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ACP: the kinship report

April 2009

Some people probably believe that writing for the T.G.H.M.O.A.T. (“the greatest hospitalist magazine of all time”), otherwise known as Today’s Hospitalist, is quite a cushy gig. Six-figure stipend? Think pro bono. Company car? Think bus pass. Fame? Chalk up one encounter where someone did say, “Hey, you look familiar. Do you write for Tomorrow’s Hospitalist?”

But recently I was given one noteworthy perk: a press pass to the ACP 2009 convention last week in Philadelphia. So I donned my green visor, stuck a pencil behind my ear and headed off to find a breaking story. Under the crushing weight of my editor’s expectations and deadline, I managed some crack reporting … well, at least some observations, as follows:

First, it is always a great experience to be among hordes of people (about 7,000) whom you have never met but have an instant kinship with. I could feel my dopamine receptors becoming saturated just by walking among so many people who understand what it is to survive the challenges of medical school and the rigors of residency.

Most of the attendees seemed to be in my age demographic or older, so it was rewarding to be reminded that what we accomplished, just by making it through those years, was no small feat. This sense of solidarity got stronger as I realized that, as a collective, we’re contemplating the prospect of near-certain, far-reaching health care reform, a topic discussed at the opening ceremony.

The packet I received for the lay press contained two definitions of “general internist.” The first: a doctor who cares for ambulatory and hospitalized patients. The second: “…internists are known as ‘hospitalists’ and care for patients only in the hospital.” This struck me as somewhat odd because I suspect the majority of general internists now see only outpatients, even if the name proposed for them–”Ambulist” by Deluca in Annals in 2000–never gained much traction.

And I was introduced to a new definition that I suspect has the potential to crowd out “general internist” altogether. In an excellent small lecture on pulmonary embolism, participants were asked to introduce ourselves.

Two doctors identified themselves as “traditionalists.” The speaker looked baffled and asked what that meant, and was told it is a doctor who treats both inpatients and outpatients. To which the speaker replied, “Oh … you mean a doctor?” The audience bellowed with laughter, and I imagine many of my fellow hospitalists thought, “Touché.”

And now for something completely different. I would like to meet the person who developed the interlocking conference chair. I imagine this is the same person who once flew coach intercontinental and thought to him- or herself: “If only such comfort could be recreated on the ground!” Maybe 14 inches wide, with only three inches between them when conjoined, these chairs made surviving 90-minute lectures tough. This cheek-to-cheek intimacy was not exactly the sort of solidarity I had in mind.

Every lecture I attended was pretty good. It really is a plus to be able to spend a day or two just listening to experts opine on how best to treat what one sees on a daily basis. However, halfway through most lectures, given my midlife attention deficiencies, I often think back to the following words of wisdom (courtesy of one of my siblings): “If you have something to say, and it is not funny, don’t say it.”

Take-home point: I marvel at those who can teach with humor (an actual majority of the lectures I attended), as they have the ability to make even the most arcane medical subjects interesting and, perhaps most importantly, memorable.

So it was a great experience. It has whetted my appetite for the SHM’s meeting in only a few short weeks. Sold out, I hear–a signal accomplishment for our field. I just hope the organizers stay away from those darn interlocking chairs.

That said, the conference is in Chicago, a great Midwestern town known for its 30-ounce porterhouse steaks and obscenely cheesy deep-dish pizza, so I’ve got that going for me, which is nice. Indeed, Chicago earned a ranking in Men’s Fitness Magazine as the fattest city in America (as of 2006–chances are, not much has changed).

So, given the girth of its inhabitants and the fact that, as a longstanding hotbed for innovative architecture and design, there is no way our Chicago convention center hosts will force us to submit to devices of such discomfort.