THE WORSLEY TIMES

Author: Worsley Times

  • Leeds University Medics and Dentists Theatre Society’s The Lightning Thief: A Review

    Leeds University Medics and Dentists Theatre Society’s The Lightning Thief: A Review

    Holly Dobbing, Year 2

    This month was the Leeds Amateur Medics Musical and Performance Society (LAMMPS) production of ‘The Lightning Thief – The Percy Jackson Musical’. If you haven’t already heard of the books or movies—what else were you doing as a child?—the story follows a teenage boy, Percy, who discovers he is the son of a Greek god and is given a quest to find Zeus’ missing lightning bolt. Along the way, he makes friends and encounters various mythological monsters. I was a bit sceptical at first—I mean Percy Jackson? Forgive me, but I did not think Greek gods and fighting teenagers would make a particularly good musical. But I was completely proved wrong. 

    Firstly, the cast were so very impressive. Cameron Mullin (Percy), Nathalie Hall (Annabeth) and Mya Lane (Grover) made a terrific trio. Not only were their voices incredible, but their comic timing and interactions made their scenes hilarious. At Camp Half-Blood, Percy also meets Luke, played by Zak Muggleton-Gellas, one of our very own Worsley Times writers. I already knew Zak had an incredible voice, but he really shined as the trickster villain. Percy also hears a story about Thalia (Kate Gerrard), Zeus’ daughter who died at Camp Half-blood when Annabeth and Luke were children. Showing the cast could do more than just comedy, this moment felt genuinely sincere and I loved the symbolism of Thalia as the tree rather than an obvious leaf-and-bark costume. 

    Whilst at Camp Half-Blood, Percy meets Silena (Maisie Wilson), daughter of Aphrodite, and Katie (Nell Halls), daughter of Demeter, who were both hilarious. He later encounters Oracle (Lucy Hanson-Wilcock), who gives him the prophecy for his quest. He also meets Clarisse (CJ Proctor). CJ has such an incredible voice—her performance was utterly unforgettable and gave me chills! The fight scene between Clarisse and Annabeth in ‘Put You in Your Place’ was so entertaining, combining a big combat choreography and both of their powerful voices. The tension between the two groups was highly believable. 

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    Another interesting dynamic was that between Percy, his mother Sally (Leah Greenman), and his stepfather Gabe (Josh Phillips). Although I know that the actors were the same age and not related, I was completely convinced that Sally was Percy’s mother—as Sally, Leah was so maternal, even in subtle ways like how she simply looked at Percy. And as for the hilarious Josh, all I’m going to say is bean… dip. 

    I have a special appreciation for the actors who played the teachers. Henry Marshall as Mr Brunner was hysterical—his total commitment to being a centaur saw him galloping around the stage at any given opportunity. When chatting about the show with my friends after, we all agreed Cara Staniforth was a total scene-stealer as Mr D, stepping into the role of a fed-up exiled god in a way that was simply incredibly. And not forgetting Katherine Stanton who played Mrs Dodds and really threw herself into the role of creepy, monstrous teacher. 

    Later in the show, Percy encounters Charon—the entity tasked with transporting souls across the River Styx into the Underworld. Charon was played by Adele Kirby, who sang possibly my favourite song of the entire show ‘Dead on Arrival’. Not only was her voice amazing, but choreographer Niamh Robinson pulled all the stops out to create a huge dance number featuring the entire cast.

    There were also a variety of big names from Greek mythology throughout the play including Medusa (Sewa Sangowawa), Hades (Kayleigh Corbin), Kronos (Amy Wilson), Ares (Ciara Devlin) on a motorbike and Poseidon (Abraham Sondhi) in a Hawaiian shirt and flipflops.

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    Also not forgetting the all-important ensemble made up of Sevval Akkaya, Imogen Blacklidge, Niamh Rose, Eleanor McDevitt, Esther Mekako and Lauren Simmonds. All of them were great throughout the show, although I particularly liked them as fish that bobbed around Poseidon—so funny!

    And the music was simply incredible. Not just the cast’s singing, but the entire band and musical directors Alex Boulton and Zara Harris were outstanding. I also felt the lighting really reflected the mood of what was going on onstage. This isn’t something I normally notice when I’m watching shows, but in this performance, it really did stand out. The set itself was relatively simple but brought to life using a projector screen which showed clouds, forests and even Las Vegas. I thought this was a creative way to illustrate such a variety of scenes on one small stage. The production team behind this included Jay Sunley as Production Manager, Olivia Tinker and Shelley Smith as Co-Stage Managers with Beth Warriner as Deputy Stage Manager, Ben Nuttall as Lighting Director, Marta Fiorini as Set Designer, Nick Caddy and Daniel Stelmach as Sound Designer and Assistant Sound Designer respectively, James Bushby as AV Designer and finally Asher Lei as House Manager.

    Overall, I was super impressed. I want to offer a huge congratulations to all of the cast, musicians, production team and backstage team for such a fun show, and especially to director Ruth Rusnak and producer Martha Dawson for bringing it all to life! 

    Photos by @aswainphotography on Instagram

  • Superman or Super Ordinary: Are We Born with Special Gifts or is ‘Natural’ Talent a Myth?

    Superman or Super Ordinary: Are We Born with Special Gifts or is ‘Natural’ Talent a Myth?

    Holly Dobbing, Year 2

    I’m sure you know someone who makes solving maths equations look as easy as reciting the alphabet. Or there’s always that one addition to your quiz team who seems to have an eidetic memory. And even people with gifts for sports, who can turn their hand at any physical activity and appear like they were born to do so. We can all think of people who seem so naturally talented in a given area, that it seems impossible that they weren’t born with some sort of genetic advantage. But is this the case? Are some of us born with different abilities or are there other factors at play? 

    Of course, practice is pivotal to excelling in a certain field. Violinists in the world’s top orchestras don’t achieve that level of excellence without complete dedication and gruelling practice throughout their lives. Likewise Olympic athletes and world-class sportspeople, elite academics and even those people who can solve a Rubik’s cube in under a minute aren’t able to do these things overnight. In his book ‘Talent is Overrated’, award-winning journalist Geoff Colvin discusses the importance and necessity of ‘deliberate practice’ in being successful (Colvin, 2019). He explains how we often assume we have either have an aptitude for something, or we don’t, when actually no one fits into these strict categories—talent isn’t something you have or not, it is something you gain (Colvin, 2019). He also says ‘great performance isn’t reserved for a preordained few’ because in reality, there is nothing genetic or insurmountable difference separating us from world-class performers except practice. 

    Another key and often over-looked factor is opportunity. This can be as simple as where you live. In his book ‘Bounce’, international table-tennis champion Matthew Syed discusses the true nature of talent and how success isn’t confined to those with a genetic predisposition to greatness (Syed, 2010). He talks about his success in table tennis, and how the street he grew up on produced ‘more outstanding table-tennis players than the rest of the nation combined’ (Syed, 2010). Was someone putting something in the water? No. They just all happened to attend the same school, with the same hard-working coach, and a high performing table-tennis club nearby (Syed, 2010). He also talks about a similar scenario in Canada, where almost all top ice-hockey players are born in January, February or March (Syed, 2010). Of course, this isn’t due to some crazy genetic mutation—it’s actually because the boys born earlier in the year were more likely to be picked by scouts because they looked bigger, stronger and more mature, and so would have additional opportunities to train and practice and therefore improve quicker and ultimately be more successful (Syed, 2010). Strange to think, but if you imagine one of your role models—maybe if they were born somewhere else or at a different point in time, they wouldn’t be where they are today. Maybe if Tiger Woods was born six months earlier, he wouldn’t even know how to hold a golf club. Similarly, maybe if you were born in the catchment area of a different school, you would be at the next Olympics representing team GB in the diving final alongside Tom Daley. Maybe not. But just maybe.  

