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الأربعاء، 8 فبراير 2012

The world needs one hundred doctors

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No.1 vs. mediocrity – Fart in a teacup – Commitment – Schedule –
Structuring  – Internet supplement – Language – Editorial team –
Mentor – Time frame – Deadline – Team of authors – Budget
The decision has been made. You intend to take on one of the 100
important medical topics and contribute to the task of making medical
information available without restriction and free of charge. As you
know, if your book project is well-organised, it can be completed in 9
months, 12 at the most.
Before you begin to structure your topic and put together the group of
authors, here are a few brief comments concerning your own personal
qualifications.
Personal qualifications
Firstly: in order to write a medical book, you need expertise (Table
2.1) and time (Table 2.2).
Secondly: you can’t write a clinical Flying Publisher textbook all by
yourself. Standard textbooks are joint efforts. You should therefore
know enough experienced colleagues who can take on a chapter of
your project and deal with it competently. This assumes that you know
your way around the national scene. This requirement can usually
only be fulfilled if you come from a university institute or one of the
big teaching hospitals.
The time factor needs to be considered. Getting a textbook on track –
i.e. writing the first edition – is not for the faint-hearted. A rule of
thumb is: most texts are produced between 9 p.m. and 2 a.m., and
evolve at the expense of family and friends. This means that at least a
minimum level of enthusiasm is necessary. Sometimes, the thought
that the sacrifice is only temporary and the subsequent editions will
require considerably less work can help. In addition, youth is an
advantage. The fifth decade should be exactly right. You push the
project through and then say “never again!”, because that’s life. Some
things you only do once, but once they are done, they are done. Think
of Andy Warhol: “It's work, the most important thing is work.”
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If the basic conditions are favourable, you can begin planning the
project. Set aside a month for this task. But first, here are two thoughts
which will help you to avoid wasting time:   Your should only write if your book can become the No. 1. There
are as many mediocre books out there as there are rats in the
sewers of Paris. It is a waste of resources to write yet another
mediocre book, which no-one will even notice and which will not
be remembered later.   Medicine is in flux. Anyone who writes medical textbooks should
be prepared to have to make a number of editions over the years.
Annual updates are ideal. Don’t forget: writing only one edition
of a textbook is as if it had never been written at all (vulg.: fart in
a teacup).
Are you still on board? Good. Then lay down the keel of the project.
The following items have to be taken into consideration:
Contents and structuring   Contents and structuring   Internet supplement   Spelling   Language   Editorial team   Timeframe   Deadline   Budget   Team of authors
Contents and structuring
A lot has been written in the past, and anyone who writes wants to do
it better. What evolves does not do so in a vacuum but builds on
proven material. You are not building a castle like Neuschwanstein,
but are being permitted to add a few bricks to existing walls. Thus you
should:   Obtain the existing standard textbooks and analyse them
carefully. Every book has its own strengths. Identify them and
distil the best ideas. The synthesis of the best existing ideas plus
your own new ones are the backbone of your project.   Structure the material and draft the working titles of the
individual chapters.   With clinically orientated topics, plan a chapter for “drug
profiles”. The evaluation of drugs can change from year to year.
The readers will appreciate finding up-to-date assessments.   Decide which chapters are essential for the first edition and which
can wait until the second edition. There’s no need to put
everything you have in the first edition. The readers really
appreciate it if work is done between the editions and the
subsequent editions have new chapters.   Make sure the book is innovative and related to practice.   Plan the volume of the book. Most standard textbooks have 500
pages and more.   Define the length of the individual chapters. You, the editor, plan
the whole “work of art” and have to balance out the individual
2. The world needs one hundred doctors
chapters. Some authors provide twice as many pages as agreed
without thinking about it. Don’t go along with this.
A Word document with most of the elements which make up a book
(Credits, List of collaborators, Contents, Tables, Charts, Index) can be
found on the internet under www.HIVMedicine.com/textbook.doc
Download it onto your hard disk and change the title page, credits,
foreword and list of collaborators.
Internet supplement
With regard to the planned internet publication, the following points
must be taken into consideration:   Diagrams should be designed in colour. They then appear in their
original form on the internet, whereas for economic reasons, they
are usually printed in black and white in the book.   A text can have supplementary chapters in the internet version
which don’t appear in the book. The reason: additional pages in a
book increase the printing costs, while additional pages on the
internet barely incur any costs.   For the same reason, you should spend some of the initial
planning stage thinking about whether you wish to supplement
individual chapters on the internet with photos. As before, barely
any additional costs are incurred, since the disk space which is
made available by the provider contracts is usually large enough.
