Authorship in Forensic Psychiatry: A Perspective

Shakespeare Not Required

William Osler¹ in his treatise, “Creators, Transmuters, and Transmitters,” divides writers into three categories. The first category, the world's creators, is extremely rare. The writing of creators is altogether unique and original. Osler offers Shakespeare as an example. But Freud and Darwin also come to my mind. In American forensic psychiatry, Bernard Diamond arguably achieved creator status with his 1959 article, “The Fallacy of the Impartial Witness.”² Isaac Ray in his “A Treatise on the Medical Jurisprudence of Insanity,” published in 1838, was indisputably a creator.³ When he wrote the “Treatise” at the age of 31, he was a general practitioner in Maine and had no experience in treating the insane.⁴ Ray, more than any other 19th-century physician, is associated with the development of forensic psychiatry.

In the second category, a transmuter takes an idea and puts a new spin on it. Osler noted that, “The melting-pot of the transmuters has changed the world. They have been the alchemists at whose touch the base metal of common knowledge has been turned to gold” (Ref. 1, p 1). In the 1990s, the transmutation of violence prediction to actuarial assessment of the risk of violence was a major step forward in advising the legal system about violent offenders.⁵

In Osler's last category, transmitters distribute ideas and information. Review articles and textbooks fulfill this important function. The systematic reviews of evidence-based studies on lithium and suicide led to the discovery that lithium had antisuicide properties for patients with bipolar disorder.⁶ Systematic reviews are at the top of the clinical evidence pyramid.⁷ Systematic reviews of research underpin evidence-based general and forensic psychiatry. Transmuters and transmitters are essential to education and research.

The distinction made by Osler among creators, transmuters, and transmitters is too categorical. Creativity is not the sole province of literary geniuses. Forensic psychiatry provides many opportunities for creative authorship at all levels of writing, without one's having to be a Shakespeare.

I am a clinician who writes about psychiatric issues. I do not possess the writing skills of a professional writer. I neither have formal training in writing nor make my living by it. I am incapable of writing a novel or even a short story. But medical writing and creative writing have different goals and sources of knowledge. Creative writers dig deep into the human psyche to produce works of art. In fantasy, one can go anywhere, be anybody, do anything. I once heard a commentator compare medical writing to singing in the shower, while creative writing was likened to singing at the Metropolitan Opera. The comparison is unfair. The creative writer's task is to imagine. The forensic psychiatrist's task is to analyze, educate, and inform. Neither writer is superior to the other; each requires skills that serve different ends.

The Experience of Writing

For some psychiatrists, writing is agony. Next to the fear of public speaking, expressing one's thoughts in writing for others to read can be terrifying. I recall a colleague who, in order to write his overdue reports, would travel to a remote location thousands of miles away. There, he wrote voluminous reports. Despite this enabling travel ritual, he told me that writing for him was like having his bowels yanked from his body.

Others feel driven to write. Henry A. Davidson, a pioneering forensic psychiatrist, in his book on medical writing titled the opening chapter, “Stalking the Idea.”⁸ But authors often find that they are stalked by an idea rather than being the stalker. The idea follows them wherever they go. Anguished cries of, “Go away! Leave me alone! I have other things I want to do!” are of no avail. The idea hauls the author, kicking and screaming, to the desk to write.

Some writers compare the experience of the writing process to that of a protracted illness. George Orwell,⁹ for example, found that, “Writing a book is a horrible, exhausting struggle, like a long bout of some painful illness. One would never undertake such a thing if one was not driven by some demon that one can neither resist nor understand” (Ref. 9, p 395). Orwell was “cured” by writing such books as Nineteen Eighty-Four and Animal Farm.

Others compare writing to an addiction. This analogy reflects the recidivistic behavior of those who continually return to writing, despite the draining effort and personal cost. Writing, like an addiction, is an escape from reality. Some authors describe “withdrawal symptoms” after finishing a book. Others have enablers, persons who relieve the writers of day-to-day chores so that they can write. Yet others have compared writing to an affair, depicting the relationship between the author and the writing as a passionate, all-consuming dalliance.

I prefer to think of the experience of authorship as an enchantment that brings joy, but also some inevitable misery, to the author's life. A biological analogy for this experience is a wanted pregnancy. Writing is a labor of love, similar, as far as I can discern, to the experience of a pregnancy. Once an idea is conceived, it must be nurtured. It grows over time, through a continuous gestational process of writing and creating. If the process is interrupted or stops, the idea will abort and die. At full term, the article or book is delivered. Some authors experience a mild postwriting depression. Perhaps Jonathan Swift¹⁰ reflected a similar experience when he referred to books as “children of the brain.”

