New York Stories from the PGA and Matzoh Ball Soup

  • Pauker, Kenneth, MD
| Jan 16, 2012

It was December and I managed not to work on my birthday, something I’ve done at my spouse’s urging for the past few years. I did of course write some things for the CSA, but that’s much closer to a labor of love, even now, eight months into my presidential term. It is amazing to me how much writing is required as CSA President, and how much more is not actually required but begs to be done anyway.

As CSA President, traveling to the PGA was quite a schlepp. I felt almost “incommunicado” in New York, but strangely at home. After all, I was born there and grew up 90 miles north in Kingston. My mother Helen was a first generation New Yorker, born on the lower East Side, and she cried like a baby when my dad Carl moved the family north to Ulster County to run the distribution center for the family shmatte business, Barclay Knitwear. But today she’s still in New York, as are all of my deceased relatives, a whole bunch of characters amongst them, in Old Montefiore Cemetery in Queens.

My wife Debbie and I stayed at the Marriott Marquis in Times Square, where there are no floor numbers inside the elevators, only in the vestibule before you get on, and you are directed toward the proper elevator to board for your selected floor. Once inside, you are transported in a kind of cage, encased within large glass windows so you can look outside into the inside of the more than forty-story atrium of the hotel. The first nine floors, where the PGA meeting was held, are supposed to be accessed by meeting goers via escalators, and the lobby is, strangely, on the eighth floor. It’s not for the claustrophobic or acrophobic either, but most any other phobia will do.

It’s hard to get a good corned beef sandwich in Orange County, so my spouse (who is from Pittsburgh) just had to have one immediately when we got to New York. The Carnegie Deli is just a few blocks from the hotel, so we trudged uptown in the cold, noisy, night air to get there just in time for dinner, and what a New York dinner it was!  Matzoh ball soup, corned beef, chopped liver, real kosher and dill pickles, and even stuffed derma — treats of sacred childhood memory, but heavy to consume.

It almost goes without saying that the people in New York have this heavy, characteristic dialect, and they also gesticulate with their hands. I suppose that the accent somehow evolved from the speech patterns of hoards of working class, European immigrants — English, Dutch, Germans, Italians, Irish and Jews — who melted together during the 19th century. Wikipedia seems to confirm my suspicions.

It is possible for me to go on with many more tales about our adventures in New York, New York, but let’s get on to the meeting itself.

Developing this notion of the New York dialect, Dr. Steve Thomas, an illustrious New York anesthesiologist now at Cornell, famous for not wearing socks, comes to mind. Dr. Thomas used the term “Matzoh Ball Argument” in his introductory remarks at the Plenary Session of the PGA. He explained that matzoh balls are mostly made of ground up matzoh; they are held together loosely with egg whites and fat; they sometimes incorporate a few secret ingredients to make them float or taste really good; they are rather fragile; and, when made correctly, they fall apart easily when touched. He went on to suggest that for those unfamiliar with matzoh balls, they should ask the person sitting to their right. He characterized some of the pseudo-scientific reasoning he sees these days as being constructed in this very manner. This made me wonder about some things I myself have seen published recently in Health Affairs, wherein outcomes with different kinds of anesthesia practitioners are ostensibly compared. I used to say, “Nonsense!” Going forward I will use Dr. Thomas’ more colorful and evocative New York term instead.

Opening the Plenary Session on Saturday morning were two actual stars of New York theatre singing a medley of show tunes, “Broadway on Broadway.” What fun! The scope, variety and quality of the educational sessions at the PGA were truly stunning.

For example, Dr. Richard Dutton of AQI fame painted a humorous and enlightening picture of anesthesiology at “Utopia General Hospital,” where data drives care. Dr. David Reich from Mt. Sinai Hospital exhorted us to own up to our own adverse perioperative outcomes. Dr. Steve Shafer, from Columbia and Stanford and late of testimony in the Conrad Murray trial, recounted his experiences as Editor of A&A in trying to ensure that what is published is not hewn from whole cloth. And all of this was just the beginning—scientific panels, focus sessions, problem-based learning discussions, workshops, mini-workshops, poster sessions, medically challenging case report posters, technical exhibits, hospital visits and social activities. I myself even had a hand in the “scope” of things, participating in one of Dr. David Wlody’s Focus Sessions with Dr. Randy Clark from Colorado and Chuck Assini, counsel to the NYSSA, on Scope of Practice.

I had forgotten how truly wonderful the PGA is—as well as the fun of New York in December—and have resolved to come back as often as I can.

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