Grand Rounds, edited.

Edited essay

This last week I received over 60 submissions for Grand Rounds and included 26. This decision came after sharing some Carl Jungian vibes with Kim at Emergiblog and receiving the blessing of Nick Genes of Blogborygmi. Kim has since received a great deal of attention for her critique of the swelling Grand Rounds. According to the comments, the idea’s a hit and things may change. Next week’s host, Dr. Anonymous, has already thrown down the gauntlet:

This may be my last time hosting Grand Rounds, and I may get a lot of flack (and all my future submissions may be rejected). But, hey, I’m the editor and I’m deciding what’s in and what’s out this week. Being included in Grand Rounds is not an entitlement; it’s not a right; it’s a privilege.

Whether you agree or disagree with me, my vision next week is to put the best medical STORIES (ie – first hand anedcotes) out there for people to read.

As a host I had plenty of resources and support but as an editor I was unsure about what I could and couldn’t ask from fellow bloggers. I’m offering this post as an example of how I approached the problem of writing letters to the authors and helped a few posts that were almost there get over the edge. Accepted, rejected or edited, I sent over 80 emails and received only one response that was not enthusiastic or understanding. From this, I have to assume that people are open to the idea of constructive criticism.

If you’re an author, please don’t be put off by this. As Susan pointed out to me, “editing is also an act of love, and also a compliment on the part of the editor who spent so much time on your work.” I couldn’t have said it better and hope it’s a sentiment that every author who’s asked for edits takes to heart.

Permission was granted from Susan and the Angry Medic to show the emails below.

Letter to an author I was not including:

Thanks [author] for your submission. I have decided to not include your post in this week’s Grand Rounds. While I applaud your mission statement, I feel that the issue of prevention as the next hurdle for the medical world has been adequately covered elsewhere. For Grand Rounds I’m looking for original literary pieces about the life of medicine, patient encounters and experiences, and educational pieces aimed at those already within medicine.

Sorry to disappoint, topher.

Susan’s post went through two edits. This was the first:

Hi Susan, and thanks for your submission. I’d like to include it but feel it needs one significant change before I do. The hook for this piece is the coming analogy and your basic structure is set-up, delivery of analogy, elaboration, and finally reflection. I think it works well. However, you spend five paragraphs in set-up and five-paragraphs on the rest and this feels unbalanced. The fifth paragraph is what I would like to change.

My vision of the afterlife is that we all wind up together, with each other and God; if we’re delighted that everyone else is there, it’s heaven for us, but if we’re appalled at the state of the neighborhood because we’re next to those people — however we define them — then it’s hell.”

It is a long sentence and a repetition of the beginning of the fourth paragraph that begins “[s]o my idea (undoubtedly heretical) is that we all wind up in the same place, and “that how we respond to it determines whether it’s heaven or hell for us.

As repetition, it hurts the flow of your writing and offers nothing new. Rereading the entire post and skipping this paragraph gets us to the analogy faster and keeps the writing tight. Between the two, I think that the opening sentence of the fourth paragraph is stronger and should stay while the long sentence should be deleted.

Let me know how you feel about this change. topher.

The Angry Medic’s post was originally longer. We went through a few edits as well:

Angry Medic, this is much better. It’s got grit, grizzle and the honesty of frustration that makes for good writing. I can’t pick up on all the changes you’ve made, but on the whole it’s a smoother read. If you’re still up for some editing, I have only a few suggestions for the post:

“Being a puny medical student, I might sometimes not be able to fully understand the disappointment of old hands like Dr Crippen, Shiny Happy Person or PaedsRN. Now, far be it from me to suggest that a simple first-aiding assignment can fully capture the frustrations of working in the NHS, but it sure did give me a damn good picture.”

These two sentences aren’t part of your story. Your story is about your frustrations with a different style of teaching and the contrast that’s brought to bear in a clinical (football) setting. By referencing the hulking mess of NHS out of the blue, you distract the reader who’s now wondering, “Where did this come from? What have I missed?” Your writing is strong enough without it and I think you could delete it.

“Some, having suffered the tiniest of cuts, came hobbling over screaming like they’d been disemboweled by a very cranky Cyclops and demanded that we clean them up repeatedly.”

The line about convincing them that women will still scream their names is very funny and makes your point about having to “hold the hands” of certain players. This sentence makes unnecessary fun (which makes you look bad) and prevents the paragraph from ending on a joke. I think deleting it is win-win.

“I’m not convinced it’s the best way to learn medicine, but in the end I don’t think it really matters. I’ve seen great doctors from Cambridge and great doctors from Hull. And it’s convinced me that, just like any other profession, it’s what’s on the inside that matters.”

This is a big change in tone from the rest of the writing. Your finish is the last thing they read and remember and should be powerful/funny/memorable like the rest of the post. After you talk about the compromise for the coat of arms, try to finish with something slightly more edgy. “Now I’ve seen great doctors from Cambridge and Hull, so I know that none of it really matters. All the same, I’d like a little more blood on my shield/crest” or something like this. You get the idea.

All in all I think the writing is solid and I look forward to including it. Thank you for being so receptive about my editing as you’d have been within your rights to say, ‘sod off.’
See you in Grand Rounds, topher.


Editing with Susan and AngryMedic was a lot of fun. It might look like nit-picking or other harshness, but I really liked their stories and told them so. I wanted everyone to read and enjoy them. To make sure that it happened sometimes required clipping a sentence here or moving a thought earlier or later in the post and was no different then trimming a flower to join a bouquet.

One Response to Grand Rounds, edited.

  1. #1 Dinosaur says:

    Having done quite a bit of editing myself in assorted contexts, let me say that I’m very impressed with your editorial abilities, as well as with your diplomacy, which will serve you well as you progress through your career.

    (And for what it’s worth, I’m flattered that you liked my post “as is.”)

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