Straws in the Wind

What is happening to traditional modes of medical history discourse, now, seven and more years out from the introduction of the Web browser to the Internet and to our collective consciousness? Here we are, five years or more into this column, and all suffering a bit, it is safe to say, from the Internet Seven-Year Itch. Where to next? It is tough to write about this phenomenon. All we know is that the infant has reached churlish adolescence. One probably predictable general-society result has been the recent die-off in many of the earliest Internet activities around electronic publishing and commerce. Beyond this negative, though, it is perilous to say too much more about the enterprise itself. There is the pesky matter of the time lag between my writing a short piece (it is now late winter 2002) for the traditional McLuhanesque "hot" medium of the Bulletin, and the "cool" state of the Internet at some point when the journal's readership sees these words. I mean, zounds, what if I am wrong about scholarly life when you actually read these words? What if some new "killer application" looms up and turns us all into ultra-techies? Despite such nervous qualifications, I believe we can identify some rather interesting straws in the wind for medical historians' life on the Internet.

It is clearer than ever that books have not gone, and will not go, away. There are too many peer review and technical quality issues still hovering over all of us for that to happen anytime soon. On the other hand, the reissue of books is being revolutionized. My own earliest publisher, Cambridge University Press, recently approached me about their new On-Demand Publishing program, using newer micro-lot and "one-off" publishing technologies that combine digital and traditional publishing, over very small print runs. You can imagine the revolutionary potential of this development. It is a Good Thing. Such developments, in publishing and in education, have not, in a sense, arrived a moment too soon—given the economics of the production and, particularly, the warehousing of traditional hard-copy books and journals. (Every medical history author will recognize this phenomenon in recent years in the rush to remainder his or her work.) But even before the Internet this trend was apparent, providing incentives for publishers to make the transition once it was upon them.

"Hybrid" technologies, such as the on-line purchase and creation of print media, mirror the recent relatively greater success in e-commerce of traditional bricks-and-mortar companies over "pure" Internet concerns. (This despite the fact that a few industry leaders such as Amazon do still hang on.) Such hybrids will probably represent more and more of what we see in libraries and classrooms. Just as adolescents become integrated into adult society, this is all part of the consolidation and reintegration process whereby Internet-based resources are absorbed into the general world of scholarship. In these columns, my collaborators and I have already made this notion of "hybrid" efforts (that is, take a little on-line, mix well with a little off-line) a leitmotif. So do we not look smart? For example, distance education "customers" want a bit of the old hand-shaking and -holding. They will surely get that mix, in a variety of ways, as academicians increasingly abandon the podium and the whiteboard as twin fulcrums of education. What will take the place of those traditional fulcrums? By now, I suspect, many of my Bulletin-reading colleagues will already have experience in using some of the newer software instructional tools, for which an entire industry has grown up. My own view is that these tools are far better at teaching medical skills and facts than they are at teaching history. But as conduits to resources, Web sites are not bad. And electronic podia do have some advantages. Unfortunately...