You gotta have love…

I was 14 when I nearly considered deliberate defenestration. It’s probably the closest I’ve ever been to suicide, but the memory of the angst that made me contemplate this action is still vivid.

The Headmaster had asked each of the 30 pupils in our class to give a talk. I cannot even remember the details now, but the prospect of standing in front of my peers caused me so much distress that jumping out of a fourth floor window seemed easier. Kind compassionate man that he was, he recognised my distress and engineered the situation such that I did not have to speak…hence I am still here.

Since then I have struggled with confidence … particularly confidence in public speaking. I have worked to overcome this, such that now I quite enjoy giving a talk on something which I am passionate about (trauma, airway, rural medicine). But talking on the big stage at smaccGOLD was a huge hurdle for me.

Spot the Imposter. From L to R : LeCong, Leeuwenburg, Greenland, Weingart, Levitan & Reid
Spot the Imposter. From L to R : LeCong, Leeuwenburg, Greenland, Weingart, Levitan & Reid

For those that don’t know, smaccGOLD was the second ‘social medic and critical care’ conference, following the debut in Sydney last year at smacc2013.

 “Innovation, education and creativity at the cutting edge and beyond the confines of convention. This conference was delivered by passionate patient focused, idea-nurturing visionaries” 

via Dr Bishan Rajapakse’s #smaccGOLD reflections

As Mike Cadogan said, if FOAMed was conceived (like many great ideas) in a Dublin bar at ICEM2012, then smacc2013 in Sydney marked FOAMed’s birth. I spoke at smacc2013 on my passion of rural prehospital care & was invited back to smaccGOLD. Thanks to the convenors, I was privileged to be invited to help teach in the pre-conference Airway Workshop, to enter into a debate with Minh le Cong and to deliver another presentation on rural resus room management.

Like all of the other presenters, I poured my heart and soul into preparation, yet with the spectre of my fears on public-speaking still present.

You can see narrated slideshows of the checklist debate and rural resus room management talks by right-clicking highlighted links, or download PDFs from these links

“Real airway experts use checklists – pro” slide set and “Rural Resus Room Feng Shui” slide set.

Preparation for speaking at smaccGOLD was one thing; being nominated to participate in #SimWars was another…all the stress of being on a stage, with the challenge of overcoming fear of public humiliation due to failure. I was pushed far out of my comfort zone – and this was a good thing.

The crowd
The Crowd : 1300+ attendees at smaccGOLD
SimWars fracas
Team leader – this resus is really “grillin’ my corn!

Many people have asked me what makes smacc special. From fears such as those of Scott Weingart at smacc2013 that it was going to be “just five guys in a bar talking about Twitter”, smacc has evolved into THE leading critical care conference and is a wonderful demonstration of the power of FOAMed & Social Media.

Those who engage in FOAMed share a passion for advancing their craft, for sharing ideas and for education – in short, they strive to make themselves and the care of their patients “better”.

At the same time, it is not uncommon for people to experience fears – fear of sharing thoughts and work in a free, open-access format; fear of criticism of our expertise by those operating in another arena, fear of difficulty. My passion for FOAMed was predominantly driven by fear. Fear that as an isolated rural clinician I would be at risk of being the weakest link in management of my patients and friends.

My obsession about difficult airway management and critical care was borne from a ‘lesson hard learned’ – and a commitment to overcome both my own fear and ensure that harm does not befall any patient through lack of training, equipment or expertise. FOAMed resources, harnessed through the power of social media, enable us to engage in asynchronous learning from experts worldwide – and there is no longer any reason nor excuse not to be aware of the latest medical developments relevant to my practice.

“Fear is what drives much behaviour.

But I think we are best when driven by love”

The most important lesson that I’ve learned in medicine is to love your patients (no, not in that way!). A colleague taught me the power of a handshake when I was an ED registrar – not just as a formal introduction to each patient, but also to emphasise the symbolic nature that I am genuinely here to help you.The handshake is an affectation that I have carried on into my work in primary care…and along the way I’ve added other tools – sitting at patient level, giving the patient time, not being afraid to have the difficult conversations, showing empathy and ensuring we use names, not bed numbers.

This isn’t just about the doctor-patient relationship; it is also about how we interact and look after each other – we operate in different systems, and it is too easy to criticise colleagues or different craft groups without understanding their circumstances or challenges. And love is what mades smaccGOLD such a good conference.  Sure there were inspiring speakers, great slide sets and some excellent hardcore critical care research. But there was also love – a shared passion for critical illness, a willingness to laugh and cry and play together, sessions on end-of-life care and bariatric medicine that challenged us to really think about our values as clinicians.

smaccGOLD was set modelled around a tribal theme – a main stage set that mimicked a tropical island (akin to an episode of ‘Lost’ or ‘Survivor’).  Delegates and speakers strove to break down the traditional silos between us, to consider aspects of critical care from different perspectives – and to unite in common love for critical care and celebration of the joy of discovery.

