That evening, Eleanor stayed late. She pulled a stack of 500 index cards from the catalog and began a radical experiment. She took the most frequent words in medical journal titles: Acta , Annales , Archives , Journal , Medical , Research , Surgery . Then she invented a shorthand. “Acta” became Acta (no change—it was short enough). “Annales” became Ann. “Archives” became Arch. “Journal” became J. “Medical” became Med. “Surgery” became Surg. By midnight, she had a list of forty abbreviations.
The NLM knew they had a tiger by the tail. In 1963, with the advent of computerized indexing (the precursor to MEDLINE), they formalized the system into what became known as the . Every abbreviation had to be unique, reversible (you could reconstruct the original title from the abbreviation, mostly), and language-agnostic. English, French, German—all were flattened into a common, Roman-alphabet code.
Eleanor Fitzpatrick never patented her system. She retired in 1985, and the NLM’s current List of Serials Indexed for Online Users (LOCATORplus) contains over 26,000 unique journal title abbreviations. Her original handwritten card for Z Exp Med is now displayed in the NLM’s historical reading room, under a small plaque: “Here began the quiet discipline of brevity.” That evening, Eleanor stayed late
The journal’s full title was “Zeitschrift für die gesamte experimentelle Medizin einschließlich experimentelle Chirurgie.” It took twelve seconds to say aloud and consumed nearly an inch of a typed index card. Eleanor’s supervisor, Dr. Harold Cairns, had a simple rule: “If a title takes longer to write than the abstract it describes, we’ve failed.”
In 1960, the first Index Medicus with abbreviated journal titles appeared. The reaction was swift. A letter from a librarian in Chicago praised the “delightful compactness.” A professor in London wrote that the abbreviations were “cryptic to the point of prophecy.” But a young researcher in Stockholm accidentally misread “Scand J Clin Lab Invest” as a single Finnish surname and spent three days looking for a non-existent doctor named Scand. Then she invented a shorthand
This was the golden age of the Index Medicus , the NLM’s comprehensive monthly compilation of global biomedical literature. Scholars from Paris to Tokyo relied on its gray, densely printed volumes to navigate the exploding post-war tide of research. But the system was choking on its own verbosity. A single issue might list 15,000 articles, and each journal title—no matter how monstrous—was spelled out in full.
He convened a committee: three catalogers, a medical historian from Johns Hopkins, and a frustrated cardiologist who actually used the Index Medicus every day. For six months, they argued over every slash and period. Could “New England Journal of Medicine” become N Engl J Med ? (Yes, but only if “New” was not abbreviated to N. alone—too vague.) What about “Journal of the American Medical Association” ? That became JAMA —but was that an abbreviation or a new word? (They decided it was a “title word contraction.”) And the German monster? Z Exp Med. Everyone held their breath. It fit on one line. “Archives” became Arch
By the 1970s, Eleanor’s midnight experiment had become the global standard. When PubMed launched in 1996, the “Title Abbreviation” field was non-negotiable. Today, every medical student who types “N Engl J Med” into a search bar is using Eleanor’s shorthand. Every systematic review that cites “JAMA” or “Lancet” (which amusingly needed no abbreviation at all) owes a debt to those weary index cards.