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Ann Thorac Surg 2002;73:15-16
© 2002 The Society of Thoracic Surgeons
a Division of Cardiothoracic Surgery, Department of Surgery, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
* Address reprint requests to Dr Edmunds, Editor, The Annals of Thoracic Surgery, 5000 Ravdin Court, Hospital of the University of Pennsylvania, 3400 Spruce St, Philadelphia, PA 19104-4283, USA
e-mail: ats{at}uphs.upenn.edu
Anatomists use the word "tongue" to designate an anatomic part; poets use the word to mean language. Poets speak of men with "forked tongue" to connote slanders, lies and serpent-like deceit and in so doing illustrate the richness of the English language and also its bewildering complexity. When verb tenses, articles, complex sentence construction, impossible spelling and an almost infinite number of word choices are added, few who were not born to the language, would elect English "the language of science." Yet, for various reasons English has become the common language of our profession and, at the same time, a heavy burden for over half of our colleagues.
English is only one of 2,700 languages and is the first language for only 350 million of the world’s 6.2 billion people. Another 400 million use English as a second language, but still far more people speak dialects of Mandarin Chinese than dialects of English. The modern world has need of a common language; air traffic control is one such need. Unlike Chinese, English is spoken by at least a few people nearly everywhere and this dispersion, which largely occurred in the 18th and 19th centuries, more than any other reason, established English as the default language between speakers of differing tongues. The development of global air travel and telecommunications in the 20th century accelerated the use of English as a second language. Now it is the predominant language of telecommunications, computer databases, science and to a lesser extent business.
Attempts to define "standard spoken English" have failed [1]; like any widely used language English now has many dialects. And, as many realize, there are different versions of written English. If lexicographic quibbles are ignored, "standard written English" may be defined as text that can be easily understood by anyone who reads and speaks the language.
As a default language, what does English offer the modern world? It is a rich language that contains over one million words, over half of which are scientific words. This vocabulary far exceeds any other and new words, such as "weekend" and "software," and acronyms, such as "NATO" or "FYI" (for your information) are constantly being added. The language is backed up by an ample literature and the wide availability of new and old printed material in the form of newspapers, pamphlets, magazines and books.
But English also has drawbacks. Apparently, basic English is easy to learn, but more advanced English is very difficult. David Crystal cites two reasons why scientific English is even more difficult [1]. "It is possible to grasp the vocabulary of an area of scientific enquiry, yet still have a major difficulty in comprehension because of the way the sentences and discourse have been structured... . When less usual patterns of grammatical structure combine with a high proportion of technical vocabulary, as is often the case in occupational varieties of English, the result is a sharp increase in comprehension difficulty." In other words English has an arsenal of words to communicate precise thoughts and information, but comprehension depends upon how words are organized in an exceedingly demanding and complex framework. This is the heart of the problem for authors who use English as a second language. While many may speak English, sentence construction, syntax, word choice and advanced grammatical rules are forbidding barriers to non-native authors who wish to write scientific reports.
The need for a common language has spawned a network of teachers of English as a second language around the world. In non-English speaking lands these instructors may teach English to students as part of the educational system and/or to scientists and professionals who need to communicate in the spoken and written versions. Two international organizations, TESOL (Teachers of English to Speakers of Other Languages) and IATEFL (International Association of Teachers of English as a Foreign Language) represent over 60,000 of these teachers and provide support that includes developing effective teaching methods [2]. In major English speaking countries educational programs provide formal training for English teachers of foreign students, yet still many instructors learn on the job in the field. Consequently, expertise in both the language and in teaching ability varies widely, but both can be expected to improve as teaching efforts increasingly bear fruit. As demand accelerates, linguistic professionals have responded by developing better and more focused methods for teaching English as a second language [2]. In the United States research oriented universities, such as the University of Texas and the University of Pennsylvania, have created student-faculty programs to help foreign postdoctoral students write scientific papers in English. These long-range efforts will eventually remove the language barrier from non-native writers and speakers, but this goal is far beyond the horizon now.
