Margin

Once I thought of Rubenstein and Wayne's Lecture Notes on Clinical Medicine, I could not agree more with the wisdom of its original authors - and, unfortunately, the change in the layout of this handy volume mirrors the evolution of medical practice and education over the years.

You know what, the first edition of the Notes was merely 200 pages, with text printed in a single column, and there was plenty of empty space along the side of the printed text.

"... the margins of the pages are intentionally large so that the reader may easily add additional material of his own." So was it written in the preface of its first edition, back in 1975.

Alas, where do we end up now ? Some 400 pages, with text printed in two columns, leaving little space at the margin, and, ironically, the field seems quite less well covered than we had decades ago.

And, the same happens with our curriculum and practice. There's no time for student to ponder and digest, or for busy physicians to talk to their patients.

As TS Eliot says:

• What is the wisdom we have lost in knowledge ?
• What is the knowledge we have lost in information ?

PS. Old bookworms like myself used to believe in a rumor: the material in the Notes was so condensed that every space, comma, or full-stop has a hidden meaning. That is, of course, an over-statement. But it gives us hope, and I am still convinced that the whole of the wisdom for medical practice could be summarized in that tiny space.