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Reflections on the World Muscle Society

2021; Elsevier BV; Volume: 31; Issue: 10 Linguagem: Inglês

10.1016/j.nmd.2021.07.401

1873-2364

J. G. F. Miller,

History of Medical Practice

The year is 1995. OJ Simpson walks free from court, found not guilty of murdering his wife. ‘Next generation sequencing’ saw the birth of Dolly the cloned sheep. Eric Cantona notoriously delivered a kick to the face of a spectator in the front row of a Manchester Utd vs Crystal Palace football match and is banned from playing for 8 months. Baring's Bank, Britain's oldest merchant bank, collapses as a consequence of Nick Leeson's rogue trading, while mobile phones were little gadgets used simply for making telephone calls. DVDs made their first appearance and the Internet was just taking off, with just 1% of the UK's population having internet connection. Robert Metcalfe, co-inventor of the ethernet, predicted that the internet would collapse within a year, and, if not, he'd “eat his words”. He subsequently took a printed copy of his speech, added water, and perhaps a touch of vodka, put it into a food blender, and consumed it. In this same year, beneath an inconspicuous suburban London semi-detached house in a semi-subterranean network of low-ceilinged basement rooms reminiscent of a clandestine wartime printing press operation, seminal notions were brewing in the mind of a semi-retired medical professor, Victor Dubowitz, who had a spontaneous vision of a way to enhance the dynamism of a niche neuromuscular journal that he had founded with European colleagues five years earlier. Neuromuscular Disorders was cruising happily at a moderately high altitude but needed a booster to catapult it into earth's orbit and beyond. At the same time, two close collaborators in Italy experienced a similar flash of inspiration. Within minutes telephone lines between London, Bologna and Naples were buzzing red-hot - long before Zoom was a twinkle in the eye of any passing asteroid – and very soon after Victor Dubowitz, Luciano Merlini and Giovanni Nigro met in person and hatched a game-changing plan for the journal: the idea of a muscle society that would grow and support the journal to mutual benefit was thus conceived. After a period of gestation involving meetings and discussions to draw up a charter, a healthy, bright-eyed bouncing muscle baby in the form of the World Muscle Society was born, and a whole new muscle universe created. Central to the WMS has been its annual congress, so far, 25 in memorable exotic locations around the globe. At the helm of WMS in the early days was the Executive Board with the three founding members at its core: President, Victor Dubowitz; Treasurer Giovanni Nigro; and Secretary, Luciano Merlini. Striding forth into its bright new future, the very first congress was a modest size by today's WMS standards, held at the Commonwealth Institute in London in September 1996. Nevertheless it offered a rich program with many international keynote speakers and 170 posters. Attended by 200 international delegates, already firm allies and friends in their enthusiasm to develop the means to combat muscle disease, this first congress introduced a sprinkling of the magic ingredient that would go on to make the WMS a uniquely personal and interactive and thriving Society: a great networking banquet was organized afloat on the Thames to bring all delegates together to relax and socialize, consolidating friendships and forming new collaborations and strengthening ties. Inspiring company, tasty food and free-flowing wine. The following year the congress moved to the African continent, to Tunisia, in keeping with the Society's philosophy that the location of its congresses would not be static, but a globetrotting myological movement of academic exploration in many locations worldwide that would reach out to distant communities. In the late spring of 1998 the congress venue was Naples, home city of co-founder, Giovanni Nigro, who hosted this third successful congress. The social element of the Society moved a step upwards as this congress included not only a networking dinner, but the opportunity for many delegates to join a group excursion post-congress to the island of Capri on a gloriously sunny Sunday, where myologists could unwind and share the beauty of the island in like-minded company before dispersing to their homes. In 2002 the WMS congress venue was the lively port metropolis of Rotterdam, and registration reached “full house” and proceeded to an extended ceiling of 370 delegates. Following a packed scientific programm during the day, delegates were treated to an exclusive WMS-only tour and viewing of the exhibits at the Boymans van Beuningen Museum accompanied by wine and canapés, while on the following evening, delegates were invited on board a large vessel to enjoy a