In America

At the end of a busy three weeks I take a trip to Boston to advise Big Pharma about the unmet needs in hematological oncology. Since the success of imatinib in CML everyone is into targeted therapy. It sounds good, but when it comes down to it there are just too many targets, and the drugs that are the excitement of the moment, Velcade and Revlimid, seem to block just about every pathway. So despite the brilliance of molecular biologists it is the clinicians who can point to where the effort should be focused. Readers of this blog could probably write their own script for CLL. We need something that doesn't also wipe out the T cells and we need something that kills cells that have lost their p53 genes.

The first thing that struck me about Boston was the new tunnel that moves you out onto the freeway in double quick time. The second thing was the weather. Almost as hot and humid as Singapore. The East Coast has been having tropical rainstorms and flooding, though it didn't rain in Boston while I was there. I flew business class by BA. The flight is less than seven hours so the red-eye doesn't take long enough to get a good night's sleep, even in those clever electric chairs that turn into beds. Instead, BA serves you dinner in the lounge before you fly so can at least get 5 hours shut-eye.

American television is never so good in America as it is in England. The News channels are parochial and everything is constantly interrupted by advertisements. Even on PBS you get thanks to all our sponsors, who are often the same people who advertise on the commercial channels. I enjoy watching House, ER and Gray's Anatomy. I was always a sucker for medical detective stories. I can leave aside the smooching and concentrate on the cases. My daughter is fan of CSI. But these shows take forever in America because of the adverts. At home I VCR them and fast-forward over the ads.

Americans are as friendly as ever and opinionated about their President (and his team/henchmen - strike one for whichever side you are on). I think this is new. It used to be that the President always attracted goodwill because of the office (like our Queen - we may rant about Prince Charles, but when he becomes King [Heaven forfend]we will revere him) but now somepeople haven't a good word for Mr Bush, and those that do haven't a good word for his opponents.

One of my correspondents, a poet with CLL, has written a new poem about the disease and posted it here. I think it captures very well the pathology of CLL and is very clever in relating the life of the tumor cell to the life of the patient.

The verse form is called a villanelle - you can Google it for an explanation - but he has departed from the strict rhyming structure. The best known example is 'Do not go gentle into that good night' by Dylan Thomas. I think that by using this verse structure he is evoking the memory of Dylan Thomas's poem, and expressing what most CLL patients feel - I shan't let this disease beat me without a fight.

There is a strange resistance in America to soccer and the World Cup. This quote from Andrew Sullivan's blog "Soccer is the perfect game for the post-modern world. It's the quintessential expression of the nihilism that prevails in many cultures, which doubtlessly accounts for its wild popularity in Europe,"

I guess this fits in with Gary Lineker's description, " Some guys in shorts and long hair run around in the sun for a couple of hours chasing a ball, then the Gemans win on penalties." It's certainly how the host nation beat the Argeninians this afternoon.