I beat the vulture. By “beat” I mean that I slapped its wing at the top of Doomsday Hill while running the annual Bloomsday run in Spokane, Washington. 

I had come to Spokane with a physician friend to attend a Primary Medicine Conference and compete in one of the largest organized runs in North America. The race in­cludes a long climb out of the river valley topped by a large vulture (not a real vulture, as that would be cruel) watching for stragglers. The passing runners slap the vulture’s wing in celebratory tradition. In case you look up my time, I run under my Kenyan pseudonym, Allan Kiprono.

My buddy and I had attended the same conference 15 years ago and re­turning to Spokane was an interesting cultural experience. One of my first observations was that Americans drive closer to the speed limit, which I think can be attributed in part to the numerous gun-slinging Clint Eastwood-esque highway patrol officers. Also, the people of eastern Washington are very nice but they talk funny (just my opinion). 

Fifteen years ago the conference exhibits were staffed by pharmaceutical companies handing out a plethora of items including towels, clocks, and laser pointers. Due to current severe advertising restrictions I only found a few booths detailing some of the new­er medications, so sadly I couldn’t replace my faded Viagra towel. 

This year the space was filled with various health groups advertising their services and programs. I also find it interesting how medications change names as they travel across the 49th parallel. For example, Pradaxa is Pradax in Canada. How can you leave off the “a” considering our speech habits? Maybe they believe we will add it anyway—Pradax eh?

Conferences tend to be the same and, without a doubt, physicians in Washington State dress just as poorly as physicians in BC. The only place you will probably see more pairs of pleated pants is at an engineering conference. I also observed the same demo­graphics—physicians are an aging profession. One contrast I noted is that the speaker introductions tended to be long, worshipful summaries of credentials. I never realized how many of our Washington State colleagues are Nobel Prize–winning, philanthropic, recreational astronauts.

We often hear about how American physicians have it so good what with their high salaries and elevated quality of living. I think they actually have a very difficult job. They have to navigate the fine line between managing costs for the insurance companies while pleasing one of the most litigious societies in the world. This struck home when, after answering one of the presenter’s questions, he asked me if I taught residents or medical students (either I gave a good answer or he wanted me removed). I answered, “Not since the trial!” You could have heard a pin drop in the room. I quickly added, “Just joking,” at which point everyone laughed with relief.

Spokane is a very pleasant city and I was briefly able to picture myself living there. However, I changed my mind after browsing through a department store that had an entire wall dedicated to guns and ammo. As enjoyable as the weekend was, there is something very comfortable about being greeted by a Canadian border guard sitting with her feet up, pretending she cares if you have anything to declare.
—DRR