In 1885, when John Shaw Billings started the database that would, over time, morph into PubMed he recognized the hopelessness of trying to keep abreast of the literature. In addition, he appreciated how trivial most of what passes for “the literature” is when he wrote:
There is a vast amount of effete and worthless material in the literature of medicine. Our preparers of compilations and compendiums, big and little, acknowledged or not, are continually enlarging the collection, and for the most part with material that has been categorized as ‘superlatively middling, the quintessential extract of mediocrity.1
Over the past 132 years, the situation has only gotten worse. Today, the National Library of Medicine (NLM) indexes over 3500 journals in MEDLINE (searchable via PubMed). What physician could keep up with even those in their own specialty, if all they did was pore over medical periodicals?
What we are proposing with Keepers is to house classic articles here: some old and some new. Each month, we will post the one or two articles we deem most inspiring.
We will also include books that deal with humane aspects of healthcare. There are some classics and each year a few new titles are added to the canon.
The Keeper Philosophy was articulated by the Canadian novelist, Robertson Davies, in The Cunning Man2:
[We] don’t decry research. Some fine things are done.
Not nearly enough for the amount of money spent. Too much machinery, too much administration, and not enough brains and intuition. Research harbors a lot of second- and third-rate people.
The huge labs are what monasteries were before Henry the VIII took the axe to them. More humanism and less science – that’s what medicine needs. But humanism is hard work and a lot of science is just Tinkertoy®.
1. Billings, JS . An address on our medical literature. BMJ 1881; 2: 262–268.
2. Robertson Davies. The Cunning Man, Viking 1994