It was deeply troubling to learn that the Morbidity and Mortality Weekly Report was not released last week for the first time in my memory. This important report is published weekly by the Center for Disease Control, however communications at several federal health agencies are now under a temporary freeze by the new presidential administration.

This is profoundly disappointing and heartbreaking.

In the summer of 1980, the Morbidity and Mortality Weekly Report was my lifeline as a newly minted 26-year-old doctor in the United States Public Health Service. With medical school training at Dartmouth in New Hampshire and a one year rotating internship at the University of Colorado under my belt, I began my three-year obligation as a general practitioner in the underserved community of Provincetown, somewhat anxious about the prospect of having to independently care for a year-round population of 5,000 and a summer population of 50,000 in a small health center 50 miles from the nearest hospital.

With youthful enthusiasm, a mop of long curly hair and a solid reference medical library, I undertook what in retrospect was an audacious assignment.

Historical Provincetown on the tip of Cape Cod was a most unique melting pot comprised of families of merchants and working commercial fisherman of Portuguese/Azorean descent, old Yankees dating back to the Mayflower, a vibrant creative community of artists and writers, and a significant population of gay men and women whose numbers increased exponentially during the summer months along with throngs of sun-seeking tourists.

My training allowed me to confidently deal with management of chronic diseases such as diabetes, hypertension and emphysema as well as routine pediatric and early pregnancy care. Trauma frequently interrupted my schedule, for minor injuries such as fishhook removal or laceration suturing, or major care for near-drowning or fractures. The local rescue squad brought patients to the clinic at all hours, or would bring me out to remote sites when needed. All in all, a true trial-by fire and incredible challenge for a young inexperienced physician.

One area that required deeper resources was treatment of infectious diseases, which were amazingly common and varied. With the help of photographs in dermatology textbooks, skin lesions were identified as Lyme Disease and Rocky Mountain Spotted Fever, then uncommon tick-borne diseases. Pediatric rashes such as hand/foot/mouth disease could be differentiated from chicken pox.

Fish-handler’s disease required different care than other ulcerating skin infections. The same resources were invaluable in differentiating the presenting signs of  sexually transmitted infections, and it soon became apparent that the gay men who came to Provincetown from around the country would provide me with quite an education in this field.

The weekly updates from the Morbidity and Mortality Weekly Report provided practical guidance in these and many other cases, alerting me to trends in communicable diseases and optimal current treatment options. The slim pamphlet issued by mail every Thursday became an invaluable trove of timely medical information, and in the pre-internet age a lifeline that connected a rural family doctor to the world. I read it cover-to-cover and always learned something valuable and applicable to my practice.

By the summer of 1981, with a year of experience as a general practitioner under my belt, I was confident in my knowledge and abilities and comfortable with the broad range of practice. It was then that a number of young men began to present with unusual illnesses, such as widespread swollen lymph nodes as seen in certain cancers, and non-viral pneumonia that didn’t respond to usual treatments, and strange purplish rashes that were unfamiliar. Small surgical biopsies of the lymph nodes were deemed equivocal by the pathology laboratory I sent them to. And then, suddenly, these young otherwise healthy patients began dying. It was mystifying and terrifying and overwhelming.

On June 5, 1981, the Morbidity and Mortality Weekly Report published a report of five cases of Pneumocystis carinii pneumonia (PCP) among previously healthy young men in Los Angeles. All of the men were described as “homosexuals”; two had died. The editorial note that accompanied the published report stated that the case histories suggested a “cellular-immune dysfunction related to a common exposure” and a “disease acquired through sexual contact.”

Additional case reports came in from New York City, San Francisco and my little outpost at the end of the Cape. For the next two years I cared for, and sadly lost, many more patients with the condition first known as ‘diffuse lymphadenopathy of gay men’.

Epidemiologists from the Center for Disease Control worked locally with my patients to identify the major risk factors for the condition, then also referred to as “quatre h/4h’s” (homosexual, heroin user, hemophiliac, Haitian).

Within months the Morbidity and Mortality Weekly Report issued recommendations for prevention of sexual, drug-related and occupational transmission based on these early epidemiologic studies and before the cause of the new, unexplained illness was known. The Morbidity and Mortality Weekly Report went on to publish hundreds of ongoing reports about human immunodeficiency virus (HIV) and AIDS as knowledge evolved. To this day it remains a primary source of information about the epidemiology, surveillance, prevention, care, and treatment of a multitude of diseases afflicting people nationwide.

As a physician going on 50 years of practice, must I say that all politics aside, medicine is imperfect at times, but the dedication to relief of human suffering should nevertheless be supported by every possible resource, and in particular the Morbidity and Mortality Weekly Report.

Dr. Steve London lives in Oak Bluffs.