Welcome to the February 2025 chapter newsletter. 

CHAPTER NEWS

• Chapter’s First Social Event of the Year

• Publications Committee

• Call for Submissions

• Open Call for Volunteers

• Join our AMWA North Central LinkedIn Community

FEATURE ARTICLES

• Hemingway and Faulkner: Simple Insights on Composition for Medical Writers from Two Iconic American Novelists

• Grammar Talk: Faulty Parallel Construction

• Book Club Notes: In Shock by Rana Awdish, MD

JOB BOARD

• Announcements

CHAPTER NEWS

Chapter’s First Social Event of the Year

It is almost time that time of the year! Thank you to everyone who responded to the survey that was recently sent out regarding the time and place of the gathering. Plenty of fun, socializing, and free food is on the calendar for the end of March. Stay tuned, more information is coming soon! If you have any questions or ideas for future events, please reach out to our programming chairs Angie Herron (angelayherron@gmail.com) and Tony Larson (lars4689@umn.edu).

Join Our Publications Committee!

We are looking for 2 candidates to join our growing publications committee that oversees the content development for the Chapter newsletter. If you are interested in this role, please reach out to the Publications Committee Chair, Dora Miedaner (dora.miedaner@gmail.com).

Call for Submissions

To all Chapter members, we welcome your upcoming contributions. If you are interested in writing for the newsletter, please contact Dora Miedaner (dora.miedaner@gmail.com). Submissions are due at the beginning of the last week of each month and may require a round of editorial revision before being published.

Open Call for Volunteers

The AMWA North-Central Chapter is always welcoming volunteers. We have a variety of roles that you can take on individually or team up with another AMWA member. If you are not sure a particular role is the right fit, you can “try it out” for a period of time while being paired up with a senior member in the role of your interest.  If you would like to join us or have any questions regarding open roles, please reach out to bod@amwanorthcentral.org. 

FEATURES

Hemingway and Faulkner: Simple Insights on Composition for Medical Writers from Two Iconic American Novelists

By Toni Larson, MD

I must preface this article by admitting that I am neither a literary expert nor am I endorsing the lifestyle choices of either Hemingway or Faulkner. But, through my leisurely reading, I have identified essential features related to sentence structure and word choice that medical writers can learn from these two famous 20th-century novelists.

Today, we live in a plethora of writing styles. For much of the 19th century, however, American writers like Melville, Hawthorne, and Fenimore Cooper upheld earlier European stylists' extravagant and winding approaches. This began to shift in the early 20th century with the advent of a new era in American composition. One author, Ernest Hemingway, sparked the interest of fiction readers for a fresh type of prose. Rather than employing lengthy, intricate sentence structures filled with complex vocabulary, Hemingway distinguished himself through concise, punchy sentences and straightforward language.

Some might say that a fifth grader could have written such simple English as Hemingway—which is probably true. But the magic of his writing comes from his stylistic simplicity: the blend of brief yet descriptive sentences allows readers to create a vivid mental picture of the characters and scenery. Further, this also enables readers to easily follow the plot and not get lost in complicated sentences. This is evident in Hemingway's works, including the novels The Old Man and the Sea and A Farewell to Arms, which I have recently read.

Despite Hemingway’s popularity, William Faulkner, another early 20th-century American author known for several well-regarded novels such as The Sound and the Fury and Absalom, Absalom!, also captivated readers. As an antithesis to Hemingway, Faulkner became famous for his lengthy, meandering, complex sentences reminiscent of earlier European writers—his longest sentence exceeded 1,000 words. It has been said that Faulkner’s ornate and convoluted style likely reflects his life in the open, flowing countryside of the South, where he wrote most of his work. This contrasts Hemingway—who cut his writing teeth as a journalist—whose pithy, blunt style perhaps better mirrors his extravagant, cosmopolitan lifestyle.

Examples of each might better illustrate my point. This first excerpt is from Hemingway’s 1936 short story, The Short Happy Life of Francis Macomber: 

“There was a good smell. He was tired. The sun was shining.”

It’s hard to envision a simpler sentence structure. Elementary-aged writers could certainly craft such straightforward prose. Yet, we can’t help but picture a man with droopy eyes soaking up the sun while enjoying a pleasant aroma. In contrast, here’s a passage from Faulkner’s The Bear:

“The dogs were there first, ten of them huddled back under the kitchen, himself and Sam squatting to peer back into the obscurity where they crouched, quiet, he eyes rolling and luminous, vanishing and no sound, only that effluvium which the boy could not place yet, of something more than dog, stronger than dog and not just animal, just beast even.”

