3. The Critical Newsletter

This is a copy of my first Substack newsletter. This will be a new modality for sharing some of my writing, although they will also be published here on the blog. You can sign up to get it through to your email inbox here. 

Hi everyone,

Welcome to the first edition of the Critical Newsletter!
I’m really pleased to have you join me here and excited to start this new project. To help you understand my plan here, I wanted to spend a couple of minutes outlining what the goals of this project actually are.
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But first, let me take you back a few years and tell you a bit of a story of how I got here. In the distant past of 2013 (yes, I’m feeling old!) I first started my writing journey. I was preparing to start my anaesthesia training and fascinated by many of the challenges that I was about to face. To help me try and make sense of some of this, I started writing. After a short while, I realised that I was actually quite enjoying it. Indeed, some of the content I thought was actually half decent. As such, I decided I would start a blog (I think it was a bit of a thing back then). In honour of my chosen speciality I named it Rapid Sequence. The writing was sporadic, and the quality variable, but I continued it for a number of years. On reflection, I have never really stopped. My focus has drifted over the years - I have started new projects and let old ones slide. The pressure of exams led me to focus more on creating useful learning material, and I started sharing my notes at thegasmanhandbook.co.uk. This project took on greater centrality and my blogging faded away, although I came back to it from a different direction. As I got further into my training, aspects of cognition and psychology began to fascinate me, and my writing targets moved to more adjacent topics. The medical writing drifted.

But the love was always there. I continue to find writing an excellent modality for engaging with topics. It is a trigger for thought and a stimulus for deeper analysis. In short, whilst I was deeply enjoying my other learning endeavours I was beginning to miss the engagement in medicine. The completion of my medical training had lessened the structure of continuing personal development (although it never goes away) and thus seemed to have resulted in me stepping back from some of these projects.

This is a renaissance. My goal here is echoed by that on my website Critical. I want to bring together the projects that excited me through my training and which I have stepped away from. These are the topics that have always interested me, but which I have stopped bringing together in a single place for many years.

These topics are broad, and obviously include the aspects of delivering high quality critical care and anaesthesia. But my interests around this have evolved over the years. Much of my previous interests were about ‘what’: what are the best techniques? What is the latest evidence on a topic? Essentially, what should I be doing in my practice? I find my latest focus is more effectively captured by ‘how’. That is, how do we apply ourselves, as humans, to these challenges? How can we learn more effectively? How can we make fewer mistakes? Essentially, how should I practice medicine?

As such, I expect aspects of medical education, human factors, and quality improvement may feature more frequently than my previous focus dissecting the medical literature for nuances of clinical practice. We shall see.

Ultimately, I want to use this format as a prompt for discussion. The benefits of a Substack newsletter is that it can come straight to you inbox and allows easy discourse. My blog will continue to have the same posts, but the engagement tends to be less in this location. And whilst I find the writing valuable in and of itself, it is not nearly as enjoyable without it being part of a larger discussion. As such, I hope you will consider signing up and joining me in this new direction. I’m looking forward to it.
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Tom