The event should have been glorious. Beginning Oct. 30, the American Society of Tropical Medicine and Hygiene (ASTMH) held its first in-person meeting since 2019. As 4,200 attendees from 115 countries registered, waved and even hugged while probably wondering (like me) if we really needed to wear an N95 mask while fully vaccinated, I felt the same eager anticipation that marked my first ASTMH band about four decades earlier.
At the time, after returning from London with a degree in tropical medicine under my belt, my then medical boss in Boston kindly gave me 3 days off to fly to New Orleans and drink my full of information on pests and plagues. Looking back, I can only marvel at the global scourges we have since fought, the lessons we have learned and the challenges we still face. That said, back to this year’s meeting in Seattle.
My first symptoms – a slight sore throat and fatigue, nothing more – started during the opening speech. I worried, even though I was captivated by a lecture by Mauricio Barreto, MD, PhD, MPH, titled “Poverty, Inequality, Social Justice and Health: Notes from Brazil” (which ended in exciting “just-in” news of who won Brazil’s presidential election). Nevertheless, since my COVID-19 antigen test came back negative, I attended three more inspiring symposia the following day. The first, covering different aspects of malaria, honored the late Col. Alan Magill, MD, a colleague who served with distinction as a clinician, researcher, and military adviser and later headed the malaria program at the Bill and Melinda Gates. The second session addressed present and future threats from ticks and mosquito-borne viruses in a “warmer and wetter” world. My final pick was an earthy dissection of failing sanitation and intestinal parasites in poor pockets of rural southern America. I then went to one of my favorite parties — the London School of Hygiene and Tropical Medicine’s annual reception for its mini-UN alumni — and ended the evening with dinner with friends.
What can I say ? Our Halloween meal of apple salad and seafood paella on Terra Plata’s rooftop terrace was delicious, as was the evening’s conversation shared with a reporter and pediatric infectious disease specialist Lisa Frenkel, MD whose father discovered the life cycle of Toxoplasma gondii. But when jerky coughs interrupted the night’s sleep, I could no longer blame my illness on the arid air of the hotel. Instead, a bright magenta line on a second test kit from a biodegradable bag emblazoned with the ASTMH motto – “Advancing Global Health Since 1903” – told an all-too-familiar story. (Fortunately, I was able to confirm later that none of my friends at dinner had contracted it.)
I then went into the COVID-19 lockdown for the rest of the conference.
Reflections of the 33rd floor of the Sheraton Grand
As an ASTMH lifer, I have long cultivated ways to avoid the “Stop the madness! My brain is full!” feeling that the annual meeting can trigger, whether it’s in person or online. I just can’t get enough of the content. Accordingly, this year in particular, I derive comfort from my one-year access to taped coverage of all plenaries, symposia and scientific sessions. In my future columns “Des parasites et des pestes” in MedPage todayI will definitely rely on this content in addition to the latest medical news.
But do I regret traveling from Los Angeles to Seattle to spend 5 surreal days and nights in voluntary incarceration? Barely. Just showing up and seeing old friends, even out of the corner of my eye – and then receiving thoughtful inquiries about my health – added to the joy of the community at a time when medical professionals health and “field workers” often feel discouraged and alone. As one (admittedly biased) executive wrote of ASTMH the day I left, “there is no more welcoming professional home!”
This brings me to something else. Yes, the culture of medicine has changed over time; for some, lifelong allegiance to a professional society now seems outdated. But throughout my years as a doctor, teacher, and journalist, my involvement with ASTMH, a growing global tribe, has been an incredible touchstone and anchor.
So what awaits the next generation? I started wondering during lockdown. Will this be a future in which other respiratory illnesses slam the door at large in-person meetings? I sure hope not (plus I didn’t get COVID-19 at this year’s ASTMH but probably before I left home, since my husband tested positive in California the same day my test turned pink). On the other hand, today, no international company can ignore the cost and carbon footprint of long-distance travel. So while the decision is not mine, I foresee more hybrid confabs and regional sub-meetings in the future of ASTMH, which both inform and connect subsequent waves of devotees.
My final insight stemming from the COVID-19 lockdown was much more personal.
A final epiphany
In my late thirties, I realized that some friends and mentors were real “collectors”. Some were drawn to exquisite pens, others to old medical instruments, others to antique books. Great! I thought, concluding at the same time that I didn’t share their passion for acquiring a certain “thing”.
But this year’s very first “Story Slam” at ASTMH (which I was supposed to co-host) reminded me that I collect something invaluable, like most of us in medicine. Selected from narrative essays published in the American Journal of Tropical Medicine and Hygienethe tales presented wove together not only dramatic events, but feelings forged in sadness and joy and intimate truths about the human condition around the world.
Authentic and sincere stories and feelings. What a new improvement for any medical gathering, whether it’s a beloved annual reunion or an ad hoc get-together of homecoming professionals. And so, feeling fully recovered after 5 days of rest and nirmatrelvir/ritonavir (Paxlovid), I finally left lockdown with a renewed appreciation for in-person medical meetings and hope to enjoy them for years to come.
Claire Panosian Dunavan, MD, is a professor of medicine and infectious diseases at UCLA’s David Geffen School of Medicine and past president of the American Society of Tropical Medicine and Hygiene. You can read more of his writings in the “Of Parasites and Plagues” column.
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