Innominate Issue 1 2020

INNOMINATE VOLUME 69| ISSUE 1 |2020 THE SYDNEY UNIversity MEDICAL SOCIETY MAGAZINE

INNOMINATE - ISSUE 1 2020 A magazine written by and for Sydney Medical Students Copyright 2020, Sydney University Medical Society Director of Publications: Brooke Carmody Design & Layout: Brooke Carmody Cover Art: Brooke Carmody

Contents 4 From the Director 7 Recipe Therapy 8 My Story. 12 A Quick Guide To Life After Medicine; Anaesthetics Edition 20 Scenes From Med Camp. 26 Doctor Vostrum VS The world

From the Director From the Director BROOKE CARMODY This edition of Innominate comes at an unprecedented time for the Sydney Medical Program, and indeed, society at large. With students spread across the country, some on placement, some tuning into class via Zoom, I am pleased to bring you this magazine - something that was sprung from the imaginations of these very students. It has been amazing to produce this magazine, to enjoy surprising creativity in tough times. I hope you can all read Innominate and smile, consider new perspectives, be a bit more informed, try one of the student made recipes or enjoy one of the stories. As always, stay safe, stay connected, and stay engaged.

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Recipe Theryapy Dhal and Vegetable Curr y Hey everyone, so this recipe is something that I cook all the time. It’s a combo of a dhal and vegetable curry. In no way is it authentic, however, as a vegetarian I love it since it’s full of carbs, protein and iron (emphasis on iron- I’m still trying to get off iron supplements). It isn’t really a recipe and is more of a template- as long as you have the onion, garlic and ginger combo you can adjust this how to please/to your pantry and budget. Enjoy! Ingredients • 1 brown onion, diced • 1 tablespoon oil (olive, vegetable, coconut or whatever I’m not your mum) • 2 cloves of garlic, diced (channel your inner Brad Leone & add more. You know you want to) • 3 cm nub of ginger, peeled and diced • 1-2 handfuls (around 300g) of 2 different chopped vegetables • 2-3 chopped potatoes (depends on how big ya taters are) • ¾ cup/150g dry red/yellow split peas (can substitute with any other lentil) • Water/stock (read lentil packet for volumes) • ½ teaspoon of chilli flakes (put more in if you need a reminder that you’re alive) • 1-2+ Spicesssss (roughly 1 teaspoon of each) • Garam masala, cumin, cinnamon, coriander, turmeric, curry powder, asafoetida etc • 1 cup cooked rice (or however much you need to eat) Method JAMES WEIGHT 1. Prepare all your ingredients beforehand you disorganised hoe. 2. Heat large saucepan/pot and oil on medium-low heat, add onion and cook until translucent (around 3-4 minutes). 3. Add garlic and ginger, cook until it’s aromatic (aka it smells good). 4. Chuck in your spices and mix. 5. Throw in chopped vegetables and potatoes, and fry until soft and they have gotten nice and bright (this takes around 5 minutes). 6. Toss in the split peas and mix. 7. Turn heat up to high and add water/stock. 8. Bring to boil, reduce heat to low, cover and simmer until water is mostly absorbed and lentils are soft (check lentil packet for timing, generally 10-30 minutes). Stir every few minutes, and top up with more water if it’s starting to get prematurely dry. 9. Plate ya mean meal up and garnish with some S&P. 10. Feel proud that you managed to make a healthy(ish) meal *2 hours later go to your fridge and eat 200g of hummus using only your finger*

Recipe Therapy -07 KASIA MARCISZEWSKI Polish Beer Cake Ingredients 4 eggs 3 cups flour 1 cup oil (vegetable or olive) 1 ½ cups of white sugar 1 glass of beer – make sure you leave the beer out of the fridge overnight. Cold beer stops the cake from rising, room temperature is best. I usually use a Crown lager, unsure how a dark beer would go. 1 packet vanilla sugar or a splash of vanilla essence 3 teaspoons baking powder Method 1. Combine eggs and white sugar in a mixer and blend until smooth 2. Mix baking powder and flour together. 3. Slowly add the flour & baking powder mix to the egg and sugar mix. 4. Add the oil and beer, slowly! There’s a lot of liquid and it will splash with a mixer. 5. Drink the remainder of the beer. 6. Grease a cake tin 7. Bake 40-50min @ 190 degrees Innominate

