The Ripple Effect

Every drop of effort counts,

Don’t underestimate the power of the mind,

Love, then trust, and see what you will find?

For the world is not what it seems on the surface.

 

Those who have the courage are the ones that beam,

Using energy, inspiration and gratitude as a team,

 

With positivity, we can only but learn,

Growing like a fern,

Unfolding and understanding,

That in fact “to try our best” is to actually “to be” our best,

 

Beckoning success as our “fate”,

Accepting this journey in “flow-state”,

 

For after all,

To be fast is really to be slow,

And to question wisely, is perhaps to know.

 

26-6-17   Taking the plane home after after an inspiring journey to Melbourne indulging in the world of resuscitation and trauma management at Andy Buck’s ETM course (i.e. th Emergency Trauma Management course). I have come away with a multidisciplinary, multi background “total immersion educational experience” in trauma management. As part of this one of the highlights was meeting some wonderful and inspiring people coming from different stages of training (residents through to experienced and creative consultants educators in EM and Anaesthetics) and coming from different backgrounds of practice (eg. rural GP anaesthetists, Public Health anthropologists, experienced life-style oriented career medical officers) who are perhaps helping us lead health care into better directions.

Thanks for a great course everyone – it really hit the spot! 🙂



 

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Two Poems for champions of my heart

Equality

 

We are all equal,

There is no sequel,

For we have only this one life.

 

Heaven or strife,

This is our choice,

 

So use your voice,

And your heart,

To rise above the dirt.

 

Make use of your mirth,

That heals up the scars and the pain,

 

Let it flow, let it rain,

 

For perhaps solace lies in the “insane”,

Who can feel the beauty of the life that we live,

Giving of ourselves without a seconds thought.

 

 

16-6-16

 

At the moment my world is inundated with study, work and exams.

As I am progressing through the arduous and challenging joruney of completing specialist training in Emergency medicine, most aspects of my life outside medicine have taken a back seat, to dedicate focus to wards the path of learning the matrix of what is is to be a specialist. I am doing what I feel is effective, and and have learned to possibly be helpful, such as reading widely in books, attending practice exams, studying alone and in groups. I have sometimes been sharing the highs and lows with others on the path, but mostly experiencing them alone, in a solitude that will never be known to the world at large (apart from in daring writings such at this).

Today I learned of the exam results being released for the OSCE (objective, skills and clinical examination), and it is with great joy and simultaneous sadnesss that I heard of the success and failure of friend who are dear and near to me in both my heart, but in terms of the journey that all fellowship candidates are on, past and future.

In the joy of one particular friend I breathed a breath of relief, and for others I shared in a gasp of despair. It seems unfair that some individuals who have such a heart, such skill, and such potential for this profession, have not made it through (this time) final gate of a greater than 10 year training. Whilst this exam processess is well intentioned, and designed to empower these very qualities, it can arguabley, on occasions, be seen to perhaps fall short of what it set out to achieve.

As a researcher in education systems, and someone who has been observing their own progression through various stages of a very diverse journey of education in the arts, sciences, surgery, research and now emergency medicine, I am acutely aware that “assement” and “qualification” are but a prediction tools of relative certaintainty, but are simultanously not gold standards in this objective. In my own endeavours to help improve education and assesment systems, I’ve realised that training, sitting exams, and passing are but steps on a much greater journey, in which the destination can perhaps never fully be realised, for it is ever-evolving.

So then how do we evaluate the concepts of failure, or success?

Is it not an imaginary line (albeit, calculated through a process and mechanism), on a continuum of life-long learning?

Perhaps in specialist training, and many other forms of education for that matter, this line forms a both an psychological, and actual barrier to progression. I wonder how well the impact of examinations correlate to the end product of achieving skilled, well rounded individuals?

These may seem like esoteric questions, but to an educational researcher they questions that could potentially form a life’s work.

