A miracle has occurred. Actually there was no miracle at all, just a ton of hard work by a number of talented professionals and me. The second edition of my textbook, Medical Neurobiology (Oxford University Press, 2017) is in production. My part is done. Of course my part started with a few years of writing which was greatly aided by my human and feline family. None of that simple-2nd-edition stuff for me. No, of course not… Instead I chose to essentially rewrite huge swatches of the book. Very reminiscent of Camus’s Grand in The Plague despite my efforts to let-it-be.

Here is Gris-Gris helping me to write. I find that it is always important to keep cats in one’s mind, no matter what task is at hand.

About 2½ years after I signed the contract, I was done with the revised manuscript. And quite a bit worse for the wear.

Here I am on June 1, 2016, a few hours before I sent in the manuscript. Full press effort had precluded my taking time for a haircut and since I hate hair in my eyes, I was left with this charming approach (either this or take a scissors to my own hair, an action that is vehemently opposed by my sensible spouse).

You would think that sending in a manuscript would be the end. Not so much. For those of you who have never gone through the publication process and are interested, here are the steps that follow manuscript completion. For me these steps took place over the course of about 6 months from June (completed manuscript) to yesterday (sent in corrections to corrected proofs).

• Complete manuscript and upload to publisher
• Receive copy edits (by talented copy editor who thankfully clears the manuscript of errant homonyms). This comes in separate word files for each chapter and “front matter”
• Go over all copy edited files. This involves reading the whole text and trying to stay alert and fresh to the text. Make corrections. Return.
• Receive art proofs (about 120 files in 28 chapter-folders)
• Go over art proofs and upload correct tiff files where needed.
• Receive proofs (from “Project Manager” at the press which partners with OUP to put the manuscript into book form) – in one pdf file
• Go over proofs. This is a haphazard task. You don’t read the whole text again. I checked that every figure, table, chapter and section reference was correct (many weren’t), and scanned for errors such as a completely rogue = sign in a section title. Mark errors on pdf. Return.
• Make an index. This is an odious task. I received my old index from OUP and updated all of the old terms – this means taking the word and searching the pdf for that word and putting in every worthy mention. Then I added in topics that were added in to the second edition. Indexing is an exercise in making decisions, not necessarily right ones or wrong ones but consistent ones. I found that indexing was best done early and that by 4-5 pm, I was only able to do “easy” terms such as a person’s name or a drug that is mentioned once or twice. No indexing “Pain” or “Development” or even “Parasympathetic” after 4 pm! Upload index.
• Receive corrected proofs – again in one pdf file
• Go over corrected proofs. This was extremely straightforward and took just a couple of hours. I went to every error that I had found in the original proofs and in the art proofs (luckily I had a list). I found three errors, one of which was mine. Return.

As it turns out, I am still not done, having just received an email to expect to receive the typeset index tomorrow….. serious eye-roll. 

The most difficult task of all was checking the copy-edits. It is just really difficult to read text that you are way too familiar with and look at it with fresh eyes. I would find myself going into zone-out mode and wonder how long I had been blithely reading without attention. Then I would quit for a spell until I could re-engage anew.

The most odious task was indeed the index. It totally did not help when everyone asked me why I didn’t use a computer program or have someone else do it. Control freak much? But I found a way to get through the index, which was to play Handel, really, really loudly. And not just Handel but three pieces in particular. In descending preference, the pieces were:

• Zadok the Priest – this is really the best version ever – I listened to them all. My favorite by far, by far. Only down side to this piece, whichever version, is that it’s short (and I am too computer illiterate to know how to put a youtube video on continual repeat)
• Royal Fireworks  – close second to Zadok. Long enough that it ended up being the music I played for the most time.
• Water Music – late comer. Nice and long but not quite dramatic enough for the tedium of indexing.

I surprised myself with my strong preference for Zadok the Priest given that the brief piece is all about Long live the King! God save the King!  But as the poor souls that ventured into my office during this time learned, very loud praise for the King works for me when I am indexing.

Concurrent with the copy editing stage was choosing the cover and the page style. For the page style, I was given three different color schemes to choose from. I asked lots of people for their favorite and then promptly ignored the clear crowd favorite (blue). I went with green….

The cover was an adventure. MOOC students had sent me (several times over), via Twitter, an image of hands making a brain. I just love that image. But when I searched for it, all I could find was Pinterest, which I do not do and is mysterious to me. I despaired of this state of affairs to my spouse who promptly found the photographer, Angelo Cordeschi, in less than 15 mins. Angelo could not have been nicer and for <50 euros, we had a knockout image which OUP’s design team then put together into a smashing cover. I will keep you all in suspense until physical publication.

This post is all about putting the second edition to bed. To accomplish that, I thought I would scroll through the book to see what is new. I expected to come up with a list of 10-15 items. But as it turns out, it’s a lot more than that. I also know that this list is far more than virtually all of you are interested in reading about. But listing all the changes felt good to me, bringing to me a sense of accomplishment commensurate with the stretch of time that this book has occupied in my life. Below I’ve listed the changes within four categories.