My Story. My Story. FARAZ MAHBOOB When asked to write a piece for this journal, scans identified the unmistakable shadow I jumped at the opportunity. Currently of brain cancer. Silently growing in my isolated, demoralized, and forced to head, this unwelcome intruder left me interact with our beloved classmates solely slipping in and out of consciousness, through the dystopian hellscape known paralyzed, and ultimately brought me as Zoom, I thought this was the perfect to the brink of death. Lost in a flurry of opportunity to tell a story of the immense medical jargon, I found myself giving up impact that medicine can have our lives — all autonomy to a collection of strangers in this is my story to medicine. the desperate hope that they would return Although some of you may already know me to health. me as “that weird guy from Facebook” or The good news was that it was operable. “Farzan’s not so attractive doppelgänger”, However, while a six-hour surgery freed let me formally introduce myself. My me of this beast, resulting complications name is Faraz and I am a first year who were far less positive. I had significant just moved to Australia. Six years ago, I cognitive and physical deficits, with the was abruptly confronted with my own inability to speak coherently or control the mortality when a series of CT and MRI left side of my body.

-09 Whilst these complications are well- also going haywire, frantically trying documented (technically called to make sense of what had happened. apraxia and hemiparesis), they do not It was agony. I would stay up all night convey the utter horror and fear that it crying in pain, finding no relief in the involves. Alive but no longer living, I toxic levels of morphine being pumped was trapped in my own body — alone into me. Desperate to end this living with my thoughts and a pain so severe, nightmare, my troubled mind resorted all I could do was cry. Within merely to one of its most primal instincts — days, I’d been transformed from an to place pressure around the wound. independent, capable young adult into It seemed that surely, this, if anything despondent, helpless shadow of my would ease the pain, like touching a sore former self. wound, or rubbing a painful mosquito After three full weeks in the hospital, bite. But as my pain only grew stronger, I was transferred to my new home; a as did my desperation. I became collection of buildings located far away fixated on a solitary thought — “break from the buzzing city, as isolated from your bones, it’ll help”. Fortunately, society as its occupants. Surrounded in my semi-paretic state and unable by the worst neurological cases that to articulate this perfect plan, all I the greater Toronto area had to offer, I achieved was screaming incoherent couldn’t help but feel as equally close to nonsense. This would be the only time death as the 80-year-old stroke victim I’d ever contemplate suicide. next to me. I wouldn’t recognize the fundamental Despite the blurred memories of the flaw of my logic until many years later. next six months, the first night still All medical students are taught about stands out sharply in my mind. Given the pain gate theory, but again, it doesn’t the choice between various juices, I quite encapsulate the experience. While was handed an assortment of beige pain gate control can dull the perceived containers haphazardly strewn across pain of real injury, instead it was my an equally yellowed tray. Struggling, I mind that was injured. The ‘pain’ a opened the closest one and sheepishly simple manifestation of my sensory brought it to my mouth. I missed, neurons firing on all cylinders. This spilling lukewarm tomato soup all was an unmentioned consequence of over myself. With my curtains drawn my brain repossessing space previously for privacy and unable to call for help, stolen by a gargantuan tumor. I spent that first night covered in the Recognizing that life was more than mess and overpowered by the smell of the avoidance of suffering, a sense of tomatoes and antiseptic. The memories determination set in. No matter how of playing rugby, spending my summers much it hurt, I knew I couldn’t give up in the Himalayas, and conquering the hope, I had to recover, no matter how British highlands felt a lifetime away. I long it took. had lost my identity. It would take me two weeks to finally Whilst my brain was healing, it was remember the name of my nurse — Jane. Innominate