 

Coping with Success and Failure – through the relationships we make along the way

As a friend who was studying for his own specialist exam in another field, Anaesthetics, once reminded me “failure is an event, not a person” (taken from a line provided by personal development legend Zig Ziglar). This advice came in incredibly handy when I sat, and failed, my own big exam, the fellowship “written” exam. I have now been studying for a whole year since then, whilst working, getting over the loss of esteem, and building an entirley new strategy. If I pass this time around in August, I have the opportunity and privelidge to sit the same exam, the OSCE, that I am celebrating and mourning the results of with my friends, who are at this next stage.

It seems like a very long and uncertain journey, and perhaps this is why the final result will be so very special.

However, in the meantime there is so much pain, and equivalent joy. The joy partly lies in the hope of achieving what I set out to do, partly in feeling the success of others, but perahps the most guaranteed joy of all, is the wonderful relationships that are forged along the way – irrespective of outcome.

When studying for this exam we are in positions of vulnerability and humilty that most would not actively choose to occupy. Some, perhaps, will quickly forget how uncomfortable it feels to not definitely know if one can make it “there”, whilst others will never forget, no matter how well they perform, for it is in their nature to help others on the path.

Two of these such people, who are always there to help others, ironically did not pass the the OSCE this time around (and I’m sure there will be more good candidates to come, who also didn’t pass, for the OSCE has a pass rate often hovers around the 50%, or less, mark).

Perhaps you also know someone like this, someone who is clearly capable and desrving of such a pass? Perhaps it is even you, the reader.

Whatever the case, the following poem wholeheartedly dedicated to all of you, and all of “us”, life-long learners, who courageously endeavour to live, learn and love.

 

Wisdom, compassion and humility

 

Champions of wisdom, compassion and humility,

Using a pathway to divinity,

That has guided us thus far,

 

Whether we drive a sailboat or in a car,

The vehicle is of no consequence,

If we are not guided by light.

 

Use your sight to look within,

And feel the unity of “Humanity”,

As we once knew and later forgot,

 

We only have this shot,

To get it right,

To live without fright,

For there is really no fight,

 

When we use our energies together at large,

Voyaging in natures communal barge,

That can only be experienced as “Love”.

The rising tide of burnout – a major threat to our healthcare system?

Physician burnout 2

http://catalyst.nejm.org/videos/physician-burnout-stop-blaming-the-individual/

The above is a link to a brilliant talk by the program director for Physician Wellbeing from the Mayo Clinic, Tait Shanafelt, illustrating how physician burnout is a “system issue”.

“We tell physicians to get more sleep, eat more granola, do yoga, and take better care of yourself. These efforts are well intentioned,” says Shanafelt. “The message to physicians, however, is that you are the problem, and you need to toughen up.”

Shanafelt goes on to describe how the six drivers of burnout amongst physicians are largely derived from the characteristics in the work environment.

These drivers are stated as;-

1) Excessive workload

2) Inefficiency and undue clerical burden

3) Loss of flexibility and control over work

4) Problems with work-life integration

5) Loss of meaning in work

6) Organisational objectives that conflict with the altruistic values of the profession

He also states that promoting professional wellbeing is the shared responsibility of individual physicians and healthcare organisations.

Whilst this talk comes from the US setting, I believe the themes that are discussed are becoming increasingly relevant to the Australasian healthcare. My own observations from working in a number of busy tertiary and secondary hospitals across Australia and New Zealand is that we have developed highly efficient systems of delivering essential medical “management”, however, heartfelt “care” appears to have become optional extra.

Hearts in Healthcare

An increasing number of doctors, and doctors in training, have experienced disillusionment the conditions of medical training, and practice, and at the consequential neglected dimension of “care”. I have had countless conversations with caring physicians over the past 5-10 years, at all levels, which has led me to believe that there is a deeply “broken” element to the current healthcare system. Some have felt strongly about the issue of restoring humanity, and the heart, back into medicine that they have also made it their life’s work.

