“Whatever you do, don’t call it a redesign. The alumni will just freak!”

The warning came several years ago, early in my tenure as editor of the Bulletin. “Use the word ‘refresh,’” my predecessor advised. “Assure them that you’ll only be tweaking it.”

She cautioned me, too, that some alumni harbored proprietary feelings about the Bulletin. After all, they had been reading it—and writing much of it—for decades. She mentioned one alumnus in particular, a pioneer in surgery, a brilliant mentor, and an object of terror for generations of medical students. Sure enough, it wasn’t long before Francis Moore ’39 called to check on the new editor.

When I slipped into the conversation my thoughts about a redesign, he didn’t speak for a full minute. “Young lady,” he finally intoned, “you must treat the Bulletin reverently. The Bulletin”—here he paused for emphasis—“is like Shakespeare and the Bible.”

It was then that I understood: This was no ordinary alumni magazine. Suddenly I felt the indecision of Hamlet, the hesitation of Abraham. With Dr. Moore’s injunction still ringing in my ears, I studied the Bulletin’s pages again. The magazine hadn’t changed in nearly a decade, and even then the alterations had been modest. The pages were often gray, the images sometimes static. And yet the prose was compelling. A second color would certainly brighten the pages; a more dramatic design would render the text more inviting.

With some trepidation, I uttered the word “redesign” at an Alumni Council meeting. When no one flinched, the editor-in-chief and I exchanged a glance. Emboldened, we launched a new design in the summer of 1999. For the first time in the seven decades of its existence, the magazine gained a second color on its interior pages. A silhouette of Elvis in full gyration illustrated musical preferences in the operating room. A series of increasingly muscle-bound G.I. Joe action figures revealed the dangerous evolution of male body ideals. An astronaut floated, untethered, across a magazine spread.

The phone rang, and the verdict was in. “I like it,” Dr. Moore growled. “But don’t let your designer go crazy.”

As You Like It

For 75 years now, the Bulletin’s readers have been examining the magazine, diagnosing its ailments, and writing sometimes pungent prescriptions for its recovery. Founding editor Joseph Garland ’19 had encouraged a sense of ownership among the alumni from the outset: “It is your Bulletin—you should have a hand in deciding what sort of bulletin it should be.”

For the most part, his strategy seems to have worked, as readers have more often praised the magazine than panned it. “From cover to cover, the Bulletin is splendid,” William Castle ’21, a towering figure in the history of medicine at Harvard, declared in 1951. “It’s wise, it’s witty, it’s human. I hope that all who see it will feel a deeper pride and—yes—joy at being an alumnus of HMS.”

Even those bent on criticizing the Bulletin found laudable elements. When asked, in 1972, to write an article for what he assumed to be a stodgy magazine, one young physician at first found his worst suspicions confirmed. “The parochialism and narrowness of vision were evident enough,” he wrote. “Evident, too, was the almost pathological involution which seems all too characteristic of alumni publications.”

Yet once the physician “mustered the courage to get past the cover,” he found “not only a spirited exchange on the war in Vietnam, but a very nearly militant attack on fee-for-service medicine. Another issue included a sensitive piece on emergency medical care in East Pakistan—albeit sandwiched between Libritabs and Valium, Class Notes and Charter Flights. Genuine issues, genuine feelings, seemed undeniably to be slinking into these staid pages.”

Such slinking was, to a great extent, just what the editor had ordered. Since the magazine’s inception, the editors have sought to coax impassioned responses out of their readers.

“We have suffered from a lack of burning issues,” Garland wrote in 1928. “Any graduate who has an actively burning issue is invited to send it in, but it must be no smoldering, damp affair. It is not smoke we want, but a fierce and burning flame. We had conceived the idea of offering cash prizes for burning issues but the treasurer soon put a stop to that.”

Years later, editor George Richardson ’46 proclaimed, “We prefer provocation to sedation, and rather fancy ourselves as a magazine of true adventure.”

Readers themselves debated whether the Bulletin should provoke more and sedate less. In 1955, one alumnus accused the magazine of skirting controversial issues.