My Story. It would take me another few weeks before The purpose of this essay is not to inspire I could visit the bathroom on my own. sympathy nor attract attention. Rather, Although somewhat challenging to regain it is to illustrate the vital importance my cadence and accent, by the second that doctors, nurses, and all healthcare month I was talking normally. Having workers play in our lives. Irrespective of achieved this, I knew I could push myself my grim prognosis, I’ll never forget the further, I knew I could be more. relentless hope my physicians gave me. Almost sadistically, I would wake up each Every morning before rounds, residents morning with an impossible goal in mind, would come sit down by my bed, listing torturing my body to the point of vomiting off all my achievements from the past trying to reach it, challenging what day. They helped me feel greater joy in everyone thought was possible in order to achieving the mundane than any sports regain control of my body, my mind, and trophy or academic award I had won my life. Through what felt like a lifetime, before. They helped show me that the role after four months of hell, I finally felt like of a good physician extends far beyond I’d recovered some semblance of my former searching for a diagnosis but will go the self — albeit a bit slower than before, with extra mile to comfort the patient, to help a minor fear of stairs, but I was happy. them understand their disease, and act Yet I soon realized that my struggle had as a much-needed pillar of support. They only just begun. And my return to reality helped me realize I was more than my couldn’t have been more unwelcoming. As Kaplan-Maier statistic and that I possessed a British citizen living in Canada, I was every quality for a positive outcome. I was quickly deemed a burden on society by the young, I had a great support system, and government and chastised by a university most of my tumor was resected — I had the that only cared about its reputation, and world to live for. bottom line. Treated as if being diagnosed So, the next time you encounter a patient, with brain cancer was a choice, I was told just take that extra second to empathize that I would face deportation if I didn’t with them, to hear then out, to understand return to full time education immediately. that they’re scared and are trusting you With months of rehabilitation ahead of me, with all that they have left. However I had little choice in the matter. I would insignificant it may seem; you have the have to learn how to study again while I ability to change their life forever — it’s up studied. to you as to whether that’s for better or for I found my pleas for compassion falling on worse. deaf ears, trapped in a system that couldn’t A few years on, I am still determined to care less for the unwell. It was as though this fight for a future where I can provide others traumatic, perilous struggle was nothing that same second chance I was afforded more than a minor inconvenience faced by — moving beyond my disease and every everyone. Compared to my peers, I would other obstacle that’s come in my way. I am spend the next two years balancing out- incredibly grateful to study medicine with patient rehabilitation, my degree and the such an amazing cohort at the University monumental demands that any pre-med of Sydney; I cannot wait to see where this student must tackle. Yet it was a challenge wonderful journey takes all of us. I was proud to have taken on.

-011 First Steps Post Op. Innominate

After MedicineA Quick Guide To Life Anaesthetics Edition

ASHER DIXON In today’s day and age, getting into a specialty into Anaesthesia looks like for the “Non- program is a daunting and challenging Gunner”. Internship is compulsory to attain task. More often than not, students will medical registration, and Residency is neglect thoughts of the future and push basically essential to gain the Anaesthesia, them to the furthest reaches of their brain. Critical Care and ICU terms that will make Many students feel there is nothing they up the foundations of your experience. can do as ‘mere’ medical students that can These years will make up the majority of sway the odds in their favour. But luckily your PMET time. During this period, the for the many bright minds reading this, a terms you are allocated can make or break general understanding of the long journey your chances for an ideal SRMO position. ahead can help to plan your exciting next As such it is important to preference the few years. So please, HOLD ON TIGHT… right hospital in your final year of medical school (ideally pick one which has the THE BASICS: most terms related to Anaesthesia). All this Unlike most programs, Anaesthesia information can be found in the AMSA selection is purely based upon: 1.CV … 2. Internship Guide. Interview … and 3. References. Of course there are certain requirements Now … Theoretically it is possible to gain that must be fulfilled before you’re eligible selection into a program straight out of to apply, including: residency, but most of these cool cats have done some serious groundwork during 1. Be a Registered Doctor (duh). 2. their years as a medical student. As such Completion of 52 weeks FTE Prevocational these types of people are mostly legend and Medical Education Training “PMET” spread far & thin. Remember it is important (Meaning you have to have at least to focus on your own journey rather than completed internship; however, this is compare yourself with others. . However, usually a minimum requirement and does for those of you who wish to know how it not provide anywhere near enough ICU or is done, look no further… ITS TIME TO Critical Care experience to gain selection). CV BOOST. 3. Pay the application fee of $625 AUD (sadly, nothing is free). But before we get ahead of ourselves, it is important to understand, what a pathway

