Blue Sky Ideas for Perioperative Care – An Introduction

Exciting changes are afoot in medicine. Twenty-first-century medicine has aspirations to deliver so-called Precision, Personalised or Stratified Medicine where diagnostics and therapeutics are tailored to individual genomics, molecular analysis and phenotypes. Individuals have been using a similar approach to optimise their personal health and performance using the concept of “Biohacking”, “self-optimisation” and the “Quantified self”. This paradigm has gained traction in the United States over recent years and the UK is set to follow. The concept is that of using yourself as an “N of one experiment”  to continuously test various nutritional approaches, supplements, biotechnology and forms of exercise.


At the same time Functional or Integrative medicine has been evolving over the past twenty years in the US and is now becoming mainstream. Several “Ivy League” institutions have begun providing functional medicine alongside more traditional specialties. The traditional medical model focuses on disease diagnosis by “single organ system” doctors who then provide symptomatic treatment. This is a disease-centred model. Functional medicine focuses on the cause of disease using a system-wide biological approach and a patient-centred model.

Furthermore, innovations developed to enhance athletic performance in the realm of sports medicine research may application in the clinical population.

Professionally I have been immersed in the acute medical specialities of anaesthesia and intensive care medicine for over twenty years, driving perioperative innovations via Enhanced Recovery Programmes for the past 8 years and consumed with research delivery and management for the past seven years.

On a personal level, I’ve pursued endurance sport for most of my life, starting with my first marathon in 1990 and triathlon for over 20 years. I have been optimising my own health and performance using biohacking principles for the past two and a half years. This has been a revelation. My family and some friends have experienced great improvements in health and performance after implementing my nutritional changes.

I believe some of these concepts have the potential to cross fertilise into clinical areas. This blog will focus on the possible translation of my various discoveries combining my area of expertise – perioperative care for major surgery – with my hobby interests of enhancing human performance. Many of the concepts will be considered “blue sky” thinking in traditional clinical medicine and may not be feasible to test with conventional research trials. This does not demean their potential value to patients and society more widely.


I will challenge dogmas, suggest new paradigms, stimulate debate and hopefully introduce some controversy.

Each of my future posts will explore a concept I encounter as I attempt further self-optimisation and through my broader research of these developing fields.

I hope I have sparked your interest for future posts focusing on a different “blue sky idea” each month.