The Weekly Dose - Episode 22

The Weekly Dose...

... the latest from Dr Karan

  Here is your weekly dose...  

Hi all!Here is your weekly dose of the Sunday Six! A few things I found interesting this week. If you enjoy this please feel free to forward this to friends. families and enemies alike!**You'll find more in depth analysis of some of these subjects on my social platforms in the links just below, including Dr Karan Investigates! for deep dives into interesting topics on my YouTube channel.**

3 Racist Encounters...

Let me tell you three short tales of racism. Unfortunately I've faced countless more in the NHS and in everyday life but these three stand bluntly in the front of my mind.

The father and the sonA night shift in my first year as a surgical trainee brought with it a call at the beginning of the shift from the emergency room; I was required to see a child with possible appendicitis. On first glance, the child appeared very unwell and it took a mere gentle palpation of the abdomen for the child to yelp in agony. I suspected the appendix was not just inflamed but perforated. The child needed immediate surgery. The father of the child arrived soon after and his eyes immediately conveyed feelings of disgust when he looked at me. He said he wanted a white surgeon for the child, an english surgeon.I hadn't faced anything like this in the hospital before so brazenly so I lost my bearing and my words briefly. I left the room and called my boss, who was also from an ethnic minority background. I told the father that there were no general surgeons on shift in our hospital who were white. The father promptly picked up his child and carried him out of the hospital.The securityWhen I was on my final placement of medical school in the final year of medical school, I had to go the security lodge to get my ID badge authorised for access to the various wards in the hospital. I was with a group of 3 other medical students and we all happened to be of South Asian descent. The security guard jokingly said "I already know you lot are medical students - your type ends up being doctors, lawyers or engineers..typical". I kept quiet, one of the other students chuckled nervously and we got our badges authorised and went about the rest of our day without openly acknowledging this event. It doesn't seem overtly racist perhaps, just a "harmless" joke, a play on stereotypes...but normalisation of a specific type of perception can breed something more harmful with time.The drunk patient and the nurseA patient presented to the emergency room with severe upper abdominal pain and was suspected to have a diagnosis of pancreatitis, an inflammation of the pancreas. When I went to review him, he was still drunk and in his inebriated stupor, he shouted "I don't want your kind dealing with me, f*ck off back home". I turned away without a word and spoke to the nurse looking after that patient. I explained to her, from the vital signs it appeared the patient was stable and that he refused treatment from me and I explained the obvious reasons why. She looked surprised, went to the patient and said "don't worry lovely, we'll find another doctor for you".I was shocked. Who was more at "fault" here? The patient who is obviously prejudiced or the nurse that normalises his behaviour and furthers the appropriation of biased behaviours and helps to institutionalise and normalise this type of behaviour. What standard do we set when we don't have a hard line on racism to staff?

What I Learned About Health Information Online...

If you're reading this you know I am a big proponent of health education online. Social media helps to expand the reach and access to health information which is fantastic but there are some downsides here. How accurate is the information we watch online? How do we know someone isn't just trying to sell us the latest crystal enema or some juice detox shrouded in pseudoscience? I was forwarded

this interesting paper

by a colleague which quantifies the volume and quality of men's health-related content on TikTok and Instagram and the headline is: Physicians create only a small portion of total TikTok and Instagram posts (10.3% and 12.9%, respectively) across men's health topics and the accuracy of content was poor but physician posts were more accurate than non-physician posts.

I spent my Saturday giving a talk to Doctors from UK, Europe and the USA who aspire to begin their social media journey. The most important lesson I tried to emphasise was not to go "viral" for the sake of virality and popularity but to do content THEY would enjoy and that would IMPACT other people. Going viral will take care of itself. There is a hidden epidemic of misinformation and pseudoscience online and it can be a lonely place to be when standing against this tidal wave. I for one think more doctors online combating this can only be a good thing. Plus maybe one day you could even see your doctor doing a little dance or lip-sync.

What You Should Do About Winter Blues...

