The over-arching theme of smaccGOLD was the bringing together of people from all facets of critical care to share ideas, collaborate, learn from one another and understand each other. Victoria Brazil (@SocraticEM) kicked off the conference with an amazing talk that set the scene for everything that followed. She examines the tribal nature of the health professions, the harms that can result and how we can make things better so that our patients benefit – with examples like cutting STEMI door-to-needle times in half.