro m th i s I g a i n e d m a te r n i ty l e a ve o f 9 m o n th s. Fr o m
so me mo re l e tte rs a fte r my n a me 2 0 0 1 o n w a r d s Pe p e a n d I h a ve
FGD P. s h a r e d th e w o r ki n g w e e k . Eve n
w h e n I h a d a fu r th e r 3 c h i l d r e n I
My ti me w o rki n g i n g e n e ra l p ra cti ce h a d 3 m o n th s o ff fo r m a te r n i ty
h e l p e d me h o n e my ski l l s i n sta ff
11l e a v e a n d th e n r e tu r n e d to p a r t ti m e D e n ti str y i s u n i q u e i n th a t ta ki n g
w o r k i n th e kn o w l e d g e th a t Pe p e ti m e o ff fo r c h i l d r e n d o e s n ’ t a ffe c t
w a s a t h o m e m i n d i n g th e b a b i e s ! I yo u r ca r e e r p r o sp e c ts a s yo u c a n
th i n k w e h a v e b e e n so fo r tu n a te r e tu r n a t th e s a m e l e ve l . Ob vi o u sl y
a n d I k n o w th a t th i s i sn ’ t r e a l l y th e I w o r k i n g e n e r a l p r a cti ce b u t th e r e
n o r m a s I w a s a b l e to h a v e a ve r y i s h u g e sc o p e to s p e ci a l i se a n d /o r
s u cc e s s fu l c a r e e r w h i l st n o t r e a l l y w o r k i n th e h o sp i ta l e n vi r o n m e n t. It
missing out on my children growing i s a c h a l l e n g i n g d e g r e e to g e t o n to
up. a n d th e r e i s sti ff co m p e ti ti o n a s
th e r e i s fo r m a n y vo ca ti o n a l
Q: ANY COMMENTS TO ASPIRING co u r se s, b u t th a t s h o u l d n ’ t p u t yo u
DENTISTS? o ff tr yi n g . On e o f th e g u ys o n m y
co u r se w a s o r i g i n a l l y a
I kn o w th a t m y c h i l d r e n w i l l a l l r o l l g r e e n g r o c e r . H e stu d i e d i n th e
th e i r e y e s a s I co u l d w a x l y r i c a l e ve n i n g to p a ss h i s 3 A l e ve l s a n d
a b o u t d e n ti s tr y a n d I fe a r th e r e g a i n e d a p o si ti o n a t Bi r m i n g h a m
i s n ’ t e n o u g h sp a c e i n y o u r d e n ta l sch o o l… If th a t i sn ’ t i n s p i r i n g
m a g a z i n e ! Wh a t I l i k e th e m o st i s th e n I d o n ’ t kn o w w h a t i s!
th e r e l a ti o n s h i p th a t yo u b u i l d u p
w i th y o u r p a ti e n ts. Pe o p l e c o m e to
m e e v e n w h e n th e y a r e w e l l a n d so
I se e th e m r e g u l a r l y a n d fr o m th e r e
y o u g e t to k n o w p e o p l e c h a r a cte r s ,
e x te n d e d fa m i l i e s e tc. In va r i a b l y a
p a ti e n t w i l l b r i n g i n p h o to s o f th e i r
new grandchildren, children’s
w e d d i n g s e tc .
Dental anxiety during the
pandemic amongst children
WRITTEN BY YEAR 12 STUDENT GABRIELLA KIM
An x i e ty c a n b e th e fe e l i n g o f b u tte r fl i e s ci r cl i n g i n si d e yo u r sto m a ch o r r a p i d
h e a r t b e a ts b u t n e v e r th e l e s s i t i s n o t a n e n j o ya b l e o n e . D e n ta l a n xi e ty i s th e
m o s t c o m m o n a n x i e ty p e o p l e e x p e r i e n ce a n d i t i s n o t su b j e cte d to a c e r ta i n
a g e g r o u p . It i s u su a l l y tr i g g e r e d b y d r i l l i n g n o i se s, n e e d l e s o r j u st th e
12d ental setting itself. So what is dental anxiety like in adolescence? Studies
have shown that 74.1% of childr en suffer from moderate to severe dental
a nxiety and this figure has been proven to have risen due to the ongoin g
pandemic.
W hen dental clinics reopened after the first lockdown, the government
im posed sanitary regimes and social distancing measures, which is thought
t o have provoked anxiety in dental settings, especially for children.
