I have just returned from the Eighth World Congress of Psycho-oncology, which was held in Venice on October 18–21, 2006, and attracted the largest number of attendees ever to participate in the annual scientific meeting of the International Psycho-Oncology Society (IPOS). There were close to 1500 participants from 58 countries. Professor Luigi Grassi of the University of Ferrara, the current President of IPOS, was the organizing chair of the Congress, and he and his local scientific committee did a magnificent job of hosting a most diverse and multidisciplinary meeting. A Pre-Congress Psychosocial Academy, consisting of two days of intensive workshops led by outstanding international faculty, was held in beautiful Ferrara, just prior to the start of the Congress in Venice. As the incoming vice president of IPOS, a member of the Psychosocial Academy held in Ferrara, and an active scientific participant in the Eighth World Congress in Venice, it is fair to say that I was pretty busy. In fact, because of all of my activities related to this conference and IPOS, I was away from home and work for nine full days, the longest time I've ever been away from my family. This commitment of an unusually inordinate amount of time to a scientific conference activity made me sit down and evaluate whether the commitment of that much time was really worth it. I was aware, the entire time I attended the conference-related activities, that I needed to come away with at least one important lesson, idea, thought, or inspiration; otherwise I would have felt that I had not spent the time wisely. In other words, I needed the answer to the questions “What brought me to Venice, and where was I going beyond Venice?” Existential questions? Of course!
The Psychosocial Academy in Ferrara was extraordinary. The workshops were held in an ancient Jesuit monastery. The acoustics were terrible. The space was alternately too cold and then too hot. But the spirit of the search for knowledge and truth was palpable in the air and on the surfaces of the walls and floors. Fifty psycho-oncologists, from 20 countries, of all disciplines, ages, and experience levels, spent the entire day learning about meaning-centered psychotherapy from my research fellow Shannon Poppito, Ph.D., and myself. It was exciting to see how my group's work in developing these novel psychotherapy interventions for patients near the end of life resonated so positively and powerfully with clinicians from all over the world. While a positive experience, it was not that dissimilar from other teaching experiences I had had before in countless cities and varied settings. This was, alas, not the reason I made the trip.
The bus ride from Ferrara to Venice was short and uneventful, although the scenery was quite beautiful. Arriving in Venice was confusing and hurried. I had never been to Venice before, and so only had the images of Venice captured in countless films I had seen as a barometer of what to expect. My first impressions of Venice were a bit disappointing, but I had little time for sightseeing. We rushed to the hotel, changed quickly, and then rushed to the site of the Congress (which was not in Venice proper, but on the mainland, accessible only by going over a bridge by bus or car) for the opening plenaries and opening ceremonies.
The Congress itself was overwhelming in terms of the variety and breadth of science represented. There were some 800 poster presentations, workshops, and symposia on everything from communications skills, to cultural diversity, psychotherapy interventions, pharmacotherapy interventions, cancer survivorship issues, cancer and the media, bioethics, the family and cancer, existential and spiritual issues, as well as psychiatric and psychosocial aspects of palliative care. Hundreds of copies of Palliative & Supportive Care were distributed at the meeting. There was even a workshop on how to get your manuscript published, led by a panel of six international journal editors (I represented Palliative & Supportive Care). The meeting's scientific content was superior, although I must say that I had little time to attend other speakers' talks because of my own speaking schedule. One session stood out: a plenary session on spirituality that consisted of a panel responding to the themes evoked by a scene from the 1927 Luigi Pirandello play, The Man with the Flower in His Mouth. The scene from the play involved two strangers at the train station who sit at the same table and engage each other in conversation. One is a businessman who missed his train because he was so distracted running errands and shopping, the other a bohemian artist who, as we learned, has disengaged from life and his loving wife, in response to a diagnosis of oral cancer (an epithelioma—the flower). The play evoked numerous existential issues including the limitations of life, responsibility, freedom, groundlessness, death anxiety, and, in particular, existential isolation and meaninglessness. The play was a highlight of the meeting. I learned the power of the humanities and the arts in teaching existential issues, but I sensed that this also was not the lesson I was meant to learn on this trip.
Of course there were the parties: a Gala dinner at the Excelsior Hotel on the Lido, dinners with good friends from all around the world, making new friends from exotic locations like Forli, near the Adriatic coast. But then there was Venice itself. The Congress location made it difficult to just leave the scientific sessions and walk through the city of Venice. My schedule at the Congress also made sightseeing impossible. I had only two occasions to see some of Venice, both near dusk. On my second evening in Venice I decided to walk from my hotel to the restaurant where a group of current and former Memorial Sloan-Kettering faculty were gathering. I walked from the Rialto Bridge toward the Piazza San Marco. The shops, the clothes, the jewelry, the glass, the food! So this is Venice! I walked along narrow streets, winding left then right, following signs to San Marco. Suddenly I emerged into this vast open space: The Piazza San Marco. Breathtaking! Magnificent! A wonder of the world! I walked through the piazza, turning around and around in a circle, trying to take it all in. It was beautiful. Almost too beautiful to believe that it truly existed. Then the flooding. Part of each day the entire piazza is submerged beneath two feet of sea water. All this beauty was transient. It would not last forever. It was only going to exist for a few more decades before it was irreversibly submerged, unless something dramatic is done to save this unique treasure. On my last night in Venice, a group of us got lost trying to find a specific restaurant. What a wonderful debacle. Venice was filled with beautiful churches, palazzos, piazzas, everywhere. I vowed that I would come back again to Venice, because I had only been allowed a glimpse of its beauty. I would return with my family and really explore its beauty. But, somehow this also was not the reason I had traveled so far for so long.
On Sunday morning at 8 a.m., a water taxi picked me up from my hotel for the trip to Venice's Marco Polo International Airport. That morning, Venice was shrouded in the thickest fog I have ever encountered in my life. It was only the driver and me in this water taxi, so I stood at the front of the water taxi next to the driver as we cut through the dense wet fog with breathtaking speed. Speeding through the wet mist of the fog was exhilarating. The fog was so dense that I could see only 5 feet ahead of me. As I rapidly sailed through the fog of Venice, I felt as if I were speeding through some worm hole in space, able to only see a few feet around me. Everything was cloaked by the dense fog. I saw nothing else. We traveled through the Grand Canal, and then past the Piazza San Marco and all of those beautiful churches, and towers, and palazzos. I had a sense that they were there, but I saw nothing, I heard nothing, I had no tangible sensory evidence of the existence of the incredible beauty of Venice that lay beyond the fog. This heaven on earth was all hidden from me. If I had not seen the Piazza San Marco the day before, I would have had no idea that it existed. At least I thought I saw it. Or had I just dreamt it? I had not taken any pictures as scientific proof. No, I believed that I had seen the beauties of Venice. I had faith that it was there beyond the fog. All my senses were ablaze, but these senses could not perceive Venice in the fog. Yet I did have a sense that it was there, because of my experience, and my belief that it existed. This was the reason I had taken this trip. These moments in the fog of Venice. The realization that because of our limitations as human beings, we could travel through a world of incredible beauty and not perceive that it existed all around us. The lesson of the trip was all about what lies beyond the fog in Venice.
