Reflections on 2021 from St Emlyn’s

We asked each of the St Emlyn’s team for their reflections on 2021. We hope you have enjoyed the blog and podcast his year. Thank you, as ever, for all your support. With all best wishes for a happy, healthy, educational and fun 2022.

Simon Carley – Professor of Emergency Medicine

When I look back at 2021 it’s easy to focus on the negatives of the pandemic which is still raging here, and there is no doubt that it has been incredibly tough, but there have also been highlights and things to celebrate. Despite the attention seeking, ignorant, science phobic media hungry minority who seem to come up with a new crazy idea about the pandemic on a weekly basis, science really is winning. We know so much more about the way that COVID19 spreads, how to protect against it and also how to treat it. Just for fun try and think of another disease that has as many proven/disproven therapies as COVID19 and I just don’t think there is one despite the fact that it’s not been around for that long. In large part this is due to the work of the RECOVERY trial which we have covered extensively on the blog and podcast this year. In our NHS roles many of the team have been actively engaged in recruiting and to the trial and running it at hospital level, for me this has been the absolute highlight of the year. There is no doubt that it’s kept us away from other projects, but that’s no bad thing,

You can read the RECOVERY trial blogs here

In other news the blog and podcast go from strength to strength with another record breaking year in terms of visits and engagement. We’ve collaborated with colleges, universities, and other #FOAMed providers wherever we can and we are keen to carry on with this in 2022. Mostly this was virtual of course as travel and face to face meetings have been hard but not impossible. My personal feeling is that online conferencing, and online meetings have allowed us to maintain medical education to a degree, but that it’s largely been a holding mechanism. We still need the personal interactions that only come from direct interaction  to accelerate innovation and real change. In that regard I was lucky enough to get to one major conference in 2021. The EuSEM conference in Lisbon was amazing, not just for the content, but also for the opportunity to meet others and to just share ideas. Spending a few hours walking the streets of Lisbon and taking in a few shops and cafes with David Carr was a huge highlight of the year for me. I need lots more of those kind of conversations in 2022 to recharge, inspire, challenge and scare me into making real changes to my practice.

Personally my biggest achievement of the year was getting signed off for our local BASICS prehospital care team. I now respond as a volunteer to support the ambulance service in caring for the most critically ill and injured patients. It’s been an amazing experience to go back to being a trainee, working alongside true experts in the field and learning as much as I can from ambulance and medical colleagues. I’ve still got a lot to learn, but that learning journey is very rewarding.

The prolonged lockdowns here allowed me time to get through a fair few books and other media and my (not particularly academic) recommendations are below. Let me know if you give them a try.

Fiction book. The Word is Murder by Anthony Horowitz. This is the  first of the Inspector Hawthorne mysteries and is both narrated, written and features the author himself as a Watson to Hawthorne’s Sherlock. It’s a new way to tell a detective story and I especially liked the way that the author/narrator/lead character seems to get the best out of others, despite not knowing everything himself (maybe I identify him as the ED consultant?).

Option 2: The Book of Koli trilogy. Escapist futurism.

Non-Fiction book. Re-reading Free Will by Sam Harris (and as recommended by Scott Weingart). If you have an interest in decisions, decision making, philosophy and/or behaviour then understanding some of the artguments around free will is definitely worth some of your time and this is a reasonable introduction.

Option 2. Everybody lies. What the internet can tell us about who we really are. Seth Stephens-Davidowitz. Truly terrifying!

Podcast. Despite going for a paid version in 2021 EMCRIT still cuts the mustard.If not that, then St Emlyn’s (of course).

Liz Crowe – Advanced Clinical Social Worker

Like many people around the globe, 2021 did not pan out as expected. A dearly loved aunt died, my partners’ mother died, and we were unable to attend the funerals. I was separated from family and friends, we missed out on things, holidays, events, and milestones all were lost. However, I would have to say that 2021 was one of the most wonderful years of my life.  I have learned to be far more grateful for everything that I have, even when it is hard. I have people to love and am, in turn, loved. I have commenced a new career working fulltime in staff wellbeing at a tertiary adult hospital which I love. I am constantly in awe of the knowledge, insights, and talents of others – I have much to learn.  There never seem to be enough hours in the day to learn, laugh, connect and be humbled.  I wish I could ease the general fatigue and exhaustion of my colleagues and friends around the world.  As Australian’s, most of us have been very fortunate to not yet have experienced this.  However, my pledge for 2022 is to try and bring energy, information, fun and education into people’s lives when they need it.  We do see and hear you.  We just can’t get to you at the moment.  This time too shall pass.  In the meantime, take care.

