Next time I'll look at the Falls.

I've been 'off air' for some time. For those who don't know, I have been to Niagara to speak to North American CLL sufferers. The Canadian CLL group did a great job in organizing the meeting in a luxurious hotel complex at White Oaks, Niagara on the Lake. Apart from myself, the other medical speakers were John Byrd, Ronan Foley, Graeme Fraser and Susan Leclair. Bill Evans, the Chairman of Cancer at the Juravinski Cancer Centre in Hamilton gave an overview of cancer services in Ontario and Stephen Segar spoke about complementary medicine. In addition there was a patient advocacy session run by my old friend Laura Cleveland and Ryan Clarke.

The Friday was mainly for doctors and the Saturday mainly for patients.

I did in fact visit the Falls on the Friday morning. Since I was last there about 12 years ago there has been a lot of spending on luxury hotels and a couple of Casinos. The Falls themselves seemed unchanged. Pretty spectacular, but good for a day-trip rather than a week's vacation.

All seemed to be going well until around 10 pm on the Friday when I began vomiting.

I remember as a student, a consultant asked his assistant on a ward round (slyly criticizing a student's spelling), "Do you spell 'vomiting' with two 't's, Keith?"

Keith replied, "Only if it is particularly severe, sir."

This was vomitting.

It went on until the early hours accompanied by equally liquid diarrhea. I was weak and exhausted, hardly able to raise myself from the bathroom floor. The thing about luxury hotels is that they have telephones in the bathroom. I never knew why until now. I was able to contact the night porter, who summoned my host, Dr Foley. Don't tell his patients, but the kind Dr Foley does house calls at night. Ronan helped me back to bed, got me an anti-emetic and some fluid in the form of one of those Sports drinks that his high in electrolytes to replenish what I had lost.

I slept for a while, then started bringing up the Sports drink, then slept again. I had hoped to give my second talk on the Saturday afternoon but as the day wore on I was getting worse, not better. Eventually, Dr Foley had to get me admitted to hospital for intravenous fluids. I was so dry that I could not speak. Dr Foley negotiated me through the beaurocracy of the Niagara Falls hospital. It was a smart facility, newly built (with Casino money?). The Emergency physician just happened to be someone who was at Med school with Dr Foley and my time in hospital could not have gone smoother. I was given two anti-emetics and an anti-spasmodic iv together with two liters of iv fluids and allowed back to the hotel by 9 pm. Dr Foley stayed with me the whole time. The conference organizers booked me into the hotel for another night and put all my travel arangements back 24 hours. I spent the extra time in bed. The flight home was smooth and I have been taking it easy back here in England.

What caused it is anybody's guess. Was there a bug in the Niagara spray that I inhaled? Nobody else at the meeting was ill (apart from with CLL) so it is unlikely to have been the hotel food, and I did not eat anywhere else. Was it the food on the plane? Or perhaps the bar of chocolate that I purchased at Heathrow airport. Perhaps it was a virus?

I have lost 8 pounds. Every silver lining comes wrapped in a cloud. The Canadians were great hosts. Anyone can entertain a visiting speaker. It takes special qualities to care for a sick one.