I like the Summer BTS. It’s not as well attended as the Winter meeting in London, there’s a smaller choice of talks, it’s doesn’t have a pub right opposite into which to retire post conference, there’s a far smaller number of posters, talks, and it’s shorter, out there’s something relaxed about the Summer meeting that I like. It’s certainly nice to run into old friends and colleagues at these meetings.

The program is necessarily limited, as there’s not many rooms, but the organisers have sorted out a very interesting and diverse meeting.

I skipped this morning’s year in review, instead going to “Sarcoid”. It’s pleasing to hear that essentially everyone has the same problematic patients labelled with “Sarcoid”, who continue to have symptoms, deteriorating lung function, and more, despite having this seemingly straightforward, steroid responsive disease. Evidence not in abundance, but opinion valuable. PET scanning, gadolinium enhancing cardiac MRI, leflunomide, methotrexate at rheumatologically laughable doses. A great session.

I stayed in the exact same seat for the PE session, chaired by my old classmate Rachel Davies, now one of the pulmonary hypertension consultants at the Hammersmith – she’ll not thank me for mentioning that she was in the year above me at med schl, but she did teach me how to do ophthalmoscopy in the medical school bar.

What is a massive PE, what is a submissive PE? Who should we thrombolyse, who should we sit tight and watch? Luke Howard: “[vs tPA] placebo wins hands down”. How to set up a PE follow up service, but no clear decision on who to give life-long anticoagulation to – Patient preference was proposed as the first step… If we can’t decide, how can we expect the patients to decide??? A whistlestop tour of the novel oral anticoagulants wrapped up the morning session.

There might not be a pub round the corner at the Knavesmire, but the food onsite is always pretty good. Menu (with local Yorkshire translation from my step father): Tagine Lamb (lamb stew with an apricot in it); Salmon Mornay (fish in white sauce); mushroom risotto (something veggie).

Non-Tuberculous Mycobacterial Infection in the afternoon. Charles Howarth, Andreas Floto, Michael Loebinger, Rob Wilson – the usual top notch presentations, with gems of wisdom from Rob Wilson. The interactive voting system was out in force – nice to see the experts in the room and the audience completely disagree on management of complex NTM infection…

The Tour de France starts on Saturday in Leeds, stage 2 starts on Sunday in York city centre. The whole of Yorkshire has gone cycling crazy – it’s great to see. Usually when I visit God’s Own County I see a couple of folk out on their bikes; this year I’ve seen hundreds. Every shop has a bike in the window. Every village has a yellow bike on the village green. I cycled up Buttertubs pass on Monday – it’s pretty brutal, 1 in 4 for long stretches, and 1 in 3 for a short stretch. It might not be as long a climb as the Col de la Croix de Fer, but it’s steep enough!

Tomorrow, day 2 in the BTS house. Bronchiectasis, Lung Cancer Survivorship, Occupational Lung Disease, Interventional Procedures, Quandries in TB, and commissioning (not for the Scots and the Welsh). And what will be for lunch?