Scenes from a convention

I came to get learning specific

In San Diego, out by the Pacific.

I took lots of notes

and paraphrased quotes

But the coincidences were really terrific.

Synopsis:  I’m a family practitioner from Sioux City, Iowa.  I danced back from the brink of burnout in 2010, and, honoring a one-year non-compete clause, went to have adventures and work in out-of-the-way locations.  After jobs in Alaska, New Zealand, Iowa, and Nebraska, I returned home and took up a part-time, 54 hour a week position with a Community Health Center.  I’m just back from a working vacation in Petersburg, Alaska and an educational trip to the AAFP Scientific Assembly in San Diego.

I walk into the San Diego Convention Center, my third time here for the American Academy of Family Practice Annual Scientific Assembly.  It still smells like San Diego, the ocean, the palms, the sea.  I stride from one end of the Center to the other, counting the steps and making note of the time, further than my commute from my cottage to the Medical Center in Petersburg, Alaska.

I have the handouts in my backpack.  In years past the book swelled from a couple of hundred pages to two thick binders.  Now they exist on a simple thumb drive.  The same backpack carries my iPad and its associated keyboard.  Last time I came I used a smaller keyboard and my Palm to take notes.  Light and easy to carry, it could beam but not email data.

Now instead of a cell phone I have a smart phone, and I download an app that gives me the course listings with times and places and lets me enter my CME (continuing medical education) credits as they happen.  When I first came to the AAFP convention the words smart phone, Wi-Fi, download, and app did not exist; wireless meant radio, usually two-way, in stodgy British, and the word router denoted an electric wood-working tool.  If you said high-speed net service you might have been laughed at but if you used the term repeatedly you would probably get locked up.

The Exhibition Hall stretches for a cavernous quarter mile inside the Convention Center.  Big Pharma, now barred by law from giving out toys, flashlights, pens, or note pads as advertising, concentrates on pitching drugs.  My Community Health Center patients, half of whom have no resources and no money, can’t afford the new drugs.  But I stop at the Lilly booth and thank the reps for their company’s generosity; they give my facility an enormous quantity of insulin for free.

The lecture on smoking cessation strategies features lackluster content and a passionless presenter.  My attention wanders, I yawn, I try to keep myself awake doing carpal tunnel stretches.  I nod off, then I fire up my iPad and read my email.  I look around and see other attendees either with eyes closed or with their faces illuminated by their portable screens.  No one pays attention.  Five minutes from the end of class I pull out my Droid to try to enter my CME credits, and find I can’t do it without a major workaround.

Even if Big Pharma can’t give us advertising freebies, they can serve us fantastic meals and hire gifted teachers to lecture us.  While I munch an outsized turkey sandwich I marvel at the teaching effectiveness of an FP from Pennsylvania.  She speaks with dynamics and enthusiasm and imparts information I’ll retain after the drug comes off patent.  Except she never mentions a new drug or even an old drug; she talks about urine sugar reabsorbtion and diabetes.

Bethany and I sit down to lunch the next day with a young doc in the Indian Health Service; she nurses her infant while we talk.  At the end I challenge her to keep track of her hours for two weeks, use that number to figure out how much she’s getting per hour and compare that rate to locum tenens.

I run into a doc I knew in residency; I run into him six times more in the course of four days.  Then I run into a doc who now teaches in that program.  In the hotel elevator I run into two more FPs who finished the program and still work in Casper.

One evening Bethany and I dine with a doctor who still works at the Practice Formerly Known As Mine.  At the end of the meal we stroll along the marina.  We come to the Vibrant Curiosity, the world’s 60^th largest yacht.  We had seen the 5 story wonder coming up Wrangell Narrows while we were in Petersburg.  We make jokes about how the owner must be following us and the next thing you know it will come cruising up Perry Creek.

True coincidence occurs but rarely.  But I don’t know what it all means.

The Valiant Curiosity passed close by

 

On this island is it peace that they sought?

Or perhaps it’s the fish that they caught.

Up the Narrows, please note,

There came a large boat,

The world’s 60^th largest yacht

 

Synopsis:  I’m a family practitioner from Sioux City, Iowa.  I danced back from the brink of burnout in 2010, and, honoring a one-year non-compete clause, went to have adventures and work in out-of-the-way locations.  After jobs in Alaska, New Zealand, Iowa, and Nebraska, I returned home and took up a part-time, 54 hour a week position with a Community Health Center.  I’m taking a working vacation now in Petersburg, Alaska.

Bethany and I walked back the half-mile from the Petersburg Medical Center on a beautiful late summer evening.  As we ascended our stairs, we looked up Wrangell Narrows at the incoming boat traffic.

A lot of commercial fishing ships call this part of southeast Alaska home.  A series of fjords makes a previous mountain range a cluster of islands, and Wrangell Narrows doesn’t permit the entry of the big Alaska cruise ships.  In the process of learning the difference between, for example, a seiner and a long liner, we look at the structure, and guess out loud.

“It’s a couple of seiners,” we say, “See the skiff being towed and the pile of net on the afterdeck.”

Then we wondered what we saw approaching.  “I think it’s a pleasure craft,” I said.

“Something that big?” Bethany asked.

The vessel stood three stories above the water, but lacked the worn look of a working boat.  In fact, it gleamed white.  No one stood on the foredeck, as for a cruise ship, and the afterdeck sported tables with umbrellas and chairs but no tourists drinking cocktails or eating al fresco.

As she passed by 70 yards away I read the name, Valiant Curiosity.  In the Information Age, we could gawk while she passed out of sight, and, five steps later, put the name in the search engine.

The world’s 60^th largest yacht, built at a cost of $100 million for a billionaire German screw tycoon, had purred in front of us at a pace of 18 knots.  It left Seattle on June 18 for an Alaska cruise.

Pretty, but not as beautiful as the tree-covered mountains rising abruptly out of the water 400 yards across the Narrows.  Not breath-taking like the snow-covered peaks looming to the south.  Graceful, but not like the eagles, geese, or even the ducks.  Impressive, but not as impressive as the 900 seasonal cannery workers at their 16-hour-a-day, 7-days-a-week jobs.

We wondered why such a craft would come to Petersburg, a fishing village of 3,000 permanent residents, no gourmet dining and nightlife limited to two blue-collar bars.

I do not plan on finding an answer to that question.  And the best questions don’t have answers.