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In this guest blog, Lison Lafarge from Buckinghamshire reflects on her experience of the 2023 NDS Work Experience Programme.

NDS Work Experience students in a QUOD lab session with Postdoctoral Research Scientist Dr Letizia Lo Faro.
Lison (pictured middle) and fellow peers in a lab session with QUOD scientist Dr Letizia Lo Faro (pictured far right)

Yes, I woke up at 5.30am every morning to travel to the John Radcliffe Hospital for a week, sitting in the main reception by 7.45am, to wait for the 9.00am start of the bustling day ahead.

Yes, I was tired. And slept on the bus. And almost missed my stop… multiple times. But yes, the experience was so worthwhile and enriching, with a rewarding buzz of excitement in every new day of knowledge beyond my A Level courses. The fact that the concepts we were currently learning were tangibly applicable to real life research and theories created an even stronger liking for my subjects. This placement thus has revigorated my passion for the subjects I love and motivated me even further to learn more for next year.

And yes - the John Radcliffe is immense. Venturing through the corridors, the hospital gave me a flavour of the copious number of activities present, strong staff, scientific innovations and even doors to departments I never knew existed before.

Student holding a skeleton model with clubfoot deformity.Being an in-person programme for the second year in a row after the pandemic, I was lucky to join the Nuffield Department of Surgical Sciences (NDS) with five other successful candidates. These people built the foundations of my experience here, as we all quickly got along together and performed strongly as a team. This in fact made me think about the importance of a team, especially in medicine, where trust and collaboration are essential for systems to work. We noticed this in terms of the communication between patients in triage and between other hospitals, as well as the strong bond between research and clinical work that are just as important as each other to enable the development of health all around the world - the Global Surgery (the left picture is an example of clubfoot) and Picture a Scientist workshops opened our eyes towards injustices towards healthcare institutions in developing countries through this. This made me reflect not only on the hidden challenges around the world that still remain in the modern day, but the importance of communicating science, especially considering how it has been facilitated through technology. Thus, my initial ideas of journalism seemed to fit well with what the world requires to enhance better performance and surgical interventions.

In particular, Science Communication with the inspirational Dr Hannah McGivern, who describes herself as being very 'unconventional' in her journey into the QUOD biobank, where tissue samples are analysed to optimise a surgeon’s knowledge on whether to use certain organs for transplant, by looking at its general health, number of proteins present, and as a result its longevity in the patient. This determines a ‘fingerprint’ rather than a ‘footprint’ of information. I no longer have the image of a PCR being a sticky mucus swab inside your nose, but learnt the intricacies of temperature change to break, replicate and record the rate of replication of DNA through several cycles. Dr McGivern captured my attention when she mentioned making videos and her love for writing, as well as her initial degree in archaeology which utterly differed to her current job.

Suddenly, the choice between journalism and a healthcare related profession didn’t seem so starkly apart. Suddenly, the burden of giving up one passion for another was alleviated. I can do both, and with the abundance of advice given to me, I now feel less isolated in finding my purpose in the adult world. 

I additionally had the chance to shadow junior doctors and nurses in triage within numerous different departments, including vascular, urology and oncology. Horror stories with amputations from not stopping to smoke and immense blood clots taken by catheters caught all of our interest, and realisation that these are real life cases with shortages of beds every day in triage.

There I learnt the process of ‘clerking’ and the calm manner and patience required to discuss with patients, where questions involved background information and even carrying our ECGs. These sectors all had different manoeuvres and installations, which created interest and in fact taught me lots about myself in terms of what I want to pursue later in life. Having doubts over a medical pathway especially, the experience allowed me to truly connect with careers in healthcare, which are outside of the unrealistic representations I had at home in front of the television.

This was so much more different than I expected. 

Awaiting myself to feel faint or uncomfortable with the patients, it was a surprise that I didn’t shudder when the words ‘let’s do a blood test’ came out from nurse Bea’s mouth. I watched, incredulous and thankful for the patient who had consented for us to watch the interventions that came along - I felt an urge to help, with no fear at all. It was like losing any perception of your previous senses, and being immersed in the present moment, no longer controlling over your own needs. The prominent impact of being with patients can only be experienced by yourself and was really interesting for me to do.

Other skills acquired included new methodologies and equipment used, including flow cytometry indicating cell size, types and densities through using laser light and the dynamics of sheath fluid, and histology from fluoroform tagging antibodies towards tissues, shown in the recently funded work by Dr Hisashi Hashimoto on regulatory T cells. These methods of research were unknown to me and generate incredible results that are almost artistic to look at like MRI scans.

These were only a few of the activities we had done - in fact, we additionally visited the Churchill Hospital and Botnar Research Centre to provide all our sessions. The variety in each day compelled me and simply showed the vast amount of opportunities in science and healthcare professions. Providing an environment where we constantly learned and saw novelty, I could not believe that neurosurgery as outlined by Mr Martin Gillies was as ‘easy’ as ‘sewing or cooking’ to be a good surgeon. Mr Gillies was a character that I could talk with forever, with constant learning and research projects intriguing me further, as well as his own horror stories with difficult surgeries. Although it was intimidating to talk and ask questions to such famous experts in the field, who have appeared multiple times on television or newspapers, we quickly realised these expert researchers were human just like us. And like all human life, we are all curious and innate drives to help others. This connection between us and the adult staff during the placement completely engaged us to find out more, for example the future projects in place in the Surgical Intervention Trial Unit (SITU). Having seen Deep Brain Stimulation (DBS) trials’ notable power on repairing a sufferer with Parkinson’s to walk unattended, I wished that I had known of this technology for my own grandpa. DBS enables the patient’s need to move, using an accelerator, to allow the participant to move when needed. It is programmed through daily patterns in accordance to beta activity in the basal ganglia area, and the comparison video truly outstanded me.

Professor Feng Wu demonstrating HIFU.Seeing the beauty of humankind, and not just the destructive chaos we forge in the world, was a heavily strong message that I received by the end of the week. Teams of people are spending years of their life, such as Professor Feng Wu (pictured left), designing, rectifying, trialling therapies to benefit anyone of all groups. High Intensity Focused Ultrasound (HIFU), for example, alters from invasive surgeries where women may lose their feminine identity with mastectomies, and additionally suffer from infections and severe blood loss. Mr Alastair Lamb moreover showed us his multiple works in genetic mapping of cells using the transcriptome for prostate cancer, where this would decrease the number of ‘unnecessary’ operations which constrain erectile functioning and thus fertility. Noticing robotic surgery spring to life in everyday surgical procedures made the idea seem less futuristic and associated to sci-fi, and I was fascinated at the sheer intricacy in the seven degrees of motion the robot had without the need of sensory feedback. To me, this seemed absurd, yet sensory touch could be attained through visuals and textural appearance. So, what is the point for humans to have a sense of touch? NDS certainly answered - and generated more - questions to spark passion and interest in the scientific field.

People here love their job, and love so much that their excitement was contagious to us all in the group. NDS showed me that if I choose the path that I love, the degree that I engage with most and keep asking questions and researching, that I will always be welcome to have a career in healthcare and science. This has reassured and strengthened my desires for the future, and is an unforgettable experience for all those that are interested in healthcare - not just aspiring doctors.

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