The Resourceful Patient

To the bookmakers


  1. A printer and bookbinder (1515)
  2. One who compiles or composes a book (often disparagingly) (1533)
  3. A professional betting-man (1862)

Shorter Oxford English Dictionary

Why the worthy toil of composing or compiling books should often be disparaged by the title 'bookmaker', whether often or seldom, is not explained in that treasure house, the Shorter Oxford English Dictionary. Publishing, as an activity distinct from writing and printing, was a term which came into common use in about 1700. For the last four hundred years, three distinct trades of writing, printing and publishing were clearly distinguishable, and the current meaning of the term 'bookmaker' evolved in the nineteenth century.

The revolution in writing and printing, enabled by new software and the Web, is transforming the business of making books. At one end of the chain still sits the author, scribbling in pencil, preferably a 2B, with the translation to Word effected by the incomparable Rosemary Lees, his amanuensis for nearly a quarter of a century. About a million words have been produced in this way with an editor in the offing, guiding and cajoling, before releasing the "manuscript" for its transmutation into a book.

In 'The Book Business: publishing, past present and future' Jason Epstein, the publishing guru and co-founder of the New York Review of Books, gives a powerful, clear and realistic vision of a future in which a single copy of a book, ordered by a reader punching numbers or typing text into a machine about the size of those that dispense Pepsi and Coca-Cola, would be rewarded in a few minutes with the clunk of a book dropping into the receptacle, printed, glued and bound.

Although we are some years away from this position, printing is changing fast, and a print run of 10 or 25, or 17 or 29 (if that is the number of people coming to your conference) is no longer impossibly more expensive than the print run of 2,000 or 3,000 that high risk monographs such as this one usually merit. Furthermore, a print run of 10 can be kept on the author's shelf for mailing out as e-mail orders come in, thus doing away with the pleasureless expense of lorries, warehouses, stock control, and, all too often, pulping or remaindering. The pleasurable expense of the bookshop, about one-third the price of a book sold there, can also be dispensed with. Bookshops rarely stock those high risk monographs, preferring the perennial sellers like J K Rowling, or the heavily promoted best-sellers by Victoria Beckham or Nigella Lawson.

The first printing of this book was done in three days, from Word file to book in hand; the second printing, with simultaneous production of the e-book version and web site, took less then twenty-four hours. Obviously this required a very clever printer, and The Alden Press in Oxford, a sixth generation company in that city of venerable printers, provided a team who could realise the future - Steven Neville, Brian Jelph, Robert Hay, Jo Wainwright, and their visionary and practical Chief Executive, William Alden.

The ability of the printers to produce the book with such speed, however, was due not only to their skill but also to the architecture of the file delivered to them. The production of a hybrid book - paper plus electronic - is the result of the design and building of a document created expressly for this purpose by the book's architect, Harry Rutter. The book architect subsumes the functions of commissioning editor looking after a linear text, but needs to think in four dimensions, creating a hypertext in which every part can be linked to every other part, which will evolve over time.

The logic and clarity of the text is due to the excellence of the editing of Jackie Rosenthal and Jane Wyatt. Finally, thanks are due to Otto Rutter whose arresting photograph on the cover not only attracts the eye but reminds the reader that the changes we recommend may seem radical to the patient of 2001, but the generation of Otto Rutter, who will be 20 in 2021, will expect the resources we describe to be routinely available, and the culture of clinical practice to be one which starts from the assumption that the patient is in charge.