The View from Firenze

We have truly provided the world with an international scientific language.

When I learned the first World Congress on Lung Health would be held in Florence, I decided to visit my daughter in London en route to the conference. Arriving via Delta at Gatwick, I had not fully realized that it was some 40 miles from central London and a £100 taxi ride. After celebrating my daughter's birthday, enjoying the theater and catching up on the latest about the sale of her E-business (FirstTuesday.com, to Yazam in Tel Aviv), we proceeded on to Florence, the birthplace of the renaissance.

Driving must be a favorite sport in Italy. The taxi driver who drove us from the airport to downtown Milan, for our train to Florence, ran everyone off the road at 160 km per hour.

During opening ceremonies of the Congress, a large "cigarette mortality" clock was started to record the deaths from cigarettes, with one person dying every eight seconds. There were 1,800 deaths by the end of the evening, and more than 50,000 deaths during the five-day meeting.

The World Congress was sponsored by the American Thoracic Society (ATS), the oldest and largest participating society, founded in 1905; the International Union Against TB and Lung Disease (IUATLD), which has had 32 biennial meetings; the Asian Pacific Society of Respirology (APSR) founded in 1988; and the European Respiratory Society (ERS) founded in 1990.

There were 13,500 attendees from 60 countries. Every person I met knew where Sacramento was except one doctor from Milan. I was proud to be from a city with such wide name recognition. When one participant found out I was from Sacramento, she responded, "Then you must know my aunt and uncle in Los Angeles."

Although the conference had interpreters for English, French, Italian and Spanish, all speakers gave their addresses in English, and very few attendees wore head phones to listen to a translation. There were 15 concurrent sessions daily and excellent conferences every evening.

I also attended the various conferences of the ERS during lunch hours (we never had a bad Italian lunch or dinner) patterned along the lines of the American Thoracic Society. Although there are no English-speaking countries in Europe, these meetings were in English.

A doctor from Finland confided that the Scandinavian Respiratory Society had always encouraged its members to use their native tongue at their meetings. But he said that for the last several years all four countries gave all their addresses in English.

We have truly provided the world with an international scientific language. Isn't it unfortunate that some misguided people in this state and country still want to impede emigrants and other ethnic groups by having them schooled in their native tongues, rather than the scientific language of the world? Most of us who knew no English when we started school, and continued to speak our native tongue at home, were thankful that we were immersed in the science world's language and had to learn it from day one in grade one.

The Congress covered the entire field of pulmonary medicine, from interstitial disease, obstructive disease, asthma and allergic disease, occupational lung disease and neoplastic disease, to diagnostics and treatments of each, along with their global implications. AIDS has so increased the incidence of tuberculosis that it now infects more people than it did before the discovery of Streptomycin.

John Murray, MD, Professor and Chief of Pulmonary and Critical Care Medicine at UCSF, gave the Millennial Lecture. He traced the history of pulmonary medicine, beginning with the invention of the stethoscope by Rene Theophile Hyacinthe Laennec, to the great leap made possible by Roentgen in 1905, and into the new millennium. In 1966, the NIH conference concluded that we know everything needed to prevent and cure diseases. All we must do now is apply the knowledge. In 1969, US Surgeon General William Stewart stated, "It is time to close the book on infectious diseases." TB, which was decreasing then, is now spreading so rapidly there is no end in sight. Murray quoted Groucho Marx: "Even the future isn't what it used to be."

The symposium on the Global Respiratory Problems with AIDS was horrifying. With 30 percent of sub-Saharan Africa infected with HIV, AIDS is expected to kill half of the population. There were over 5.4 million new cases last year. It is estimated that 13 million children have been orphaned by AIDS. Organizers of the Congress expected this to be a popular topic and scheduled it in the largest meeting room with 900 chairs. However, only 35 of us attended.

A symposium on the final day was the Global Respiratory Problems of Tobacco. Never was it highlighted that cigarette profits are a major funding source in many countries of the Orient and South America, through government ownership as well as taxes. The second to the last speaker was from Japan where smoking is endemic and 65 percent of physicians are smokers. When he stated that there may be evidence that cigarettes are detrimental to lung health, I left ~ deciding the conference had really ended one hour ahead of schedule.

International conferences provide an important global perspective on health care and health problems, and the difficulty of scientific advancement worldwide. It seems incomprehensible that a majority of physicians are still smoking, if not experienced first hand. Some nations are just beginning discussions we had four decades ago. We must continue to make our research available to the world at large. Many countries have no basic scientific journal. Some, as in South America, only publish reviews from the medically advanced countries. There is still much to be done. The First World Congress on Lung Health was a good first step.

We enjoyed the rest of our vacation in Venice, where the taxis are boats, and Rome, where the whole city is a museum much like Florence. Internet cafes are common, allowing us to communicate daily with our office. Although bars serve spirits, the primary fare seems to be wine, sandwiches and gelato.

We particularly enjoyed our excursion into Tuscany and the wine country made famous by San Francisco professor Francis Mayes, who, along with her husband, purchased a 300-year-old villa and restored it over summers and quarters off from teaching. Her books give an insight into Italian life, habits, dietary practices, the importance of olive oil, their lovely complexion, and their civilized custom of afternoon naps.

One day, while using the bidet after a nap with her husband, she realized, "Now I know the reason for the sunny disposition of Italians and Mediterraneans in general ~ most are conceived during the sunlight." She has just come out with another volume, a coffee table edition. I look forward to displaying it.

delmeyer@healthcarecom.net