Clinical Advances in Hematology & Oncology
March 2013, Volume 11, Issue 3
A few months ago, an Italian friend, Massimo Federico, asked me if I would be interested in participating in “La Cantera.” When I looked up the term and saw that the first definition was “quarry,” I wasn’t sure that I wanted to chop rocks, even if it was in Modena, Italy. Fortunately, there was a subsequent definition—relating to the famous Spanish Cantera of the F.C. Barcelona, currently considered the best of the European football teams. La Cantera refers to their program for developing young, aspiring, talented players. What Massimo was requesting was that I be the “Coach” for a team of junior hematologists specializing in lymphoma. The event was sponsored by FIL—Fondazione Italiana Linfomi—and required I spend 4 days with them, which in Cheson travel terms, is usually about 3 trips to Italy. He told me that it was the second La Cantera, and the first coach had been Volker Diehl. How could I possibly refuse the opportunity to perform some international mentoring and to be considered in the same category as Volker? After agreeing, I received the details from Massimo’s colleague Monica Bellei, who did all the organizing and would serve as my “Assistant Coach.” I was to arrive on a Monday, have dinner with introductions to the team and, over the next 3 days, give 6 lectures of about a half hour each followed by discussion for 1–1½ hours. The topics were “Milestones in Lymphoma,” “Standard Therapy for Lymphomas,” “Harmonisation,” “How We Get From Clinical Trials to Clinical Practice,” “New Lymphoma Drugs,” and “Response Criteria in Lymphoma.” I also had to provide a reading list for each of the topics. I was to prepare some case studies, and would discuss those that they would present. Finally, they would form into groups to develop potential research projects that I would critique, and decide on a winner.
So off I went. Massimo and Monica met me at my hotel prior to the first dinner and presented me with an official Real Madrid warm-up suit which, on the back, read—“Coach B.D. Cheson.” It was spectacular and I wore the jacket every day. At dinner, I met a delightful group of 12 young women and one man; 10 had traveled from all over Italy, and 3 from various cities in Spain. I forewarned my team that what they would be taught would be Lymphoma According to Cheson, and would likely be at odds with what they heard at home, even in the recently published ESMO Guidelines. That always intimidates the youngsters! But, things loosened up a bit after some prosecco, a nice local red, and an excellent meal. The next day we got to work, and it became immediately clear that there were a few who were more outspoken, while most remained a bit shy. I had to work to get them to ask enough questions to fill the time; but, they became progressively more interactive. Dinner was, again, excellent. A bit of wine, some grappa, and everyone seemed happy. The next day, the reticence was gone and they all got into it with lots of very thoughtful questions. They were particularly intrigued by the concept that we overtest and overtreat patients; unnecessary bone marrows, scans, maintenance therapy. It wasn’t how they were taught to practice at home, but my rationale made an impression. They did express some frustration that, here I was telling them about new and exciting drugs that were available in clinical trials in the U.S., yet they felt like children looking into the window of a toy shop—will we ever have the chance to study them, will we ever be given the opportunity to play a major role in clinical trials? I assured them it was possible.
That night, dinner was at an elegant “Pizzeria” with a superb “Cantina” (wine cellar). Sometime during the meal, and after several glasses of a regional merlot, the subject of rock and roll came up. Out came my iPhone, which played some tunes from my Oncotones days. They couldn’t believe that the old Prof/Coach was really doing the singing and playing, and it brought waves of delight. On the final day, I walked into our classroom only to find that one of the women who was from Modena had brought in a borrowed guitar! So after the presentations of their research proposals, they insisted I play for them. I played and sang while they projected the lyrics from the internet onto the screen so they could sing along—Blue Suede Shoes, Johnny B Goode, Like a Rolling Stone, and others. They were boppin’ and taking pictures of the venerable professor in his alter ego.
I couldn’t in good conscience give an award to one group and not the others, so I came up with “Best Science,” “Best Collaboration,” and “Most Original Concept” to reward everyone for their efforts. I was touched by how deeply they had bonded with each other, and I was optimistic that they would continue to communicate and, hopefully, collaborate. They were now friends, and from that lot could emerge the future of Italian and Spanish Lymphoma. It was truly an experience that would last with them for a lifetime.
I left with a bottle of 25-year-old balsamic vinegar, a Modena specialty (but, unfortunately, not with a Ferrari, the other Modena specialty); a large block of Parmigiano-Reggiano, the cheese of the region; and a wonderful cartoon of our group with their heads photoshopped onto bodies of a soccer team. But, most notably, I left with a sense that I had done something important for them. I had taught them not to accept doctrine without questioning, to be inquisitive, and to have confidence that they could do something meaningful in their careers, that they could make a difference.
Of all the activities I have participated in over these many years, La Cantera sits proudly at the top, and I am grateful to Massimo and Monica for giving me this honor.
Fino al mese prossimo . . .
Bruce “Coach” Cheson