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Bruce Campbell MD

A Fullness of

Uncertain Significance:

Stories of Surgery, Clarity, and Grace


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(Originally published in the Kern Institute MedEd Blog - 1/3/2023)

Bruce H. Campbell, MD FACS

Dr. Campbell shares highlights of a recent podcast moderated by Toni Gallo, the Academic Medicine staff editor, with practical tips that will smooth your way into publishing in the journal ... Happy New Year! Maybe one of your resolutions this year is to publish a MedEd article in a top-tier journal. You can do it!

To make it more likely, the editors of Academic Medicine created an Academic Medicine Podcast (12/19/2022) where the people who help decide what will get into print offer a peak behind the curtain. The episode is entitled “Writing Effectively and Navigating the Publication Process." First of all, here are links to online medical writing resources:

Below are tips and suggestions that each editor offers. As you prepare your manuscript, remember that folks like these editors will eventually be reading it.

Colin West, MD, PhD (Deputy Editor, Professor of Medicine, Medical Education, and Biostatistics, Mayo Clinic)

Three things to think about when preparing a manuscript:

  • Be clear on how a practical application of your work bridges the gap from theory to practice without overstating your findings

  • Be clear about the paper’s place in the field of study

  • Be honest and thoughtful about the paper’s limitation

Jonathan Michael Amiel, MD (Assistant Editor, Professor of Psychiatry and Senior Associate Dean for Innovation in Health Professions Education, Columbia University)

Things he hopes to see when reviewing a submission:

  • A clear demonstration of how the work helps make medical education better

  • The paper doesn’t overreach; rather it takes a “small bite” and rigorously addresses the problem

Laura E. Hirschfield, PhD (Assistant Editor, Associate Professor of Medical Education and Sociology, University of Illinois-Chicago)

Things she looks for when reviewing a submission:

  • A clear demonstration that the authors have engaged with the foundational papers and authors in relevant fields, even if outside the traditional MedEd disciplines.

  • A well-demonstrated link between the research question or topic and the research design

Gustavo Patino, MD, PhD (Assistant Editor, Associate Professor of Neuroscience, Oakland University William Beaumont School of Medicine)

Questions he asks as a reviewer:

  • Do the authors clearly articulate the research question?

  • Have they described the knowledge gap?

  • What was the genesis of the idea?

  • Why is it important that this question be answered?

  • Are the research methods and study design appropriate to answer the question?

  • In the Discussion, are the claims and takeaway points consistent with the Methods and Results?

Dan Schumacher, MD, PhD, Med (Assistant Editor, Associate Professor, University of Cincinnati) His advice to authors:

  • Pay attention to Lorelei Lingard’s idea of “It’s a Story, Not a Study.” Tell the reader why it’s important, what you found, and why what you found is important.

  • Rely on well-crafted research questions and matching methodologies.

  • Write with clarity.

John H. Coverdale, MD (Associate Editor, Professor of Psychiatry and Behavioral Sciences, Baylor College of Medicine) His advice to authors:

  • For both qualitative and quantitative research, make the Methods section crystal clear. Explain how the design relates to the research question or hypothesis, including how it is appropriate to the question.

Mary Beth DeVilbiss (Managing editor) What she likes to see in the visuals:

  • Exhibits, tables, figures, charts should have a clear purpose and add value.

  • Visuals that enhance and illuminate the text, but never repeat it.

Teresa Chan, MD, MHPE (Associate editor) How she describes the Academic Medicine "Innovation Reports":

  • They are a first stab at a new way of doing things that builds on previous literature but then tweaks it in a novel way. Outline the problem, outline the approach, and always provide a reflective component.

Bridget O’Brien, PhD (Deputy editor, Adjunct Professor of Medicine, UCSF) Things she suggests to authors before they submit a manuscript:

  • Read through the manuscript three times before submitting.

  • Read as an author. Make certain arguments flow and that essential details are covered.

  • Read as a reviewer. Try to apply the manuscript review criteria you use to your own work.

  • Read as a reader. Is it interesting? Do you skip sections? Does it make sense?

  • Then ask others to read your manuscript from these perspectives, as well.

Tony Artino, PhD (Assistant Editor for Last Pages, Professor at the George Washington School of Medicine and Health Sciences)

Reactions he suggests you have if you are asked to “revise and resubmit”:

  • A revision request is a win, right? Don’t be discouraged! It is better to get it right before publication than after.

  • Revisions always result in a better paper.

