Sometimes Vancouver is on the way to Shanghai

By Della, Wicked Witch of the Midwest

Romantic Advice from a woman who lives with cats.

After my friend Martha revolutionalized the care of lupus patients and started getting invited all over the world to give talks, she was invited to China but could not go because of her nephew’s wedding. A bit later, several other friends of mine mentioned that they had received a letter from some maniac, asking them to fly to China with very little notice.

A few weeks later, I received an email from a woman I knew at Arisa Laboratories, the makers of BeStaturan.

Dear Dr. Sugar:

Although this is a little last minute, would it be possible for you to consider flying to Shanghai, Guangzhou and Beijing for a tour of China. I have taken the liberty of scheduling you to speak to large 1,000 seat auditoriums which will be full of physicians in each city and there will be a banquet in each town.

In Shanghai you will be speaking at the Chinese National Rheumatology Association and in Beijing you will be a distinguished speaker at the University of Peking. Please let me know as soon as possible, since we need to fly you out, via Vancouver and Hong Kong by the 20th of this month and there is barely enough time to arrange for your VISA.

Yours Sincerely,

Peti

Petronella Chang H.A.G.L.

Vice President and Global Liason

Arisa Laboratories

I was thinking, “How like Peti not to mention that I was not her first choice of speaker and how arrogant of her to even imagine I might drop everything on my crowded calendar and travel to China with only two and half weeks notice. And more to the point, how like her to only invite me AFTER both Sammy Kravitz and Amanda Sneed had turned her down first, could she not appreciate that we might be talking to each other and did it not occur to her that of the three of us I was a lot more famous and a much better speaker?

On the other hand a Global Liason for a small pharmaceutical company cannot be expected to know all the subtleties in the pecking order of our field, and since this letter arrived less than 48 hours after I had been dumped by my boyfriend, Will, maybe I was being a little hypersensitive…..and what is it they say, anyway about what you should do when you have been dumped?

SHOVE THAT ICE CREAM BACK IN THE FREEZER, PUT ON YOUR MAKEUP AND GO OUT INTO THE WORLD! I am pretty sure if you click on any of the links that google puts at the edge of my column that is the advice you will receive, and I agree with it.

Dear Petronella: I wrote.

I would be absolutely delighted to go. Tell me what I have to do next. Yipeeeee!

Della

Della Sugar, M.D.
Head of Immune Pharmacology
Ardmore Medical Research Foundation

I had first met Peti at EULAR, the year they had that disastrous meeting at the convention center near the Arch de Triomphe in Paris. That was the year all the toilets broke in the entire building, and there was a team of five or six little men in red jackets, running around getting one toilet at a time to work for a while, but each time they got one going and rushed off to do the next one, the first one would quickly get clogged from immediate overuse. For some reason there seemed to be only this one toilet repair crew, and these poor harried workmen were, needless to say, scowling at all the desperate people and refusing to answer any questions or even to look you in the eye....but then again they were Parisians, so maybe this was not situational.

I had progressed towards the front of one of the endless toilet queues, hoping to reach a currently working commode before it was too late. Behind me was a very unhappy conga line of cranky, uncomfortable EUROdocs, snaking half way around the exhibit hall. A few minutes before, some nincompoop from the WorldImmune Pharmaceutical Company had decided the thing to do was offer free coffee to this bladder-challenged mob, and started rolling a cart with a steaming pot on a scorching hotplate and teetering towers of plastic cups up and down the narrow space between the line and the exhibit booths. He was lucky to escape with his life.

Paris is the most beautiful city in the world except for the toilets.

While advancing, one tentative flush at a time, along this line of miserable EURO delegates, I noticed a tiny but elegant Asian woman gliding by in six inch heels, which brought the top of her head almost up to my chin. She appraised me cooly as she blew past, then did a double take and turned back.

“Dr Sugar?” she cried in a perfect, piercing British accent. “What fantastic luck!”

“How do you do?” I put out my hand. I had just given a really brilliant talk about why clinical trials have not worked very well for lupus, and figured she had been there.

“Darling, you are on my list of KOLs,” she said. “And I had no idea you might be at EULAR. Can we have a chat now?”

“Well,” I said, “I can’t leave this line, I am only 20 people away from the toilet.”

“Pish tosh,” she said. “I will take you to a proper ladies room.”

She grabbed my elbow and glided me away to a door in the wall that said “Convention Center Staff Only, Do not Enter.”

“This is a helpful shortcut that I discovered this morning,” she explained, haughtily staring down the functionary who was trying to bar us from the door, and ushering me past him with a dismissive little hand wave.

Feeling a little like Alice in the rabbit hole or Dorothy in the tornado, I gratefully followed her into a narrow stairwell, which she clicked her way down with admirable grace in those heels. At the bottom was a door which opened into the adjacent hotel. We rode an elevator up to the private club suite and I was soon in delighted possession of a large, private bathroom with granite countertops and lavender scented hand towels. “Oz,” I murmured appreciatively.

You may be wondering what a KOL is. I learned, soon after finding out that I had become one, that it stands for “Key Opinion Leader.” This is a person, usually a doctor, who has been identified by the pharmaceutical industry as likely to have some influence in the field. At first I had the low-functioning and slightly paranoid idea that their goal was to flatter me and then influence me in favor of their product. But although that might happen in the lower echelons of pharmaceutical lobbying, is not unknown between drug reps and the local doctors, it is very different in the rarified air of Global Liasons, Product Leaders, Vice Presidents in Charge of Immune Therapies, and KOLs. Our relationships are far more interesting than that.

