Dr. Thomas Bruce Ferguson - Asian Annals Tribute

This article is republished with the permission of the Asian Cardiovascular & Thoracic Annals.

The narrative below on how the Asian Annals finally became indexed has not been previously published. The recent passing of Dr. Ferguson compelled me to pay tribute to the man who was instrumental in helping the Asian Annals achieve its most prized goals of indexing along with regional credibility and international acceptance through membership in CTSNet.

When someone describes an individual they've come to know well as “one of a kind” it normally implies a special set of talents or skills in their chosen field of endeavor. As Founder of the Asian Cardiovascular & Thoracic Annals, I can say with unabashed clarity, Dr. Ferguson truly was one of a kind, exceptional as a man, surgeon, editor, mentor to the journal, and as a loyal friend. Allow me to explain. After investment was confirmed in 1992, I was able to start a publishing company (Asia Publishing Exchange), thereby initiating the launch of a new cardiac journal covering Asia where none existed before. Makeup of the editorial and advisory boards would, of course, be crucial as a first step in the long road to acceptance by cardiac specialists. In this regard, I was quite fortunate to have built close relationships with the top cardiac surgeons around the world through various positions I held in the heart valve industry based in the USA, Europe, and Asia. In March of 1993, before the first issue was published, it became apparent that having a connection with the leading western scientific journals and editors in the field would assist us in trying to emulate their quality standards. We started off slowly with submitted manuscripts marginal in quality and clinical relevance. Case reports outnumbered clinical studies and rejection rates were high, making the first eight issues light in scientific content, importance, and accordingly, readership. Despite these shortcomings we saw marked improvement in the third year and had our first attempt at indexing (Index Medicus) by America's National Library of Medicine (NLM) in 1995. This resulted, somewhat expectedly, in failure, but we were not deterred, and more importantly the journal began to attract manuscripts from the established surgeons in the region.

Shortly after this first attempt at indexing, I encountered the renowned Dr. Thomas Ferguson at a meeting of the Society of Thoracic Surgeons (STS), introduced to me by Dr. Gerald Rainer of Denver, Colorado, a good friend from my previous days working for Shiley. Dr. Ferguson, then Editor-in-Chief of the respected The Annals of Thoracic Surgery, reviewed an issue of the Asian Annals. He was curious about what motivated us to start a new journal knowing full well the effort required to be successful. Our ultimate goal was to see Asian surgeons recognized for the excellent work they were doing in a credible forum of their own. For years most of their scientific articles had been routinely rejected by western journals and some suspected a bias against Asia existed. I asked him directly at that point if he'd consider assisting us by serving on our advisory board and he came back with a resounding “Count me in”! It seemed the fate of the journal was about to change for the better from that point forward.

In late 1996, Dr. Ferguson wrote an editorial for us entitled “Cardiothoracic Surgeons of the World, Unite!” (1996, Vol. 4, No. 4) in which he discussed the STS website launched a year earlier and some ambitious goals he and colleagues shared. The objective was “to unite all the cardiothoracic surgeons of the world into one cohesive body, intellectually, educationally and socially, and the medium that can make this possible is the Internet” as noted in his editorial. This heralded the birth of the far-reaching and now established CTSNet (Cardiothoracic Surgery Network), his specialty's first multi-society internet platform. Dr. Ferguson, who served as its Founding Editor for 10 years, was passionate about bringing the surgeons of Asia into this new grouping and saw the potential for the Asian Annals to be “a key team player” in the project. We were eager and ready to follow his lead. Striving to continue improving the journal, our new Editor-In-Chief, Professor Cho Bum Koo of Korea and I asked Drs. Rainer and Ferguson to serve as Senior Editorial Advisors, starting with the first issue of 1997 (Vol. 5 No. 1). They were tasked with evaluating the manuscript submission and acceptance process and the interaction the journal staff had with reviewers and authors. We were planning to seek a second evaluation at that point so this was an important step for us. In fact, just prior to the review, Dr. Ferguson on his own initiative wrote to the NLM's literature review committee responsible for indexing journals and stated: "I have seen the journal go from its first halting steps several years ago to a publication that I think is not only first class scientifically in the field of cardiothoracic surgery, but in my opinion has one of the best layouts and graphics design of any journal with which I am familiar. This is the only journal of significance in publication in the Pacific Rim, and I am certain will be the print spokesman for cardiothoracic surgeons throughout the Far East and Asia."

Despite this strong endorsement and what he, our editors and others believed was significant improvement since our first review in 1995, we were denied the coveted rating once again. In a surprise to our Board, Dr. Ferguson, while attending a conference in Washington a month later, called on the Executive Editor of NLM's MEDLINE/Index Medicus section to determine exactly why the journal failed to be indexed. It was made clear to him scientific content had to be improved! Accordingly, we decided to invite Dr. Ferguson to address our next Editorial Board meeting in October 1997 in Sydney, Australia, during the 13th Biennial Asian Congress on Thoracic & Cardiovascular Surgery. Insightful input from this renowned surgeon who had reached the top tier of scientific publishing was taken to heart by our Editorial Board and Manuscript Editor, Dr. Eugene Sim of Singapore. They heard from someone who understood the process and cared about us, and a new urgency for improvement flowed from that talk in Sydney.

