From left to right: Lois DeBakey, William L. Winters, Jr., Selma DeBakey

Nothing hinders communication as much as words, when they are used poorly or incorrectly.1 Those observations were the incentive for Selma and Lois DeBakey when they began their careers at Tulane University School of Medicine. Petite, demure Southern ladies, the DeBakey sisters were to pioneer the field of biomedical communications with the same energy and authority as their esteemed brother, Dr. Michael E. DeBakey, when he ushered in the era of cardiovascular surgery.

Natives of Lake Charles, Louisiana, Selma and Lois forged highly successful professional careers, giving full credit to their parents for instilling in them the highest societal principles of integrity, altruism, and dedication while showering them with love, guidance, a fruitful education, and life's comforts. They learned early that the honor of their name was more valuable than wealth or fame. The DeBakey family remained very close throughout their long lives, perhaps best reflected in a letter from Michael to his sisters on Christmas 2005: I love you both dearly, and I thank God He blessed me with two angel sisters. In interviews, he observed, Deep down, you really depend on your siblings.... You share your thoughts with them, even though you may not be able to share them with others. You don't feel alone.2

Selma led her class academically throughout her education. Her career began shortly after graduation from Sophie Newcomb College, when she began abstracting, translating, and editing medical manuscripts for her brother Michael, a member of the Tulane Medical School surgery faculty. Her college education in English and postgraduate studies in languages and philosophy provided the foundation for her to assist Michael and other physician-authors in their preparation and drafting of manuscripts. Critical reasoning and analysis, logical organization, narrative style, literary ethics, graphics, and use of other supporting data were among the armamentarium she brought to her teaching.

Selma excelled and in 1941 was chosen to head the editorial department at the Alton Ochsner Foundation. She soon launched the Ochsner Clinic Reports as its foundation editor. In 1944, she became director of the Department of Medical Communication at the Ochsner Clinic Foundation and designed original courses meant to solve the communication problem.3 In August 1954, the editor of JAMA solicited from Selma an article entitled Suggestions on Preparation of Medical Papers. As the first paper on the subject, it became the benchmark for scientific writers, thereby launching the field of biomedical communication.4 Lois extolled Selma's foresight for this endeavor and for mentoring Lois in her early career, and she proudly lauded Selma as her preceptor and alter ego. Committed to her profession, Selma was the founding editor of the Cardiovascular Center Bulletin, editor for professional medical writing organizations, and guest editor of special issues of several medical journals. She also was a member of advisory committees of the Friends of the Texas Medical Center Library and with Lois served on the editorial board of the Methodist DeBakey Cardiovascular Journal.

Lois DeBakey graduated from Tulane University as a Phi Beta Kappa with a B.A. in mathematics. She went on to earn a master's and Ph.D. degree that included courses in biostatistics at the Tulane University School of Medicine, where she later served as professor of scientific communications. In 1962, at Tulane, Lois and Selma introduced the first curriculum-approved communication courses ever offered in a medical school.

Lois also served on the faculty of Tulane's English Department and on the editorial board of Tulane University Studies in English. Her many honors included, among others, membership in the Golden Key National Honor Society, the Harold Swanberg Distinguished Service Award of the American Medical Writer's Association, and the first John P. McGovern Award of the Medical Library Association. She served on many prestigious editorial boards including the Journal of the American Medical Association, as regent and consultant to the National Library of Medicine (NLM), and as chair of many of their committees, including chairman for Index Medicus and MEDLINE databases and chairman of the Medical Media Center of Excellence committee of the Friends of the NLM. She has also served on the advisory panel of the American Heritage Dictionary and as team leader of Encyclopedia Britannica medical database. Her authorship includes editing and publishing numerous books and articles. One in particular, The Scientific Journal: Editorial Policies and Procedures, has been considered the definitive word for medical journal editors.

In 1968, Selma and Lois were recruited by Baylor College of Medicine in Houston to become tenured professors of scientific communication and to support the vision and global activities of their brother, who was chairman of Baylor's Department of Surgery. They became critical factors in his success, providing him invaluable support every step of the way. They continued their work as editors, consultants, and course directors, and their courses for the American College of Surgeons were wildly popular.5

The DeBakey sisters were the first to carve out a niche teaching doctors to think, read, and write critically and to express themselves in lucid language. They maintained that literacy is the nation's pedigree and that English is alive, well, potent, and malleable, not dull and lifeless as portrayed by too many medical authors.6 Dr. Robert Moser characterized them as the conscience of American Medical Letters.7 When asked what they taught, the sisters answered, the logic and language of medicine.

Throughout their 60-year professional careers, Selma and Lois together defined the profession of biomedical communication through their writings, lectures, courses, and conferences. They produced a voluminous number of publications on topics that included the responsibilities of authors, editors, and reviewers; logical organization; literary ethics and etiquette; plagiarism; grammatical integrity and style; jargon and other inscrutable usage; and fuzzy thinking, among others. Their didactic signature was the clever use of humor and cartoons to encourage clear, concise, coherent prose. Let thy words be few, they implored, and let them be well chosen.8 They began holding 2-day seminars at medical conventions around the world, and today their body of work is acknowledged to be the gold standard in medical communications.

Recognition of their contributions came from near and far. The City of Houston named a day in honor of Selma and Lois. Selma was named one of the 50 outstanding women in Houston in 1990 and was nominated for the Texas Women's Hall of Fame in 2008. In 2009, the Selma and Lois DeBakey Lectureship in Biomedical Communication was established at Houston Methodist Hospital to honor their literary excellence and contributions. Baylor University in Waco established the Michael E. DeBakey, Selma DeBakey, and Lois DeBakey Scholarship in the Medical Humanities to honor their advocacy of this subject as a means of better understanding the human condition. The two sisters were also nominated for the Presidential Medal of Freedom in 2011. Their names are to be found in nearly every honorary directory and Who's Who list of the United States and the world.

Dr. George Noon, the longstanding associate of their brother Michael, knew Selma and Lois well. In his words, Selma DeBakey was a quiet, unassuming genius. She developed and promoted the field of biomedical communications for which she was recognized nationally and internationally. Her collaboration with her brother, Dr. Michael E. DeBakey, and her sister, Dr. Lois DeBakey, set the stage for modern biomedical communications. Selma always had a beautiful, warm, and winning smile. What a wonderful woman and friend she was. She was a giant among giants.

Selma and Lois DeBakey grew up together, went to school and college together, and worked together. They could be seen walking arm in arm to Houston Methodist Hospital, where their offices were adjacent to their iconic brother's. Throughout their lives, their love for their parents, siblings, and profession remained foremost and unabridged. They had legions of friends and admirers who proved to be a true life support for Lois when Selma passed away in March 2013.

I remember with fondness our weekly Tuesday morning tea and cookie sessions, when we discussed issues regarding the Methodist DeBakey Cardiovascular Journal and our profession in general. Conversing with two such profound, articulate intellectuals was, in itself, a rare experience. Their memory will live long in the annals and hearts of the biomedical communication world and especially in the lives of those, like me, who were their closest colleagues. Blessed are those who basked in their sphere of influence. Although petite in stature, both were giants in the field of biomedical communication.