harbor tour, dinner and dance. The 8th congress of the WMS in 2003 was most appropriately held in Szeged, Hungary, coinciding with the 110th birthday anniversary of Albert Szent Györgyi, Nobel Laureate, myologist and humanitarian from the town and an excellent example for our growing muscle community. For a second year the number of delegates had way exceeded the notional ceiling of 300 and with demand for the congress clearly increasing the WMS Executive Board would have to put on its thinking cap to find a way to accommodate increasing numbers in future years while retaining the personal element and camaraderie that had become a hallmark of WMS. Amidst informal chat at congress social events there soon emerged a nickname for the World Muscle Society, the “Triple-E Society”, representing the tenets of the Society of Education, Enjoyment, Excitement. Not surprisingly, this has had many additional suggestions over the years at various times, including Ecstasy, Endeavour, Exploration and sometimes Exasperation as occasionally organisers encountered troublesome logistical hurdles. Meanwhile the Italian organizers of the 2007 Taormina congress put forward they imaginative suggestion for a new ‘E’ - EEEtaly! With each congress that passed, the scientific programm became increasingly packed and the hours extended. An additional E for the Triple-E Society, Exhaustion. By 2010, the duration of the congress was increased from 3 days to 4. Another E: Extension. This allowed for an extra half day on the scientific programm, but also the opportunity for delegates to take time out for one afternoon in the middle of the congress to help process and discuss with colleagues the immense amount of new learning they were taking on board by offering an excursion to a local place of interest. This first 4-day congress was in Kumamoto Japan, and the local organisers arranged an excursion Mount Aso National Park to experience the remarkable geological landscape with an active volcano as smouldering at its heart. In keeping with the WMS philosophy, the families and close friends of WMS delegates are encouraged and made to feel welcome, and accordingly all WMS congresses offer an Accompanying Persons programme. In Kumamoto, while delegates crammed their heads with new learning, their family members might be seen participating in a Japanese tea ritual, or dressing in traditional costume, kimono and hakama. Key tenet of the WMS has been to nurture the young and to support and encourage them from embryonic myologist to full maturity as scientists and practitioners, establishing and growing their own teams of enthusiastic young researchers. As the Society has grown and developed some real muscle strength, it has been possible to introduce an increasing number of fellowships for juniors, to subsidize their expenses on attending a congress. Starting with a modest dozen in Szeged in 2003, by the time the Copenhagen congress came along in 2019, over 70 such fellowships could be awarded. Not forgetting muscle experts from earlier years, now retired, WMS has also provided a handful of senior fellowships each year to encourage them to share in the congress activities, bringing their broad perspectives to the community. Prizes were introduced in the year 2000, for best oral or poster presentation in recognition of the resourcefulness and ingenuity of the younger Society members, courtesy of Elsevier, publishers of the Society's journal, Neuromuscular Disorders. In subsequent years the number of prizes soon increased and today there are 6 main Elsevier Prizes as well as 20 subscription prizes for Neuromuscular Disorders for the runners-up to nourish the hungry young minds and encourage them as they develop their careers. 2005 was an auspicious year, celebrating the 10th Anniversary of the WMS at a resort hotel in an idyllic setting not far from the Iguaçu Falls in Brazil where delegates enjoying views from their rooms of parroquets and toucans flying amidst an abundance of lush tropical greenery. Marking this anniversary year, Victor Dubowitz published his memoirs Ramblings of a Peripatetic Paediatrician and during a special celebratory dinner an auction was held for the first unbound copy, the proceeds of which would be used to launch a President's Prize Fund and the establishment of the President's Prize for Young Myologist of the Year. Two years later, this thriving Prize Fund was able to introduce a second President's Prize, for the best First-Timer in the muscle field, beckoning new talent moving from other medico-scientific disciplines into myology. Also in the early 2000s a new specialist prize was launched emerging from the personal tragedy of a talented violinist, Natalia van der Mersch, who had lost her baby daughter Léa to spinal muscular atrophy. At a moving recital marking the start of the Bruges WMS congress in 2006, Natalia launched