Traditional publishing? Perish the thought

When the news came that John Brown was about to be executed for his seditious raid on the federal garrison at Harper’s Ferry, Henry David Thoreau rang the village bell in Concord, Massachusetts, to call his townsmen together. When a neighbor asked him what prompted this action, Thoreau replied: “I have something to say.”

Throughout human history, many of us have had something to say. The problem was that, up until fairly recently, there was no venue readily available for the dissemination of the thoughts and ideas of the common person. That, of course, was before the Internet exploded upon the scene.

Traditionally, most would-be writers had to submit their work to countless publishers before getting anyone to consider it. And if any editor did bother to peruse the manuscript, the upshot was most likely a letter of rejection. Because name recognition goes a long way toward mounting a successful book marketing campaign, many editors and agents preferred to work with previously published authors. This left the unknown writer in a bind. How to get recognized by a publisher without an agent? How to secure an agent without having name recognition?

Traditional publishing houses are not necessarily in the business of bringing new literary talent to the reading public. First and foremost, traditional publishing houses are in business to make money. They search for marketable writers with name recognition, those who craft good stories that will sell to a large audience. Authors take their traditional 15 percent cut and royalties, leaving the publishing house with the bulk of the proceeds from book sales.

The Internet has proven to be a great equalizer, giving voice to the average person who has something to say. Witness the explosion of personal blogs on sites like MySpace and Facebook. The latest leveling on the literary playing field has come in the form of self-publishing sites. Would-be authors no longer have to pursue literary agents or beg editors to peruse their work.

For a small fee, these online publishing firms will transform an author’s manuscript into a bound book, complete with glossy cover and ISBN barcode. Because these enterprises function by print-on-demand, initial financial outlays are kept to a minimum.

The current recession is impacting book sales nationally. Everyone in the bookmaking business is suffering—traditional publishing houses, book sellers, editors, literary agents—except the print-on-demand entrepreneur, who stands ready to give the little guy who has something to say a venue for his voice.

What can we learn from the humanities?

Stanley Fish, dean emeritus of the College of Liberal Arts and Sciences at the University of Illinois at Chicago, has posted a series of thought-provoking pieces on his New York Times blog “Think Again” about the humanities. His specific question has to do with their relative value as an academic pursuit: to wit, what is the justification for the study of the humanities?

Professor Fish goes to some length to rebut the argument that studying the humanities will make us better individuals. He counters those who opine that wrestling to understand the great literature of poetry and prose, philosophy and history serves to make us more moral, more sensitive to the plight of our fellow human beings.

According to Professor Fish, the humanities will not save us. Indeed, a close reading of these pieces leads you to conclude that, apart from enhancing the subjective aesthetic experience of the student, the humanities have little to offer a society at large.

While Professor Fish is heartened to learn that some of his former students report life-changing experiences as a result of their studies, he is certain that the vast majority would report something quite different. He asserts that “mastery of literary and philosophical texts and the acquisition of wisdom are independent variables.” In other words, exposure to the humanities will not necessarily equip you with the wisdom of the sages. He goes on to say that “the value of the humanities cannot be validated by external measures like increased economic productivity, or the fashioning of an informed citizenry, or the sharpening of moral perceptions, or the lessening of prejudice and discrimination.”

It was once felt that the humanities provided a way to develop critical thinking; yet to Professor Fish, all thinking is ultimately critical thinking, else it wouldn’t be thinking at all. (To me this statement is a perfect example of critical thinking.) And he further argues that the humanities do not enjoy a monopoly in this regard.

Over the course of my thirty-year career as a clinician, I have been an advocate for the humanities in medicine. I reasoned that exposure to good literature, good poetry, good music and quality art would ultimately serve to cultivate and enhance empathy and understanding on the part of the clinician toward the patient. This could only lead to more humane medical care. To my way of thinking, the concept of caring is deeply embedded in the delivery of health care and its ultimate object—the healing of the patient.

If I read Professor Fish correctly, all these years I have been merely whistling in the dark.

We are taught compassion at our mother’s knee. We struggle to learn fairness and regard for the feelings of others in the sand box. Robert Fulghum asserts that all we really need to know we learn in kindergarten.

