Letter from the Editor

In 1984 I performed a lumbar puncture on a young man who had presented to our hospital in San Diego with a confusing constellation of issues: profound weight loss, progressive dementia and unremitting diarrhea. Although I didn’t know it at the time, Peter was the first of many hundreds of patients I would treat over the next five years as the AIDS pandemic ravaged my community and the world. In those first years virtually every AIDS patient died of the disease, and the experience of caring for those patients was one that profoundly affected me and those I worked with. I suspect that experience still influences the way we practice medicine and, more generally, the way we perceive life and death.

Over the ensuing years we have been joined by a new generation of physicians, and I never fail to marvel at the fact that for most of them the AIDS pandemic has little more relevance than, say, polio of the 1940s and 50s. And yet now, with them - these bright, compassionate and inspiring students and physician trainees - I have witnessed a wholly different type of viral pandemic. A pandemic spawned by a virus whose virulence perhaps is to be measured more accurately by its impact on our culture and society than by mortality rates. How will it affect those who replace us as caregivers? Will it affect them?

Who knows? Suffice it to say that living and working through these two pandemics has reinforced for me a conviction that the quality of life is to be valued far more than the quantity of life we expend.

So how in the world does this relate to headache? or, more specifically, relate to a magazine intended for migraineurs? Well, in terms of the public health, little on this planet degrades quality of life more than migraine. And while the practice of headache medicine is hardly glamorous, it does get at the crux of that for which medical practice is, ultimately, best intended: restoring and preserving quality of life.

May this current pandemic recede and your quality of life increase, and in its small way may this magazine serve to nurture that process.

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