Left behind.

Ah, the sights and sounds of convention season, otherwise known as fall--the signs are unmistakable. Workdays get shorter and speeches get longer. Ice covers the salad bars and fills the cocktail glasses. Vendor sales reps change color and fall from their barstools.

At the American Health Care Association (AHCA) convention in Las Vegas, the scene was unforgettable, and I wish each of you could have been with me as I strolled along the Strip each night. From Circus Circus to the Bellagio, rows of dedicated, bleary-eyed nursing home professionals filled blackjack tables and pulled slot levers, each committed to personally solving the nation's senior care funding woes. They were passionate. Driven. Some of them were even crying. I don't think I've ever been so moved.

Later in San Antonio, a few thousand members of the American Association of Homes and Services for the Aging (AAHSA) strolled into town. It was a fantastic experience, and I hardly know where to start in describing it. The opening general session took place in a big room filled with chairs filled with people filled with free coffee and bagels. The chandeliers and video screens were enormous, the mood electric, the speaker inspiring. Welcomes were delivered, stirring pronouncements made, continuing education cards punched. It was the perfect start to a perfect day.

[ILLUSTRATION OMITTED]

And now I have to admit something. I wasn't there. Not in Vegas. Not in San Antonio. I wanted to go. I begged and pleaded for someone, anyone, to send me. I generously offered to let the editor of this very magazine pay for my travel, food, entertainment, and lodging. I did everything but steal Girl Scout cookie money, but all to no avail. So here I am, left behind. Alone again, naturally.

While I'm getting things off my chest, I suppose I should also confess that since I write this column months before publication, these events haven't even happened yet. But under the circumstances of my inevitable future absence, I'd like to make a few predictions. In the course of the 2005 fall conventions, certain things are almost certain to occur:

* A PowerPoint presentation will freeze, and audience members will soon be on intimate terms with the speaker's Windows welcome screen and personal desktop icons.

* Two hundred people will pack into a seminar space intended for 50, while just down the hall five will enjoy a room for 1,000.

* A cell phone will ring in the middle of "Benchmarking HIPAA-Compliant MDS Strategies for Macroeconomic Risk Management"--and defying all rules of propriety and civility, its owner will answer it. Out loud.

* AHCA members attending Elton John's Caesars Palace show will be thrilled to discover he has rewritten the words to "Candle in the Wind" for the 22nd time, crooning "Hello, survey team," while three dozen showgirls form the Quality First logo.

* The words "tipping point," "sustainable future," "culture change," and "staff empowerment" will be used 473 times, and that's just on the bus to registration.

* A helpful woman, possibly named Sue or Karen, will be tasked by a much more important and better-paid male colleague, probably named Mark or Ken, to take extra-thorough notes and pick up a lengthy list of session handouts. It seems Mark/Ken has an important business meeting at 10 a.m.-9:30 if he's going to practice his putting first.

* A balding, goofy-looking gentleman will purchase ten Excedrin for $53.99 at the hotel gift shop, and ruefully wish he had made better choices last night. Oh wait, I didn't go this year. Never mind.

* A new session headlined "Continuous Quality Improvement the FEMA Way" will be poorly attended.

I'm no Nostradamus, but I feel these are extremely educated prognostications, fired in the crucible of experience at more than a dozen long-term care conferences over the past five years. So many memories dot the corners of my mind. Like flying into Boston shortly after 9/11. Tiptoeing around piles of anthrax on the sidewalks of our nation's capitol. Standing scalp to hairpiece with Newt Gingrich, almost stepping on Michael Dukakis, and getting lost in the eyes of a former Miss South Dakota. I've walked to Starbucks and back during pauses in one of Dick Gephardt's speeches. I've watched Tom Scully cast his diabolic spell, wept to the verbal stylings of Mitch Albom, and seen fire shoot from Nancy Pelosi's nostrils.

With this wealth of relevant perspective, I feel qualified to ask some nagging questions:

* Why do associations plan conventions in cities with so many recreational and nightlife distractions that it becomes almost impossible to show up for any actual meetings? Maybe attendees should be sequestered, like the O.J. Simpson jury, or quarantined like Apollo astronauts. Or perhaps a permanent location should be chosen, one without amusement parks, beaches, historical landmarks, fancy restaurants, or other carnal temptations. I suggest the Sonoran Desert or northern Saskatchewan.

* Where did this vendor booth giveaway thing get started, and how did it get out of hand? Why are we so drawn to shiny objects and trinkets? Do I really want a key chain that constantly reminds me of wound care, or a bottle opener shaped like an Enablex tablet? How practical is a chocolate mouse pad? Has anyone actually ever said, "What a great squishy stress ball! Please tell me more about Barney's Medical Supply Co." I think not.

* What do I do with five years of commemorative tote bags covered in sponsor logos? They're everywhere I turn, taking over my house, garage, and storage unit, running amok like kudzu or zucchini. It's like I'm living in a remake of The Birds--but with small pieces of flying luggage lurking about me. I think they must be mating, and I hope one of these years AHCA will give away a much larger tote bag so I'll have something in which to store my tote bags.

Like most of life's riddles and puzzlers, perhaps there are no satisfying answers to these great mysteries. But I'll continue undaunted in my quest for truth, which also means admitting that for all their amusing idiosyncrasies, these massive national conventions represent a surprisingly effective instrument for all concerned. Business does get conducted, important information is shared, relationships are formed, synergies created. Beyond the weak coffee, bad hotels, and long hours on torturous chairs, something truly special happens each fall when nursing home people get together.

So here's a final revolutionary thought for providers, who I know hang on my every word of counsel. How about sending a few more frontline caregivers to these events? I know money is tight, but your investment will be richly repaid. They'll treasure and be empowered by your affirmation, fill their tote bags with supercharged enthusiasm and cart it all back home multiplied exponentially, infusing those who remained behind. If you've ever attended a NAGNA (National Association of Geriatric Nursing Assistants) convention, you know exactly what I'm talking about.

There's something amazing and inspirational about the collective energy of an underappreciated profession, and conventions are a perfect time to maximize it. Wherever long-term care professionals are gathered at this time of year is always my favorite part.

I just wish I could be there to see it. Oh well. At least I have the memories--and this candy-coated highlighter/divot repair tool I got last year at the Care e-Osity booth.

Gary Tetz is the former editor of SNALF.com and SNALFnews.com, and writes from Walla Walla, Washington. To send your comments to the author and editors, e-mail [e-mail]. To order reprints in quantities of 100 or more, call [phone].