For example, Dr Robin Youngsen, who is a NZ Anaesthetist, has highlighted the importance of creating “time to care” in his first book, which takes on this very title. He also furthered this message his recent TED talk “perfectly broken and ready to heal”, and has set up an organisation dedicating to rehumanising healthcare, called “hearts in healthcare”.

The power of humanity in health care

Looking both forward and backwards in time, isn’t it “humanity” that is at the what is special and important in healthcare?

It seems to me that through a greater understanding, and appreciation, of the benefits of the “human side” of medicine, it is still possible to steer the evolving culture of healthcare in a better direction.

The opening story in Tait Shanfelt’s talk perhaps conveys this better than any, where he recalls how one particular doctor took a deeper interest in his son on a personal level, when he was a patient in hospital. Despite the all round exceptional treatment his son received in hospital, it was this one persons humane interactions that stood out, and also meant so much to him.

Which future shall we steer towards : physician burnout, or, physician wellbeing?

I am a big believer of the notion that often the question is more important than the specific answers.

We now know that burnout exists in high proportions than ever before , but the question remains, how do we respond to this rising tide? Perhaps one strategy can be rather than reacting to the negative effects of burnout, we can proactively create more wellbeing?

But how do we apply this vision in local physician settings settings? Perhaps a start is by asking the question “what can we be doing to improve physcian wellbeing?”.

What am I doing to improve my wellbeing?

What is happening within my hospital or training organisation?

…and

How can I help this ever-growing movement?

What are your reflections on preventing physcian burnout, and promoting a culture of physician wellbeing? I would love to know your views.

I’m just putting this out to further the coversation, between the ever-growing, increasingly diverse network of caring physicians who have a vision of healthcare that values the wellbeing of all, starting with the one who cares.

Physician burnout editorial

Ref: http://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(17)30940-6.pdf

Loving Kindness for 2017?

A highlight of my recent trip to Sri Lanka to attend the Developing EM conference in Colombo included a visit to the Ayya Khema meditation centre to visiting Bhikkuni Kusuma a spiritual teacher of wisdom and kindness.

Bhikkuni Kusuma is an amazing lady. She grandmotherly figure in her late 80’s who has lead an increadibly rich lay life as a scientist, wife and mother of 6. She later took to the robes to become a leading figure in reviving the female Buddhist order in Sri Lanka.

One of the many intriguing stories she talks about life includes her experience as a university science teacher, when she undertook a masters degree in molecular biology many years ago in USA. She is said to have earnestly enquiries from her then supervisors “what I am leaning about is quite amazing, but I am really searching for the answers to the deeper questions in life like ‘why are we born?’, ‘why do we die?'”. To this her supervisors replied “i’m sorry, but science has yet to discover all that”. It was from here that she changed tack in here career and focus her efforts in a field that was dedicated to the complentation of all such entities. Upon returning to Sri Lanka she embarked upon her first PhD in Buddhist philosophy at the Sri Jayawardenapura university in Colombo.

She initially completed a masters thesis investigating aspects of Vipassana (insight meditation), and later completed a PhD on the Dasasil Mattha (Ten Precepts Buddhist nun movement) in Sri Lanka. However, due to the civil instability in Sri Lanka at the time  she submitted her first thesis there were problems with first PhD being awarded, so she embarked on a second PhD (tho only person I know who has done such a thing, perhaps a testimony to her patience and determination as middle aged woman who also had a family of her own). Here she went on to study the female Buddhist order in Sri Lanka, and she investigate why the order seemed to have dissipated, eventually fuelling the difficult journey leading to its resurgence.

At the end of this period of study she herself ordained as a female Buddhist clergy-woman, otherwise know as Nun or “Bhikkuni”. When I asked her why she became a monk she emphatically, and affectionately exclaims, “I had to! They told me I must”, referring to the moral obligation of knowing all the trouble that Bhikkuni’s had faced in establishing equal footing of an order for females.

