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any people can't write wellparticularly those of us in the professions. Perhaps, it is a weakness of the educational methods in our present-day culture. In the scienc~s, particularly, most of us are under the impression that as long as we know our subject we have achieved our goal. We forget that to make ourselves understood, we must be able to express ourselves clearly and intelligently. Moreover, not only must we be able to write so that we can be understood, but we must write so that we will be read or listened to. Perhaps, nothing is more difficult than trying to convey one's own thoughts to the minds of others. Mostly, we use words to do so. If we want to be understood, we choose our words carefully and arrange them in order. In speaking, we generally enunciate for emphasis and punctuate our phrases with bodily action. ,B ut, no matter how painstakingly we do these things, there are always some people who will misinterpret our meaning. The differences of interpretation may be slight or great but they are there. Human communication is a complex and difficult process, subject to a variety of individual blocks and distortions which change meaning. Did you know that it was a misinterpreted message which resulted in the famous disastrous charge of the light brigade at Balaclava in the Crimean War? A carelessly worded order to "charge for the guns"-meaning that some British guns which were in an exposed position should ,b e pulled back out of reach of the enemy-was interpreted as an order to charge for the Russian batteries instead and the British soldiers were decimated. o Based on a talk presented to the graduate school of pharmaceutical sciences at N ortheastern University, February 1966.
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But, even.in less perilous times, it is often difficult to compose an English sentence that ,c annot he misunderstood. Instead, the more we consider human communications, the more astonishing it becomes that we communicate as well as we do. Communication can be defined as the transmission, imparting or interchange of thought, opinions, knowledge or information by means of speech, writing or ,signs. According to M. W. ThistleCommunication is like overlapping rings; on the left of the ring is what I mean and you didn't get; on the right is what you got and I didn't mean and the overlapping part in the middle is all we can ever hope to convey.
To the enlargement of this middle area students and practitioners of communications must dedicate themselves -whether they are in medicine, education, industry, science or politics. The biological and medical professions are heavily involved in communications these days. An information explosion is taking place and the lines of contact are becoming plugged to a point where messages are coming through garbled, "noisy" or not at all. The job of clearing the wires and reducing this so-called "noise" is becoming more difficult to solve. Its solution involves recognizing that data vital to one person may be inconsequential to another. We all spend much of our time in writing. Individual estimates of actual time spent vary widely but the average is around 25 percent. When a high percentage of the product is of poor quality, something should be done about it. One of the greatest weaknesses of many technical articles is their lack of purpose. The mere' recital of facts,
Journal of the AMERICAN PHARMACEUTICAL ASSOCIATION
interesting in themselves, will not hold the reader. From his point of view, the most important part of an article is not what was said but what the information means to him. His reading set is, "Why should I read this article? What can I do With this knowledge?" In reading the technical article for the professional joUl,'nal, the reader will often ,ask in addition, "How can I adapt this inform~ tion to help solve my problem? Can I go a step further and extrapolate from the author's results?" In pharmaceutical education, we need to utilize all means of communication efficiently if weare to be more effective. If the knowledge is obtained, it must be disseminated, clarified, integrated, utilized, expanded and redisseminated. The most useful medium of technical communication is, of course, the printed word. Perhaps one reason is that many ideas, presented verbally or pictorially, can be expressed in writing. Another reason is that the printed word reaches the largest audience of any communications medium since it isn't restricted by either time or place. All educational assets (good faculty, excellent facilities, etc.) should combine to create an extremely favorable climate for conducting high level research of real significance. Unfortunately, this means little or nothing unless the researcher can extract information of consequence from his data and effectively communicate it to his colleagues. We are all acutely aware of the progress made in medicine, physiology, biochemistry, microbiology, etc. However, we are not as much aware ofnor have we made-comparable progress in the art of writing. That there is a need for improving medical and pharmaceutical writing is
As director of medical communications for Schering Laboratories, Jerome J. Harris assists in the preparation and review of scientific and technical documents and oversees medical communication activities at Schering. A native of New York City, Harris is a graduate of Long Island ·University and earned his PhD from New York University. Before his present appointment, he 'lpas a medical coordinator at Ciba and has also been chief advertising copywriter atWarner-Lambert, an information specialist for USPHS and a reporter for Science Service. Memberships inClude the National Association of Science Writers, American M,edical Writers Association, New York Academy of Science, American Association for the Advancement of Science and Drug Information Association.
