Let the teachers teach English and I will teach baseball. There is a lot of people in the United States who say “isn't,” and they ain't eating.
— Jay Hanna “Dizzy” Dean (1910–1974)
After Dizzy Dean ended his glorious career as a major-league pitcher, he became a popular baseball announcer. When a frustrated interviewer exclaimed, “Mr. Dean, don't you know the King's English?” Dizzy responded, “Sure I do, and so's the Queen.”2
If Old Diz did know the King's English, you couldn't prove it by the way he spoke. Similarly, many physicians and scientists may also know the King's English, but you couldn't prove it by the way they write. Accordingly, 26 years ago, one of us (HLF) helped create a series of “Dizzy Awards”—awards for excellence in bewildering, unintentionally comical, or downright terrible medical writing.3–9 And in all of those instances, the awards also represented poor editing.8–10 The “winners” were excerpts from articles in prominent medical publications.*
Because dizzy medical writing and editing continue to plague the scientific literature, we decided to harvest a new set of Dizzy Awards from a seemingly ever-present bumper crop. Witness the following:
The No Hits, No Runs, One Error Award
“Invasive disease such as septicemia, hepatosplenic abscesses, or other organ colonizations due to Y. enterocolitica are extremely uncommon….”
— It are?
The Batty Title Award (6-way tie)
“A Study of Lymphoma of Large Granular Lymphocytes with Modern Modalities”
— Were the modalities in the cytoplasm or the nucleus?
“Occult Pheochromocytoma in Association with Hyperthyroidism Presenting Under General Anesthesia”
— “Occult” is right.
“Plasma Cell Granuloma of the Colon: A Report of a Case Removed by Endoscopic Polypectomy”
— Most editors would choose rejection over resection.
“Trainability of Arms Versus Legs in Men Previous Mycardial Infarction”
— Was the proofreader out to lunch?
“Dysglycemia in Critically Ill Patients From Medicine”
— Were they from Medicine Hat, Alberta, or Medicine Bow, Wyoming?
“Licking Breast Cancer with Salivation Army Pennies”
— No comment.
The Suicide Squeeze Award
“It's a small series and needs more patients and other investigators. If it does prove to be true, it will be extremely helpful in picking up sudden death.”
— If that's the case, we'd rather not participate.
The Removed from the Line-Up Award
“Treatment of an asymptomatic nodule which has been removed surgically is controversial.”
— Once it is out, who cares?
The Flagpole Award
“We recommend that practitioners examine patients who are to be treated with a calcium antagonist for gingival overgrowth.”
— We recommend that practitioners examine all of their patients.
The Charley Horse Award
“While smoking, the spasm increases, but 5 min later it disappears.”
— What brand does the spasm smoke?
The Cut-Off Man Award
“Only 17% of patients with pancreatic cancer are alive one year after diagnosis, and most of these patients were resected.”
— Give me resection or give me death!
The Wrong Ballpark Award (6-way tie)
“This approach has been reported in only a fewpatients….”
“[T]hese infections have been reported in patients with underlying disease.”
“The performance of this monitor has now been reported in patients and in the laboratory.”
“Previous reports of recurrent hemoptysis associated with sexual activity have all been in patients with cardiac disease.”
“Most of the case reports are in caucasians of European descent.”
“Constipation is reported in over 33 million adults….”
— Reports can never appear in patients.
The Batted Out of Order Award
“If diagnosed early, catheter drainage combined with antibiotic therapy usually results in satisfactory healing.”
— But it can't heal bad syntax.
The Fog on the Playing Field Award
“Radiation pneumonitis has been argued by Komaki et al. to necessitate its occurrence withinthe irradiated volume.”
— ???
The Rooting for the Wrong Team Award
“Mannitol has been used intraoperatively in the attempt to prevent prophylaxis against acute renal failure for three theoretical reasons.”
— We get better results by promoting prophylaxis.
The Called Because of Darkness Award
“Although the manifest indicators of our psychopathic subtypes are continuous dimensions, the subtypes themselves represent relatively homogeneous and mutually exclusive patterns of trait covariation that constitute natural classes or taxa in a ‘formal-numerical’ sense.”
