Friday, June 26, 2009

Milan!


I realize that this post is a bit outdated, as I visited Milan in the middle of June, but I've been busy with med school applications (among other things) since my return. At this point, I'm not even sure where to begin - my trip to Milan for the Annual Meeting of the European Neurological Society was incredibly educational, and rather fascinating!

To start, I found the four-hour train ride from Geneva to Milan to be absolutely beautiful! The train circled Lac Leman and then passed through the Alps. With scenic views of farms, vineyards, snow-capped mountain peaks, and waterfalls, I had a hard time believing that the commuters in my train cabin could become so accustomed that they were able to sleep during the trip.

Upon arriving in Milan, I found that public transportation is the most convoluted conglommeration of trams, trains, trolley cars, metro lines, buses, and taxis that I have ever seen. During my stay, I must admit that I was only able to successfully use the train, the metro, and taxis without direct supervision from Milanese natives.

During the conference, I attended lectures and workshops nearly all day for all five days (with the exception of half a day off on Monday - I'll explain that later, and half a day off on Wednesday for traveling back to Geneva). Many of the other attendees seemed to be impressed that I sat through so many lectures, but honestly, I think the difference is that everything was relatively new (and usually interesting) to me. I had enough familiarity with much of the background information supporting the neurological disorders and treatments discussed, so I could certainly follow along. However, as I lacked the formal training that the other physicians had, I soaked up new information like a sponge.

After the first day of teaching courses and lectures, I toured Milan's San Raffaele Hospital through a visit organized by the European Young Neurologists in Training. (I'm not European, I'm not a neurologist, but I am young and in training, so I suppose that was enough for me to be invited.) The hospital rooms were very much the same as any that I've seen, but the buildings (just like the University Hospital in Geneva) seemed to have more green space both outside and in courtyards inside than most of the medical facilities I've visited in the States. During the visit and dinner afterward, many of the other neurologists talked to me about the challenges of health care (in all countries) and finding funding for hospitals and research. It was fascinating to hear so many different perspectives! Another really interesting aspect of the tour was a statue that our guide (a Neurology resident from the hospital) pointed out. The statue was a large angel perched on top of a dome on the hospital, and our guide explained that since the facility has religious roots, she is there to "take care" of the patients. He went on to say that within the domed part of the hospital is a spiral staircase designed to look like a double-stranded DNA helix that rises up to meet the angel. This representation of the cooperation between science and religion was cool to see, but possibly contradicted by some of the information I learned on the tour. For example, one of the Italian neurologists was telling the group that it's difficult at his hospital to gain all of the information that he would like to have for a clinical study. He explained that autopsies are generally not conducted on deceased patients for religious reasons. While they are admittedly morbid, autopsies often provide crucial insight into organ structure and function (or dysfunction), and so it is easy to see how such restrictions might limit scientific progress.

At the conference itself, some of the presentations that I found to be the most interesting were those that coupled patient videos with guidelines for diagnosis. There was a teaching course like this on various movement disorders and another on epilepsy. The epilepsy presentation was especially cool because specific physical characteristics of the seizures were shown (through EEG) to correspond to different regions of the brain. Another lecture that I enjoyed was one discussing pharmacogenetics, or the use of genetic testing to find the medicine that will be most effective and have the least side-effects for each individual patient. This is awesome because there are often several different medications to choose from, but various mutations and different protein levels make some work better for different people. To me, being able to determine the best treatment before a patient has had to struggle with several unsuccessful ones sounds like a great idea.

I took Monday afternoon off to go on a walking tour of the city. I was able to visit Milan's Duomo, the Victor Emmanuel II shopping gallery, the Scala Theatre, and the Castello Sforzeco.

Milan's Duomo (the photo at the beginning of this post) is the world's third largest church, and one of the city's most iconic sites (apart from the shopping galleries, of course). It's made out of a stunning marble, but it's so interesting to explore because (according to our tour guide - otherwise, I have very little architectural knowledge) it's experienced quite a few restorations over a span of several centuries. As a result, some sections were built in the Gothic style with others in Baroque style, and restorations have been conducted by both French and Italian workers who didn't always get along. The result is still fabulous, but an architectural anomaly nonetheless.

Below are photos of the Castello Sforzeco, the Scala Theatre, and the Victor Emmanuel II shopping gallery.

During my stay in Milan, I also had the opportunity to socialize with other neurologists and scientists through a welcome reception (held at the Castle) and a banquet (at the Museum of Design). It was great to meet so many different people and to talk about so many different things - where to travel, President Obama, neurology conferences, how to use Ebay, and all sorts of other topics. It was nice to speak in English, since my French pronunciation is not always the best. However, on this trip, I found out that my Italian certainly isn't any better. I think the epitome of my pronunciation difficulties became apparent when a Milanese neurologist asked me if I spoke even just one or two words of Italian. I enthusiastically replied, "Yes, I know how to say, 'Grazie!' Smiling, he told me that it was great that I know how to call "Taxi!"

On that note, I will finish this post to go work on reviewing my notes from Italian class (I started taking lessons just for fun last week). Ciao!

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