Canadian Family Physician

IN THIS ISSUE

• Clinical Review: The downside of weight loss
• Révision clinique: Les inconvénients de perdre du poids
• Physical Activity Series: Physical activity in type 1 diabetes mellitus
• Série sur l'activité physique: L'activité physique dans les cas de diabète de type 1
• RxFiles: Diabetes in the frail elderly
• Research: Emergency contraception
• Full Table of Contents
• Les visages de la médecine familiale: Gerald Moore MSc MD CCFP
• The Cover Project: Canadian Family Physician has embarked on a project to assemble the portrait of family medicine in Canada. Each cover of the journal will feature a family physician chosen at random from our membership list, along with a short essay—a brief glimpse of the person and the practice. Over time, the randomness will become representative and the differences, taken together, will define what it is that all family physicians have in common.

Gerald Moore MSc MD CCFP
Outside with his wife, holding a book and drink, looking out on the ocean and laughing: a small vessel needs scolding because it is in the way of a ferry; the ferry's loud horn then brays; the ship is slow to realize it is the reason for the sound. All these nuisance ships. An easy way to tell who's local and who’s not by determining who is in the way.  Dr Moore is often out on the water himself on a ship he rechristened Diastole, a 17-foot fibreglass sloop with inboard diesel, easy to singlehand, a pocket cruiser, the boat Canadian-made, by C&C at Niagara-on-the-Lake. He often sails alone, winter being the best time because the wind is up, the best time to sail in one of the best cruising grounds in the world, the Gulf Islands.  Diastole because of what sailing is and does; Diastole because of the relaxation phase, the unclench, the satisfied and watchful peace that comes with effort, the flowing along as a result of work, worldly concerns receding as the tide takes him forward.  There are several local races, another at Salt Spring Island, another at Victoria, and as in all manner of races with developed and sophisticated equipment, the idea is to make necessary marginal adjustments to gain just a few more feet. He has raced with patients, with colleagues, with family. Everyone watches the water with the appropriate wariness.  The 3 forms of medical emergencies pertaining to sailing as experienced on Pender Island are hypothermia for those overboard, carbon monoxide poisoning for those caught in enclosed spaces with inadequate ventilation and petroleum engines, or run-of-the-mill impalements and bumps.  Dr Moore once treated 3 children found by their parents late one evening. The kids were sleeping in the cabin; the diesel engine had been left running. They were somnolent, vomiting, and had headaches; after initial therapy, transport was arranged to a hyperbaric chamber. They lived.  You can die in the water; you can die out of it.  Outside, his property terminating at the ocean, Dr Moore is reading Patrick O'Brian's Navy by Richard O’Neill. O'Brian is a beloved author of a series of 20 books (among other titles) about life in the Royal Navy during the Napoleonic Wars. A main character in this series is Dr Stephen Maturin, the ship's surgeon, who serves on a brig-rigged sloop of war among other vessels. This character is famous for his ability to nearly drown. Diastole, from the Greek, meaning dilation. The ocean filling; the sails filling; the patients filling the clinic, systole.