Chapter 02: Learning the Editor’s Craft
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Description
Mr. Pagel begins this Chapter by quickly sketching his educational path, including his track at Rice University, where he first majored in electrical engineering, then switched to English Literature. A career counselor at Rice suggested he apply for an opening in Scientific Publications at MD Anderson, and in 1971 he became an assistant editor. He describes his activities at that time and notes that he began to learn what it meant to be an editor. There were 6-8 editors in the department at the time, handling about ten articles per month.
Next Mr. Pagel explains that he left MD Anderson in 1974 to become Assistant Managing Editor (then Associate Editor, 1975) for the Quality Review Bulletin published by the Joint Commission on Accreditation of Hospitals in Chicago, Illinois. The Bulletin published narratives of care provided at institutions; frequently review of the details provided would indicate need for a further audit of the institution prior to its accreditation. Mr. Pagel point out that the Joint Commission came to understand that more than physician notes are needed to assess the quality of care.
Identifier
PagelW_01_20120801_C02
Publication Date
8-1-2012
Publisher
The Making Cancer History® Voices Oral History Collection, The University of Texas MD Anderson Cancer Center
City
Houston, Texas
Interview Session
Walter Pagel, ELS (D), Oral History Interview, August 01, 2012
Topics Covered
The Interview Subject's Story - Professional Path Joining MD Anderson Professional Path Evolution of Career Institutional Processes Professional Practice The Professional at Work
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.
Disciplines
History of Science, Technology, and Medicine | Oncology | Oral History
Transcript
Tacey Ann Rosolowski, PhD:
Okay. I wanted to start with just basic background questions. Where were you born and when? Where did you grow up?
Walter Pagel, ELS (D):
I was born in the west—at the United States Military Academy Hospital in West Point, New York. I grew up in Germany and Kansas and Kentucky and Texas and Illinois. I was in Germany twice.
Tacey Ann Rosolowski, PhD:
Wow. Military family. Yep. And you didn’t say a year. Do you want to say a year?
Walter Pagel, ELS (D):
In ’47.
Tacey Ann Rosolowski, PhD:
Thank you. When did you come to—I noticed that you— Well, before I ask that, was anyone else in your family involved in either the sciences or in writing?
Walter Pagel, ELS (D):
Nobody I knew, but there are Pagels who are famous medical historians. They’re probably not related to me. Or if they are it’s so distantly that I know nothing about them. But if you look up Pagel in medical history on Google you would get a bunch of returns—Julius Pagel I think was one of them who wrote a book about medieval medicine, and so on and so forth.
Tacey Ann Rosolowski, PhD:
And you’re not enough of a genealogist to want to track that down and see if there’s a connection?
Walter Pagel, ELS (D):
Not so far. I’m retiring because I have lots of stuff I want to do.
Tacey Ann Rosolowski, PhD:
Well, maybe that’s one of them.
Walter Pagel, ELS (D):
My wife is into genealogy, so maybe she’ll do it someday.
Tacey Ann Rosolowski, PhD:
Your wife’s name is—?
Walter Pagel, ELS (D):
Frances [Pagel].
Tacey Ann Rosolowski, PhD:
Frances. And in the sciences specifically—were there any practitioners of science specifically?
Walter Pagel, ELS (D):
No. My mother was a nurse. Does that count?
Tacey Ann Rosolowski, PhD:
Well yeah. I’m just—there’s no right answer. I’m just looking for the context, right?
Walter Pagel, ELS (D):
Nope, nope.
Tacey Ann Rosolowski, PhD:
Where did you get the writing bug and the science bug? How did that all happen?
Walter Pagel, ELS (D):
I won’t say I have a writing bug, but I’ve got a science bug just because I was good at it—in high school even.
Tacey Ann Rosolowski, PhD:
Un-hunh (affirmative). How did that start showing itself?
Walter Pagel, ELS (D):
High school subjects that dismayed other people were easy for me—science and math. I didn’t know what the dismay was about until I got to college and found that it could be a lot more complicated.
Tacey Ann Rosolowski, PhD:
And you went to college—?
Walter Pagel, ELS (D):
At Rice.
Tacey Ann Rosolowski, PhD:
At Rice University. And why did you choose to come to Rice?
Walter Pagel, ELS (D):
I was living in San Antonio. It was a good school. It was public. It was small—probably had something to do with it.
Tacey Ann Rosolowski, PhD:
But I notice that your major was English actually, so how did that happen? Or do I have that wrong?
