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Thorax in the 1980s
  1. R A L Brewis
  1. Correspondence to:
    Dr R A L Brewis
    High Barn, High Side, Bassenthwaite, Keswick, Cumbria CA12 4QG; alistairbrewis{at}

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Reflecting on the experience of editing Thorax, now more than 20 years ago, what stands out in the memory is not any individual ground breaking paper but rather an impression of the huge variety of topics which clamoured for attention under the thoracic banner, and of the general mood of enthusiasm and cooperation which prevailed at the time.

By the early 1980s respiratory medicine had broadened out from its earlier essential focus on tuberculosis and industrial lung disease and seemed at last to have an established position within general medicine. Bright young academic minds were increasingly attracted to the specialty and the quantity and quality of research were advancing in proportion. The British Thoracic Society was newly formed and had confirmed Thorax as its official organ. The general enthusiasm for the subject clearly evident in the Society’s meetings was transmitted to the journal. Specialists from a rapidly widening variety of clinical disciplines and basic sciences contributed to the submitted papers, and there was a steady increase in submissions from overseas. Thoracic surgery with its more direct links to cardiology was also changing in character but maintained a strong presence and, up to this time, Thorax still had medical and surgical editors working in tandem. The Editorial Board, which had tended to be the preserve of the silver haired and distinguished, became populated by younger high performers.

The task of editing Thorax was an exciting one involving responsibility, privilege, and a great deal of hard graft—much like doctoring in general. The role had something in common with that of an overworked paediatrician confronted by doting parents (authors) with ailing offspring (papers). In each case a careful history would be followed by detailed examination and, with the help of investigations and specialist advice, the formulation of a diagnosis and then a plan of action directed, wherever possible, towards a successful outcome (publication). In some the course of the illness was protracted; in others radical surgery might be required. Regularly it was necessary to break bad news.

The Editor felt responsible for ensuring fair treatment of authors and an obligation to be true to scientific and ethical principles, but additionally felt a duty to stand as representative of the common reader. This proxy role was assumed to excuse the arrogance of the working rule that, if the editor did not understand something, there was something wrong with the material or the author’s presentation. Experience showed that the most impressive researchers were able to describe even advanced concepts in simple terms whereas lesser individuals often tended towards over-elaboration and lack of clarity. One of the most enjoyable aspects of the Editor’s role was the licence it gave to approach anyone with special understanding or expertise with a view to producing an illuminating editorial.

An underlying practical challenge was that of improving the actual process of assessing and publishing papers. Opportunities to meet editors from other fields and access to kindly guidance from Stephen Lock were helpful here, as was a steady improvement in the overall standard of work submitted. This was typified by better understanding of the use of statistics, facilitated in the medical field by Douglas Altman and Sheila Gore among others.

Any Editor leans heavily on those who are both highly effective and good natured, and it quickly becomes clear who qualifies under both headings. One of the lessons learnt as Editor was how astonishingly consistent people are. Someone who returns material the next day will continue to be a lightning performer; someone who requires two reminders before replying will always require two reminders. On the theme of reliability it may be interesting to record that, in the days before e-mails and before the Editorial Office had even a word processor let alone a computer, thousands of paper handling actions were completed without loss or significant delay using a manual typewriter, a handwritten ledger system, and the Royal Mail. In those days at least, the mail performed impressively. If a manuscript was held up or thought to be lost, it was invariably located later in some hospital or university post room, or in the office of the author making the enquiry. It is nice to be able to record here the contribution made by Thorax secretaries. Some authors writing in the 1980s will recall the efficiency and alertness of Pat Haselhurst who set a standard happily taken up by the secretaries to the newly appointed Associate Editors and maintained, it seems, to the present.

The Associate Editors were the key to the next stage in the growing up of Thorax. Dividing up the workload had become a practical necessity given the volume of time consuming work, but what resulted was teamwork which improved the standard and broadened the character of the journal as well as providing stimulating companionship.

Jumping ahead two decades, we find Thorax promoted to a higher league having emerged from its domestic embrace to be resoundingly adopted by the international respiratory community as a whole. Quality undoubtedly attracts quality, but this virtuous positive feedback is not an automatic process. The combination of energy, imagination, and care contributed by the recent Editors has been the essential catalyst and great credit is due to them. Editing is often described as a thankless task. This may not be strictly true, but it is very nearly so. Few letters of thanks are to be found pinned to the Editor’s wall (or, nowadays, perhaps un-erased in the inbox). In celebrating the 60th anniversary of Thorax there is an opportunity to thank the Editors of recent years for their part in the evolution of a journal in which all involved in thoracic medicine and its related sciences can take some pride.

Congratulations Thorax; thank you recent Editors; keep going …

Editor, 1982–1987

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