attested to by the plethora of articles on the subject. Some attempt to provide instruction; others merely comment on the quality of technical writing. Stich important periodicals ,as Science, lAMA and the New England Journal of Medicine have deplored this situation editorially many times. Some of us who admire a particular writer for his excellence and distinction may feel that the effect comes from his inherent genius. ,N o one will deny that genius varies widely, but a number of good writers in the beginning were not good. They achieved eminence .with time and practi'ce. They improved and worked to master their technics of writing. No amount of speaking or reading on how to write can make you into a writer. You achieve this position primarily by writing-plugging away, practicing, getting and taking criticism and using words carefully until finally they come easily and well. Some special aspects of writing cannot be learned even from books on Writing. One is the particular flavor of a technical language. Another is the set of conventions that go with professional publications. Others are hard-headed matters like meticulous accuracy in special places, absolute scientific validity and (where appropriate) good use of statistics. You must learn how to use "the literature." You must know how to prepare illustrations, handle edited papers ( and editors) and obtain reprints. Dangers seem to proliferate in the field and they must be avoided-faults in experimental design, jargon or inappropriate language usage and unwarranted promises by the author that can undermine the whole paper, to mention only a few.
How should a pharmaceutical article be written? Before you begin,
decide what you want to say, then say your piece as briefly as you can. Tell your story and stop. Use simple words and understandable sentences. Let your pictures be dear. Cut out unnecessary words. Although we may not fancy ourselves great writers, many of us, once we have put words on paper, find it very difficult to cut. To do so while still glowing with the pride of authorship is, as I, and probably many of you, well know, very difficult. But, if we put our manuscript aside for a day and then reread it, not lovingly as our own, but dispassionately or even critically, pretending we are a third person, we can make appreciable improvements.
What qualities would you · demand of a paper you would publish? This question was once asked of some physicians and pharmaceutical student$. The answer included many of the following points-practicality, originality, reader-interest, accuracy, authoritative references, intellectual honesty, pictures and diagrams where appropriate, good introduction and summary, current information, conciseness, clarity, completeness (for subject), legitimate conclusion, order and sequence of ideas, stimulus for further study, statistical validity (where statistics are used) , neatness and standard form, paper fulfills own objective, fluency, medical importance, good organization and scientific principles for a basis. Obviously, not eyery paper published nor every journal meets such criteria, although it would be ideal if it did. However, such criteria are good goals to strive for. Most pharmacists are reasonably skilled in presenting ideas in an uncomplicated manner. A good part of their working day is spent in discussion with people and colleagues. Principles which
make communications dear in everyday speech can be applied also to a cliriical paper. A fair amount of the depressing material we are forced to read has been put together carelessly and without the writer's being aware of his responsibility to his readers or able to translate his awareness into effective action. Apparently, when a pharmacist-or for that matter anyone-uses a pencil, pen, or dictating machine, the clarity of his thinking melts. Complex writing drives the reader of medical, dental and pharmaceutical journals ,a way from information he really should have and use. Multiply this fact by the approximately 1,200,000 articles published every year and the some 50,000 technical, profelisional and scientific journals printed and you realize the time and valuable iriformation lost. We know that the professional man's time is valuable. We know from controlled experiments that if we teach a scientist to ,write well, we can cut the reading time of any article he writes by 50 percent and increase the reader's comprehension of and desire to use the material. In writing for technical people on subjects about their field we should write in terms they expect to read and they understand. But even so, simplification is the key to quick and correct communication. Readability studies show conclusively that writing communicates best when it is just below the comprehension level of the reader. Specifically, simplification is achieved through using the familiar over the unfamiliar, the short over the long and the nontechnical over the technical. These distinctions between words, of course, overlap considerably. The experienced writer knows the Vol. NS7, No.8, August 1967
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logic of his standards of writing. Conventional writing rules guard ·a gainst misunderstanding and aid in presenting facts clearly and quickly~ A good style is much more than these. It identifies an author as uniquely as his fingerprints and reveals his personality. What 'does a man gain if he discovers a new world in science, but his style discourages all from reading what he writes about? In speaking of style, I cannot help but quote from one of the m~ny editorials on medical writing by Dr. William ,B. Bean, who is world-rioted for his lucid, scintillating style of writingMany people who try to write have no style and never will. On the other hand, style in writing and style , in dress do not depend on the same thing. If you have a pocketful of money and a good tailor, you could achieve some semblance of sartoria~ style. Personality and character are the base rock of style in writing. Upon this, one adds brick by ' brick and year by year with an i ncredible amount of toil the substance and the form which together constitute style. Then, one polishes with care and labor..
