Exploring uncertainty

Diane Kelsall

May Heaven bless this New Year. May it be a year of fruitfulness, of peace and prosperity; may it be a year of peace and unity for all mankind; may the world be freed of cholera.*

—Giacomo Meyerbeer (1791–1864)

At the time of Giacomo Meyerbeer, cholera was a mystery. No one understood where it came from or why some people would die and others wouldn’t. No one knew how to treat it or how to prevent it. The only certainty was that, when cholera did come, it would come quickly and result in widespread illness, death, and grief.

Mysteries. Enigmas. Puzzles. There are many aspects of medicine that we still don’t quite understand. In other words, we know that we don’t know. There are other areas, however, which we think we understand fully, where our understanding will be proved to be incorrect in time. After all, many of those researching cholera in the 19th century thought it was caused by miasma or “bad air.” It wasn’t until 1883 that Robert Koch isolated Vibrio cholerae and proved that it was the cause of the disease.

In 2007, Canadian Family Physician (CFP) will continue to explore areas of uncertainty. Do you routinely prescribe medications with codeine for postdelivery pain? Check out Motherisk ( page 33) for a tragic story that might call this practice into question. Each month, the debate section will delve into the pros and cons of various controversies in family medicine. How are you leaning on the issue of medical marijuana? See whether the rebuttals on page 22 will change your mind.

Throughout this year, CFP will be publishing new research that might change the way we think and practise. How do women make decisions about managing menopausal symptoms ( page 85)? What factors affect birth choices of women in rural communities ( page 79)? Are doctors who do procedures more satisfied with their choice of family medicinethan those who don’t ( page 93)?

In each issue of CFP, you will also find reviews of current literature on common problems in family medicine. Abnormal uterine bleeding ( page 58), diabetes mellitus ( page 73), and Alzheimer disease ( page 50) are some of the topics covered in this issue.

Emerging knowledge. Controversies. Practical information. 2007 promises to be an exciting year for CFP. I join Meyerbeer in wishing that this will also be a year of peace, happiness, and health, not only for you and yours, but for the many who are suffering around the world.