Friday, April 20, 2012

I break the rules.

image credit

Recently I had the distinct pleasure of putting together and running an elective workshop for fourth year medical students on narrative writing in medicine. 14 students signed up for this session and we had three luscious hours to explore and discuss and . . .yes. . .write! I used that word "luscious" on purpose because that's exactly what it was to me--luscious--which by definition means richly satisfying to the senses or mind.

Loved. It.

So we started off with a discussion about why it's important for physicians to consider writing as a means of reflection. We chatted about how it connects us to the awesome responsibility we've accepted of caring for human beings and their families, and how it prompts us to pay attention. I shared a power point presentation with a few things from the medical literature about narrative writing and ways to get works published in our medical journals. That slide set also included some of my own approaches to writing, which isn't necessarily evidence-based. I guess it was just sort of my-own-experience-based.

Someone in the group asked me, "So were you an English major, Dr. M? A journalism major or something like that?"

And the answer to that was the honest-to-goodness truth: No. I'm just a person who has always loved to tell stories. . . . and also one who always loved to write.

Wait. Always? Hmmm. Let me clarify what's meant by "always."

By always, I guess I mean that remotely I had crappy journals and diaries stuffed in the side of my bed as a kid and a few times I wrote something that a teacher commented on for being not-too-horrible. Then as more time passed, I found myself sitting at computers writing for no reason. About this, that and also the other. So this is what I mean by always. But as far as some formal, hoity-toity training in writing. . .the answer is no.

This makes me a renegade writer of sorts. Kind of like some untrained person who shows up at a Broadway audition and just starts doing their own little pirouettes in a corner that they practiced in front of their bedroom mirror. But who someone sort of likes so they somehow makes the cast of a show or two.

Yeah. Like that.

We chatted about my blog and the other places that I write. That got me thinking about writing here and how intensely therapeutic it has been for me. There are days that I can't wait to open my laptop and just write. Write and write and write. With reckless abandon, without rules, without word count restrictions. To just get it out of my head and somewhere else and for it to be okay to have fragments for emphasis or silly sidebars and sayings like "awww hells naw!" or "the hairy eyeball" or to even refer to someone as the "teenage mutant target checkout chick."

So anyways. That three hours was luscious indeed. We spent some time using our words to paint pictures. I gave them a few scenarios and asked them to describe them with words. And they did. Wow they did. We shared those pieces and dissected them for the most decadent parts, too. Then they all took about fifteen minutes to write a longer narrative. Yes. Fifteen minutes--which I know doesn't sound like much but surprisingly can yield some substantial thoughts. We shared those pieces, too, and it was jaw-droppingly amazing and perfect and good.

Yes. Yes!

I walked away from that session so full and so encouraged. I was excited about writing and teaching and talking about writing, too. The students were so gracious with their ideas and so engaged with the process that I was like a rabid dog for more. (Do rabid dogs want more of things? Hmm.) Anyways. What was so good about this session was that all 14 of the students truly wanted to be there. They had chosen the elective and wanted to write. It wasn't being forced upon them like some lukewarm porridge; it was exactly what they'd selected off of the menu.

Ant during our writing elective, 2012, which she picked from the menu.

This made me wonder what more I could do with narrative writing for our learners. So over the last few days, I've toyed around with some ideas and have started researching some things to flesh those ideas out. That research led me to this article that had been published in the New York Times by a highly respected writer named Elmore Leonard. Leonard wrote this oft quoted piece (which later became a book) called  "Easy on the Adverbs, Exclamation Points and Hooptedoodle." It's his ten rules for writers which, if you hit a quick Google search, seems to be one of the closest things to the Gospel on Writing out there.

Anty-WHO. I read the article and had a major ah hah moment. Or better yet a rut roh moment. I break the vast majority of his rules quite often. Except for the last one. I think. Or at least I hope.

So first, let me share his rules and my take on how they apply to me as a writer. In a way this is a bit of a top ten. Well sort of. The bold is his rule as published. The part after is my thoughts on it. Capisce?

Okay. . .and away we go.

1.  Never open a book with weather.

Okay. I've not written a book, but I think there have been times that I've talked about the weather right off the rip. Oh well. Sometimes weather matters, man. It totally does.

 2.  Avoid prologues.

Again. I haven't written a book. But according to him, prologues can be annoying. Hmmm. I guess. Sometimes they annoy me, sometimes they don't. The thing for me is simple: Every book gets about 75 pages. In fact I have read the first 75 pages of  just about 75 books. Without ever finishing. If you haven't grabbed me in 75 pages--or 75 words if it's a blog post--then I will probably get distracted and do something else. The prologue counts in that. So if it's an interesting 75 pages, I'm cool with that. Prologue and forward included.

3.  Never use a verb other than "said" to carry dialogue.

Dude. I profusely break this rule. In my head sometimes people yell things or whisper things or mumble things. And sometimes they just said it, but that rule? I break a whole, whole, whole lot.

4.  Never use an adverb to modify the verb "said”…he admonished gravely.

Hmmm. This is good advice. . .I think. I am trying to go easy on the adverbs. But you know?  I'm not against them if it adds to the image. I guess I break this rule, too.

5.  Keep your exclamation points under control. You are allowed no more than two or three per 100,000 words of prose. 


Ha. I don't think I'm super exclamation-pointy. But I am also not against some caps or some exclamation points here and there if it paints the picture. See? I break this rule, too.

