Conference of the International Union Against Tuberculosis and Lung Disease, Day 1
I set an alarm but woke up before it went off after a mediocre night of sleep. With earplugs in, I hardly noticed the other people coming in, but still I did not sleep particularly well. I wanted to make it across town to the Palais des Congres by 8 am so that I could register before everything got started. I left too early to get breakfast at the hostel, so I had to grab something from a stand in the Porte-Maillot Metro station when I got there. I was able to register - which was not a big concern, but was something of a question given how late I decided to go. Two hundred fifty euros (about $300)...gulp. Oh well, I just charged it and will pay it off later. As one person encouraged me when I was deciding whether or not to go: I might be broke come June, but I'll worry about that in May!
Trying to pick which sessions to attend at a conference is always a fun challenge. An early-morning talk on migrant health - especially the problem of trying to track workers who are on the move during the six month-long standard TB treatment course (which, if interrupted, can encourage drug-resistant bacteria in that patient and anyone they pass it on to) - looked particularly interesting, so I went. It turned out to be very apropos - most of the talk was on the issues across the US-Mexico border, particular what happens when workers get deported in the middle of treatment, or are diagnosed during detainment. This was certainly not a new scenario to me (since Portland is on the I-5 corridor, and this is clearly an issue in the county clinics), but the programs to deal with it were innovative and fascinating - such as coordination between the Department of Homeland Security and the Department of Health to track migrants in and out of detainment. Another program worked to get repatriated workers to be met by TB treatment teams at their port of entry so that they wouldn't be lost to treatment during the transition period. I'd never heard of any of these program, and certainly it will be useful to keep those in mind when I go back to Oregon next year.
I noted the speakers and the organizations they came from for future reference. I also hid my face in my notebook for a good bit of the time, since half-way through the session a woman came in and sat a couple of seats down from me who I recognized as Delia, one of the researchers who had lectured to our class last week. Ooops! I did chat with her later in the day, so the precautions turned out to be moot, but I still wasn't entirely anxious to share the fact that I was ditching class for two days to attend the conference.
After that session, I found Anne out in the registration area. Her alarm clock had not gone off, so she had just arrived. We looked around a while, running into her former professor from Canada who just happened to also be the former head of the organization who was putting on the conference. Soon we went to the first plenary session, where a charismatic African-American woman spoke on the need to pull together the political will to start facing up to a disease which, despite technical obstacles, should be a 100% curable disease. She also outlined the newest technological advances on the horizon, which center on better diagnosis (since current methods rely on problematic smears as well as cultures that can take a month to return results), better vaccines (the current BCG vaccine is only partially effective, and no one really understands how it works anyhow), and more effective drugs to shorten the course of treatment from six months to, well, something shorter than six months.
That last part was interesting, because back at OHSU I had encountered a controversy between the general medicine doctors who wanted to use this drug (called moxafloxacin - kind of an amped-up version of cipro) for various infections and the infectious disease specialists who insisted on reserving it for its potential against tuberculosis. I was tempted to ask if there were any policy statements in the works in regards to this issues, but I held off in lieu of the fact that all the other questions asked were far more sophisticated, and by far more prestigiously-credentialed people than myself. I was also curious about how this drug - one of the most expensive antibiotics on the market owing to how new it is - was going to get into the hands of TB patients, who almost uniformly come from the poorest sectors of whatever society they originate from.
After lunch Anne & I split again, and I went to see a talk on the new vaccines in the pipeline. This turned out to be one of the less interesting ones I went to, since it was more biochemistry than anything else - what I wanted to know could have been covered in five minutes, and the rest was way over my head. Though obviously vital to the process of research, this kind of stuff is in the realm of what I decided I needed to largely ignore when I started medical school - if I try to stuff that into my brain, I'm going to lose the clinical things that I actually need to be a doctor. One radiologist at OHSU jokes about this with the analogy of penguins on an iceberg: you're iceberg doesn't have infinite space, and if you start getting too many penguins on it, they all start sliding en masse back into the ocean. OK, it's funnier when he tells it! The talk ended with a flamboyant southerner who presented some data on his work then ended with a grandiose comment on his supposed next project: coming up with a trivalent vaccine for TB, malaria, and HIV, which received the expected round of guffaws and giggles. Ha! A trivalent vaccine for TB, malaria, and HIV! Hilliarious! And that's when I realized that I have officially become a geek. I assume that will not be funny to anyone who can't claim equal geek-dom in the realm of infectious disease, but I was pleased that I at least got the joke, eye-rolling as it might have been.