    Still, even after reading all of this, I wasn’t one hundred percent convinced. What about people who excel at something the very first time they try it? You may argue that typically these people have prior experience in similar activities, where the very basic principles are the same. For example, being good at tennis because you have previously played badminton, or even less tangible links like being good at art and becoming an excellent surgeon (some studies indicate artistic hobbies improve dexterity and subsequently improve surgical practice (ADEA, 2022)). I’m still not convinced, but I think partly this is because it feels almost like a betrayal to be told that natural talent is a myth. We’re so used to looking up to our role models and thinking there is something special about them that sets them apart from us. But actually, maybe there isn’t. Perhaps it really does come down to opportunity and practice.

    It’s interesting because we’re so quick to believe that our circumstances in life reflect the disadvantages and failures we experience—not getting into your chosen university or not making it onto the top sports team—but we seem to be so reluctant to believe that these things could also give us advantages. Yes, it’s obvious that you will have advantages if you’re born into a family with lots of money and influence, but you can also be privileged just by being born at the beginning of the school year, or by being the youngest child in the family. Ultimately, what I’m trying to say is this: talent may or may not be a concept made by humans to explain people who are more successful than ourselves, but it is not confined to a select few. Hard-work and determination will result in success.  

    References

    ADEA. 2022. The Importance of Manual Dexterity [Online]. Available: https://www.adea.org/GoDental/Application_Prep/Preparing_for_Dental_School/The_Importance_of_Manual_Dexterity.aspx [Accessed 16th March 2022].

    COLVIN, G. 2019. Talent is Overrate: What Really Separates World-Class Performers from Everybody Else, Nicholas Brealey Publishing.

    SYED, M. 2010. Bounce: The Myth of Talent and the Power of Practice, UK, Fourth Estate GB.

  • Thumbs Up to Air Up?: Water Bottle Review

    Thumbs Up to Air Up?: Water Bottle Review

    Zak Muggleton-Gellas, Year 2

    Even after being met by a flurry of negativity from my trusted peers, my deluded hope for science to be revolutionary bested my doubts. I was on my way to buying a brand new water bottle: the Air Up. After having it recommended by a friend, I decided to cough up a monstrous £35. Two weeks later, I was – to what can only be compared as a child on Christmas morning – ripping apart the box to get to my new water bottle. 

    For those that have managed to avoid the copious amounts of adverts released by this company – I may classify it as bombardment – the air up bottle uses olfactory (smell) receptors (since a large majority of taste is from smell) to allow the consumer to experience a variety of flavours, compared to when just drinking plain water. I am a sucker for science that I would deem to be ‘pretty damn cool.’ I dashed upstairs when the doorbell rang and quickly rinsed the bottle (admittedly could have been more thoroughly, but then the water bottle tastes like soap for days and, if we are honest, that would ruin just about anyone’s day) and filled it to the brim with cold, refreshing water. 

    The pack comes with a sturdy water bottle, a thick straw, an insert that gets attached to the straw, a lid and a few sample flavours (lime and passionfruit). After constructing the bottle, I inserted a lime disc and got ready to try it out. I took my first sip and was conflicted. 

    It is scientifically wondrous that pure water with nothing added turned out to taste even reminiscent of the projected flavour. They have invented what is effectively a glorified perfume mechanism and it does work! Additionally, it has to be said that I drank significantly more water than usual for the coming weeks, maybe just motivated by the novelty? The million dollar question: Does it work well enough?

    Each disc is claimed to last for 5 litres, which is definitely less economically viable than a £1 bottle of squash. A human should drink up to around four litres a day, and at a staggering £2.30 (6.95) per pod, it is an expensive hobby. Upon purchase, I was under the impression that it lasted for 60 litres, but that was entirely due to my lack of common sense. 

    Even if someone were to have blindfolded me and tested if I could correctly identify the taste, I probably would have got it correct, but that’s not the crux of the issue. It tasted almost like drinking water with squash but only a few drops of it in a cup. In order for it to be fully worth the money, the flavour would have to be more pungent. If you are expecting a substitute to alternatives (such as squash) then airup is not what you’re looking for, but if you are simply just intrigued, then why not? Personally as a student, I’d recommend saving your money. 

    Almost four months later, the bottle is broken (it leaked almost every time I tried to use it) and the tag at which you can hold the bottle by has ripped off. This could be an individualised experience which is why I’ve decided not to include it as a negative above. But nevertheless, I wouldn’t say my care was particularly haphazard, so maybe I deserve a replacement. But as I’m sure many can relate, the effort that would require is just a little too great – unlike this water bottle.

  • Conversion Therapy: Why Medical Students Need to Stand With Their Trans Patients

    Conversion Therapy: Why Medical Students Need to Stand With Their Trans Patients

    Amy Wilson, Year 2

    Stone, G. (2022) – Image of the protests following the ban’s announcement

    The Government’s decision not to ban conversion therapy for transgender people just days after this year’s Trans Day of Visibility has shown why, now more than ever, we need to be educated on issues that will affect our trans friends, family, colleagues and patients.

    Conversion therapy, also known as cure therapy or reparative therapy, refers to any form of treatment or psychotherapy that aims to change or suppress an individual’s sexual orientation or gender identity (Stonewall 2022). The Trevor Project, a charity that focuses on LGBTQ+ mental health and suicide prevention, states that conversion therapists use “a variety of shaming, emotionally traumatic or physically painful stimuli to make their victims associate those stimuli with their LGBTQ identities” (Young, S. and Ng, K. 2022). It can take place in a variety of contexts, such through religious, cultural or healthcare groups (Ban Conversion Therapy 2022).

    It is not an uncommon occurrence. Alarmingly, 7% of LGBT people have been offered or undergone conversion therapy, jumping to 10% of asexual people and 13% of trans people (Ban Conversion Therapy 2022). In healthcare settings, 1 in 20 LGBT people have been pressured to question or change their identities when accessing services (Stonewall 2022).

    As a practice, it has been widely condemned. In the UK, all major counselling groups alongside the NHS have signed a Memorandum of Understanding decrying it (Stonewall 2022). This is due to its numerous negative impacts, such as increased depression, suicidality, self-hatred and social isolation (GOV.UK 2022). As practitioners of evidence-based medicine, the lack of credible support for it is key as we consider the Government’s failure to ban conversion therapy for trans people.

    Initially, the government said it would drop plans for the ban for all LGBTQ+ people, announcing that ministers would explore non-legislative routes (Milton, J. 2022). It then announced that the ban would go ahead for LGB people, but not their trans counterparts. This led to enormous backlash, with LGBTQ+ organisations and The Memorandum of Understanding Coalition Against Conversion Therapy (MOU), whose members include NHS England, the BMA and several major counselling and psychotherapy bodies, openly criticizing the motion (Parry, J. and Moss, L. 2022). Both the Welsh and Scottish governments have been investigating routes for banning transgender conversion therapy (Milton, J. 2022).

