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Rcsiroyal College of Surgeons in Ireland Inside: In search of an HIV vaccination Volume 13: Number 1. 2020 ISSN 2009-0838 smj Royal College of Surgeons in Ireland RCSI Student Medical Journal The story of narrative medicine RCSI DEVELOPING HEALTHCARE LEADERS WHO MAKE A DIFFERENCE WORLDWIDE Acknowledgements Thank you to the RCSI Alumni for their continued support of us as students – providing career advice, acting as mentors, enabling electives and research, and supporting the publication of the RCSIsmj since its inception in 2008. As today’s generation of students and tomorrow’s generation of alumni, we are very grateful for this ongoing support. A warm and special thanks to Prof. David Smith for the time and encouragement he has given to the RCSIsmj Ethics Challenge, and for his support of the annual debate. We would also like to thank the Dean, Prof. Hannah McGee, for her sponsorship, and Margaret McCarthy in the Dean’s office for her constant endorsement and assistance. The RCSIsmj was extremely privileged to have a number of professors and clinicians involved in this year’s journal clubs. We would very much like to thank the following individuals for their support of and participation in the journal club, and to express our appreciation of their time, knowledge, and expertise: Prof. Arnold Hill Dr Mark Murphy Dr Jennifer Clarke RCSIsmj contents 4 Editorial Royal College of Surgeons in Ireland Student Medical Journal 4 Director’s welcome Executive Committee Director Rachel Adilman RCSI Ethics Challenge Editor-in-Chief Alyssa Conti Peer Review Director Magar Ghazarian 5 RCSIsmj Ethics Challenge 2020/2021 Senior Editor Brian Li 6 RCSIsmj Ethics Challenge winner 2019/2020 Assistant Peer Review Director Alison Hunt Executive Secretary Audrey Potts Research spotlight Webmaster Tiffany Yeretsian 10 Biological differences matter Senior Peer Reviewer 12 AMG 510: the kryptonite of mutant KRASG12C Alexandr (Sacha) Magder Peer Reviewers Interview Samantha Tso Savvy Benipal 14 Prof. Catherine Godson Michelle Gyenes Nikki Cliffe David Seligman Case reports Kassandra Gressmann 17 A case of spontaneous pneumomediastinum in an asthmatic young adult Jake McDonnell Jeremy Lau 22 Morvan syndrome: rare or underdiagnosed? Claire Gallibois Lori Israelian Alexa Higginbotham Original article Ananya Pentaparthy 26 Patient perception of health status in the setting of multimorbidity and polypharmacy: a Sean Coll Angela Joannou preliminary analysis of baseline SPPiRE trial data Blaire Beers-Mulroy Ashka Shah Jessica Iyer Review articles Flavia Dumitrascu 34 Have you tried zapping it? Neuromodulatory treatments for drug-resistant epilepsy Lisle Blackburn Eva Stolz 39 Blue light blocking glasses: should we all be wearing them? 45 The applications and limitations of the Tei index Senior Staff Writer Katie Nolan Staff Writers Staff reviews Hannah Suchy 50 In search of a HIV vaccination: failures, successes, and innovations in eliciting humoral Deena Shah Christine Okeefe and cellular immunity against HIV Carol Rizkalla 56 Supercentenarians: a look into the lives of the world’s oldest old Aidan McKee 62 Living in lead: the evolution of interventional radiology Director of Education 69 3D models lead a revolution Sannihita Vatturi 75 Precision psychiatry: made-to-measure medicine Education Secretary Tayler Declan Ross 82 Marijuana in medicine: wonder drug or ‘I wonder if it really works’ drug? Education Officers Matthew Patel Perspectives Harleen Jhinger 90 Remembering the Great War: figures of the First World War Fraser Jang-Milligan 95 Breaking the cycle of condescension: the medical hierarchy Public Relations Komal Marwaha 99 The story of narrative medicine Yavani Kulasingham 107 Gender identity and stigma Abstracts JOURNALISM CONTENT DESIGN 112 3D in vitro collagen-based scaffold platform to study neuroblastoma growth and The Malthouse, 537 NCR, Dublin 1. migration T: 01-856 1166 F: 01-856 1169 www.thinkmedia.ie Design: Tony Byrne, Tom Cullen and Niamh Short Book review Editorial: Ann-Marie Hardiman, Paul O’Grady and Colm Quinn 114 The Soul of a Doctor Please email comments to [email protected], join our Facebook page, or follow us on Twitter @RCSIsmj to discuss journal articles. Submissions to [email protected]. See www.rcsismj.com to find out more, see past editions, and to follow our blog. Volume 13: Number 1. 