A Quick Guide To Life After Medicine Anaesthetics Edition ASHER DIXON THE CV: your cleverly preference‘d’ terms during Firstly, your Curriculum Vitae is your residency. Ideally you would like to canvas to paint during your PMET years. gain additional terms in ICU, ED, Intensive Be sure to have a template that looks care and Anaesthesia. However, it’s clinical professional and demonstrates your and procedural involvement attention to detail, beyond that, what you that can make the difference to your fill it with should demonstrate nothing application. Selection panels want to see short of excellence. Don’t be afraid to sell that their applicants (potential yourself, but also never lie about what you trainees) will always go above and beyond. have done, it can come back to bight you. This is when your general 9-5 (which you Section I (Education): will never get) should be used as a platform to boost your CV. This should outline your tertiary education career, identifying the years in which you completed it and your extra- curricular involvement (that’s related) beneath each degree. Remember if you have received ‘Deans List’ or ‘Honours with Distinction’ be confident, let your future employer know. Getting into Anaesthesia is highly competitive and any edge you may have on your competitor can mean the difference. As such any additional education you can gain is invaluable: • Masters of Critical Care. • Grad cert in Ultrasound. • MPhil in respiratory depression. • Honours in Anaesthetic ADR’s. • PhD in acute blood loss. Section II (Medical Experience): This is the section where you can flaunt

ASHER DIXON • Contact the relevant consultants, the back of your mind and be prepared express your interests in intubation, to book them well in advance as places as any experience you can demonstrate short. If you manage to attain selection puts you a league ahead (be on call without completion of these courses, for any ‘resuss’ situations should they they’re a mandatory component of the arise). Anaesthetic trainee program and will have to be done at some point, none the less. • Practice cannulation and record how 1. Effective Management of Anaesthetic many you have successful completed crisis (EMAC): 2. Advanced Life Support during your PMET years, if you courses (ALS1/2): 3. Can’t Intubate Can’t have recorded over 1000 successful Oxygenate course (CICO): 4. Paediatric cannulations by the time you apply: Life Support Couse (APLS): 5. Neonatal put it on your CV under procedural Resuscitation course: 6. Early Management skills. of Severe Trauma (EMST): 7. Basic Assessment & Support in Intensive Care • Ask to learn and perform (BASIC): bronchoscopies and spinal anaesthesia Section I V (Research & Audits): administrations (the more nerve blocks This a chance for many academics to hustle you can say you were involved with, the their way to the front of the pack. Never more likely they will choose you). underestimate a broad array of research publications to dazzle the eyes of a selection • Get involved in organ retrieval committee. Research not only indicates programs for the hospital. curiosity and intuition, but also the capacity to add value to the hospital department. • Complete FAST scan ultrasound The more poster presentations, conference courses and ask supervisors to learn speeches and research papers that you and perform central line insertion. have authored, the more well-rounded you Be proactive with your professional (as an applicant) you will appear. As such development. during your medical years try and gear all research towards pharmacology, vitals and Section I I I ( Professional Development ): anaesthesia, as this will go a long way come Prior to selection, completion of the application time. relevant professional development courses can help your chances of selection, these can only be done after you’ve completed your medical degree (this is particularly frustrating for those with lots of spare time), however you should keep them in