the Léa Rose Foundation in memory of her beloved Léa by performing some beautiful melodies on her violin. A final specialist prize, also continuing today, was introduced in 2012 thanks to of the Duchenne Research Fund and was awarded for the first time at the congress in Perth, bringing the total number of prizes available for delegates up to 30. We are of course well aware of the many prominent senior experts in the field of neuromuscular disorders today. Take a look at the names of the young, unknown prizewinners from the early years of WMS and you'll see how many are very familiar now! There have been additional prizes, too, for regular congress attendees. In 2005 “ten-timer” trophies were bestowed on a group of 20 delegates who had attended all 10 WMS congresses to that date. In 2015 the twenty-timers were celebrated, numbering just 10 by then. By last year, WMS 2020 saluted the 25-timers with virtual certificates, the number having dwindled to seven: Victor Dubowitz, Eugenio Mercuri, Francesco Muntoni, Anders Oldfors, Haluk Topaloğlu, Jiri Vajsar, Thomas Voit. The competition is hotting up to see who will have managed to attend all 30 congresses by 2025. The organization of a congress when circumstances are set fair is never plain sailing, though one might be deceived by the outer calm of organizers, like swans gracefully floating on the water, while little webbed feet paddling frantically below the serene surface. But over the years congress organizers have found themselves navigating some unimaginably treacherous waters far beyond the routine challenges. There have been crises of all kinds. For three consecutive years around the turn of the Millennium the annual congress came close to disaster. In 1999 Turkey suffered a dreadful earthquake that had knock-on effects for the Antalya congress, while storms in the year 2000 caused severe flooding in South Africa and spurred frenetic activity as organizers of the congress, who were just finalizing details at a resort hotel in Skukuza National Park, had to abandon plans for the submerged resort and seek a new and dry venue at Witwatersrand. Then in early September 2001, a catastrophe borne of deep-seated human conflict. Taking an excursion at the end of the Utah congress to the great Salt Lake and Antelope Island on 9 September and absorbing the profound solitude and tranquility of this vast open space, one could never have imagined how the world would change within 48 hours. At the Taormina 2007 congress, delegates initially bathed in myriad founts of knowledge, drenched in the myo-knowledge of key speakers and posters, while keeping a cautious eye on a potentially fiery Mount Etna, not least because of an ominous deep grumble emanating from it in the distance. But the rumblings were “only” from thunderclouds. Followed by heavy, unremitting, precipitation. For hours. Into days. Zebrafish no doubt loved it, as did a number of opportunistic street traders selling brollies and wellies; meanwhile resolute delegates strode on, trousers rolled up or skirts hitched high as they waded through the semi-submerged poster hall; an unexpected additional and very soggy challenge to test their mettle and muscle in their quest for learning. By the final morning, some delegates awoke to find themselves afloat on their beds as their suitcase and other belongings quietly bobbed by. In spite of the challenges through the years, the feisty spirit of WMS has always prevailed, either weathering, dodging or out-manoeuvring the proverbial projectiles hurled in its direction. Clearly these regular challenges are no match for some of our congress organizers, who have had the capacity not only to keep the scientific programm on course, but also to actively participate in the evening entertainment. In Copenhagen 2019, Chair of the organizing team, John Vissing, surprised and delighted the audience on the opening night at Det Ny Theater as he stepped onto the stage with his guitar and accompanied a young and talented final year medical student, pianist and singer, Konni Kass as they serenaded the enchanted audience. And at WMS Berlin 2014, an enthusiastic band of musicians Echte Aerzte (“Real Doctors”) performed magnificently at the networking dinner, drawing myo-disciples inexorably to the dance floor. Amidst this bestetherscoped musical array comprising paediatricians, a neurologist, a psychotherapist and a radiologist was none other than co-organizer, Arpad von Moers. More usually known as an unassuming, diligent medic focusing on his needy patients, his alter-ego radiated on stage as he blasted out some magical riffs on his gleaming tenor saxophone. An enduring feature of the WMS myo-disciples is their unstinting endeavor to achieve healthy muscle. Closely allied to musical entertainment, this applies not only to the science and medicine but also to prowess in muscle movement on the dance