A Visit to Oz

by Steve Elias, MD, FACS

Somewhere in northeast Italy exists Mediclinic. A surreal place—an amalgam of Italian design, smart buildings, spa culture and highend outpatient medical care—it probably should be called the “City of Oz.” The presiding benevolent wizard is called “El Presidente.” Ostensibly, he made his fortune in clothing manufacturing, but in Italy, who knows and who cares where the funds actually come from? Apparently he really is a nice guy.

The ISVD (venous course) was held there in late September. The meeting’s codirectors are two good friends of mine: Dimitrios Kontothanassis and Nicos Labropoulos. Dimitrios is the medical director of the Mediclinic. Dimitrios is one lucky guy. I’ll get to the educational part in a bit. First, a little more about Oz (Mediclinic). Aesthetically, it is sleek and calming. Sixty-two bathrooms (apparently in Italy when you need to go, you need to go), motion detector–controlled climate and lighting, and antibacterial floor tiles. It has automatic shoe cover machines—step on them and sterile covers wrap around your shoes, or anything else you place on these machines. Let your imagination run wild with this image. Scrub tops and pants that are labeled “small,” which are actually small and fit someone like me. You could probably even wear them to some “business casual” meeting. Pool, jacuzzi, steam room, sauna, snow making machine (for when you get out of the sauna), a full technogym exercise/rehab area, MRI, advanced mammography, stereotactic biopsy machine, two large fully equipped ORs, and the Café Mediclinic, which serves espresso, cappuccino, wine, pastry, gelato, etc. Not to mention the intelligent and beautiful staff that is taken for granted in Italy. Oz.

Now for the educational aspect of this meeting. The course started at a civilized time, 9 a.m., which in Italy means sometime before lunch. In the US, there are breakfast sessions before breakfast, working lunch sessions, dinner symposia, online sessions during the live meeting, rapid fire three-minute talks, etc.—all cramming information into our brains at an incredible pace. We are doing something wrong. We are like that 15-year-old child who is doing his homework online while listening to music on Spotify while checking his Facebook page while texting his friends from his phone while in the bathroom. Most studies have shown that multitasking leads to lower efficiency and data comprehension, yet many US meetings insist, or even pride themselves, on this formula.

This meeting had the pace of a pleasant interplay between friends who were meeting to catch up on their latest doings, other friends, and families. It was an open-ended affair which concluded when it ran its course. Don’t get me wrong—the meeting had an agenda, which sooner or later we covered, but nobody had a timer going and no one’s slides disappeared after the allotted time was exceeded. Faculty and attendee interplay and interaction were the main goals. Italians can talk, sometimes exhaustively, but always with compassion and conviction. This was refreshing.

Are we too goal-oriented in America? On the wall of my high school’s auditorium, which was built in the 1930s during the Great Depression by the Works Project Administration (WPA), there was a saying: “The virtue lies in the struggle, not the prize.” For the Italians and Europeans in general, the experience of a meeting is as important as the prize (venous knowledge). Education should be fun and not pure work.

The Mediclinic venue and course directors, Dimitrios and Nicos, leant to the feeling of fun while learning. After each morning session, lunch was outside, catered by a good friend of Dimitrio’s. Casual Italian food, wine, cappuccino, and dessert for at least an hour and a half. Frank Veith would be jealous. Nothing medical discussed for over an hour at a medical meeting? Waste of time? I think not.

I am not suggesting that every meeting should be like the one held in the Land of Oz, but come on, we’re doing something wrong. Education should be about quality and not quantity. Go to some hyperkinetic meeting-within-ameeting- packed meeting. Wake up at 5 a.m. to not miss that very important 6 a.m. pre-breakfast meeting about something you may already know something about so you can hear the experts talk about it, even though they don’t want to be there at that time anyway. We’re killing ourselves with the old school thinking that real doctors should be on call every night, because if it were only every other night, we would miss half of the good cases.

Attend a meeting outside the US. Go to the ISVD meeting and see the Mediclinic, the Italian incarnation of medical Oz. See why they take more vacation time than Americans. See why they go to meetings. As Dorothy says in The Wizard of Oz: “Toto, I don’t think we’re in Kansas anymore.”

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