One of the authors of the Oxford Handbook of Clinical Medicine

Authors: Krishna Chinthapalli 

Publication date:  18 Feb 2006

Murray Longmore is a doctor with two careers. The first, of which few doctors are aware, is general practice in the village of Ferring, Sussex. The second, of which few patients are aware, is as one of the authors of the Oxford Handbook of Clinical Medicine. As it approaches its 21st birthday, the Cheese and Onion (as it has been nicknamed) has now sold three copies for every doctor and medical student in the United Kingdom.

When did you have the idea for the handbook?

Neither I nor Tony Hope (the other founding author) actually had the idea. We met during our clinical years in Oxford, and of our group, we were the only two to carry our notes with us. I had a notebook and Tony had a small Filofax-style binder. Because we had these on the wards in the Radcliffe Infirmary, our friends would turn to us for quick answers, such as the causes of a disease, lecture notes from previous weeks, and treatment guide-lines. By the time finals loomed, they suggested that we should publish our notes. I said, “Don't be silly,” but Tony was less sceptical and thought it was worth a try. We sent some sample pages to Oxford University Press and they liked them. Looking back on those pages, I'm not sure they were actually that good.

Was it difficult to write the original handbook?

Writing such a book was certainly a challenge back in 1982. Nobody had ever included all of general medicine into a pocket book before and we did not know if it would be possible. Our closest rival was Lecture Notes in Medicine, which could just fit into the pocket of a white coat, but not without discomfort. Students would instead dip into textbooks whenever they had the chance. However, we managed to produce a manuscript during our house officer and senior house officer posts. Surprisingly, I wrote most of my part during a neonatal intensive care unit post with 1 in 2 on-calls.

How did it fare initially?

The book was finally published in January 1985. I had just started working in a general practice, and I was unaware of how the book fared after its release. The target market did not comprise any of the patients or doctors I was working with. It was only a few months later, when I was walking down the corridors of the Oxford University Press offices, that the director came and shook our hands and said: “Well done, your book has been a great success.” I found out then that they had just ordered their first reprint.

Part of its popularity stems from it being banned in certain medical schools, apparently because it made clinical studies too easy. Of course, that was fantastic for the publicity that the book received within those schools.

Has it affected your career?

By the time it was published, I was already working as a GP at my current practice here in Sussex, so it hasn't been a stepping stone to any other career. In fact, it is my career now. It goes hand in hand with my job in the practice, and this works both ways. Some encounters with patients make their way into the books. Likewise, one day I might be revising a certain page and later see a patient with that illness in the surgery. My wife, Judith, who is also a doctor at the practice, has been drawn into it too: she not only proofreads my manuscripts, but she is also one of the authors of the Oxford Handbook of Clinical Specialties. We submitted a proposal for this after the success of the original handbook in 1987, and now I work on each of them in alternate years.

How do you keep abreast of the range of specialties covered in the handbook?

I've been doing medicine for about 20 years now, so I have seen my fair share of rare diseases. But of course I don't rely on seeing patients with such conditions to write the book. I read journals regularly and search Medline for recent relevant articles. Nowadays, I can sit in the garden with my laptop while reading papers— much easier and more pleasant than before. Finally, each chapter is read by an expert in that field. I am now moving towards finding specialists for each topic within a chapter. As a GP, I am aware of the importance of finding the right specialist not only for each patient, but for each page. For example, the page on malaria would now be read by a specialist in malaria, not just an infectious diseases physician.

What does the future hold for the books?

I thought that the internet and easy access to medical knowledge would mean that the books would become less popular. But the opposite has occurred; perhaps being flooded with so much information has meant that the books are a refuge of concise information, with just the one page on a topic.

Have you received any fame or recognition from the book?

No, I'm pleased that I haven't had any attention because of it, and I am glad that it is known as the Oxford Handbook of Clinical Medicine, not Hope and Longmore as it was originally. It means it now has a life of its own, without me having to be associated with it. This page really is my 15 minutes of fame. ■

Krishna Chinthapalli foundation year 1 house officer London

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