6.  Never use the words "suddenly" or "all hell broke loose."

When I read that rule, suddenly all hell broke loose. Yep. I've broken that rule, too.

7.  Use regional dialect, patois, sparingly.

Rut roh. I break this one constantly. Especially telling stories from Grady. Sigh. This guy would hate my writing. Hate it, I tell you.

8.  Avoid detailed descriptions of characters.

Okay. Elmore Leonard would not make it through 75 words of anything I have ever written. My favorite thing to do is describe people. My absolute favorite. Another rule--broken.

9.  Don't go into great detail describing places and things.

See number 8. Sigh.

10. Try to leave out the part that readers tend to skip.

My fellow Grady doctor Neil W. is my guru for helping me here. He's good for striking a whole paragraph out of something I'm submitting for publication without me even knowing he did it. I probably break this rule on my blog. But oh well. Elmore Leonard would never have made it beyond one post so it's not like he'd notice.

 My most important rule is one that sums up the 10.  If it sounds like writing, I rewrite it.

Yes!  A rule that I actually follow!! (Whoops, too many exclamation points, sorry.)  I try hard to make my writing sound like dialogue or a real conversation. I want you to feel like you were there. So even if I break all of the other rules, if it feels like we're chatting over coffee or a yummy red wine, I have succeeded.

 * Excerpted from the New York Times article, “Easy on the Adverbs, Exclamation Points and Especially Hooptedoodle”

So. I am thinking of trying to put together of Council of Physician Storytellers at Emory. Don't you think that would be cool? A council of health providers as writers. . . .students, residents, faculty, and just people who want and need to write. But see? Now I'm all wondering about these rules and such. Man. I hope suddenly all hell doesn't break loose. Heh.

*rubbing forehead with the heel of my hand*

Man. This rule business makes it all feel so hard. Uggghhh.

Okay, seriously? Here's what I'm mostly thinking of telling folks should this pipe dream of a Council of Physician Storytellers become a reality. . . . I'm thinking of telling them just like that creepy, pock-marked dude told Danny Zuko before the car race scene in Grease:

The Rules Are, There Ain't No Rules

"The rules are--there ain't no rules."

Well, except for one. If it sounds too much like writing, then rewrite it. 


Happy Friday. 

How do you do with these rules? What do you think about them or rules in general? Weight in.

This is how I was feeling after our three hour writing workshop--giddy like these guys. Now playing on my mental iPod. . . .


  1. I can't believe I just watched that whole song and dance thing. I think his rules could be the reason people don't like to write. What does he write??!!! Don't describe characters?? Don't talk about the weather? Yours works for me - if it sounds like writing etc. etc.

  2. Hey, Doc Writer ... You write so incredibly well that I can't imagine how you have any time left for all the other parts of your life! I was a newspaper editor for 25+ years; if even a tiny fraction of reporters wrote as well as you do, people would still be reading newspapers. Well, more of them would be, anyway. Me, I love rules -- and I love breaking them even more. Elmore has some good ideas/suggestions in those rules, but he's not the Gospel (no matter how it looks on the Internet). My No. 1 rule: Tell me a story. If it needs exclamation points -- or adverbs or verbs for dialogue other than "said" -- and it all fits in the story, use 'em. Happily. The far greater sin is to be boring, dull, incomprehensible or otherwise revolting. And you, ma'am, are never boring, dull or revolting in any way. You have an absolutely magnificent voice, and it shines through in your blog. Never let any set of "rules" tone that brilliant voice down. And a Council of Storytellers at Grady? Marvelous idea. I can only imagine how some of those medical reports must read. Please, please, please find a way to spread the magic of writing well into medicine! Thank you for sharing your voice with us ... much appreciated! Blessings to you and yours...

  3. Hi Dr. Manning -- I read your blog entry and really like your idea of having physicians write. I've never encountered writing from a doctor that was so personal and open. Your writing has given me even more respect for you and others in your profession than I had before I found your blog. Anyway, after reading your post, I went to Ms. Moon's blog and read her entry and I kept thinking about the rules you listed and finding that I wanted to toss all those rules away and just read and enjoy. I don't want to know if she or you follow those rules, I just want to read and learn or read and enjoy or read and feel. Your writing captures attention immediately and after reading I feel like I visited Grady or you and your family or experienced the attitude of that check out girl at Target. So for me, I like the "no rules" rule the best. Joanne

  4. Ok, I'm going to chime in here. This guy may be a big player, but this is what I have learned from working in the communications department of a fortune 100 company. There is a huge difference in the way you write a news release, a sales sheet, a white paper or a business blog and the way you would write a blog, a short story or novel. In business communication you state the objective facts in a way that would be appealing to the audience. The audience is looking for information on a product. They aren't pleasure reading. People reading blogs, short stories or novels are interested in the subjective side of writing. They are voyeurs looking for the plot and the story being told. The more objective description the better the story will be. How would we have known that Ron Weasley in the Harry Potter series was copper headed probably with pale skin and blue eyes, or Rue in The Hunger Games was darked skinned with brown eyes if the characters had not been described? Descriptions of people and places add to the fabric of objective narrative. He may be a great communicator, but I don't think his rules apply to every situation.

  5. My comment tonight is actually a question: how can I join your Council of Storytellers?? Sign me up!

    Sincerely, a Grady Student Doctor

  6. All I gotta say is - is there some way you can make a Council of Physician Storytellers for everywhere? Because I'd definitely sign up!!

    Especially when it's headed by a physician storyteller as awesome as you :)


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