A Quick Guide To Life After Medicine Anaesthetics Edition ASHER DIXON One essential component for selection is • Apply for Peer Assisted Study Session the completion of a hospital audit (these (PASS) Leadership positions, Non- are not too difficult, however are time Science Tutorials. consuming. If planned correctly you can complete several during your pre-clinical • Apply for Anatomy tutorial positions. years) • Assistant/ Associate lecturer positions • Audit on Anaesthesia vital sign • Clinical Skills Tutor for medical monitoring during long cardiac students. surgery. • Volunteer bedside tutor for health • Examining effectiveness of fascia iliac blocks in medication adherence. students. • Audit of hand washing adherence in • Student Mentor positions. Department of Anaesthesia. • Peer Support positions. As you can see a lot of work is starting to Keep in mind, all of these suggestions are add up and we’re only up to section IV, possibilities, and are often hard to attain. thus it’s important to try and overlap your So be mindful and apply to all in the hope efforts. i.e. get the maximum reward for the to get one or two of these roles. least amount of effort. Such as; completing an honours part time during your M.D in Section V I ( Prizes & Grants ): bronchoscopy technique methods as an This section of your CV is where residents audit and publication (could be used to can really stand above the rest of the knock several birds with one stone). applicant pool. The more academic prizes and research grants you can “hustle” during Section V ( Teaching Experience ): your undergraduate and postgraduate Clinical expertise and procedural skills years, can make all the difference for your are essential for any training position. application as an Anaesthetic trainee. However, personability and the capacity Unfortunately, many prizes are purely to convey information to junior doctors criterion based, and you have to be are equally valuable skills that consultants constantly (actively) looking to apply for look for during selection. This can be quite scholarships. Here, in most cases, it is the easily displayed through volunteering and tortoise rather than the rabbit that wins the teaching positions: race.

ASHER DIXON Often there is a disparity between • Form a charity with other doctors or applicants, whereby some will have many medical students. prizes and others will have none. This says nothing about their academic ability, but • Do voluntary service for St John purely which student played the long game. Ambulance. • Search for specific prizes and • Join the Army Reserves. scholarships related to your university, Section VIII ( Extra Curricular Involvement department, government, research area ): etc. Where the most fun is to be had, is definitely • Actively prepare a CV and personal during your extra-curricular involvement. statement that can be moulded to fit This section is particularly easy to each and every application. overindulge, as it should represent the • Lastly, apply for everything that you see activities you are most passionate about. It (You got to be in it, to win it). also gives the selection committee a rough Once you get a single scholarship, there understanding of your personality type. If rest flow onwards. So be sure to play the hunting is your passion… perhaps its best long game rather than get caught up on to leave that off your CV. Most often: high each and every exam result. This requires representation in sports, outdoor activities focussing on a single academic aim or and music are common things seen amongst pursuit and executing. doctors. Now, this doesn’t mean go out and Section VII (Leadership & Community ): become an Olympian, but what it will show This section of your CV allows the selection is that you are well balanced and have other committee insight into who you are as a interests besides putting people to sleep (as person. This is something that cannot be creepy as that may sound). It is important faked. If you are passionate about helping to remember, that we are all human, and people (as most doctors are) then your the pursuit of excellence in ABSOLUTELY mindset should extend beyond that of EVERYTHING, may not be the healthiest your achievements and aspirations. Do thing. But if you can’t help it… May as well anything that involves your time that helps put it to good use. others (make sure it’s something you’re actually passionate about, otherwise there’s no point).

A Quick Guide To Life After Medicine Anaesthetics Edition ASHER DIXON • Pursue your favourite sports • learn These are some ideas that often look that instrument you always wanted too. notable, but don’t get caught up in the façade of titles, what matters is that the • Go rock-climbing & Mountaineering person you are receiving a reference with your friends. from is actually someone who has had a significant impact on your development • Enjoy that Friday board game night (Be it personal or professional). (there is most certainly a world championship for scrabble). Section IX ( References ): The Interview: This can certainly be the most challenging Throughout your medical degree, you aspect of the application for introverted individuals. However good preparation will meet influential professors, amazing should not be overlooked and can make all the difference. Now this doesn’t mean academics and extraordinary individuals. drafting entire answers from memory, but it does mean having a good idea of Always be on the lookout for a potential what’s to come to ensure you may answer truthfully and overcome the nerves that mentor to help guide you during your are associated. Some prior questions for Anaesthetic positions have been collated journey. Having said that, be sure to remain from firsthand sources: Tell us about oyour career/clinical open as an individual for others who experience to date. Tell us what qualities you possess that make you a good candidate may look to you for guidance (personal for this position? Tell us what practical skills you would bring to the position? development is a two-way street). All What process of personal assessment do you undertake? Describe a time you went medical specialities are difficult to get above and beyond what was expected of you. Tell us about your career highlights into, and like any profession, connections to date, your plans for the future and how [insert hospital] fits in? Tell us about mean everything. If, when the time comes yourself? What are your plans for next year? Give an example of an error? What you have done all the right things: pursued did you do and how did you deal with it? How do you know you’re a safe clinician? your interests and were open to criticism (as hard as it is for many of us) the right supervisors and referees will be there when you need them. • References from two consultant anaesthetists. • Reference from an academic supervisor or professor. • Personal reference from a collegiate dean or other notable individual. • Reference from international departments of Anaesthesia • References from Deans of faculty

-019 Innominate

Scenes From Med Camp. Scenes From Med Camp.