A Polish study on dental anxiety of children demonstrated that under
pandemic related lockdown the fear of pain at the dentist can be further
induced by the stress from the presence of the virus, and also by the
p sychological tension from their guardian who are deciding to leave home
w i th the fear of contracting COVID-19. Also, PPE requires dentists to wear
mas ks and this does not allow children to read facial expressions which is
s i gnificant to building trust with the dentist. Additionally, changes in the
dentist’s tone of voice can make it difficult for them to understand what the
dentist is saying, therefore hindering their interaction.
The study conducted research pre-pandemic
and during the pandemic by asking the
children’s guardians to evaluate their child’s
emotional state by selecting one out of the
six images on the side. 1—calm; 2—
uncertain; 3—reserved, closed and
uncooperative; 4—avoiding; 5—loud; 6—
crying.
The results shown as a bar graph on the left,
are evidence for the changed emotional
state.
The most common symptoms of anxi ety in
children are crying and being
uncommunicative, which are all expressions
that have increased in the study, before and
during COVID-19. Unfortunately, this study
therefore, provides evidence that the affects
of the pandemic are linked to the rise of
dental anxiety amongst children.A typical day
Ge n e ra l d e n ti sts h a ve th e a b i l i ty to
ca rry o u t a w i d e ra n g e o f
as an
p ro ce d u re s h o w e ve r I w a n te d to
fu rth e r my tra i n i n g a n d ski l l s so I
Orthodontist
w e n t o n to sp e n d ti me i n a n Ora l
a n d Ma xi l l o fa ci a l Su rg e ry
d e p a rtme n t w h i ch w a s q u i te
d i ffe re n t fro m ro u ti n e d e n ti stry. I
WRITTEN BY DR BHAMRAH
a sse sse d a n d tre a te d p a ti e n ts w i th
GURPRIT
fa ci a l a n d d e n ta l i n j u ri e s a n d
Or th o d o n ti c s i s a s p e c i a l i s e d a ssi ste d i n su rg i ca l p ro ce d u re s
b r a n c h o f d e n ti str y i n vo l v i n g su ch a s re mo vi n g i mp a cte d te e th
r e c o g n i s i n g a n d co r r e c ti n g a n d j a w su rg e ry. I h a d th e
i r r e g u l a r i ti e s o f th e te e th o r o p p o rtu n i ty to sh a d o w a C o n su l ta n t
d e v e l o p i n g j a w s w h i ch c a n i m p r o ve Orth o d o n ti st i n th e d e p a rtme n t w h o
th e fu n c ti o n a n d a p p e a r a n ce o f th e tre a te d co mp l e x ca se s a l o n g si d e
te e th a n d fa ce . Th e j o u r n e y to th e ma xi l l o fa ci a l su rg e ry te a m. I
b e c o m i n g a C o n s u l ta n t Or th o d o n ti st sa w p a ti e n ts w h o n e e d e d
r e q u i r e s a c o m m i tm e n t a n d h a r d o rth o d o n ti c b ra ce s a s w e l l a s
w o r k h o w e v e r i t i s i m p o r ta n t to g o su rg e ry to co rre ct th e i r j a w p o si ti o n
to w o r k e v e r y d a y a n d e n j o y w h a t to i mp ro ve th e i r b i te a n d th i s i s
you do. w h e n I kn e w I w a n te d to tra i n a s a n
o rth o d o n ti st.
M y j o u r n e y i n vo l ve d c o m p l e ti n g 5
y e a r s u n d e r g r a d u a te tr a i n i n g a t I sp e n t a fu rth e r ye a r i n Pa e d i a tri c
D e n ta l Sc h o o l w h e r e I g a i n e d a n d Sp e ci a l C a re D e n ti stry w h e re I
e x p e r i e n c e i n va r i o u s fi e l d s o f co mp l e te d p ro fe ssi o n a l
d e n ti s tr y . I sp e n t ti m e i n a d e n ta l q u a l i fi ca ti o n s w h i l e fu rth e r
p r a c ti c e w h e r e I w o u l d se e c h i l d r e n d e ve l o p i n g my ski l l s, i n p a rti cu l a r
a n d a d u l ts fo r r o u ti n e c h e c k u p s tre a ti n g a n xi o u s p a ti e n ts w i th
a n d c a r r y o u t tr e a tm e n ts s u c h a s se d a ti o n .
fi l l i n g s , d e n ta l e x tr a c ti o n s a n d r o o t
c a n a l tr e a tm e n ts . Th e g r e a t th i n g
a b o u t b e i n g a d e n ta l s u r g e o n i s
h a v i n g th e tr a i n i n g a n d s ki l l s to
l i s te n to p a ti e n ts ' c o n c e r n s
( e s p e c i a l l y w h e n th e y p r e s e n t w i th
d e n ta l p a i n ) a n d b e i n g a b l e to
d i s c u s s w i th th e m th e i r tr e a tm e n t
o p ti o n s a n d d e l i ve r i n g th e ca r e th e y
require.