Apparently she had discussed this with her family at the time who she is still in touch with and taken to the robes in her 60’s, over 20 years ago. Since then she has become a humble leader in gently promoting the sharing of whatever wisdom she can disseminate through years of contempative meditation, and the writing of several books about the application of Buddhist philosophy and wisdom in everyday life.
http://www.bhikkhunikusuma.info/

An autobiography that was written at the request of her daughter and chief disciple, outlining her insightful path from scientist and family woman to religious clergy and leader. The book is called “Braving the unknown summit”, and this details the incredible journey further, explaining the great challenges that were faced in re-establishing the female Buddhist order in Sri Lanka. It also covers on a more personal not the impact of several tradgeies she faced whilst working, doing research and having responsibilities as a family woman, which included illness and death of her mother and the premature deaths of one of her daughters in her 20’s and her eldest son in his 40’s, who both died from cancer.

Meeting Bhikkuni Kusuma (2006-10)
I was very fortunate to have met Bhikkuni Kusuma during my 4 years of living in Sri Lanka, as she is actually a relation (my fathers first cousin). This was a very special situation for me because one of my aspirations in returning to Sri Lanka after a life of growing up abroad, was reconnecting with my extended family, and also learning more about meditation and spirituality. Meeting Bhikkuni Kusuma seemed to incredible offer both.

I remember when I fist met her she fondly recounts looking after my father and his older brother, her small younger cousins, proudly taking them by the hand in order to sit some school entrance examination many years ago. I wanted to learn from her about Buddhism, and had some trepidation about following the correct respectful rituals in order to engage with a senior clergy woman. However, upon Meeting Bhikkuni Kusuma I realized that beyond the surface  appearance of a woman in saffron robes, whatever distinction this may have had at the time, lay a kind hearted human being who was as easy going as ever.

It was like meeting a kind wise old aunt, or grandmother, who readily shared insight and wisdom, as well as the occasional mischievous smile that made me feel quite at ease, and lucky at the same time.
Those days I learned many points of wisdom through candid discussions with Bhikkuni (some of which I have audio recorded and video recorded) that helped me through challenging times in my life when I returned to Australasia and had to face writing up a PhD thesis whilst undergoing specials training in emergency medicine (which I am still completing). I am forever grateful for the the kindness and enthusiasm that Bhikkuni Kusuma displayed whilst teaching so much about the insights that meditation offered, including principles outlined in the Dhamma (the experiential teaching of the Buddha).

The Ayya Khema Mediation Centre 2017

During my current visit to Sri Lanka, it was a high priority to visit the Ayya Khema Meditation Centre where Bhikkuni Kusuma now resides and teachers meditation and Buddhism to people who both live locally and around the world. I came there with my fiancé who isn’t a Buddhist and didn’t grown up with a background of eastern religions, and my little brother who lives quite a modern New Zealand lifestyle, including working and playing, and enjoying life when we can- much like myself and my older brother.

Both of them had not really stayed in a Sri Lankan meditation centre like this, but I believe our short but impactful overnight stay was also a highlight for them too.


We were also fortunate to meet other people who were interested in learning wisdom from Bhikkuni, including a lovely couple from Hungary who had been living in London for many years, one of whom plans to release some of the recorded discussions on an internet website (a link to which I endeavour to share! Thanks Ferenc).

Coming here after attending an amazing medical conference in Colombo was a fitting follow on to a finely pitched conference that explored the science of Emergency medicine, but also delved into many broader topics that address the philosophical issues of humanity in health care. For me this visit to the meditation picked up where the medical conference discussion left off. We addressed many philosophical topics through discussions with Bhikkuni Kusuma over those two days at Ayya Khema, following the week-long medical conference, about the “awareness of the true nature of life”, and the journey onwards in order to understand both the source of human conflict and suffering and the alleviation of suffering.

.
Loving Kindness for 2017
Finally, I will share one of the rough edits of a video clip I recorded at the end of our stay at the Ayya Khema meditation centre where Bhikkuni Kusuma wanted to teach me a useful meditative practice of extending a wish for loving Kindness to encompass all living beings. This is my New Years wish for 2017, and would like to share it with anyone who feels the benefit from knowing such practices exist and are improving the lives of many around the world. I certainly have felt the bendit of this Metta (loving kindness) meditation in the past and hope to bring the practice back into my life this year.

