San Francisco

I've just returned from a 10-day trip half-way around the world to Puerto Rico and San Francisco and back. 

Me racing under the Golden Gate Bridge in San Francisco at the ADA 5k.
Photo credit: Novo Nordisk

The study center visit to Puerto Rico provided a great opportunity to catch-up with the PEARLS clinical trial team at the University Hospital in Rio Piedras (see blog entry below). Albeit a relatively short visit of just four days, we crammed in many meetings to discuss progress and future plans, including phone meetings with our National Institutes of Health program officers up in Washington D.C.. Whilst the study is very challenging, the importance of undertaking health interventions in this underserved and overburdened community remains clear to us all I think, which keeps the team motivated. 

I left Puerto Rico late Thursday afternoon and flew via Houston to San Francisco, arriving at my hotel about 12 hrs later, in the early hours of the morning local time. The nine hour time difference meant everyone back home in Sweden was up and about, so I had a quick call with my wife to catch-up on life back home, before putting my head down for a few hours. 

For the past few years I've traveled extensively with work, clocking-up a couple hundred thousand miles of air travel. These trips often involve traveling to distant time zones, which can really mess with one's sleeping and eating routines, both of which are important determinants of metabolic health. So far as I can, I try to keep fairly aligned with European time, so I don't fall too far behind with work back home or suffer major jet-lag in either direction. Whilst getting up at 2 or 3am local time on the US east coast (8-9am back home) is doable for a few days, getting up at an equivalent time when I'm on the west coast (midnight local time) is completely impracticable, so a bit of jet-lag is inevitable! The early mornings allow time for a run or swim (usually in the dark!) and as well as conference calls with members of my team back in Sweden. E-mail responses are done by 5am, and an hour later I'll have located a cafe and be tucking into breakfast. By 8am, the first meeting of the day will have begun, with almost a full European working day behind me! The down-side to this topsy-tervy world is that nights are short, as dinner engagements often make getting to bed early impossible, but for a few days this is manageable.

My trip to San Francisco was for the ADA (American Diabetes Association Scientific Sessions), the annual Mecca for diabetologists in the US and beyond. The meeting attracts well over 10,000 clinician/scientists and includes hundreds of presentations on the state-of-the-science in diabetes research. These meetings are important events in my calendar, not only because they facilitate the exchange of new knowledge and ideas through formal presentations, but also (perhaps most importantly) because of the social networking opportunities. So I had many discussions on the sidelines of the congress, with almost every breakfast, lunch and dinner shared with past, present or prospective collaborators. 
   
The ADA, like many meetings for health scientists and health professionals, also includes a 5km run race for delegates and members of the local community. The race at this year’s ADA saw more than 1,000 people cross the finish line, with the fastest guys coming from Novo Nordisk’s team of professional runners, all with type 1 diabetes (see: www.teamnovonordisk.com/elite/).  

The start of the ADA 5km, with the Novo pros center and me far left.
Photo credit: Novo Nordisk

It’s half a lifetime ago that I last toed the line for a 5km race. With such a strong and deep field at this year’s ADA 5k, I knew the race would be fast. My hotel was a few kilometers from the start line, down by Pier 32 on the San Fran bay, right next to the Golden Gate Bridge. So I rented a bike from one of the many roadside bike stations around the city, and headed down to the start. The cold windy morning didn’t seem to have put anyone off, and the music and PA announcements blared out from a distance as I approached the start. After ditching my gear at the bag-drop, checking the course map, and catching-up with a couple of friends, we were corralled into the start area and moments later the gun went and we were off. Wow!! I’d forgotten how fast these things are. The three Novo Nordisk team pros went off like greyhounds out of the trap, with a thousand others in tow. I had no idea how to pace my race, as I haven’t come close to running this fast for at least a decade (perhaps two), so I just tried to hang with the front group as long as I could. I hit the first mile mark (1.6 km) in about five and a half minutes, with a bunch of guys ahead - all felt good. Living in a Sweden, where everything is expressed in metric units, I was trying desperately to recalculate my pace in mins/km, which felt analogous to the cognitive tests climbers do at high altitudes and divers do at the bottom of oceans to check their brains are working properly. Hypoxia was apparently getting the better of me though, and after a few rough guesses, I gave up and focused on running. At two miles the pace held and we hit a switch-back, which allowed a view of the runners coming up behind. The night before I’d had dinner with a great pediatrician friend and collaborator at Harvard, Marie-France Hivert MD, and her Canadian coworker Dr. John McGravy. Both are keen runners, and I knew John would be fast, having run competitively for many years through college and after. As I hit the switch-back I saw John was 10 meters down. Another half mile and we hit a second turn and headed back on ourselves, at which point John was hot on my heels, and with 400 m to go he passed me. My lungs were bursting as I tried to respond, but as we sprinted the last 100 meters to the line, I knew it was over, and I trailed in a second behind John at 18.07, to finish 9^th. What a great way to start the day!