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The Greatest Show on Earth

Louie, Ted MD

Infectious Diseases in Clinical Practice: July 2008 - Volume 16 - Issue 4 - p 209
doi: 10.1097/IPC.0b013e31816955f6
Reflections of an ID Specialist

University of Medicine and Dentistry of New Jersey, New Brunswick, NJ.

Address correspondence and reprint requests to Ted Louie, MD, 579A Cranbury Road, East Brunswick, NJ 08816. E-mail:

I gazed intently at my ceramic bowl, steaming and fragrant with the earthy odor of mushrooms, and sniffed reverently.

"Wood mushrooms from Japan," I explained loftily to my companions. "They only grow for a very short time period, and then they are gone for the rest of the year."

My dinner companions looked at me, impressed, until I added a bit more humbly, "Or so the waiter just told me."

We were in Toronto for the 2006 IDSA convention. After a long day of "Meet the Professor" sessions at 7 AM, followed by coffee, symposia, more coffee, poster sessions, keynote lectures, and still more coffee, we had gathered at this lovely Japanese restaurant to feast. Our eclectic little group represented the various subdivisions within our profession: there was a clinical researcher working for the industry, a chief of pediatric infectious diseases at a tertiary care center, a CDC officer, and myself, a private practitioner. We were joined by a common love of IDs and sashimi. Although the convention sessions were intense, and we were saturated with ideas and knowledge, we had all enjoyed ourselves thoroughly.

There are those naysayers in our profession who feel that going to medical conventions is an inefficient, costly way of obtaining continuing medical education. Certainly, after the expense for transportation, meals, and housing, the whole proposition is not cheap.

However, although one can certainly accumulate a good amount of continuing medical education online for next to nothing, the experience pales in comparison. At their best, medical conventions such as IDSA and ICAAC are at once cutting-edge, inspirational, scientific, and humanistic: part seminar and part social event. They make the connection from basic science on the bench to practical applications in the clinic and strive to empower us to make the world healthier. And looking around the convention center, surrounded by esteemed peers from all around the globe, there is a feeling of camaraderie and good will, a sense that there is indeed an idealistic world community striving to make the world a better place.

At the past several years' conventions, there have been moments of real emotion. At the 2005 IDSA meeting, there was the highly charged, courageous presentation by Dr Barbara Murray, updating the situation of Dr Tom Butler. Dr Butler, at that time the Chief of Infectious Diseases at Texas Tech University, an academician with a long and distinguished career, had voluntarily reported several vials containing Yersinia pestis missing from his laboratory. Much to everyone's surprise, he was subjected to intense pressure by the FBI and was subsequently sentenced to jail time on very dubious charges, probably as a result of Federal pressure to make him an example for would-be bioterrorists.1 The sense of outrage in the room was palpable. It is just not in the nature of the ID physician to sit idly by while there is injustice in the world.

Another memorable presentation was given at the 2006 IDSA meeting. Dr Wafaa el-Sadr, in a truly magical lecture, described the evolution of the worldwide AIDS epidemic as a "perfect storm."2 In quiet, thoughtful tones, she spoke about the difficulties and joys of caring for AIDS patients in Harlem and Africa. She shared with us the story of a desperate intravenous drug user who, with proper medical treatment and aid from social services, managed to turn her life around, eventually becoming an HIV counselor. In a moment of supreme irony, the patient later told Dr el-Sadr that testing positive for HIV virus had been the best thing that ever happened to her.

At the conclusion of this wonderful lecture, there was a long standing ovation. Nearly everyone in the audience was reduced to tears: tears of sadness for the victims of AIDS and their families and tears of gratitude for Dr el-Sadr's years of selfless toil and steady resolve in the war against HIV. For, despite the "perfect storm of HIV," there was also, in the quietly confident words of Dr el-Sadr, a "silver lining."

That type of feeling, along with the opportunity to sample authentic wood mushroom soup, will get me back to the convention center each and every year. And now that ICAAC and IDSA will once again be united as a single event in 2008, it will once again be "The Greatest Show on Earth."

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1. Murray BE, Anderson KE, Arnold K, et al. Tom Butler: was justice served? Clin Infect Dis. 2005;40:1044-1048.
2. El-Sadr W. The global HIV epidemic: perfect storm, silver lining. Presented at: IDSA 2006; October 12-15; Toronto, Canada. Session 84.
© 2008 Lippincott Williams & Wilkins, Inc.