Bhikkuni Kusum was adamant that I share her teachings with as many people who are interested as possible, and was very happy to use whatever mediums (eg, video, blog, audio) as I saw fit. I am very grateful for this and thus will share the following You Tube recording. I hope you find it of interest. Feel free to leave comments as you so desire.

I have detailed the Pali words from this version of the Metta Sutta below, along with their  translated meanings (which the video also outlines).

Metta Sutta: Radiating kindness without limit:-



uddham – above

adho ca – below

tiriyañca – across

asambhādam – without pain and suffering

averam – no anger/hatred

asapattam – no enmity (no enemies)

sabbe sattā – may all living beings

bhavantu – be

sukhitattām – well and happy

Dear Venerable Bhikkuni Kusuma – Thank you for your patient effort in teaching me a small about of wisdom in your kind and compassionate ways.

I will cherish he words and the sentiment of this verse, and hopefully share the inspiration I have gained from you and the Bhuddist teachings I have learned through you.

A wish for 2017! 

May all beings be well

May all being be happy

Best wishes for 2017!!!

1-1-2017

Leadership is Key: we have time 

I just watched this incredible interview by Simon Sinek on London Real. 

The points he conveyed we so on the mark about the shift in society. 

Some key point were about;

  • The addiction to social media in modern society 
  • The lack of correlation between shiny social media profiles and how people feel inside
  • Confidence is often surrupticiously low in the younger generation (despite higher achievements than ever before)
  • A practice of Patience is what is needed
  • Companies and organizations need to prioritize looking after their people rather than their number if we want to see a shift (and perhaps avoid an epidemic of mental health decline) 

And… leadership is Key

To take it one step further I would like to say that everything in Simon’s argument could perhaps be consumed in a different flavour if one replaces the word “they” with “we”. 

This came to me as a reflection after watching this brilliant interview, because as a 41 year old human, I can relate to many of the traits that were ascribed to the millennials. I’ve always related to the younger generations, maybe because I grew up with a kid brother who was 12 years younger than me, or maybe it’s due to my free spirited nature, or perhaps it’s owing to a number of factors including taking on PhD during my 30’s (which lead to an extended period of an international student lifestyle)- who knows? Whatever the reason, I can relate on many counts to many perspectives ascribed to the newer generations (gen Y & Z). However, there is  also a salient difference in that I also well relate to my own generation stereotype and with that can clearly remember life during a time before the age of smart phones and social  media- this was a time when we talked in person a lot more, and we were less socially shielded from interpersonal encounters.

Mediation Retreats: ground zero for social media

When I did a 10 day silent mediation retreat in the Blue mountains, near Sydney, last year, one of the conditions of the retreat centre was to hand in our mobile phones to be locked away for the duration of the retreat.

The retreat itself had a profound effect on my mental health and state of wellbeing,  but perhaps an important confounding variable in the personal study of the effects of 10 days of mediation had to be the simultaneous disconnection from mobile/social media/emails (i.e. I often wonder how I would have felt if I just locked away my phone for 1 week, and didn’t check emails, and did no meditation). 

On thing I learned by doing a retreat where you cut back your regular routines to a minimum is that habits (and in some instances addictive tendencies – or addiction itself, quickly surfaces). It is my hypothesis that it’s not just the millennial that are addicted to these light emitting plastic communication devices. Social media and smart phones have become so embedded in modern society (affecting many age brackets), that it is difficult to appreciate how much so unless one completely removes themselves from it. 

The new face(book) of society?

Perhaps the first step to changing the direction in which society is moving is to appreciate this very uncomfortable proposition, that many who are not outright addicted are probably  habitually constrained, to varying degrees. After all a therapy or way of being to address the deficits for the millennial is most likely a therapy that we could all benefit from to varying degrees. Now wouldn’t that be an interesting shift – from “us” and “them” to simply “all of us who are interested”.

