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Highlights from this issue
  1. Ian Wacogne
  1. ian.wacogne{at}

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In the odd delay built into a journal like E&P, I'm writing this in the immediate aftermath of attending the Royal College of Paediatrics and Child Health Spring Conference. It's interesting that in this age of more real print and virtual print than we can even begin to think of completing, and more resources for learning than our predecessors could have imagined, we still make the time to travel and to sit in the same room as a speaker, to hear them talk. I wonder why we do this?

I suspect there are a few reasons. One of them is to do with trusting that an eminent speaker will have prepared an interesting and stimulating talk, which introduces us to a new set of ideas. Another is to listen to how people have responded to difficulties similar to our own. But I suspect that the main reason is the buzz of meeting a bunch of people, some of whom you've never met before, some of whom you've not seen for a year or two, and, well, chatting. It would be easy to create a misunderstanding here—after all, our employing bodies are often supporting us financially to attend, and I'm pretty sure they'd be reluctant to fund us to go on a general gossip. So, to clarify, it's more than a gossip—it's the pollination of different ideas across multiple people, and the creation of exciting new thoughts. And what about when you're in the same room as a bad speaker? Well, these days there is always WiFi. But, that aside, I also find value in a conference where I can unfocus a little, and let the thoughts rattle around a bit.

What can a journal do to recreate the best parts of a conference? Well, obviously it can't simulate putting people in the same room. But it can bring the thoughts of some diverse people into the room you're in—which, by some accounts, might be the littlest room in the house. This issue we've got lymph nodes, croup, BCG abscess, mouth ulcers, neonatal antibiotics, haemangiomas, odd X-rays, capillary refill time, pulse oximetry, and a Picket on cooling after brain injury. I reckon that's pretty eclectic, and should, if you unfocus a little while reading, give you a few fairly diverse thoughts.

My Editor's choice is the paper on recurrent oral ulceration in children (see page 82). Esse Menson, who wrote this paper with Kirsty Le Doare, Esther Hullah and Stephen Challacombe, has been helping curate a infectious diseases sub-series within the Fifteen-Minute Consultation section, so expect a lot of these over the next few months. Oral ulceration is a clinical scenario I find tricky; the range of possibilities, from idiopathic to some very serious diagnoses, and the high incidence—from 1 to 10% of children—make it important to pick the right child to investigate robustly. The authors provide a helpful table of first line investigations with the useful caveat that the absence of systemic features, you can usually avoid testing.

A while ago I used to take copious notes in talks, convinced that I'd pore over them later, absorbing the knowledge and becoming a Better Doctor. Of course, I never did pick them up again, so over the years I adapted my style, and trying to limit myself to just a few things from each talk. Rather than “What information is here”, I moved towards “What actions will I take as a consequence of this”. A couple of days at a conference can still give me a to do list longer than I'll ever achieve, but I find that the actions I do take, really do take me a long way. Philippa Prentice edits the guidelines section brilliantly in this way—making sure that authors give you a list of things to do, and sometimes more importantly, things not to do. I'd be interested to hear what you do, or stop doing, after reading this month's E&P. Just unfocus a little and it will all make sense…