The Writing Process

An essential element of writing is getting started and finishing on time. I have asked forensic psychiatrists who have decided to write an article or a book when they intend to begin and finish their writing project. On many occasions, I have received the response: “soon,” “in the near future,” “next spring,” or some other indefinite time. Writing requires an internal discipline that adheres to a specific starting and finishing time. Otherwise, the writing project is likely to falter. Emerson¹¹ observed that, “The great majority of men are bundles of beginnings.” Some writers will do almost anything to avoid getting started. But once started, the writing process must be husbanded with care.

The fear of failure and embarrassment is a major obstacle to writing an article or book. It takes courage to put one's ideas in writing for everyone to see. While such fears afflict most writers to some degree, others are inhibited from writing altogether. Perfectionism can become the enemy of the writing process. The perfectionistic writer will experience difficulty starting or finishing. The writer cannot let go of the work because it is not perfect, even though the writer knows that no perfect article or book has ever been written.

Many excuses serve procrastination. Excessive research can delay or stall the writing process. The writer is gripped by an analysis paralysis. Procrastination wastes valuable energy that could be better used for writing. Moreover, the longer the procrastination, the greater the expectation regarding the quality and scope of the work. I once heard an author exclaim, “Write something! Write crap! You can come back and clean it up later.” Sylvia Plath¹² scorned procrastination, “Nothing stinks like a pile of unpublished writing.”

Before writing can begin, the writer must be clear about the message to be conveyed, who the readership will be, and where best to publish. For example, a forensic psychiatrist writing a book about serial killers would write it differently for lay readers than for professional readers. I have found it much more difficult to write a trade book for the general public than a book for a professional audience. There are no short-hand terms of art that can be employed. Everything must be clearly explained.

Once an idea is developed, the research completed, and the outline constructed, much of the writing or composing of the written word occurs in the writer's head. Some authors have described becoming aware of a subconscious writing process while cutting the lawn, driving a car, taking a shower, or milking a cow.

Agatha Christie¹³ observed that, “The best time for planning a book is while you're doing the dishes.” Writing does not take place at the desk, only transcribing. The writer cannot expect to find his muse waiting at the desk, no more than the surgeon waits for inspiration to operate. The blank page holds no terror for the writer who is settled in the process of writing.

W. Somerset Maugham described this mental process well: He goes about his ordinary avocation with patience; the subconscious does its mysterious business, and then, suddenly springing, you might think from nowhere, the idea is produced. But like the corn that was sown on the stony ground, it may easily wither away; it must be tended with anxious care [Ref. 14, pp 240–1].

When writing an article or book, keeping a pen and piece of paper handy helps capture ideas that bubble up. Some authors keep a pen and piece of paper handy when jogging. The belief that the thought will surface again or be remembered later is often self-delusive.

I have found that working at the same tidy, well-lighted desk promotes the process of writing. My tools include a good dictionary, a thesaurus, and a writing guide such as, The Elements of Style by Strunk and White.¹⁵ The radio, television, pager, and cell phone can be fatal distractions. I turn them off. Some writers can only write with a radio, television, or music playing in the background. Other writers are able to write effectively on airplanes, even with a screaming baby nearby or when sitting next to a chatty passenger. These intrepid writers, already having written in their heads, transcribe “between the cracks.”

A few writers, such as myself, can only write by putting pen to paper. I find dictation results in fluffy “thoughts while shaving.” Most writers use a computer, which they find to be more efficient than pen and paper. The computer is unmatched for ease and efficiency in writing (e.g., cutting and pasting). But I have found that putting pen to paper creates an unbroken intimacy between thought and word. Sherwin Nuland, surgeon and award-winning author, analogized writing with pen and paper to a surgeon who operates from thought to hand (personal communication with Sherwin Nuland, MD, October 28, 2006). “Whatever works” for the writer is the byword.

