Written diagnosis - Issue 58 - Magazine | Monocle

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Richard Horton is a busy man. It is late Tuesday afternoon in London and the editor-in-chief of The Lancet has just signed off the last pages of the medical weekly’s next issue. He’s now making the final tweaks to his fortnightly schedule before heading to New York for the UN General Assembly. After the US, next on the agenda is a keynote speech at the 24th Scientific Meeting of the International Society of Hypertension (ish) in Sydney and then he will be heading to Tokyo for the annual meeting of the imf and the World Bank.

Horton is certainly no newbie to such commitments: over the course of two decades at The Lancet he has been a regular at myriad health-related conferences and conventions across the globe. The 50-year-old joined the journal in 1990 as an assistant editor (“I was the coffee boy,” he laughs) after studying physiology at the University of Birmingham and completing his medical research at London’s Royal Free Hospital.

He was transferred to New York shortly after to run what was then the newly opened North American bureau before returning to the UK in 1995 to assume his current position. As if his primary job doesn’t take up enough of his time, Horton also writes regularly for the New York Review of Books and is a medical columnist for The Observer in the UK. His love for the written word is irrefutable; the bookshelf-dressed walls of his office are packed with volumes of reports by ierg (the World Health Organisation’s Independent Expert Review Group), issues of The New England Journal of Medicine (The Lancet’s main competitor, based in Boston) and, of course, heaps of previous editions of The Lancet. “I’ve always had two passions: medicine and literature,” the editor says from behind the precarious pile of books perched on the corner of his desk. “The Lancet turned out to be the right place to combine them both.”

The journal first appeared in 1823 as founder and surgeon-cum-MP Thomas Wakley’s platform to inform and instruct English society. Today it is owned by Dutch publishing giant Elsevier and has bureaux in London, New York and Beijing 
accommodating 82 full-time editorial staff, mainly made up of doctors and scientists with previous writing experience.

Whether running controversial articles on death-toll figures in Iraq or critical editorials about Rome’s policy on condom use, the journal has caused a stir or two on several occasions down the years. “We have a voice of our own and are dedicated not just to informing but also to bettering global health, and challenging government policies,” 
explains senior executive editor Dr Pam Das. “The Lancet is first and foremost about tackling global health issues and getting the bigger picture.”

The content is a solid mix of clinical research papers, editorials, industry job ads and “This week in medicine”, a listing of forthcoming highlights, all skillfully laid out over 80 pages. Once a month The Lancet also publishes three speciality journals – on oncology (launched in 2000), infectious diseases (2001) and neurology (2002) – with two new monthlies on respiratory medicine and diabetes planned for 2013 and 2014 respectively.

With its encyclopaedic density and simple, straightforward layout, the weekly relies on the committed readership of 35,000 private and institutional print subscribers (mainly medical libraries, students and GPs), some of whom have been with the magazine for over 20 years. There are also 1.3 million registered online users accountable for 100,000 website hits per week; the rest of the revenue comes from advertising by medical suppliers and drug manufacturers.

As monocle leaves the evening is closing in; with the last pages sent to press two hours ago, Horton and the first floor of Elsevier headquarters can finally call 
it a day – and an issue.

The Lancet's peers

Nature Outlook
The first Nature weekly came out in 1869, covering topics such as physics, chemistry and clinical medicine. Nature Outlook is its monthly supplement that examines a pertinent science or health issue in depth.

Medicinsk Vetenskap
Published by Karolinska Institutet four times a year and aimed at the general public interested in medicine. Medical Science is the English edition that comes out once a year.

Ugeskrift for Læger
A Danish journal covering health and wellness. The weekly was founded in 1839 and has been available online since 1999.

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