Measured words: announcing the winners of the first CMAJ Essay Prize

Medicine is rooted in the realm of action and wears whatever intellectualism (as opposed to brute intellect) it possesses with some awkwardness. There is not much point in posing a medical argument for its own sake. In medicine, an argument is meant to lead somewhere: with any luck, to an improvement in practice. This commitment to action may explain why few of the 80 entries in CMAJ's first Essay Prize competition were of the variety described in an essay on essays by American writer Cynthia Ozick:

An essay is a thing of the imagination. If there is information in an essay, it is by-the-by, and if there is an opinion in it, you need not trust it in the long run. A genuine essay has no educational, polemical, or sociopolitical use; it is the movement of a free mind at play.1

One might object that no mind is as free as all that. Even the most engaging and enduring flights of reasoning arise inevitably, albeit with varying degrees of obviousness, from the social and political reality of their time. The essays selected by our panel as winners in the general category — Angus Rae's “Osler vindicated: the ghost of Flexner laid to rest” — and in the student/resident category — Daniel Roth's “Humanitarian aid and medical research: an illusion of dichotomy in international health” — both arise from the very present concerns of a profession in the grip of rapid change. Angus Rae2 (page 1860) considers the unnecessarily narrow path along which Abraham Flexner's early 20th-century reforms in medical education have led us; Daniel Roth3 (page 1862) considers where unnecessarily narrow dogma in international research ethics is likely to lead. For Ozick, the persuasiveness of an essay is the collateral effect of a literary seduction; for the 2 winners chosen by our judges, persuasion is an entirely conscious enterprise.

Angus Rae traces the historical development of an idea and considers how meritoriously it has withstood the test of time; Daniel Roth teases out the shortcomings of an ethical concept by testing it in 2 slightly different contexts. And with this notion of testing we arrive at the essence of an essay: free play or not, a discursive form in which one conducts the trial of an idea. In selecting finalists in each category to refer to our external panel of judges, we pondered the root meaning of essay, “to weigh.” Hence we looked for writing that weighed a concept or idea, taking the measure of it, analyzing, exploring or challenging it. (The connection with the chemist's word, assay, inescapably struck a chord.)

The entrants that caught our attention ventured beyond what an essay was to most of us in high school or university: a set piece in which one is obliged to summarize, in some reasonable order, everything one has read about a subject. The 9 finalists were the submissions that we felt had the most general appeal and the most original or engaging voice. What was tested or weighed, we concluded, might be an ethical proposition, a metaphor, a state of mind, a cluster of associations or something else. We asked our judges to assess each piece by the following criteria: the quality of the thought, the quality of the writing, and the effect of the 2 combined. Our trio of judges drawn from CMAJ's editorial board — Judith Hall, Neill Iscoe and Donald Redelmeier, a geneticist, oncologist and internist respectively — brought varying professional perspectives and experiences to the process, but still managed to reach their decision, thoughtfully, by consensus.

To our judges, and to everyone who sent us their manuscripts, our sincere thanks for making this first essai of an Essay Prize contest a success. The first, and not the last: we announce the Essay Prize for the year 2001: this time, a single prize of $1000 in an open category. We welcome all comers — physicians, students, residents, nonphysicians — to take the measure of their ideas in 2000 words or fewer, in a manner that will engage, and possibly persuade, a general medical readership. We welcome your submissions by mail, fax or email until the deadline of Dec. 1, 2001.