Coincidental to our attempt at becoming indexed, we were pursuing a direct association with a regional society. This motivated us to move closer to the Asian Society for Cardiovascular & Thoracic Surgery (ASCVTS), a group formed around the time the journal was launched. Our Regional News section had highlighted ASCVTS events over the past few years and many of our key editors were members of the society. It seemed preordained we would eventually become their “Official Journal”. However, it was not so simple as many in the society were not convinced of the importance of the Asian Annals in their field. They were reticent to have us serve as their official publication, especially since we were not indexed or affiliated with the leading western journals. Again Dr. Ferguson and his colleague, Dr. Robert Replogle of Chicago, helped move us in this direction. Dr. Replogle, a prime mover in getting CTSNet off the ground, liked what he saw in the Asian Annals after being introduced to us by Dr. Ferguson. In concert with Dr. Ferguson's trusted aide, Ms. Carol Blasberg, we began cooperating with the fledgling CTSNet in order to have our journal join the three western journals (The Annals of Thoracic Surgery, Journal of Thoracic and Cardiovascular Surgery, and the European Journal of Cardio-Thoracic Surgery) with full text online on their website. Carol, cognizant of my affection for Dr. Ferguson, sadly informed me of his passing shortly after his death. In a recent email, aware I was preparing a tribute to him for the Asian Annals, she wrote: "You know how important it was to Tom to disseminate scientific information around the globe and for the Asian Annals to be apart of CTSNet. He encouraged you to publish the guidelines with the other CTSNet journals, i.e., the Joint Statement on Redundant (Duplicate) Publication by the Editors of the Undersigned Cardiothoracic Journals in 1999, for the journal to become indexed, and for it to grow with the other CTS journals. Our specialty was the only one to have all the journals in one portal."

In January of 2000, the Asian Annals became the Official Journal of the ASCVTS, thereby strengthening its position in Asia by having the support of, and direct relationship with, a major society. Our association with the eminent Drs. Ferguson, Replogle, and Rainer and others from the three western journals on CTSNet had been timely and fruitful. Thanks to the guidance, trust, and persistence of Dr. Ferguson we joined this highly valued and select grouping of journals shortly thereafter. We were in with the “Big Guys” now and had to do our part in representing all of Asia in a credible fashion. And, yes, much of that credibility involved improving scientific content moving us towards indexing. In fact, our third attempt was set for late 2001, and without fail, Dr. Ferguson wrote to the head of the Literature Selection Technical Review Committee of the NLM and stated: "Another important plus since the last review is that the Asian Annals is now the official journal of the ASCVTS which, of course, assures a steady flow of good content into the journal." Continuing, he wrote: "… it is of significance that the board of directors of CTSNet, made up of representatives from all of the major organizations around the world, felt strongly that our journal collection for CTSNet should include a journal from the Pacific Rim to give our viewers a truly international flavor."

Dr. Ferguson added in his letter to the head of the committee: "I know from personal contact with Mr. Tamru and his office staff that since the last review by your committee, the Asian Annals has striven to meet or exceed the standards recommended by the committee. In my opinion they have done this. I hope your committee will think likewise." It was a significance endorsement accorded our young journal from such an esteemed man in the field of cardiac surgery. We had joined with three established western scientific publications on CTSNet and our spirits were high. A third unsuccessful attempt at indexing however could signal the demise of the journal.

After letters of support from other internationally renowned surgeons comparable with the one from Dr. Ferguson, an unfathomable letdown was felt as the Asian Annals was again rejected by the NLM. A psychological low point was reached in my long career in Asia as all of us were poised for acceptance by the review committee in Washington. Where to turn for advice/solace? Dr. Ferguson, as expected, shocked when I informed him of the rejection, encouraged me to seek immediate details on scoring as we had to be close to making the grade. We also discussed the possibility of asking for a rare Collateral Review, and within 24 hours, both were done. The request was accepted and within a month we were officially notified of a successful review and inclusion of the journal in MEDLINE Indexing. My email to Dr. Ferguson on April 11, 2002 simply said: “Tom, we did it. Thanks for everything you've done for us!” The travail of seeking to be accepted for indexing by the prestigious NLM was finally over and the Asian Annals could add the most cherished “Index Medicus” rating to its growing stature in Asia. Authors sending articles to the journal could now be assured their published work would be sourced through a MEDLINE search. Although a long and difficult journey, it was well worth the effort to gain recognition by peers in the scientific publishing community. Of course, with a sage and dedicated mentor and friend like Dr. Thomas B. Ferguson, the Asian Annals could not have had a better, more determined gentleman in its corner, and most assuredly “One of a Kind”!

Winston Churchill once said: “Good and great are seldom in the same man”, but of course he never met Tom Ferguson!