    The ban will impact the trans community in multiple ways, but particularly within medicine. The BMA Media Office (2022) pointed out that “services for trans individuals in the NHS are already insufficient; the waiting list for young people to access gender identity development services can be two years or more”. They later went on to say that without the protection of the conversion therapy ban, trans and nonbinary people will likely face increased amounts of isolation and social prejudice.

    This is on top of current prejudices within medicine. According to Stonewall and YouGov (2018), two-thirds of trans people in their study had avoided treatment out of fear of prejudice, likely due to 20% of them having witness discriminatory or negative remarks regarding LGBTQ+ people.

    Trans people are not just being discriminated against in the UK. With Florida’s “Don’t Say Gay” Bill, LGBTQ+ people could be forcibly outed and discriminated against within schools in the state (Woodward, A. 2022). Additionally, trans people in Ukraine are being prevented from crossing borders due to the gender markers on their passport being perceived as incorrect, leading to fears of being trapped in a country with no anti-discrimination laws and in danger of Russia’s transphobic policies (Tondo, L. 2022).

    Trans and nonbinary people are being discriminated against in the UK and beyond. As medical students with a responsibility to our patients, I urge all cisgender students to take the steps to educate themselves and include this community in your work. It may only seem like small steps but doing whatever we can matters now more than ever. 

    Further Resources:

    • Ban Conversion Therapy – The best starting place for further resources on the ban and instructions how to write to your MP. See references for link.
    • GLADD – The Association of LGBTQ+ doctors and dentists, with plenty of resources on being an ally and how to take care of yourself as a queer doctor. Available at: https://gladd.co.uk/. 
    • Future Learn’s Transgender Healthcare course – provides information on trans issues and how to provide good care for trans patients. Available at: https://www.futurelearn.com/courses/transgender-in-healthcare 

    References

    Ban Conversion Therapy (2022). “Home”. Banconversiontherapy.com [Online]. Available from: https://www.banconversiontherapy.com/. [Accessed 03/03/2022].

    BMA Media Office (2022). “Ban on ‘conversion therapy’ must extend to every member of the LGBTQ+ community, says BMA”. BMA.org.uk [Online]. Available from: https://www.bma.org.uk/bma-media-centre/ban-on-conversion-therapy-must-extend-to-every-member-of-the-lgbtqplus-community-says-bma. [Accessed 07/04/2022]. 

    GOV.UK (2022). “Conversion therapy: an evidence assessment and qualitative study”. www.gov.uk [Online]. Available from: https://www.gov.uk/government/publications/conversion-therapy-an-evidence-assessment-and-qualitative-study/conversion-therapy-an-evidence-assessment-and-qualitative-study. [Accessed 07/04/2022].

    Milton, J. (2022). “Trans conversion therapy must end without delay”. Pinknews.co.uk [Online]. Available from: https://www.pinknews.co.uk/2022/04/06/conversion-therapy-ban-uk-medical-assocation/. [Accessed 07/04/2022].

    Parry, J. and Moss, L. (2022). “Mental health groups call for trans conversion therapy ban”. BBC News [Online]. Available from: https://www.bbc.co.uk/news/uk-61018404. [Accessed 07/04/2022].

    Stone, G. (2022). “After the Government’s conversion therapy U-turn, trans people need LGB allies more than ever”. I News [Online]. Available from: https://inews.co.uk/opinion/governments-conversion-therapy-u-turn-trans-people-need-lgb-allies-1552968. [Accessed 07/04/2022].

    Stonewall (2022). “Conversion Therapy”. Stonewall.org.uk [Online]. Available from: https://www.stonewall.org.uk/campaign-groups/conversion-therapy. [Accessed 07/04/2022].

    Stonewall and YouGov (2018). “LGBT In Britain Health Report”. Stonewall.org.uk [Online]. Available from: https://www.stonewall.org.uk/system/files/lgbt_in_britain_health.pdf. [Accessed 07/04/2021].

    Tondo, L. (2022). “I will not be held prisoner”. The Guardian [Online]. Available from: https://www.theguardian.com/global-development/2022/mar/22/i-will-not-be-held-prisoner-the-trans-women-turned-back-at-ukraines-borders/. [Accessed: 07/04/2022].

    Woodward, A. (2022). “What is Florida’s ‘Don’t Say Gay’ Bill?”. The Independent. [Online]. Available from: https://www.independent.co.uk/news/world/americas/us-politics/dont-say-gay-bill-florida-ron-desantis-b2048570.html. [Accessed 07/04/2022].Young, S. and Ng, K. (2022).

    “Conversion therapy: what is it and has it been banned in Britain?”. The Independent [Online]. Available from: https://www.independent.co.uk/life-style/what-is-conversion-therapy-ban-lgbt-b2048823.html. [Accessed: 07/04/2022].

  • Why Would They Do Such a Thing: What is Motivation and Does it Link to an Individual’s Mental Health?

    Why Would They Do Such a Thing: What is Motivation and Does it Link to an Individual’s Mental Health?

    Matty Griffiths, Year 2 Sports and Exercise Science, Durham University.   

    The importance of people’s psychological well-being in western societies has been translated into many areas, one of these being sport. Sports psychology has proved itself to be key in maximising performance within the athletic population. One of the most important and intriguing aspects of sports psychology looks at motivation (Marheni et al, 2018) and more recently its elevated significance in mental health. This article will walk you through how motivation is categorised and later explore how it may be linked to mental health, as I think the findings have a broader application than the sporting context in which they were conceived. 

    How motivation is categorised 

    Research around Motivation by Deci and Ryan (1985) saw the emergence of the Self-determination theory (SDT), the basis for much of the academic understanding of motivation. Within SDT, Organismic Integration Theory (OIT) describes the states of motivation an individual can experience: Amotivation, Extrinsic Motivation and Intrinsic motivation. 

    Starting with Amotivation, this is a state where an individual simply feels unmotivated. They are no desire to engage which will mean an individual perceives themselves as incompetent and/or has the perception that any outcome from participation will yield no positive impact. 

    Meanwhile, extrinsic motivation has multiple layers which investigate how external entities affect an individual’s drive. Different regulatory styles explain how someone is externally motivated. An externally regulated individual would have rewards and punishments dictate their engagement in a specific exercise. Introjected regulation results in an individual’s compliance being a result of them feeling shame if they did not. Identified regulation would mean someone sees the benefit in partaking in an activity but not the activity itself. Finally, integrated regulation is when someone feels participation is part of their ethos and in line with their values. For example, someone who attends all of their academic commitments because being a ‘good student’ is something they believe in. 

    Intrinsic motivation, however, simply refers to the drive to do something coming from the pure form of enjoyment and inherent satisfaction that is felt by someone partaking in an activity. While this is a better predictor of long-term engagement with activities over extrinsic motivation, it has also been shown to correlate with higher burnout rates due to the intensity of application that it can lead to.

    What can impact motivation? 

