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DFTB in Dublin – A reflection


I have a confession to make. I hate people.  I hate lots of people. Not in the obscenity-spitting, swilling distilled hatred from a brown bag sort of way but in a way that is just as disruptive to my life. You see, I am an introvert. There, I have stood up from my chair at Introverts Anonymous and made my pledge.

At work, the scrubs I wear are my uniform, my cape and my cowl. My embroidered name becomes the symbol on my chest. When I change from my (now) not-so-secret identity as a mild-mannered Clark Kent wannabe I become immune to the fear of it all, of exposing myself. I know my stuff. I am a good doctor. When I walk into the resus bay to see a still-fitting child and a look of indecision on the face of the team, I take control of the situation. But it is not with loud words or an overbearing attitude but with a sense of calm. You see, you can be an introvert and have a commanding presence too. Those of you who have read Susan Cain’s book, Quiet, will have discovered that we are taking over the world. My heart is not racing along at 140 beats per minute thrusting me into Condition Black, it is pumping at 80 affording me fine motor control. When I talk to the parents about what is happening, I don’t spout thoughtless platitudes and interrupt their questions. I remain calm and quiet and I listen. That is what an introvert does. We listen.

But what do you do when you fly 17,208 kilometres to attend one of the world’s foremost medical experiences whose very name implies talking to people – not at work, not in my protective uniform – the Social Media And Critical Care conference?

I had been there at the start, in Sydney, but I had my family with me. They were an easy excuse to duck out of functions and head to Darling Harbour and have a rainbow gelato. At that time, I was barely on Twitter and Don’t Forget The Bubbles was merely a glimmer in Tessa Davis’ eye. I knew a couple of people from work and so enjoyed the talks for what they were and left feeling energised and enthusiastic about my job.

But now I am in Dublin, a long way from home.  I could have done the same, but I saw it as a wasted opportunity. Over the three years since Sydney, Don’t Forget The Bubbles has grown in content and readership and has become a large part of my non-work life. I have had more late-night conversations on Twitter and Slack with my colleagues Tessa, Ben and Henry than nearly anyone I know. I have taken part in virtual journal clubs and discussions with doctors, nurses, paramedics, and pharmacists from all around the world.  But all that was behind the pseudo-anonymity of a 400 by 400 pixel image. You cannot do that at a conference – especially if the wifi doesn’t work as planned.

Then I had a revelation, that lightbulb moment. The people at the conference were not strangers at all. They were friends – good friends. When I saw Jesse Spurr in Dubai airport, I went up to him and put my hand out and said ‘Hello. We had never spoken in real life, but because of social media, we knew each other and any awkwardness was lost. He greeted me with a huge smile (despite having been on a plane for 14 hours), and we chatted before boarding for Dublin. When I met Casey Parker, the man who started me blogging, I didn’t even need to pluck up the courage to put out my hand as he beat me to it with a warm grin, and we talked of our families and holidays and our hopes for the conference. When I met Henry, who (despite having written and edited with for almost four years) I had never met, we exchanged a manly hug. It was like greeting an old friend.

Sure, going up to people you have never met can be a terrifying experience. You worry that you may say the wrong thing or stop them from doing something important (sorry, Cliff), but it doesn’t matter. Nobody is out to make you feel small or stupid. There was an overwhelming spirit of kindness and compassion at the conference that was reflected by a number of the speakers but I think Ash Liebig put it best when she spoke about the golden rule. If you treat others how you would like to be treated, then that little bit of courage will be rewarded ten-fold. And once you start, the positive feedback loop becomes a wonderful form of Skinnerian reinforcement.

So, as I became more confident putting myself out there, I spoke to some of my idols – Simon Carley (who is just as nice in real life), Haney Mallemet (who is as charming as he is intelligent) and Ross Fisher (who is as antithetical to the surgical stereotype as you could imagine). And you know what? None of them brushed me aside, asked why I was talking to them, and told me to go away.

