We All Shine On

John Lennon was murdered 34 years ago today. Here’s a documentary about his last day, December 8th 1980. I saw it originally in December 2010 on the 30th anniversary his murder. It’s noticeable for the interview that begins around the 27 minute mark with Dr Stephen Lynn, the Emergency Room doctor who attended to John when he was brought to Roosevelt Hospital that night. From an emergency medicine perspective, he tells us that Lennon, in the attempt to save his life, had a thoracotomy – every EM clinician will understand what that means. He retells the story in such a way that you re-realise the horror of his killing.

And would you please explain about the 50 ways…


This is an idea I’ve been kicking around for 2 or 3 weeks. It arose after having a conversation with a specialist registrar where I was going on about technology and online learning, as I usually do.

Here’s the thought I had after that conversation: “I realy need to make sure that I listen to more emergency medicine podcasts regularly.”

Now, if you do listen to EM podcasts regularly, then well done. You’re dismissed.

If you don’t listen to EM podcasts regularly, you probably fall into one of these two groups:

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Don’t start me talking, I could talk all night…

Another big idea that raised its head at DotMed is disruption. Where is it going to come from in healthcare?

The examples outside of healthcare are many: Kodak filing for bankruptcy, video stores closing down… Connectivity and the internet have disrupted so many business paradigms, why should medicine be immune?

Think of the music business. The internet has changed it utterly since the turn of the millenium. Record shops gone, sales volume down, content delivery changed, social listening…

The internet was not music’s biggest disruption. The invention of recorded sound was what changed music forever, from a passive experience that could only be enjoyed live (e.g. in a concert hall), to a user-controlled, time-shiftable, medium where that end user decided how to interact with it (e.g. listening to a stream of any song, anywhere).

Consumer technology is now at a point where for patients, interacting with a medical professional does not have to be a real-time interaction where the hospitals are concert halls and the doctors are the musicians. If the healthcare user has access to healthcare anywhere, how do the clinicians practice their skills, deliver their content?

Technology has always been present in healthcare, but on the side of the clinicians (just look at radiology). Patients are about to bring their technology to the table. The change in healthcare will be more akin to the music business changes in the first half of the 20th century, when the end users got to have some control of it for the first time. What has happened to the music business in the 21st century has just been a revision of decades of content delivery to end users. In healthcare we’re at the point where gramaphone records are about to take over from pianos and sheet music.

Changes in healthcare and disruption are topics I’ll come back to a lot in this blog. Where is it coming from? How will it work? What will it look like? What are the good ideas? And if a disruption in practice produces an improved way of delivering care, is it really a disruption?

Perfecting Sound Forever: The Story of Recorded Music
Perfecting Sound Forever: The Story of Recorded Music – Kindle Edition

And you may ask yourself: “Well, how did I get here?”

Last week I was lucky enough to attend the DotMed (Or .Med) conference in Dublin. It was billed as a “Festival of the Future of Medicine” but also cleverly had content related to the humanities. To be honest, I went for the techtalk. It was only afterwards when I looked at the event as a whole did I figure out the benefits of keeping it all human (see also: the latest Daft Punk record).

The event had ideas and concepts which fell into that category of “this is obvious, but if it’s so obvious, why didn’t I think of it.” I’m going to talk about one of those ideas now.

Doctors can’t just consume any more, they also have to create, cultivate and converse.
This came as part of a talk by Dr Bryan Vartabedian (@Doctor_V ) when he discussed the concept of The Public Doctor. The paradigm of the doctor consuming knowledge in order to become (and remain) a learned medic isn’t enough any more. If you’re going to be part of it, you have to get involved.

This hit home quite hard for me. I had been to a talk by Mike Cadogan (@sandnsurf ) at the ICEM 2012 conference 18 months earlier that touched upon the same issues. I came away from that talk thinking “Maybe I should remove my Twitter pseudonym and start a blog…” I was now being told the same thing again, but still I had reservations. Thankfully a slide came up which told me that if something scared you, it was probably worth doing.

I have been contributing online in forums for about 15 years now. Newsgroups, message boards, fan sites, Reddit, and, in the last few years, Twitter. 10,000+ tweets, 600+ followers. I know my way around online. However, I am from the last generation of doctors to have started med school without the internet, I think I’m programmed to believe that medicine should be separate to all that online, “fun” stuff.

DotMed made a point of bringing things together. By having a conference which bounced between serious medical talks to art appreciation to patient stories to banjo playing, the whole thing felt like my Twitter feed come to life.

So I changed my Twitter account so that it would show my real name. Then I dusted down an old WordPress registration and got to work assembling some kind of blog, and here it is.

I have called it Emergency Medicine, et cetera, or E.M. etc. for short. Or shorter still: emetc. The main idea is to end the notional separation I still maintain between medicine and the other things that interest me, namely technology, e-health, social media, arts, popular culture and music. One hand washes the other, so to speak, and I will do my best to write about these things on this blog.

You don’t have to be a doctor to read this blog, but it might help.

I realise there’s a lot of blogging around these days, and we live in an age where the most precious commodity is someone’s attention. I hope that by talking about what interests me, you might be interested too.