At the end of the day, we met back up and without making any particular plans, we wandered away from the Palais des Congres with minimal directional sense of where we were going. After some amount of wandering, we finally looked at a map. Having wandered in several different directions, we managed to take a full hour to walk the few blocks between the Palais de Congres and the nearby Arc de Triomphe. We got our bearing, took a few pictures of Anne in front of the monument to send to her boyfriend back home (who is French by birth), and kept going. Still without any destination in mind, I aimed toward Saint Michel again, and we ended up repeated the epic walk I did last night, which after we did find a place to get cheap food. She had some kind of Greek dish and I had - what else? - a crepe, and we sat and talked for hours about class, the conference, and everything else. We finally cleared out when the cook/manager/cashier started glaring our way.
We walked around Saint Michel a bit more, deciding that we really had to have desert. This absolute necessity would be satisfied only by the Haagen Daaz stand on the corner. Anne had a long and somewhat esoteric discussion with the cashier in her passable but imperfect French, at the close of which the attendant charged her Visa 16 euros and gave her back a handful of change. Apparently they wouldn't charge a card under a few bucks, but after this negotiation, we got our ice cream and happily kept on our way. Thank goodness she is originally from a marginally French-speaking region of Canada, because my vocabulary would have run out right after I figured out how to say ice cream. From there we walked the very short distance to the island where the cathedral of Notre Dame stands. Inside the massive main hall of the church, a film was playing on a screen hanging from the ceiling. The rays of the projector splayed from the altar towards the entryway where we stood, spraying an eerie mosaic of multi-colored lights across the ancient walls of the cathedral. We stayed to watch for a few minutes, but exhaustion eventually won out and we moved back toward Saint Michel and the Metro station.
Before we split and went separate ways on the Metro, we made one last stop at a fruit stand. Anne is on a much tighter budget than I am (I knew this when we went, I just didn't realize exactly how tight until she told me explicitly - after which I tried to take on more of the expense, since it was my idea to go out and eat in any case), so she was trying to get some food for the next day. She picked up a persimmon and squeezed it a bit to test its ripeness, which brought the owner (a man of some unidentifiable race that is nevertheless almost certainly related to one of France's former colonies) running and hollering at her in his own heavily accented French to not squeeze the fruit. We slunk away before he could inform us loudly of any other social transgressions we had committed, amidst whispered comparisons to a certain soup chef from the show Seinfeld.
Back in Montmartre, I slept heavily but again not particularly well, which is not unexpected in the unpredictable activity of the hostel.
Trying to pick which sessions to attend at a conference is always a fun challenge. An early-morning talk on migrant health - especially the problem of trying to track workers who are on the move during the six month-long standard TB treatment course (which, if interrupted, can encourage drug-resistant bacteria in that patient and anyone they pass it on to) - looked particularly interesting, so I went. It turned out to be very apropos - most of the talk was on the issues across the US-Mexico border, particular what happens when workers get deported in the middle of treatment, or are diagnosed during detainment. This was certainly not a new scenario to me (since Portland is on the I-5 corridor, and this is clearly an issue in the county clinics), but the programs to deal with it were innovative and fascinating - such as coordination between the Department of Homeland Security and the Department of Health to track migrants in and out of detainment. Another program worked to get repatriated workers to be met by TB treatment teams at their port of entry so that they wouldn't be lost to treatment during the transition period. I'd never heard of any of these program, and certainly it will be useful to keep those in mind when I go back to Oregon next year.
I noted the speakers and the organizations they came from for future reference. I also hid my face in my notebook for a good bit of the time, since half-way through the session a woman came in and sat a couple of seats down from me who I recognized as Delia, one of the researchers who had lectured to our class last week. Ooops! I did chat with her later in the day, so the precautions turned out to be moot, but I still wasn't entirely anxious to share the fact that I was ditching class for two days to attend the conference.
After that session, I found Anne out in the registration area. Her alarm clock had not gone off, so she had just arrived. We looked around a while, running into her former professor from Canada who just happened to also be the former head of the organization who was putting on the conference. Soon we went to the first plenary session, where a charismatic African-American woman spoke on the need to pull together the political will to start facing up to a disease which, despite technical obstacles, should be a 100% curable disease. She also outlined the newest technological advances on the horizon, which center on better diagnosis (since current methods rely on problematic smears as well as cultures that can take a month to return results), better vaccines (the current BCG vaccine is only partially effective, and no one really understands how it works anyhow), and more effective drugs to shorten the course of treatment from six months to, well, something shorter than six months.
