By Dana Cook Grossman

When I started out in publishing, in 1974, my tools were a manual typewriter and a film camera. As a reporter for a weekly newspaper, I covered high-school sports, planning board meetings, and Memorial Day parades. I took pictures, developed them (ah, those darkroom chemicals—I can smell them yet), then pounded out stories on the paper's crotchety typewriter.

For a long time, I thought of myself as being in an ink-on-paper business— though after I moved to the Dartmouth Alumni Magazine in 1979, the way the ink got onto the paper changed a little, with the advent of computerized typesetting.

I began putting ink on these pages in 1986, when I was offered what has to be the best beat on campus. (Yes, I'm probably prejudiced, but the stories in medicine are so fascinating—who could disagree?) Soon, on top of a new beat, I had some new tools. First it was what used to be called "desktop publishing" and is now the only way anyone designs a publication. Digital photography was next. In 2001, we established a web presence. Clearly, publishing had become an ink and pixels business.

Then, in 2006, we began to produce multimedia web-extras. It was the late Paul Gennaro, DMS's web architect, who pitched the idea to us. We'd had a great relationship with Paul ever since he'd redesigned our website a few years earlier. But I have to say, I thought this idea was beyond the pale, or at least beyond our pale. Sure, I'd watched a YouTube clip or two, and I occasionally clicked onto the slide galleries or videos on the New York Times website. But such swank, I felt, was not for the likes of us. Paul could be persuasive, though. He was a real evangelist for multimedia. He said he'd help us. On his own time. So I said, "Uh . . . okay . . . I guess so." And just like that, we added devices like digital recorders and software like iMovie to the tools of our trade.

We posted our first web-extras with our Spring 2006 issue. A big plus of any online venture is that it comes with ready-made data; our monthly "traffic report" would tell us if this highfalutin scheme was a huge time sink or a worthwhile endeavor. The answer was unequivocal. The number of visits to our site jumped 21% from the month before to the month after the web-extras launched (compared to only 16% growth in the preceding six months).

We've produced from three to five web-extras with every issue since—videos, podcasts, slide galleries, or text that augments what's in print. The WEs, as we've come to call them, capture sights and sounds that can't be put on paper, such as the innards of DHMC's award-winning "green" wastemanagement operation or the nuance in a physician- poet's voice as he reads his work. During 2007, our first full year with web-extras, monthly visits to our site grew 105% from the pre-WE era. And we can tell the multimedia is responsible for much of that growth from the pages people go to.

We also soon realized that although the WEs take some time, they haven't taken away from the ink-on-paper part of our operation—in fact, we feel they've improved it. Yes, each web-extra is the equivalent of another article. But we believe storyboarding videos has made us better story-tellers in print. And thinking about sound and action and music has livened up our print presence.

The web did something else. It gradually made me realize that a magazine isn't an object—a bunch of stapled-together pages—but its contents: the result of gathering together raw information and then sifting it and giving it personality. The web has merely given us more ways and different ways to share that content beyond just putting ink on paper. It's really ideas, and the people who espouse them, that are the tools of this trade.

To the best of our knowledge, there are only a handful of other medical school magazines that are creating multimedia content for their online editions. The excellence of what Paul helped us produce was recognized recently with an award from the Association of American Medical Colleges (see this article for more on this award, as well as one for the magazine's print edition). Sadly, though, Paul can't savor it with us, for he died of congestive heart failure last October, a few months before the award was announced.

But he left a great legacy: A project so successful we simply have to continue it, even without his help. And the knowledge that it's people—Paul, my fabulous colleagues on the magazine's staff, our legion of collaborators and contributors, and the dedicated researchers and clinicians whose work we cover—that are the real tools of this trade