Thank you Simon for picking up this hot potatoe that so few want to catch!

These are just some instantaneous reflections from someone who intentionally caught that potatoe, whilst himself caught under the spell of a habit that is being regularly actively monitored and held at bay. 

The whale inside

The whale is inside,
Please don’t let it hide,

For you are destined for the ocean,
This magic potion that keeps us alive,

Energy is why we thrive.

So do not waste time on what matters least.
Instead have a feast,

On what you know to be true.

Endure the pain,

For soon will come the rain,
Washing you to shore,

And once more you will rise,
When we finally realise,

That love is the only prize.

8-7-16.

Last night I had a dream about whales playing in the ocean.

I have a special connection with whales ever since a close encounter that I had with them 3 years back.

I met someone randomly at the gym a few days ago. As I entered the room he came up to me and asked me about my experience on that fateful Sunday when I was knocked out by one of the most majestic marine mammals to roam the planet.

This person went on to tell me about his own amazing encounter with whales whilst surfing only a week back. He was just surfing by Stanwell Park, in the Illawarra when he was surrounded by a whole heard of whales, curious and interactive.

My new found friend and I seemed to connect on many levels. It was refreshing to meet someone like this, who was incidentally a masters student in Medical Philosophy, doing some fascinating research, because we seemed to be invigorated by a discussion about the bigger picture that often seems to be lost on so many who are caught up on the rat race of life.

Perhaps only those who are truly open to the great majesty and force of nature will be even close to expressing how beautiful it is to behold. This is something we both could relate to, and it wasn’t just about an experiment with whales, it was more about recognizing the gift of nature that is there every moment we are aware.

“In the stillness of a single moment of nature doth the power lie”

I never really know what the purpose of the whale’s message was, but perhaps if we love ourselves enough, we can find a part of their wisdom within us.

 

#SmaccDUB – critical care and beyond…

I recently returned from a 4 day convention titled “smaccDUB”, the conference otherwise known as “social media in critical care”, this year held in Dublin, Ireland. The conference stayed true to its founding virtues of learning, education and innovation in pursuit of excellence within critical care. Smacc is also the ideological meeting place for all those passionate about promoting “free open access meducation” (a.k.a. #FOAMed) as a means of disseminating and translating knowledge to improve the world of medicine. However, for me this years conference had something a little extra within it, something rather special. The opening laser ceremony touted the themes of exploration, connection, and inspiration and by the end of the conference I couldn’t help but feel this was exactly where we had journeyed. I hope to share some of the reasons why I felt this way through the musings of this blog post.

 

Diversity and creativity

SmaccDUB pushed boundaries, moving beyond the diverse range of resuscitation and education themes that I’ve grown enjoy at the 2 previous Smacc conferences I’ve attended. The talks expand further than ever before on the spectrum of leadership, communication, teamwork, and ethics in the critical care.

Many of the talks showed a progression from pure science to the humanities, and even the philosophy of modern health care and science as we know it was repeatedly challenged during the course of the 4 day convention. To this end the use of the current journal system as a means of knowledge creation and dissemination was questioned in an interesting debate. The panel included former BMJ editor, Richard Smith, and the current editor in chief of the New England Journal of medicine, Jeff Drazen, who argued their differing perspectives on the benefits, or shortcomings, of the current peer review system.

Perhaps exploration of this nature, challenging entire paradigms, is called for at this point in history. For anyone who has witnessed the rapid technological advances that health care has seen over the last 20 years, will be forgiven for wondering just where we are going in the future. With the increasing focus on protocol driven investigations and treatments, it was refreshing to note that the conversation amongst the Smacc speakers seemed to continually  bring the focus of conversation back to the “human aspects” of care.

On the other hand, creativity was an equally important theme embraced by the conference, which itself was a highlight for me. It seemed as if fun and creativity, branded by the use of music, lights and live performance, were like the vessels through which the content was delivered. It was as if “science” and “art” seemed to be inextricably linked at every stage. This was particularly evident for me in the pre-conference sessions which included a workshop on creative writing, design and fine art in order to help make educational content more interesting. But it persisted every step of the way, from the rock-concert style opening ceremony, with laser lights display, right up until the final act of the grand finale.

