Editor’s Corner
Cyclothymia and the ASH Annual Meeting
A
FTER YEARS OF attending the ASH annual meeting, I’ve come
to understand my meeting-related emotional cycle well enough
to avoid taking it too seriously. Each December, I rotate through
a set of five now-predictable peri- and intra-meeting moods,
paralleling Freytag’s classical dramatic arc – a trivial version of
Elisabeth Kübler-Ross’ canonical stages of grief.
If you attend the ASH annual meeting this year, perhaps you will
note some of these states of mind reflected in your own temperament.
Phase 1
Months of expectation-building logistical management serve as
background and exposition: jumping on housing website within
the first six minutes of its opening to secure a hotel as close as possible to the convention center; scrambling to round up co-author
approvals and submit abstracts in the closing moments before the
August deadline (that magical day of the year with the greatest outpouring of hematology research); blocking out time to attend key
sessions; and scheduling side meetings and advisory boards.
When December finally arrives and I sign out my pager on
departure day, I feel like an eager schoolboy – fresh Trapper Keeper
in hand – heading off on a crisp September morning to the first day
of class. I board an airplane bound for one of the five cities that the
ASH annual meeting now rotates among (San Diego, San Francisco,
New Orleans, Atlanta, and Orlando, but somehow never Las Vegas)
with a legal pad listing exactly where I need to be and when.
Phase 2
The hyperkinetic second phase of the annual meeting cycle
begins when the plane touches down. Phase two is a frenzy of
saying hello to old friends, making new ones, and rushing from
room to room to speed-date with the ideas of scientists and
clinicians from around the world. (In recent years, early meeting
activities have also included filling out forms at Friday Satellite
Symposia so that Senator Chuck Grassley can personally review
how much I ate for lunch and predict the influence of that meal
on my prescribing behavior for the subsequent year.)
News and greetings materialize as fast as starfields when the
Millennium Falcon jumps to light speed entering hyperspace.
Meetings start as early as 6 a.m., while receptions stretch until
after midnight; by Sunday night, exhaustion looms.
Phase 3
And perhaps that exhaustion contributes to the inevitable arrival of an
unwanted third phase: a deep, enervating depression. The fundamental human condition of chronic disillusionment – interrupted only by
daily crises – begins to weigh heavily. Repetition of buzzwords and
trendy topics (I’m looking at you, “personalized medicine” and waterfall plots) lead to ennui, which begets a dispiriting cynicism.
Every new treatment, no matter how ineffective and toxic, seems
to be labeled “worthy of further investigation” and “tolerable”; every
scientific observation, no matter how far from the clinic, is hyped as
the basis of the next major therapeutic advance, an easy drug target
and a slam dunk for approval by the U.S. Food and Drug Administration. At the same time, my own work feels increasingly worthless
in view of all the genuinely amazing developments.
ASHClinicalNews.org
To escape the cacophony, I
usually skip at least one planned
evening reception to curl up in my
hotel room with a novel. Coincidentally and unintentionally, books
by Julian Barnes have accompanied
me to at least three recent meetings,
but as Barnes wrote in Flaubert’s
Parrot, “Books make sense of
life; the only problem is that the
lives they make sense of are other
David Steensma, MD, is senior
physician at the Dana-Farber
people’s lives, never your own.”
Cancer Institute and associate
If, amidst the hustle and bustle of
professor of medicine at Harvard
phase one I forgot to pack a novel,
Medical School in Boston, MA.
reading the annual meeting education book can serve as sufficient
distraction.
In bad years, I never escape the gravitational pull of this
existential black hole