The New England Journal rents a floor of the Harvard Medical School library. The journal is owned by the Massachusetts Medical Society and has no formal relationship with Harvard except that of a tenant.
To those familiar with mainstream journalism, its offices have a rarified quality. Walls are spotless, the furniture deep-grained and warm. And the air is utterly devoid of frivolous chatter. "It's like a monastery," said one staffer, only half in jest.
While Kassirer has final say over all manuscripts published in the journal, Angell plays an important role in whittling 2,500 scientific manuscripts each year to the 250 that make the final cut for publication.
Presiding over a recent meeting, Angell pressed a deputy editor about an article that seemed interesting but endless. "I think this must be about 16,000 words," the deputy said. "Can we get it to 4,000 words?" said Angell. "Tell him 5,000 and not a word longer."
Angell also has the freedom to write editorials on topics that interest her, and to choose outside experts for others. Many readers, she said, mistakenly believe that editorials represent the views of the New England Journal of Medicine. Rather, she said, the editorials are the views of their authors. That is why they are signed.
She is guided by several intersecting values. "I don't want people to suffer, and I define suffering as what patients call suffering." She believes medical care is a human right, not a commodity.
"And I hate woolly thinking, which can rear its ugly head. I am concerned about the American public's inability to deal with the issue of evidence."
In her book "Science on Trial," she said the case against implants was based on anecdotes, not scientific evidence.
"So the breast implant issue has to do with autonomy" -- a woman's right to choose cosmetic improvement -- "but mainly it has to do with greed and superstition and hysteria and opportunism substituting for evidence."
Pub Date: 10/26/97
