Melissa Walton-Shirley, MD


September 03, 2016

I'm typing from the bulkhead row of a Delta flight traveling from Rome to Nashville by way of Atlanta. I traditionally leave on the last morning of the European Society of Cardiology (ESC) Congress because there are no hot-line sessions and work is waiting in the US. Tony, my husband, is engrossed in his third in-flight movie; ear buds dangling, he chuckles more loudly than he realizes. We are enjoying the short time we have together as we are painfully aware our jobs will separate us again for a week at a time. I'm counting the hours until he retires in December because I still like him a lot. I begged him for months to come with me on this trip, but he had witnessed firsthand my schedule when he traveled with me to DC for the ACC. Four nights later at ESC, he was still trying to sleep in the soft glow of my laptop until long past midnight. He kissed me good-bye in a fog at 6:30 am nearly every morning. He knew on these work trips his only sure bet was a nice supper. He tried good-naturedly to have a conversation with his distracted wife, to no avail. We saw the Sistine chapel together the day before the meeting started in earnest. At least that was really something.

I barely made it out of Rome alive this time. The Italians smoke double–fisted, even more than the French, who hold the dubious distinction of smoking with one hand while they eat with the other. I shouldn't say much. You aren't considered a good parent in some parts of Kentucky unless your 10-year-old is smoking at least "a half a pack a day." We have a mind-boggling penchant for COPD, lung cancer, and premature heart attack in our state. The good old boys in the legislature are bound and determined to make sure it's everyone's right to die unimpeded as early as possible. The Italians are not only on the same latitude but seem to be on the same trajectory. I was fumigated heavily during breakfast the morning of our arrival. As I dug into what would be the first of 1000 servings of Buffalo mozzarella, my eyes and throat began to burn as if I'd inhaled aerosolized jalapeños. The skinny gorgeous Italian woman in the Gucci sunglasses had just lit up behind me. Although we were on the patio, we were under a roof. By Tuesday, if I could have strapped my inhaler onto my head like a CPAP apparatus I would have gladly walked around with it on for the duration of the meeting. I fantasized about a giant snorkel that could reach over the top of the cloud of carcinogens to a stratosphere of clean air. By the end of the trip I was so ill with asthma and bronchitis I was digging in my purse for premium pseudoephedrine like a meth chef in an abandoned minivan.

We had to get up early to catch the 7 am bus on the first morning of the meeting. Jet lag and the disorganization of my partially unpacked bags sabotaged any opportunity for breakfast. Nice beautiful young people stood out in front on the hotel sidewalk, smoking of course, and greeted us warmly as we tried to board the bus. "Where is your ticket?" one of them asked, checking her list and finding none of our names. A tall scruffy fellow, vaping something the size of a large bong, walked over to help. It became apparent none of us had a ticket because we didn't need one. I did not pass up the chance to chastise them gently and encourage them to not sacrifice their lives in the name of a burning weed. The one with the vaping bong piped up and said, "Air pollution is a problem, Madame, in the US," as fake smoke barreled out from every orifice at the speed of a boiler-room pipe leak. He gets points, though, for trying to quit even if he is going to die from popcorn lung and singlehandedly ruin any chance of the city of Rome passing an air-emissions test.

