BASHH

So it's good to be back after the rigors of the BASHH Spring Meeting last week and for those of you who couldn't make it this year what did you miss? Well there was everything from Simon receiving a ‘this was your life' achievement award - well deserved and managing manfully to avoid any Gwyneth Paltrow style acceptance speech tears - to Keith and Mark F in a rap-style ‘dance off' following the Gala Dinner (marginal exaggeration for media effect on my part there perhaps...) to a reputation-mangling debate about the future of NRTIs between the ever fragrant Ed  and the ever er... challenging Mark N. Oh, and a lot of great presentations and posters in between of course.

Having finally detoxified from the experience (there's always a lot of... em... rich food at these events as you know...) I sat down to think about what was topical at the moment. Three hours later having dealt continuously with my persistently pinging iphone and my cheerfully chirping computer I rather exhaustedly settled on the subject of technology.

Now those of you who have read my previous blogs (thank you, mum...) will know that I have admitted to being a bit of a technical dinosaur...Cue proud roar... But unlike my now extinct fossil friends my brain is large enough (although it doesn't feel like it most days) to calculate that evolution is inevitable so it's advisable to at least try to keep up with technological advances.

And, let's be honest, there are so many good things about technology today (not least of which was Google maps and a smart phone, the combination of which allowed me to wend my way back to my hotel in Newcastle unscathed following the BASHH gala dinner without having to accept the help offered by some overly friendly strangers!). Medicine must be one of the disciplines that has benefitted most from such advantages; really it's staggering to think about what we can technically do now for patients and surely very few would question that this is a good thing. The world-wide web has expanded our horizons beyond all imaginings and vast streams of knowledge are now readily accessible by many, although admittedly not all. Anyone who has friends or relatives abroad can't fail to be aware of Skype and although I was initially sceptical of this, it really does make a difference to be able to see people on the other side of the world, even if you cannot be there in person.

BASHH too was impressively up to date at the conference with presentations highlighting the benefits of technology to our own speciality. Our colleagues from north of the border (streets ahead of us as so often...) expounded upon their national electronic record system (NaSH) and Gary Brook was justly awarded the Cathy Harman Memorial Prize for his admirable (if unenviable volume of...) work towards the Central Middlesex clinic electronic patient record (EPR).

So with all of these positive effects why am I still uneasy about the beast that is technology? Perhaps as a human we are innately programmed to feel threatened by the rise of the machines, but is it more than that? In these modern times we're never really able to be out of contact which might sound like a good thing but not if it never allows us the quiet, reflective time that I think we all need. Are we really so bored that we need constant stimulation? Have we forgotten how to relax and just exist? I'm in danger of sounding like a Buddhist philosopher (and not a very good one either!) so I'll come to my second, more tangible, point. Are we in danger of losing the so-called human touch and, if so, what does that really mean? Contact (as is the case with so many other things) is about quality, not quantity. Can we really convince ourselves that emails and texts are worthy substitutes (albeit more convenient ones) for a face to face interaction? I have a patient who recently confided in me that she had miscarried at home with only a text conversation with a friend as company during the actual event. I felt incredibly saddened by this, wishing instead that the friend had come straight to see her rather than carrying on with this poor surrogate for real contact. We can see when someone is distressed in front of us. We can't see it on a computer or a phone screen and they won't always say it. Technology with all its wondrous applications is no replacement for being there in person. Medically too I worry about the quality of the consultations we have with our patients when technology interferes. We have probably all been a patient at some point where the health professional seeing us has spent more time gazing at/typing into their computer than actually looking at us and I think it leads to feelings of dissatisfaction in both parties and lessens the value of the clinical interaction. Human contact and intimacy are at the very heart of our particular speciality. I hope that we remember this as we also attempt to embrace the technical challenges ahead.

In the end I suppose I have accepted an uneasy sort of compromise. I am not on facebook or twitter (aside from anything else I don't need to be associated with anything with ‘twit' in the title - I have enough problems!). I have a computer which I need for almost everything but I don't use it while I'm talking to patients. I have a mobile phone but I don't always answer it. Am I basically on the fence? Well, dinosaurs don't generally sit easily on fences so I suppose I'm bound to tumble down on one side or the other. I choose the human one. The march of the machines will undoubtedly continue. I just hope I'm not the only one trundling suspiciously behind them rather than striding enthusiastically alongside.

More soon (if my computer hasn't murdered me for disloyalty...)