14I w a s th e n a b l e to a p p l y a n d Th e b e st p a r t o f m y j o b i s h a vi n g
c o m m e n c e m y 3 ye a r s Or th o d o n ti c th e ski l l s to b e a b l e to i m p r o ve
tr a i n i n g w i th i n a h o s p i ta l so m e o n e ’ s te e th , sm i l e a n d
d e p a r tm e n t a n d s u c ce s sfu l l y co n fi d e n ce w h i c h th e y w i l l b e n e fi t
c o m p l e te d a M a ste r o f Sci e n ce fr o m l o n g te r m .
( M Sc ) d e g r e e i n Or th o d o n ti c s a n d
WHY
p a s s e d p r o fe s si o n a l e x a m i n a ti o n s
to th e n b e a b l e to r e g i s te r a s a
Sp e c i a l i s t Or th o d o n ti st. As a n
o r th o d o n ti st y o u a r e a b l e to w o r k i n
h i g h s tr e e t p r a cti ce , a co m m u n i ty
s e tti n g o r w i th i n a h o s p i ta l
DENTISTRY?
d e p a r tm e n t a s se s si n g a n d tr e a ti n g WRITTEN BY YEAR 12 STUDENT
ISABELLE LI
p a ti e n ts w i th r e m o v a b l e a n d fi x e d
b r a c e s . I d e ci d e d to c o m p l e te a I a s p i r e to stu d y i n th e m e d i ca l
fu r th e r 2 y e a r s tr a i n i n g to b e a b l e fi e l d a n d b e tr u ste d w i th th e g r e a t
to tr e a t m o r e co m p l e x ca s e s to r e sp o n s i b i l i ty to ca r e fo r s o m e o n e ’ s
b e c o m e a n Or th o d o n ti c C o n su l ta n t. h e a l th a n d w e l l - b e i n g . Fo r m e ,
d e n ti s tr y sto o d o u t fr o m o th e r
C u r r e n tl y I w o r k a s a H o s p i ta l fi e l d s o f h e a l th ca r e p r o fe ss i o n s
C o n s u l ta n t a n d a l so w i th i n a b e c a u s e i t h a d th e a d d i ti o n a l
s p e c i a l i s t p r a c ti ce . Th e m a j o r i ty o f a sp e ct o f i n tr i ca te m a n u a l w o r k ,
p a ti e n ts I tr e a t i n th e h o sp i ta l s o m e th i n g I w a n t a s a fe a tu r e o f
r e q u i r e m u l ti d i sc i p l i n a r y c a r e m y e v e r y d a y j o b . D e n ta l s tu d e n ts
i n v o l v i n g o r th o d o n ti cs w i th Or a l a n d h a v e th e o p p o r tu n i ty to l e a r n
M a x i l l o fa c i a l Su r g e r y a n d /o r h a n d s - o n a n d tr e a t th e i r o w n
R e s to r a ti v e D e n ti s tr y i n vo l ve m e n t p a ti e n ts w h i l st l e a r n i n g . Th i s
s u ch a s p a ti e n ts r e q u i r i n g b r a c e s m e th o d o f l e a r n i n g w a s a p p e a l i n g
as well as jaw surgery, replacement to m e a s i t m o ti v a te s s tu d e n ts to
o f m i s s i n g te e th o r u n c o v e r i n g a cti v e l y e n g a g e i n th e i r l e a r n i n g
d i s p l a c e d b u r i e d te e th . Wi th i n th i s a n d i m p r o v e th e i r ski l l s . Wh i l st
c a r e e r I h a v e a g r e a t v a r i e ty o f w o r ki n g o n m y GC SE Ar t a n d
r o l e s fr o m p l a n n i n g co m p l e x D e s i g n Te xti l e s p r o j e c t, I
tr e a tm e n t w i th o th e r sp e ci a l i ti e s , d i sco ve r e d h o w m u ch I e n j o y e d
c a r r y i n g o u t o r th o d o n ti c tr e a tm e n t h a v i n g th e cr e a ti v e fr e e d o m to
a n d tr a i n i n g o r th o d o n ti c s p e c i a l i st d e s i g n a n d co n s tr u c t i n tr i ca te
tr a i n e e s a s w e l l b e i n g i n vo l ve d i n p i e c e s o f a r t, s u ch a s a n e l a b o r a te
r e s e a r c h a n d d e ve l o p i n g h o sp i ta l e m b r o i d e r y o f a k i w i fr u i t o r a fr u i t
services. i n sp i r e d s i l k p a i n ti n g .
