The journal and originality.

When you click on the journal’s content or open up the hard cover of Neurocritical Care, you expect to see something new or even something provocative. And yet there are less earth shaking issues. That is the hard truth, and it applies to all journals—great and small. Every editor would like to see the most original work by the most original study group, and only the journals with the highest impact factor can count on it. To publish an important first observation that may go on to become a landmark in the literature of neurocritical care is a lofty goal, but something we could work toward. Although the architect, Ludwig Mies van der Rohe, famously said ‘‘It is better to be good than to be original’’, in our continuously growing specialty, we have to be both. Skeptics will point out that all concepts have been articulated before. Just go back far enough, and you will find it. They would say just look at renewed interest in the spreading depression already proposed by Leao in 1944— How about penicillin neurotoxicity now more often seen as cefepime neurotoxicity. I need not remind this readership that before we diagnosed cerebral salt wasting, we had SIADH and even before that—guess what—cerebral salt wasting. Can we still be original? We should forcefully reject the ‘‘everything has been done before’’ argument. I continue to be pleasantly surprised by the highly interesting submissions over the years. In our field, advancement could come with a new original description, but this may also include an important rarity that has immediate consequences for management. There is no shortage of careful clinical descriptions of difficult patients, a new treatment, the first review of a major topic, and a never seen before neuroimage. We continue to publish papers that may seem a niche interest to some, but to others, their life’s work. Therefore, authors submitting material to the journal have noticed that although their papers are important observations, the work has been rejected because it lacks novelty. I have been rejecting papers that are not advancing our knowledge, are much of the same, and certainly studies that do nothing but confirming the obvious. Also, over the years, manuscripts have been rejected without external review. I have taken the liberty to reject papers that fail to meet our increasing higher standards, and papers that are clearly serving the interest of the industry. I have, to the best of my knowledge, not rejected a well-executed manuscript but reconsidered if I was wrong or too quick on the draw. In truth, the originality of a paper remains our most important measure. Editors would want to avoid significant time spent on very weak manuscripts. Does this include case reports—the bane of journals? Case reports are rarely cited and may reduce impact factor if other worthwhile papers—that could be cited—are not published. Imagine a case that leads to a new concept or insight. We do not want to miss that. So how could we define ‘‘originality’’ in a manuscript? Does it all have to be pristinely novel? What is synonymous with originality? One could say it should contain an innovative thought, a probing study into a new area, a rarely photographed or video-recorded clinical sign and even more closer to the bedside a validated new tool. Unoriginal does not need a definition, and we all recognize shopworn and uninspiring material. E. F. M. Wijdicks (&) Division of Critical Care Neurology, Mayo Clinic, Rochester, USA e-mail: wijde@mayo.edu