Rooms Without Windows

Leonardo Da Vinci's anatomy laboratory was a room without windows, deep beneath his villa. Here, working completely by candlelight on fresh corpses which had been stolen from graveyards, he created what may have been the first realistic drawings of the human interior. If he had been found out he would have been excommunicated from the church, at the very least. He could have also been tried for witchcraft and burned at the stake. So he wrote his notes in enantiomorphic (backward) script which could only be ready by holding the document up to a mirror and, understandably, kept his findings private.

Although most people are unaware of it, because Leonardo did not make his findings public, no matter what the reason, he was not a scientist, nor was he doing science. If that statement seems a bit unfair to Leonardo, it is only because most people do not adequately appreciate that the critical exposure which the scientific publication process creates is not an option or extra, but it is the very essence of scientific process. Without publication, private individual observations will forever remain unscrutinized, untested, unreplicated, uncorroborated, uncorrected, uncalibrated, unavilable to others, and unintegrated with the rest of human knowledge. Without publication there is no feedback; without feedback there is no improvement and no science.

But it is equally important to understand that scientific publication, which includes the process of prepublication peer review as well as universal access by means of indexing, is a good deal more than the mere process of printing, although merely appearing in print can often impress people. Indeed, the technology of writing, printed or handwritten, was for thousands of years the sacred property of high priests and kings, who must have appeared wondrous, inspired, and even godlike in the way they could accurately and consistently reproduce the thoughts and speech of those long dead or far away. The magical validity and veracity of writing survived the invention of the printing press; and even today, just the fact that "it is written" still impresses many people, especially those who are least literate.

Over the years, I have accumulated an entire shelf of self-published books and "journals", at first sent to me by amateur "psychologists" and "philosophers" and more recently, by chiropractors. Most of the older books, which were mimeographed, rather than xeroxed, have embarrassing typographic and spelling errors. Often they have hand-drawn figures, sometimes grotesque or anatomically impossible, often with smudges or other amateur imperfections. Perhaps you have seen such books.

The newer books look much better, of course. They are word-processed, spell-checked, computer-graphed, laser- printed, and desktop-published. Only the plastic binding gives them away now. I received one of these new types last week, with an equally handsome cover letter from a DC somewhere in the Midwest. The letter began proudly by saying that a significant contribution to "chiropractic science" (meaning the book) was enclosed. However, it then went on to ask if I could find someone in the Consortium who would review and critique all several hundred pages of it, and perhaps "do experiments" to "prove" various aspects of the work.

I was again struck by the tragedy of this obviously conscientious, dedicated healer who had, without a doubt, worked very hard to generate this naive document. The real tragedy was that in the midst of an information explosion, in the middle of the best educated country in the world, minutes away from all the recorded cumulative experience of humanity, he had worked in virtual isolation, deprived not only of the work scientists and clinicians in all parts of the world were doing which might have had direct relevance to his own work but deprived also of the ongoing, worldwide professional feedback which the scientific publication process would have generated for him as he developed his ideas. With the critical power of all of the best minds in the world at his disposal, he had worked alone, in dim light, in a room without windows.

How, in the 20th century, could this otherwise intelligent man have come to believe that the millions of health care scientists and clinicians in the world today were incapable of generating any information or providing any criticism useful to him? Is it possible that this man had actually been taught that because it is often associated with medicine, science itself is inherently "bad" and should be avoided at all costs? Perhaps. But it is far more probable that he was simply unaware of the scientific publication process, of what it was, how it worked, and of its critical importance in the creation of human knowledge. This kind of ignorance, while certainly an indictment of chiropractic education in the past, is today a major concern being addressed by chiropractic educators everywhere.

The Consortium for Chiropractic Research is dedicated to, and is an active participant in, the scientific publication process. And, although we still are disappointed by the occasional self-printed book or article, we are generally heartened to see more and more enlightened individuals in chiropractic abandoning the easy process of printing their findings and taking up the difficult but infinitely more valuable process of scientifically publishing them.