    Appreciating the complexity of motivation is vital when looking at its link with mental health (Lake and Turner, 2017), such as the quality of an individual’s motivation over its extent or. seeing that their motivation may be situational (Gillet et al, 2017). An example of this can be seen in Vygotsky’s Zone of Proximal Development (1978). Vygotsky (1978) suggests there is an optimum level of difficulty to maximise learning: a task needs to be stimulating enough to require effort from the leaner, yet not so challenging that they do not see themselves as competent enough for it. This can occur naturally, as Vygotsky observed that parents naturally speak to their children slightly above their child’s current linguistic ability, yet not too far beyond it so that the parents can still be understood.   

    This links to an aspect of SDT (Deci and Ryan, 1985) called Basic Needs Theory. This theory states that there are three criteria that an individual needs to support a healthy psyche: Competence, Autonomy and Relatedness.  As stated in Vygotsky’s Zone of Proximal Development (1978), an individual must feel they can be competent at a task for them to participate effectively, which is echoed within Basic Needs Theory. Autonomy is the need for an individual to feel as they are in control of what they are doing, which can be a criticism of extrinsic motivation. Relatedness links how the individual feels a certain activity will affect them within a social context. Basic Needs Theory helps support the blend between social and physiological requirements and contextualises them when looking at motivation. 

    How does motivation affect mental health? 

    A study conducted by Sheehan et al (2018) aimed to look at the correlation between types of motivation and mental health within a sporting population. Some intriguing findings were made, for example, introjected regulation within an individual who is externally motivated resulted in a poor mood along with feelings of anxiety in those who experience extrinsic regulation. Looking at intrinsic motivation, while there was a correlation between factors such as autonomy and an increase in positive mood states, depressive states were also common. 

    Context when assessing mental health is vital, so taking these findings with caution is advised. However, there is a clear correlation between poor moods and feelings of anxiety for the extrinsically motivated and positive mood states for those who are intrinsically motivated. One exception is the link between depressive states and burnout in intrinsically motivated populations (Leymre et al, 2007)  

    Although these findings are taken from a sporting context, I feel the awareness of where our motivation comes from and how that makes us feel is key in caring for our mental health. So, as we move into exam season, I think the biggest takeaway is just to be aware of what drives you to get up for that early lecture or pull that all-nighter at the library and how that might be making you and your peers feel. 

    References

    Deci, E.L. and Ryan, R.M., (2012). Self-determination theory.

    Gillet, N., Morin, A.J. and Reeve, J., (2017). ‘Stability, change, and implications of students’ motivation profiles: A latent transition analysis.’ Contemporary Educational Psychology, 51, pp.222-239.

    Lake, J. and Turner, M.S., (2017). ‘Urgent need for improved mental health care and a more collaborative model of care.’ The Permanente Journal, 21.

    Lemyre, P.N., Roberts, G.C. and Stray-Gundersen, J., (2007). ‘Motivation, overtraining, and burnout: Can self-determined motivation predict overtraining and burnout in elite athletes?’ European Journal of Sport Science, 7(2), pp.115-126.

    Marheni, E., Purnomo, E. and Cahyani, F.I., (2019). ‘The Role of Motivation in Increasing Achievement: Perspective Sports Psychology.’ In 2nd International Conference on Sports Sciences and Health 2018, pp. 59-62.

    Sheehan, R.B., Herring, M.P. and Campbell, M.J., (2018). ‘Associations between motivation and mental health in sport: A test of the hierarchical model of intrinsic and extrinsic motivation.’ Frontiers in psychology, 9, pp. 707.

    Vygotsky, L. S. (1978). ‘Mind in society: The development of higher psychological processes.’ Cambridge, MA: Harvard University Press.

  • Animals in Mental Health Treatments

    Animals in Mental Health Treatments

    Imogen Jones, Year 2

    Mental health disorders can be chronically disabling for many people, with around 14% of the global burden of disease attributed to neuropsychiatric disorders (Prince et al., 2007). Many conditions such as depression and anxiety have been linked to an increased risk of developing many diseases, as well as increased incidences of both intentional and accidental injury (Prince et al., 2007). Since the start of the COVID-19 pandemic the prevalence of mental health disorders in many societies has significantly risen and strain on NHS mental health resources has increased as a result. This study aims to assess the prospective success of emotional support animals as a means of ongoing help for individuals living with different mental health conditions.

    The Problem of Mental Health & COVID-19

    During the COVID-19 pandemic we saw a rise in the prevalence of mental health conditions, with anxiety and depression being the most common. Through the first month of the April 2020 lockdown the population prevalence of clinically significant levels of mental distress rose from 18.9% to 27.3%, showing an almost 50% increase (Pierce et al., 2020). This rise in mental health disorders has put strain on the NHS, with waiting lists for therapists and psychologists reaching around six months. 

    Mental health disorders can cause many health risks beyond the psychological toll they have on patients. With risk of injury, illness and other health conditions rising in individuals suffering from mental health conditions it is important that measures are put in place to assist people struggling with mental health disorders in the long term (Prince et al., 2007). These long-term measures may include many types of therapy as well as drugs such as antidepressants. However, these drugs can have many side effects and are not a viable option for all individuals.

    The Effect of Animals on Mental Health Outcomes

    Animals have been used in the treatment of mental health disorders since the late 18th century in England (Shubert, 2012). Since then, animals have been used as tools in therapy sessions, schools, offices and many other places to help individuals lower anxiety and improve mental health outcomes. In one study by Barker et al. (2003), patients who were being treated with electroconvulsive therapy (ECT) took part in a trial to see the effects of animal assisted therapy (AAT). During the study, half the patients were assigned 15 minutes of AAT before their ECT treatment while the other half spent 15 minutes with magazines before treatment. The patients were tested to discover their fear and anxiety levels and found that ‘AAT reduced fear by 37% and anxiety by 18%’ (Barker et al., 2003). This study suggests that the presence of an animal, even only for 15 minutes, can help reduce anxiety levels significantly.

    Another study by Wołyńczyk-Gmaj et al. (2021) involved patients suffering with anxiety disorders. During the study, half of the patients spent 15-20 minutes walking with a dog and researcher outside, while the other half walked with only the researcher. The research found the group who walked with the dogs reported lower anxiety and fear levels as well as resting heart rate being reduced. 

    Current Laws Surrounding Assistance Animals

    In the UK, current laws give leniency to service dogs such as guide dogs, allowing them entry to different shops and social areas, as well as preventing individuals such as landlords from rejecting potential tenants. However, as emotional support animals are not recognised as assistance animals, this can lead to many problems for owners who rely on these animals in everyday life. It is important to note that for emotional support animals to be recognised as assistance animals there would need to be clear guidelines on the qualifications to require one, as well as levels of training that the animal will need. It would also be important to know that the patient has the ability to care for the assistance animal fully.

    Overall, the evidence of current research suggests that animals such as dogs can be extremely successful in improving mental health outcomes, especially for individuals suffering from depression and anxiety. This indicates that the inclusion of emotional support animals as assistance animals could be successful in improving the lives of many patients suffering with different mental health conditions. However, before this inclusion can be made, standards would need to be created with regards to the training of animals and eligibility of individuals.

    References

    Barker, S.B., Pandurangi, A.K. and Best, A.M. 2003. Effects of Animal-Assisted Therapy on Patients’ Anxiety, Fear, and Depression Before ECT. The Journal of ECT. 19(1), pp.38-44.

