Oh Henry

In the Internet age, attending national meetings may seem unnecessary, but it offers the epinephrine of comradeship

“We few, we happy few, we band of brothers.”   

-Henry V 

It’s that time of year again, when I am “forced” to prepare for the ACEP national meeting, the Scientific Assembly. It’s in San Francisco this year – not bad. It has a list of courses that boggles the mind and virtually every committee of the college, as well as the ACEP Counsel and Board of Directors, comes together to debate the issues of our time. The convention display floor brings together every new gadget and widget currently available to emergency physicians. 

A quick aside about the exhibit floor. Don’t confuse the assembled multitudes with the fact that most of these gadgets have not actually been proven to work, and that most of them will disappear like Ozymandias. Nostrums with no more validity than eye of the newt and wing of the bat will be trumpeted to the heavens as well as have their names placed on pens and shopping bags. I am sure you all have drawers in your emergency department full of five-year-old gizmos we first saw at the national meeting. We purchased, used them for a short while, and then they fell into the abyss of this drawer. Like my dryer which consumes the occasional sock, such drawers are notorious for eating our hopeful life-saving device fantasies. Oh well, back to the drawing board. 

The real question is why I have been attending the ACEP meeting every year since 1976. Lets ignore the fact that for the 31st year in a row I have been giving multiple courses, and I am a past president of the college. If I put these facts aside, would I still attend? As my wife says, “Do we have to go to more open houses and cocktail parties with people who want to tell you their latest rectal foreign body story?” My answer is, “God I hope so.” But why? 


There is no piece of scientific information or philosophical debate which cannot be obtained from your desktop. The reason we come together is not for fact or philosophy. It is not for left brain functions. It is for the epinephrine of comradeship. 


Now that I am admittedly more flaneur than paladin – preferring more to think than to fight, as it were – I have spent some time contemplating this “moth to the flame attraction” of emergency medicine meetings. I can give you the standard company line why people should join their professional societies (and during the course of my board service and presidency I did so at least a hundred times). We join and come together for our own self interest. Such organizations work to defend our incomes (we’re great at this), lessen our medical legal risk, exert influence on the structure of education, gain a better life style, and to garner respect within the house of medicine for our members. We have done this better than any other medical speciality society over the past thirty-five years. 

But these obvious reasons for joining and paying dues do not defend our coming together. With teleconferences and web sites, there is no piece of scientific information or philosophical debate which cannot be obtained from your desktop. The reason we come together is not for fact or philosophy. It is not for left brain functions. It is for the epinephrine of comradeship. I have never been accused of having a panglossian view of the world; I don’t wear rose-colored contacts. I am the ultimate economist. I am the cost-benefit guy and proud of it. But I have come to believe there are genuine benefits – much greater than knowledge and trinkets – that we get from medical meetings. The truth is, I know my colleagues around the country, and indeed around the world, better than I know my own neighbors. My fellow emergency physicians are really the only people around whom I can just be myself. There is no other group among whom I can use the term “terminal fibromyalgia” and get a knowing smile. Among my peers, I can talk straight and have it appreciated. Emergency doctors get it. Being marooned together on this bank and shoal of time allows us to speak of our own hopes and fears without being concerned with petty judgement. This is the one crowd where you can say what you think and continue to be a member of the club. Emergency physicians have a built-in bullshit meter. They have been lied to so long by administrators, the government, and patients that they know how to test the validity of any statement I make. 

I am a true Baby Boomer – 1946. We were and are compulsive joiners. Our parents beat the Germans and the Japanese, lived through the depression, and saved the world. We founded things like ACEP to improve medical care and patient care. I know that present generations view the world differently. Those of you in the X and Y generations are more pensive and introspective. But I beg you not to become the generation of the flat screen. Go to your organizational meetings. Feel the sense of power. Feel the energy of being physically present with the best minds of our generation. This camaraderie is the stimulus that cements not only ideas but warm feelings. It’s where you make life long friends and confidants. It is where you meet people who you will test reality with, and will eventually call for sage advice. Do not grow to comment on the medical world with the indignity of a sophist. Don’t be Niche’s pitiable “Last Man,” indulging in what Alan Bloom called “debonair nihilism,” like the clever sophomore college student who declares the end of meaning to be very meaningful. Intellectual atheists need not apply. There are no mulligans in life. 

The answer to my wife – or anyone else who asks if I’m going to ACEP once again – is hell yes. Hell yes I am speaking and debating. I intend to do so until they put dirt on my ashes. The one day in my life I fear more than any other is the day they no longer ask me to participate at the national meeting. A consummation devoutly to be feared. Before I drop into a melancholy retrospective and start exposing my views on the superiority of the Baby Boomer generation, allow me to end this plea to my young colleagues in short commands. Attend. Participate. Interact. Introduce yourself to the faculty. Find future mentors. You have nothing to lose but your cynicism. See you in San Francisco.


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