Walter Pagel, ELS (D):
No, you don’t have it wrong. I started though as a double-E major—electrical engineer. I got all the way through the end of my sophomore year doing that, but my second year physics—second semester, second year physics was relativity and magnetism. There’s a close relationship between the two but I never understood it, so I decided I wasn’t up for being an electrical engineer. There are many stories like the one I’m about to say. Years later I asked a friend of mine who’d succeeded in engineering. I told him why I’d dropped out, and he said, “Walter, nobody understood that.” So. But I’m glad I did what I did. I don’t think I would have enjoyed being an engineer. Then I went—actually then I decided to go to medical school so I moved over to biology. By the middle of my junior year I decided I didn’t want to work that hard, didn’t want to work more, and moved over to English Literature, which I’d always been good in and kept going even when I was taking all of these science and math courses. Somewhat ironically my best friend is a physician who was in class with me, and years later I told him the story—you know—how I didn’t want to work that hard, and he said, “Well, I’ll tell you what. Medical school was a breeze compared to Rice.” What can I say?
Tacey Ann Rosolowski, PhD:
Educational paths and career paths can be quirky-quirky. So you got your degree in ’71?
Walter Pagel, ELS (D):
Right.
Tacey Ann Rosolowski, PhD:
And how did it happen that you came to MD Anderson?
Walter Pagel, ELS (D):
A career counselor at Rice didn’t know what to do with me but did have some connection with MD Anderson—not a connection but a knowledge of this department and sent me over here. And I came three times before they finally interviewed me.
Tacey Ann Rosolowski, PhD:
What do you mean you came here three times?
Walter Pagel, ELS (D):
I came here three times applying, and after the third application they interviewed me.
Tacey Ann Rosolowski, PhD:
And what job were you applying for?
Walter Pagel, ELS (D):
Editor. Assistant editor. I actually interviewed for a job in Public Affairs too, but it was clear I think almost immediately that I was not a public affairs kind of person. I had a very frank interview with the person who was the director at the time—Jane Brandenberger —and we reached agreement that that was not my field.
Tacey Ann Rosolowski, PhD:
Did she have another suggestion? Did she encourage you to go to—?
Walter Pagel, ELS (D):
She probably encouraged me here but I don’t remember well enough.
Tacey Ann Rosolowski, PhD:
So tell me about your interview here and how you ended up getting this job and what you did when you came.
Walter Pagel, ELS (D):
I don’t know exactly why I got the job. Probably because they needed people because there was so much turnover that they couldn’t find people that were—I mean—I had a strong science background and a good English Literature background. That should—it seemed to me—qualify me to be an editor. The problem was I did have some difficulty because Rice in those days reported As as ones and Ds as fours, and so finally you could see there was a lot of reluctance on the interviewer’s part to say, “Hmm, something’s wrong here. What’s the trouble here? How come you got such bad grades?”
Tacey Ann Rosolowski, PhD:
Oh.
Walter Pagel, ELS (D):
Fortunately she said that instead of just sending me away with the impression that I had bad grades, so I was able to clarify that. Twos weren’t great grades, but they were good enough. What did I do? Stupid work. I cut out clippings from newspapers, typed bibliographies, went to the library to check references with the original sources, wrote a few things for the newsletter—I’m sure they were extremely amateurish—began to learn what it meant to be an editor.
Tacey Ann Rosolowski, PhD:
Who did you report to?
Walter Pagel, ELS (D):
I think it was somebody named Jill—I don’t remember her last name—and she got carried out by the mental health specialist one day.
Tacey Ann Rosolowski, PhD:
Stories. Interesting.
Walter Pagel, ELS (D):
But the person who had the greatest effect on my knowledge was a woman named Dorothy Beane who ended up being in the—she was my princess of—
Tacey Ann Rosolowski, PhD:
Tell me about the department when you joined. How large was it? How many editors were on staff? What were the expectations?
Walter Pagel, ELS (D):
I think there were six or eight editors. I believe we edited approximately ten articles a month. Expectations for me were probably just that I learn not to mess up other people’s stuff while still correcting the really bad stuff—bad parts.
Tacey Ann Rosolowski, PhD:
So they—did they give you something to do like a first-pass on and then you handed it on?
Walter Pagel, ELS (D):
Uh-hunh (affirmative). Yes.
Tacey Ann Rosolowski, PhD:
Okay. Yeah. When you said you were learning how to be an editor, what were some of the big lessons that you learned in those first couple of years that really stuck?
Walter Pagel, ELS (D):
I don’t know. Truthfully, at that point in my career I was not learning that much except how to be—I was learning to keep my hands off if it didn’t need something, and that may be the most that I learned. And I learned something about how to make a long thing shorter. I learned how to use reference books, make sure things were correct. Those are relatively trivial things. That’s the way I think of them now.
Tacey Ann Rosolowski, PhD:
Sort of building—just the building blocks.
Walter Pagel, ELS (D):
Right.
Tacey Ann Rosolowski, PhD:
Right. When did you feel like you made the big switch—when you stopped—you moved beyond the rudimentary stuff and really were beginning to practice your craft?
