Indexing Specialties: Medicine, ed. by Pilar Wyman (Information Today, Inc., 1999)

I have been curious about medical indexing since I heard Mary Russell from Australia speak on the subject at the Indexing Society of Canada’s conference in 2014. Though I don’t have a science or medical background, the way that Mary described the thoroughness and comprehensiveness of a medical index, and the logic behind medical terminology, made a lot of sense to me. Anne Fifer will soon be presenting a 3-part webinar through ASI on medical indexing (see here if you are interested), which seems like the perfect opportunity to further explore this area of indexing. First, however, I decided to finally read ASI’s book on medical indexing, which has been sitting on my shelf since last summer.

A slim volume at about 120 pages, including the index, I found the book to answer most of my questions as a newcomer to the field. It was published almost twenty years ago, however, and so I also often wondered while I read how relevant certain chapters still were.

The book is split into four sections. The first, Medical Indexers, consists of an interview with Frances Lennie, of Cindex fame, and Alexandra Nickerson, as well as a short autobiography by Shelley Greenhouse, who does database indexing. I found these interesting, the interview especially, as I felt that it gave a good sense of the different types of projects and situations a medical indexer might face, some of which I imagine is still relevant today. It would also be great to read an updated interview, to see if there is anything new in the current indexing climate.

The second section, Medical Indexes, consists of two chapters by Pilar Wyman, one looking at medical indexes which have been reviewed in The Indexer, and the other looking at award-winning medical indexes. I also found these chapters to be very helpful, as they give a good sense of the qualities that a good medical index should have, namely accuracy, thorough analysis, comprehensiveness, and usability. For me, this section is among the highlights of the book.

The third and most extensive section of the book, Medical Indexing, consists of a mixed bag of chapters on different aspects of medical indexing. The two chapters I found most relevant were Cynthia Bertelsen’s chapter, “Indexing Food and Nutrition Materials,” and Irving Conde Tullar’s chapter on all of the different issues that one might face, ranging from text structure to terminology to considerations for different medical specialities. These chapters are very much on the nuts and bolts of dealing with the content, and as such very helpful, if also a bit intimidating. I got the impression that Tullar is trying to discourage people from entering this field, and perhaps he is. As he writes, “I would not recommend that anyone think of specializing in medical indexing without first becoming a competent and time-efficient indexer. I also would discourage the indexer who contemplates devoting only a minor part of total indexing time to this speciality because it is the cumulative experience from numerous projects that prepares one to index at the requisite speed not only to meet the increasingly uncomfortable publisher schedules but to be adequately compensated for the effort and stress.”  You, and I, have been warned.

Also interesting and clearly written, though potentially less useful, are the two chapters on medical database indexing, a more general chapter by Max McMaster and a chapter by Helen Ochej on the MEDLINE database. My hesitation comes from hearing anecdotally from long-time indexers that most of their database indexing contracts have disappeared. Is this, then, still a viable field for new indexers to pursue? I have no idea, and I would appreciate clarification. Also, if database indexing is still a thing, is the technology used the same as described in these chapters? If not, then the chapters’ usefulness also diminishes, though you still get a good sense of the theory and purpose of database indexing.

Also interesting, though also possibly a historical footnote today, is Susanne Humphrey’s chapter on the MedIndEx Project, which was (is?) an attempt to automate aspects of medical indexing. Whether this actually worked, I have no idea. Googling it didn’t reveal much either, so I’m guessing it either now goes under a different name or the initiative failed. 

Lastly, there is a curious and short chapter by Gerry L. Messner on why nurses make potentially great indexers. I have no arguments with the author, and presumably this would be most useful for someone with a nursing background who is considering a career change.

The final section is on resources, consisting of another chapter from Cynthia Bertelsen and a chapter by Carolyn Weaver. I found these chapters, especially Bertelsen’s, to be helpful in knowing what types of resources I am likely to need, but given the age of the book I feel that I can’t trust these chapters to be up-to-date. I expect that I would need to do my own research to see what is still in print, if any of these resources are now available in a digital or web-based format, and what new resources might be available. Ditto for Weaver’s chapter on web-based resources, which I assume would now be much thicker.

Besides the periodic sense that material was out-of-date, I would have also appreciated more information on project workflow and schedules. A typical book for me now, indexing in the humanities and social sciences, is 200-500 pages, and I have 2-3 weeks to complete the index. How do you jump from what I am familiar with to working on a book that is say 1,000+ pages, or in multiple volumes? Tullar touches on this by saying that some projects can stretch out over many months and that he often receives books in batches of chapters, not always in order, but I still didn’t get a clear enough sense of how that worked in practice. How do you schedule your time for such a project? How do you invoice? How do you negotiate budgets or a schedule? How do you keep track of that much information? What is it like to receive disparate chapters at a time? How are long are typical indexes? Any tips for editing such a large index, so that nothing falls through the cracks? I feel like this could take up a chapter in itself, or at least a significant portion of a chapter.

For a contemporary edition of this book, I would also want to know about embedded indexing, or other forms of digital or web-based indexing. Are they now common for medical texts? Are books expected to be outputted into digital or web-based formats? I know that my previous family doctor primarily used her smartphone during consultations to check my medical records and other information. How does today’s technology affect how doctors access medical information, and how does that in turn affect indexers? Is there anything about the indexing process that is particular to medical indexing? Besides understanding the subject matter, do I also need to learn new technical skills?

I am also curious about name indexes. In theory they sound easy, and I understand that they are often subcontracted out to other indexers, but if the book is 1,000+ pages long, that is a lot of names, which could magnify problems by virtue of sheer volume. So, are name indexes common in medical texts? Any tips for compiling both a names index and a subject index for a book? Any conventions that I should be aware of? Common issues?

Despite my reservations, I do highly recommend this book, especially as there does not seem to be any competitors. There is mention in the references to a book published in 1995 by the Society of Indexers in the UK, Indexing the Medical and Biological Sciences, but that appears to be out of print. I also checked the index for The Indexer, and it appears that the last time The Indexer published an article on medical indexing was in 2009. I don’t have access to Key Words, so I don’t know if any recent articles have been published there. So beyond Anne Fifer’s new webinar, which seems a most timely addition, this book is it for resources. There is still much of value here. I also sincerely hope that ASI will consider publishing an updated edition, which can only improve upon the strengths of this book.