- Del Meyer, MD - http://delmeyer.net -

Medical Writing

A professor of medicine told his students, “Make your textbooks and journals your friends. And always read one popular publication such as Reader’s Digest to keep up with your patients.” This has now evolved into “you better watch American Medical Television (AMT) for two hours every Saturday morning to keep up with your patients.” They come in wanting that new drug for the treatment of asthma, arthritis, cholesterol, prostate, and other problems, you know the one that replaces the one you have given the patient.

The American Medical Writers Association annual West Coast conference at the Asilomar Conference Center in Pacific Grove has concluded. There were a number of groups having conferences on the grounds, including the Youth Authority and psychologists, and the dining room was very efficient in serving high cholesterol meals at the rate of 30 per minute. It was a rewarding experience to meet with medical writers, editors, and authors from across the country and from Europe, and a privilege to meet Ed Huth, the recent editor of the Annals of Internal Medicine. We interfaced with editors and writers from the Cleveland Clinic, Mayo Clinic, and managing editors from other medical societies, as well as in house editors from the larger hospitals around the country. AMWA was started by Physician writers about 40 years ago and now includes any medical writer and editor that is interested. The faculty for the conference included professors from Stanford, UC Berkeley, UCSF, UCLA, USC, and Tufts.

The opening keynote address at the AMWA conference was by Dr.Ingram Olkin, PhD, Stanford Professor, who spoke of Meta-Analysis, the quantitative method of combining multiple scientific results. The “Info explosion” is beginning to confuse even the researchers. The sheer weight of Index Medicus has gone from 30 kgm in 1976 to 45 kgm today and will be 100 kgm by 2017. There are now 40,000 scientific journals with one million articles per year. The psychology literature has increased 10-fold in the last decade. It is estimated that 60% of articles are either trivia or duplication. New information will come from a large number of similar and diverse studies over a wide geographic area. The statistical combination of all this is what meta-analysis is all about. Meta-analysis is now being used to plan new studies.

The AMWA conference had a number of excellent seminars. In addition to biomedical illustrations (illustrations of accident victims designed for attorneys in order to demonstrate injury and thereby sway a jury seemed open to abuse), and FDA submissions (never receive a phone call from a government bureaucracy without a written confirmation of the conversation as you recall it), a popular seminar was Discerning “Right” from “Wrong” at the frontiers of life and death by Dr. Ernle` W. D. Young, PhD, clinical professor of Medicine and Pediatrics and Coordinator of the Center for Biomedical Ethics at Stanford. He covered major issues: Conception (the women’s movement could not have happened without birth control); Abortion (No meeting of the minds. Dr. Young felt abortions should only be allowed until the time when personhood occurs; when no one could agree as to when personhood occurs, a woman near the back stated that in her family her older brother was not thought to have arrived at personhood until he was accepted into medical school); Infertility (no law has ever said that fertilized ova are human beings); Surrogate motherhood (Is the purchase of a human body for parenthood any different than the purchase of a human body for other purposes, e.g., sexual gratification? Some felt Surrogate Motherhood was OK if done by a family member, free); the Genome Project (the critical line between treatment and enhancement–is it different than breast implants for treatment after cancer vs enhancement?); Persistive vegetative state (no consensus at this time–expressed concern about the Netherlands extending euthanasia when they were so close to the extermination camps.) He pointed out the positive aspects of law which allow society to get on with its business. In 1965, the federal courts ruled that States may not prohibit sale of contraceptives to married couples. This was later extended to unmarried couples and subsequently without restrictions. Society through law states that a conflict is now legal and the issue, e.g. contraception, is settled. Society can continue to fight about the other issues until further law (consensus) is developed.

The seminars which I looked forward to as a writer and editor were on the business of editing, medical writing, paragraphing in writing, issues in writing, etc. This was complemented by the informal evening fireside meetings. How does one write an opinion, an editorial, a column? It turns out the plans others used were similar to the ones we had developed. Where does one get his ideas? How long does it take to write a column? As long as it takes to make the deadline which for this journal is the first Friday of the month before publication. Since I send my columns out for independent review, my deadline is the previous Friday. How far ahead are columns stockpiled? Varies. Information comes from a wide variety of exposures and networks. Ideas which early on seem to meet the needs of a particular column may not hold muster as the deadline nears when 3000 words have to be reduced to 1500 words. This means that half of the ideas may get pushed down into computer memory for another day. On one occasion, with a sudden change in the “medical winds,” the entire column got pushed down one week before the deadline and a new one was written. This is made possible with a topical file and networking which was vastly expanded at the AMWA meeting and continues to provide us information and exchange of ideas for future articles and columns.

Coming home to the realities of life with seven SactoBEES on one side, seven SFChrons on the other, and a foot of mail in front of me, we received a call from a contributor, the journal’s lifeblood, who was insistent on talking for 30 minutes about a proposed article. It is interesting to get to know one’s colleagues on a different level during the challenges of being an editor and writer. It can be all engrossing. Like the practice of medicine.