Walter Pagel, ELS (D):
I think it’s kind of ironic in a sense. I left here after three years and went to work for the Joint Commission in Chicago on a magazine called The Quality Review Bulletin. This was a brand-new magazine and a brand-new subject area. And none of the experts—or that is to say the physicians who were doing quality audits—audits of the quality of medical care—knew the first thing about how to write an article. My job was to transform those into something interesting for readers, but for the longest time I didn’t realize that. I thought my job was to edit these things, and my job was to respect very much the author’s point of view. Well, the author had no decent point of view whatsoever. My job really was not to edit. It was to write something based on what this person thought he was writing, and when I discovered that I—once you start writing yourself you begin to realize what it takes—something of what it takes anyway. So that’s probably the main place that that happened.
Tacey Ann Rosolowski, PhD:
Tell me more about this project and how it came into being. And why did they tap you to be part of it?
Walter Pagel, ELS (D):
Which project would that be?
Tacey Ann Rosolowski, PhD:
The Joint Commission project.
Walter Pagel, ELS (D):
They didn’t tap me. I interviewed for it.
Tacey Ann Rosolowski, PhD:
You interviewed for it? Okay. Uh-hunh (affirmative).
Walter Pagel, ELS (D):
My wife and I decided to go to Chicago and look for a job.
Tacey Ann Rosolowski, PhD:
And that was 1974, 1976?
Walter Pagel, ELS (D):
Right. Right.
Tacey Ann Rosolowski, PhD:
Okay. Why did you want to leave MD Anderson at that time?
Walter Pagel, ELS (D):
Because I disliked my boss deeply. It was a good thing. I’m glad I did it.
Tacey Ann Rosolowski, PhD:
Uh-hunh (affirmative). Well, it sounds like you really just kind of made a qualitative leap in the Joint Commission work.
Walter Pagel, ELS (D):
I didn’t know that though. The people who ran it had come from Playboy.
Tacey Ann Rosolowski, PhD:
That’s amazing. Huh.
Walter Pagel, ELS (D):
They knew something about how you transform an article into something interesting to people.
Tacey Ann Rosolowski, PhD:
Tell me more about the quality review project. What was its purpose? Why was it established then? Why did they want to do it then?
Walter Pagel, ELS (D):
I can go way back.
Tacey Ann Rosolowski, PhD:
Was it an ongoing thing or was it a one-off?
Walter Pagel, ELS (D):
It was ongoing. It was a journal every two months.
Tacey Ann Rosolowski, PhD:
Every two months. Okay.
Walter Pagel, ELS (D):
And theoretically it published other people’s stories, but as I said mostly it was almost like commissioned works. And then you had to re-do them so that they would sort of fit the mold. And the story is—each story was about—you would take a disease and—not I but the physician experts on the editorial board would imagine what were the features that showed that the care that people who were treated for this got high-quality care, and there would be what they called an audit in which you would pass medical records through a screen—at the time a manual screen. You would just read the article—you would identify what you were looking for, and you would say where you would look for it. You would say then what you expected to see, and if you didn’t see it then it would be called an exception. Certain kinds of exceptions indicated really bad care, and sometimes an exception indicated that you needed to ask more questions—not of the people at the institution, at Joint—but of the people who were concerned about the quality of care at their own institutions. And that arose because Joint Commission decided that audit was an essential feature for the accreditation. There have been waves of feelings that there should be audit, and I think that there’s another wave going on now, although I’m not sure. Basically because of a series of medical malpractice—big time malpractice suits in which it became clear that you could not rely on the physician notes to know whether the person got the kind of care they deserved. The Joint said, “We need you to look at more records, and we need you to look at them systematically in a way that will lead you then to investigate deeper if it turns out that the incident—the incidents or the care of this particular person—that there were signs that it wasn’t quite as good as it should have been.” Basically there was a man in California who was—he was a big surgeon, and he kept doing back surgeries and claiming he was very successful. Meanwhile all the other notes in the medical records said that the person was in extreme pain, couldn’t walk, and couldn’t get out of bed, and so on and so forth. The suit ended up costing millions of dollars by the hospital it was that he practiced in. There were, I’m sure, other cases like that, but that’s the one that we were always told about.
Tacey Ann Rosolowski, PhD:
Uh-hunh (affirmative). Well, it’s pretty striking. So, you were there for two years? Was there any kind of change in what you did over the course of that two years? How did your own understanding of your work evolve in ways other than what you may have already mentioned to me?
Walter Pagel, ELS (D):
They didn’t. But that’s basically what changed. I had to manage a few things, but that wasn’t hard.
Recommended Citation
Pagel, Walter ELS and Rosolowski, Tacey A. PhD, "Chapter 02: Learning the Editor’s Craft" (2012). Interview Chapters. 1271.
https://openworks.mdanderson.org/mchv_interviewchapters/1271
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