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The Cover
October 23/30, 2002

Model of a Boat

Author Affiliations

The Cover Section Editor: M. Therese Southgate, MD, Senior Contributing Editor

JAMA. 2002;288(16):1947. doi:10.1001/jama.288.16.1947

From Antiquity, the river has been accorded mystical status. It is an object of coexisting opposites, simultaneously giving and taking. In its power are both the origin and the end of life; its length is the measure of a man's days, its twistings and turnings the vicissitudes of that life. At the end it is a way of passage to another life where the cycle of birth, journey, and rebirth begins again. To those who live along its banks, its cycles are obvious, like those of the moon; it is a bringer of life and a bringer of death in a most tangible, immediate fashion: in flood, it destroys; in retreat it becomes a fertile plain. It is a means of transport and a means of sustenance. Its surface carries cargo, its deeps the fish of the earth; its banks provide food and medicine. It is a barrier to be overcome, but in war it is a protection against the enemy. Small wonder the river is both feared and revered: To some it is a god, to others an evil demon. But always, it is someone to be reckoned with. If sometimes its behavior seems quixotic it is only because, like a god or a demon, the river can assume any shape it will.

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