“Let’s have more light and less sweetness,” he urged, signing his letter “Pugnax ’41.”

“Irritated ’35” shot back: “Pugnax’s demands that the Bulletin rush headlong into controversial issues of medical politics, ethics, and economics are either ridiculously puerile or shrewdly aimed at bringing about the self-destruction of the paper. He should leave the Bulletin to pursue its excellent course undisturbed. Personally, I regard his suggestions as asinine.”

Although “Pugnax” and “Irritated” had graduated only six years apart, the condemnation of the younger correspondent as “puerile” is telling, for opinions about the magazine’s contents have tended to reflect the generational sensibilities of the Bulletin’s readers, who range in age from their early 20s to late 90s.

“Please—what has the Bulletin to do with that giant conclave of pigs at Woodstock?” a member of the Class of 1943B demanded in 1975. “It’s supposed to be an alumni magazine, but it’s completely dominated by the snotnoses of the ’70s. Strike me off your list, gentlemen. Once and for all.” (His name clearly stayed on the list, for several years later he was still inveighing against all the “tomfoolery” to be found in the Bulletin.)

A presumably aggrieved “snotnose” defended the magazine’s Woodstock coverage, arguing, “By its focus on current issues that touch medicine in its broadest human sense, the Bulletin has metamorphosed over the years from a somewhat creaky vehicle into an exciting, vital, and occasionally passionate forum for ideas and debate, which I look forward to reading with each new issue.”

The intergenerational conflict did not cease with the passing of the controversial Woodstock era. “It saddens me that the Bulletin seems to have degenerated into a series of shrill, sophomoric essays by medical undergraduates who fancy themselves to be ‘dehumanized,’” an older alumnus complained in 1982. “Has the whole HMS student body become a group of dyspeptic little Hamlets who mope about constantly ruminating and soul searching? Please, let’s return to the old Bulletin, and have something which ‘neither starveth the soul nor outrageth the intellect.’”

Much Ado About Nothing

From the beginning, the Bulletin’s editors have sought to nourish both soul and intellect. “Our Bulletin will continue to represent a refreshing sounding board for alumni,” editor John Brooks ’43B wrote in the magazine’s 40th-anniversary issue, “so that all may express themselves in areas not purely scientific or clinical, but rather in ways whereby they can maintain the breadth of pursuit that makes for the happy life of the doctor. Medical politics and community health, medical law and insurance, travel, hobbies, and humor: these are the pursuits that keep the doctor from being a narrow man.”

With most of the articles written by HMS graduates themselves, the Bulletin has, over the years, delved into some wonderfully offbeat topics: Sherlock Holmes’s affection for dogs; miniature recreations of infamous murder scenes; the seven Sutherland sisters, whose combined tresses measured nearly 37 feet. Even medical stories have explored quirky angles: diagnoses of the maladies of literary characters; clinical encounters with whales in distress and chimps in traction; visual correspondences between art and anatomy, with Vincent van Gogh’s Starry Night resembling ovarian tissue samples from rats.

Such courageous eclecticism has not, however, satisfied all readers. In 1979, one alumnus reported that a classmate had been urging him to write an article on a “delectable but much maligned vegetable”—the parsnip: “Of course, I was a bit puzzled by the idea of the parsnip as a subject for the Bulletin. It does not cure acne, it does nothing for hypertension, and schizophrenics are unmoved by it (except in certain instances in which they have been observed to spit it out quite ungraciously). Why then for the Bulletin? The latest issue led me to discard my scruples. The reason—an obvious lack of material. So why not parsnips?”

Measure for Measure

Broadsides aimed at the Bulletin’s choice of content—or lack of choice content—have represented but one form of gleeful criticism by the magazine’s audience. Parsing the Bulletin’s prose, discerning readers have seized upon lapses in language, peccadilloes in punctuation, and sins in syntax.

One reader, taking the Bulletin to task for several mistakes, noted crisply that, with regard to prescriptions and inscriptions, “your critic hopes for accuracy in the former, but would enjoy it in the latter.”