    Pierce, M., Hope, H., Ford, T., Hatch, S., Hotopf, M., John, A., Kontopantelis, E., Webb, R., Wessely, S., McManus, S. and Abel, K.M. 2020. Mental health before and during the COVID-19 pandemic: a longitudinal probability sample survey of the UK population. The Lancet Psychiatry. 7(10), pp.883-892.

    Prince, M., Patel, V., Saxena, S., Maj, M., Maselko, J., Phillips, M.R. and Rahman, A. 2007. No health without mental health. The Lancet. 370(9590), pp.859-877.

    Shubert, J. 2012. Dogs and human health/mental health: from the pleasure of their company to the benefits of their assistance. U.S. Army Medical Department Journal. p21+.

    Wołyńczyk-Gmaj, D., Ziółkowska, A., Rogala, P., Ścigała, D., Bryła, L., Gmaj, B. and Wojnar, M. 2021. Can Dog-Assisted Intervention Decrease Anxiety Level and Autonomic Agitation in Patients with Anxiety Disorders? Journal of Clinical Medicine. 10(21), p5171.

  • COVID Self-Isolation: A Review

    COVID Self-Isolation: A Review

    Elizabeth Ratcliffe, Year 2

    Day 5, Covid-19 self-isolation. Safe in the knowledge that my covid-y brain fog would prevent the creation of an insightful article on current medical affairs, I am going to review the simple trivial pleasures that have gotten me through the past five days. The idea for this piece was forged somewhere between my latest dose of painkillers and the next Netflix episode that I will certainly doze off during, and is partially for both my own entertainment/distraction and because I should contribute to the paper that I sit on the committee for. I cannot promise nuance or complexity, but I hope this is vaguely engaging and possibly funny. 

    Spoiler alert – read at your own risk!

    Entertainment

    The Hating Game – Sally Thorne

    4/5 stars

    A trashy novel – PERFECT for enjoyably mindless reading!

    The Hating Game follows colleagues/archnemeses Lucy Hutton and Joshua Templeman navigate the world of publishing and balance the fine line between love and hate.

    A simple and unrealistically romantic novel, with an enemies to lovers plotline—what more could a girl want? It would be an ideal holiday read and with the constant breeze from my window that can’t close properly and the brief rays of sunshine that Leeds managed this week, I could almost imagine I was reading on a beach in the south of France. 

    Almost, but not quite.

    I would recommend this book – it was a brilliant distraction from covid that I devoured!

    And if reading isn’t your thing Amazon have just adapted it into a film…

    Jake Wesley Rogers | Spotify

    Jacob Wesley Rogers’ Music

    5/5 stars

    A beautiful distraction – give his music a listen I promise you won’t regret it!

    With fewer than twenty songs on Spotify, Rogers is not yet a household name and I’m borderline embarrassed to admit that I found his music on TikTok (insert eye roll here). The 25-year-old singer/songwriter’s aesthetic is eclectic, eccentric and objectively cool, evoking the glam-rock fashions of David Bowie and Elton John, which let’s face it promises good music. Although his repertoire is limited to a mixture of singles and EPs and he ‘only’ has 279,359 monthly listeners (for context Drake has 53,662,363) his varied and emotive music alludes to the beginning of a very successful career. 

    His songs chronologically transform from paired back covers of The Pretenders’ ‘I’ll stand by you’ and Yazoo’s ‘Only You’ to his brilliant indie/rock and indie/pop originals. Rogers’ has the skill of all great songwriters to create songs that every listener can identify with and he effortlessly pairs them with big melodies.  ‘The Pretender’ tells the story of an inappropriate first love that is equally depressing and beautiful; and with lyrics like “And we embraced like the sand and the sea, I handed over contraband parts of me”, it tugs at the heartstrings. My personal favourite ‘Jacob from the Bible’ addresses the complexity of forgiveness, identity and religious guilt through a soaring melody and lyrics that are tangibly passionate. Whereas ‘Dark Bird’, his latest release, is like a 70s pop/rock song with a disco-y chorus that reminded me of long car journeys listening to my parent’s music – fun & nostalgic. It is blindingly clear from the 250 words I have just written that I am a big fan but if my ramblings can’t convince you to give his music a chance, Elton John thinks he is a ‘future superstar!” and I don’t think higher praise really exists. So don’t listen to me, listen to Elton!

    مشاهده وتحميل فيلم The Choice مجانا فشار | Fushaar

    The Choice

    3.5/5 stars

    Nicholas Sparks at his best -> my emotions at their worst

    A classic Nicholas Sparks film: boy meets girl, they’re an unlikely match, they’re both played by gorgeous actors, they fall in love and just as you’re getting comfortable, drifting off into a covid-y nap. BAMM!! Suddenly you’re in the middle of the husband’s tortuous decision about whether to turn his wife’s life support off and suddenly I’m applying the four pillars of medical ethics like it’s nobody’s business. It was acutely emotional and I was right there with them – truly immersed in the story.

    The film made me laugh and made me cry which is what I consented to when I put on something by Nicholas Sparks. My only objection is that the film focused more on the husband’s career as a vet rather than the wife’s blossoming medical career, this didn’t really detract from the plot but I’m deducting half a star because I can. 

    If you like a soppy romantic film it’s ideal (just maybe bring a Kleenex).

    Bridgerton

    4/5 stars

    Takes Jane Austen & makes it sexy…

    I promise I’m not that late to the party, COVID just gave me the perfect opportunity to rewatch Season 1 of Netflix/Shondaland’s Bridgerton, just in time for the release of Season 2 in late March. However, just in case you’ve been burying your head in the sand, Bridgerton glamorously captures the intrigue and suffocating etiquette of Regency London in a heady wash of pastels and florals. Romantic, funny and actually surprising, this series kept me thoroughly engaged the first time I watched it and mostly engaged (between naps) the second time; and I’m really looking forward to the next series coming out. 

    If you have ever watched Pride and Prejudice and thought ‘this is too prudish for my taste’, Bridgerton is the perfect series for you!

    Food

    PRINGLES SALT & VINEGAR 53G (12)

    Salt and Vinegar Pringles

    4.5/5 stars

    I am a salt & vinegar girl so I have (almost) no complaints…

    I bought them for a reason and I will always love them. That vinegary-ness that is so sour it burns a little is perfection, although not ideal for a very sore throat (but I soldiered through). 

    HOWEVER, I have deducted half a star because Julius Pringles (yes that is his name – I googled it!) has had some sort of minimalist makeover that I do not approve of. 

    Although I am not deterred and will obviously buy them again – they are a classic!

    My Breakfast Wraps

    5/5 stars

    Created pre-isolation these wraps have truly come into their own – cheese, avocado, egg, tomatoes – they’re an ideal filling breakfast with all the food groups. What’s not to like? 

    Perhaps it’s a little self-indulgent to award these wraps five stars as I created them but I am reviewing them so… 

    Morrisons Kitchen Aromatic Shredded Duck

    3.5/5 stars

    Better than expected!!

    For £2.75 I didn’t have high expectations for my little “treat yourself you have covid” fake-away but it was surprisingly tasty and almost as good as my local Chinese. I decided to go rogue, ignore the instructions and crisp up the duck under the grill with the sauce on it (which I would thoroughly recommend). All in all, a very good dinner which made me feel a tiny bit fancier than pesto pasta would have done.

    Other

    Amazon Prime Day 2020: When Will The Sale Start This Year ...

