The second Emergency Neurological Life Support (ENLS) course in Athens, Greece took place in May 2023, marking a significant post-pandemic milestone four years after the first course was held. Dr. Vasso Zisimopoulou, MD, MBA, a former Major in the Greek Air Force, once again assumed the role of organizer for this highly anticipated event. After spending six months training in the Neuro-ICU at Henry Ford Hospital in Detroit, she now manages one of the leading private neurology clinics in Athens. More recently, she joined forces with Professors Panos Mitsias and George Tsivgoulis to spearhead the implementation of cutting-edge Ischemic Stroke management therapies in Greece, including thrombolysis and mechanical thrombectomy.

Compared to its predecessor, the 2nd ENLS course followed a different format. Instead of being condensed into a two-day program, it spanned three days from May 4–6. Based on our personal experience, we believe this extended duration proved to be advantageous in several ways. Not only did it allow for a more immersive learning experience, but it also facilitated stronger and more active participation from attendees. The more relaxed schedule provided ample opportunities for in-depth discussions, fostering a deeper understanding of the course material. The venue was the Pasteur Hellenic Institute, with a spacious amphitheater located in the heart of downtown Athens.  

The course trainers included Sarah Livesay, the President of the Neurocritical Care Society (NCS); Panos Varelas, the Immediate Past-President of the NCS; Jose Suarez, Past President of NCS; and Christos Lazaridis, a well-respected colleague from the University of Chicago. All brought a unique perspective to the course and facilitated the dissemination of cutting-edge advancements in neurocritical care. 

In addition to the ENLS course itself, the three-day conference featured 3 captivating debates. The first focused on the feasibility of Late Endovascular Thrombectomy (EVT) without the use of computed tomography perfusion (CTP). Professor Papanagiotou, an Interventional Radiologist from the University of Athens, presented arguments against this approach, while our own Jose Suarez provided a counterpoint. The second debate dived into the intriguing topic of brain death as the ultimate form of "real death." Sarah Livesay and Panos Varelas eloquently argued opposing viewpoints, challenging the audience to ponder the philosophical and ethical implications of the topic. The last debate tackled the issue of whether intracranial pressure (ICP) monitoring in traumatic brain injury truly improves patient outcomes. Christos Lazaridis and Chariklia Vrettou, a Professor of Pulmonary Critical Care from the University of Athens, engaged in a spirited discussion that was backed by the latest research. As to the outcome of these debates, we shall follow the paradigm of ancient Greece and refrain from revealing the winners, as the purpose of such intellectual discourses was often to stimulate the mind rather than determine a definitive victor. 

The course attracted a diverse audience of 74 colleagues hailing from multiple disciplines, including neurology, anesthesiology, pulmonary critical care, and neurosurgery. Attendees spanned various experience levels, ranging from students and residents to seasoned attending physicians, with numerous dedicated nurses also present. The attendees demonstrated fluency in English, the language of instruction, which facilitated seamless communication throughout the course (despite rare interjections in Greek by Vasso, Christos, and Panos).  

The questions and discussions that arose from the course encompassed not only specific details pertaining to the diagnosis and management of patients with acute neurological emergencies but also the practical considerations of implementing this newfound knowledge within the Greek healthcare system. The audience exhibited a keen interest in both the theoretical and pragmatic aspects of applying these newly-learned principles to real-world scenarios.  

The overwhelmingly positive feedback received from the participants following the ENLS course’s completion serves as a testament to their appreciation for the course's content and format. We perceive this enthusiastic response as a reflection of the thirst for knowledge among our Greek colleagues and highlights their eagerness to stay at the forefront of advancements in the diagnosis and management of neurologic emergencies. In response to this enthusiasm, the course’s organizers are now considering the development of a specialized brain death simulation course in Greece as well as future ENLS courses in other major Greek cities such as Thessaloniki. 

As a gesture of gratitude, speakers who had traveled from afar and were burdened with mild jetlag were provided with two additional bonuses. The first was a dinner held on a terrace overlooking the illuminated Acropolis hill. The second was a trip to the ancient Poseidon temple in Sounion, situated 40 miles southeast of the city, with its breathtaking views of the Aegean Sea. The trip concluded with a traditional Greek feast, allowing the speakers to forge lasting connections with their Greek counterparts.

In conclusion, the 2^nd ENLS course in Greece was a great success and will hopefully be followed by future NCS courses. Our gratitude to the organizers, speakers, and participating colleagues cannot be expressed in words!