Thus this is a period of transition. The immediate task for The Annals and other professional publications that attract submissions from non-native English speakers is how to convert poorly written English into "standard written English." In the absence of a better term The Annals calls this process "language editing" and defines the phrase as editing a manuscript written in English to standard English by correcting sentence structure, syntax, word choice and grammar without changing the author’s intended meaning. A language editor must first decipher the author’s intended meaning and then put it into "standard written" or "easily understandable" English. Copy editors and translators cannot do this because they do not understand the subject matter. A native English speaker who is also a cardiothoracic surgeon is required. Language editing requires both concentration and time and typically 5 to 8 hours are needed for a 4-5000-word manuscript. Few cardiothoracic surgeons are available to do this work and fewer still are willing to do it on an ongoing basis.
Given the realities that The Annals is published in English, that 51% of submissions are from countries where English is not generally spoken and that neither the editorial office nor the publisher have the resources to "language edit" manuscripts, how can this problem be managed? The editor applauds the strenuous efforts being made around the world to teach English as a second language, but this is the ultimate not the immediate solution. However, the editor also believes that highly trained cardiac and general thoracic surgeons are best used in the operating rooms, intensive care units, wards, clinics and research facilities of their institutions and not in English classes. The Annals wants to publish the experiences, ideas and discoveries of these non-native English speaking surgeons; their contributions are vital to our mission statement, which appears on the masthead page of every issue. What can be done?
The Annals has made a start, but more and better ideas are needed. The editor personally "language edits" all titles, abstracts and correspondence, but simply does not have time to do more. This at least allows readers an easier introduction to an author’s work, but is hardly a solution.
When revisions of a paper in need of language editing are requested, the editor also requests that the author go over the paper sentence by sentence and side by side with an advisor who is a native English speaker or who is truly fluent in the language. The advisor, who need not be a surgeon, but who should speak the author’s native language, can learn from the author what he or she is trying to say and then render each sentence into easily understood English. This process may take a few hours, but it would be less than the time required for another cardiothoracic surgeon who is working alone to "language edit" the manuscript. This policy has been developed and implemented over the past two years with the result that approximately half of the authors return excellent, easily read manuscripts, a quarter ignore the request and another quarter obtain help from someone who is not fluent in English.
Eight American surgeons have "language edited" approximately 15 Annals’ manuscripts. All have confirmed both the time and difficulty involved, but have produced superb writing, which the authors have endorsed as accurate. Needless to say the authors are uniformly grateful, but few surgeons are willing to do this work on an ongoing basis. However, even if a cadre of native English speaking cardiothoracic surgeons are recruited, the demand for this service would far exceed supply, if for no other reason than the fact that the author shifts the language burden to the language editor.
Non-native English authors have much to gain from communicating their work in easily read, understandable English. Easily understood English invariably attracts more readers to the article. Lucid English reduces the chances that an author is misinterpreted or misquoted. Good English increases the impact of the article and the number of times it is cited by other authors. CTSNet offers the means to distribute information all over the world instantaneously. The postal services of the world are not the barrier to real time communication between cardiothoracic surgeons; the barrier is the English language.
This editorial states the problem; the editor and editorial board members now solicit solutions. We can no longer continue to ignore or gloss over this difficulty; we must discover and implement practical ways to lighten the "language burden" of our colleagues for whom English is a second language. The Annals seeks to publish the best clinical and scientific papers in our field from any and all cardiac and general thoracic surgeons who have information that he or she believes is of interest to colleagues. Recognizing the problem is a start; your good ideas will uncover solutions that all of us can implement. Please send them to the Editorial Office.
References
This article has been cited by other articles:
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  J. R. Benfield Cardiothoracic Surgeons Divided By a Common Language Ann. Thorac. Surg., August 1, 2007; 84(2): 363 - 364. [Full Text] [PDF]
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