Speaking of Spokane

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

David R. Richardson, MD. Speaking of Spokane. BCMJ, Vol. 54, No. 6, July, August, 2012, Page(s) 273 - Editorials.



Above is the information needed to cite this article in your paper or presentation. The International Committee of Medical Journal Editors (ICMJE) recommends the following citation style, which is the now nearly universally accepted citation style for scientific papers:
Halpern SD, Ubel PA, Caplan AL, Marion DW, Palmer AM, Schiding JK, et al. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002;347:284-7.

About the ICMJE and citation styles

The ICMJE is small group of editors of general medical journals who first met informally in Vancouver, British Columbia, in 1978 to establish guidelines for the format of manuscripts submitted to their journals. The group became known as the Vancouver Group. Its requirements for manuscripts, including formats for bibliographic references developed by the U.S. National Library of Medicine (NLM), were first published in 1979. The Vancouver Group expanded and evolved into the International Committee of Medical Journal Editors (ICMJE), which meets annually. The ICMJE created the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals to help authors and editors create and distribute accurate, clear, easily accessible reports of biomedical studies.

An alternate version of ICMJE style is to additionally list the month an issue number, but since most journals use continuous pagination, the shorter form provides sufficient information to locate the reference. The NLM now lists all authors.

BCMJ standard citation style is a slight modification of the ICMJE/NLM style, as follows:

  • Only the first three authors are listed, followed by "et al."
  • There is no period after the journal name.
  • Page numbers are not abbreviated.


For more information on the ICMJE Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals, visit www.icmje.org

BCMJ Guidelines for Authors

Leave a Reply