Cruising

Well, another BCMJ cruise conference is approaching, and once again I’ve been conflicted. I’ll be going, but is it for selfless or for selfish reasons? Going on the Caribbean cruise in 2007 could have been rationalized at the time as public-spirited and courageous, as indeed it was, but in 2009 things are different. We have financial and political uncertainty, climate change, and changes in systems of communication, all of which can provide persuasive reasons to stay at home.

But, I rationalize to myself, these reasons mostly target big conferences in fancy places. The carbon footprint of thousands of conference attendees, through energy expenditure in travel, and the consequences of hotel and convention centre maintenance is enormous—it has been estimated at 600 000 tonnes of carbon for world-wide medical conferences alone. Most of these mega-conferences comprise presentations given by august speakers in large, darkened halls, a smattering of questions that may or may not receive direct answers, and a feeling that little will change in your practice as a result of attending. In fact, after decades of attending such conferences, the key concern for older attendees is to ensure the continuation of regular bowel activity. So far as meaningful transfer of knowledge is concerned, journals (such as BCMJ, of course), computers, web sites, and videoconferencing do a better job—in my opinion—than attending a mega-conference.

The approaching BCMJ course in Ecuador and the Galapagos Islands will be far removed from a mega-conference, and much of the travel involved will be self-propelled. It will involve 100 delegates, including speakers, some of whom will not really be interested in the presentations at all. It will involve 2 days of presentations on an eclectic range of topics, and I anticipate that the lights will remain on and the audience will remain engaged throughout. The best part of small conferences, however, is that presenters have nowhere to hide, and direct questions require direct, practical answers. Some years ago a randomized trial of sorts in New Zealand explored the effectiveness of different methods of knowledge transfer at a medical conference and found that the most effective method—and the most sought after—was one-on-one time spent with an expert in an area in which the delegate felt uncertain. Intuitively, such a method seems ideal, but it is a labor-intensive format and the best substitute for it is the small-group session. The BCMJ conference will provide both kinds of sessions in spades.

Realistically, though, attendees will not be going primarily to hear the speakers—and that’s okay. The Galapagos Islands are a full-time lesson in evolution, but more importantly, the number of threatened species of plants and animals provide lessons in the effects of environmental and climate change. Visiting the islands and viewing (from a distance) the enormous variety of birds, animals, and vegetation found only in the area will be, for virtually all attendees, a unique experience. But the knowledge that our grandchildren may never know of, let alone see, giant tortoises or Galapagos penguins may well make eco-warriors out of benign BCMJ readers. I think it is inevitable that we will come back changed and (speaking personally) no longer conflicted about BCMJ cruise conferences.

—TCR