Impossible is just a perspective,
So let us be reflective,
And ponder with mild imagination,
Letting go of cessation,
And seeing what may fly,
Like babies and adults that cry,
Let’s not deny, the humanity that exists within,
But instead let our dreams open and sing,
The song of becoming,
For in observation we can only find,
That medicine can also be quite kind,
If we first reach the heart within,
Perhaps “this” is what possibility may bring.
21-11-17 Reflecting on the the first day of the ACEM 2017 ASM (that is, the Australasian College of Emergency Medicine’s 34th annual scientific sessions), held this year in Sydney, with a conference theme of “Impossible is just a perspective”, and a secondary theme of “getting the balance right”.
When I heard about the planning of this conference at the SMACC Dub conference last year, I was waiting in anticipation. The welcome speech by Sally McCarthy, an ex-president of ACEM and conference chair, confirmed the importance of the theme. It highlighted just how far the specialty of Emergency Medicine had come in recent decades, perhaps partly owing to this positive perspective where “impossibility” was only an impostor. However, Sally also highlighted how this rapid progress had also brought about new challenges which included keeping one’s career sustainable, and thereby released the secondary theme of “getting the balance right”.
This first speech was very powerful, and also relevant to me having recently attended the very first EM conference in Sri Lanka(SLEMCON 2017), and seen the rapid evolution of the specialty of EM since I was living there in 2006. Sally herself was a keynote speaker at this inaugural conference in Sri Lanka, and referred to this incredible progress in EM development as further evidence to the primary theme of this years ACEM conference.
Opening Plenaries – (day 1)
The opening plenaries where all gripping and impactful in their own ways. Maaret Castren’s, a Finnish Professor in Emergency Medicine, took us to the frontiers in resuscitation. This talk was delivered with Scandanavian precision, and factual flow, but also a tinge of nordic humour (“I only share Polar Bear photo’s that I take myself” – classic!). Maaret shared some pearls from her own research on leadership training in CPR as well as shedding light on controversies in the resuscitation literature. Included in Maarets many accolades is the fact that she has been a chair of the European Resuscitation council, is part of ILCOR, and had also trained as a nurse prior to training as a doctor, and a professor.
Then there was the Westmead trained FACEM , Rick Brennan who is the director of emergency operations for the WHO, who shared his insights, horrors, and triumphs form being tasked with dealing with the Ebola outbreak in West africa in 2014 (resulting in over 28,000 cases and 11,500 deaths), along with another FACEM Ian Lawton. This was a truly heroic effort by the entire response team, and it was inspiring to see an Australasian trained Emergency Specialist in the leadership role of this challenging global health crisis.
Next was Sue Ieraci, a senior Emergency Physician from Sydney. She took us on a reflective journey through the creation and subsequent evolution of Emergency Medicine as speciality. Having seen, and been part of, the initial changes in the creation and earlier stages of evolution, she put it to the audience, in an ever so metaphorical manner, that whilst creating a dream specialty, we have along with it also been party to the creation of a few nightmares. These included things like the backlash of 4 hour rules, EDs been driven by performance targets, and triage creep, just to name a few. She left us with some great food for thought about the potential steps for re-creating the system which put “leadership” and “wellbeing” at the helm of the ship.
Finally, in the opening plenary we were introducted to Karen Hitchcock, a Physician and a writer, and favourite by many in the conference for the ongoing creative “outside EM” perspective, which she so eloquently brought back to the centre of the emergency echelons at this conference. She presented so humbly, yet so powerfully. On this first day, she presented on this first day ethically challenging talk on Euthansia and a range of scenarios and attitudes that could associated with this term in modern medicne.
Prioritising Wellbeing culture in Emergency…the future?
There were so many brilliant talks in the ensuing 6 parrallel tracks run at the conference, which make it impossible to even cover with any meaning (perhaps check out the tweets at #ACEM17), however, perhaps one talk that stood out for me, and really struck a chord with my heart was that by Bethany Boulton, from Queensland, which was about creating a great working environment and specifically “why wellbeing is so important”.
One of the most memorable aspect of Bethany’s talk was the storytelling of her own challenging, yet interesting and creative personal journey in medical training that led her to taking an active role in creating cultures of wellbeing at her local Emergency Department, and collaborating internationally with this movement. She also brought to light some uncomfortable yet striking evidence about how prevalent psychological impairment, and burnout, are in modern Emergency Medicine. Bethany also highlighted key international literature outlining strategies for the promotion of wellbeing and also how this had been translated in her local hospital setting. This inspiring talk highlighted that sharing one’s vulnerability is surely a sign of strength. Well done Bethany – your talk was so good, and the model presented was very inspiring!