The traditional paradigm of lecture theatre gatherings, authoritative Textbooks, accredited congresses and conferences has rapidly dwindled. Today people are choosing Twitter Experts, non-peer reviewed electronic publications, and on-line Presentations without live interactions. Love it or loathe it, there is no going back. Fake News communications are increasingly succeeding in getting published in previously reputable journals; we know this, because fraud detection techniques are being improved and increasingly widely used by Journal Editors. Concerns about Opinions commissioned from academics by the health industry are long standing, and seem not to have been addressed by use of Conflicts of Interest Declarations in the small print of the full publication. We should see Conflicts of Interest prominently revealed alongside each Author name, even in Abstract citations. Review articles written by professional script writers, with names of supported academics added to Authorship, should be clearly labelled as Promotional Material. I feel strongly about this because I have on several occasions been warned not to talk down biophysical colloid osmotic pressure therapies on threat of, and in fear of, withdrawal of vital Sponsorship.
My own mission after a lifetime of bedside critical care practice is to see basic fluid physiology and glycobiology recognised as essential knowledge fields for the Examination of critical care clinicians. Syllabus setters should require an appreciation of the heterogeneity of Capillaries and the consequences for the chemistry of each tissue’s interstitial fluid. The ‘second circulation’ of extracellular fluid by capillary filtration and lymphatic pumping, returned by absorption to capillary blood in lymph nodes or by further pumping to the efferent lymphatic system, should be basic knowledge, and ways to promote that second circulation should be appreciated.
In recent weeks I have had increasing numbers of requests from practitioners around the world to clarify certain points, either for personal study or for the preparation of teaching materials. I am delighted to receive such communications, and do my best to reply within a few days. Very occasionally I have to ask for a week or so to construct an explanation of difficult, or not yet well explored questions. Please keep them coming. Please also consider asking me to schedule a teleconference if you want real-time interactions, such as committee meetings or tutorials/ seminars. I am here to help. After the amazing pandemic-fighting efforts of critical care colleagues around the world, I feel it is the least I can do in order to express my gratitude and admiration.