Thus, clear, coherent and simple style may be achieved by anyone. By reading good literature you can acquire a feeling for words, sentence structure and paragraph development, a ,l arger vocabulary and an appreciation of effective style. These benefits will be reflected gradually in your writing. Unfortunately for the nonreader, there are few other ways to acquire this knowledge easily. Private tutoring, handbooks, exercises, writing classes may help, but they can give much more to a man who reads. Admittedly, it is never !possible to write a paper, much less a monograph or a book ~hich is altogether satisfactory. The one arriving closest to this goal is one planned with thoughtfulness, corrected many times, polished, set aside for a period during which matter and m'a nner are totally forgotten, and then brought out for another series of reviews when insights are fresh and critical vision clearer. One method of removing obscurities and eliminating faults and harsh, unnecessary or misleading constructions is to read a paper or parts of it aloud. Since everyone is his own poorest critic, it is helpful to have a friend criticize a paper, not necessarily to follow his advice or every recommendation but to get a better insight as to the reaction of an unbiased reader. Even with our best efforts we fall Being short; we are inconsistent. tired, we become sloppy. To do good writing, you have to care about it. Writing is no different from any other skill. You can't expect 428
well formed prose ,to drop from your pen. Go over everything you write several times and test it against the rules. ISentences and phrases ~hat glowed with perfectiori when you wrote them now may .appear dull and clumsy. If a man has something to say which interests him and he knows how to say it, then' he need never be dull. The dullness of an article depends much upon its presentation. That is, the way ' it is set out, the order in whioh the f~cts are placed and the way the diagrams and the pictures are arranged. , The successful author spends much time on Tevision-sometimes as much as an hour on one sentence. The famous author, Gustav Flaubert, once described the problems he was having in writing a bookI am going on very slowly. I give myself an accursed lot of trouble. , I have just suppressed phrases at the end of five or six pages, which have cost me the work of entire days. It is impossible for me to see the effect of anyone of them before it is finished, refinished and poHshed.
As a matter. of fact, Science for August 6, 1965, describes John W. Gardner, secretary of Health, Education and Welfare, as an author of renown. The aTticle notesHe writes well and, ;in an age of literary ghosts and editorial assistance, is that rarity among prominent men who does it himsel'f -frequently, say his associates-in several painstaking drafts. [I underline those last three words mentally.]
Scientists, who write papers which they hope will be read widely and will influence professional thought must remem ber that only a very small fraction of the enormous amount of material now being published each month can even be glanced at by the most rapid readers. Polls show that professionals today are scanning more and reading less. Most are reading only summaries of articles. At night, when they are tired, they can still read simple English, but cannot tackle po()r writing with long complicated sentences and highly technical words. What does this mean? It means that the writer ~ho would like to have his articles read had better make them brief; he hac!, better leave out the preambles and the long summaries of the literatures; ,h e' had better use simple speech; he had better try to be interesting; and he had better make a brief and adequate ·summary. There are so many articles clamoring for attention that a professional reads only those few that attract him as he looks at the title, the first paragraph or the summary. The big trick
Journal of the AMERICAN PHARMACEUTICAL ASSOCIATION
is to capture his attention in the first paragraph and then hang on to it. A score of times editors have writt~n to a contributor saying-"I'll accept your manuscript if you will throw away the preamble and begin on page four." . ,I t takes years of study; it takes countless hours of practic~ in the art, in the technics, in the work of writing. It is said that a person must write at least two million words out of his system before he really begins to write well. One must get rid of the rust in the pipes before he ' can hope to have a clear flow of water. And, finally, why write if no one will read what you have written? . Now, let me conclude with a wonderful lAMA editorial (3-21-64) takeoff on good writing from a familiar Shakespearian play. This editorial is entitled "Polonius' Counsel to Authors." Polonius as a professor of medicine is saying goodbye to Laertes, his young student who is leaving for a major research center. [Enter Polonius.] Polonius: Yet here, Laertes! Aboard, aboard, for shame! The ' wind strains at the chamber of your jet, And you are stay'd for. There; my blessing with thee! And these few precepts in thy ,paper See thou character. Give thy thoughts no pen Until thou be assured they are un· publish'd. Be thou vernacular, but by no means jargon. Thos,e words thou hast, and their adoption tried, Grapple them to thy soul with hoops of steel, But , do not dull thy work by using all ... Beware of titles tha't are too long. Be thou precise But yet concise; laboring hard to be not labored. Give every man his name, but few thy byline: Work authored by many is authored by none. Contract'd thy abstract as thy pen can write, But yet express'd ,i n fullness; terse, not wordy: . In truth the summary oft proclaims the work. Keep figures pure and tables simple; aye, The editor's a most ungenerous chief in that. Neither a borrower without credit be Nor yet too many references append; Fo'r borrowing dulls the edge of truth. This above all: to thine own word give eye, And it must follow, as the night the day, Thou canst not then be dense to any man. Farewell: My blessing season this in thee! [Exit.]