Mentorship and Scientific Writing

We are fortunate in neurosurgery to have so many great thinkers and superb writers. Our literature is replete with innovative ideas and communication in the print and digital realms. Of course, there is always annual turnover in contributing authors. People retire from practice and research, and new students, residents, and trained surgeons begin their careers. While not everyone contributes to the scientific body of literature, most do at some point in their journey. The desire to do so, pursuit of mentorship along the way, and the eventual creation of a valued message are core elements of this journey. Some people seem to be natural writers. I was not. If I had one trait, it was desire, but I had to learn how to develop an idea and craft an articulate report. My first mentor, Mark Bernstein at the University of Toronto, taught me the former, and my fellowship director and subsequent partner Dade Lunsford at the University of Pittsburgh, taught me both! The enthusiasm I felt with my first publications in the Journal of Neurosurgery and Neurosurgery cannot be overstated. I truly felt that the neurosurgical community at large was telling me that what I had to say (or write) was “worthy.” I was in the club! Sometimes a scientific report takes on the form of an essay, using skills gleaned in high school or college. Verbosity has no real place other than perhaps in the Discussion section if appropriate. This is why journals have word limits. The report should be focused on the question at hand, not a broad review of concepts beyond the question. Some journals also have limits for the number of edited text pages allowed per year by their publisher. Good copy editing is costly and adds to the expense of publication. Fortunately, Neurosurgery Publications does not have page limits per se, but we do have word limits per article. I have expanded these to provide more latitude for authors, particularly when asked by reviewers to provide more information about some issue (which of course, means more words). Mentorship of students and residents often begins with the development of a research idea. Students come to me and ask to write an article or get involved in research. I first tell them that one of my hardest jobs is coming up with a good idea. So I ask them to go and look over recent journals and think of 5 neurosurgical questions that they think we need to answer. Then, I invite them to come back in 2 weeks to discuss the list. The lists they make are always interesting! Some seem to tackle the great questions of our specialty, some suggest themes for which there is no readily available data, and some bring ideas I had not considered. “That is a great idea, but let me tell you why that would be very difficult to organize and complete,” is a response to wanting to do a randomized trial of resection versus radiosurgery to see what is best for hearing preservation in vestibular schwannomas. “However, we could evaluate the location and configuration of the tumor and its position inside the auditory canal to see how that relates to hearing” and that would have value for readers. That is a project they could complete. One of my students was interested in a neurosurgery ethics topic. That was more challenging to me personally, and it led to our work on several articles related to the definition of “standard of care” in neurosurgery. How does innovative work become “standard” and who decides this?1 The actual writing of a scientific report can seem a daunting task. Does the writing start once all the data are collected? No! It can start right away. A literature search allows the background material within the Introduction and Discussion sections to be written. The work to be done allows much of the Methods section to be composed. The Introduction can start to be written on day 1, as the idea is formulated. The Results section comes with the data, and most of the Abstract comes last, when the real tone of the message is created. Dr Mark Bernstein taught me to write within the confines of these short sections, which were always easy to do. “I want to see the Introduction section on my desk tomorrow,” was a fairly simple task because he was only asking for 3 paragraphs. These short, focused essays quickly constructed the report. For this editorial, I asked our Associate Editors to share whatever advice they received. Comments included, “Be brief and to the point; the simplest message is usually best” (Howard Riina); “Publishing lots of papers is good, but spend the time to write one great article each year that everybody will want to read and that will make an impact on neurosurgery” (Michael Lawton); “It is very important to acknowledge the previous work and studies published in the area (usually within the introduction/discussion), yet also inform the reader about how your study adds substantially to the existing literature”, and “There needs to be coherence between the introduction and discussion sections. A strong introduction is necessary to capture the reader's attention, and the discussion section has a similar tone and cadence, yet provides additional detail and context while highlighting the key findings of the study” (Langston Holly). Russell Lonser was taught by Ed Oldfield, “always write with an economy of words, never repeat yourself and use an active voice.” Praveen Mummaneni provided “Look at the journals for research ideas and publish frequently,” comments provided during his residency with Dr Mitchel Berger. Fred Barker wrote, “I was taught by a medical writer at UCSF to start the Discussion section with a brief paragraph summarizing the findings (Results).” Aviva Abosch noted that she was encouraged to “step outside the topic at hand…and re-read every section from start to finish for logical flow.” For me personally, the writing of a scientific article is the exciting culmination of a research idea that becomes a reality. There is nothing better than sharing that in print and online, as part of a journal issue, and then as archived science that becomes part of the history of our specialty. Douglas Kondziolka, MD, MSc Editor-in-Chief, Neurosurgery Publications New York, New York, USA This Editor's Message has been simultaneously published in Neurosurgery and Operative Neurosurgery.

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