This provides a more elegant expression than saying, “They bent down and saw some smelly dogs,” which, for many readers, and in contrast to Hemingway, presents greater sophistication and invites a broader range of interpretations.

The two were also known to have feuded. A famous example of this is when Faulkner said critically of Hemingway. “He has never been known to use a word that might send a reader to the dictionary,” to which Hemingway replied, “Poor Faulkner, does he really think that big emotions come from big words?” 

These icons are undoubtedly exemplars of literary excellence, regardless of their style. I have come to understand, however, that many readers tend to prefer one over the other; some resonate with Hemingway’s simplicity, while others fawn over Faulkner’s elegance. But, effective writers need to know how to craft both types of sentences. How can medical writers use these two figureheads to model their sentence structures? The answer largely depends on the kind of writing and the intended audience.

Many types of medical writing—including regulatory submissions, manuscript and abstract publications, medical news, and CME writing—are intended for the eyes of regulators, scientists, and clinicians, all of whom have saturated schedules with little time for fluff. Therefore, a Hemingwayesque sentence structure might be, I think, more effective for engaging this type of audience: utilize data to tell the story instead of using elaborate language.

This does not mean, however, that there isn't a place in medical writing for Faulknerian prose. A prime example of this is narrative reviews—especially those that aren't intended to be overly technical. This form of writing engages the reader by presenting an intriguing story about a medical topic, such as immune checkpoint inhibitors, pulsed-field ablation, or acute myeloid leukemia. Consequently, someone who picks up a narrative review manuscript will likely appreciate a more complex, flowing sentence structure—à la Faulkner.

For medical writers, sentence structure and word choice selection primarily rely on personal preference, the type of deliverable, and the intended audience. In his seminal work, On Writing Well, William Zinsser asserts that great writers are shaped by “imitating” their favorite authors. I believe both Hemingway and Faulkner are intriguing authors to read, regardless of one's literary taste, and they can provide valuable insights into developing one’s writing style.  

Grammar Talk: Faulty Parallel Construction

By Tess Van Ee

One of the most common problems in new home construction is often invisible to the buyer: foundational and structural wonkiness. Whether from building on uneven ground or misinterpreting plans during framing, poor construction can compromise the entire build.1

Crafting sentences with faulty parallel construction is similar to building a new home with un-squared walls or a sinking foundation. If the construction is defective, the sentence seems…off. Here, we’ll define faulty parallel construction, discuss how to avoid it, and offer an alternative fix.

What is Faulty Parallel Construction?

Parallel construction groups similar elements, such as phrases or verbs, together in a sentence.2 Parallel construction is “faulty” when the elements don’t match. Here’s an example. 

“The medication is indicated to reduce fever, relieve minor pain, and improves patient comfort.”

The first two elements are infinitive phrases functioning as adverbs. They describe the medication’s indications. The last element, however, is a verb. Two adjectives + one verb = faulty parallel construction. Rewriting the sentence corrects the construction and clarifies the meaning:

“The medication is indicated to reduce fever and relieve minor pain, improving patient comfort.”

How to Avoid Faulty Parallel Construction

Deconstructing a sentence with a list of two or more elements can help you verify parallel construction. Look at each element in the list individually to verify it works with the beginning of the sentence. Covering the remaining elements with your hand or a piece of paper can help. Let’s test it out in the next sentence.

“This morning, I walked the dog, showered, and drank coffee.”

“This morning, I walked.”

“This morning, I showered.”

“This morning, I drank coffee.”

All the elements work with the beginning of the sentence, so the construction is sound.

To avoid faulty parallel construction, do not mix verb forms, adjectives and nouns, noun phrases and verb phrases, or clauses with varying structures or phrases.3 The following sections provide examples of each item. 

Example #1: Varied Verb Forms

Faulty: “Trial participants opted to receive surveys by mail, answering questions during clinic visits, or complete questionnaires online.”

Fixed: “Trial participants opted to receive surveys by mail, answer questions during clinic visits, or complete questionnaires online.”

Example #2: Amalgamated Adjectives and Nouns

Faulty: “Patients diagnosed with arthritis should avoid exercise that is jarring, repetitive, high-impact, and tennis.”

Fixed: “Patients diagnosed with arthritis should avoid exercise that is jarring, repetitive, and high-impact, like tennis.”  

Example #3: Knotted Noun and Verb Phrases

Faulty: “Researchers’ goals include recruiting at least 100 participants and to achieve a 75% retention rate.”