    Amazon

    0.5/5 stars

    Please don’t judge me too hard…

    It’s ruining the planet, it’s morally beyond dubious and one has to sell their soul to Jeff Bezos BUT it’s just so damn convenient! From where else in the confines of my self-isolation could I order a book, Morrisons groceries, a moisturiser and a fob watch for placement? They just make it so easy to sell out to capitalist overconsumption!! 

    So, in order to regain some of my self-indulgent moral superiority, I’ll only rate Amazon half a star (the products were good) and I’ll reflect upon my actions/spending choices and do better next time. (Maybe). 

    Leeds TV | NEWS ROUNDUP: Enhanced COVID-19 testing - Leeds TV

    Woodhouse Moor PCR Testing Centre

    2.5/5 stars

    Could have had a better outcome!

    As getting my PCR test was my last venture into the real world, I want to give the experience 5/5 stars. The staff were lovely, the centre was quiet, I didn’t have to queue and I got to walk through Woodhouse Moor which was looking exceptionally springlike with crocuses emerging through the chaos Storm Eunice left in her wake. Would have been a perfect trip out had it not been for the dreaded NHS automated ‘you’ve got covid’ message which put a dampener on the experience.

    COVID-19

    0/5 stars

    I would like to speak to a manager about a refund!!

    I am very grateful that my experience with covid has been comparatively mild and inconsequential thus far, but I am also SOOO over having covid. Firstly, it’s really boring, secondly, I have no desire to cough up my own lungs and thirdly I’d like to be able to do literally anything and not require a nap! I am DEEPLY regretting the number of immunity/’built different jokes’ I have made in the past. True I got to do a lot of nothing, but I cannot emphasise enough: I do NOT recommend Covid!

    Lizzie’s Self-Isolation Breakfast Wraps

    Ingredients:

    • Tortilla wrap(s) – I go wholegrain it feels healthier 
    • Nando’s Medium Peri-Peri Sauce – other brands and levels of spice are available 
    • ½ Avocado 
    • Polish gyros seasoning – trust me it works 
    • Lemon juice 
    • Egg(s)
    • Cheese – I’d recommend a selection for some variety – e.g. cheddar, feta and grated mozzarella
    • Sliced tomatoes 
    • Salad leaves – I like spinach and rocket  
    • Salt & pepper
    • Cumin seeds – these go sooo well with eggs 
    • Butter

    Method:

    1. Melt the butter in a frying pan, scramble your egg(s) into it and season with salt, pepper and cumin seeds.
    2. Meanwhile, mash the avocado with some lemon juice and gyros seasoning.
    3. Assemble the wrap: a smear of peri-peri sauce, then avocado, egg, salad, tomato and finally crumble on the cheese. Fill it as much as your heart allows then try to roll it up. 
    4. Quickly wash up the frying pan and get it back on the heat. 
    5. Toast the wraps until the outside is golden brown, slice in half and serve (with a cup of tea). 

    Have one wrap, have two. Go wild and add crispy bacon, black beans, some pickled jalapenos, fresh coriander, roasted peppers – the world is truly your oyster.

  • Week In the Life: First-Year Medical Student at Sheffield

    Week In the Life: First-Year Medical Student at Sheffield

    Elora Graham, Year 1

    Hello all! I am a first-year medic at the University of Sheffield and have been commissioned to write about my average week as a student here. Hopefully it is of some interest to the lovely medics of Leeds to get a snapshot of how an MBChB runs at a nearby university. If not, you are indulging my delusion of being the main character—and for that I thank you. 

    Our first year consists of seven main modules, similar to those at Leeds. We start with IMS and finish the year with body systems: Cardiovascular, Respiratory, GI/liver, Neuro, Musculoskeletal and the awkwardly named ‘SUGER’ (Skin, UroGenital, Endocrine, Reproductive). Within each block we cover anatomy, physiology, histology and some pathology. Alongside the lectures we have cadaveric dissection, GP teaching, small group tutorials and research projects. 

    The standard format is 9:00am – 12:00pm lectures,  but fortunately it’s quite easy to sneak in slightly later. All of our lectures happen in Medical Lecture Theatre 1 in the Royal Hallamshire Hospital. I daren’t count up the hours already spent there, or more concerningly their impact on my spine due to the seating’s notable lack of lumbar support. 

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    The week kicked off with a glorious late start: a 10am lecture in MLT1. Then, we headed down to the dissection room on campus for our anatomy session. Typically, four hours per week is timetabled for dissection.

    I admit I didn’t particularly consider anatomy teaching styles when applying for medicine, however dissection has become one of my favourite parts of the course here. Each group of around eight students gets one cadaver to work with throughout the year, dissecting everything while supervised by a demonstrator. It is such a great privilege to be able to see a whole human body in front of you and quite literally unpick the puzzle that makes up our anatomy. 

    I remember my first ever incision—it was a shallow, long cut along the S-shape of the left clavicle. The utter newness was startling to begin with and it can be nerve-wracking to pick up a scalpel week 1.  Having spent a fair few hours in the DR now, the stench of formaldehyde is oddly familiar (although ladling out formaldehyde from the lung cavity today was particularly pungent).

    I am endlessly grateful to those who have donated their bodies in support of our medical education. As much as it’s a cliché, I genuinely believe it’s an incredibly humbling experience. It is completely unique and truly valuable.

    For anyone considering Sheffield as an option for application, I would say that the full body dissection is one of its biggest selling points and is part of the course that has been developed extremely well. 

    In the evening, I went with some friends to the Notty House pub quiz—the #1 go-to for students (free nachos). No victories to write of, unfortunately.

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    We start as usual in our favourite place, MLT1, from 9-12 with some cranial nerve anatomy and pathology lectures.
     Afterwards, we commence our odyssey to GP Early Years. These fortnightly afternoon placements can be anywhere in the South

    Yorkshire area: for me, this means trekking 35 miles to Retford. On the weeks without GP, there are group tutorials covering physiological topics relevant to the module currently being studied. 

    In GP this week we discussed a hypothetical stroke patient, exploring the condition and its treatment. Then, a real life patient came in to chat about their own patient journey; this particular patient had an ischemic stroke that left him with homonymous hemianopia. I find being able to relate content from lectures to real clinical scenarios is very helpful. 

    The same can’t be said for the 35 mile journey home. 

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    Lectures again 9-12: a mix of public health and psychiatry. Though I am very grateful to have in-person teaching, one major drawback is the inability to pause or rewind real time. Some lectures could easily be understood in half the

    time whereas others you are in a constant state of panic, getting further and further behind. 

    I then went to my French class, which forced me to venture onto the actual uni campus and interact with the (saner) humanities students.

    That evening, I went to the Medics Revue – a comedy sketch show by students. It was a gloriously amateur performance; think gaudy lights, DIY costumes and lots of heckling. It mostly consisted of painfully accurate inside jokes and subtle digs. Some of my favourites were the musical parodies: Lizzo’s Good as Hell was adapted to “I’m feeling overwhelmed”…obviously could never be me. We finished the night at Roar, the student union’s Wednesday club night, which is the go-to for many uni sport societies and thus displays some of the absolute best/worst of student fancy dress. 

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    I just had one lecture this morning and so had the opportunity to get on with some of the ever-growing pile of work I need to finish off. 

    Sheffield is riddled with hills and the walk home is no different. It would not surprise me at all if a cross-sectional study found Sheffield students to have glutes of steel. 

