Please judge this book by its cover
Emmanuel Carrere said, “To write a book, you’ve got to be persuaded that you’re the only person who could write it.” A corollary to that is that the book that you are writing does not exist already because you are not only the only person alive but the only person for all time. A tall order that is slightly mitigated by the steady accumulation of new knowledge and happenings, rendering many of today’s books not writable in previous eras.
When I decided to write Medical Neurobiology almost 10 years ago, I knew that the book I thought had to be written did not exist. Neuro’ textbooks for medical students were in fact written by research scientists but were oriented toward graduate students. Bizarre, I know. Consequently, once I made the pledge to write with the specific needs of medical students exclusively in my mind, my task became simple. I stressed deep tendon reflexes, neural tube defects, and walking while omitting classic favorites such as sound localization in the owl, transmembrane receptor families, and center-surround receptive field organization; as painful as those omissions were (and some were painful).
Fast forward 5 years and my editor raised the possibility of writing a second edition. This was a welcome opportunity to correct some mistakes and update information. The very first correction that I made, with great joy and relief, was to correct my 5-page insanity of calling the upper spinal cord cranial instead of cervical; how that error made it through all the rounds of editing and checking, I will never know. But I didn’t just want to correct and update. If I was going to write a 2nd edition, it had to fulfill a niche that the 1st edition did not. As I discussed in an Oxford University Press blog, I added some stories, knowing that specific narratives about fleshed out people stick far longer than do abstract concepts. This meant correcting some gross oversights such as the omission of cerebral palsy and the paltry treatment of the pupillary light reflex. I got to add a seriously rocking illustration that explains Horner’s syndrome; I secretly hope that this becomes the diagram that is pirated throughout the world’s classrooms. Hey don’t tell Oxford I said that…
Another major change in the 2nd edition is one of attitude. Some years ago, I went to hear Richard Gunderman of Indiana University give an incredibly insightful talk on medical imaging that somehow ended up being about ethics in patient care. Afterward, I chatted with him a bit about how to incorporate ethics into a Neurobiology course for medical students. At the time, my final lecture to the medical students was a plea to listen to their patients and use their understanding of disease (the pathological process) to treat illness (what the disease means to a patient’s life). [Sherwin Nuland’s articulation of the difference between illness and disease was quoted in the New York Times Obituary for Lia Lee, the subject of Anne Fadiman’s moving book, The Spirit Catches You and You Fall Down. This concept immediately resonated with me and I have never forgotten it. ] Dr Gunderman said something I have never forgotten. To paraphrase, “Don’t marginalize the topic by sticking it at the end. Sprinkle ethics throughout the course in every place where it applies.” I took this advice and several of the sections that I am most proud of are more about patient experience and choice than about neurons and action potentials. As I said in the Preface to Second Edition, “I hope that readers will develop the skill of speaking plainly and compassionately with patients and their loved ones.”
Finally, I want to end with a word about the cover of the 2nd edition of Medical Neurobiology which I love, love, love. I initially thought that we would use the same design but with a changed color palate. I was informed No. Once I knew that a new cover was needed, an image of a brain made of hands immediately popped into my head (thanks to all my MOOC students and Twitter followers that shared the image with me many times over). I went to find the copyright owner of the image to no avail. This went on for a while. I would be working, finish some task, not know what to do for an instant, and go back to fruitless internet searching. Finally, Oxford was pressing me for a decision. Giving up on the hands-brain, I found a highly artistic image but the cost was high (and this cost was my responsibility if I chose to go outside of the public domain for a cover image). I went to talk about spending that kind of money with my spouse who responded, “What about the hands-brain?” I told her of my fruitless search. She basically kicked me out of her office and turned to her computer. Within 10 minutes, she called me in to show me the work of Angelo Cordeschi including Human Brain Made with Hands. Angelo could not have been nicer, allowing us to purchase the image and use it as a cover for the ridiculous price of 35 Euros, which OUP ended up paying. I can now only hope that the 2nd edition of Medical Neurobiology lives up to its cover. Please judge this book by its cover!