During the long, complicated process of developing new treatments for a small-market disease such as lupus, these companies do not want to lose their shirts by fantasizing that some product will be effective when it is not. So early in treatment development they identify the very people that would be least likely to be influenced by free penlights and lunch for the clinic staff, people who have established independent careers in their own right, and they use us to educate the world about the mechanism of action of treatments in development, and to help them in the design and interpret their clinical trials. Maybe after the first treatment is approved for lupus, things will be different, but until then, my relationships as a KOL are pure.

And any meals or honoraria or trips to a fancy bathroom I get, I earn, without compromise. You will see.

After I had washed my hands with the lavender soap, and spritzed myself with the lavender cologne, and wiped my face with the heavenly lavender-scented hand towels, Petronella took be into the sky restaurant for a coffee. We sat at a window with a view that swept all the way down the Avenue de la Grand Armee to the Champs Elysees. I learned that Peti was obsessively glamorous. When I complimented her haircut she told me that she always waits to get to Paris for that. When I complimented her shoes, she told me that all women gain a foot in six inch heels. When I complimented her diamond bracelet, she told me that the President of the Combined Hospitals of Singapore had given it to her even after she refused to sleep with him.

Some women have all the luck. I never got any presents like that even after...well never mind...

Now here I was about to fly to Shanghai, Business Class. Have you ever flown Business Class? I often do, these days, because I am an Executive Platinum on American Airlines and I get 8 free system wide upgrades every year, and unlimited domestic standby upgrades. That is how often I fly, but not at retail prices.

In this case I was traveling at full price, courtesy of Arisa Laboratories, but I was not on my preferred airline, Peti had explained that she likes to keep tabs on her KOLs and everyone would be flying together on United.

I have nothing against United, but you have to fly to Denver, from Oklahoma to get to New York. Unless you go to Chicago where you are very likely to be stuck for three days. The current ticket was even more bizarre. I had a meeting in New York the day before we had to leave for Shanghai, so Peti had booked me from New York, to Chicago to Vancouver, arriving after midnight, with a flight out to Shanghai early in the morning with her in the next seat. I happened to get a look at the tickets and it was obscene, because this booking cost almost twice as much as New York to Shanghai without all the convolutions. But, I was being well cared for, I figured.

Until I landed in Vancouver after midnight and the hotel they had “booked” for me had never heard of me. It was a very fancy hotel, and they were willing to put me up there in the only room available which was a Princess suite for almost a thousand dollars. I said no thanks and went back to the airport.

I have slept in a few airports. I am not in serious credit card debt or anything, and when traveling for a company, they usually have a reimbursement policy if you get stuck with an extra hotel bill while connecting flights, but when you travel as much as I do, you have enough trouble with your invoices and tax records without trying to remember which company owes you what and who you should (or did already) invoice and what they require on the invoice, and did they ever pay you or not….. sometimes it just seems worth sleeping in an airport.

When I got back to the airport, there was quite a crowd of Asian people there, preparing to bed down on the benches. Men, women, families with little kids, at least 500 people. I went in the ladies room and found a place in a long row of Mandarin-speaking women, all wearing pretty clothes and carrying their toothbrushes in their purses. It was a respectable, middle class crowd, and I realized that I had found a travel haven. They exist around the world, airport waiting rooms where regular tourist class people know it is safe to stop off and do an overnight on a bench, avoiding the expense of a hotel, while connecting to long distances.

Near the closed Food Court there was an internet hookup for ten bucks and hour. It was Canadian bucks, though, so how much could it be? I put in my credit card, answered a few pressing emails from my staff about my patients, then I sent an only slightly irate notice to Peti that I was about to bed down in the waiting area of the Vancouver airport. Not far from where I was sitting, I saw five feet of empty bench, so I clicked “send” on that last email without thinking very carefully about whether it was entirely tactful or not. Then I ran for the open spot on the bench before somebody else got it. Almost instantly I was asleep with my backpack for a pillow and my computer bag under my knees.

Between 5 and 6 AM people began to stir around me and somebody was brewing coffee at Kentucky Fried Chicken. I opened my eyes and smiled at a little girl, whose mother was brushing her hair on the opposite bench. I was groggy and stiff, but the smell of coffee and greasy biscuits were enticing, and the human life around me gave me a feeling of family.

You may wonder what this has to do with romantic advice, but do you think, waking up on a bench in the Vancouver airport that I was giving even one thought to Will, who had dumped me less than three weeks before? Nope. I was thinking about brushing my teeth and having a couple of biscuits from Kentucky Fried Chicken. And that's all.

In fact I have no memory of even knowing that Will existed that morning, and so the object lesson here is that when somebody dumps you it is very important to go out into the world and try to get your mind off it. And if you are not yet ready to go on any real dates, or to have one of those nightmare evenings where you plan to paint the town red with your girlfriends and end up getting drunk and crying and wake up with a hangover, I can highly recommend, as a far superior alternative, sleeping on a bench in the Vancouver airport. On your way to Shanghai.