Therefore, you should ask your co-authors if they have the time
and the inclination to work on an illustrated book for publication
on the internet only.
Language
If English is your mother tongue, you write and publish in English. If
not, as a rule, you should first write the text in your mother tongue. If
you happen to have the available capacity and/or uncommitted items
in your budget, you should also plan an English version in the mid-
term. The reason: a text that goes around the world has 10 to 100
times as many readers as a text that does not exist in English.
Furthermore, you can only remove the copyright for other languages if
you translate your text into English. (see page 70) It is usually not
sufficient to remove the copyright in the native language alone – you
are then considerably restricting  the circle of possible translators.
Therefore, the road to multilingualism leads via the English version.
The editorial team
Editors
The editors structure the material, define the chapters and choose the
authors. As soon as the authors have supplied their texts, the editors
review the contents, discuss any questions not yet clarified and send
the chapter to be proof-read.
This all sounds very easy – but it isn’t.
The number of doctors who only write moderately well is higher than
you would think. This is not surprising, for a doctor does not need to
be a brilliant writer in order to be a good doctor. Thus, the editors
have to guide their authors. Someone who writes a textbook has to put
the contents in order and then write it all down in simple sentences. A
textbook editor who has skilled authors who present their material in
an inadequate order and in a form that is barely comprehensible, has
to take the revision of the chapters into his own hands. In some cases,
he will edit texts very carefully indeed.
But what if the editor is not able to absorb the stylistic and didactic
finish, and achieve the linguistic harmony of the chapters? Or if he
doesn’t have the time? Then revision is delegated to external
assistants, usually to medical editors. This incurs additional costs
which need to be allowed for at the planning stage.
Over and above the textual and stylistic supervision of the project, the
editor has an additional sacred duty. He has to bring the texts
submitted by his authors into the public domain. Everyone who has
ever been involved in writing a medical textbook knows from stories
or from his own experience about those exasperating cases where
good texts evolve during long nights of work and then are published
either years later or not at all.
This means that as soon as an author submits a text, you are under
obligation. You must publish the text and increase the fame and
reputation of your authors to the best of your ability. If you have
decided to publish finished texts on the internet before publishing
them in a book, you should put them on the internet very quickly,
preferably within 4 weeks of submission. If, moreover, the budget is
assured and the project accounts are well-filled, it would be a graceful
gesture to pay the authors their agreed fee, or at least an instalment.
Editors should be grateful to their authors and demonstrate this
gratitude freely.
The editor is not only there to organise and delegate: the third duty of
the editor is to bear a part of the work on his own shoulders. This
doesn’t have to be the exemplary commitment of HIV Medicine's
Christian Hoffmann who writes 350 pages himself and proofreads 450
pages, but the editor should reserve a pivotal chapter for himself.
Young colleagues, in particular, don’t wait to be asked twice and take
the pickings while they can. They are perfectly entitled to do so. The
more the editors write, the better they understand their authors and the
more qualified they are to give advice.
Mentor
A young editor profits from discussing his textbook project with an
experienced colleague; an older editor should seek the advice of a
good friend and colleague. It is possible to publish a book as a lone
wolf, but it is easier to lose your way alone than in pairs.
The role of the older mentor has gone out of fashion lately, and that’s
a pity. It is not only the younger colleagues who refuse the help of the
older ones; sometimes the older ones no longer possess the mellow
goodwill to watch their younger colleagues working on projects for
which they themselves are too old.
Medical Readers
In the section on editors, we saw that medical readers may be needed
to help with the stylistic and didactic finishing of a book. Medical
readers are often doctors themselves, and a proof-reader with 20 years
experience can be a valuable addition to an editorial team. The
additional financial burden should be allowed for in the budget, but it
is worth every penny when editors are unable to perfect texts for the
final print version due to lack of time.
Proofreaders
There is no such thing as an error-free book, but you should make
every effort to produce as perfect a text as possible – gifted
proofreaders can help you. Proofreaders are the last ones to work on
the chapters before they are put together as a whole. It is not easy to
find good proofreaders. Make sure you attend to this as early as
possible.
Secretariat
A text passes through several stages before it is published. The stages
which it must complete before it is incorporated in HIV Medicine are
shown in Table 2.3.
For each text, a careful account is kept of the stage it has reached. In
the production of HIV Medicine, this task is performed by the editors;
other projects have a project secretariat.
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Time frame
We have defined the time frame for a new book project in Table 2.2.
If all the authors get to work straight away, a textbook project can
theoretically be completed in 6 months. 9 months are more realistic.