  • (Tongue-in-cheek) Editors and reviewers are always right. Realize that arguing only delays getting your manuscript into print.

  • Remember that medical and health professions education is a very small world. Your work might end up in the hands of the same reviewers if you re-submit to another journal. So, be gracious.

That should get you started. Happy writing!

Bruce H. Campbell, MD, FACS, is a Professor in the Department of Otolaryngology and Communication Sciences and in the Institute for Health and Equity (Bioethics and Medical Humanities) at MCW. He is on the editorial board of the Transformational Times and a member of the Faculty Pillar of the Robert D. and Patricia E. Kern Institute for the Transformation of Medical Education. He has published two Innovation Reports in Academic Medicine and still learned some stuff listening to and summarizing this podcast.

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What Readers are Saying About
A Fullness of Uncertain Significance

In this tender and candid collection of short essays, Dr.  Bruce Campbell illuminates how much medicine is truly  the sacred act of holding vigil with and for our patients.  Through his reflections, we get a glimpse of how surgeons  hone their instincts, grow through challenges, and cope with  disappointment as they navigate the uncertainty inherent in  medicine. Through his polished lens, the reader understands  how even in the pressurized world of surgery, heavy with the  responsibility of healing through a scalpel’s cuts, there are  moments of intimacy that are filled with grace. 


—Rana Awdish, MD, FCCP, FACP, author of In Shock: My  Journey from Death to Recovery and the Redemptive Power of Hope  

Dr. Bruce Campbell turns his scalpel on his own history  as a surgeon, probing the medical field past, present, and  future. His vibrant stories illuminate the fundamental human  underpinnings of medical science, bringing to light the glories,  tragedies, imperfections, and uncertainties we must all grapple  with. Eminently readable and richly satisfying.  


—Danielle Ofri, MD, PhD, Clinical Professor of Medicine  at New York University School of Medicine, Editor-in-Chief of  Bellevue Literary Review, and author of When We Do Harm: A  Doctor Confronts Medical Error 

Dr. Campbell’s reflections will resonate with those who treat  cancer patients as well as those who have had cancer themselves.  Medical students and residents will also be inspired by his life’s  journey as a surgeon and teacher, aspiring to their own joyful  and meaningful lives in medicine. 

—Julie Ann Freischlag, MD, FACS, FRCSEd(Hon), DFSVS,  CEO Wake Forest Baptist Health, CAO Atrium Health, Dean of  the Wake Forest School of Medicine, and 2021-2022 President of  the American College of Surgeons.  

In this rich collection of stories and essays, Dr. Campbell  reflects on his years of caring for patients and training young  doctors to follow in his footsteps. With compassion, humility,  and shimmering prose, he shares the joys, pains, and somber  responsibility of being a surgeon. 

—Gayle Woodson, MD, surgeon, educator, and award winning author of After Kilimanjaro and Leaving La Jolla  

Bruce Campbell is no average surgeon and no ordinary  writer. He takes the excellence of his medical trade and weaves  the challenges, exhilarations, and tough decisions of surgery  into beautiful prose. Here is one who clearly doesn’t reduce  patients to a diagnosis, but who sees them as whole persons  worth getting to know. The chapters in this book are like  windows into the humility and generosity of a man I’d like to  have as my personal physician. 

—Peter W. Marty, editor/publisher of The Christian Century 

With his willingness to delve beneath the surface, Bruce  Campbell has created a deftly interwoven series of lessons gleaned  from poignant moments of a fulfilling surgical career. In a warm,  compassionate, and honest voice, Dr. Campbell delivers to the  reader not just insights on medicine, but truths about humanity.  

—K. Jane Lee, MD, author of Catastrophic Rupture: A  Memoir of Healing 

Humorous and humble, serious and sublime, these lean essays  offer a glimpse behind the surgical drape to show what it’s like to  be a cancer surgeon over the course of a long, rewarding career.  From Campbell’s first invitation into the “inner sanctorum” of the  O.R. as a nurse’s aide while in college, through tender interactions  with patients, to his projections about the profession when he is  long gone, this smart, sensitive surgeon illustrates how doctors can  listen to, care for, and learn from their patients. He courageously  goes to the “hard places” as well as sharing those special moments  that make it all worthwhile. Early in the collection, Campbell  writes, “Besides being a surgeon, I am also a human being.” This  beautiful book is about both. 