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    Yet more lectures this morning, followed by our first neuro formative assessment. These assessments are an open-book, informal way of gauging your understanding. Talking of assessments, our end of year exams have 3 components: single best answer, multiple

    choice and an anatomy spotter. As a baby medic who hasn’t done any of them yet, I reserve any comment. 

    Then onto my second French class of the week, before heading to the train station to meet up with my gorgeous boyfriend for the weekend.


    Congratulations for reaching the end of my ramblings—I hope they were even slightly interesting! If you know anyone thinking of applying to Sheffield, I’m more than happy to answer any questions about applying or studying here. Just send me an email on egraham4@sheffield.ac.uk 🙂 

  • Why Should Healthcare Students Care About the Humanities?

    Why Should Healthcare Students Care About the Humanities?

    Alice Barber, Intercalating

    What are the humanities?

    When a lot of people—especially scientists like medical students—think of the humanities, it can often conjure thoughts of ‘fluffy’ subjects with no solid foundation. But, according to the British Academy, the humanities are as far from this as you can get – they are the study of the human societies that we live in, past and present (MacCulloch, D. 2018). As this suggests, it  includes a diversity of subjects—from history and politics to literature and ethics. The nature of the humanities is never-ending—not only are there many different human societies, but they evolve at such a rapid rate that they are not the same from one decade to the next. The humanities have much to offer and it is important for healthcare students to engage with them. 

    How can the humanities help us as medical students?

    Let’s look at how the humanities can benefit us personally. It is widely recognised that it is important for well-being to have interests outside of medicine (Mind, 2022). Whilst there are many different hobbies to consider, the humanities present a wide range of opportunities that are accessible to everyone. They provide us with outlets for the stress of our studies and allow us to focus on something that isn’t upcoming exams or what we saw on placement that day. 

    Other than just being a hobby, the humanities can help us to be better and more effective medical students and clinicians. In an emerging field known as bibliotherapy, reading fiction has been shown to greatly improve mental health and navigation of the uncertainties of life (Dovey, C. 2015). If reading can help us to develop emotional resilience as future doctors it should be an invaluable tool during our medical school careers and beyond. As well as personal development, fiction can help us develop skills key to being a doctor. For example, reading fiction has also been shown to help people to develop greater empathy (Dovey, C. 2015).  

    There are other areas of humanities that are essential to being informed about the world of medicine. It is imperative that we learn about the history of medicine, and its many failings, so that we can learn from the past. An example of this is the history of how women have been historically failed by medicine, which is discussed in great detail in the book ‘Unwell Women’ by Dr Elinor Cleghorn (Cleghorn, E. 2021). It is important that we are aware of the failings our predecessors and learn from them. 

    So, not only can the humanities help us to rest from the busy world of medicine, but they can also equip us with knowledge that makes us better clinicians and maintain our well-being whilst doing this. 

    How can the humanities help patients?

    Evidence has also shown that the humanities can present powerful ways to treat and support patients (Stuckey, H. L. & Nobel, J. 2010). The ways in which the humanities can benefit medical students by improving their mental health can also benefit patients. 

    In addition to the mental benefits, research has shown that engagement in humanities, especially music, can have physical benefits for patients (Hirsch, S., & Meckes, D. 2000). Music therapy has been shown to not only reduce anxiety levels in cancer patients, but also to reduce pain levels and increase immunity (Hirsch, S., & Meckes, D. 2000). Alongside music, expressive writing has been shown to have benefits for both mental and physical health, in particular immunity and the cardiovascular system (Esterling, B. A. et al. 1999).

    This creates a strong argument for health care students learning how to include humanities in patient care. As health care students we are studying to be able to provide the best care for our future patients, as the evidence has begun to show the vast benefit of the humanities, we should be willing to engage in learning about these avenues of treatment. 

    How can medical students get involved in humanities?

    Getting involved in the humanities doesn’t just have to be along the lines of what we learnt at school—like geography and religious studies (although these can be interesting to learn about!). Engaging in the humanities can be done via joining a book club, creative writing, crafting, learning a language, listening to new genres of music, learning about the history of the medicine we study every day. 

    There are ways that we can get involved in humanities in structured ways, such as intercalating in a medical humanities subject, or joining a language course. There are also more informal methods, such as setting time aside to read in the evenings or learning a new craft. Whichever way you choose, you can’t go wrong—the humanities are of great importance to medical students and are invaluable in medical practice.

    Resources:

    References

    Cleghorn, E. 2021. Unwell Women. London, UK: Weidenfeld & Nicolson. 

    Dovey, C. 2015. Can reading make you happier? [Online]. [Accessed 27th Feb 2022]. Available from: https://www.newyorker.com/culture/cultural-comment/can-reading-make-you-happier

    Esterling, B. A., L’Abate, L., Murray, E. J., & Pennebaker, J. W. 1999. Empirical foundations for writing in prevention and psychotherapy: mental and physical health outcomes. Clinical psychology review. 19(1), pp79–96. https://doi.org/10.1016/s0272-7358(98)00015-4

    Hirsch, S., & Meckes, D. 2000. Treatment of the whole person: incorporating emergent perspectives in collaborative medicine, empowerment, and music therapy. J Psychosoc Oncol. 18(2), pp65–77.

    MacCulloch, D. 2018. What are the humanities? The British Academy. [Online]. [Accessed 27th January 2022]. Available from: https://www.thebritishacademy.ac.uk/blog/what-are-humanities/

    Mind. 2022. Five ways to wellbeing. [Online]. [Accessed 26th Feb 2022]. Available from: https://www.mind.org.uk/workplace/mental-health-at-work/taking-care-of-yourself/five-ways-to-wellbeing/Stuckey, H. L., & Nobel, J. 2010. The connection between art, healing, and public health: a review of current literature. American journal of public health. 100(2), pp254–263. https://doi.org/10.2105/AJPH.2008.156497

  • Words, Weapons and Why: The Forgotten Legacy of AIDS Ignorance

    Words, Weapons and Why: The Forgotten Legacy of AIDS Ignorance

    Austin Keane, Year 2

    Language codifies how we navigate the world. It is essential in capturing this experience in a communicable and authentic way, but can only do so under certain conditions: those of respect, inclusivity and continual acknowledgement of the limitations of a single perspective. I want to understand the impact language has had on those living with HIV/AIDS, and how it affects both the self-perception of their condition and how they interact within different contexts.

    —History of Language: Us Versus Them

    Language possesses the essential quality of malleability: as public consciousness changes, so too must the words that we use. However, the ‘public’ consists not only of people for whom HIV has no actual daily reality, but also the diverse and fluxing populations of people living with HIV. Hence, it is important that language used is appropriate and accurate to the latter. As Crimp writes, AIDS possesses no reality separate from that of the routines that allow one to conceive of it; cultural and political manifestations of AIDS operate and are sustained by this linguistic framework (1987, p107). This exemplifies the importance of acknowledging the need to actively challenge and examine the power language has, and thereby achieving a greater control over this process. Historically, this is the means through which people have been able to mobilise and affect meaningful change. (Dilmitis, S. et al., 2012). 

