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For two years the COVID-19 pandemic has upended the world. The physician and medical historian Jacalyn Duffin presents a global history of the virus, with a focus on Canada. Duffin describes the frightening appearance of the virus and its identification by scientists in China; subsequent outbreaks on cruise ships; the relentless spread to Europe, the Americas, Africa, and elsewhere; and the immediate attempts to confront it. COVID-19 next explores the scientific history of infections generally, and the discovery of coronaviruses in particular. Taking a broad approach, the book explains the advent of tests, treatments, and vaccines, as well as the practical politics behind interventions, including quarantines, barrier technologies, lockdowns, and social and financial supports. In concluding chapters Duffin analyzes the outcome of successive waves of COVID-19 infection around the world: the toll of human suffering, the successes and failures of control measures, vaccine rollouts, and grassroots opposition to governments' attempts to limit the spread and mitigate social and economic damages. Closing with the fraught search for the origins of COVID-19, Duffin considers the implications of an \"infodemic\" and provides an cautionary outlook for the future.

\"In 1964, an international team of thirty-eight scientists and assistants, led by Montreal physician Stanley Skoryna, sailed to the mysterious Rapa Nui (Easter Island) to conduct an unprecedented survey of its biosphere. Born of Cold War concerns about pollution, overpopulation, and conflict, and initially conceived as the first of two trips, the project was designed to document the island's status before a proposed airport would link the one thousand people living in humanity's remotest community to the rest of the world--its germs, genes, culture, and economy. Based on archival papers, diaries, photographs, and interviews with nearly twenty members of the original team, Stanley's Dream sets the expedition in its global context within the early days of ecological research and the understudied International Biological Program. Jacalyn Duffin traces the origins, the voyage, the often-complicated life within the constructed camp, the scientific preoccupations, the role of women, the resultant reports, films, and publications, and the previously unrecognized accomplishments of the project, including a goodwill tour of South America, the delivery of vaccines, and the discovery of a wonder drug. For Rapa Nui, the expedition coincided with its rebellion against the colonizing Chilean military, resulting in its first democratic election. For Canada, it reflected national optimism as the country prepared for its centennial and adopted its own flag. Ending with Duffin's own journey to the island to uncover the legacy of the study and the impact of the airport and to elicit local memories, Stanley's Dream is an entertaining and poignant account of a long-forgotten but important Canadian-led international expedition.\"-- Provided by publisher.

For a decade, Canada and other countries have been wrestling with shortages of drugs, defined as situations in which an authorization holder for a drug is unable to meet demand. The causes are poorly understood, and so far, solutions have been aimed at mitigation rather than prevention. Here, Duffin examines whether drug shortages might be provoked by good doctors dutifully following clinical practice guidelines.

[...]the drugs that become intermittently unavailable in any given country are the drugs that it needs; many of the drugs are generic. The two agencies track annual drug shortages and efficiency in managing them. Since March, 2017, Canada requires companies to list drug shortages on a website, without yet publicly analysing the nature or rate of shortages. Since 2018, the European Medicines Agency and the Heads of Medicines Agencies collaborate through a joint taskforce as a clearing house for information about shortages in the EU; national reports were released in 2019, with a centralised list, built as an EU non-profit project. According to WHO, about 120 countries have such lists, dominated by low-income and middle-income countries.

The case report in this issue of CMAJ raises two intriguing questions. First, do humans really sweat blood? Second, what is the medical history of this phenomenon? Hematohidrosis has made brief but increasingly fewer appearances in dermatology texts. In 1895, Moritz Kaposi defined it as the occasional spontaneous oozing of arterial blood from the sweat glands, and he cited observations by distinguished predecessors, including Ferdinand Ritter von Hebra. In answer to the first question, then, ambivalence is evident. Nevertheless, a steady stream of reports prompted the physician couple Joe E. Holoubek and Alice B. Holoubek, both devout Catholics, now deceased, to publish a 1996 classification based on their careful review of 76 selected cases published from the 17th century to 1980. The opinion may have derived from the wisdom that some animals known to the ancients, such as the hippopotamus and certain horses, secrete red sweat long construed as blood. The physiologic possibility of bloody sweat also appeared in the work of Aristotle's successor, Theophrastus.

this research addressed the question: is musical memory preserved in dementia, specifically, dementia of the Alzheimer type (AD)? Six tests involving different aspects of melody and language processing were administered to each of five groups of participants: 50 younger adults, 100 older adults, and 50 AD older adults classified into three levels of AD severity—mild, moderate and severe. No test was immune to, but not all tests were equally sensitive to, the presence of dementia. Long-term familiarity for melody was preserved across levels of AD, even at the severe stage for a few individuals. Detecting pitch distortions in melodies was possible for mild and some of the moderate AD participants. The ability to sing a melody when prompted by its lyrics was retained at the mild stage and was retained by a few individuals through the severe stages of AD. Long-term familiarity with the lyrics of familiar melodies was also found across levels of AD. In contrast, detection of grammatical distortions in the lyrics of familiar melodies and the ability to complete familiar proverbs were affected even at the mild stage of AD. We conclude that musical semantic memory may be spared through the mild and moderate stages of AD and may be preserved even in some individuals at the severe stage.

Next appears Vesalius' masterwork, the enormous Fabrica (1543). It presents human anatomy in seven books of multiple illustrations. The frontispiece proclaims the author's anatomic agenda. Vesalius performs his own dissection of a female cadaver. Displaced assistant dissectors squabble on the floor. The animals that once informed [Galen]'s work are thrust to the periphery. The artist - possibly the Flemish Jan Stephan van Calcar - shows himself sketching the scene amid a crowd of onlookers that includes professors and students. Suspended above the cadaver in the place of the professor's lectern is a skeleton: Galen is dead. Beyond its blend of art and science and its astonishing contributions to anatomy, the Fabrica is a triumph of the technologies of book printing, less than a century after Gutenberg's invention of movable type. The drawings were carved into woodblocks that were transported across the Alps for printing at the workshop of Johannes Oporinus (1507-1568) in Basel. Just as anatomic images were rare in the mid-16th century, European printed book illustration in general was still in its infancy. A favourite early example of the medium is Hartmann Schedel's Nuremberg Chronicle (1493), a book that reuses identical images to depict different towns. A half century later, as distant landscapes were coming into sharper focus on printed pages, Vesalius turned an inquiring eye on the landscape of the human body, increasing the realist detail that viewers could expect from illustration. By insisting that the images be informative in themselves, Vesalius, his publisher and the artists and woodcutters who helped realize his visions were reimagining the possibilities of the new medium, even as they were deepening anatomic knowledge. A copy of this second edition, with its numerous marginalia, is the most exciting element of the exhibit. Its owner since 2007, Vancouver pathologist and bibliophile Dr. Gerard Vogrincic conducted a careful investigation that indicated the likely identity of the writer, but he could not decipher the comments.2 He involved Professor [Vivian Nutton], who confirmed that the notes are written in the hand of Vesalius himself and advised that Vogrincic deposit the book in the Fisher Library.3 The \"Toronto Vesalius,\" as Nutton calls it, contains over a thousand of Vesalius' annotations and instructions to his printer in preparation for a third edition. Given that the second edition had not yet sold out - to the great financial distress of its publisher - this third edition must have been entirely hypothetical. It was never published.