Low mood, lethargy, finding it difficult to get up in the morning and more. It's not uncommon to experience this type of "winter depression" when the days get cold and darkness seems to engulf both the day and night. Sometimes this group of depressive symptoms which are exacerbated during the winter months are collectively known as Seasonal Affective Disorder or SAD. Surprisingly we have yet to fully understand it but it is linked with a reduced exposure to light when the days are shorter in the winter and less light has a variety of profound effects on the internal control centre in your brain, the hypothalamus:1) The production of melatonin can be affected which can cause dysregulated sleeping patterns2) The production of serotonin can be affected which can affect mood and appetite3) Your body's internal clock (circadian rhythm) can be influenced by abnormally low light levels plunging your body into disarray due to sleep and wake times being disrupted and this has a domino effect on other bodily functions too.Here's the bit you've been really waiting for....what can you actually do to combat this?The lowest hanging fruits here are simply to try to expose yourself to as much natural sunlight as you can to "reset" your body clock in addition to regular exercise which can not only help to offset low mood but exercise can actually raise serotonin levels and produce endorphins, natural mood elevators.If sunlight is hard to come by wherever you are, you can purchase special lamps called light boxes which simulate sunlight - these are common place in Scandinavian countries where light is at a premium at certain times of the year.

Who Wins: Gut versus Brain

The Brain, according to the brain anyway, is apparently the most complex thing in the known universe. It would say that wouldn't it? The gut is also a fascinating thing - a vast jungle that is home to trillions of microscopic aliens we call the gut microbiome.On the face of it, it's easy to think the brain is the master in charge of the entire body, the puppeteer pulling all the strings. However as our understanding of the "second brain" in the gut has deepened and the concept of the gut-brain axis has come to the fore - our original hypothesis has been challenged. Is our brain truly in charge or is it slave to neurochemical influences from these gut bugs dwelling with us? We know the gut and brain communicate closely via the vagus nerve (my favourite nerve) but is there more to it than this gut brain highway?We know genes are a powerful driver of risk for autism, but some researchers suspected another factor was also at play: the set of bacteria living in the gut. This study and many more like it reveals that mice develop autism-like behaviours when they are colonized by microbes from the feces of people with autism. This result doesn't prove that gut bacteria can cause autism. But it suggests that, at least in mice, the makeup of the gut can contribute to some features of this condition. The idea that molecules produced by bacterial digestion—can influence brain activity seems plausible and is backed up by many studies which have found differences between the composition of the gut microbiomes in people with and without autism.We known the gut microbiome can drive our appetite, our cravings, our mood, our mental state...could they even drive key cognitive decisions we make? Are we just a meat suit driven by bacteria? Unfortunately we are just at the tip of the iceberg when it comes to understanding the intricate connection between the gut and brain but the mysteries we might yet unlock could prove game changing.

An Unsettling Fact About Your Body...

One thing I've found enjoyable about my time on social media is watching fellow humans' journey of learning about their own bodies and how it often is just one long series of exclamation marks and expletives.For example, take your nerves for example. Nerves ae composed of nerve fibers, like an internet cable. Each fiber is a single cell that runs from your spinal cord to it's destination - it's one long tube not a series of connections. So that means you have cells that are 3 feet or more long running all the way down to your toes.  

I Need To Tell You Something Exciting...

First of all apologies I've not told you yet. I was meant to tell you this news last week but things got a bit hectic and the news had to be delayed. I haven't got anyone pregnant, so take a seat please. I have been working on a secret project for quite some time now and it has eaten away most of my nights, days off and weekends. I promise I will share it with you this week so keep your eyes peeled across my social media pages - it will be worth it!

As always, please give me feedback on Twitter. Which of this weeks Sunday six is your favourite? Is there something you want more, or less of? I'm open to any suggestions so please let me know! Just send a  tweet to @drkaranrajan and use the hashtag #theweeklydose at the end so I can find it!

Have a wonderful week, all.

Much love,

Karan