Lessons for Worthing from the Western cape.

I have never been to a conference before, they didn’t particularly appeal to me despite being an unashamed ED nerd. I don’t find a lecture a fantastic way to learn and I turn my nose up at networking. Which is why it seemed strange decision to fly halfway round the world on my own to go to a field with 150 people I have never met to talk about emergency medicine in Africa. This turned out to be the best educational decision I have ever made. I want to thank Sarah Hall (a bona fide supermentor) right from the get go for encouraging and helping me apply to the Worthing educationally body, who helped fund this unparalleled experience.

To explain a bit about the festival for those who just thought I was off on a jolly to South Africa (he says as he looks over a view of table mountain). It was set up by a group of enthusiastic Emergency doctors based in cape town- they produce free online resources under the tittle “brave African discussion in Emergency medicine”- BADEM (not dissimilar to our em-wsht.org). They decided to get a group of people passionate about this topic together. But the simple genius was to do this in a beautiful location in the mountains 90 minutes out of town. Talks were in a Bedouin tent , questions were around a campfire, wilderness simulation was in the actual wilderness, the ultrasound machines were convenient close to the bar (I didn’t think I would be able to combine love of whisky and scanning) and we slept in the poshest tent I could imagine.

What made this experience so special is the equality and community this set up established. I learnt from people of different grades, professions and nationalities and all hours of the day and night. We learnt together, swam together and drunk together. I asked a criminologist about causes of drug epidemics over lunch, a Lithuanian EM registrar the technical details of filming resus cases over dinner and a paeds EM consultant about kindness around a campfire. Most importantly I felt I belonged. These are my people, I am not quite sure who we are but I know what we do. We try and make things better for acutely unwell people and we love doing it. It doesn’t matter if I am in Worthing or Western cape. These are my people and this is what we do.

But this is all very well and good, I was once a cynic like some of you reading this, what’s the point of the airy-fairy nonsense. Well here is some lessons, entirely of the top of my head,  that I think can we heli-evac straight into our lovely little district general hospital.

 

1/ Specialty bashing. Stop. I have been guilty of this. It is fun to laugh at an orthopod and convenient to blame a GP. It makes us feel better about ourselves. But it makes them live up to their stereotypes and leads to tribalism and bad communication which harms patients. We are all on the same team.

2/ Pregnant women can get scans. The risk exists to the foetus, but is a lot less than you think. Like all other radiology decisions, we should think twice, but if they need it, they need it.

3/To CPR or not CPR- this was nicely phrased as the chain of survival- if they can survive they chain they should have CPR, if they can’t they shouldn’t.

4/ Artificial Intelligence is coming, we need to get on board or fall off the train. If by 2025 if computers can’t read ecg’s better than me I’ll eat my hat. (setting the bar low…). In the short term there are much better ways to refer than by fax.

5/ ECG’s (til the machines take over)- check the p wave rate to help with distinguishing type of heart block.

6/ You pretty much can’t overdose on Anti-retroviral drugs.

7/ But you definitely can on anti TB meds.

8/ Feeling rubbish after a major incident for a few days is normal, psychiatrist early don’t help, friends do.

9/ Be kind.

10/ Super mentors make you jobs worth doing. They keep us going. The South African’s seemed pretty lucky to have at least a few. I am luckier in Worthing as I have a whole squad of them.

 

This list is completely off the cuff, I am writing this without internet and without the programme of talks in front of me. I will go back and re post this with credit to those who taught me the above when I am a bit more linked in to the grid. But I needed to share my sheer enthusiasm with my fantastic colleges back home who are valiantly holding the fort. After all this inspiring learning I am genuinely looking forward to coming and joining them on the shop floor once again, well, right after a quick holiday- I’m in a very beautiful country after all.