floor. Alongside the serious science, an essential component of all WMS congresses is party and dance. Watch the transformation as reflective delegates, brows furrowed through concentration reading posters by day, emerge dramatically by evening on the dance floor. Flat shoes, reading glasses and notebooks all thrown to one side as myo-revellers don their white disco suits, shiny shoes, or sparkly party dress, stockings and stilettos and dance the night away, maximizing movement in the gluteus maximus, muscle-bound with boogie-biceps and pulsating pecs into the wee small hours. Here they are truly in their element. Indeed one of the key responsibilities of a WMS president has been to lead the way on the dance floor as we well as in the post hall and auditorium. On one occasion the president and other respected senior myologists, were obliged – in eager spirit – to attire themselves in Turkish dance robes and move hips and torso in oriental dance, with varying degrees of grace and ability. Size isn't everything, and just because something is miniscule, doesn't mean it can't be rather disruptive. For all the challenges that natural, geo-political or fiscal events that have been thrown in the path of a WMS congress but been successfully navigated, the COVID-19 micro-organism has proved to be the only entity to have sunk the preparations for a WMS congress - at least in physical form.Fig 2From posters to podium, congress days packed with learning and discussion.View Large Image Figure ViewerDownload Hi-res image Download (PPT)Fig 3Myo-acolytes delve into their favourite read.View Large Image Figure ViewerDownload Hi-res image Download (PPT)Fig 4Prize winners 2012: neuromuscular stars ascending in the skies over Perth.View Large Image Figure ViewerDownload Hi-res image Download (PPT)Fig 5Water and fire. (a) Taormina 2007: will it ever stop raining? (b) Kumamoto 2010: miscreant Mt. Aso disobeys signage.View Large Image Figure ViewerDownload Hi-res image Download (PPT)Fig 6Celebrating the 10th anniversary of the World Muscle Society, Foz d'Iguaçu 2005.View Large Image Figure ViewerDownload Hi-res image Download (PPT)Fig 7Hosts entertain. (a) Arpad von Moers wows myo-revellers on tenor sax. (b) John Vissing accompanies final year medical student, singer and pianist, Konni Kass.View Large Image Figure ViewerDownload Hi-res image Download (PPT)Fig 8Let's dance! Proximal and distal muscle movement is core in the daily lives of WMS delegates at work and at play.View Large Image Figure ViewerDownload Hi-res image Download (PPT) Not to be defeated by this pandemic, the WMS executive board and organizing team launched into action swiftly and boldly, encountering a very steep learning curve, and circumnavigated the troublesome virus by migrating the congress into cyberspace. And so the WMS Phoenix from its inferno despatched the covid iceburg into an ineffectual cloud of vapour. This Virtual Congress attracted nearly 3000 delegates, its virtual platform comprising many of the features of a real congress including a main lecture hall and poster rooms, with excellent opportunity for learning and discussion. That said, one cannot deny there has been a craving for the human contact that was just not possible on a virtual platform. We bide our time now for 2022 when the much-missed Real congress can return, and muscle afficionados the world over can rejoice in a real reunion for the postponed Halifax congress, complete with networking dinner extravaganza and rigorous myo-movement on the dance floor after three years of pent‑up power. Three years’ Triple Energy to be released for the faithful disciples of the Triple-E Society. The one person who has been the constant through the whole of the history of the WMS from its inception, and who has been its president for most of that time is its founding father, Victor Dubowitz. On the Society's 21st birthday and coming-of-age, he decided the time was ripe for some next generation sequencing and at the Granada congress in 2016 he announced that he would not stand for re-election to the Executive Board and would leave things now to the “youngsters”. He had watched the Society grow from a tiny three-cell cluster into a strapping, healthy and financially secure entity which now accommodated congresses with over 800 delegates and enjoyed great interest from industry offering sponsorship and support. Thank you, Victor, for bringing the Triple-E Society into Existence, and with your Endurance, Energy and Enthusiasm, raising and nurturing it to robust strength in adulthood. The future of WMS looks assured, in the safe hands of the Executive Board under the dependable presidency of Volker Straub, and supported by a solid Secretariat under the wing of Clare Beach guiding her phenomenal team. Long may the World Muscle Society thrive and expand and march forwards in its mission to cure muscle disease!