Gutenberg’s innovations in the printing technology revolutionised medieval Europe’s ability to share expertise and increase knowledge. As we begin 21st century, further revolutionary change is possible through the impact of electronic books. This technology is already mature enough for clinicians and academics, even though the UK medical publishing industry has not yet caught on.
The Printing Press
The nations of 1450’s Europe were undergoing a massive increase in complexity, with developments in science, commerce, law and warfare. In many cases, the bottleneck for further development was the ability of scribes to produce written materials. No matter how many new entrants to the profession, society still needed more.
Enter Johannes Gutenberg – inventor, goldsmith… and businessman. Like any good businessman, Gutenberg was constantly on the lookout for market opportunities. He diagnosed the market’s need for mass produced writing. Like any good businessman, Gutenberg borrowed money to research a solution for this gap in the market. He produced the printing press, with innovations in the use of movable metal type. And like any good businessman, he was good at marketing. His first publication was thus the bible, the world’s first, and still greatest, bestseller. But Gutenberg had an eye on where the real money was – Indulgences. Indulgences were rich people’s way of buying forgiveness from God for their sins, and the Church’s way of funding religious wars. Gutenberg wanted to mass produce these indulgences for the Church, in effect a license to print money.
Sadly for Gutenberg, he never got that far in his business model as he was unable to pay off his creditors in time. His press and patents were confiscated. But he had still unleashed a revolution.
Future historians may decide that Harry Potter was the pinnacle of publishing in the 20th century. The book that became a brand reminded millions of children of the joys of reading and contributed to mass literacy. To me, however, the contents of my college library represent the pinnacle.
As an undergraduate medical student, I was initially frustrated by the books held in this library. None of the major textbooks that I needed were available when I needed them most. Eventually, I grudgingly bought these textbooks, and made peace with the library. I was then free to explore its other books with an open mind. And these books were obscure. Really obscure.
One book, for example, was devoted to the six muscles of the eye. Not vision, not the eye, but the six muscles of the eye. Another book was entitled Queuing Systems. Queuing theory, I discovered, is an expanding science, with applications from computer networks to aircraft control.
Each year, the publishing industry produces thousands more such books, ever larger, ever more specialised, ever more obscure. Yet every year, the industry’s cost-effectiveness manages to make money from such books, allowing further investment. The miracle of modern publishing is that it is cost-effective to produce obscure texts.
With electronic books, there is the possibility of further bringing down the costs of publishing. And the price of handheld electronic book readers is also coming down. Prices are already low enough to allow anyone to publish to everyone, for reading everywhere. The UK medical publishing industry has held back in taking advantage of the new possibilities, waiting to see the results of the US experience.
However, members of the BMIS community can still push ahead with using the technology. Think about it. You can easily and cheaply produce an electronic book that contains articles, lectures, protocols, papers or any other information you want to carry with you and share with colleagues. And the cost of distributing the content is close to zero. Put it on a floppy, email it a colleague, post it on your institution’s website – the knowledge is available for others to read and use. Move beyond Harry Potter and continue Guttenberg’s good work.
Published in issue 35 of Biomedical Informatics Today (BMiT)
in the Spring of 2002. BMiT is the official newsletter of the