Although it may not be possible to teach empathy, exposure to the humanities could allow students to rediscover it. Some of them just might go on to incorporate it into the way that they relate to their fellow human beings.

Can the humanities save us? Professor Fish would answer a resounding no. And I would have to agree with him in that regard.

It will take more than the humanities to save us. If we are to become a world community, fighting will have to take a back seat to forgiveness. But even forgiveness will not save us. No, it will take something much deeper, more profound, a more radical mystery—or if you prefer, a miracle—to do that.

‘Tis Pity She’s a Whore

First published in 1633, John Ford’s play ‘Tis Pity She’s a Whore portrays profound and disturbing truths about lust and greed. As such, it serves as a critique of contemporary culture and morality.

Interested readers can peruse my latest narrative of the same title, recently published in Dermanities, the online journal focusing on the art of dermatologic practice and the medical humanities.

The same issue also includes The Surge, a vignette depicting a poignant patient encounter.

Our daily work

If there is a certain humility in serving, there are also untold rewards in our daily work.

The Kabul rehabilitation center, constructed on an old hospital graveyard, has never been attacked by any political faction in Afghanistan, even though it is staffed primarily by foreigners. One of the workers serving in a managerial capacity there also provides direct patient care as a physiotherapist. Alberto Cairo traded a career in law for the opportunity to serve the poor, the maimed, and the hopeless under the auspices of the Red Cross in this war-torn country. According to him, there is nothing else he would rather be doing with his life. Mr. Alberto has become the most revered Western relief worker in Afghanistan, at least among the Afghanis.

“What I’m doing here is so rewarding,” he said. “For me, it’s perfect. I feel I have been very, very lucky.”

“To watch the first faltering steps of men, women and children, some standing for the first time in years, is a transformative experience.”

In his essay The Master-Word in Medicine, Sir William Osler reveals the secret of the professional life in medical practice: “Though a little one, the master-word looms large in meaning. It is the open sesame to every portal, the great equalizer in the world, the true philosopher’s stone, which transmutes all the base metal of humanity into gold….Not only has it been the touchstone of progress, but it is the measure of success in every-day life….And the master-word is Work…”

Indeed, although he penned his essay a century ago, Sir William’s words seem to foreshadow Mr. Alberto’s attitude in action: “You enter a noble heritage, made so by no efforts of your own, but by the generations of men who have unselfishly sought to do the best they could for suffering mankind….Yours is a higher and more sacred duty. Think not to light a light to shine before men that they may see your good works; contrariwise, you belong to the great army of quiet workers, physicians and priests, sisters and nurses, all over the world, the members of which strive not, neither do they cry, nor are their voices heard in the streets, but to them is given the ministry of consolation in sorrow, need, and sickness.”

In Alberto Cairo’s words: “If you can improve the life of a person it gives you so much joy….If I had to compare what I give to what I get, I get much more than I give.”

Wired to hear colors and smell sounds

Imagine hearing a color or smelling a sound. What if numbers had texture that you could see, or hours were visualized as the time it took to bake a loaf of bread?

Neuroscientists group these phenomena together under the umbrella of synaesthesia, an unusual mixing of the senses in which a stimulus in one sensory modality (for example, a sound) elicits perception in another modality (e.g., visualization of a color).

This concept seems strange to the average person. On the whole our brains appear to be wired in the same way. We think rationally, we perform complex mathematical operations logically; we hear music, we see colors, we smell the odor of fresh baked bread hot from the oven.

Yet there are people who cogitate in different ways. Perhaps their brains have been hard-wired using different templates.

Take the case of the person with autistic spectrum disorder. Profoundly autistic individuals are unable to communicate with others. Higher functioning autistic individuals can communicate their thoughts, although they lack the ability to read the social cues of others. They operate in their own worlds, light-years from our own. Yet once in a great while autistic individuals appear who possess the ability to explain their innate thought processes.

Animal scientist Temple Grandin relates that her autism allows her to perceive things as animals do. Grandin has used her ability to see how animals cope to design humane systems for handling cattle and hogs during veterinary procedures and slaughter.

