My Week on Hawaii’s Big Island

  • Yost, Paul, MD
| Nov 03, 2014

Editor’s Note:

For the first time this year, the CSA hosted our Fall Anesthesia Conference at the Fairmont Orchid resort on the Kohala Coast of Hawaii. The October 27-31 meeting drew nearly 240 anesthesiologists and their families from all over the world, including Canada, Australia, New Zealand, S. Korea, and even Norway. We congratulate Mark Zakowski, MD, the Program Chair, and the CSA Educational Programs Division under the leadership of Sam Wald, MD, MBA, on the meeting’s outstanding success.

CSA President Paul Yost, MD, kept a diary of his experiences on the Big Island last week. After reading his enthusiastic report, we’re surprised he agreed to come back to California at all!                                                                                                                                          --Karen Sibert, MD

As the President of the California Society of Anesthesiologists, one of the most enjoyable duties that I have is being an ambassador for the CSA at our educational events. Our CSA Hawaii meetings are known for world-class faculty who speak about cutting-edge clinical topics and updates on the trends in our specialty, all presented in an exquisite vacation setting. But nothing prepared me for reality. All I can say is WOW!

The setting for this year’s Fall Anesthesia Conference was the Fairmont Orchid, a first-class resort on the west side of Hawaii’s Big Island, with excellent restaurants, ambiance, sports, and service. As you walk into the open air lobby, you are met by warm tropical breezes, soft Hawaiian music and a stunning view of the ocean and grounds. The concierge places a lei of polished native kukui nuts around your neck, and you immediately feel at home. You pat yourself on the back for a great decision to come to the CSA Fall Anesthesia Conference!

The educational meeting began on Monday morning with a great buffet breakfast consisting of fresh local fruits and more traditional Hawaiian fare. The first day’s educational sessions included first-rate talks on obesity, sleep apnea, and outpatient surgery crisis management by Girish Joshi, MD. Dr. Joshi is Professor of Anesthesiology at the University of Texas Southwestern Medical School, and directs ambulatory anesthesia at Parkland Health and Hospital Systems in Dallas.

After Dr. Joshi spoke, the CSA’s own Mark Zakowski, MD, who heads obstetric anesthesia services at Cedars-Sinai Medical Center, gave an excellent update on managing obstetric hemorrhage. Brian Rothman, MD, the medical director for perioperative informatics at Vanderbilt University, then discussed “Navigating the Regulatory Bermuda Triangle”—the impact on medical practice of regulations concerning electronic medical records and “Meaningful Use”, and the huge powers of federal agencies including the Office of the Inspector General and CMS.

The week’s program included other talks by Dr. Zakowski on preeclampsia, neurologic complications, and medico-legal considerations in obstetric anesthesia. Michael Gropper, MD, PhD, a critical care specialist and Interim Chairman at the UCSF Department of Anesthesia and Perioperative Care, spoke about what every anesthesiologist should know about mechanical ventilation and about shock resuscitation.

Keith Ruskin, MD, who directs neuroanesthesia at the Yale University School of Medicine, talked about anesthesia for neurovascular procedures and the treatment of traumatic brain injury. An experienced pilot, Dr. Ruskin also spoke about the physiologic changes that occur during commercial air travel, and how to manage in-flight medical emergencies.

I have to say that in most of the lectures I learned something I didn’t know before that is applicable to my current practice! All the way through Friday, the educational talks were stimulating, interesting and extremely relevant to today’s practice of anesthesiology. Most attendees stayed through the final lecture on Friday at noon—rare for any educational meeting!

Many physicians brought their children along to the meeting. Although the Fairmont Orchid isn’t as child-oriented as a Disney hotel, there is an excellent “keiki” (child) program for 5 to 12 year olds, with special tours and activities. There is also a great tennis facility with ten lighted courts, a pro shop, teaching pro, ball machine, and everything a serious (or social) tennis player would need to be happy. I did find a group of Canadians who needed a fourth for doubles, and we had several great tennis games in the late afternoon. The Fairmont Orchid also features a “spa without walls” for pampering yourself in a secluded area right on the ocean. Of course there’s a gym and even a regulation beach volleyball court complete with antennas and lines. My wife and I played several great competitive games with a group from San Diego.

In addition to land-based sports, Hawaii offers truly wonderful ocean sports, and the Fairmont beach staff members are both expert and very helpful. There is excellent snorkeling right off the hotel, with many sea turtles and colorful tropical fish. There are stand-up paddle boards—with the option of a floating yoga class—as well as outrigger canoes, and beach-side yoga every morning.

There is much to do on the Big Island in addition to learning about anesthesia! Two of the highlights of my trip were the evening snorkeling trip with giant manta rays, and a helicopter trip to the volcanoes and windward side of the island. The hotel concierge made organizing these trips easy.

The Kona side of the Big Island has several protected bays that are the natural habitat for plankton, the primary food source for manta rays. These giant rays are harmless filter-feeders that don’t have teeth or stinging tails. For the last decade or so, dive companies have been running evening manta ray dive and snorkel trips. The dive boats are specially equipped with high-powered underwater lights that attract plankton. The manta rays come to feed, and provide an opportunity for humans to see them up close. It is an incredible thrill to be in the water with these gentle giants floating right next to you!

Another excursion that I highly recommend is a helicopter tour. Seeing an erupting volcano and active lava flow is a once in a lifetime experience! However, what I enjoyed even more was the flight along the inaccessible windward side of the island, hovering in the middle of an extinct volcanic crater with a ring of waterfalls cascading for thousands of feet in an area only accessible to birds! The flight back to the Kona side along the rugged cliffs was a close second.

The CSA Fall Anesthesia Conference offers world-class anesthesia education for four hours each morning, and still leaves ample time to enjoy all that the first-class Fairmont Orchid has to offer in a tropical ocean playground with stunning beauty. CSA Hawaii meetings should be on your bucket list!

Photos courtesy CSA 2014 Fall Speaker Keith Ruskin, MD, and CSA President Paul Yost, MD
Check out more photos from our Fall Anesthesia Conference on Facebook and register for our upcoming CME meetings in 2015!

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