Last week I resolved to give up international conferences. It was at 5 am in a hot Asian airport, after waiting an hour for someone to stamp our papers. In the plane I cooled down and reflected that it could have been worse. At least I didn’t have food poisoning this time. On balance the trip seemed worthwhile. Women in that resource poor country needed better health care. Our conference may not have done much to help them, but I would do even less by staying home and sulking.

But I suppose this debate is about big conferences in posh places. It is easy to be cynical about them. Medical journals keep expressing doubts, from an urbane Lancet editorial in 19571 to a BMJ cover in 2003 depicting doctors as pigs fed by pharma reptiles.2 In 2008 our guilt is expressed as concern about carbon footprints,3 so I should start …