The Write Stuff: Let’s Be Clear

“Since writing is communication, clarity can only be a virtue.” 

—Strunk and White, The Elements of Style

– – –

Let me show you the first paragraph of an article I submitted to this publication many years ago. See if you can guess the topic:

I think I’ve found an alternative to middle-of-the-night pages, big-boned patients, and interoffice politics: retirement. I’ve been experimenting with it for three months, as I wait for the therapeutic climate and healing waters of Millersville, Tennessee to kick in.

Was I writing about retirement? Sounds that way, but no. The wonders of Millersville, Tennessee? Wrong again. The next paragraph:

The biggest challenge has been staying busy. The last time I was this idle, Johnson was president. No, not Andrew Johnson, but thanks for buying into the whole sage-advice-from-a-senior-medic theme.

There’s that retirement vibe again, along with a lame attempt at humor—neither of which helps you, dear reader, figure out what the heck I was trying to say.

Craving Clarity

I was hoping to write about the EMS version of Trivial Pursuit, a game I’d helped develop, but I seemed more interested in dazzling readers with a pretentious preamble. It’s hard to find an audience willing to wade through that much flotsam before knowing the author’s intent. By the second paragraph I needed to be more specific.

You’re probably as surprised at my subject as my editor was. She insisted I demystify my topic or pick another.

We decided on the latter because I couldn’t think of a way to make my story as interesting to others as it was to me. What had once seemed like a compelling narrative had instead become an exercise in self-indulgence. 

Perhaps you’ve had a similar problem clarifying a pet theme. Before you waste as much time as I did on a stillborn project, ask yourself if you’re getting sidetracked by any of these issues.

Passion

Passion can blind us to life’s gray areas and is a poor substitute for diligence, especially when we’re crafting technical articles. Left unchecked, passion can also become an unwelcome surrogate for value. A manuscript without value is nothing more than an intellectual exercise for the author and waste of time for the reader.

Many of us in EMS are passionate about our industry. I think anyone who hears me talk about EMS for more than 10 seconds can tell I have strong feelings about this business.

And why wouldn’t I? I devoted 20 years of my life to patient care. It was frustrating at times, and even scary, but there were enough rewarding moments to make me feel good about the job most days.

Frustration, fear, exhilaration—these are intense emotions that influence the way we tell stories and the stories we tell. We expect feelings to prompt a writer’s point of view, but they can also overwhelm objectivity and lead to arrogant essays filled with opinions masquerading as facts. Sweeping generalizations are one indication of that.

When you write, do you use unconditional terms like always or never? What about phrases like there’s no question, without a doubt, or the truth is? Such absolutes often exist only in the mind of the author.

Wait, take another look at that last sentence: Can you find the one word that lends flexibility to my comment? Often, like occasionally and sometimes, is a fairly safe way to tame hyperbole. If I’d left out often, I’d be refuting every instance of categorical expressions—an exaggeration I wouldn’t want to own.

According to Strunk and White, “A single overstatement, wherever or however it occurs, diminishes the whole.”

The absence of a clear theme—as in my aborted tale of Trivial Pursuit—is another sign of passion overload. So is an unsupported argument weakened further by emotion. Here’s one from another author:

The sad truth is that some of us have lost the ability to perform an actual hands-on assessment (if we ever really knew how) as skill is replaced by technology… If diagnosis is really 90% of treatment, we’re in big trouble, and so are our patients.

Whose “sad truth” is this? What are examples of “hands-on” assessment skills replaced by technology? (I couldn’t think of any.) Who says diagnosis is “90% of treatment”? And what’s with that parenthetical implication that we never really knew how to assess?

As a reader, instead of finding anything of value in that excerpt, I’m left wondering whether the author knows what he’s talking about.

Elitism

Writers who are elitists (not elite writers) think their knowledge alone is reason enough for us not-so-elite readers to appreciate their work. Elitists also believe their experience is as trustworthy as any research, and research at odds with their opinions is necessarily flawed. 

The editorials elitists present as scholarly work often feature poor attempts at humor or sarcasm. The onus is on readers to get the jokes. An elitist rendered pliable by a scopolamine drip would probably admit, “I think I’m the cleverest one in the room.”

What effect do elitists have on literature? They complicate it. They shortcut explanations of things their minions might not understand. They use bigger words when smaller words would do. They cram unnecessary detail into paragraphs that should be sentences.

Why do elitists do these things? Because they can.

I should add that most of us who write for a living are way too insecure to be elitists.