Another reader labeled the misidentification of a photograph an “unseemly practical joke” on the part of editor George Richardson. “I presume he has skipped town,” the offended party wrote, “and therefore demand an abject apology in the next issue of your rag. Our class will not be in town again until our 50th reunion; but at that time if the editor has sneaked back, we will be glad to ride him out on a rail, suitably clad in tar and feathers.” (“Since reading this peevish epistle,” Richardson responded, “I have oscillated between challenging the writer to a duel and eating crow. I have elected to eat crow. Mea culpa! Mea gravissima culpa!”)

A question posed in a 1964 article—“Surely, by then diabetes may be no more threatening than to be born now with such errors of metabolism as phenylketonuria and congenital hypothyroidism?”—led another reader to wonder whether “the syntax was veiled in a membrane too tough for the surgical skill of the editor.

“Whenever time hangs heavy on my hands,” the critic wrote, “I can always go back to this interrogation and try to decipher it. I have tried the cryptographic approach, such as omitting every third word and then taking every second letter of what remains, always being careful to transpose the d and the b. So far this hasn’t clarified the question. An alternative would be the cabalistic approach, where the initial letters of each word correspond to numbers of special metaphysical significance known only to the initiated.

“I have even considered the psychiatric approach, considering the whole sentence a gigantic Freudian slip,” the reader continued, “indicating that the author was probably a bottle-fed baby expressing some latent resentment against his mother. Or perhaps someone failed to exorcise the devils who lurk in the bowels of linotype machines and cause the flatulence which becomes manifest in the printed word.”

The Tempest

As wittily—or as irascibly—as they have sometimes grumbled about the Bulletin’s content, readers have often saved their most devastating diagnoses for the magazine’s design. In the 1960s, readers urged a return to the format of the 1950s; in the 1970s, they pleaded for some flair. In the 1980s, they yearned for the 1970s look; a decade later, they accused the magazine of trying too hard to be trendy.

“What has gotten into your editorial board, approving the current cover as it has?” one alumnus griped in 1966. “While the rest of your alumni body are busy improving a cockeyed world by providing therapy, your board is taking the easy path, and helping in the general degeneration. If you intend to keep on with these childish pranks, please don’t send any more copies to my office. The Columbia doctor next to me saw that cover and laughingly asked whether our board members really are Harvard Medical graduates.”

“I am a firm believer in style,” another alumnus declared a decade later. “Your Bulletin lacks style. From a typographic standpoint, it is so drab, so soporific—it’s abominable. I have complained before; I will complain again. Why not walk down the street to the New England Journal of Medicine and see how they do it? It’s not the best format in the world but it’s light-years ahead of yours. Please let me read the Bulletin with pleasure. Please get up some style.”

Several years later, an alumnus denounced the “execrable taste” of a Bulletin cover that mimicked the famous New Yorker map of the world. “This serious travesty at alumni expense will be reflected in annual giving,” he warned. “If the Bulletin feels that this is appropriate filler for its pages, I suggest that we begin a diligent search for a new editorial staff. If it has no further choice, I suggest that the office be closed.”

Yet the Bulletin’s most acute affliction, according to its many diagnosticians, flared up in the summer of 1981. That issue sported a new look, the result of “some cosmetic surgery,” as the editor’s column optimistically framed it. Day-Glo colors electrified the cover’s celebratory photomontage, turning balloons vermilion, ribbons pistachio, and frosting fuchsia. The tilted reunion photos were tightly cropped, lopping off many a physician’s head at mid-temple. Illustrations depicted everything from Lilliputian doctors scouring a Brobdingnagian ribcage with magnifying glasses, to a Los Angeles freeway swirling through a Chinese landscape, to a shark circling above a submerged dentist, armed only with the dental probe, mirror, and toothbrush stowed neatly in his pocket.

The bold design drew high praise from publishing professionals. “Your transformed Bulletin made waves in our office this morning,” one wrote. “When the mail came in, our publications staff dropped everything to gawk.” Another observed that the magazine’s excellent contents had been wrapped in drab packaging for far too long. “But,” he predicted, “you are sure to hear howls of protest from those to whom tradition has no rival.”

