Who is Ivan Schwab?

We live in the age of biography. They fill and spill over the shelves of bookstores. They have become gigantic in length (example, Lord Black’s new biography of Franklin Delano Roosevelt is 1278 pages in length).¹ It is perhaps, therefore, not surprising that Papalkar and Francis in their letter to the journal this month ask, “Who is Ivan Schwab?”² Actually, if we understand them correctly they are really asking, “What are Ivan Schwab’s qualifications to write about interesting aspects of the eye in various animal species?” The fact that Ivan Schwab is a renowned corneal surgeon with a side interest in the eye in evolution is interesting. That he plans a sabbatical in the homeland of Papalkar and Francis to study with a marine biologist is perhaps even more noteworthy. Yet, is he qualified to write on these topics? He does not have a PhD in zoology, animal behaviour, etc. As with most American physicians he has only a single degree, an MD. Is any of this important? Are the covers of the journal less interesting because of Schwab’s amateur’s status? Are his descriptions any less provocative because he lacks validation with a university degree in zoology, etc?

The question Papalkar and Francis ask—who is qualified to contribute to the journal?—is an important one. Yet, we strongly disagree with their conclusions. We would assert that qualifications necessary to contribute to the scientific literature include intellectual curiosity, knowledge of appropriate study design, and most important—honesty. Listing authors’ degrees and academic appointments seems unlikely to address the question of whether they are qualified to write on a specific topic. Reviewers and readers alike will come to their own conclusions after carefully reading the paper in question. Or to make the point another way—did Linus Pauling’s multiple degrees and two Nobel prizes make him qualified to wax on about the wonders of vitamin C?

We fear that what Papalkar and Francis refer to as “qualifications” are in fact primarily statements about “authority.” After all, the hospital trolley boy may be very qualified to write about first hand observations in the hospital. The history of medicine is replete with tales of authority suppressing new, important information from those with a less authoritative voice. For example, Richard Horton, in his discussion of Sherwin Nuland’s new book, The Doctor’s Plague: Germs, Childbed Fever, and the Strange Story of Ignac Semmelweis, points out that although Semmelweis “turned obstetrics into a respectable science” he also “revealed how professional eminence and authority could breed stupidity and bitter jealousy.”³ The resistance of the Viennese medical establishment to the young Semmelweis’s investigations of epidemic childbed fever is a sordid tale of well respected, seemingly qualified medical authorities obstructing the dissemination of an important medical discovery.

We do agree with one aspect of Papalkar and Francis’s letter—the journal should be consistent in “appending qualifications.” We would suggest that the journal should not publish any such “qualifications” or “academic titles.” We would also propose that perhaps masking the authors’ names and qualifications from reviewers might provide for a more uniform and fair review process that would make it less likely that second rate papers from world authorities are published and that original thought provoking ones from less well known physicians are not overlooked. Although we do not agree with the thesis of the letter by Papalkar and Francis we wish to thank them for bringing the issue to our readers. We would encourage readers of the BJO to express their opinions as a “rapid response.”