Fixed: “Researchers’ goals include recruiting 100 participants and achieving a 75% retention rate.” 

Example #4: Conflicted Clauses

Faulty: “After reviewing the manuscript, we concluded the introduction was convincing, accurate citations, the methods were thorough, and the conclusions were well supported.”

Fixed: “After reviewing the study, we concluded that the introduction was convincing, the citations were accurate, the methods were thorough, and the conclusions were well-supported.”  

When Faulty Parallel Construction Indicates Bigger Problems

Technically, faulty parallel construction doesn’t break foundational grammar rules.3 But it does muddy sentence meaning. Sometimes, faulty parallel construction can also indicate when to split a sentence into two (or three) sentences. If you’re struggling to make elements parallel, it may be that they are not meant to be grouped together.

Take the following sentence, for example.

“The new scheduler can send out appointment reminders, suggest appointment times, predict when appointments will become available, and helps our receptionists get their work done.”

The faulty structure is at the end of the sentence and could be fixed by changing the verb form (“helps” to “help”). However, upon closer examination, the first three items in the list are tasks the software performs, and the last is how the software benefits employees. The sentence would have more impact if the tasks were separated from the effect. Let’s revise.

“The new scheduler can send out appointment reminders, suggest appointment times, and predict when appointments will become available. Relegating these tasks to software frees our receptionists to focus on helping patients.”

Separating the sentence instead of modifying the parallel construction improves its readability and brings the main point into focus.

Finding and fixing faulty parallel construction, whether by breaking apart a sentence or modifying a clause, strengthens writing. Stronger writing leads to robust, clear pieces that can stand the test of time.

Unlike the new house down the street with the leaning frame. 

References

1.     Miles H. 21 new home construction defects. Home Inspector Insider. Updated January 15, 2024. Accessed January 22, 2025. https://homeinspectioninsider.com/new-home-construction-defects/

2.     Christiansen S. Grammar. In: Christiansen S, Iverson C, Flanagin A, et al. AMA Manual of Style: A Guide for Authors and Editors. 11th ed. Oxford University Press; 2020. Accessed January 17, 2025. https://academic.oup.com/amamanualofstyle/book/27941/chapter/207565818

3.     Luo A. Parallel structure & parallelism: Definition, use & examples. Scribbr. Revised February 6, 2023. Accessed January 17, 2025. https://www.scribbr.com/sentence-structure/parallelism/ 

Book Club Notes: In Shock by Rana Awdish, MD

By Paul W. Mamula, PhD

Our book club met virtually on January 27, 2025, to discuss In Shock: My Journey from Death to Recovery and the Redemptive Power of Hope by Rana Awdish, MD. Awdish is a critical care physician and pulmonologist who wrote the book after her experiences as a patient. She advocates for better patient-physician communication, improved physician training, and efforts aimed at relieving physician stress to combat burnout.

The Book

In Shock is short—only 262 pages—but captivating. It traces Awdish’s medical difficulties during pregnancy, recovery, subsequent pregnancy and illnesses, and dealings with physicians and medical staff. After experiencing the rupture of a previously undetected tumor during the sixth month of her first pregnancy and with medical staff disregarding her symptoms over her protestations, Awdish nearly died twice. Although she recovered, she encountered many other problems: internal hemorrhages, complication-related kidney and liver failure, ventilator use, a stroke, tumors, embolization and resections, and sepsis. Throughout her care, she dealt with dismissive physicians and staff. In her initial encounter, physicians ignored her protestations and sent her to Labor and Delivery rather than the hospital’s trauma 1 center because of hospital policy about women whose pregnancies were at 6 or more months gestation, a decision that nearly caused her death. Her child died, however.

Nursing staff could be just as dismissive. One nurse urged Awdish to hold her dead child, even though it had been several days after the death. The nurse argued that Awdish would never get another chance. Awdish was put off by the nurse’s self-righteous insistence. This would not happen with her second, successful pregnancy. When Awdish reflexively said, “It was OK,” to a nurse’s condolences on the loss of her first child, the response was swift. Mary Knatterud agreed that the nurse’s response was apt. She added, “I appreciated the example given of something HELPFUL, rather than demoralizing, to say to someone who has suffered a pregnancy gone horribly wrong. Quoting a truly caring caregiver who said, ‘It will never be OK that you lost the baby,’ Awdish affirmed that acknowledgment as ‘the kindest and most loving thing she could have said’ (p 152).”