    A key example of when this has not occurred is an article, concurrent with much of the initial journalism on the burgeoning epidemic, with the headline: “New Homosexual Disorder Worries Health Officials.” (Altman, L. K., 1982) This article also refers to ‘GRID’ – meaning gay-related immunodeficiency – a term that persisted and precipitated the notion of a gay cancer, plaguing queer men even after its usage decreased with the adoption of AIDS in 1982 when evidence showed it wasn’t gay specific; HIV itself was not so-named until 1986 (Kher, U., 2003). These emphasise the distinction between the homosexual and the reader, and, just as convincingly, that between the affected homosexual and the unaffected. In another article, Altman (1981) even purports that no danger is posed to ‘nonhomosexuals.’ 

    Specific and calculated language produced this polarisation, delineating HIV (without evidence) as something that remains separate and belonging solely to homosexuals. Ultimately, this further stigmatises the condition as it is now underscored by the cultural taboo surrounding homosexuality. This, in conjunction with the inflated perception of the other and its unique attachment to HIV, justified limited action from both governments and the public – regardless of the evolving medical understanding (Platt and Platt, 2013): they were the majority, ergo they were, according to the language they employed, safe. 

    It is arguable that, due to confusion and the changing narrative landscape, doctors did not know how to write about the emerging epidemic. Altman himself acknowledges this difficulty today, and has apologised (Peters, J. W., 2018). This, however, does not negate the impact this language has had, either then or since its implementation. Further, this protective distance is observed routinely by, as with GRID, naming the offensive other; more recently, this practice can be seen with Trump’s use of “Chinese virus” in lieu of coronavirus (Gearan, A., 2020); Sontag reiterates this in her observation of how syphilis was, to the English, the French pox whereas the Florentines called it the Naples sickness, and so on (1991, p133). These observations would suggest that, culturally, language in this way serves division, and that it was not just a by-product of AIDS ignorance. 

    —Stigma, and The How of Health Literacy

    Health literacy describes the extent to which a person can receive, comprehend, evaluate and share standard information regarding health, as well as means of access to services to permit them the correct course of action (AUCD, 2010). It has been observed in those with low literacy that social stigma is a significant independent predictor of poor medication adherence (Waite et al., 2008). Stigma is an inherently social construction, and I would argue one that is promoted through the specific language used to define HIV/AIDS and the contexts in which it is discussed. The idea of language as a tool that shapes societal behaviour is attractive – it is a convincing metaphor that can be extrapolated to describe what happens to tools, however unintentionally, when mishandled: they become weapons. Indeed, Watson et al support this view in their description of how the use of language validates patterns of stigmatising behaviour and thought: the cultural connotations of disclosure are both negative and imply deception; ‘infected’, especially in relation to people, mirrors ideas of contamination and corruption, promoting antonyms like ‘clean’ on queer dating apps (Watson et al., 2019). Therefore, this stigma may have a real impact on both physical health and the management of illness because of the way these attitudes, promoted by specific words, affect patients following diagnosis.

    Furthermore, dialogues themselves are complex: the specificity of the language used, the structure, the associated context (Roter D. L., 2011). Each of these may further complicate the interaction between patient and caregiver. In fact, Singleton and Krause (2009) suggest that language and culture can both act as a basis for the acquisition of health literacy. Stigma therefore adds another dimension to navigate an understanding, since one’s inclusion within their respective culture is limited — such language isolates, perpetuating a distance that dehumanises and blames, rather than clarifies. A key understanding noted by Mogobe et al (2016) contends that two things determine ease of acquisition: the patient’s ability to utilise available resources and the means by which healthcare providers communicate information. Stigma has been linked with impairing both — medication adherence, again, is a clear example of this (Waite et al., 2008).

    —Arresting Understanding 

    Language may also work to prevent accurate understanding. Words give form to the otherwise intangible, so can be used to achieve greater respect and awareness of the experience of those living with HIV, or to inhibit (and sometimes oppose) any growth. Ideas are often sensationalistic, employing hyperbolic imagery that is more easily digested, more memorable to the general public – not pertaining to any medical, empirically-justified reality. As an example, the notion of ‘full blown’ AIDS has never been medically defined yet it remains a popularised term in contemporary use (Watson et al, 2019). Such ideas persist in the public consciousness and may overwrite the less accessible or less interesting clinical actuality of HIV. This prioritises ease of understanding over legitimacy, or alternatively the consumability and marketability of an idea that may serve to fuel biases. Sontag continues, suggesting that this reinforces the sense of fatalism already in existence and aids a notion that there is an inevitable evolution into the ‘full blown’ and therefore death. This idea obscures the fact this is no longer true. (1991, pp115-116)

    It could be suggested that this is a justifiable, harmless error in understanding, even that it would be unfair to expect a layperson to challenge all that they have internalised. But this does not just occur in relation to medical facts of HIV, and this pattern of holding a false idea above reality is something repeatedly seen and not without negative consequences. This is shown in discussions surrounding people who are diagnosed with HIV, and the associated prejudice. It isn’t that attitudes of judgement and responsibility are proportional, or equally applied in relation to illness; only a specific group of people are perceived as being responsible and vulnerable, even though this isn’t accurate. Sontag conveys a similar idea in that AIDS was conceived as only affecting the already stigmatised — intravenous drug users, the homeless, Black, queer (1991, p113). Looking at English women with HIV you can see how their resulting displacement from the narrative ultimately harmed their health — they reported more problems and symptoms across all areas, especially anxiety and depression (Brown et al., 2019).

    These interpretations have served not those living with HIV, but those separated from it. Language has shaped cultural conceptions of who HIV should affect, even impacting the health of those who contravene this standard; it complicates the way patients navigate their own outcomes; it can promote fear, compounding this notion of the other to increase the extent of their foreignness. It has hurt people.

    ***

    In the only surviving recording of Virginia Woolf’s voice (for a BBC broadcast in 1942) she speaks on the subject of craftsmanship: words, she said, “have been out and about, on people’s lips, in their houses, in the streets, in the fields, for so many centuries. And that is one of the chief difficulties in writing them today—”

    From this, we can understand the power of language as a tool to shape culture, in fact, to be indistinct in this relationship: it cannot be extricated from understanding. We are compelled to evaluate who this culture/language serves and why, and a key way of doing this is through remembering and examining the contexts in which it originated — those of prejudice and fear. It is then that we will be able to better parse the history of AIDS and even examine this complicated legacy in a meaningful, positive way. 

    I’ll finish by considering the final part of Woolf’s quote from above; she explains why exactly writing words is so challenging.

    “—that they are so stored with meanings, with memories”

    And it’s our job to save them, to preserve them; to derive from them a ‘full blown’ understanding, if you like. 

    References

    Association of University Centers on Disabilities. 2010. Patient and Affordable Care Act of 2010, Title V [Online]. 28 May. [06/01/2021]. Available from: https://www.aucd.org

    Altman, L K. 1982. New Homosexual Disorder Worries Health Officials. New York Times. [Online]. 11 May. [06/01/2021]. Available from: https://www.nytimes.com

    Brown A, Rawson S, Kelly C, Nash S, Kall M, Enayat Q, Croxford S, Delpech V. 2019. Women and HIV in the UK: October 2019. [Online]. Public Health England, London. [06/01/2021]. Available from: https://assets.publishing.service.gov.uk

    Crimp, D. 2014. AIDS: Cultural Analysis/Cultural Activism. In: Jones, A. Sexuality. London: Whitechapel, p107.

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