In her book Thinking in Pictures, Grandin writes: “I think in pictures. Words are like a second language to me. I translate both spoken and written words into full-color movies, complete with sound, which run like a VCR tape in my head. When somebody speaks to me, his words are instantly translated into pictures….When I was a child and a teenager, I thought everybody thought in pictures. I had no idea that my thought processes were different.”

Commenting on Grandin’s recent NPR interview, one listener wrote: “through-your-sometimes-agonizing-sensitivity-and-insight–we-can-see-glimpses-of-the-great-wisdoms—they-can-show-us-about-ourselves–souls/minds/hearts.”

Autistic savant Daniel Tammet has written a book Embracing the Wide Sky in an attempt to explain the process behind his mathematical and linguistic skills.

For Tammet, numbers and words have texture, form and color. He says that, unlike a computer, he does not crunch numbers; rather he “dances with them.” He also describes an overlap between visualizing words and their meanings.

Tammet taught himself French, Finnish, German, Spanish, Lithuanian, Romanian, Welsh, Estonian, Icelandic and Esperanto. In 2004 he set a European record for memorizing 22,514 digits of pi (5 hours, 9 minutes).

According to Tammet, he wrote the book “to show that minds that function differently, such as mine, are not so strange, and that anyone can learn from them.”

Synaesthesia is the exception to the rule that might eventually give us greater insight into how the human brain functions.

Think about it.

“Notes from a Healer” — Heartfelt Morning

Morning, a time of transition—from sleep to wakefulness, from dreams to consciousness, from darkness to first light. Although I have a habit of rising early, this particular morning promised to be a poignant one.

The latest installment of Notes from a Healer — Heartfelt Morning — is now online, newly published in the Yale Journal for Humanities in Medicine.

The Yale Journal for Humanities in Medicine is an online clearinghouse for manuscripts dealing with the humanities and medicine.

The Gift of the Magi

All is ready now. The big orange suitcase is packed, laden with gifts she got at Christmas. Her clothing has been laundered and neatly folded. Her coat hangs on the back of a kitchen chair, waiting for her tiny arms to be thrust through the sleeves before being zipped up.

Soon the car will be loaded; soon we will be on our way back to the airport, where, after spending two weeks with us over Christmas break, my granddaughter will fly back to Florida to be reunited with her mother.

In two days it will be what the Spanish refer to as El Dia de los Reyes—Three Kings’ Day, when Christendom celebrates the coming of the wise men from the east. According to some historians, these three magi had been on a quest for nearly two years, following a bright object in the heavens, not knowing exactly where it would lead them. They bore gifts—precious gifts—fit for a king.

We don’t know much about the magi. Presumably they had some sort of academic bent, because they knew of an old prophecy and studied the stars. Perhaps they were astrologers—that breed of scientist who looks to the stars to predict future events, or to make some sense of current affairs.

Among the stories penned by the American writer William Sydney Porter, perhaps the most famous is his short Christmas tale, The Gift of the Magi. Writing under the pen name O. Henry, Porter spins the story of a young married couple who have fallen on hard times. The husband’s salary has been cut by a third, the name on the mailbox has lost its luster, it’s Christmas eve and Della, the wife, has only $1.87 to buy her husband Jim a Christmas present.

Through O. Henry’s magic, we learn how Della sells her long auburn tresses for $20 which she then uses to buy a platinum fob chain for Jim’s gold pocket watch. Meantime, Jim arrives a bit late from work, having pawned his watch to buy an expensive set of tortoise-shell combs for Della to adorn her hair. In foolishness, each sacrificed that personal thing of greatest value in order to procure what turned out to be a useless gift for the other.

This Christmas, in addition to A Child’s Christmas in Wales and The Night Before Christmas, I read The Gift of the Magi to our granddaughter. Despite a few big words and several archaic turns of phrase in the text, she managed to grasp the gist of the story. This I know, because she explained it all to me afterwards.

“That’s an example of irony,” I told her. She looked puzzled. “What’s that?” she asked. I did my best to explain it to her, using Della and Jim as an example.

This Christmas my granddaughter gifted me a mug that bore the picture of a kitten. It cost her one dollar. (She forgot to remove the price tag on the bottom before she wrapped it up, and a fine wrapping it was.)

This Christmas that was the second best gift I got. It was given to me by the best gift herself. It was a gift of the magi.