12 months should be the longest time accepted.
The workload of the editors depends on how many chapters they write
themselves and how deeply they are involved in the textual and
stylistic correction of the authors’ chapters. For the first edition, this
can be anything from 100 to 400 hours. However you organise it: the
first edition means work and stress. It is not until the second edition,
and more so in the subsequent ones, that the workload is reduced to
between a third and a quarter of the initial number of hours.
Deadline
The co-authors have to read up on their subject, structure the material,
write and correct the text. This needs to be organised and fitted in to
the full schedule of a busy hospital doctor. If the circumstances are
good – the colleague is highly motivated, happens to be on holiday
and throws himself enthusiastically into his work – it is realistic that a
chapter of 20 pages can be written in 6 weeks. So do not be afraid to
ask your co-authors if they can submit their text “at the end of next
month”.
In other cases, more time may be required, but it does not make sense
to set a deadline too far in the future. If you give someone 12 months,
he will rarely start work before the last four weeks. Therefore, a
deadline of four months should only be extended to six months in
justified exceptions (post-doctoral lecture qualification, work on an
important publication, etc.) Someone who cannot deliver 20 pages
within six months will not deliver them in 12 months either.
Perhaps you should give your co-authors the option of choosing a
deadline of between six weeks and four months. Make sure that the
deadlines are spread evenly over this period, so that the texts do not all
arrive at the editorial office at the same time.
Point out, once again, that a deadline is just that – a dead line – and
not a midsummer night’s ball. If you sense that this unsettles your
author, you can always modify the date for text submission, but insist
that a deadline is deadline, and that means the new deadline too.
Budget
The budget you require for your project is made up of the items
printing costs, webhosting and authors’ fees.
Printing costs
The printing costs for a book comparable in size (24 cm x 15 cm) and
length (800 pages) with HIV Medicine 2005 are listed in Table 2.4.
The relatively high costs for small editions are due to the fact that
print preparation (construction and setting up of printing plates,
adjustment of the printing machine, test printing, etc.) are unchanging
cost factors, regardless of the size of the edition. Once the printing
machine is up and running, the costs are reduced dramatically. While
for an edition of 500 copies each print costs 14 Euro, every book over
th
and above the 1000
 costs only 3.50 Euro (see Table 2.4).
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* Calculation for an 800-page book; dimensions: 24 cm x 15 cm; printed in
Germany
So you see: printing costs are not just trivial amounts. In chapter 4, we
have to make sure that we recover this money.
Webhosting
Compared with the printing costs, the cost of placing your text on a
computer with internet access is relatively low, at between 10 and 30
Euro a month.
Author’s fee
There are two possible concepts:
1.  The editors have certain financial reserves and can finance the
project from their nest egg. In  this case, they can offer their
authors a fixed fee. For example, the authors are guaranteed 13
Euro per page, plus a further 13 Euro per page if book sales cover
the printing costs.
2.  The editors have no financial reserves and cannot offer their
authors a fee. In this case, it is a good idea to form a financial
partnership. If book sales and entries from company logos
displayed on the internet site generate a profit, this will be split
according to the number of pages written. The authors bear the
whole risk – for the whole profit.
Team of authors
Concept, structuring, editorial team and scheduling make up the
framework of a project. What is missing now are the people you need
to press ahead with the project. It is not easy to find them, especially
as you have to acquire between 15 and 30 co-authors for a large
medical textbook. What are the  criteria for assembling a team of
authors?
The following should be regarded as rough guidelines:   Your colleagues should be experts in their field   They will generally be younger than you, because older
colleagues usually don’t have the time   Your co-authors should enjoy writing and be good at it. They
should also enjoy imparting their knowledge to other people.   And – perhaps most important of all: the editors must be able to
get their authors to commit themselves to a deadline. This is
usually only possible via friendship or authority. You must decide
whether at least one of these conditions is fulfilled.
E-mail is the modern method, but the telephone is better. Call your
preferred candidates and explain your project. Emphasise the fact that
it is an Flying Publisher project and that you could publish the
individual chapters on the internet within a few weeks. If the
candidates are not familiar with the principle, refer to this book.
Discuss the following items:   Subject and title of their contribution   Length   Fee   Deadline   Word processing software (mostly Word)
The most important message to put across to your authors during this
discussion is: “You will be No. 1”. The authors need to know that they
are not working on just any old project, but on an adventure with
exciting and successful years ahead.
Immediately after the phone call, send an e-mail summing up th
details discussed. Set a time limit within which you expect a fina
decision about the candidate’s participation in the project.
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