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Austin Van Niel

Advanced Writing
Prof. Suzanne Richard

Writing in The Medical Field has Huge Implications

Medicine is, was, and always will be a system of trial and error. There always will be new
ways of treating things that have been treated previously that may work better; or they may not.
Documenting this information in patient files is how care providers communicate with one
another. Medical journals take this information and make it available to other care providers
within the community of medical professionals and presents it in a scientific way. Data is given
as evidence with case studies to back them up and to give examples. Within the community
there is a lot of communication that needs to happen in a precise manner through patient
summaries, which are completed at the end of every visit to the care provider. Writing in the
medical field differs from other scientific writing because of the personal implications that it has,
the information will be used to help someone overcome an illness or injury.

Science and by effect medicine is a team activity. There are people who are specialized
in every area of medicine that have specific jobs to do. In order for them to do their jobs it is
necessary to disseminate information wherever it needs to go. Pediatric Traumatic Brain Injury:
Characteristic Features, Diagnosis, and Management1 is a journal article that synthesizes more
than 30 years of emergency and neurological information. Detailed information and terminology
is presented in a concrete and simplified way such that a doctor does not need to reference
other documents to understand this information. Tables are used instead as an aid here to
present more basic and background information in a succinct and easy to follow manner.

Journal articles in the field of medicine often take a more general approach and cover all
the possibilities that may occur, rather than just what has occurred for a particular patient. Even
when case studies are included in a text, they are very rarely included by themselves. Very
diversified cases are always explained together. Medicine is a collection of real life events
where the success stories become knowledge used for other people. When something is
learned it is not kept quiet like in some other discourse communities so that publishing rights
and patents can be given to the people that found it first. It is distributed in journals where
professionals can safely see that something works and that it can be implemented in order to
have a more positive outcome for their patients. To give an example, in Pediatric Traumatic
Brain Injury: Characteristic Features, Diagnosis, and Management1, a common treatment in the
past for traumatic brain injury (TBI) has been the application of intravenous corticosteroids to
reduce swelling by suppressing the immune system. This has recently been found to increase
the occurrence of ventilator associated pneumonia. The alternate treatment of hyperosmolar
therapy is proposed as a much safer alternative because it only relies on osmotic properties of
water to decrease swelling, not modulation of the nervous system.
As with all science, evidence is required. It is not simply satisfied on the credentials of
the writer or the institution that published the writing. Sources are a necessity. In journal articles
sometimes over one-hundred sources are included to back up claims like the one made about
corticosteroids. Sources about the efficacy of the drug mentioned, dexamethasone, are included
as well as documented evidence from studies and trials on that topic from research facilities.
This twelve paragraph section on treatments, outcomes, and alternate treatments uses over
nineteen sources from other members of the discourse community who are trying to present
their information so that the authors of this article can apply their findings and share what they
found in order to add to the collective knowledge of the community. They include outcomes,
ways to monitor progress, assessment and reassessment techniques, age related differences,
and pharmacological interventions that can be used in concert to increase the likelihood of a
positive outcome.

A lot of journal articles are written for the purpose of preview before the information is
presented at a medical conference where many other care providers will be in attendance. This
is the perfect opportunity for people to ask questions and propose their own theories for further
study or research as the writers of the articles and those who worked on the cases will likely be
in attendance with information that may not have been publishable or has arisen since the
publication date. These types of conferences and encouraged to the point of requirement, as
they can count towards credit for continuing education because they are so informative and
foster fresh ideas within the discourse community.

When information is presented in a written form, it appears as though brevity and

concision are valued above all else. In this particular field it would be hard to find an article over
15 pages and even that one would be considered quite long. Within these pages, it appears that
short and blunted paragraphs are used in order to convey as much information as possible in
the shortest amount of time. They follow the general format of section, subsection, reason for
the subsection, why it is important, and where the evidence came from. This allows the reader
to get all of the information and not get stymied by verbose language that would take away from
the overall message of the article or subsection. The exception to this seems to be the
conclusion and the introduction which often has a short narrative attached to it in order to
convey relevance to those reading the article. The conclusion is a restatement of the
introduction but often without the narrative and will include what the implications of the article
were and what direction should be taken next as a result of these implications.

In an emergency setting, patient visit summaries are created so that if and when the
patient returns to the hospital, or their primary care physician is following up, there is a brief
documentation of what occurred and what brought them to the emergency department that day.
They are less than half a page in length and contain only the necessary information. It is
essentially a report by one provider to another provider of the same patient giving the
experience that was had on that particular visit. The main goal of these is to prevent repetition of
treatment or if there is repetition to discover the pattern and what it explains. This has become
even easier as medicine is slowly moving towards a paperless system.
Visit summaries are the best example of this because it condenses all of the information
from a visit that is potentially hours or days long, and gives it in half a page to a page. Since
they are purely expository in nature, there is no need for them to contain anything other than
what happened, what was done about it, and what was the result. No need for a formal
introduction or conclusion because then there would be extra information that is necessary to
the care of the patient. The introduction can be as simple as the age and gender of the patient,
and why they presented to the Emergency Department. Everything else is explicative as to what
was done about it and what the outcomes were. This information will be used later if the patient
returns at another time as a patient history.

The implications of writing poorly in the medical field are enormous. There is no room for
error when mistakes or omissions could have very consequential results. Concision is highly
valued because it leaves no room for misinterpretation and it is quickly scannable for the
important information. Information is published and disseminated to the discourse community in
journal articles and conferences so that questions can be answered and care of patients can be
improved. Evidence is assembled from other members of the community so that everyone can
benefit from new discoveries and implement them in their own practices. Continuing their
education through examining the works of others keeps everyone on the forefront of their fields
within the discourse community. As medicine is an aggregation of different specialties and roles,
communication is of the utmost importance.

1) Araki T, Yokota H., Morita A: Pediatric Traumatic Brain Injury: Characteristic
Features, Diagnosis, and Management. Neurologia medico-chirurgica: Advanced
publication 1/20/2017
2) Waltzman M. (2017, January 21) personal interview, email interview