Writing requires energy, commitment, and a quiet mind. The writer may not find time to write or achieve the quiet mind that is so essential to writing without the help of a spouse, partner, or an assistant. Even with support in place, time to write does not simply appear. A major challenge for authors is creating time to write. The author must squeeze time out of a busy schedule. The bustle of clinical or forensic practice with all its demands and distractions can shut down the opportunity to write. Thus, a writing project should be made a part of the forensic psychiatrist's professional practice; otherwise, it may loom too large and overwhelming. Authorship should be given a moderate, reasonable priority. A writing project that is added to a busy practice and other personal responsibilities is unlikely to succeed.

Those who wait for a quiet moment to write are not likely to find it. I prefer to write early in the morning before the phone rings and everyday duties beckon. Some writers write in the evening, either by choice or necessity. Writing at night can be labored due to fatigue. Others may find that they have to juggle their writing times between multiple work and family responsibilities. The opportunistic writer is able to write when time unexpectedly comes open.

Finding time to write can be especially challenging for women, who often bear the majority of child- and house-care responsibilities. Raising a family, practicing full-time, and writing require accommodations and sacrifices by family members. The sacrifices may not be cheerfully borne by family members who feel their needs are being ignored.

I have found that the method of writing described by Anthony Trollope, the 19th century novelist, to be very productive. Trollope writes in his autobiography, “I have allotted myself so many pages a week.” Trollope notes that, “A small daily task, if it be really daily, will beat the labors of a spasmodic Hercules” (Ref. 16, p 103). He draws a quaint analogy between the writer and the shoemaker who both, workman-like, produce so many words or shoes a day. While not always possible, a workman-like approach that produces a certain number of words or manuscript pages per day or week maintains the writing process. But some writers find this method stifling, preferring a hare rather than a tortoise approach to writing. For a few, the hare wins.

Trying to find time to write on a weekend or during a vacation can disrupt the writing process. Writing becomes an onerous task to be avoided. Binge writing, a type of event writing, usually fails for the same reasons. Unless a writing project is given some priority, other interests or demands on the writer's time will take its place. “Process” and “workman-like approach” are key concepts that describe effective writing. Forensic psychiatrists who dislike or even loathe writing must nevertheless write. They can reduce their angst by adopting a strict workman-like approach to a writing project, as described herein. The process of writing is not a frenetic dash to the finish line. It is more akin to a leisurely walk that is enjoyed.

For Whom Do We Write?

William Zinsser, in his book On Writing Well,¹⁷ declares that, “Writing is an act of ego and you might as well admit it. Use its energy to keep yourself going” (Ref. 17, p 25). But does it matter whether anyone else reads our writing? Cyril Connolly,¹⁸ a superb essayist and journalist, reminds authors, “Better to write for yourself and have no public than write for the public and have no self.” Yet, the pure writer who writes just for the pleasure of writing and without the need for approving readers is indeed rare. One cannot imagine a speaker addressing an empty hall. Writing is a dialogue; it must always consider the reader as a chef does the diner with a discerning palate. John Updike describes the meeting of writer and reader this way: It is the site of an encounter, in silence, of two minds, one following in the other's steps but invited to imagine, to argue, to concur on a level of reflection beyond that of personal encounter, with all its merely social conventions, its merciful padding of blather and mutual forgiveness [Ref. 19, p 27].

Psychiatrists who author books or articles must first and foremost write for themselves. They cannot write successfully for money, for fame, or for immortality alone. Rarely do writers of professional books make money that exceeds their expenses. If an author earns $5,000 (a princely sum for a forensic book) that took 2,000 hours to write, the hourly wage earned is the munificent sum of $2.50 an hour, not counting substantial costs incurred in writing the book. If the author spends half that much time writing the book, he has earned $5.00 an hour. And then, there is the opportunity cost. Much more money could be earned in performing other remunerative professional activities, for example, writing a forensic report.

Similarly, the forensic author and the book should not expect to appear on The Oprah Winfrey Show or to make the New York Times Best Seller List. The chance of achieving fame is considerably lower than the chance of winning the lottery. Approximately 200,000 new book titles are published every year.²⁰ Very few sell over 100,000 copies. Publishers of professional books consider a forensic psychiatric book that sells 1,000 copies to be a success. Overly optimistic expectations—for example, writing an award-winning article for a leading journal—can quickly discourage the fledgling writer. Writing is a humbling experience. Although fame will prove elusive, the author may gain personal gratification through professional recognition that writing can bring. He or she may receive an award or obtain case referrals from colleagues or lawyers who scour the Internet for experts.