Favourite song for 2021:  either Hypocrite by Drapht (to exercise) or Seventeen Going Under by Sam Fender for singing in the car.

Favourite Fiction Book: Lenny’s Book of Everything by Karen Foxlee. This book came out in 2019 however I only read it this year. If you want to consume a book in a couple of days, and you want to laugh and cry this is your book. This book is so incredibly humbling, heartbreaking and uplifting. I loved it!

Favourite Movie: Riders of Justice: this Danish film is labelled as ‘action/drama’ however it is so much more than that. It is confronting and funny and takes you on such a crazy journey of morality and justice. I absolutely loved this film, and it has become an all-time favourite.

Favourite Podcast: The Hidden Brain has remained my favourite podcast series year after year (though I must admit Ladies We Need to Talk has nearly made me fall over laughing a lot this year). My favourite episode of the Hidden Brain this year was ‘Group Think’ (released 20th September) it is so confronting to realise how frequently we make unconscious decisions and how much we want to belong. As our world becomes more divided, I think these are critical conversations to have. This episode led me to my favourite non-fiction book this year as found below.

Favourite Non-Fiction: The Power Of Us: Harnessing Our Shared Identities to Improve Performance, Increase Cooperation and Promote Social Harmony by Jay Van Bavel and Dominic Packer (2021)

Rick Body – Professor of Emergency Medicine

Dr Rick Body

During the pandemic, I’ve been co-leading a research programme to evaluate new tests for COVID-19: the COvid-19 National DiagnOstic Research and evaluation (CONDOR) platform – and within that I lead the FALCON study. This is a bit like the RECOVERY trial for diagnostic tests, whereby we evaluate numerous tests under one umbrella protocol. We published the findings of our moonshot programme evaluation of lateral flow tests for COVID-19 in June, together with the findings of others working on lateral flow test evaluation in the UK.

We published the findings of our moonshot programme evaluation of lateral flow tests for COVID-19 in June, together with the findings of others working on lateral flow test evaluation in the UK. We’ve come a long way since: lateral flow testing has become part of our daily lives, which has been a huge paradigm shift. We have included over 8,000 patients in the FALCON study in total, across 70 hospitals and 15 testing centres – and it’s been a huge privilege to work with so many people to evaluate exciting new tests for COVID-19 that could improve our pandemic response.

Right at the end of 2020, I took on a new role as Group Director of Research & Innovation at Manchester University NHS Foundation Trust (MFT), so I’ve now spent a full year in that post. MFT includes ten hospitals and employs over 600 staff within Research & Innovation, so I’ve had a steep learning curve. I know it’s a senior role, and I definitely still have a sense of impostor syndrome. It feels like only yesterday that I started out in research. However, I also know that I can’t let that feeling linger. It’s an honour and a privilege to hold the role, but with that comes a big responsibility to set and deliver on our strategy, and to give our staff the platform they need to shine.

Lastly, one of the things I’ve most enjoyed in 2021 has been the opportunity to work with so many up and coming stars of emergency care, who inspire me every day.

I hope that 2022 will see us edging further towards the end of this pandemic, I look forward to completing some more exciting research studies and I hope to see those stars of the future continuing to develop and shine, taking us forward to a brighter, happier and exciting future for emergency care.

Nick Harvey Smith – Head of Clinical Teaching and Assessments Manchester University

2021 has been an challenging year in education. We tried to deliver a quality education and assessment programme whilst coping with social distancing, isolation and a pressure on the NHS like never before. What has been amazing is the way clinical colleagues have adapted and still delivered ward based teaching to our medical students, providing opportunities for learning whenever they can and continued to provide support for non-clinical based education such as communication skills and OSCEs. As we move in to 2022 there are more uncertain times ahead as we don’t know what effects the spread of the Omicron variant will have on the delivery of education and the ever increased numbers of medical students starting clinical placements in the next few years (a knock on effect of students having been given their predicted A level grades in the last few years) will place pressure on an already pressurised system. The upside of this is that people have been looking in to different ways of delivering education, increasing the quality of online and digital learning, innovating and finally there seems to be some understanding that education needs to be properly funded. Happy New Year.

Favourite film of 2021: Has the be No Time To Die on the grounds that its an epic conclusion to Daniel Craig’s tenure as Bond (and also because it was the only film I saw in 2021)

Favourite fiction book of 2021: I’m certain that my fellow StEmlyns team member will have chosen very highbrow books however I’m going for the pure escapism of tea and time travel with Just One Damn Thing After Another by Jodi Taylor

Favourite non-fiction book of 2021: How To Make The World Add Up by Tim Harford which is essentially a book about the importance of statistics and how we should interpret them. Since I listened to that as an audible book I am going to cheat and list another favourite which was a physical book Organise Ideas by Oliver Caviglioli and David Goodwin about the use of graphic organisers in education.