— Your argumentation is most efficacious, although any positive covariation in the direction of transparency would be meliorative—we think.
The Change in the Line-Up Award
“… I recommend that the rest of my patients follow American Heart Association guidelines until they are revised.”
— And once your patients are revised…?
The Bag of Soda Pop Award (4-way tie)
“Like previous reports of splenic injury, we advocate early CT scans to help exclude this rare complication in patients with abdominal pain….”
“Unlike adults, the mortality in young children exposed to excessive mercury vapor is high.”
“In contrast to our patient, the diagnosis of acute pancreatitis….”
“Unlike salicylates, we are unaware of any case reports….”
— We unlike false comparisons.
The Box Score Award
“In survivors, medical resources use after VAP diagnosis was significantly higher in high and very-high-risk patients when compared to mild-risk patients, evaluated using ICU length of stay (22.5 ± 10.3 days vs 18.7 ± 12.9 days; median, 21.0 vs 16.0 days; Mann-Whitney U test Z statistic = −3.413; p < 0.001) and duration of mechanical ventilation (18.9 ± 9.9 days vs 15.1 ± 11.5 days; median, 17.0 vs 12.0 days; Mann-Whitney U test Z statistic = −3.454; p < 0.001) after VAP diagnosis.”
— Thanks for clearing that up!
The Home and Away Award
“He does not recall any foreign travel although he has been to Houston, Texas within the last several months.”
— And we can see Mexico from our house.
The Cases at the Bat Award
“These cases comment on the physiology of the peritoneal cavity.”
— When cases speak, everyone listens.
The Final Out Award
“It was first described by Pretty in 1931 when an autopsy on a 42-year-old woman with chest pain who died revealed a coronary dissection with rupture.”
— Death before autopsy is always preferable.
The Screwball Award (3-way tie)
“In contrast to the urinary tract, hepatobiliary tumors infrequently cause bleeding in the biliary tract.”
— Huh?
“In this report, we describe a patient with a mass lesion in the right lung who concealed the diagnosis of Behçet's disease 2 years earlier, based on neurologic symptoms.”
— What?
“In this article, six patients were operated on because of chest wall hydatid cysts between the years 1989 to 1991 have been reported.”
— We give up.
Footnotes
*References available upon request.
Address for reprints: Herbert L. Fred, MD, MACP, 8181 Fannin St., Suite 316, Houston, TX 77054
References
- 1.www.dizzydean.com
- 2.Fadiman C, Bernard A. Bartlett's book of anecdotes. Little, Brown, and Company; 2000. p. 159. On-line: http://books.google.com/books?id=me7V5vIm214C&pg=PA159&lpg=PA159&dq=dizzy+dean+%22DON'T+YOU+KNOW+THE+KING'S+ENGLISH%22&source=web&ots=jJ_NfmobdO&sig=Wm3KTpi3jKzBn6z6qqnG1PgDq8o&hl=en&sa=X&oi=book_result&resnum=2&ct=result
- 3.Fred HL, Robie P. Dizzy medical writing. South Med J 1983; 76(9):1165–6. [DOI] [PubMed]
- 4.Fred HL, Robie P. Dizzy medical writing: part II. South Med J 1984;77(6):755–6. [DOI] [PubMed]
- 5.Fred HL, Robie P. Dizzy medical writing: concluded. South Med J 1985;78(12):1498–501. [DOI] [PubMed]
- 6.Fred HL, Robie P. Dizzy medical writing: report on recent relapses. South Med J 1989;82(7):897–9. [DOI] [PubMed]
- 7.Fred HL, Robie P. Dizzy medical writing: will it never end? South Med J 1991;84(6):755–9. [DOI] [PubMed]
- 8.Fred HL, Robie P. Dizzy medical editing: causes, consequences, and cures. South Med J 1991;84(6):760–2. [DOI] [PubMed]
- 9.Fred HL. Dizzy medical writing and editing: no relief in sight. South Med J 1992;85(7):743–5. [DOI] [PubMed]
- 10.Fred HL, Scheid M. Dizzy medical writing and editing: a decade of non-progress. South Med J 1993;86(6):705–9. [DOI] [PubMed]