When we arrived after the 20-minute journey to the convention center Fiera di Roma, we encountered a metal detector, a first in my 12 years of working at the ESC meetings. It's probably now a necessary evil and it didn't really slow us down much. But it was a sad way to start with such a stark reminder that the world has changed forever. I carried my roll-around up 30 steps of the iron exterior staircase, an exercise my thighs could use. I'd do it about 100 times per day. The pressroom was hot, with only enough drinking water if your mother was a camel. They of course tried to make me drink fizzy water. I was not going to drink fizzy water, because mom gave me Alka-Seltzer once as a kid and I threw it up through my nose. I requested "naturella" in my horrible Italian accent every time. I tried to get an entire bottle of water once and instead the server grabbed a miniature clear plastic cup and filled it with a whopping 3 ounces. I don't know if he was a former altar boy and thought he was rationing communion wine or if water is just that precious of a commodity. He is the same server who poured only enough black thick coffee to fill a thimble. On top of that, it tasted like Starbucks had switched from coffee beans to tree bark and would probably have made a good chemotherapeutic agent. Pushing past my concerns about dose-dependent cardiotoxicity, I drank it when I noticed no one swooned around me. My fellow press core are great taste testers because in desperation, we'll eat almost anything. This was also the exact same server who stubbornly refused to let us get at any morsel of food until precisely 12:40. He stood there lording over empty metal warming trays as grown men and women with deadlines panicked. The next presentation time loomed daily at 12:45 pm. I saw one journalist actually try to steal something to eat while he thought the server wasn't looking, but he shooed him away, twice. I'll bet his uncle, Seinfeld's real-life soup Nazi, would be proud.

Some of us were "lucky" enough to occasionally get some food so we could stand up to eat it. There were no lunch tables. We were served a rendition of mozzarella with familiar texture but no taste and these tiny leftover pizzas that hung on after breakfast until lunch. I figured since the pizza I ate for breakfast as a college student never killed me, this probably wouldn't either, but I just couldn't bring myself to eat them. There were several cold gelatinous mutations of quiche that I used for sustenance. I actually liked these most delightful and unusual little salad dressing and mushroom sandwiches. I thought I might even try to reproduce those at home, but I will need to put them in the fridge before serving them and then expose them to the night air to get the dryness of the bread crust just right. There were only pastry options for breakfast that also served as a lunch dessert. They were to be admired because the morning batch had the same staying power for afternoon snacks as the tiny breakfast pizzas did for lunch. Only Jesus Christ who blessed the loaves and the fishes could have made enough to go around. They were quite beautiful, though, as well as tasty if you got them in the morning. Out of desperation for yogurt, I finally found some of it frozen on a stick in one of the vending trucks that was subsequently dipped in dark chocolate and rolled in pistachios before I could protest. What the heck? I was eating breakfast at suppertime in the US, anyway, so no harm, no foul.

As for the security team, they've watched Meet the Fockers (with Italian subtitles of course) far too many times. Every time you tried to walk somewhere it was like being in that scene at the airport where Ben Stiller was the only one in the gate. One of our journalists wanted to step just a few feet through the exhibit area to cover the posters, but the guard sternly barricaded her. She could almost touch where she was going so when he turned his head she tried to sneak past him only to hear "Madame, no!" The pressroom staff was very kind, but again, we weren't allowed in until just a few minutes before the press conference. The first couple of days all of the news outlets circled like buzzards hankering for road kill until we finally resigned ourselves to just sit on the white fake leather couches and wait. We love to peruse press releases and sometimes make notes to prep for the Q&A session, but not this meeting. I've not been told "no" that many times in a week since I was a teenager with a new car.

The pressroom was another fun foray into frustration. The right-hand side and the left-hand side were oddly separated in the rear by a glass partition. We could see our colleagues on the other side but couldn't get to them to discuss a case or borrow a converter without walking around the front or outside in the rear and then back in the other side. At least prisoners on Orange Is the New Black had access to a clanky landline phone that connected them to the folks on the other side. I yearned for a heavy black handset attached with a silver slinky metal chord. Like them, all I needed was just a few minutes of conversation. There was also the issue with the outside doors that were randomly chosen daily as to how we would gain entry. Choose the wrong one and you'd be wandering around like a middle schooler in a county-fair fun house. I guess I should have been okay with that, as long as they didn't make me look fatter, but it was frustrating nonetheless. Don't they know we postmenopausals have no short-term recall? Even if they had kept it the same door every day, they all looked alike, and we'd never be able to remember which one we just came out of. Why not just unlock several of them to up our chances?

