The adrenaline rush was unbearable. I could feel my palms sweating. When I tried to clip the microphone on to my coat, my hands were trembling. Eager looking eyes of the audience were pinned on me. I took a deep breath and with my heart still pounding, I said, “Hello everyone!”

This is how my talk on therapy of altitude sickness started at the “Snakes, Bugs and Altitude Conference” last Monday at Hotel Yak and Yeti in Nepal. I cannot attribute my anxiety to one particular reason. But the most important one, in my opinion, was that this was my first conference as an ‘expert’ speaker.

I had presented at some of the international conferences before. But then, these usually were competitions during student conferences and the rest of the presenters were students or young doctors like me.

Things were different here. This was a conference being organized by Professor Andrew Pollard of Oxford University and there were doctors from the UK, USA and New Zealand who had flown in to Nepal to give their talk in this conference.

How often did I get to share the title of a speaker with pioneers in their respective fields such as Professor Buddha Basnyat (Expert in altitude medicine with many landmark papers), Prof. David Warrell (Editor of the Oxford textbook of medicine), Prof. Andrew Pollard (Director of the Oxford vaccine group), Dr David Shlim (Expert on travel medicine from USA) and many others like them?

To even have my name amongst the names of these speakers seemed like a big achievement. But of course, that added to the tension as well. The pressure to perform was enormous. I was the youngest amongst all the speakers. That had been the whole point of the conference. To encourage young doctors from Nepal get interested in their indigenous problems such as Typhoid, Rabies and High-Altitude Illnesses.

I was not much worried about the subject matter of my talk. I have been fortunate to work under the guidance of Prof. Buddha Basnyat in the Mountain Medicine Society of Nepal (MMSN) for the last three years. I have been part of a research at high altitude, have conducted a health camp at 4380 m, and have participated in trainings and other academic programs related to altitude medicine. Hence, I had been selected to speak on altitude medicine and I was confident that I would do justice to my topic. I had other concerns.

Could this experience in altitude medicine help me out to speak confidently as well? I had my doubts. I wondered if my talk would be boring enough to make the audience fall asleep. This was likely considering the fact that my talk was at the end of the conference after thirteen other speakers. I tried to make my slides for the talk as interactive as I could.

In the end, it was not that bad after all. I did face some minor problems. I realized that I had few problems with articulating some of the larger words which would not have happened on a normal day. Everything else seemed to go on smoothly. Half-way through the talk, I was confident that I would finish it without looking stupid. When I finally finished my talk, I received a big round of applause like everybody else.

Many of the young doctors came on to say that they liked my talk. I hope they were honest in their comments. I have a video of my talk and when I look at it I see myself smiling most of the times during the talk. I remember myself as being anxious and nervous only and I don’t know how I managed to smile. It must have been some kind of defence mechanism but I think it worked well with the audience.

I always enjoyed listening to external speakers during the conferences that I attended. But switching places showed me how much difficult this can be especially if it is your first time. I hope we can only improve with practice. So, I am looking forward to the next one where I can be a speaker again!!

I am sure many of you who will read this blog will remember their first instance as a speaker in a conference. I would love to hear more about them on the responses to this blog. Thanks!!

Competing interests: I am a recent medical graduate from Nepal, former clegg scholar at BMJ and an active member of Mountain Medicine Society of Nepal (MMSN). I am grateful to Prof. Buddha Basnyat for providing me with the opportunity to speak at the “Snakes, Bugs and Altitude Conference.”

Siddharta Yadav is a former BMJ Clegg scholar.