Natalie May – Consultant in Emergency Medicine and Pre Hospital Care

Dr Natalie MayWe feel very fortunate to have had a far more normal 2021 than many; in fact, I had been double vaccinated before I ever touched a COVID positive patient. I’m under no illusion as to how privileged that makes me and it’s something I’ll continue to reflect upon in the coming weeks and months.

With Australian borders closed for most of the year, though, another 12 months has passed without us seeing our friends and family in the U.K. When we moved to Australia – and when we decided to stay for a bit – we had always imagined being able to “pop home” at least once a year. It’s been a source of sadness, but we are glad our families have also been vaccinated and have remained safe. When we make it back in 2022, there may be another shortage of toilet roll – I expect there will be many tears to mop up!

I’ve had some great work challenges; we moved a lot of COVID positive patients in NSW’s winter wave, including some ECMO transfers. We managed to hold another Resuscitology course – face to face! – in October and it was as brilliant as ever. 

During our brief COVID reprieves I managed to see some amazing theatre – Hamilton twice, and Come From Away – and we managed a trip to Queensland in which I got to catch up with Liz (as well as some other FOAMed friends – Jesse Spurr, Eve Purdy, Charlotte Alexander). I started reading “The Art of Gathering” by Priya Parker. It’s well worth a look.

My biggest lesson for 2021 remains the daily opportunity to reflect on the fragility and transient nature of our lives. I hope I take less for granted these days. 

Rusty Carroll – Director of Primary Care Network

Rusty Carroll2021 was a year to feel diverse.  Despite being male, pale and occasionally stale I realised that I was often the diversity amongst the community of practitioners I worked with.  This diversity most frequently manifested in the question “why” when facing assumptions made by those I was interacting with. 

The value of such cognitive diversity was highlighted in the Centre for Army Leadership’s podcast with Dr Tara Swart (here).  Challenges abound as we prepare to start another year of pandemic, with the old solutions not scaling to current times, maybe it is time to try to understand what organisational plasticity means to the individuals and organisations that strive to be part of the solutions. 

To quote Jocko, all problems are leadership problems, and to quote John Amaechi, leadership is a behaviour.  I commend you to his latest book addressing just this issue (here) and ask yourself: what leadership behaviour am I displaying right now?

Chris Gray – Senior Trainee in Emergency Medicine and Intensive Care

Chris Gray2021 has been a year of achievement for me. I have passed 6 exams this year and so added FFICM and FRCEM to my name. No more exams ever! My partner Lauren got her training number in plastic surgery, and we ran a half marathon together (something I never dreamt I would have enjoyed, but I did!)

But it’s also been tough. Work has been hard, it’s been tiring, and we’ve missed out on a lot of the usual family and social interaction because of it. Having things to keep me occupied (albeit revising for exams) has helped a lot, but I’ve appreciated the friendship of my work colleagues even more this year. Please remember to check in on your friends and family, and keep your eyes and ears open to the small signs that someone you know may not be ok.

I hope you have all achieved something you’re proud of in 2021 and that the New Year brings much happiness (and maybe a reduction in exit block please!). All the best for 2022!

Favourite book – The Invisible Library series by Genevieve Cogman has transported me away from medicine in between work and revision

Favourite song – It’s not from 2021 but I’ve rediscovered Chvrches this year (whilst running), and listened to Graffiti more times than I can count

Favourite podcast – Josh Farkas and Adam Thomas on the IBCC podcast have been hugely helpful for revision – thank you both for getting me through it!

Zaf Qasim – Assistant Professor of Emergency Medicine and Critical Care

Zaf QuassimFor me, 2021 was a year of mixed emotions. It was one of worry (new variants, rollercoaster levels of COVID cases, continued political upheaval and scaremongering) but also of hope (got some traveling in, reunited with family and friends, helped with the vaccine rollout, and very happily saw a family member come back from the brink of death). I was grateful for the more open and louder conversations around the value of my healthcare colleagues and about mental health in general. Here’s hoping 2022 will yield continued tolerance, collegiality, acceptance, (and people getting vaccinated!)

Here are my picks of 2021

Top book: A bit late to the party, but finally read Peak, which was excellent

Top TV show: Squid Game

Top movie: The Father

Iain Beardsell – Consultant in Emergency Medicine

Iain Beardsell

Please don’t hate me, but I’ve rather enjoyed 2021. Yes there’s been a pandemic and all that, but I count myself very lucky that I continued to have a job I (mostly) enjoy and pays me a decent salary, three sons who constantly make me laugh and question everything I thought I knew about being a Dad and a partner who I utterly adore. 