PHOTO: AMIR MUSTAVI

Scenes From Med Camp. PHOTO: AMIR MUSTAVI

PHOTO: LEO DUNSTAN-POT TER

Scenes From Med Camp.

PHOTO: LEO DUNSTAN-POT TER

Doctor Vostrom Doctor Vostrom VS The World A short story by Darcy Lawler

DARCY LAWLER ‘Excuse me,’ said Dr Vostram, ‘I’m a doctor.’ occasionally to retain their ringside seats He elbowed a tall young man in the kidneys to the fabulous entertainment which was causing him to double up in pain. smeared on the road at their feet. He was a small rather wiry man of at least ‘Excuse me,’ he said yet again while sixty who had worn tweed jackets since attempting to separate an enormous he was fourteen. He wore large glasses young man and his wife who were which enlarged his small, flighty eyes to an clutching each other’s hands and staring almost normal level. His hair was grey but with fascination at the tar. The couple thick and was combed perfectly over as it neither moved aside, nor acknowledge his had been since he was eight. presence but continued, instead, to mutely ‘Excuse me.’ He said again, pushing his gaze downwards. Dr Vostram bobbed, way roughly past a desiccated old woman, pugilistic like, first to one side and then knocking over her wheely trolley and another in attempt to edge past. Perturbed sending cans of beans and rolling down the yet determined, he decided to attempt a street. Moving his arms like an Olympic different tact. He stepped one large pace breaststroke medallist he continued to to the right, surreptitiously reached out his make his way through the viscous, sticky left hand and firmly smacked the bottom crowd. of the woman who was still gaping at her ‘Pardon me.’ He said trampling a lost loaf feet. She let out a sort of stifled yelp and of generic white bread beneath his well- pirouetted rapidly to face a spotty youth polished R. M. William’s, ’Let me through in bicycle lycra who had been craning his please. I am a doctor.’ neck to look over her shoulder. Attempting to edge at a tremendous speed ‘How dare you!’ past a mother holding the hand of her she bellowed, causing her husband to awake young child he managed to knock the from his trance and slowly, lumberingly child sprawling. ‘Pardon me young man,’ turn to face the young man also. As the he said pausing briefly ‘but I simply must enormous man drew back a fist like a get through. I am a doctor.’ The child, who dictionary, Dr Vostram slipped daintily was laid flat on the ground said nothing, between them and into the inner circle so he turned instead to the mother and surrounding the patient. Straightening his offered her what he considered to be his tie and simultaneously smoothing his very most conciliatory facial expression. The neatly trimmed beard (a trick perfected mother simply looked astounded, which Dr throughout a long and illustrious medical Vostram took to be a very good sign indeed career) he finally managed to observe the and so proceeded. Pushing and shoving his patient for himself. What he saw however way forward, he encountered the final ring made him stop mid smooth and gape. At of onlookers clustered around the patient. his feet lay a woman in her early to mid- They were staring silently down. Jostling thirties.

