A celebrated Polish pianist, Waldemar Malicki, opened the Wonca Europe conference. A masterful performance by a maestro. His improvisations were funny, fascinating, and faithful to the theme of the conference; science and art. He drew different emotions from the same melody- from humorous to heartbreaking, uplifting to depressing, and showed how music tells a story far beyond the notes on a score. Playing variations on well known pieces in the styles of various composers he toyed with our musical preconceptions. He reflected on the huge interest in the piano in China, acknowledging the dedication, commitment, and sheer numbers of pianists. Deadpan, he suggested that there could be 8 million Chinese entrants to the next Chopin competition in Warsaw-and, all so accomplished, all would be invited.

Greg Irving (UK) played almost the same tune. In the first academic presentation on the first morning, he described a systematic review undertaken in collaboration with colleagues in Peking University, on the protective efficacy and safety of the Hepatitis A vaccine. They found 17 trials, four from the west and 13 from China. The Chinese studies were enormous and limited only by methodological rigour. His was the same message – the incredible potential for Chinese research powered by the sheer scale of their population. With method issues ironed out, they will produce high quality research on an industrial scale. Just like the Chopin competition, editors can expect a flood of submissions.

Kathryn Hoffmann (Austria) identified another challenge for editors. Her paper described a systematic search of the grey literature on antibiotic resistance in primary care in Austria and identified work predominantly in German. As an editor looking at such work – how should one search the grey literature, what languages should you use, and what search engine is appropriate? Indeed, should editors demand that systematic reviews always include the grey literature? And furthermore is it valid to restrict a search only to English? Reflecting on Greg Irving’s work, we should always include Chinese literature. Later in the day, Ana Dantas (Portugal) included not just work in English but also the Portuguese and Spanish literature, the first languages of many of the delegates, in her systematic review. And, I was impressed by the French primary care journal Exercer edited by Denis Pourchain with Jean-Pierre Lebeau (France) opening up a whole new range of relevant research. Chapeau! English may be the established language of scientific communication but, by looking only to research in English we miss a lot.

Late for the dinner, I found myself placed with some new friends from Portugal, Slovenia, Norway and a Peruvian based in Barcelona. The conversation was in English. How I admired their ability to communicate in their second language… and felt so inadequate.

Domhnall MacAuley is primary care editor, BMJ