The hope of achieving immortality is unrealistic. William Osler observed, “The vast majority of all books are dead, and not one in ten thousand has survived its author” (Ref. 1, p 1). Most books have a short half-life, unceremoniously buried in the publisher's backlist. Electronic publishing is no exception. A dubious immortality is achieved. The book will live indefinitely, but in a persistent, electronic vegetative state.

Clarity and Precision

Writing with clarity and precision is essential to good writing, whether writing a research grant, report, article, or book. Opaque and wordy writing will create misinterpretations, ineffectiveness, and loss of credibility. Sentences longer than 20 to 25 words tend to lose the reader's attention. The only remedy is hard-nosed multiple revisions. A sound rule of writing is, “When in doubt, take it out.” James Michener²¹ revealed that, “I'm not a very good writer, but I'm an excellent rewriter.” Clarity and precision in writing can be improved by reading good authors. Steven King²² advises would-be writers to “Read, read, read.”

Most forensic psychiatrists are not professional writers. The rules of English 101 are violated with regularity in forensic reports, articles, chapters, and books. No writer, no matter how skilled, avoids these transgressions. Constant vigilance is necessary. For example, the excessive use of adjectives and adverbs causes the reader to be overcome by an offensive logorrhea that is often found to coexist with a constipation of ideas. Writing in the passive voice is lifeless. The sentence, “The jury found the defendant guilty” is much more vigorous than, “The defendant was found guilty by the jury.” It has conviction! The use of the phrase “in terms of” is an entrenched habit among psychiatrists and other mental health professionals. Strunk and White,¹⁵ in their essential reference for writers, define this phrase as, “A piece of padding usually best omitted.” The phrase “in the light of” frequently litters the writing of legal commentators.

The Forensic Case Report

I draw no invidious comparison between writing a report and writing an article or book. The writing of a competent case report is a skilled endeavor. Some forensic psychiatrists have elevated the case report to an art form. When the American Board of Forensic Psychiatry was offering certification examinations, the Board required that a written report be presented and defended. It was the most challenging element of the examination and the most frequent cause of examinee failure.

For some forensic psychiatrists, writing case reports can be drudgery. The report is written for another party, not for oneself. The report must encompass many facts, both clinical and legal. All too often, the report is requested on distressingly short notice. Creativity is neither required nor desirable. The forensic psychiatrist may find the case to be of little interest. The writer also knows that opposing counsel will scrutinize every word.

These conditions may result in a defensive writing style, easily identified by the number of “howevers” the author uses. If used, however, it is best neatly tucked inside the sentence. An exasperated attorney once complained to me that psychiatrists have “hand problems.” He explained that, “When you ask a psychiatrist for an opinion, what you get is ′on one hand it's this and on the other hand it's that.’ ” The attorney was looking for a “one-armed psychiatrist.”

No matter how competent the writer, good writing may fall casualty to a long and often dry forensic report. Some forensic reports run many pages, occasionally 100 pages or more, at substantial cost to the retaining party. After much effort is expended in writing the report, few will read it. The forensic report, though important, has a brief life that is terminated with resolution of the legal case. Dr. Seymour Pollock, a founding member of the American Academy of Psychiatry and the Law, advised that a forensic psychiatric report should not be longer than three pages. A brief report usually takes more time to write. As written by French mathematician and philosopher Blaise Pascal, “I have made this [letter] longer, because I have not had the time to make it shorter.”²³ In report writing, as in other writings, less is more.

Collaboration

Writing in partnership with colleagues can be very stimulating. A creative synergy often develops between authors. But coauthors and coeditors have to be chosen wisely. Delineation of responsibilities must be clearly drawn. No doubt should exist about who is the principal author. Coauthors and coeditors may have agendas or expectations that are not expressed initially. It is best to know personally a collaborating author or editor; if that is not possible, it is best to choose one who comes highly recommended and who will deliver an acceptable manuscript on time. The vetting process should be done before agreeing to coauthor an article or chapter or to coedit a book. Divisive disputes and even lawsuits have arisen between collaborators because of a lack of clarity about who is the principal author or editor, as well as other misunderstandings.

Single-authored and multi-authored books all have their advantages and disadvantages. Single-authored books tend to be more consistent in quality, whether high or low. The single author also has more control over meeting production schedules. Writing a single-authored book can be lonely and fatiguing. A multi-authored book requires less writing by the editors but can be uneven in quality. A book editor should be more than an impresario. Editors need to contribute chapters just as they have asked others to do. They must demonstrate their legitimacy as experts in the subject matter covered by the book.

