Welcome to the Dotter - Monday August 2nd

Learned yesterday’s lesson and started what I think must be my favourite ever daily commute on the Portland Aerial Tram (cable car). The “sky tram” is initially very impressive but any mention of it is greeted with scorn by OHSU staff. A favourite local white elephant it cost $57 million to build after initial estimates of $15 million and 85% of the bill was footed by OHSU.

The Portland Aerial Tram

My fellow passengers were all like minor characters from Grey’s anatomy, commuting to work in their fitted scrubs and flirting over their morning lattes. The tram passes over a large supporting tower halfway up the hill. The attendant has to warn the passengers that the tram may swing a little and this is the cue for all the nurses to grab the arm of an attractive man. All very entertaining.

The day at the Dotter institute starts at 07:30 with the morning conference lead by Dr Fred Keller and Dr John Kaufmann. The two fellows (who have to “pre-round” all the patients at 6am) present the cases for the day while Drs Keller and Kaufman hold court and skewer the poor fellows with pertinent questions.

John Kaufman (left) and Fred Keller (right)

Keller and Kaufman are a brilliantly contrasting double act. Keller is short, still, sardonic and probably never says anything that doesn’t need to be said. John Kaufman is tall, lanky and nervously energetic in a Woody Allen sort of a way.

After the conference I spent most of the day watching a series of IR cases with the opportunity to discuss the cases with the staff doctors (equivalent to consultants I think) and fellows. I had expected the cases to be complex, the equipment to be cutting edge and the department to function very efficiently and I wasn’t disappointed in any respect but more than anything else I was struck by just how similar the whole setup is to the NHS and I felt a little pang of pride for the little old nash. It says something that our cash strapped health service can provide something (very nearly) equivalent to the most famous IR centre in the world, which clearly has enough dosh to make Solomon blush.

Lost in Portland - Sunday August 1st

Woke up at 5am (thank you jetlag) and took in my surroundings. The hotel receptionist apologized endlessly last night that my room was on the ground floor but it's lovely to be virtually on the river, so after unpacking and a a few cups of coffee I set off for a run along the river path.

iPhone snap from my balcony

My hotel is about a mile south of downtown Portland and a mile southeast of the OHSU hospital. It backs directly onto the river and I can pretty much run straight off my balcony onto a few miles of riverside running track. Portlanders are famous for their outdoorsiness so even at 6am there were plenty of runners, cyclists and rowers out.

After breakfast I decided that my main mission for the day was to find the hospital so, armed with simple directions courtesy of Google maps I set off. I was a little surprised that Google suggested that the mile walk would take 45 minutes but I assumed that this was aimed at tubby Americans so I anticipated a 10 or 15 minute stroll.

Wiggly route to hospital

When I arrived at the hospital, and hour and a half later and dripping with sweat I realized that I had forgotten two things:

1. American cities (even "compact, accessible, pseudo-European cities") are never designed for pedestrians. Sidewalks lead you into 6 lanes of traffic then entirely disappear and there seem to be no footbridges or tunnels so the Google instructions are entirely unusable!
2. Portland is built on a volcanic plain surrounded by volcanoes so there is some serious elevation. The climb to the hospital is fairly punishing but the view from the top is spectacular.

Panorama from the OHSU balcony. Mt St Helens and Mt Hood visible in the background. Downtown to the left, my hotel behind the wooded area to the right.

 The hospital itself is truly spectacular and stands fifteen stories high on stilts to counter the steep hillside. The main OHSU is accessed (by all sane people) by a cable car which runs between a riverside tram stop and the hospital pavilion. The main building is then joined to the veterans hospital by a long sky-bridge. It is all fairly breathtaking and more than lives up to Nigel Hacking's claim that this might be the most beautiful IR lab in the world.

I found the Dotter Institute on the 11th floor with a plaque outside the institute proclaiming "At this site on January 16th, 1964, Charles T Dotter MD performed the world's first percutaneous transluminal angioplasty". This might seem unexciting to non IRs but for me this is tantamount to visiting Mecca. It's also incredibly intimidating and I just hope I don't make a complete fool of myself when I start tomorrow. Wish me luck!

Plaque outside the Dotter Institute