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By most reasonable measures I'm a little over halfway through my active medical career. It's been a time of the most extraordinary change. For example, while I was an undergraduate at medical school I remember a tutor sharing with us his excitement at a series of publications in Science detailing the discovery of the gene associated with cystic fibrosis1—from the identification of where it is on genome through to a putative function of the gene product. At around the same time, if you wanted to find publications on a particular subject you went to a book called Index Medicus, published each month, which listed the relevant publications. Shortly after this someone called Tim Berners-Lee began inventing what became the World Wide Web, and a few years later I can, in between looking at …