I cannot recommend a ‘full time’ job enough (and by that I mean ‘only 10 PAs’ in UK speak).  It has given me breathing space to do other things, so that when I go into the ED to work I (almost) always look forward to it and enjoy it. 

Without doubt the most satisfying part of my year workwise has been increasing my involvement with the medical students of Southampton University. Their enthusiasm is infectious and the hour a week I spend with the four final years that I tutor is a particular highlight. I am very grateful them for tolerating my nonsense and pretending that they learn stuff. 

I really enjoy New Year: not the parties, but just the chance for a fresh start. An optimism for the twelve months ahead. As the pandemic rolls on we have plans for a vegetable patch and perhaps even keeping pigs (we’ll see if these come true), trying to read more (I am hopeless at real reading) and tweet less, and attempting to finish Assassin’s Creed on the Xbox (‘Origins’ for those who are interested in these things). Oh, and I want to lose a stone and will give dry January a go. I realise I may not achieve all of this (especially the last two), but it’s rather exciting to think that I might… 

Dan Horner – Consultant in Emergency Medicine and Intensive Care

Dan Horner

I think it’s fair to say 2021 wasn’t really the breath of fresh air we’d been hoping for. More like a stagnant funk of uninspiring politics, pandemic uncertainty and leisure cancellations. Having said that we’ve seen some great science this year, I’ve learned a lot and Chris Whitty got a knighthood. So, all is not lost.

In terms of papers, I was particularly impressed by COVID STEROID 2 – a much needed study which was well conducted and sensibly reported, including some fascinating post hoc Bayesian analysis chat. The latter analysis again raises the uncomfortable question of whether we have always had it wrong when we try to dichotomise results. Perhaps we should indeed look primarily at the probabilities of positive and negative impact from research, accepting that we practice individual patient (rather than population) medicine. I certainly have a lot of colleagues in critical care who already think like this. Fascinating stuff.

A couple of systematic reviews got my attention also – this contemporary one on using the d-dimer for exclusion of PE in pregnancy and this earlier one from 2020 covering the use of additional PCC (on top of conventional FFP) for correction of coagulopathy in bleeding trauma patients. More to come in the latter space with the TAP trial.

I’ve also been encouraged by everyone finding their evidence-based feet a little more with COVID19. We published on this early in the pandemic – now NICE have grasped the nettle and continue work on their living guideline with sensible, deliverable and evidence-based recommendations, along with expert consensus suggestions. And would you believe it – it’s a no to Ivermectin. Encouraging stuff.

What have I been reading when not at work? Not lots if I’m honest, as I have been busy. I’ve done Nudge as an audiobook and would highly recommend it; essential reading for anyone who wants to change anything, anywhere. I have just started on 10 arguments for deleting your social media account by Jarod Lenier and enjoyed David Baddiel’s recent documentary on a similar theme. Let’s see if my Twitter account makes it to February…

Finally, I have escaped from real life with the Assassins Apprentice trilogy by Robin Hobb, which is a decent modern fantasy saga for those of you who enjoy such things. I also went to see Matilda the musical with my kids. It was amazing and I cannot recommend it highly enough.

Roll on 2022. As Yazz and the plastic population once wisely said – the only way is up.



Cite this article as: Iain Beardsell, "Reflections on 2021 from St Emlyn’s," in St.Emlyn's, December 31, 2021, https://www.stemlynsblog.org/reflections-on-2021-from-st-emlyns/.

Posted by Iain Beardsell

Dr Iain Beardsell. MBChB (Birm), DipIMC (RCS Ed), FRCEM is section lead for podcasts and Lesson Plans. Editorial Board Member St Emlyn’s blog and podcast. He is a Consultant in Emergency Medicine at University Hospital Southampton and a Consultant in Pre Hospital Emergency Medicine. Iain qualified in 1998 and over the past 20 years has trained and practiced medicine in major teaching hospitals both in the UK and overseas. He has been a consultant at University Hospital Southampton for the past thirteen years, including a three year term as the unit’s Clinical Director. UHS is the main Major Trauma Centre for the South Coast region of England as well as the eighth largest hospital in the UK. Iain is also a highly regarded advisor to television medical dramas, including Casualty and Good Karma Hospital. An acclaimed speaker, Iain has spoken at international conferences in Australia, Ireland, Austria and Germany as well as across the UK. You will find him on twitter as @docib

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