Mary E. Knatterud

Mary E. Knatterud

Associate Professor
University of Arizona, Tucson

The focus of my day-to-day work as a scholarly surgical editor, as well as of whatever qualitative research and writing of my own that I manage to fit in, is empathy.  My perspective is 3-fold: empathy for the harried surgeon-scientists who draft journal articles and related manuscripts, empathy for the busy readers of those materials (including, at the outset, the gatekeeping editor-in-chief and peer reviewers), and, always already, empathy for the vulnerable patients they describe.

Empathy has long been my overriding interest, as evidenced by my very first published academic article back in 1991 (“Writing with the Patient in Mind: Don’t Add Insult to Injury,” Bethesda, Maryland: American Medical Writers Association Journal, February 1991, Vol. 6, No. 1, pp. 10-17)—an article that is quoted in the Publication Manual of the American Psychological Association (beginning with the 4th edition in 1994) and cited in Health Writer’s Handbook by Barbara Gastel, MD (Ames: Iowa State University Press, 1998).

And empathy was the overarching theme in my1997 doctoral dissertation, First Do No Harm: Empathy and the Writing of Medical Journal Articles, published by Routledge (New York and London) in 2002.

Empathy remains my paramount concern in every research article that I substantively edit, for both language and organization, for my colleagues in the Department of Surgery at the University of Arizona, no matter what their particular subject matter or subfield.  To name just a few examples on my plate lately (or, rather, on my computer screen, awaiting track changes), the next item in my To Do pile might deal with the optimal timing of levothyroxine therapy in brain-dead solid-organ donors, or the impact of legislation on gun-related injuries and deaths, or the effect of fall height on the severity of cervical spine injuries, or the potential of smartphones to transform telemedicine.

Besides the research article destined for a scientific or clinical journal, other genres also abound in my workload (with the most recent content that I reviewed listed in parentheses), such as the how-to synopsis (on the surgical technique for robot-assisted septal myectomy), the brief report or editorial(urging more frequent use of selective vascular isolation of the liver for grade 5 injuries), the case report and literature review (on diagnosing a Dieulafoy lesion as the cause of post-splenectomy bleeding), the personal statement (for a chief resident’s surgical oncology fellowship application), the letter of recommendation (for an American Heart Association grant), the proof (of a book chapter on living donor pancreas transplants), the abstract (on the most effective bumper height for percutaneous endoscopic gastrostomy tubes), and miscellaneous public relations documents (the department chair’s message for our annual newsletter, a biosketch for a faculty member for a conference brochure, the program for the graduation ceremony honoring our residents and fellows, the announcement of a party for a retiring cardiothoracic surgeon).

My own ongoing writing currently takes the form of a monthly Q&A column, which I dubbed “Write Rounds” when it debuted in March 2009, that is emailed to our Surgery and Medicine faculty, residents, and staff.  Topics in the past few months have encompassed the appropriate use of passive voice in medical writing; the foregrounding of writing and editing, along with medical and psychiatric themes, in this year’s Academy Awards TV show; the importance of paragraphing; the styling of the term “Level I trauma center”; the difference between the words “principal” and “principle”; and the concept of summer reading as preparation for even formal writing.

In addition, 2 publications solely authored by me are in the works: (1) an original vignette, “ ‘Sturdy and Staunch’: Editing Surgical Manuscripts,” slated for the September 2013 special issue on The Profession of College Composition and Communication and (2) a book chapter, “Being Truly Present as Good Physicians, Online and Offline,” that I submitted in February 2011 and updated in January 2012 for Rhetoric and Online Health Communication.  I previously presented portions of that book chapter as part of the “Information Design in Medical Fields” panel at the annual meeting of 4Cs in San Francisco in March 2009.

Finally, the upcoming edition of Harmony, the humanities magazine produced each year by the Arizona Health Sciences Center, has accepted 3 more of my poems for publication in the fall of 2013: “Rejection,” “To My Grown Kids,” and “Sidewalks.”

key words to describe work

empath, presence, reader-friendly prose, patient-friendly terminology, physician-patient communication, conciseness

Work related to symposium keywords

The words that relate most to my work are connections and ethics.

My work focuses on forging healthy and ethical connections—on paper, on screen, in person—between physician-writers and readers, especially with respect to/for patients.  To quote the 3 “intertwining premises” of my dissertation-turned-book, (1) Language matters: words have deeper meanings that both reflect and shape the underlying power structure; (2) The effect of allegedly harmful linguistic choices—however unintentional, however minor in isolation—is cumulative; and (3) There is a place for individuals’ perceptions in what counts as useful knowledge.  All of those premises intricately involve the impact of semantic and syntactic connections (whether positive or negative) and of ethical (or not) language choices.

Participation questions

“Health communication” is often thought of primarily as oral conversations (or, too often, one-sided, top-down, cursory lectures) involving physicians and other health care providers vs. patients and their families.  However, I consider it to be a bigger umbrella term that also covers written materials.

“Medical editing” is my preferred term for what I do most, although I sometimes narrow it to “surgical editing” in honor of my typical authors’ distinct field and in deference to the overall precision that the adjective “surgical” showcases.

But perhaps the usual term for my profession is “medical writing,” as suggested by the name of another national organization I belong to, the American Medical Writers Association.  After all, both the initial and the final stages of my work flow are seen in terms of writing, from the informal rich messiness of prewriting and drafting to the culminating formality of the typeset page or unalterable pdf file.  Editing, at least on my part as an author’s editor, is mostly an intermediate stage between the nearly finished draft and its submission in polished form to a journal, although revisions and related questions often go back and forth between the author and me, given the recursive, nonlinear nature of the enterprise.

  • How do you explain/define what you do to medical personnel and/or other stakeholders in the research process or to the public?

A painstakingly conscientious editor, I am available as a departmental resource (at no individual out-of-pocket expense) to any surgeon-author who wishes to take advantage of my skills, who wants to take some of the isolation out of his or her writing process, who welcomes the idea of fortifying an important draft via another pair of eyes and a different viewpoint (linguistic, in my case), and, ultimately, who truly desires to benefit the published article’s readers and the patients who are thereby helped.

  • How would you describe the relationship between medical rhetoric/health communication (however you see yourself) with other fields and subfields (e.g., rhetoric of science)? … In other words, how do you align what may be a specific focus with broader disciplinary concerns and tensions?

As a lifelong reader who majored in English 3 times, I see all fields as potentially related to one another, particularly when it comes to putting thoughts into written form.  I found (and still find) the field of English to be eminently compelling because it is about everything; I feel the same way about medicine, which can be about anything.  In a given piece of writing, of a certain genre, crafted for a target audience and a real-world journal, any “disciplinary concerns and tensions” must be engagingly defined and adroitly confronted within the context of that article, or letter to the editor, or editorial.


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