15I b e l i e v e th a t d e n ti str y i s a p e r fe ct b a l a n c e o f a r t a n d sc i e n ce . It
e n c o m p a s s e s th e c r e a ti v i ty o f a n a r ti s t a n d th e s ki l l s a n d kn o w l e d g e o f a
s u r g e o n to c r e a te a h e a l th y , b e a u ti fu l sm i l e th a t h a s th e p o w e r o f ch a n g i n g
a p e r s o n ’ s l i fe .
M y d e c i s i o n to p u r s u e d e n ti str y w a s r e i n fo r ce d b y d i scu ssi o n s w i th se n i o r
d e n ti s ts w h i ch a l l o w e d m e to r e a l i se th a t o r a l h e a l th i s p e r ti n e n t i n
m a i n ta i n i n g l i fe l o n g h e a l th . Th e se co n ve r sa ti o n s a l s o sh o w e d m e th a t
d e n ti s tr y i s n o t o n l y h i g h l y d e p e n d e n t o n a p p l y i n g yo u r kn o w l e d g e to r e sto r e
o r a l h e a l th , b u t a l s o y o u r e a g e r n e ss to sh a r e th i s kn o w l e d g e . I l o ve h o w
d e n ti s tr y i s a ca r e e r th a t i s d yn a m i c a n d e v e r - e vo l v i n g , th u s p r o vi d i n g
e n d l e s s o p p o r tu n i ti e s to fu r th e r m y kn o w l e d g e a n d sp e ci a l i s e i n a p a r ti cu l a r
a r e a o f d e n ti str y a n d co n cu r r e n tl y p r o vi d e a se cu r e , fu l fi l l i n g a n d e xci ti n g
career.
dental news
TOPIC: TREATMENT FOR OSTEOPOROSIS COULD ALSO HELP PREVENT
GUM DISEASE
R e s e a r c h c a r r i e d o u t b y N e w U n i ve r si ty a t Bu ffa l o , e xa m i n e d th e p r e va l e n ce
o f p e r i o d o n ti ti s i n p o stm e n o p a u sa l w o m e n . Th e stu d y sh o w e d th a t w o m e n
o v e r th e a g e o f 5 0 , w h o h a d b e e n p r e sc r i b e d o e s tr o g e n th e r a p y a l o n g w i th
s u p p l e m e n ts o f c a l ci u m a n d vi ta m i n D fo r o ste o p o r o s i s w e r e 4 4 p e r ce n t l e ss
l i k e l y to h a v e s e v e r e p e r i o d o n ti ti s th a n w o m e n w h o d i d n o t r e c e i ve th e
tr e a tm e n t.
D u r i n g p o s tm e n o p a u s e , h o r m o n e l e ve l s fa l l b e l o w
3 0 p g /m L fr o m 3 0 ~4 0 0 p g /m L a n d th i s i n cl u d e s th e
h o r m o n e , o e s tr o g e n . Oe s tr o g e n i s n o t o n l y
i m p o r ta n t fo r c o n tr o l l i n g th e m e n str u a l cy cl e b u t
i s a l s o e s s e n ti a l to b o n e h e a l th b e ca u s e i t
p r o m o te s th e a cti vi ty o f o s te o b l a s ts, w h i ch a r e
c e l l s th a t p r o d u c e b o n e s. Th e r e fo r e , th e d r o p o f
o e s tr o g e n l e v e l s d u r i n g p o s tm e n o p a u s e l e a d s to
l e s s b o n e fo r m a ti o n , h e n c e i n cr e a si n g th e r i s k fo r o s te o p o r o si s.