To all of you introverts out there, I urge you to start. Take the risk and take one step forward, put out your hand and say hello. Connect, share stories, and ask questions. That is the ethos of the FOAMed community, and that is why we all came to SMACC. And now the banners have been taken down, and nothing but the creamy dregs of Guinness remain in the glass we head home to take stock and reflect. How can you bring this feeling of compassion and kindness back to your workplace? Is it taking time to let the nervous medical student stutter out the wrong answer to a question and not berating them? Is it not questioning why the paramedic has brought in the 85-year-old granny with a sore knee? Is it spotting a resident having a hard time and making them a cup of tea or buying them a soda?

It’s time, now, for me to pack up my laptop and make my way through multiple timezones and security checks back home to my family. I’ve had a wonderful time – in part due to Oli, Chris and Roger – but mainly because of the friends I have made. Conversations on Twitter will now be with real people, not just static avatars. Plans are already being made to catch up again in Berlin for Das SMACC (if I can get a ticket), but if not, I know where I can find them all. I don’t have to hand in my membership card for Introverts Anonymous just yet, though, as I have learned to face some of my fears and reach out.

For me, this conference was about connection and delivered it in spades.




Infective Endocarditis

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RSV protection HEADER

Protection from RSV

Copy of Trial (1)

Bubble Wrap PLUS – July 2024

Copy of Trial (1)

The 82nd Bubble Wrap


Management of Button Battery Ingestion

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Cervical Spine Imaging in Kids – the PECARN rule

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The ‘Hidden C’


Necrotising Enterocolitis

Copy of Trial (1)

Bubble Wrap PLUS – June 2024

Copy of Trial (1)

The 81st Bubble Wrap


Persistent Pulmonary Hypertension of the Newborn


Diagnosing acute post-streptococcal glomerulonephritis

Not a fever HEADER

When is a fever not ‘just a fever’?

Copy of Trial (1)

Bubble Wrap PLUS – May 2024

Copy of Trial (1)

The 80th Bubble wrap x DFTB MSc in PEM

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11 thoughts on “DFTB in Dublin – A reflection”

  1. Carsten S Poulsen

    Great post:-) Scarring how I can identify with it. Only I didn’t work up the nerve to approach all the fantastic people on smacc.
    On smaccUS I also didn’t do it and at that time. Therefor I decided to man up at smaccDUB. Now I am left with regrets and the goal to try again on DASsmacc.
    One of the first people I will look up is you:-)

  2. Not every introvert I know hands out packets of TimTams though.
    Mrs KB stared at them for ages.
    Great to see you, and from one introvert to another: keep up the good work!

  3. I’ve been really surprised at the feedback received from this post, thank you everyone. It has obviously struck a chord with the #FOAMed community.

    It it amazing what we can each achieve if we just accept that people do not want us to fail.

  4. Great piece Andrew. I spend many hours mentoring trainees who are constantly being told to be more of an extravert in the workplace in order to be a good team leader. Introverts make great leaders & it’s nice to see this recognised more through social media and conferences like SMACC. Hope to meet you in person at the next one. @rulesrule1

  5. Tim, I’m sure getting naked on stage would earn you an ovation in quite a number of venues. Cheekiness aside, totally agree with you and Simon. Great to connect with even more of the lovely ppl in this wonderful community.

  6. Agree – social media connections allow us introverts to actually have the courage to go up to speak to someone…to perhaps share out story….to even share our fears…..and, in my case last year, to overcome my fear of public speaking and share inner vulnerability in a very public way (where else by smacc could you get get nude on stage and receive an ovation?)

    This year brought a LOT of those themes together – Scott on kettle bells for the brain, Ashley Liebig on PTSD, Ross on Fear….and so much more


    Safe travels to all ….

  7. Fantastic to meet you again in Dublin. I suspect that if you really tested many of the speakers they might well fall into the introvert category too. There is a difference between stage performance and comfort in social settings.

    That said, I think the best memories of Dublin for me are exactly the same as yours, the people I’ve managed to meet, chat with and to learn from. I’ve never had the opportunity to connect with so many and like you that was a deliberate act at this conference. To try and speak to as many new people as possible, to take time to meet new friends as well as revisit old and virtual ones.

    It was a truly friendly week, perhaps fuelled by the high number of emotive talks. I think we were all challenged to consider our emotional intelligence and skills by some incredibly powerful talks.

  8. It was an absolute pleasure to meet you. I expect most of us are quaking in our boots- we just hide it to varying degrees. Can’t wait to do more with you and the DFTB crew!