Naiveté

I’ve reviewed dozens of manuscripts by unpublished writers—unpublished outside of casual venues like blogs and social media, that is. Most of those writers seem to underestimate what’s required to get their work past traditional publishing’s gatekeepers—professional editors who know the difference between well-intentioned authors and proficient ones.

I can relate to naiveté; I used to think I could be a musician. After experimenting with the clarinet, saxophone, and oboe in high school, I bought one of those early electronic keyboards, taught myself to play, and impressed a bunch of people: my mother, father, and brothers. It wasn’t until I worked with real musicians many years later that I realized how clumsy I was compared to the pros. I’d had no idea what it takes to play music for money.

It’s hard to blame prospective authors for not appreciating their weaknesses when there’s so much unsupervised self-publishing. Rarely do online “friends” criticize ponderous writing. If you want to make written composition more than a hobby, understand that communicating clearly and convincingly takes practice. Some areas to target are:

• Clichés and colloquialisms—Not all of your readers grew up speaking English the way you do, and some of them are too young to spot decades-old cultural references. More on that later.
• Poor or inappropriate analogies—Straightforward comparisons that help make a point are fine, but don’t get too creative. Hint: Likening anyone to Hitler or anything to Armageddon probably won’t enhance your credibility with readers.
• Contradictions and ambiguities—These might be hard to notice, which is one reason I review my work, like, 17 times. Try reading your manuscript aloud to yourself or give it to someone honest and close to examine. As rock-star novelist Stephen King points out in On Writing, if you find yourself deflecting criticism with “Yes, but…,” your piece needs work.

Indifference

Inappropriate or insufficient reinforcement can turn a naive writer into an apathetic one. In today’s open-access publishing environment, where anyone with an Internet connection can self-identify as an artist and get instant gratification via a paroxysm of likes, it’s hard for inexperienced authors to find really useful feedback. Consequently novice writers who don’t know any better become indifferent to the creative process, mimic lazy authors, and start embracing some pretty unrealistic notions about high-quality composition, such as:

• It’s like writing a long Facebook post—You mean except for planning, research, organization, editing, style, syntax, grammar, and punctuation? Perhaps.
• I should be able to knock this out in an hour or two—Only if a minute or two of readers’ attention is all you want.
• The editor will fix whatever needs fixing—Once. Maybe.

One characteristic that seems to be shared by passionate, elitist, naive, and indifferent writers is a desire to “tell it like it is,” as if such noble intent excuses lack of clarity. To the contrary, “tellers” should pamper their readers with unpretentious, unambiguous content. “Clutter is the disease of American writing,” says William Zinsser, author of On Writing Well. “We are a society struggling with unnecessary words, circular constructions, pompous frills, and meaningless jargon.”

If you’re as determined as I am to avoid such confusion, maybe your manuscript needs a fresh start. Begin with an opening that’s neither dull nor mysterious.

‘What’s It All About, Alfie?’

When Dionne Warwick first sang that verse in 1966, there weren’t any EMS books or magazines. EMTs wouldn’t even exist for another three years. Half a century later, though, over 800,000 EMS providers in the U.S. stay current with the help of industry-specific literature. The best of it withstands the scrutiny of those gatekeepers I mentioned above.

What kind of writer are you? Can you dedicate yourself to clear, concise prose in support of a worthwhile theme?

Publishable pieces need beginnings that introduce topics promptly and unequivocally. I’m not suggesting something as tedious as “Today I will write about oxygen,” but rather a few sentences that engage readers and make them want to see more. Let’s look at an example:

Writing for publication can be fulfilling and even cathartic for EMS providers. Having a story to tell is just part of the process; to entice editors, prospective authors must offer clear, persuasive content. Ambiguous, narcissistic prose confuses readers and has little chance of being accepted.

That’s the first paragraph of my e-mail to EMS World proposing the article you’re reading. It’s just another bit of text by an author trying to make a point: I want to write about writing.

Notice how the reference to EMS in the first sentence implies industry-specific relevance. Without that the opening paragraph would sound more general and less persuasive. Also, I tried to stimulate interest and show confidence in my topic with strong adjectives like cathartic and narcissistic. 

My work was far from finished, though. Most immediately it needed a nudge in a practical direction—an indication of more payback for readers than mere opinions I might have about writing.

Something of Value

Here’s my second paragraph:

The proposed piece would focus on style, key story elements, and practical structure. I’d include samples from my own submissions—failures as well as successes—to help illustrate effective manuscript construction. The tone would be conversational.

