When it came to writing a preface, it was with some uncertainty whether we would compose a preface or a foreword for this edition of DeMyer's The Neurologic Examination: A Programmed Text. A preface is typically written by a book's author, while a foreword is an introductory essay by a different person that usually precedes it. The purpose of a preface is for the author to explain to the reader why the book was written or how it came into being while it typically ends with their acknowledgements to those who assisted in its conceptualization, development or who provided the author support through the endeavor. With that background it would seem that we are clearly the "different person" and should limit ourselves to a foreword, but we also have a tale to tell as to how we became involved at Dr. DeMyer's and his family's request.
One of us (JB) when Chairperson of the Department of Neurology at Indiana University School of Medicine not only knew but worked with and frequently collaborated with Dr. William E. DeMyer who was already a legend as a consummate and gifted educator blessed with insight, wisdom, and encyclopedic knowledge. His neuroanatomy course for the neurology residents was considered a highlight of their training and despite his encyclopedic and seemingly photographic memory he still reviewed and prepared before those sessions. This was never interpreted as a sign of uncertainty, but a demonstration of how deeply Dr. DeMyer felt about the importance of what he taught and respect for those he always felt privileged to teach. This book (and another he completed shortly before he died, Taking the Clinical History; Oxford University Press, 2009) emphasized his strong belief that the learner needed to be actively involved with their learning and the importance, if not the necessity, of selfobservation and of course the need to practice.
It was always Dr. DeMyer's intent to revise and update this textbook, but as he became ill, he realized it may not be possible for him, but may be for others. He hoped to update his text, correct any errors, and improve the illustrations, but as to significant revisions, he did not feel they would be necessary. Those were the hopes he expressed to his family, his publishers and to us before he died on September 20th, 2008. Yet, for we who agreed to undertake this work there was some trepidation as to whether our task of updating or revision would maintain the voice of the author.
When Edith Grossman published her splendid translation of Miguel De Cervantes' Don Quixote1 she expressed consternation ("fear") as to whether she would capture Cervantes' voice and expressed those concerns to Julian Ríos, the Spanish novelist. However, it was his "advice" to her which we took to heart and applied to the task Dr. DeMyer assigned to us.
… Cervantes, he said was our most modern writer, and what I had to do was to translate him the way I translated everyone else—that is, the contemporary authors whose works I have brought over into English. Julian's characterization was a revelation; it desacralized the project and allowed me, finally to confront the text and find the voice in English. For me this is the essential challenge in translation: hearing,in the most profound way (I mean, to write) the text again in English…
This 6th edition of the DeMyer's The Neurologic Examination: A Programmed Text has been retained in Dr. DeMyer's voice, but updated and refreshed where necessary (Bill would have accepted nothing less) and our publishers were of immense help in updating the formatting of the text and its illustrations. Presentation was always important to Dr. DeMyer and we all believe he would be happy with these changes. As we undertook this update what proved to be a pleasant surprise and source of satisfaction for us was that since the first edition in 1994, the text has essentially stood the test of time and fulfilled Dr. DeMyer's hoped for outcome in his preface to his fifth edition,
A masterful history and examination, conducted with competence and grace, leads to the physician's pleasure in discovery and to the patient's trust in the physician. No technologic procedure and computerized form can ever replace the mutual knowing process and bonding that occur during the clinical encounter. Mastery of the neurologic examination provides a giant step in achieving the clinical competence that fosters the maximum reward for you and the maximum benefit for your patients throughout your career.
We are forever grateful to Dr.William E. DeMyer for his scholarship and professional competency that exemplified the very highest qualities of the physician, scientist, and teacher. It is our sincere wish that the readers of this textbook embrace Dr. DeMyer's hope for all of those who practice medicine and for the patients in our care; each encounter should always begin and end with our patients foremost in our mind. Oh, and by the way, this is our foreword.
1Don Quixote by Miguel De Cervantes. A new translation by Edith Grossman. Harper Perennial, 2005.
José Biller, MD
Gregory Gruener, MD, MBA
Paul W. Brazis, MD