“Could be Rotterdam, or anywhere…”
by Dr Ollie Minton, Palliative Care Consultant and roving reporter/content creator at the European Association for Palliative Care 18th World Congress in De Doelen, Rotterdam, Netherlands
Uitbuiken is Dutch, and literally translates as ‘out-belly,’: it means to sit back and let your food go down. There’s no English equivalent, but it’s a universal act, especially after a long meal. So now that I can digest the last week of EAPC activities, (whether I got zero, 1, or even 2 brown food bags at each day of conference I will leave for YOU dear reader to decide) and sit back: Welcome, bienvenue, welkomen – that was a long 4 years (no comment Ed). We all know what happened in the interim and how many guidelines were produced and data collected about Covid-19. Fortunately as a speciality while acknowledging all of this, we were also able to look forward and embrace the multi-faceted nature of ensuring all aspects of what global palliative care entails.
Blog editor asks me to write about EAPC every time there’s a conference (see my “Feel the Bern“, and “EAPC Berlin” outings), and 2023 is no different. The theme at conference was to embrace equity and diversity and while I am very aware of the multiple privileges I have, I revived my roving reporter non-official role for the journal
So Rotterdam a mixture of multiple parts city seen on foot and bike, and multiple trams plus water, water everywhere – and bees at the top of De Doelen conference building, I felt at home and consoled by my low carbon footprint arrival on the Eurostar. Well done me!
You can almost forget time has passed once seeing colleagues and friends waving flags at the opening ceremony or the compulsory speeches from the government health departments, and of course the music.
Other things were included in the welcome too, including seeing this artwork, or was Father Christmas just happy to see me?
Enthusiasm was unwavering throughout, although my love of science was left still wanting more trials on new drugs, more big data, even the rate of digital progress post pandemic still felt to be lacking the interconnectedness of all things, but we do acknowledge our AI overlords will sort that by Barcelona 2024.
If Taubert’s Grote Zaal (Grand Hall, the 2,200-seat concert hall) plenary about Artificial Intelligence didn’t frighten you witless, then we may still have some time left before the machines take over.
There is always the balance to be made to make new knowledge CPD points and seek out new grant opportunities or at least someone to bounce ideas off either during the day or as is always the preferred option out and about when we brainstorm more effectively.
It was a sad farewell to outgoing presidente Christoph Ostgathe, who had bookended the two ‘in-person’ palliative care EAPC events that had Covid-19 in their midst. He has been a great asset and will be missed. A new board of directors beckons, with new challenges and opportunities.
It was a versatile programme (no paper, but an app that worked very well) from anticipatory prescribing through to compassionate communities and the Lancet Value of Death commission, all of which can be found in Palliative Medicine abstract book https://journals.sagepub.com/doi/full/10.1177/02692163231172891 via free and open access. No paywalls, folks!
So this is a selective take of impressions including book signings, selfies with palliative celebs, mint tea and an appetite for more interactive workshops to ensure less PowerPoint (we did one of those). More chance to look at the cultural differences in death rituals taken by a Dutch photographer part of normalising death and planning ahead, despite the ongoing difficulties in establishing the evidence base. We do need to continue to promote this and upskill both health care professionals and community and significant others – no shortage of suggestions noted at this event!
The international representatives from both within and outside the EU and beyond always bring cultural ethical and political issues and reminders that what we take for granted in first world countries isn’t routinely available widely – still coming back to morphine and the most basic set of symptom control measures. However knowing now palliative care is a human right and we have the support of the WHO things may improve over time.
The inequity and lack of resources seems all the more stark in a time of smartphones, chat bots and virtual and assisted reality. There was a strong theme that racial inequity is still abundant and rife. We saw the launch and premiering of the #CovPall racial inequality film (see it here). The topic on the need for better and more #LGBTQ inclusive communication- avoiding heteronormative assumptions, was also heard throughout. 
More than anything now I’m reassured by what a well adjusted lot we all are (ha ha, yes you read that right) as we deal with death on a daily basis or collate data from bereaved carers or examine population statistics. I can’t or chant report anything ground-breaking except the enthusiasm to collaborate & explore these bigger questions and be part of as many EU project grants as you can….The prize for latest night out went to Nicola White (clubbing!). In the meantime, I decided to get fit in the gym of the James Hotel which was open after-hours (Dutch beer = Dutch courage, so no probs with that 150kg bench press folks). And Taubert became part of a bouncy castle art jump-about in the Rotterdam Kunsthal, and may have become part of the permanent exhibition there (has anyone seem him back in the UK?). We stayed fit! Whilst also learning about delirium, the language children use to describe their condition and its impact on their life, learning disabilities, the challenges of Assisted Suicide in those jurisdictions that permit it. There were also excellent talks about poverty, financial hardship and what this entails for those requiring palliative care. And there was a free-pass for swearing, with the use of the f-bomb in a few plenaries, expressing what patients sometimes truly felt, without the need to be edited out.
As Brexit means Brexit, the statue of Erasmus and the scholarship opportunities seem sadly distant to us poor sausages in the UK, but if travel broadens the mind then all meeting in one place sharpens the resolve to collaborate, collect data & challenge the overt and less overt structural determinants around palliative care. EAPC have recorded a video that outlines some of the research themes and participants, take a look here.
More philosophical than cultural, this conference for me was a chance to be and feel more European again, even if the dress code for being smart casual still eludes me, and even worse when you’re roped into doing a miscommunication with the media session with free Dutch beer, but our correspondent took it in his stride. As did James Norris who served the media workshop facilitators with Dutch beers, and our very own Jeremy Paxman style interviewer, Paul Keeley who gave interviewees a grilling.
A media workshop can also be followed by a visit to the EAPC photo-booth, with many jumping at the opportunity to get dressed up! It was an unexpected addition to conference, but went down well, as the booth was less well guarded than some of the plenary and break-out rooms, and we could actually get in.
The conference was well attended (I think about 1700 delegates from across the world), but the #EAPC2023 hashtag reach was also impressive, with over 4 million impressions worldwide. I suspect the annual Science Slam, meticulously organised by Claudia Suetfeld and moderated by Prof. Dr. Dr. Berend Feddersen, will have contributed to this, and we saw some fantastic performances, bringing palliative care research to the masses.
Apart from Ouzo, Dutch beers aplenty were on offer, and it was great to mingle in person again with friends and colleagues we have not seen for a long time. Like in Berlin, gender-neutral toilets were available, albeit with less photographic signage.
Ok, that’s enough for now, hope you enjoyed the event as much as I did. And maybe see you in Barcelona, pandemics permitting!
Take care,
Ollie X