—Kim Suhr, MFA, Director of  Red Oak Writing and author of Nothing to Lose   

In lucid and succinct vignettes, Dr. Campbell illuminates  the myriad of emotions and sensations that accompany a life in  surgery. These stories of persistence, camaraderie, shame, grief,  guilt, and regret 

vantage point of experience. These ideas serve as the springboard  to discuss unique, personal insights whose wisdom is of import to  anyone in the healing profession. With elegant and engaging prose,  Campbell beautifully expresses the honor it is to be a physician. 

—William Lydiatt, MD, Chief Medical Officer Nebraska  Methodist and Women’s Hospitals and Professor of Surgery,  Creighton University in Omaha, Nebraska 

“Over the years, I have made an uneasy truce with failure,”  says Campbell in the opening pages of his debut anthology, and  yet his stories are anything but. Captivating, heart-wrenching,  inspiring—he chooses his words as meticulously as he conducts  his surgeries. 

And it’s just like a surgeon to keep you up in the middle  of the night. “One more story,” you’ll tell yourself, but with  Campbell’s reflections, it’s hard to stop. There’s a familiar ease  with which he flourishes his pen; everything falls away, and it’s  almost as if you’re sitting across the table from him as he recalls.  You laugh when he laughs, you cry when he cries, and you wait as  he waits. His memoir of stories is sure to become a rite of passage  for future doctors and patients alike, enjoyable little tunes that all  hum together in a harmony of sound. 

Turning the last page of Campbell’s novel, I succumb to my own  “fullness of uncertain significance”—I have been charged to seek  meaning, to reflect, to sit in the silence of his reverberating truths.  

—Olivia Davies, MD, poet, writer, and dermatology resident at  Massachusetts General Hospital



The words “clarity” and “grace” take on heightened  significance in this honest yet lyrical set of essays by Bruce  Campbell. The immediacy and intensity of these stories  immediately swept me into the consulting room and OR. I felt  as if I were a privileged witness to an almost sacred encounter  between surgeon and patient. Subtle language lays bare a primal  relationship. It is impossible to read this book and not be  changed by the experience. 

—Carol Scott-Conner, MD, PhD, Professor Emeritus of  Surgery at University of Iowa Carver College of Medicine and  author of A Few Small Moments: Short Stories  

Dr. Bruce Campbell sets a new milestone for doctor-writers. As  an otolaryngologist and head and neck surgeon, he treats patients  with the most advanced and aggressive cancers imaginable. Internists  like me wonder how head and neck surgeons like him do it; this  book gives me the answer. Dr. Campbell brings luminous sight  to his work. His writerly gifts let him capture the delicate and the  solemn, the tragic and the everyday dimensions of illness. Not a  set of doctorly instructions (though instruct it does), A Fullness of  Uncertain Significance: Stories of Surgery, Clarity, & Grace lays open  the profound mysteries and truths and awe about this life of ours.  These stories will change lives. 

—Rita Charon, MD, PhD; Bernard Schoenberg Professor  of Social Medicine and Professor of Medicine; Chair of the  Department of Medical Humanities and Ethics; Executive Director  of Columbia Narrative Medicine, Columbia University, New York  City; Co-author, Principles and Practice of Narrative Medicine 



In this compelling, insightful, and beautifully written  compendium of stories, Bruce Campbell shares the lessons he  has learned, and continues to learn, throughout his medical  education and his years as a highly successful surgeon, faculty  member, and teacher. A Fullness of Uncertain Significance is  refreshingly honest and introspective, exploring not only many  of the desirable outcomes when he had been faced with a broad  array of professional challenges, some potentially life-and-death,  but also those outcomes that were less than he had hoped for.  Readers will appreciate the author’s willingness to reveal that,  “As a surgeon, I have made mistakes that have hurt people. This  should not surprise anyone since, besides being a surgeon, I also  am a human being.” Providers, teachers, and students of health  care in every field and at every level of service will benefit greatly  from what the author has accurately labeled “Stories of Surgery,  Clarity, & Grace.” This isn’t merely a book about one man’s life  as a surgeon. It is a book about the need for understanding and  compassion when dealing with others, especially those in distress. 

—Myles Hopper, PhD, JD, author of My Father’s Shadow 

In this collection of essays, Dr. Campbell pulls the reader into  his Milwaukee otolaryngology clinic, the operating room, and his  medical work in Kenya. He tells story after story with wonder,  humour, and affection. He looks back on his medical training and  fantasizes about medicine in the mid-twenty-first century. He lets us  in on his unique vantage point on humanity, and does so with such  humility and grace that his own humanity is never in question.  

—Martina Scholtens, MD, author of Your Heart is the Size of  Your Fist

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