Editors are invariably vexed by the “rule of thirds.” In an edited book, about a third of authors deliver their chapter manuscripts before the deadline, another third on deadline and the remaining third are late, often very late. Unfortunately, some authors must be cajoled or even coerced into delivering their promised work. This group of dilatory authors causes editors the most distress. The complexities of organizing a multi-authored book bear a similarity to arranging a wedding.

When writing in the field of psychiatry and the law, the author should consider consultation with an attorney who has specialized knowledge in mental health law. Coauthoring articles, chapters, or books with mental health attorneys, often law professors, is intellectually challenging and stimulating.

The Publication Process

The publication process is intimately linked to that of writing. Once the manuscript is submitted, many revisions will be necessary. The manuscript is sent for independent editorial review. When the publisher sends the page proofs back to the author, there are many “author queries.” Correcting incomplete or erroneous references and legal citations can become the bane of the author's writing life. The discovery of obvious errors and omissions after publication is agonizing. The author must find solace in the knowledge that the publication process is not error proof. Most readers mercifully skip over mistakes, if the errors are not egregious.

Professional books and articles are subject to the unique process of peer review. Some writers feel threatened by the peer review process. An occasional peer reviewer can be gratuitously brutal, damning the book and, by inference, the author. H. G. Wells²⁴ observed that, “No passion in the world is equal to the passion to alter someone else's draft.” Despite some initial psychological wounding, peer review usually helps improve the quality of an article or book manuscript. It can also create a collegial feeling of, “We are in it together.” Peer review can be a breath of fresh air that sweeps over the writer who has written so long in isolation, behind closed doors.

Nothing should be left to the sole discretion of editors, no matter how competent they may be. The author must exercise oversight during the book's production from contract to cover and beyond (promotional materials). The author-publisher relationship should be collaborative. Nonetheless, the belief that an editor at a publishing house will substantially edit the author's book is an illusion.

A good book can be spoiled by a weak title or unattractive, insensitive cover. Authors should strive to create a title that catches the reader's attention, but remains true to the book. The author has only a few seconds to capture a reader's interest. One additional word in a title can make all the difference. A book entitled, Psychiatric Malpractice is not nearly as compelling as Preventing Psychiatric Malpractice, especially when prevention is the book's theme.

The burden of editing the book and seeing the publication process through must be borne by the author(s). And like the pregnant mother, the author must carry the book until publication. The labor cannot be delegated. The publication of an edited or single-authored book is indeed like the joyous, long-awaited delivery of a baby after months or, more akin to elephant years, of gestation.

Marketing

Authors have heavy personal investments in their books. They often complain that publishers do not sufficiently or effectively market their books. The publishers of professional books have a limited marketing budget to sell a large inventory of other books. In the hope of improving recognition and sales, some authors decide to promote their books themselves. Retaining a public relations firm costs thousands of dollars. Scheduled appearances on radio and television require fatiguing travel and interference with professional practice. If the author has written a trade book, an invitation may be extended to give a lecture and do a book signing at a local book store. The experience can be interesting, but the turnout is usually disappointing. I have found book sales to be of secondary importance, best left to the business of publishing.

Ogden Nash's poem “Lecturer in Bookstore” (Ref. 25, p 52) limns his disdain for author self-promotion: Behold best-selling Mr. FurnevalBehind a pile of books to autograph,Like a bearded lady at a carnivalHoping to sell her fly-specked photograph.

The author who cherishes the twin gifts of learning and creativity will not be discouraged by the daunting realities of publishing and marketing books. The personal gratification of seeing one's work in print is sufficient, providing a soft landing for lofty ambition and a balm for the inevitable disappointment of selling less than a million copies and not appearing on The Oprah Winfrey Show.

Lawyer Scrutiny

It is best to assume that opposing counsel will read all the author's writings that are pertinent to the legal issues before the court. Forensic psychiatrists who author articles, chapters, or books should expect to be cross-examined on their writing. Their written works are readily available to lawyers over the Internet through specialized search engines. This should not make the expert defensive. If the forensic psychiatrist has written extensively, reviewing all of one's writings before deposition or trial can be a daunting task and is usually unnecessary. When the author has been reasonably consistent in his writings, lawyer scrutiny should not be a problem. It is the application of the author's writing to fact-specific cases that may create the appearance of inconsistency.

