In his recent book subtitled the lost art of handwriting, Philip Hensher realises suddenly that he has never seen the handwriting of a close friend and that they communicate purely through email and text messages.[1] Are we losing something precious, Hensher asks, if we lose handwriting? While engaged to be married, my father went to Australia for a year to work. My mother remained in England and sent him a handwritten letter every day. I emigrated from England to Australia 22 years ago and continue to exchange weekly handwritten letters with my brother and sister, totalling over 3000 handwritten letters. When one son was studying overseas, his flatmates were surprised and envious that his father sent him handwritten letters. I believe our family attitude to letter-writing is unusual nowadays, but its rarity suggests that attitudes to handwriting have changed drastically.

A person's handwriting is unique, as distinctive as a fingerprint. No two sets of handwriting are identical; even identical twins have distinct handwriting.[2] Although my wife did find a sheet of multiple versions of my signature, of increasing verisimilitude, in the bedroom of one of our teenagers who was not averse to wagging school. Handwriting in Arabic script or in Chinese characters is also unique. Handwriting incorporates something of our personality and perhaps something of our humanity. The content and meaning of what we write is the most critical thing, but we lose something deeply personal and meaningful if we stop writing by hand. When a friend's parent dies, what can replace a handwritten condolence card? Surely not a condolence email?

In the pre-computer era, handwriting was of enormous import. We have learned a huge amount about their personality from the handwritten letters of great human beings. In 2012, The National Library of Australia in Canberra hosted an exhibition called ‘Handwritten’ featuring hundreds of letters and sheet music lent by the Berlin State Library (Fig. 1). There were letters by great scientists (Copernicus, Galileo Galilei, Isaac Newton, Marie Curie, Louis Pasteur and Albert Einstein), great writers (Dante, Dickens, Dostoyevsky, Voltaire, Goethe and Kafka), great philosophers (Erasmus, Rene Descartes and Immanuel Kant), great artists (Michelangelo and Joseph Beuys), intrepid explorers (Captain Cook, David Livingstone and Fritjof Nansen) and controversial politicians (Machiavelli, Otto von Bismarck, Napoleon Bonaparte and Karl Marx). There was also handwritten music by many great musicians including Bach, Beethoven, Handel, Haydn and Mozart. There was a version of the Aeneid ascribed to Virgil (70–19 BC) and a manuscript attributed to the Anglo-Saxon monk the Venerable Bede who was born in the 7th century. There were letters by the inventor Daguerre and by Roentgen and one from the great nurse Florence Nightingale. A particular favourite was an embossed letter by Louis Braille showing an early version of what would become his famous writing for the blind. The exhibition featured over a thousand years of handwritten letters and manuscripts dating back over 2000 years. It was wonderfully uplifting to see the deeply personal handwriting of such legends and scary to think that we might be nearing the end of the handwriting era.

Figure 1.

Love letter about champagne written by Karl von Meusebach from HANDWRITTEN, Ten centuries of Manuscript treasures from Staatsbibliothek zu Berlin at the National Library, Canberra, 2012.

Schoolchildren are often criticised for their illegible handwriting and a previous editorial[3] quoted the school report that stated ‘The improvement in his hand-writing has revealed his inability to spell’. For creative writing, the content is far more important than legibility. Hensher[1] devotes a chapter to Dickens and describes ‘the energy and fury of his great unreadable 19th century handwriting’ (Fig. 2). Hensher describes how the act of writing a letter is an impetus for the plot in many Dickens novels, such as Bleak House, The Pickwick Papers and David Copperfield. In the Handwritten exhibition, Dickens' letter is a touching handwritten letter to the recent widow of a writer commiserating on her loss and assuring her that Dickens' foundation will take care of her and her children financially. Imagine if, instead of the Letters of Charles Dickens, we had Dickens' emails. Or, even worse, Dickens' Great Tweets. The modern tendency to reduce communication to snippets of information such as tweets and sound bites is a recipe for trivialisation. Furthermore, emails are notoriously open to misinterpretation.

Figure 2.

Letter from Charles Dickens, 1869 in his ‘great unreadable 19th century handwriting’.

Doctors' poor handwriting is often ridiculed. One colleague wrote consultations that even he could not decipher subsequently. There are many anecdotes of prescription errors resulting from misinterpretation of doctors' handwriting; hence the trend to electronic prescribing. In hospitals, electronic health records are increasingly replacing handwritten case-notes, not necessarily to good effect. Electronic records are more legible (although the spelling is sometimes a source of amusement) and are generally less likely to be lost than paper case notes, although it is not always easy to find any relevant clinical data in electronic records. Currently in the Children's Hospital at Westmead, electronic records are confined to the two intensive care wards and the case-notes on other wards are handwritten. Junior doctors are instructed to date and sign their handwritten case-note entries, and to add their surname in capital letters and a contact phone number in case the records need to be checked later. In outpatients, handwritten case-notes are still preferred because it is easier to maintain a personal face-to-face conversation while writing than typing.

Doctors will probably continue to need to write legibly by hand for their work for some years to come. But writing by hand is also a deeply personal and human activity that we neglect at our peril. We should all nurture and treasure our handwriting.