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The collected editorials by Martin CO Bax from Developmental Medicine and Child Neurology, 1961–2003
  1. J B P Stephenson

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    Edited by Martin C O Bax. London: MacKeith Press, 2004, £18.00, pp 264. ISBN 1898683417

    And it’s only £18, including postage! But how does one review a book like this, a collection of twelve dozen editorials spanning four decades? I thought of the late Ronnie Mac Keith (“I am not your boss, I am your colleague!”) whose evocative personal memoir by Martin rounds off this book, and looked for a bottle of Madeira to accompany my morning coffee and sweet biscuit. All I could find was port, and at once I was there watching Ronnie standing on the college dining room table between the silver giving an after-dinner speech, while Martin, already an editor since 1961, sat beaming below. But before I continue, I should explain about the editor date. The year 1961 is when Martin first became co-editor (with Ronnie Mac Keith) of Developmental Medicine and Child Neurology. Martin had already been editor of Ambit (the literary and artistic magazine with poetry and visual arts side by side since 1959. That may give a clue as to why the present collections of editorials will be so fascinating to paediatricians, and not just to paediatric neurologists or students of developmental medicine. These editorials are well written (as befits a literary man), wide ranging, and a delight to dip into, delightful enough to find a place on the bedside table or even—and this is a compliment—in the loo.

    Martin’s first editorial was on animal behaviour, summarising the work of Harry Harlow on infant Macaque monkeys and the contrasting effects of cloth and wire “inanimate surrogate mothers” on the infants’ behaviour emotions and affection. He was then fresh from Guy’s, having previously been up at New College, Oxford. In a later editorial, he tells us that at his first paediatric unit two elderly paediatricians took him aside and advised him not to continue in that specialty, which they saw as declining and coming to an end, what with the eradication of tuberculous meningitis and other acute infectious diseases of childhood. But, he writes (p. 141) “There were two straws blowing in the wind: one was the developing interest in neonatology; the second was that people were beginning to wonder about the fate of the many children with congenital disabilities who at that time were often fated to be placed in institutions and to spend the rest of their lives there.” As Martin’s mentor (if not boss) Ronnie Mac Keith predicted, paediatrics did not disappear, quite the contrary, and by 1984 (p. 96) Martin is making “a plea for not too many more paediatric specialties. A paediatrician is a doctor who looks after the child, intending both to promote health and development and to care for the child who becomes ill. This is a species that should not be endangered by too much fragmentation.”

    Nonetheless, in this travel through the academic life of Martin Bax, I sometimes sense a whisper of conflict between keeping paediatrics whole, in one piece, and dividing up even into subsections of paediatric neurology, so that rare disorders may be properly dealt with, so that doctors know more than the internet learned parents. Another conflict is between the role of paediatric neurologists in centres for handicapped children (p. 56) and the Aicardi view that the prime task or skill of paediatric neurologists is to make precise diagnoses: why did it happen, will it happen again, and can it be treated, rather than can the child be managed, for the answer to the latter is always yes. The solution may lie in the various skills as doctors that each of us has, fortunately as varied as we differ from each other as humans.

    I would hasten to point out that the editorials in this collection are not predominantly about paediatric neurology. We are led through byways old and new, journeying from the clay tablets of ancient Mesopotamia (p. 205) to Hippocrates to Chaucer, to Little, Osler and Freud, and via the USA to more recent sages. By 1986 (p. 106) “I feel that the dead hand of peer reviewing and conformity hangs heavily over medical journals” whereas “The glory of language is its flexibility and its failure to obey the rules.” Regarding meetings and conferences, he favours the view of Mac Keith1 that the “greatest benefit results when small groups of 10 to 50 are together for three or four days” with “the intelligent use of guests from far-away parts of the world” (p. 61).

    The final Editorial of Martin Bax in 2003 (p. 252) includes the immortal lines “Indeed it was Hippocrates who denied that epilepsy was due to the erotic behaviour of the gods, but to some disorder which could be rationally investigated.” Much better than erratic!

    Edited by Martin C O Bax. London: MacKeith Press, 2004, £18.00, pp 264. ISBN 1898683417