The following article is another in a series of papers presented at the Annual Meeting of the Western Association of Physicians. The WAP meets in Carmel, usually in the first week of February, along with sister organization the Western Society for Clinical Investigation and the Western Federation for Clinical Research. These meetings are designed to offer members and guest physicians broad updates in multiple specialties of medicine and basic science. This eclectic approach provides broad cross-fertilization of ideas, often leading to scientific collaboration. Readers of The Western Journal of Medicine are encouraged to register and attend the meetings. The scheduled program for future meetings will be published in the December issue of the journal.