That last part was interesting, because back at OHSU I had encountered a controversy between the general medicine doctors who wanted to use this drug (called moxafloxacin - kind of an amped-up version of cipro) for various infections and the infectious disease specialists who insisted on reserving it for its potential against tuberculosis. I was tempted to ask if there were any policy statements in the works in regards to this issues, but I held off in lieu of the fact that all the other questions asked were far more sophisticated, and by far more prestigiously-credentialed people than myself. I was also curious about how this drug - one of the most expensive antibiotics on the market owing to how new it is - was going to get into the hands of TB patients, who almost uniformly come from the poorest sectors of whatever society they originate from.
After lunch Anne & I split again, and I went to see a talk on the new vaccines in the pipeline. This turned out to be one of the less interesting ones I went to, since it was more biochemistry than anything else - what I wanted to know could have been covered in five minutes, and the rest was way over my head. Though obviously vital to the process of research, this kind of stuff is in the realm of what I decided I needed to largely ignore when I started medical school - if I try to stuff that into my brain, I'm going to lose the clinical things that I actually need to be a doctor. One radiologist at OHSU jokes about this with the analogy of penguins on an iceberg: you're iceberg doesn't have infinite space, and if you start getting too many penguins on it, they all start sliding en masse back into the ocean. OK, it's funnier when he tells it! The talk ended with a flamboyant southerner who presented some data on his work then ended with a grandiose comment on his supposed next project: coming up with a trivalent vaccine for TB, malaria, and HIV, which received the expected round of guffaws and giggles. Ha! A trivalent vaccine for TB, malaria, and HIV! Hilliarious! And that's when I realized that I have officially become a geek. I assume that will not be funny to anyone who can't claim equal geek-dom in the realm of infectious disease, but I was pleased that I at least got the joke, eye-rolling as it might have been.
At the end of the day, we met back up and without making any particular plans, we wandered away from the Palais des Congres with minimal directional sense of where we were going. After some amount of wandering, we finally looked at a map. Having wandered in several different directions, we managed to take a full hour to walk the few blocks between the Palais de Congres and the nearby Arc de Triomphe. We got our bearing, took a few pictures of Anne in front of the monument to send to her boyfriend back home (who is French by birth), and kept going. Still without any destination in mind, I aimed toward Saint Michel again, and we ended up repeated the epic walk I did last night, which after we did find a place to get cheap food. She had some kind of Greek dish and I had - what else? - a crepe, and we sat and talked for hours about class, the conference, and everything else. We finally cleared out when the cook/manager/cashier started glaring our way.
We walked around Saint Michel a bit more, deciding that we really had to have desert. This absolute necessity would be satisfied only by the Haagen Daaz stand on the corner. Anne had a long and somewhat esoteric discussion with the cashier in her passable but imperfect French, at the close of which the attendant charged her Visa 16 euros and gave her back a handful of change. Apparently they wouldn't charge a card under a few bucks, but after this negotiation, we got our ice cream and happily kept on our way. Thank goodness she is originally from a marginally French-speaking region of Canada, because my vocabulary would have run out right after I figured out how to say ice cream. From there we walked the very short distance to the island where the cathedral of Notre Dame stands. Inside the massive main hall of the church, a film was playing on a screen hanging from the ceiling. The rays of the projector splayed from the altar towards the entryway where we stood, spraying an eerie mosaic of multi-colored lights across the ancient walls of the cathedral. We stayed to watch for a few minutes, but exhaustion eventually won out and we moved back toward Saint Michel and the Metro station.
Before we split and went separate ways on the Metro, we made one last stop at a fruit stand. Anne is on a much tighter budget than I am (I knew this when we went, I just didn't realize exactly how tight until she told me explicitly - after which I tried to take on more of the expense, since it was my idea to go out and eat in any case), so she was trying to get some food for the next day. She picked up a persimmon and squeezed it a bit to test its ripeness, which brought the owner (a man of some unidentifiable race that is nevertheless almost certainly related to one of France's former colonies) running and hollering at her in his own heavily accented French to not squeeze the fruit. We slunk away before he could inform us loudly of any other social transgressions we had committed, amidst whispered comparisons to a certain soup chef from the show Seinfeld.
Back in Montmartre, I slept heavily but again not particularly well, which is not unexpected in the unpredictable activity of the hostel.
posted by skylanda at 8:06 AM
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