Tribal opening
smaccGOLD – breaking down the silos in critical care – we are but one tribe!


Ultimately we are all human – and the power of empathy, compassion and shared humanity is what binds us. Was it practice-changing? Yes! The rapid dissemination of ideas via FOAMed and the global community of enthusiasts dedicated to bringing “quality care, out there” is achieving its goal.

“smaccGOLD – grilled my corn!”

I simply cannot think of another critical care, emergency medicine or indeed any medical conference that came even remotely close.

Thank you to all – the organisers, those who helped me overcome my fears, those who shared their love of critical care & humanity – and everyone who made time to come up and say “G’day”.

One tribe – we are critical care!


More reviews can be found at :

ITeachEM (Rob Rogers) Friendship, Motivation, Altruism

Manu et Corde (Eve Purde) Lessons from smaccGOLD

RoloBot Rambles (Damian Roland) smaccGOLD – it hurts!

LifeInTheFastLane day 1 – 3 summaries

PreHospitalResearch – Lessons learned from smaccGOLD  “bye,bye dogma – hello best practice”

NomadicGP (Penny Wilson) Pure Gold

Rebel EM (Salim Rezaie) – social media & critical care

Injectable Orange (Jesse Spurr) – smacc : punk rock, paeds, palliation & people



One Tribe

Ugly Mug
Ugly Mug
Opening Ceremony
Opening Ceremony
Mark Wilson & GoogleGlass
Mark Wilson & GoogleGlass
Minh - a real airway expert
Minh – a real airway expert
John Vassilliadis' corn is grilled
John Vassilliadis’ corn is grilled
Ian Beardsell "does he have chronic pain?"
Ian Beardsell “does he have chronic pain?”
Cornered between Carley & Nickson "Is your swear box broken Tim?"
Cornered between Carley & Nickson “Is your swear box broken Tim?”

Rich Levitan in airway workshop, nasoendoscopy stream
Rich Levitan in airway workshop, nasoendoscopy stream
Neurosurgery for Everyone with mate Mark Wilson - Burr Hole demo
Neurosurgery for Everyone with mate Mark Wilson – Burr Hole demo


You're gonna do WHAT with that Cric-Key? Weingart plays fast n loose
You’re gonna do WHAT with that Cric-Key? Weingart plays fast n loose
Who's gonna be the mummy & who is the daddy? Karel Habig & Anthony Lewis arrive in same Jabba-the-Hutt costumes for #SimWars
Who’s gonna be the mummy & who is the daddy? Karel Habig & Anthony Lewis arrive in same costume for #SimWars
"Might as well shove it up your arse" from John Hinds in Cricoid debate
“Might as well shove it up your arse” from John Hinds in Cricoid debate
The laryngeal handshake - LeCong vs Chrimes
The laryngeal handshake – LeCong vs Chrimes
Rural Resus Room Mx
Rural Resus Room Mx
Carley goes wild
Carley goes wild
"Punk Rock, Top Gun & Emergency Medicine" - from Deniz Tek of Radio Birdman
“Punk Rock, Top Gun & Emergency Medicine” – from Deniz Tek of Radio Birdman


18 thoughts on “You gotta have love…”

  1. Bernadette Clarke

    You were one of the best speakers at this conference. Your rural session was very memorable. Just today I was telling colleagues about you “turning your trolley” and the reorganising of your stock bins. Who in the world remembers that stuff!! Your enthusiasim and passion shone through.

  2. Patrick Plunkett

    I would not have believed you were under pressure when you were on-stage at SMACCGold, for the Rural Resus room piece.
    But, “Hey”, we can all be wrong.

    Suffice it to say, I learned from that talk.
    And I aim to make changes at home when I get there.
    (Currently on a brief R&R in the Whitsuns, where I have seen more rain in 3 days than I ever saw in 3 weeks in Ireland)

    Stay cool!


  3. Tim, you fly the rural doctor flag proudly and passionately.
    I know my relatives are in safe hands on that island

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  7. Tim – totally agree on the love comment.

    My wife said that to me about 4 years ago (before we were married) at a time when i was pretty stressed and confused about work and it stuck with me. We have to love our patients. It’s what we do.

  8. Tim I thought your talks were brilliant. I echo what Bernadette said, I would never have guessed you were nervous. All the more hope for the social stutterers among us!

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  10. Rest assured Tim you were one of the first names on the list when the smaccGOLD program was created – and you did not disappoint!
    Thanks for helping to make smaccGOLD awesome

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  12. Hi Tim,

    You were on airways in the first ever arrest I was involved in as a scared 1st yr RN.
    To this day I have still not come across someone as cool under pressure as you were during that arrest and have given me a role model to follow.

    It’s nice to see you lending your knowledge and skills to a wider audience.



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