In edited books, authors express opinions that invariably differ from each other. The attorney may attempt to undermine the expert opinions of an author who has published in an edited book by pointing out that the expressed opinions conflict with the opinions of other authors in the same book. This is to be expected. It should be explained that the differing opinions in a multi-authored book are the book's strength. Unanimity of opinion is not any more achievable in an edited book than it is among Supreme Court judges whose diversity of opinions find expression in 5 to 4 decisions.

Attorneys may attempt, through subpoenas, to obtain an author's current manuscript. Manuscripts should not be provided to an attorney unless mandated by a court order. Manuscripts are not finished products. As a work in progress, unedited manuscripts contain errors or initial ideas that may not reflect the author's complete thinking. Moreover, providing manuscripts to attorneys without a court order may violate publishers’ contracts.

Authors are often asked by lawyers at deposition and trial whether their articles or books are authoritative. Though lawyers’ definitions of authoritative differ, the author's answer should be a humble, “No.” There is much diversity of opinion in psychiatry and forensic psychiatry. Moreover, by the time an article or book is published, it will not contain the most recent research or case law.

Agony and Joy

The pleasures and travails inherent in the writing life are described throughout this article. They deserve a final word here.

The preacher in Ecclesiastes 12:12 warns, “And further, by these my son be admonished: of making many books there is no end; and much study is a weariness of the flesh.”²⁶ Taking on writing projects, especially books but also articles and chapters, is a test of character. It requires commitment, conviction, and discipline.

A strong physical and mental constitution is a prerequisite. Writers are susceptible to illnesses and physical injuries (e.g., hand, shoulder, and neck). The amount of work required to write a book or even an article or chapter can be prodigious. A concurrent physical exercise program can help reduce injuries.

A colleague once admonished me not to share my book ideas with others who might “steal” the idea. The thought never occurred to me because I know the effort, commitment, personal sacrifices, expense, and “blood, sweat, and tears” that it takes to write a book. Few individuals will undertake such a daunting task, especially when it is not their own idea.

An author can spend months, more likely years, producing a book manuscript that is on schedule and acceptable to the publisher. In doing so the writer sacrifices other professional, leisure, and social activities to writing. For example, I enjoy reading, which has been limited by the time I have spent writing. George Burns²⁷ wryly observed, “This is the sixth book I've written, which isn't bad for a guy who's only read two.”

Meanwhile, family and professional responsibilities must be met. Family members can become frustrated and angry over an author's self-absorption with a book project. Authorship comes with costs. The author may experience a painful conflict between spending time away from the family and feeling annoyed or even angry toward the family for intruding upon the writing. Family income may decrease because of time spent researching and writing the book. To a lesser degree, these problems also arise with articles and book chapters. The sacrifices of significant others, willing or unwilling, are often gratefully acknowledged by authors in their book dedications. As noted, giving writing a moderate priority within the scope of one's professional practice rather than as an add-on project can help maintain a balance between professional work, family activities, and writing.

The pleasure of writing must exceed the pain before writing can be sustained (case reports excepted). Every article or book is an exciting adventure in learning. The writer may wander into philosophy, religion, science, and other interesting venues.

Disraeli²⁸ noted that, “The best way to become acquainted with a subject is to write a book about it.” The joys of life-long learning and creativity through writing can be sublime. The experience of creativity is one of life's most fulfilling, exhilarating experiences. Thus, writers are introduced to the joys of authorship. All the agonies of writing seem trivial in contrast.

One of the singular joys that writing can provide is the experience of a splendid solitude and a communion with oneself. Wordsworth²⁹ wrote: When from our better selves we have too longBeen parted by the hurrying world, and droop,Sick of its business, of it pleasures, tired,How gracious, how benign, solitude.

Once a book or article is published, it is out of the author's hands. The author must say goodbye. Like a child reared, the book is now on its own. Where it will go and whom it will meet, the author knows not. The author may hear very little of its journey into the world. Book reviews usually do not appear before a year or even two years after the book is published. With the Internet, the book or article takes flight into cyberspace. The author meets few of his readers. But what a joy it is when a total stranger comes up to the author, usually at a professional meeting and says, “Thank you for writing your book. I enjoyed reading it. It was so informative and helpful.” Then closure takes place. The book has found a happy home. Now, on with life and, perhaps, to write another book!