Doctor Vostrom DARCY LAWLER She was sprawled on her back, unconscious ‘Where the hell did I put it?’ he muttered and breathing in short, shallow gasps. She softly to himself. ‘Ah ha.’ He said, pulling was wearing a battered bicycle helmet and a small pocket notebook from his left, to her left lay the mangled wreckage of the posterior pocket and noting something in bicycle. Apart from the battered helmet it. ‘eight’ he muttered, ‘excellent. Well,’ he and several scrapes and small cuts on her said, looking finally at Dr Vostram and face and her left forearm her diagnosis was smiling broadly, ‘She’ll be ok.’ immediately clear to one as experienced as Dr Vostram was utterly lost for words. Dr Vostram. The problem was in her left ‘What?’ He managed. ‘But’ he added. ‘You!’ leg. It had come off. She was wearing a long, He finished. flowered dress out of the bottom of which ‘I know.’ Said the young man jauntily. poked one skinny leg (minor erythematous ‘Relief isn’t it? When I saw the accident rash and a smallish surgery scar- possibly I thought she was a goner for sure.’ The historical anterior cruciate ligament tear), young man looked again at his notebook and one mangled, bloody mess of tendons, slightly perturbed. shattered bone, muscle fibres, and copious Dr Vostram continued to splutter and amounts of blood. However, it was not this cough as his face got redder and redder that made Dr Vostram gasp. He was, after and his moustache inflated like a all, a very proficient doctor who had, in startled blowfish. The young man looked his time, seen many injuries which would concernedly at him. shock a less qualified and experienced ‘Are you alright sir?’ He asked. ‘Bit too medical professional than himself. The much excitement for the morning hey. gasp was entirely due to the fact that Let’s go get you some water and somewhere grasping her left wrist and staring intently shady to sit down.’ at a cheap quartz watch was a young man This was, finally, too much for Dr Vostram in his late twenties wearing a loud, button who at last managed to yell ‘CAN’T YOU up shirt which was decidedly not tucked SEE SHEE NEEDS A DOCTOR YOU into a pair of tight-fitting chinos. IMBECILE! SHE’S IN SHOCK.’ ‘Excuse me,’ said Dr Vostram in what he The young man looked slightly taken took to be his most authoritative voice, aback at this outburst and paused for a ‘but what the devil do you think you’re second before responding in his calmest, doing? Can’t you see this woman needs most soothing voice. professional medical care?’ ‘It’s aaaaaaall okay,’ he said. ‘I’ve checked The young man held up a single finger and her pulse. eight!’ He looked rather proud continued staring at his watch for another about this particular piece of information. seven seconds before nodding to himself ‘Eight’ He repeated. ‘Not exceptional I’ll and gently placing the arm back gently grant, but given the situation… Nothing onto the woman’s stomach. He stood to do now but to wait for the ambos to get slowly, feeling in his pockets and still not here.’ looking at Dr Vostram.

DARCY LAWLER Dr Vostram’s moustache continued its trick with his tie and beard, Dr Vostram impression of a spiny sea creature, but Dr puffed out his chest and said in his most Vostram himself was suddenly calm. He impressive voice: ‘I am Dr Vostram – Head had decided that the man in front of him of cardio-thoracic surgery.’ was obviously a lunatic. Quite a dangerous ‘Oh ho,’ said the young man, ‘so you’re a one he would guess. When the paramedics doctor too eh? Well, then I suppose that got here, he would tell them so and they you see there’s simply nothing to do for the would take him away. For now, however, it moment but to wait.’ was simply imperative that he examine the ‘We-hell,’ scoffed Dr Vostram, ‘I think patient. I’ll be the judge of that my lad. After all, ‘Sir,’ he said, ‘you are obviously quite I am-’ Dr Vostram paused, scolding finger unwell. When the paramedics arrive, they outstretched. His moustache again began will tend to you. However, right now I to bristle menacingly and his eyes bulged simply must see the patient.’ from a face like a scarlet potato. Quietly, The young man looked around him, menacingly, never lowering his finger Dr startled. He looked first over his left Vostram said ‘What do you mean too?’ shoulder, then over his right pirouetting The young man was wary now, Dr Vostram to see to whom Dr Vostram was referring. was clearly unhinged. Never taking his At last, when he was facing forwards again, eyes from the outstretched, sabre-like digit he pointed a long, manicured finger at his he asked, ‘What do I mean too, what?’ chest and said, Dr Vostram, while continuing to look ‘Me?’ apoplectic managed also to look slightly ‘Yes indeed.’ Said Dr Vostram. ‘I suspect confused. you are suffering from a form of mania, or ‘What?’ He said after a pause of several perhaps a psychosis of some description. seconds. Anyhow,’ he said with satisfaction, ‘the Now it was the young man’s turn to look paramedics shall be here soon to look at confused. you.’ ‘What, what?’ He asked. ‘Oh,’ said the young man, ‘you’re a ‘What?’ said Dr Vostram again, his voice psychiatrist are you?’ He said the word cracking slightly this time. psychiatrist with a particularly ironical ‘Oh,’ said the young man, ‘I see. You meant raise of his eyebrows. This started Dr what did I mean by too, yes?’ Vostram coughing and spluttering again. ‘Yes.’ Said Dr Vostram in his newly adopted ‘A PSYCHIATRIST?’ he managed. ‘A voice of quite menace. psychiatrist?’ He asked again in between ‘As well.’ Said the young man, rather pleased coughs. ‘I most certainly am not!’ Still that he had finally got to the bottom of the coughing, Dr Vostram neatly whisked matter. a handkerchief from his jacket pocket ‘As well?’ Asked Dr Vostram. ‘As well coughed a large glob of phlegm into it. what?’ Standing up and again performing his