Th e r e s e a r c h e xa m i n e d 3 5 6 w o m e n d i a g n o se d w i th o ste o p o r o s i s a n d d i vi d e d
th e m i n to tw o ca te g o r i e s: w o m e n w h o h a d r e ce i ve d o e s tr o g e n th e r a p y fo r a t
l e a s t 6 m o n th s a n d w o m e n w h o h a d n e ve r r e c e i v e d th e tr e a tm e n t. Of th e
163 5 6 w o m e n , 1 1 3 w o m e n ch o se to r e ce i ve o e str o g e n th e r a p y . Fr o m th i s ,
r e se a r c h e r s fo u n d th a t w o m e n r e ce i vi n g o ste o p o r o si s tr e a tm e n t h a d l e ss
p e r i o d o n ta l p r o b i n g d e p th a n d l e ss g u m b l e e d i n g th a n th o se w h o d i d n o t
r e ce i v e th e r a p y.
Pr o fe s s o r Fr a n k Sca n n a p i e co , a co - a u th o r o n th e stu d y sa i d , "Th e s e r e s u l ts
h e l p c o n fi r m th e fi n d i n g s o f p r e vi o u s stu d i e s th a t su g g e ste d th a t o e str o g e n
th e r a p y to p r e v e n t o s te o p o r o si s co u l d a l so p l a y a r o l e i n th e p r e ve n ti o n o f
g u m d i s e a s e ," a n d th a t “ ...b y a d va n ci n g o u r u n d e r sta n d i n g o f h o w th i s
tr e a tm e n t c a n i m p a c t o r a l h e a l th , w e ca n b e tte r w o r k to i m p r o ve th e b o n e
h e a l th a n d q u a l i ty o f l i fe o f fe m a l e p a ti e n ts."
Pe r iodont it is : A g u m d i se a se , w h i ch i n fe cts a n d d a m a g e s th e so ft ti s su e
a n d w i th o u t tr e a tm e n t, i t c a n d e s tr o y th e b o n e th a t su p p o r ts yo u r te e th .
Os t e opor os is : A sk e l e ta l d i se a se th a t w e a ke n s th e b o n e s a n d i n cr e a se s
th e r i s k o f s u d d e n fr a c tu r e , u su a l l y th i s d i s e a se p r o g r e sse s w i th o u t a n y
s y m p to m s o r p a i n s .
Pe r iodont a l pr obing de pt h: Th e a m o u n t o f sp a ce b e tw e e n th e te e th a n d
s u r r o u n d i n g ti ss u e d u e to b o n e l o ss.
TOPIC: LOSS OF FIRST BABY TOOTH AS A POSITIVE EXPERIENCE
L o s i n g a b a b y to o th i s o n e o f th e fi r st
b i o l o g i ca l c h a n g e s to th e b o d y th a t a c h i l d
e x p e r i e n ce s co n sci o u s l y a n d r e c e n t stu d y
s h o w s th a t i t i s a l so a p o si ti v e o n e . Pa r e n ts
w e r e a ske d to co m m e n t o n th e i r c h i l d r e n ’ s
r e a cti o n s to th e i r to o th l o ss, a n d a r o u n d 8 0 %
r e p o r te d a p o s i ti v e e x p e r i e n ce . D e n ta l
r e s e a r ch e r R a p h a e l Pa tca s sa ys th a t o n e
p o s s i b l e r e a so n i n g i s th a t a b a b y to o th w i l l l o o se n g r a d u a l l y b e fo r e fa l l i n g
o u t, ‘ u n l i k e a n a cc i d e n t, i t u n fo l d s sl o w l y a n d u n p r e d i cta b l y’ . Su p p o s e d l y,
fo r c h i l d r e n th i s p r e p a r a ti o n a n d w a i ti n g ti m e fo r a to o th to fa l l o u t cr e a te s a
s e n s e o f p r i d e a n d r e l i e f w h e n i t d o e s.
Ad d i ti o n a l l y , s o c i o d e m o g r a p h i c fa c to r s a r e su g g e ste d to b e l i n k e d to th e
p o s i ti v e fe e l i n g s, fo r e x a m p l e ch i l d r e n te n d to h a ve a g r e a te r se n se o f p r i d e
a n d j o y i f th e i r p a r e n ts a r e w e l l e d u ca te d a n d n o n - w e ste r n .
