Telephone conversation with Dr. Wangensteen July 2, 1956.
Dennis: With regard to this reappraisal section in Surgery, I must confess I am confused, and I think Al is confused too.
The letter that you wrote me on the 26th suggesting that we get people who have well-known names in surgery to publish on
these items . . .
Wangensteen: I think for the first few articles we ought to have one. I think a good subject for you would be vagotomy and
D: Well, I was kind of holding off until after Karlson got this thing reviewed this summer with regard to that, because it
seemed to me that we were a little uncertain about it at the moment. I don't think it's anywhere near as good as it
looked at one time. It just looked to me as if this were going to compete with Warren Cole's section.
W: Oh, I don't think so; I don't think so at all. I think you get the idea from the letter you wrote on something
from Becker. I think it would be a mistake to start with people like that. I'd keep the articles and re-form them a little
bit. You'll have to start with a title just like in any other paper. We can't have this imitate the query and answer
section in the AMA or Modern Medicine or anything like that. It has to be a little more formalized. You get three or four
good papers. It's no use opening the section until you do There is no hurry.
D: That was the question. I was given the impression there was some reason to be anxious to get it started as soon as possible.
W: You get three or four good papers, and then . . . If you could have a couple of papers an issue that would be the thing,
I think . . .
D: Oh, just that many . . . Just a couple of them?
W: I would think so. I wouldn't struggle too hard writing to everybody. You'll exhaust yourself and exhaust the field
pretty soon and there won't be any questions to ask.
D: Well, that was the next question that bothered me.
W: Get two or three, just covering a page, something like that. Once in while it may run into two pages.
George Pack might have something for you, you know. If he's written about any controversial things. In the beginning they
should be of fairly general interest, because that will help arrest the attention of the readers. Frank Glenn might have something
for you on what's his attitude on cholecystomy. Is he on the conservative side or the operative side?
D: I'm sure he would provide us with something about cholecystectomy in acute cholecystitis or something of the sort.
Well now you propose to make these rather general and not reviews of specific papers then?
W: No, I don't think so. It's just an attitude, that's what I mean, not a specific paper. But there might be an
occasion . . . a fellow always remembers a paper that had some importance, but my thought would be - well "what's
your cocostomy-colostomy problem"? -- is a good question, but I don't think I'd feature the beginning, opening
section with Becker. He isn't well enough known.
D: I think his conclusions perplex me too . . .
W: The people who have been writing on controversial subjects would be happy to attempt to express themselves in a very brief
way. Unless we follow a sort of pattern of a paper, we'll have trouble indexing. These are just notated questions and
answers (that you have submitted), and we'll have real problems.
D: What we had done was to put the title of the original paper at the top of each report.
W: Well, I don't know; I wouldn't do that. I'd put it in a footnote. Use a new expression with a new title and
stuff, and put it in a foot-note or put a single reference at the end, or something like that. In this way, you'll be
sure of getting conventional treatment from all indexes, whereas if it gets to be a question and answer business, it will
be handled like correspondence and will never be entered anyplace.
D: Well do you propose that we should not give consideration to any papers of the sort of this Becker paper?
W: Sure. But let him ah . . . I would discuss his attitude, not so much the paper, you know. That's what my thought would
be. You may simmer down to a paper now and then, but the minute you . . . Take the Becker paper -- we'll never get these
papers indexed. I'd put the author and his title as a footnote -- list as a review or something of that sort, or just
a new title or the old title, but we want to get away definitely from the question and answer business, or you'll have
trouble with the section. It will be unpopular and will never -- from the author's standpoint, it may be popular from
the reader's standpoint -- but we want something that's popular both from the author's and the reader's standpoint.
That way it's bound to live.
W: Questions about coming out this summer, etc.
D: Let me ask you a couple of other questions if I might. I sat next to Warren Cole in Chicago last Saturday, and I hope I
wasn't out of step, but I talked with him about this Reappraisal Section and asked if his reaction wasn't that this
was -- what he felt the relation of this section to his section might be and he said "Aren't we trying to cover the
same sort of thing?"
W: What's the title of his section?
D: Appraisal of Progress in Surgery. And this is a Reappraisal Section.
W: Well, I don't know. You are dealing primarily with controversial issues where a fellow has expressed himself. I don't
think so. I don't think so at all. He's covering a broader field, obviously, but you are dealing largely, I think,
as you brought it up (to the Editorial Board) for the second time, to deal with people who have written on controversial matters.
There is a question of whether this author still believes it or not, and he may have expressed it in a dozen papers or in
one, so, rather than in referring to a paper, I think I would just ask him how he feels about this. Would he kindly prepare
a paper, and you suggest a title for him, and if he wants to alter it a little bit, good enough. Then you say that in the
body of the paper it might be well to consider these specific questions, you know, and so forth.
D: Well, now. Do you figure that each paper or the whole section would be two or three pages? in the journal?
W: Oh, each paper to have about a page. A page with a title would be around O I think a page would be about six hundred words.
With the title and everything it would be around 450 words. I would say it could occupy two pages if need be. A fellow like
George Pack writing would feel, perhaps, cramped if you pushed him into 450 words, whereas if he got 600 on one side and 450
on another, or 1000 or 1100 words, he could say what he'd like on a subject. You needn't worry about the Journal being
too fussy about this (length of papers). You just get a few good papers and you'll find them in print, and I think you'll
be satisfied with it and I think it will be an interesting labor too, and moreover, I wouldn't confine myself to American
surgeons only but in the beginning I guess it's best to have some of those.
D: Well, we'd started with reviewing those, yes.
W: Where continental or British surgeons have written on controversial subjects This fellow Heneage Ogilvie always writes
very interestingly and he has expressed himself on many things. Even Walters said during the last year a good word for gastrojejunostomy.
D: Well, what about something like Henry Doubilet, then? He sent me back a real paper all ready to go.
W: How big a paper is it?
D: Oh, I think it would take probably three pages in the journal.
W: Well, why don't you send it to me and let me have a look at it?
D: You don't think we are going to create the impression that we are being snobbish, do you, if we limit ourselves to
people who are well known?
W: Well, just in the beginning. In the end it will make an enormous difference. These fellows don't need to worry. They
won't know whose paper got in first. After you've got three or four on the line, send them in and try to get a couple
of issues with names that people would like to hear from. After that it doesn't make much difference.
D: I see. Do you think we are going to create ill feeling by having written people and gotten answers and then not publish
W: No, no, don't worry about that. Those papers that you have may have to be re-written a little bit, like the Becker
paper, you know. I don't think that would do in there.
D: It disturbed me some too. I wanted to know what your idea was.