Progressive editions of textbooks tend to bloat, getting longer and longer. I really did not want this to happen. Therefore, I tried to stay disciplined to cut as much as I added. I think I succeeded as the new edition is more than 100 pages shorter than the first edition. While some of the difference can be attributed to a change in the layout, it is safe to say that this edition is not longer and may be a touch shorter than the original.

I reorganized a few chapters and sections:

• Neuroanatomy section now comes before Neural communication section.
• I finally took the time to understand extraocular muscles. I can’t actually keep it in my head for very long. But with the very patient help of my colleague Callum Ross, the pulling directions of the extraocular muscles (from neutral and eccentric positions) are now correctly explained and illustrated.
• Much of the Brainstem Organization chapter was cut with the rest folded into the Brainstem chapter.
• Hypothalamic function has been removed from Forebrain chapter and placed in Homeostasis section
• Gaze is now the final chapter of the Perception Section, immediately following chapter on The Vestibular Sense.
• Much has been added regarding the experience of neurological dysfunction from the patient’s point of view as well as the perspective of the patient’s loved ones. The final chapter centers around this issue and features a highly evocative illustration.

Notable additions include paragraphs or segments on:

• progenitor cells
• brain cancer
• neurodegenerative diseases
• autoimmune encephalitis diseases exemplified by anti-NMDA receptor encephalitis
• diapedesis
• Kallmann syndrome
• oculosympathetic pathway
• pupillary light reflex (with summary illustration)
• disorders of consciousness (vegetative state, minimally conscious) and legal definition of death
• altitude sickness
• mechanisms of action for anticonvulsants and local anesthetics
• synaptopathies
• endocochlear potential
• hidden hearing loss
• sign language
• importance of somatosensation for movement illustrated by story of Ian Waterman
• differences between extraocular muscles/motoneurons and those of other skeletal muscles
• primitive reflexes
• cerebral palsy
• deep brain stimulation, on/off states, and punding for Parkinson’s disease
• allostasis vs homeostasis inspired by Peter Sterling’s work
• circadian entrainment of sleep and the use of melatonin for blind people

Seriously revised sections on:

• Wallenberg syndrome (aka lateral medullary stroke)
• Moniz, Freeman and the frontal lobotomy
• HM (updated to reflect his death)
• phenylketonuria or PKU
• TBI and CTE (and the term concussion)
• much improved explanation of capacitance with respect to neurons (thank you APF!)
• updated treatment of molecular mechanisms of neurotransmitter release (this goes out of date daily or weekly but at least it is more up to date than the first edition’s version)
• synaptic basis of learning (LTP, LTD) with snazzy new illustration
• cochlear implants (with story and picture of Tom Rice)
• brain circuits for language and aphasia symptoms and types
• physics of postural control and tidbit on effect of pregnancy
• corticobulbar tract laterality
• control of facial expressions
• chunking (inspired by the awesome paper by Yamaguchi and Logan)

This version of the pupillary light reflex was ultimately rejected in favor of a better one. But this does show the clean graphic style of the circuit diagrams in the second edition. [I can’t put illustrations from the textbook on the web as OUP owns the copyright to them.]

• beautiful new micrographs of synapses, nerves, and myelin from Peters, Palay and Webster (1991)
• easy reference depiction of the function and the effect of damage for each region of the CNS
• quadrupedal topography of spinal cord
• time series of arteriograms of anterior circulation (thanks to my friend and colleague Javad Hekmat-Panah)
• arteriograms of a berry aneurysm before and after coiling (ditto)
• about a dozen original pictures taken during brain-cutting at University of Chicago (thanks to Peter Patel)
• table of key spinal cord segments
• red glass testing for diplopia
• Bell’s palsy case (from MOOC student, thank you!!)
• simple diagram illustrating logic of cerebellum’s role in ipsilateral movements
• bytes as metaphor for action potential coding and effect of demyelination
• punchy illustration of known inotropic vs metabotropic receptors
• binocular and monocular visual fields and blind spot
• my mother’s illustration of what one sees with macular degeneration (thanks Mom)
• amazing photomicrograph of the human retinal fovea (thanks to Anita Hendrickson!)
• frequencies and decibels of modern life sounds, speech, telephony, and orchestral music
• outer hair cell anatomy and function
• how-to-guide for interpretation of Rinne and Weber tests
• proteinase activated receptors aka PARs
• logic of vertical and torsional VORs
• optokinetic response
• yoking mechanism for extraocular muscle pairs
• challenging postures from the hip hop dancers of UChicago’s Phinix Dance Crew (thanks to Wendy Tong for making the connection)
• supranuclear control of facial expressions vs Bell’s palsy
• lovely drawing of hemiparetic stance (thanks to Tony Reder and Sharon Rosenzweig)
• cerebellar loops (always did this on the chalkboard so here it is)
• chunking of typing inspired by the awesome paper by Yamaguchi and Logan
• new hyperdirect, direct and indirect basal ganglia pathways (replacing old ugly ones with clean, aesthetically pleasing ones)
• skull of patient with acromegaly (from Pritzker collection)

Wow, putting that list together, by scrolling through the proofs, made me realize how much I did for this second edition. Not sure if that is good or crazy. I am happy to say that the advance reviews of the book are very positive. But the ultimate arbiters are you, the readers, and I leave it to you to judge for yourselves next year!

Onward to other projects and challenges.