IMG_2906

The additional daily antics that included choreographed ultrasound displays and competitions, and finally interactive debates, making use of rap and rhyme to argue out positions on issues like thrombolysis in submissive PE, was all part of the mix.

 

Mindfulness, leadership and communication

The conference opened with the “John Hinds” plenary, named as such in honour of the individual whose career long contribution will continue to inspire, as much as his loss will be felt amongst this community of critical care workers, following his relatively recent tragic death. In this section, Victoria Brazil (@SocraticEM) kicked off by entertaining us with a high quality role play. She cleverly illustrated to a captive live audience, the potential negative and positive impacts that our everyday communication can have on the quality of education, trainee self-esteem and ones motivation to learn.

IMG_2857

Scott Weingart (@emcrit), of the EM Crit blog, similarly pushed the boundaries of a traditional talk by discussing Vipassana meditation and the role of this practice in his life. He opened minds and hearts by delivering a plenary session on a topic that perhaps has never before been delivered in a conference of this nature. Speaking from direct experience, his talk endorsed the personal and professional values of meditation when looked at entirely from a scientific perspective. Scott likened this practice to a structured “training”, or exercise for the mind – coining the phrase “kettle bells for the brain” to describe what meditation was analogous to in his mind.

To me this was a groundbreaking talk because here was a leader in our field highlighting a practice that is still relatively unfamiliar amongst our medical community, despite its great potential to improve self-awareness, communication and decrease stress. It was also encouraging to see Scott maintain a completely scientific approach, and alerting the audience of the growing  evidence base for mental health and performance benefits following a meditative practice. The benefits of mindfulness is something that I have experienced in my own life, and I thus my encourage whenever I get the opportunity. The talk even included a short demonstration of the practice meditation, and provided a motivating discussion of how the philosophy of mindfulness could potentially help in stressful settings such those that are commonly encountered in emergency medicine and intensive care.

Multiple talks furthered the leadership theme, including those by TEDMed speakers such as Resa Lewiss (@ultrasoundREL), and visionary talks about the future of medicine, by senior clinics such as Simon Carly (@EMManchester) who blogs at St Emlyn’s virtual hospital. Simon provided an insightful back track into the journey that modern medicine has taken over the last 20, and providing an insight into where it is headed. He also provided a live demonstration of an iPhone ECG trace being delivered through a $100 gadget that is easily accessible already – indeed it appears to be brave new world of health care which we are heading towards at great speed!

IMG_2889

War, fear, and love

Building on the theme of mindfulness and self-awareness the conference also included a talk on “fear”, and heart-felt presentations about working in emergency situations of terrorism and war. A wake up call was delivered to our small room audience when Kass Thomas (@KassThomas4) presented recent real life experience of falling victim to US led gunship attacks on the Kunduz Trauma hospital where she was working during her first MSF mission in Afganistan. Her courageous and chilling talk detailed how she survived the ordeal of seeing so many friends, colleagues and patients die in front of eyes on that frightful October night. Her talk in particular highlighted an urgency to address the plight of hospital aid workers across the globe as there continues to be increasing numbers of hospitals suffering the same fate by being targeted under the hospices of war.

The theme of critical care workers experiencing trauma beyond the realms of normal experience was continued in other talks such as that by Christina Hernon (@emedtox)  who was an immediate responder in the Boston Marathon bombing, and Ashley Liebig (@ashleyliebig), who is a flight nurse who recounts a story fo a heart wrenching paediatric field resuscitation. In a similar vein both these speakers courageously revealed the human behind the professional veil.