Doctor Vostrom DARCY LAWLER ‘As well’ noted the young doctor, ‘Dr M. Dr Toboggan, caught entirely off guard Toboggan’ he said extending a hand. After by this athletic display of lunacy, landed waiting some seconds for it to be shaken he firmly on his back, and Dr Vostram, still awkwardly put both hands into his chinos screeching his animalistic war cry, began and rocked slightly on his heels. He began to punch and scratch at Dr Toboggan’s whistling a jazz standard he’d had stuck in face. Dr Toboggan, alarmed, attempted to his head all morning and looked into the catch his assailant’s hands and then rolled sky at the clouds. over, forcing Dr Vostram to the ground. Dr The patient at their feet gave a slight groan Vostram however, was far swifter than he and Dr Toboggan looked down at her, appeared. He rolled out from underneath pausing with his lips pursed. ‘Nothing to Dr Toboggan and sprang to his feet- hands do I’m afraid but to wait for the ambulance.’ up in a perfect, classical boxing pose. The He said slowly and clearly to her. ‘Shouldn’t crowd around the two brawling doctors be too long now.’ were in flights of well concealed ecstasy at Dr Vostram still hadn’t moved, although this new entertainment and stared, with his face had gone from scarlet to an what they assumed were concerned faces, unhealthy yellowy-green. at the two doctors. Dr Toboggan however ‘Are you alright?’ asked Dr Toboggan was not boxer. In fact, in his university concerned again. days he had been first inside flanker and Dr Vostram was not alright. In fact, as such he launched himself, arms wide, at his levator palpebrae superioris began the venerable Dr Vostram, knocking him to twitch alarmingly. Seeing this Dr to the floor where he grabbed hold of the Toboggan shuffled briskly to the opposite venerable beard and began tugging. This side of the patient. The crowd too seemed produced, from Dr Vostram, a howl of to sense the danger and was holding its entirely new cadence. Dr Vostram began breath in excitement. Dr Vostram took one, feeling blindly behind him for a weapon shuddering inhalation, and one equally with which to beat the doctor who was rattling exhalation and, without saying a now astride him. His crawling hand word bent towards the patient. came upon a boot which, grasping firmly ‘Ah.’ Said Dr Toboggan, gently grabbing Dr he swung towards his assailant. It was, Vostram’s shoulder ‘I think it would be best however, far more than a boot. With a wet, if you left her be. I’ve already examined her slapping sound, the woman’s severed leg see, and there’s nothing to be done. Perhaps squelched into Dr Toboggan’s head and you should take a se-‘ sent him sprawling. Dr Vostram however But this, finally was too much for Dr had lost control of the leg which landed a Vostram. With an enraged shriek entirely few metres from where Dr Toboggan lay. unbecoming of a man of his venerable age Dr Vostram scrambled towards it. It was and experience, he launched himself across however snatched up by a man in a large, the groaning body stretched at his feet and dark blue jumpsuit. tackled Dr Toboggan around the waist.

-031 The doctors froze, blood smeared and panting and stared. Behind the man who had picked up the leg, two paramedics were loading the lifeless corpse of the patient into the back of an ambulance. Innominate

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