Digestive Disease Week (DDW) is always a highlight on my professional calendar. The cutting-edge science, innovative clinical updates, and world-class presentations are reason enough to attend year after year. But, if I’m being honest, as the years have passed, I’ve found myself increasingly looking forward to what I call the “DDW Shadow Conference,” the unofficial, often impromptu, and decidedly more social side of the meeting.
As a former chair of the Neurogastroenterology and Motility section, I have a deep appreciation for just how much work goes into making DDW a success. The effort to curate abstracts, select top-tier speakers, and design a seamless program is monumental, and the American Gastroenterological Association (AGA) continues to excel in pulling it all together. This year in San Diego was no exception — the AGA put on an incredible show. I want to be clear: my focus here on the fringe events isn’t meant to diminish the incredible academic work that takes center stage at DDW. Rather, it’s to highlight how these auxiliary experiences add a unique and irreplaceable layer to the conference that, for many of us, is just as essential.
The Journey Begins
The DDW experience kicks off before you even set foot in the convention center, starting with the trip to the host city. There’s something special about that flight to DDW, where the cabin feels more like a flying faculty lounge than a commercial airline. This year was a bit unusual: I flew out on Friday with no major events on the docket that day, which allowed for a relaxed start. My flight turned out to be a mini-reunion in itself — nearly half the passengers were fellow attendees.
I found myself in the middle seat, flanked by my good friend and colleague Dr. Aziz Aadam and my mentee Dr. Dustin Carlson, who crushed it at DDW this year with multiple high-profile presentations. While Dustin and Aziz were polishing their talks mid-flight, I shamelessly watched jiu-jitsu videos and a movie — benefits of having a lighter conference workload this time around. We landed late, and though many of my colleagues dove headfirst into the afterparty circuit, I opted to hide in my room to get some sleep for the grueling schedule over the next few days.
Saturday: Science and Socials
Saturday is always a whirlwind, with the conference kicking off in full swing in the morning and the evening offering a mash-up of formal obligations, working groups, and more relaxed social events. This year, one of the highlights was a reception hosted by Dr. Rena Yadlapati and Dr. Mark Fox at Ballast Point Brewing Company, celebrating the collective efforts of the esophageal working groups. Over 100 friends and colleagues gathered to toast the tremendous progress made in the Chicago, Lyon, Padova, Dallas, and San Diego Classifications.
It truly was a global event, bringing together collaborators from all over the world. The evening took a personal turn when my friends surprised me with an unofficial award recognizing my contributions as a trailblazer in esophagology. It was one of those rare, heartwarming moments where you reflect not just on the work you’ve done, but on the relationships that have carried you through. And as much as we love talking about the esophagus, it was refreshing to spend the evening catching up on family news and life outside of medicine.
Sunday: The Ultimate Balancing Act
Sunday is, in my experience, the craziest day of DDW. The academic program is packed from morning until late afternoon, and the evening becomes a delicate dance through a maze of award ceremonies, alumni events, and more shadow conference happenings.
Our Northwestern alum reception is always a key event, meticulously organized by our Education Director, who manages to coordinate everything from afar. This year threw us a curveball when our original outdoor venue fell through, forcing a last-minute relocation inside the Hilton. But, as always, the venue mattered less than the people, and we had a fantastic time. The event served as a perfect springboard for everyone to scatter off to the AGA and ASGE award ceremonies.
For me, Sunday night traditionally wraps up at what’s become a legend in its own right: the “Elmunzer Rooftop.” This impromptu gathering — brainchild of Dr. Joe Elmunzer and his close friends — typically materializes sometime Saturday, with details passed around by word of mouth and text. The rooftop offers a casual (and usually very late-night) space where many of the field’s leading endoscopists gather to catch up, recruit, and engage in what I like to call guerrilla networking. It’s a quintessential part of the shadow agenda.
Monday and Tuesday: The Wind Down
By Monday, let’s be honest, most of us are pretty fried and want to go home. The excitement of the first few days starts to fade, and the pull of home grows stronger. What keeps me going at that point are the younger faculty and trainees, whose energy and fresh ideas are always inspiring. Monday night is usually more low-key, with small group dinners and the beginning of the collective “escape planning” that signals the end of the conference.
Coming Home: Reflection
I know this reflection may seem light-hearted and, at times, even superficial. But this year, more than any before, the shadow conference took on deeper meaning. Our division suffered immense losses with the passing of two extraordinary colleagues, Drs. Ikuo Hirano and Josh Levitsky. They were not only brilliant academics and mentors but also cherished friends who had an incredible presence at DDW. Their absence was deeply felt, especially at our alumni reception.
It’s in moments like these that the true value of DDW — and its unofficial counterpart — becomes clear. The science is essential, but it’s the people, the friendships, and the shared experiences that make this conference a touchstone for so many of us. This year, more than ever, I leaned on my DDW family, and I am profoundly grateful for the community we’ve built together.
In the end, the shadow conference isn’t just a fringe benefit of DDW — it’s a vital part of what makes it so meaningful, year after year.
Dr. Pandolfino has no relevant conflicts of interest to report.
Illustration by April Brust
