The Surgical Word Book: Its Past and Future

I recently wrote a blog titled "About Words" at another site (Coding for Healthcare Professionals), in which I gave some attention to The Surgical Word Book. Doing so made me want to tell more of its story, and thus this blog entry, where I will start at the book's serendipitous beginning. You see, I had not planned to compile this list of surgical terms. Back then, in the mid-1970s, I worked days as a medical transcriptionist and taught medical terminology two evenings a week. The former activity made me acutely aware of the need for a surgical terminology book that went far beyond the standard at that time, which was A Syllabus for a Surgeon's Secretary (Szulec & Szulec, Medical Arts Publishing); I wanted a surgical terminology book similar to W. B. Saunders' The Medical Word Book by Shelia Sloane, i.e., completely alphabetical and cross-indexed. For my terminology class, I had selected The Language of Medicine by Davi-Ellen Chabner, also published by W.B. Saunders, as the course textbook. Since I was impressed by these two books, I wrote to the publisher to urge them to prepare a surgical terminology reference book for medical transcriptionists and others. Their response: Why don't you do it? And so began the saga of The Surgical Word Book, whose tale follows to some extent the course of technology, but always a few steps behind. Therein lies the story.

I told W.B. Saunders that I wanted to prepare the first edition (in the late 1970s), not on a typewriter, but with IBM-punch cards. (My husband was in graduate school at the time, and a colleague showed me how to use IBM punch cards to create a cross-referenced database.) The publisher was ill prepared to facilitate this approach and instead said they would enter my Selectric-typed manuscript into their accounting system, the best electronic means they could offer. I agreed, not realizing what I was getting myself into: As each typed draft of the manuscript was entered into their accounting software, new terms were included but duplicates could not be deleted nor errors corrected except by an additional correct entry. So, with each printout from their software, I had to note by hand what was new and what needed correction or deletion. Ultimately, when the book was published in 1981, it contained just over 500 pages, each with a potential capacity of 76 terms, so it had somewhere around 38,000 entries.

Next, the 2nd edition, released in 1991, after several years of preparation: This time I used FileMaker to prepare it electronically, but when I urged the publisher to release it electronically as well, they nixed that proposal. This edition was expanded to a larger page size and used a smaller font size, so its just-over-1200 pages could each accommodate up to 94 entries, for a total of close to 112,000 entries, almost three times the number of entries in the 1st edition.

By the time I contracted to prepare the 3rd edition, W.B. Saunders had been bought, acquired, or whatever the correct term is, by Elsevier. Instead of FileMaker, we used Microsoft Access, which offered much greater functionality. I was very pleased to finally be working with software that could do what I wanted it to do and which had basically no space limits. The publisher chose to keep the width and height of the book the same size as the 3rd edition but changed the paper thickness and reduced the point size again, thus allowing more pages and more entries per page. However, the publisher advised me that I could fill only about 2400 pages at 104 entries per page and thus my total entries could not exceed about 248,000. I advised them in turn that I couldn't add all the new terms I was identifying if I had to meet those limits. Of course, you can, they responded: Delete old terms to allow space for new ones. Well, you and I know there is really no such thing as an “old” medical term. Outdated, perhaps, but no longer used? No! However, the publisher insisted, and so I had to delete thousands of “old” terms in order to make room for new terms. And again, my strong recommendation that it be published electronically as well as in hard copy was rejected.

This brings me, finally, to preparation of the 4th edition, where at last I’m faced with the endless possibilities that the digital age provides. No longer to be printed in hard copy, indeed no longer to be printed or published by Elsevier, I am free to include as many terms as I can identify and to make corrections, all on the fly. So, when will the book be complete? The answer, really, is never. By preparing and releasing it electronically, the compilation can continue to grow and renew itself. And I want it to be more than a reference resource for transcriptionists and others working in healthcare documentation, perhaps an integral part of any medical language function or software. So, I must decide on a publisher. Or shall I self-publish? There is also the dilemma that all authors face: When will I be able to let it go? With all the plates I have in the air, I’m not sure, but I will let you know when I am.