2020 | Page 3 RCSIsmj editorial and director’s welcome Looking back to see the future of healthcare As 2020 marks the beginning of a new decade, we reawaken with how we as physicians can improve the lives of the transgender advancements in the field of medicine. However, in order to clearly see community. where we can go, we must take a step back and remember where we It is important to remember that medicine is as much an art as it is a have come from. In Volume 13 of the RCSIsmj we take a look at how science. As Hippocrates said: “Wherever the art of medicine is loved, medicine has transformed into what it is today, from Anirudh Gautam’s there is also a love of humanity”. perspective detailing the impact of the First World War, to Staff Writer It is an incredible honour to share RCSIsmj Volume 13 with you. I am Hannah Suchy’s and Senior Staff Writer Katie Nolan’s depictions of the continually inspired that the dedication and hard work of my peers evolution of specialties such as interventional radiology and precision manifests so eloquently in this journal. I hope you enjoy reading it as psychiatry. Medicine is about having the hindsight to learn from the much as we enjoyed creating it. lives of supercentenarians, portrayed by Staff Writer Christine Okeefe, while simultaneously advancing the field. This volume of the RCSIsmj pays special tribute to where the field of medicine has evolved from, while igniting excitement for where it can go. We recognise that the development of a HIV vaccine, the incorporation of 3D models in surgical planning, and the implementation of the Tei index in cardiology are paralleled with advancements in the humanistic foundations of medicine: how we can communicate with patients using a narrative approach; how we can Alyssa Conti improve medical education by adjusting the medical hierarchy; and, Editor-in-Chief, RCSIsmj 2019-2020 Director’s welcome “We represented everything from paediatric cardiology to social work to detrimental effects of maltreatment and intimidation within medical public health, but we all loved to read and write. ‘Physicians ought to training, to a discussion on the importance of transgender health write,’ said another lecturer, Dr Louise Aronson, ‘for three reasons: to education and access, we trust that the topical works presented here will reflect, to memorialize, and to advocate.’ This mirrored physicians’ triple spark important discourse and reflection. obligation to self, patient, and society.” As always, the RCSIsmj would not be possible without the support and – Martina Scholtens MD encouragement of the Dean’s office, Prof. David Smith, many RCSI faculty members, and the tremendous publishing skills of Think Media – thank It is such a pleasure to present to you the 13th edition of the RCSIsmj, a you all. We hope you enjoy Volume 13! journal created and run entirely by students. Each year I am struck by the high calibre of research being undertaken, and articles being written, by RCSI students. Being involved with the RCSIsmj over the past three years has been a wonderful privilege. I have witnessed peer reviewers hone their skills in critical appraisal and leadership, we have published works from returning authors, and I’ve seen their passion for research and writing flourish from one year to the next. RCSI students continue to inspire and engage the RCSIsmj committee and our readers with the bold healthcare questions they ask and endeavour to Rachel Adilman answer in their articles; this year is no exception. From a look at the Director, RCSIsmj 2019-2020 Page 4 | Volume 13: Number 1. 2020 RCSIsmj prize Ethics Challenge 2020/2021 The duty of candour: open disclosure of medical errors The concept of open disclosure of medical error – and the ethicality of criminal repercussions for failure to disclose – is a current ‘hot button’ issue within the Irish medical system. For this year’s ethics challenge, we would like you to consider this debate from all angles, and construct an argument either in support of, or against, criminal sanctions for failure to properly disclose medical error. Questions to address 1. Should open disclosure of medical error be mandated by law? 2. Should failure to properly disclose medical error result in criminal sanctions? What, if any, should be the criminal repercussions of failure to openly disclose? 3. Please discuss the ethical and legal issues surrounding this issue. 4. What professional impact might the threat of criminal sanctions have on physicians and trainees? This is the twelfth installment of the RCSIsmj Ethics Challenge. Submission guidelines The editorial staff would like to congratulate Gerges Abdelsayed Please construct a lucid, structured, and well-presented discourse for on his winning essay in the 2019/2020 Ethics Challenge. Please the issues raised by this scenario. Please ensure that you have see page 6 for his submission. addressed all the questions highlighted and discuss these ethical We invite students to submit an essay discussing the ethical questions issues academically, making sure to reference when necessary. raised in the scenario presented. Medical ethics is an essential aspect Your paper should not exceed 2,000 words. of the medical curriculum and we hope to encourage RCSI Your essay will be evaluated on three major criteria: students to think critically about ethical situations that arise during 1. Ability to identify the ethical issues raised. their education and subsequent careers. All essays will be reviewed 2. Fluency of your arguments. by a faculty panel of experts and the winning essay will be published 3. Academic quality with regard to depth of research, appropriateness in the 2021 print edition of the RCSIsmj.
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