What I Did in the Holidays
What I Did in the Holidays
There are (at least) three good things about working as a doctor at Dunstan Hospital: getting to study cardiology in nice places; getting time away to travel with family; and getting to do both on the same trip. I was lucky last month that my son Gareth’s trip with the Southern Knights ice-hockey team to the Friendship tournament in Cranbrook Canada happened to coincide with the American College of Cardiology annual conference at Lake Louise.
I set out, ages ago it seems, from Queenstown one afternoon, then after an overnight flight arrived in Los Angeles supposedly on the morning of the same day (like a criminal, I had to go through their customs, get photographed and fingerprinted by “Homeland Security”, just to transit their airport) then continued on to Calgary. Luckily, I had my warm clothes ready for arrival. It was late afternoon, the outside temperature was minus 10 degrees Celsius, and it was starting to snow.
The next day I took the bus up to Lake Louise. Called by someone “the jewel of the Rockies”, it’s a great place to spend a few days. The hotel, where the conference was held, built in the style of an old European chateau, sits at the end of a small ice-covered lake, surrounded by high mountains. Canada has something like twelve peaks over 10,000 feet in this part of the Rockies.
On a later visit, Joan and I took a bus from Banff to Jasper, travelling between these mountains, briefly visiting Lake Louise between showers of snow, and went onto the aptly named icefield parkway. We stopped for a view of Bow Lake, at the Columbia icefield for a guided walk on the glacier and a brave excursion above a raging gorge on the glass Skywalk, for a long time on the side of the road to watch and photograph a wild bear from the comfort of the bus, and a walk to the impressive Athabasca Falls, as well as numerous views of towering mountains, steep rock walls, and colourful surging rivers.
At the start of the conference, I met up with two wild men who had just come out of the surrounding mountains, also known as Matt Born and Garry Nixon. They guided me to the local eating places (not at the hotel; we couldn’t afford the food there) and around the nearby ski field (though I would have to question their guiding qualifications; one of the runs they took me on had a black diamond at the top and a sign saying something like “downhill racing course”). I managed to stop once, near the top, with the others lined up beneath me, and promptly fell onto them, turning my colleagues into dominos.
The same run turned out to be the site for the conference ski race, which is an annual event for attendees. It was unlikely any of us would be able to compete with the young French Canadians and other enthusiasts, so we decided to make it our own challenge, with a trophy for the winner. We looked in the gift shop and chose a magnificent carved stone eagle. Then we saw the price—25,000 Canadian dollars. We chose instead a small wooden plaque with a maple leaf design on the front. Neither Matt nor Garry could find their way to the start, and no-one from Dunstan has been back to the conference at Lake Louise, so the plaque hangs in a prominent place in the doctors’ office with their two names inscribed on the back as joint winners.
The conference was instructive and I think useful. It was impressive to hear the results of many of the major trials, such as GUSTO and AFFIRM, discussed by top North American cardiologists who had actually designed them. There was one other New Zealander, a guy from Christchurch who was talking about BNP testing.
One impressive presenter, from Los Angeles, had worked on the Human Genome Project. Unusually for a big collaborative research effort, he told us, the project had finished well ahead of schedule. There were three reasons for this: computers had got much bigger and faster and could handle unimaginable amounts of data; we share most of our genes with other species, which are easier to study; and most of our genes for our purposes are just junk—the DNA, made up of “selfish genes”, rather than existing as we might think in an anthropocentric way as a means of humans and other species preserving themselves, is using life as a way of replicating itself.
On a more practical level—and this is why he was presenting at a cardiology conference—the American researcher had found a way of inserting defective genes into rabbits. He described a study inserting the gene for hypertrophic obstructive cardiomyopathy, which causes sudden death in some humans, then testing the rabbits with pharmaceutical agents to see which ones improve mortality. I talked to him afterwards, explained I spend much of my spare time trying to cause sudden death in rabbits, and asking if he could help. He told me his ethical approval didn’t extend that far, and suggested I get some eagles, which are keeping the rabbit numbers down in North America.
The clinical scenarios were especially interesting. You get the impression, even with the more academic specialists, that the treatments they recommend are not necessarily the ones that the trials show are effective, but the ones that they can get paid for. One patient presented from Duke University, who seemed to be dying from worsening heart failure, but who Matt and I thought might warrant another effort to get him to stop smoking, ended up getting half his left ventricle removed (a high-risk operation to improve its function), his coronary arteries grafted, and an implantable defibrillator. There was a heading at the end of the suggested interventions marked “other” but, no, smoking cessation wasn’t mentioned.
The last day of the conference I returned to Calgary and met the hockey team when they arrived at the airport. We took the bus to Cranbrook where the tournament was held. It is a town of about 25,000 people in Southern British Columbia, a service centre for the regional forestry and farming and growing tourist industries. I visited the local hospital to compare notes. It is a lot bigger than Dunstan. They take in patients from nearby smaller hospitals, with a total catchment population of over 80,000, and are over four hours by road from Calgary.
The kids were billeted with local families, which was a great experience for them (real small-town hospitality), and for us accompanying adults who stayed in a local hotel but were included in a lot of the activities. A highlight for me was visiting a small farm which one of the host families owned up in a mountain valley out of town.
In general, our kids were outplayed by the teams from Canada, the USA, Japan and Korea. They did have one close game against a local team. In their last game they beat the team from Canberra. (Then when I get back, I discover that poor George Gregan has broken his leg. You do have to feel sorry for the Aussies sometimes).
Before coming back, we took another bus back through the Rockies, past Calgary, stopping to look around the Olympic Park (with the ski jump used by “Eddie the Eagle” and the bobsled run used in “Cool Runnings”) then on to Edmonton. The kids tried out sledge hockey (after a lesson from two local paraplegic boys) and played a game of ice hockey against an Edmonton team (they made the Edmonton regional TV news, which is more publicity than they ever get in New Zealand). Otherwise, they just hung around the West Edmonton Mall and annoyed the adults.
On the way back we spent another couple of days in Los Angeles, visited Universal Studios and Disneyland and bought (relatively) cheap hockey gear in a huge warehouse near Arrowhead Pond. We were all pretty tired by then and ready to get home.
I naturally arrived back at work feeling like another holiday. Luckily, I had already arranged one. Dave kindly agreed to fill in for me for the last few days of my first week back so that Joan and I could take the girls to the Gold Coast for a week. I warned the staff, who read an earlier version of this story, not to expect a report.