Letter from the Editor
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For the healthcare provider who maintains a subspecialty interest in headache, a week can resemble one cycle of the ocean’s tide. On Monday the tide is high: clinics for the week are filled with patients who often have been waiting weeks or months to be evaluated for their headache disorders; the computer screen is filled with messages from established patients whose migraine has destabilized and who want an immediate response; also on the screen and interspersed with those messages are others from patients who wish to be treated immediately in the “headache rescue room” (see “A Third Way” in this issue”), from healthcare providers desiring work-in appointments for the headache patients they are referring and from healthcare insurers requiring completion of a prior authorization process or an appeals letter before the patient involved will be allowed to receive the therapy one has prescribed.
The week progresses, and by Friday evening the tide has receded: the last clinic patient has been seen; the “rescue room” now is closed for the weekend and, finally, the computer screen is empty of electronic tasks.
All too soon Monday arrives again, and the cycle is repeated.
These days it seems to me that all of us have been caught up in a cycle that similarly is mimicking the ebb and flow of the ocean’s tide. About 18 months ago, when this virus mysteriously emerged and spread so rapidly throughout the world, our lives changed dramatically. We wore our masks, kept our distance and washed our hands incessantly. The tide was high, and we endured a year that was tragic for some and strange for all.
And then, 8 months ago, it seemed an end was in sight. We lined up for our vaccinations, scrambled to fulfill long-delayed travel plans and in large part put aside our masks. The tide was receding.
Or maybe not. Words and phrases like “variant”, “long-haul” and “break-through infection” suddenly have assumed an ominous significance. Medications either forgotten (fluvoxamine) or unknown to me previously (ivermectin) are now part of my everyday conversations with patients and friends. The masks are back. Once again, hugs are at a minimum. And here as in Australia and Great Britain, many are asking, “Is it worth it?” Put another way, does the net gain in lives saved justify the societal cost of “shutting down”? Not a question easily answered.
In this section of last winter’s issue I noted that “intolerance and extremism thrive during times of great change”. In regards to the pandemic and the challenges it posed, I suggested that “History will judge us in large part according to how patient we prove to be in our dealings with one another.” If true, and if we seek a judgment that is positive, we have some work to do. This is indeed a tide in the affairs of men, and the path to good fortune will require more than excoriating the unvaccinated and confining our children to the basement. We need science leavened with equal measures of common sense and compassion. May it be so.