 After Awdish’s second child was born, she recovered from her near-death complications, but additional medical problems found her encountering similar experiences with physicians. These interactions caused her to reflect on medical care and physician training.  Later chapters address her attention to sepsis in the medical setting, an illness that nearly killed her. The last third of the book interweaves her story with those of physician training, coping methods for stress, and how these events affect patient interactions. The last chapter, “We Can Do Better—Communication Tips,” presents a helpful guide for improving physician-patient communication and care.

Physician Encounters

Awdish’s medical problems offer a physician’s perspective of patient interactions and illustrate the dilemmas she and other patients face in communicating with doctors who often lack empathy and bristle at questions about diagnostic and treatment decisions. The narrative includes some stark interactions: The resident physician who treated her later asked her to point out the lack of a fetal heartbeat on her ultrasound photos shortly after Awdish was out of surgery (p 54). Throughout her care, Awdish’s protestations and symptoms were brushed aside. Although we are several decades removed from House of God-like medical training, her experiences show that many of the same attitudes and demeanors remain in medicine and training, eg, talking in front of patients and ignoring patient concerns. Such incidents also highlight what physicians face while in training and providing treatment.

One shocking incident occurred during her second pregnancy that illustrates many of her concerns in the latter third of the book. When an obstetrician failed to read Awdish’s case history during her pregnancy, she pointed out that his proposal to use a previous C-section scar as a guide for a second procedure would cut through her placenta and produce a potentially fatal hemorrhage (pp193-194). Rather than own his mistake, offer an apology, or show contrition, the obstetrician said, “Listen, you can’t be a passenger and pilot at the same time. And just so we’re clear, I’m the pilot.” Awdish was rightly infuriated and told him, “You will not operate on me, and you can leave” (p 194). Fortunately for her, she prevailed on a senior colleague to switch obstetricians for her delivery. This was just one of the many incidents she experienced during her care, with much of it discouragingly sexist for 21st Century medicine.

Awdish also highlights the stresses physicians face in their training and practices, and the book’s last third addresses how they try to cope. One common problem is deciding on treatment. The dilemma is that if physicians discuss options with patients, they may appear uncertain or ill-prepared, either of which may cause patients to question competence and therapy. I remember hearing Ted Mitchell, MD, speak at an AMWA conference in which he said, “Doctors might not know, but they are never uncertain.” It aptly illustrates the dilemma (as does Awdish)—balancing concern with competence. Such conflicts produce stress for both physicians and patients, sometimes with bad outcomes. For example, during Awdish’s training, two colleagues committed suicide. She also relates instances in which patients died, partly from treatment choices. Her anecdotes about care and how physicians attempt to cope offer hope that such problems are being recognized and addressed. Throughout, she contrasts keeping emotions in tow during treatment with maintaining empathy with patients. Knatterud said, “I loved Awdish’s realization that empathy can HELP, rather than deplete, physicians: ‘I didn’t understand that open channels would replenish my supply of self. That there was reciprocity in empathy’ (p 10).”

Awdish includes so much that the last third of the book seems a little terse. It does fit in well with her experiences, however. The sections about sepsis, physician stresses during training, and patient interactions are good, albeit a little brief. Those topics could easily cover a separate book.

In sum, we all liked the book. Do read it for a physician’s-eye view of treatment, therapeutic dilemmas, and patient care. Curiously, after our book club concluded, an online post related a similar example of a physician encountering care counter to her symptoms.1

For Additional Reading

Awdish’s comments are available online in various interviews and podcasts about her book. Awdish has also written numerous shorter articles on care and many of these are available on YouTube, The Beryl Institute website,2 and NPR and other media sources. Awdish is an AMWA member,3 and her biography provides many additional details about life and medical practice.4

References

1.     Bonner S. I’m an ER doctor. When I Became a Patient for the First Time, I Was Shocked by What I Experienced. HuffPost Personal. Jan 27, 2025 I’m An ER Doctor. What I Experienced as A Patient Shocked Me. | HuffPost HuffPost Personal [Accessed Jan 27, 2025]

2.     Rana Awdish - Life beyond "In Shock" - The Beryl Institute (A free registration is required to access this article.)

3.     AMWA Member Spotlight: Rana Awdish, MD. Sep 27, 2024 AMWA Member Spotlight – Rana Awdish, MD - American Medical Women's Association [Accessed Jan 29, 2025]

4.      Rana Awdish - Wikipedia

Job Board

Announcements

Are you looking for work? You know someone who’s hiring? Please reach out! The job board will be updated in every issue of the monthly newsletter. If you’d like to add your name to this list, please contact Dora Miedaner (dora.miedaner@gmail.com).