Through their captivating stories they took us, the audience, into that vulnerable space of humanity, that nobody voluntarily enjoys.  These talks generated a magnitude of interesting discussion both on the twittersphere and in-person discussions amongst other delegates. Perhaps the common theme that was uncovered was a respectful appreciation of the vulnerability that goes with the human side of the critical care, a side that rarely discussed in fast pace of daily business, and I am grateful to these speakers for creating that space.

In keeping with this gloves off approach, nothing was more “on the mark” than the unplugged presentation by Ross Fisher (@ffolliet), a TEDx speaker and Paediatric surgeons who discussed the inward reaching topic of “what scares me”, “what scares you”. In his day 2 plenary session, he challenged the audience, and guided them through recounts of salient challenges in his own professional career, towards taking a long and hard introspective view at our own personal fears.

One of the most memorable experiences for me in that talk was Ross’s request for the audience to join him in a journey of exploring one’s own worst fear. Despite the vast majority of the audience coming from a critical care background where perhaps the intense nature of the job lends itself to forge patterns of adopting a fearless stride we walk, on this occasion, when asked by Ross, whether we could identify our fear and its debilitating nature, I can’t recall a single person who was left seated. “That was fear”, acknowledge by all, and together we stood.

Many other talks that also provided a compelling discourse about other human factors that are often given secondary importance, were covered with vigor and passion, such as the importance of palliative care, bedside teaching and team training, and the topic of physician and trainee burnout.

However, perhaps one other memorable talk that pushed the boundaries, again,was that by the experienced and entertaining social worker, wellbeing specialist, researcher Liz Crowe (@LizCrowe2) who gave the first talk I’ve heard in a critical care conference whose title and focus centred on “LOVE”. With great passion and enthusiasm, and a large dose of wit, Liz delivered a very serious and important message that “love can revolutionise the way we deliver critical care”.

Liz advocated that there is science that supports what mechanistically makes sense, humans have an improved ability of to make good decisions when they work in an environment where they feel supported and cared for, as opposite to when they feel intimidated and stressed. This talk was laden with culture changing gold and I can’t wait it to come out on the smacc video cast so that we can “share the Love” that Liz speaks of!

Dublin, its surroundings and the Socials

Dublin was a wonderful city, that could provide no better a venue that offered history and culture, as well as fun and frivolity that only a Smacc participatory audience could dream of. Daily #smaccPUB, with rotating venues along the old temple bar, along with the grand finale party at the 5 story Guinness storehouse complex, fully equipped with live bands and DJs ranging from house, to rock to Irish folk – not to mention the highly acclaimed FOAMeoke, and few cats who decided to so some street jamming as part of the after party– who could ask for more?!

From physical reality, back to the twittersphere…

So I will end this post with a handful of crafted tweets by the arguably the biggest component of the conference itself, the delegates, speakers and followers both locally and afar. After all perhaps half the magic of this conference is to do with the emphasis that has been placed on audience participation and interact, that arguably no medium does better than 160 summary of words/photo/or link which the average “tweet” offers as a communication tool.

So congratulations if you made it this far in the entry that I started writing on the plane home, as part of the #smaccdown process. I tried to cut it down but there really was so much happened in such a short period of time, a fact that I’m sure those who also attended will attest. There were many other innovative talks that I attended on resuscitation, hospital systems and medical education that unfortunately couldn’t make it into this post, but hopefully some of them can be covered in the tweets below.

It is clear to see that I thoroughly enjoyed this conference, leaving energised and inspired, but as always I’m keen to hear from you, if you attended or simply were intrigued by what I have shared in these words, and images, so please leave your comments below.

Thank you to the smaccDUB organising team who did a great job, in particular Chris, Roger and Oli, and their team! Also farewell to the other delegates who are part of this friendly ever-growing social media driven med-ed community.

Hope to see you all next year at #DASsmacc!

 

Related posts; 

Scott Weingart: on Vipassana meditation

Andrew Tagg: Don’t forget the bubbles-  smaccDUB summary 

Richard Carden: St Emlyns – A trainee perspective 

Suzie Edge: Primary survey – Speaking out: teams, juniors, leaders and what smaccDUB taught me