I’m trying to add value with a “reveal” that taps into my specialized knowledge. I’m suggesting I could write from an unusual or even unique perspective. We have to offer readers something useful in exchange for their discretionary time. Education? Entertainment? Either helps sustain interest.

Although my proposal was a lot shorter than the article it became, there was just as much need for clarity and value. Even compositions as brief and informal as social-media posts would be more persuasive if their authors offered more than ambiguous outrage. Most readers aren’t going to waste time deep-diving through muddied references. 

According to Zinsser the average reader has an attention span of about 30 seconds. At a high-comprehension reading speed of, say, 150 words per minute, we’d have only as much text as my two paragraphs to draw an audience. That’s not much of a challenge for a good storyteller with great material, but medical literature includes many bland, technical topics that are hard to hype. I mean, how are you supposed to turn a piece about COPD into something inspiring?

Let’s see what happened when I tried bringing clarity and value to one of the most boring subjects in the world.

The Math Problem

Is there anything more mind-numbing than drug math? I don’t think so. Nevertheless, I tackled that topic for this magazine’s March 2012 issue. The challenge was to write about drug math in a way that:

1. Encouraged my audience to stay tuned past the first paragraph, and 
2. Offered enough value so that readers who did stick around wouldn’t feel they’d wasted their time.

My first attempt at an opening was pretty bad, starting with the second paragraph:

I could begin by telling you about famous people who’ve had just as much trouble as you with drug math. OK, I don’t really know that, but if it were true, here’s what some celebrities might have said:

“I put 3 cc of albuterol in that nebulizer, but I didn’t inhale.” —Bill Clinton

“Take my infusion pump. Please.” —Henny Youngman

“Hey, kids, can you say ‘administration set’? I knew you could.” —Fred (Mr.) Rogers

“Probably useful, definitely frustrating.” —The authors of ACLS

“Fascinating.” —Star Trek’s Mr. Spock, the only one who’d enjoy drug math

Remember my earlier point about avoiding obscure cultural references in your writing? That’s what those hypothetical quotes from Henny Youngman, Fred Rogers, and Mr. Spock would have been for some.

Even readers who’d heard of those people wouldn’t necessarily have known what they were famous for. I mean, what are the chances a random millennial EMT ever saw Henny Youngman perform? The guy’s been dead for 20 years.

Regarding value, the way I originally expressed formulas in the examples I provided was unnecessarily puzzling. Here’s an example of an IV drip-rate calculation: (2mg/min/4mg/cc)*60gtts/cc=30gtts/min.

Remember, this article was aimed at medics having trouble with basic algebra. I don’t think I would have done them any favors if I’d left that line alone. All those slashes and abbreviations camouflage the elegance of some straightforward arithmetic.

Sometimes simple changes in punctuation add clarity. After inserting tactical spaces and a layer of brackets, my formula was less intimidating: ([2 mg/min] / [4 mg/cc]) * 60 gtts/cc = 30 gtts/min.

Prose without enough periods and commas can be just as confusing. Here’s an extreme example from one of my writing presentations:

That that is is that that is not is not is that it it is.

Rarely does anyone in the crowd make sense of that. Add a little punctuation, though, and it becomes an indisputable truth:

That that is, is. That that is not, is not. Is that it? It is.

Remember that the next time you’re wondering whether punctuation matters.

Struggling Writers: Is There Another Kind?

On days when I used to feel overwhelmed by EMS, I’d try to remind myself that patient care isn’t supposed to be easy. Neither is writing.

“Writing for most is laborious and slow,” say Strunk and White, whose Elements of Style is perhaps the single most practical tool for writers of all pedigrees.

“Writing is hard, even for authors who do it all the time,” echoes essayist Roger Angell.

But the most useful lesson I can leave you with—one that summarizes our theme and suggests a realistic next step—is from Professor Zinsser:

“Writers must constantly ask: What am I trying to say? Then they must look at what they’ve written and ask: Have I said it?” 

Resources

• Brewer E. Brewer’s Dictionary of Phrase and Fable, 18th ed. Harper, 2009.
• King S. On Writing. Scribner, 2000.
• Strunk W, White EB. The Elements of Style, 4th ed. Allyn & Bacon, 2000.
• Zinsser W. On Writing Well, 7th ed. Harper Collins, 2006.

Mike Rubin is a paramedic in Nashville, Tenn., and member of EMS World’s editorial advisory board. Contact him at mgr22@prodigy.net.