An Editing Fantasy

While performing pre-Institutional Review Board reviews of clinical-trial protocols created in Microsoft Word, the medical writers–editors in our work group occasionally notice a statement or phrase that is ambiguous. We are ever mindful that according to our standard operating procedures we must return protocols to principal investigators within 7 business days and that at least four other reviewers are awaiting their turns to review a given document after we finish our work. So when we find an ambiguous passage, we write a very brief TrackChanges marginal note to the investigator, such as “The phrase ‘blah blah blah’ could mean either A or B. If you intend the reader to interpret this as A, restate it as AAA. If you intend the reader to interpret this as B, restate it as BBB.” And that is the end of the matter.

But what if we had more time? And what if we actually had the chutzpah to give a longer, more detailed explanation to influence the writing behavior of one of our valued customers? What might such a marginal comment look like?

(Imagine that the following is a TrackChanges note written in the right margin of a protocol review. It would never actually fit there, of course, but relax your critical faculties for a moment and just “go with it”.)

Note to Investigator: The phrase “Mary had a little lamb” is ambiguous and could have more than one interpretation. The ambiguity arises from two causes: (1) “had” is the past tense of “have”, a weak auxiliary verb that has a host of possible interpretations in the English language; (2) the phrase lacks specific context that would guide the reader to a unique interpretation. Below are some possible reader interpretations of this phrase.

A. Mary provided for the care, nourishment, and welfare of a small lamb. Please supply additional context for the reader as to whether this was Mary’s personal pet, it was a member of a larger flock on the farm where Mary lived (and Mary was responsible for grudgingly rendering daily chores for the entire flock), or Mary was temporarily looking after the pet of a friend who was vacationing in the Bahamas.

B. Mary ate/consumed only a small portion of cooked lamb. Please include additional context for the reader as to whether Mary was off her feed that day, she was on a strict low-protein diet, the lamb was not cooked to her liking, or she just didn’t care for the taste of lamb. Did she try it with the mint jelly?

C. Mary gave birth to a baby lamb. Mary had lost her job during the current recession, was in desperate straits, and decided to earn some extra money by becoming a surrogate mother. She signed a surrogacy contract with a vertically challenged kyphotic Transylvanian émigré named Igor who conducts ovine in vitro fertilization research in the subbasement beneath the official government laboratories down the road.

D. Some readers—those whose minds were warped by suffering through a formal course in symbolic logic—might consider the antithesis of the original assertion, namely, that Mary did not actually have a lamb, as in the following example. Mary worried about losing her job during the current recession and obsessed about this possibility to the point where she became totally unhinged and delusional. She hallucinated that she had a pet lamb and that someone had cooked it and forced her to eat some of it; consumed with revulsion and guilt, she further imagined giving birth to a replacement lamb. Mary is now in a very bad way and is urgently in need of psychiatric help.

E. Other. This is a category that people usually use when they run out of either ideas or time. Neither is the case in the present instance: We recognize you may have meant to convey an interpretation totally different from the few cited above. We suggest that you replace the weak verb “had” with an active verb that articulates Mary’s specific action(s) and that you include suitable context that will lead the reader to interpret the exact meaning of the phrase that you intended to impart.

J Peter Kusel has a doctorate in medical microbiology and 20 years of experience in medical writing. He obtained certification as an Editor in the Life Sciences in 2008.