At times the pressroom was a sauna. I felt like the guys in the Progressive commercial who say, "No mas pantalones" when their trousers spontaneously combust. Postmenopausal females are always too hot or too cold when the temperature is just right, but turn up the heat too high and we pour sweat like we're giving birth. I tried to cool off in the restroom and was pleasantly surprised that each stall had its own private sink. I made the mistake of turning on the faucet while I was resting on the commode only to be doused with about 2 liters of water. As it was dripping off my face and chest I realized there were no paper towels in the stall. There were only dryers outside. I didn't have time to dry myself from the inside out because I was behind already, so I tried to conduct myself professionally while I walked around looking like I was trying to enter a wet T-shirt contest. At first I did try to dry myself with toilet paper, but it melted like wet cotton candy before it could ever do its job.

Don't even ask me about all the nice young folks who stood around with shirts on that said in large letters, "Just ask me." So . . . I did just ask them, lots of questions, like, where is the forum section of the convention center? I can read signs with the best of them, but the arrow was pointing into a wall, and unless one morphs into a Marvel comic-book character, you can't walk through it. The young person stared blankly at me, like most of them did, because (a) they didn't speak English; (b) they didn't know where anything was; (c) they didn't speak English and didn't know where anything was; or (d) they were flirting with the gorgeous Italian security guards who didn't seem to be paying them any attention anyway. The press room was so far from Village 8 that I ran with laptop in hand on six (yes s-i-x) moving sidewalks. When I hit dry land I literally flew a few inches and had to stick my landing like an Olympic vaulter. Thanks to my postmenopausal bladder, I had to pee just as I finished the 100 meter, but already 5 minutes late (missing the intro to a session was tantamount to a death knell for anyone trying to get the tone of a presentation), I dared not wait in the endless lines of anxious women trying to get at a toilet.

The trouble with this particular journey started the minute we sat down in the Delta "premium" section in Atlanta. I'd promised Tony legroom and great food. I'd been spoiled by all the perks I'd received courtesy of Sir Richard Branson on one of his magnificent Virgin Air flights to London. As Tony folded his 6'4" moderately arthritic frame into a second-row seat, he was immediately uncomfortable. I tried to upgrade him but there was no availability. Delta did not honor his request for a gluten-free meal so I ate bread that I loathe and gave him the cheese and fruit. On top of that, I had to hold my headphone in a certain position because it would only play music instead of voices. I thought the first few minutes of my first movie were being cinematically dramatic. Tony's TV screen didn't work, and despite my trying to explain that punching it wouldn't help because it was based on thermal sensing, he punched away. The poor passenger in front of him should be commended, although he did rise up twice and stare at my husband as if he could have killed him, but he didn't.

Despite all of these distractions, I learned a lot. I enjoyed seeing my colleagues and the magnificent trialists who travel several times annually to report on their data and interpret others. I will translate this information into my exam rooms and on the hospital wards. I must also add that this tongue-in-cheek whine in no way diminishes my gratitude for the opportunities I've been given for over a decade to travel, write, and learn. I get to write my opinion and can start with a blank screen and weave it into some kind of therapy as often as I feel the need. I am blessed. Even getting to lampoon this disaster of a meeting experience is a privilege and a blessing.

I do have one regret, though. I missed the pope, who came to the last morning of our meeting. Although I'm not Catholic, my Irish ancestors were, and so my genetic memory yearns for an opportunity to confess for all the cuss words I'd said throughout the week because of the maddingly dysfunctional Fiera di Roma. I heard they were going to tear it down after this meeting and so hope they can recycle the already-recycled airplane hangers they pieced together to call a convention center into something of use. Predictably, though, if they decided to hold the ESC meeting there next year, I know we'd all pack, travel, roll up our sleeves, and pound out the news like we do at every meeting. In the history of my time as a blogger, neither rain, nor hail, nor volcanoes, hurricanes, terrorist threats, or nearby devastating earthquakes will keep us from it. The Fiera di Roma won't keep us from it, either.


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