17many thanks to:
DR REGARDSOE FOR HER GUIDANCE IN PUTTING THE MAGAZINE TOGETHER
DR JESSICA RUDNAY FOR HER INFORMATIVE ANSWERS TO OUR QUESTIONS
DR ARJUNE SEN FOR HIS ENTHUSIASTIC ACCOUNT ON LIVING A LIFE OF A
NEUROLOGIST
DR NICOLA BEARDSLEY FOR HER INSIGHTFUL ANSWERS TO THE Q&A
DR BHAMRAH GURPRIT FOR HER THOUGHTFUL DAY IN THE LIFE OF AN
ORTHODONTIST ARTICLE
REBECCA IM FOR HER INTRIGUING ARTICLE ON HENRIETTA LACKS
ISABELLE LI FOR HER INSPIRATIONAL SNIPPET OF WHY SHE WANTS TO
STUDY DENTISTRY
DR STROBEL FOR HER ADVICE AND CONTACTS
MISS BITTINER FOR MARKETING OUR MAGAZINE
MRS POUNTNEY FOR PUBLISHING OUR MAGAZINE
references:
Pr oge r ia : A C ons e que nc e of Pr ote in A c c umula tion:
h ttp s://w w w .ma yo cl i n i c.o rg /d i se a se s-co n d i ti o n s/p ro g e ri a /symp to ms-ca u se s/syc-
2 0 3 5 6 0 3 8 # :~:te xt=Pro g e ri a %2 0 (p ro %2 D JEER %2 D e ,g e n e ra l l y%2 0 a p p e a r%2 0 n o rma l
%2 0 a t%2 0 b i rth .
h ttp s://ra re d i se a se s.i n fo .n i h .g o v/d i se a se s/7 4 6 7 /p ro g e ri a # :~:te xt=Sta ti sti cs,-
L i ste n &te xt=It%2 0 h a s%2 0 b e e n %2 0 e sti ma te d %2 0 th a t,th e %2 0 w o rl d %2 0 h a ve %2 0 th i s
%2 0 co n d i ti o n .
h ttp s://w w w .ma yo cl i n i c.o rg /d i se a se s-co n d i ti o n s/p ro g e ri a /symp to ms-ca u se s/syc-
2 0 3 5 6 0 3 8 # :~:te xt=A%2 0 si n g l e %2 0 g e n e %2 0 mu ta ti o n %2 0 i s,p ro d u ce d %2 0 a n d %2 0 ma
ke s%2 0 ce l l s%2 0 u n sta b l e .
h ttp s://w w w .p n a s.o rg /co n te n t/1 1 6 /9 /3 5 7 8 # :~:te xt=By%2 0 re ta i n i n g %2 0 i ts%2 0 fa rn e sy
l %2 0 mo i e ty,%2 C %2 0 7 %E2 %8 7 %9 3 %E2 %8 0 %9 3 9 ).
h ttp s://g e n o me b i o l o g y.b i o me d ce n tra l .co m/a rti cl e s/1 0 .1 1 8 6 /g b -2 0 1 1 -1 2 -5 -2 2 2
D ia gnos ing D e pr e s s ion fr om Ea r wa x :
h ttp s://n yp o st.co m/2 0 2 0 /1 1 /0 4 /n e w -e a rw a x-te st-co u l d -re ve a l -stre ss-l e ve l s-a n d -
d e p re ssi o n -ri sk/
C R ISPR -c a s 9 a s the Mos t Effic ie nt Ge ne Editing Tool:
h ttp s://w w w .yo u rg e n o me .o rg /fa cts/w h a t-i s-cri sp r-ca s9
D e nta l a nx ie ty dur ing the pa nde mic a mongs t c hildr e n:
h ttp s://w w w .w e b md .co m/l u n g /co ro n a vi ru s-d e n ta l -ca re # 1
h ttp s://w w w .h e a l th l i n e .co m/h e a l th /a n xi e ty-symp to ms# symp to ms
h ttp s://cl i n i ca l tri a l s.g o v/ct2 /sh o w /N C T0 4 4 9 7 8 1 8
Tr e a tme nt for os te opor os is c ould a ls o he lp pr e v e nt gum dis e a s e :
h ttp s://w w w .sci e n ce d a i l y.co m/re l e a se s/2 0 1 7 /0 7 /1 7 0 7 1 8 0 9 1 5 4 5 .h tm
Los s of fir s t ba by tooth a pos itiv e e x pe r ie nc e :
h ttp s://w w w .sci e n ce d a i l y.co m/re l e a se s/2 0 1 8 /1 0 /1 8 1 0 2 4 1 3 1 3 1 8 .h tm
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