Ships of Theseus

Back in the day when I was student, I used to fondly think of medical conferences as the modern day equivalent of Epidaurus in Ancient Greece.A grand annual meeting of enlightened minds discussing important things with a noble purpose. I suppose I was blue pilled and naive.

This idea persisted even as I got into MD and was involved in a conference (like other pgs of my batch). Ironically most people from my batch, never attended conferences outside Jipmer.It seemed odd, but then work kept us busy. Slowly, things started to look different. More and more conferences didn’t resemble the idyllic knowledge meets that I had believed them to be. Try as might, I couldn’t shake the feeling that something was amiss.

In the movie Matrix , Morpheus offers Neo two choices — the blue pill and the red pill. The blue pill allows him to forget everything, continue as usual as if nothing has happened. “Take the red pill and I shall show you how deep the rabbit hole goes”, says Morpheus. As Neo reaches for the red pill, Morpheus cautions — know that this will give you the truth, nothing else. In a sense, this fork in the path is hardly unique to Neo. All of us, at some point face this — we can to either continue to live in our cozy web of fantasy or face the reality. Sadly, unlike Neo we aren’t always offered the choice.

As I got older and joined DM, I started going to more and more conferences and CMEs. I didn’t choose the red pill. It was shoved down my throat.

Many people it seemed came to conferences just to collect bags and have a good dinner with booze. The grandeur of the conferences I attended couldn’t mask the poverty of meaningful research. To add insult to injury, number of conferences and events steadily increased . Of course, you can’t conduct events without money. Somebody has to pay the bills. The industry pitched in. This meant that the content of the talks have a binary choice — be purely utilitarian or commercial. The former is to satisfy the large number of general practitioners who are fishing for that nugget of wisdom which they can implement in their practice. The latter is more insidious and has been actively banned in some countries. Nevertheless, premium slots and premium speakers are often about some drug or the other. It was as if the entire enchilada is geared towards teaching doctors what to prescribe, without getting into any boring nuances. Of course educating the generalist working in the trenches is a worthy goal in itself — provided it doesn’t devolve into mere sound bites.

The kind of difficult talks and long discussions needed to clarify a concept usually don’t have many takers. It requires much more effort to both give and listen to such talks. Consequently it needs to be protected. Think of the governmental choice between constructing a shopping mall vs a park in vacant plot. If the choices are purely dictated by revenue, this would be a no-brainer. However a government, unlike a corporation, ought to have the mettle to rise above the bottom line, numbers and do what is good, but not profitable.

As I contemplate the meaning of conferences, talks, CMEs and other meetings I have attended,I am reminded of the Ship of Theseus. The legendary Greek king Theseus won many naval battles and the people kept his ship in the shore , as a reminnder of his bravery. As the years rolled by, the planks of the ship started to rot and get damaged. Old ones were replaced by new planks and over a few centuries, precious little of the original ship remained. If the entire ship were to be replaced by new parts, does the ship still retain its identity? This philosophical conundrum has baffled men far better than I can ever be. How much of the ship can be replaced while keeping the identity intact?What is the last plank that when replaced completely changes the identify of the ship? Does the ship have an identity of its own at all — or is it irrevocably tied to the brave king ? Is identity ever independent of time?

The original creed of the medical conference, (if it ever really existed) has somehow been hit by a terrible mutation. While most doctors would claim that the big Pharma and the money are responsible, I know deep down that our community owed a big mea culpa too. Like the Ship of Theseus, conferences are in danger of losing their identity. How much commercialisation can we allow before a medical conference ceases to be one?

It’s time we had a serious conversation about conferences.