And howl they did. “Ugh! I do not like the new format,” one alumnus wrote. “The type is unattractive. The artwork is ugly, ugly, ugly. It looks as if you have gone modernistic, and the Bulletin looks like a cheap trade journal. Is this a sign of deterioration of the Medical School, or of the modernists who have taken over? Thank goodness I was in medical school when it had dignity!”

A second alumnus lamented the magazine’s resemblance to “a pharmaceutical house publication with touches of the Victorian Age.” Another condemned what he viewed as an ill-conceived foray into pop culture: “If People magazine were what I wanted to read, I might not have bothered with the Bulletin in the first place.” A fourth noted, curtly, “Cover: nauseating. Typography and layout: appalling. Drawing and ‘artwork’: pathetic. Overall: disastrous.”

Perhaps the most unnerving diagnosis came from an alumnus who laced his epithets with clinical terms: “I have been trying to analyze what is so repulsive about the latest issue of the Bulletin and have finally come to the conclusion that it’s not the literary copy but, like an inflamed carbuncle, it hurts just to look at it.

“I am not the only one left speechless by the banality and cyanotic quality of the cover picture and illustrations in general,” he added. “As if that innovative balderdash were not emetic enough, on opening the cover one is slapped promptly with staccato changes in type and headlines that flash out as blatantly as the bleats and beats of a rock concert.” The issue, the alumnus concluded, was simply a “malformation.”

In his farewell column more than a decade later, editor J. Gordon Scannell ’40 was still alluding to the trauma, labeling it “an editorial fiasco.” The cautionary tale of the Awful, Awful Issue, as it came to be known, has since been passed down to each incoming editor. Clinging to a familiar principle, “First, do no harm,” the Bulletin’s chastened guardians have since carefully avoided taking any but the most palliative of measures; readers, for their part, seem to have adopted an approach of watchful waiting.

All’s Well That Ends Well

Unflattering critiques are always a peril of publishing, and during my short tenure at the Bulletin I’ve not been immune. Indeed, a year before his death last November, Francis Moore called to dispute an article we had published about an infamous murder that took place at Harvard Medical School in 1849. By then, I had learned to consult with Dr. Moore on everything from his experiences during World War II (investigating new treatments for wartime casualties), to his musical preferences while operating (silence, interrupted only by “kind words, if not sweet words” from his scrub nurse). And by then, I had come to recognize the warmth in his baritone and the playfulness of his words—even his reproving words.

Didn’t I realize, he asked, exasperated, that Professor John Webster was not guilty of murdering his old friend George Parkman, as had been presumed for 150 years?

Dr. Moore promised to set the matter straight and was delighted when we published his entire letter to the editor, which ran nearly half the length of the original article. His missive argued for the homicidal culpability of the School’s janitor, then concluded with the hope that the Bulletin’s editor of 50 years hence—“as yet unborn”—would display better powers of discernment than those of the current editor.

More recently, a reader evoked the very bard that Dr. Moore had encouraged me to bear in mind. After soundly castigating the author of a Bulletin article, she concluded her letter with, “There is no point in going on about the hellish philistinism of this man. I leave it to Shakespeare and King Lear. The author stands convicted as surely as if he were the odious Goneril, whom Albany rightly condemned with searing words: ‘O Goneril! You are not worth the dust which the rude wind blows in your face.’”

Before we could go to press, the reader withdrew her letter, admitting that she had composed it in a fit of pique. We can’t always count on such felicity, though, so we continue to tread softly, filling the Bulletin’s pages with some sweetness, some light, and the occasional burning issue. And when our contents run dry, we know we can always refill one of the magazine’s many prescriptions: editing by cryptographic or cabalistic approach, celebrating the much-neglected parsnip, or simply thumbing through pages of Shakespeare and the Bible, seeking inspiration.

This article appeared in the 75th-anniversary issue of the Harvard Medical Alumni Bulletin.