Posterity Matters!

“A seed of a tree sown by a man is not for himself; it is for posterity. A case reported by authors is an education not for himself; it is for posterity!” One of the greatest thrills for a clinician is in being a “Sherlock Holmes,” unraveling the mystery of odd clinical presentations, joining the pieces of the jigsaw puzzle, associating with known pathophysiology, getting the right set investigations done, and finally arriving at a “rare” diagnosis. There is no doubt that the effort, the zeal, and the astute clinical mind behind this successful process, are highly commendable. The subsequent decision of the clinicians to pen it up for the public domain of medical literature, is only but expected, and desirable too. So far, so good. Now, here comes the dilution of efforts and enthusiasm. The admirable teamwork, the toil, the sweat, and the brainwork of the clinicians involved in the entire process of arriving at a rare diagnosis, abruptly slackens at this point. The subsequent work of “writing-up” the case is often delegated to the junior-most, inexperienced doctor in the team. This is disheartening and most undesirable. And even more disconcerting and ethically unacceptable is the fact that often the final “write-up” is not perused by the seasoned stalwarts in the team making the diagnosis. Notwithstanding the fact that it is adorned by names of authors who are celebrated academicians from prestigious medical institutes, the manuscript which eventually gets shaped out and submitted for publication, is an obvious sample of inexperienced, immature writing. A stupendous diagnosis and clinical management marred by flawed writing, downgrading the quality and standard of the Journal is only one aspect, but the more important and probably more damaging consequence is the negative public image it creates for the senior clinicians of our fraternity, named as “authors.” One wonders what leads to this abrupt “twist” in alacrity and interest in the same astute, revered clinicians, when it comes to transferring the clinical scenario into “black-and-white?” It appears that the global low recognition for “case reports” in the hierarchy of medical evidence, as also the total disregard for such category of writing by academic authorities, in the in the counting of the author’s personal academic performances, are the key deterrents suppressing the ardour of the perennially busy senior clinicians. However, whatsoever be their level in the evidence pyramid, or their impact in career progression, “Reports of Unusual Cases” are thriving well in medical literature and are here to stay and be read with interest by physicians. It is only expected that the motive of a clinician bringing forth a clinical scenario into the public domain should be to educate the readers regarding the approach, the challenges, and other nuances involved in the diagnosis and management; an objective completely defeated if improperly described. It is not to be forgotten that a “writing” once disseminated in the public domain, remains for posterity – not just the clinical case, but also the authors and the institution reporting it. Thus, for the sake of personal esteem of the authors, as well as for the repute of the institution, it is of utmost importance that any clinical matter meant for public reading today, tomorrow, and forever, is to be written with the same rigor and perfection which was used in solving the enigma of the case. Financial support and sponsorship Nil. Conflicts of interest Author is the Editor of the Journal.