The completion of my first textbook coincided with the birth of my third son 16 years ago. I swore then that it would be the first and the last. It wasn’t so much the discomfort of punching away at a BBC computer (remember them?) while heavily pregnant, but the lack of support from the publishers.

On delivery of the manuscript (miraculously on time, although the baby wasn’t), I had the option of indexing the text myself or being charged for their services. Yes, charged! When I had just spent the best part of a year writing the damn thing in my spare time, providing the medical illustrations and expecting a pittance in royalties.

I kept my “no textbooks” rule until last year when a publisher asked me to write one of a series of books for students following the new “integrated” medical curriculum. Half-heartedly, I mentioned it to a consultant colleague. To my surprise, he was keen and his enthusiasm carried the project towards the contract. We continue to have a happy relationship in writing the book, but that’s more than I can say for our relationship with the publishing company.

It seems to me they simply want to sign you up to produce x thousand words by a specified date to a format dictated by minimalist market research. What they haven’t added into the equation is that most teachers don’t write textbooks for the money. For the hours of labour the returns are meagre; hour for hour you’d be better off stacking shelves in a supermarket.

Given the limited market at higher education level, an author would be lucky to sell 4,000 copies over two to three years. At 10 per cent royalties on a pound;10 book, the gross income is pound;4,000. Take away tax, share it between co-authors, and its hardly a lottery win. I know a head of English in an inner-London comprehensive who has 10 school texts on the market. “I could make a lot more money tutoring,” he says.

A colleague of mine wrote an award-winning medical text. It took him 18 months, in between teaching and research. Over four years he earned pound;4,000 gross. When a colleague phoned him from the States, asking where he could order 200 copies, he contacted his publishers to discover there were only 20 copies in the whole of America, even though it had supposedly been marketed there.

If it’s not for money, is it for love? There’s more likely to be love lost at home. Ever read the dedications at the front of textbooks? They’re not to mentors and friends but to spouses and offspring - for their loving support. Translated, this means the author did not do a fair share of domestic duties and all children’s activities were curtailed.

I think ultimately we do it for the challenge, the hope of improving our understanding and thus our teaching competence. Perhaps there is some career motive but I have never known anyone achieve promotion through writing a textbook.

So why are we not nurtured and mollycoddled by our publishers? Why do they make every attempt to keep royalties to a minimum? Why charge for indexing? Why are authors usually responsible for all the proof- reading? Where is our back up?

For our current book the project editor admitted she had so many books on her “list” that she only had an average of half a day a year to spend on each. Little wonder she had not completed reading our sample chapter by the time she arrived for our first consultation. this was to announce that what the publisher really wanted was a standard format science textbook with a token gesture toward clinical medicine. Their understanding of the new medical curriculum is far from our own first-hand experience in which the emphasis is on complete integration between science and medicine from the day students enter medical school.

Now I remember why I made my resolution 16 years ago. Publishers simply want their “lists” and their money and, of course, the texts written according to their specifications. It’s strange that they give such little support and put every obstacle in the paths of their authors - after all, they are entirely dependent on them.

Dr Saffron Davies lectures in a London medical school and writes here in a personal capacity