Cough is the third most common symptom and the most common pulmonary symptom that brings a patient in to see a physician. Breathlessness is not far down the list. Tom Hanks put Seattle in the theaters with “Sleepless in …” All the Seattle city tours take any willing visitor by the “Athenian,” a restaurant in Pike’s Farmers Market which Hanks frequented while he was doing “… in Seattle.”

“Breathless in Seattle” was the actual topic of one of the scientific sequences of the recent meeting of the American Thoracic Society. When the ATS scheduled its 1995 annual meeting in Seattle 6 years ago, the average attendance was less than half of the current 13,000 which arrived this year. Hotels were filled into the next towns. Those attending as well as the presenters included Pulmonary internists, pediatricians, surgeons, nurses, researchers and techs. This diversity was hailed as a positive influence on our discussions as long as we understood each other’s perspective.

One presenter tried to illustrate this perspective: An internist, surgeon, and emergency physician are waiting in a duck blind during the duck hunting season at which time pheasant, geese, quail, and grouse cannot be hunted. The internist jumps up when the first bird flies over, takes careful aim, and follows its flight. He thinks out loud, “This is probably a duck; rule out goose, rule out quail, rule out grouse, rule out pheasant,” as the bird left his view before he reached a diagnostic decision. The surgeon jumps as the next bird appears, shoots, and as it falls into the lake, states without equivocation, “That is a duck.” Finally the ER Doc jumps up as the next one appears, takes aim, shoots, and the bird drops into the water. He turns to the internists and asks, “What do you think that was?”… A physiologist later was heard to reply, “What difference does the type of bird make? Why would anyone want to shoot a feathered creature?

We went to Seattle the day before the conference having made dining reservations a month earlier for the Emerald Room in the Space Needle 500 feet in the air. It rotates about 6 feet a minute, one circumference an hour. Hence, we saw Seattle, its skyline, docks, harbor, Puget Sound with some of its islands, and the Olympic Mountains just before sundown and during sunset. All of the lights came on during our two revolutions. A circular map helped identify all the landmarks. I had my first of numerous Washington Salmon and Washington Chardonnays. (I saw of lot of people choosing midwestern beef and California wines. Why don’t they just stay home?) We reached the Needle via the Monorail from the building adjacent to our hotel. The Park Mayflower is a nongeneric hotel, with a soul. Its watering hole, “Olivers,” has a dozen different types of martinis, and wins the annual martini contest. Ever tried Stoli & Iron Horse? Its restaurant, “The Clipper,” is also an award winner with superb salmon.

This month marks the beginning of our third year with this HHK column. In one of our first ones, we reported on the medical uses of the hair dryer. The otologists says blow-dry your ear canals. The proctologist says to blow-dry your hemorrhoids. The gynecologist says to blow dry under your breasts. The urologist has now expanded the list to beyond “blow-dry behind the prepuce.” The testosterone transdermal delivery system (Testoderm patches) made by Alza Pharmaceutical in Palo Alto, has to be applied to the scrotum. Testoderm is absorbed 10 times more readily from the scrotal skin than from other skin sites. (I wonder how that works out teleologically?) Both the package insert and the video demonstration (thanks to Bud Kahl of St. George Pharmacy) point out that after dry shaving the scrotum, one can make sure the surfaces are dry by using a blow-dryer. It also suggests wearing briefs rather than shorts to keep the patch secure… Of course, otherwise it might show up at the ankles… Remember when our grandmothers were embarrassed by what fell around their ankles when the elastic in their bloomers snapped… But maybe men can now grow old, blissful and breathless?

Hope you’re having a summer of travel, fun, sports, leisure, or whatever strikes your fancy or gives you a change of pace.