I am Tom Woodcock from UK and I was once told by a very well-known professor of anesthesia—someone you'll no doubt hear much more about in the coming decade—that patients die of sepsis because there's no starch left to plug the holes in their capillaries. That statement stuck with me. A few years ago, I decided to step away from clinical practice to fully focus on what I believe are three critical areas: law, ethics, and most importantly, fluid physiology. Why? Because as we're already discovering—on just the first half-day of this meeting—fluid physiology remains deeply misunderstood by both clinicians and physiologists. And as a result, patients are not benefiting from the level of expert care they deserve. We're operating with almost no solid evidence to guide our practice. And that's unacceptable. We need to start making greater efforts, not just to understand the science, but to translate it into better outcomes for our patients. This has been a long-standing interest of mine, one that I've pursued even more vigorously since stepping away from clinical work. And it's moments like when a colleague comes up to me and says, "I've been colloid for the last month or so"—and I see the smile on their face—that make it feel worthwhile. The traditional way we teach doctors about fluid handling is deeply flawed. Countless observations from real patients in real hospitals have proven that much of the prevailing theory doesn't hold up in practice. Something needs to change. Over the years, I've spent a great deal of time engaging with physiologists, and together we've tried to develop a more rational, predictive system for fluid prescribing—one that actually makes sense in real-world practice. But, as you might expect, it hasn't been widely accepted. Why? Because many of us were taught that circulatory collapse is inevitable without albumin or colloid osmotic pressure. But that's simply not true. Unfortunately, those who have spent their careers teaching this flawed model are understandably reluctant to admit they may have been wrong. That's why we need forums like this—where we can keep talking, and keep challenging assumptions. Not shouting or fighting, but talking, debating, evolving. Because eventually, something better will come out of it.

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