What Price Knowledge
by Ellen Lewis, Ph.D.

My previous Left Corner article told the story of a resident in Pakistan and the difficulties he encountered when trying to get copies of full-text articles for his research paper (you can read about Atif and the issue of Open Access if you missed it last month).

Equally entertaining (well, I thought so) is the story of the medical editor (me) and the problem of full-text access. This story does not take place in an exotic third world country. It takes place in a New England town, about halfway between New York and Boston, and less than ten miles from one of the top medical schools in the country. It began when I promised to send my Pakistani friend a copy of a review article published in a recent issue of European Radiology.

I would like to tell you that I drove down to the "top-medical-school-that-shall-remain-unnamed," walked into the med library, found the journal, photocopied the article, and went home.

But, I can not tell you that. First of all, parking around the "top-medical-school-that-shall-remain-unnamed" is notoriously non-existent. I keep a bag of quarters in my car specifically to feed the parking meter (six quarters buys you an hour and a half) if I get lucky enough to find a space on the street within walking distance of the library. These days they are building a new research center and they removed all but the handicapped parking from my most promising string of spaces. The only other choice is an enormous parking garage where I always forget where my car is parked and get lost trying to wind my way through the hospital en route to the medical school.

So, I had a friend drop me off near the med library. In past years, I used to walk right into the library, looking appropriately ready to study with a collection of papers and folders protruding from my book bag. Lately though, I get stopped at the entrance by a security guard who tells me that I will be granted temporary permission to use the library as a "guest" and insists that I wear a "guest" badge as I am not an employee or student of the medical school. As a guest, I do not have any library privileges.

The medical library has a reading room that houses the current year’s worth of back issues for all journals held by the library. This can be a wonderful resource for unconstrained browsing, except when the particular issue one needs is not on the shelf and then the casualness of the situation backfires totally. If the issue is not on the shelf, there is no way to find it. It may be sitting on a desk somewhere else in the library, or in the briefcase of some professor who needed it for a day or two. The only other way to get a copy of the article is through the Yale (oops) online research database and that is—you guessed it—not for "guests" of the library.

Okay, so they did not have the issue I needed. Can’t say I was completely surprised. As a final effort, I tried to bribe a friend who works at Yale to let me use his password to access the full library database. This would have worked like a charm, except my friend did not know his password- actually, he did not know about the library database either.

Next stop was my local town library. I discovered, after asking a series of pesky questions, that we have a reciprocity program with most of the other libraries in Connecticut, including the University of Connecticut Medical Center. The reference librarian agreed to fill out a requisition form and contact me when the UConn Medical Library let her know if it was possible to have the article copied and sent. Ten days later I picked up a photocopy of the article in a crisp manila envelope and was charged $11.00 for the copying service. A tad slow, and rather pricey if one needed to read, say, 25 articles for a research paper, but not a bad deal for a single publication and an unselfish gesture.

Back home, reprint in hand, I was faced with a new dilemma. The article was not digitized and I had to send it to Atif in Pakistan. When I asked about snail mail, Atif warned that it could take a month, so I suggested faxing. He gave me the fax number of his brother, who worked for a large company with international contacts. I spent half an hour or so one evening trying to fax the thirty-page article to Pakistan. I did manage to fax the first three pages, but was confounded by broken connections and an error message ("poor line quality") that repeatedly showed up on my fax machine. Two nights later I tried again, figuring that the weather, or sunspots, might be the problem. Still the same error message appeared about "poor line quality" and I was starting to wonder how much it costs to make a phone call to Pakistan.

Atif had a new plan. Couldn’t I just scan the document and then email it to him? Well, I could, but scanning a thirty page document, one page at a time, on my home scanner, would take two to three hours. Plus, the paper had multiple radiological images, and might need more memory than I had available on my hard drive. This would mean batches of pages to be scanned, saved, emailed, and then deleted.

As I was trying to cope with this latest option (or find someone else to spend three hours scanning), Atif had a brilliant idea. He could use eFax, a wonderful service that assigns one a fax number in the United States and then magically turns the faxes received into emails. I knew he was a smart kid; eFax worked like a charm, and the paper was delivered. The entire operation had taken two and a half weeks and cost me $11.00. Ah, yes, that is until the phone bill came last week. Four calls to Pakistan for a total of thirteen minutes to fax three pages: $99.97. Good thing I did not have to pay for the parking meter.