How to write a medical case report

how to write a medical case report

Charity Auction and Fun Writing Tool

This is less of a craft post and more of an update. Last month, my husband and I signed on to a restaurant project called Parella that will be opening in the vibrant Uptown neighborhood of Minneapolis this summer. I’ll be acting as the wine director, as I’m actually a certified sommelier, which is a fun piece of trivia. Not to worry, I’m still editing almost full-time with a robust list of clients. If you’d like me to help you with any manuscript, query, or publishing conundrum, please see my editorial website.

In other news, I’m participating in an auction and donating a 30-minute phone or Skype consultation with the lucky winner about anything manuscript- or publishing-related., along with authors and publishing professionals from around the world have come together to raise awareness of violence against women, as well as show support for an amazing and courageous young lady, Queena–the Bloomingdale Library victim. Back in 2008, Queena was a vibrant eighteen-year-old with a full scholarship to her dream college and her whole life ahead of her. She was returning books to the local library when she was beaten, brutally raped, and left for dead in the swamps behind the library. Queena suffered multiple brain injuries and has lost all motor skills, including speech, vision, the ability to walk, talk, or feed herself.

Now, seven years later, she still requires round-the-clock care and is confined to a wheelchair, but she makes strides every year and can communicate with eye movement and various sounds. Medical expenses and therapy cost over $70K every year, and we want to show Queena how proud we are of her for never giving up.

The Quest for Queena is hosted by and will have various reader and writer related items up for bid. 100% of the proceeds will go to Queena and her family for the therapy that helps Queena progress just a little more with each new year.

Some of the items up for bid include:

    • Critiques from literary agents Sara Megibow & Cassie Hanjian.
    • Author education courses and consultations from Authors Training Authors, Stand up-Stand Out-Rake It In, Plot Whisperer, Mary Kole, and more.
    • Top rated publishing and writing software from Save the Cat, Scrivener, & Vellum.
    Design & promotional services from Lola’s Blog Tours, Forward Authority, Colbert Creative, BookGraphics, and StoryFinds.
  • Editorial consultations & services from respected industry pros.
  • Autographed books from Leigh Talbert Moore, Brenda Novak, Livia Blackburne, Lydia Kang, Lori M. Lee, Therese Walsh, and so many more!
  • A VIP pass to UtopYA writers conference.

These are just a few of the amazing items and services. Please visit the auction website starting April 27 to bid all week long. Now is your chance to get an excellent deal while supporting a worthy cause at the same time.

On Friday, May 1, will wrap up the event with a Facebook party, in which all final winners will be announced, as well as more prizes and author visits given away.

To learn more about Queena, please visit .

Finally, if you struggle with adverbs, I just heard about this easy-peasy tool called “Adverbless ” where you can copy and paste your document into an online window and it points out all of those pesky adverbs for you. Give it a whirl, and remember that friends don’t let friends use adverbs.

Hand-Holding in Dialogue Tags

Anyone who has worked with me knows that I take a pretty hard line when it comes to telling in dialogue tags. Examples are:

“I’m so excited!” she said exuberantly.

“That’s wonderful.” Coldness radiated from his voice.

Nothing bums me out more than reading scenework where the writer has decided to take all the fun out of it on the reader’s behalf. Sometimes I call it “hand-holding,” sometimes I call it “overexplaining,” sometimes I just cross it out.

The reason behind my aversion is that writers who do this are taking something essential away from the reader. The star of dialogue is the dialogue itself. Holding the reader’s hand through each snippet of dialogue says to me that you don’t quite trust yourself to communicate the scene in a way that the reader gets it.

Scene is one of the magic places in a manuscript where characters can be on display, speaking to one another, acting toward one another, and otherwise demonstrating themselves and their relationships. It’s the ultimate voyeur’s paradise (calling the reader a voyeur here). Whenever you tell, instead of show. you take away the reader’s power to interpret and appreciate character.

The first example, above, is there because it’s redundant. You would not believe how many writers do this. If a character says “I’m so excited!” then it can stand alone, with no further explanation. I’d be a wealthy woman if I had $5 for every time I saw:

“I’m sorry,” she apologized.

“Yes,” he agreed.

The second example is more subtle. Your character is saying one thing, but there’s an undercurrent of tension and the suggestion that they mean something else. Delicious! Instead of describing tone of voice (sneaky telling), maybe match up the dialogue with action to color it:

“That’s wonderful.” He crossed his arms.

Or, maybe even better yet, leave it up to reader or POV character interpretation:

“That’s wonderful.”

“Oh yeah? You think so?” The last time he’d used that descriptor, he was watching a snake choking the life out of a mongoose.

Let the character react, which will help guide reader feelings. Dialogue tags exist to communicate information. The two biggest things they should clarify are:

  1. Who is speaking?
  2. Is there anything going on in narration or action that’s not implied in the dialogue?

But too many tags tell about emotions, tone of voice, and tension when those are better uncovered by the reader for lasting character and relationship understanding. Next time you’re working on a scene and you want to try something hard. take out ALL of your dialogue tags and see how it reads. If it’s totally confusing, layer back 25% of what you had before and see if you can make it work.

If you’re one of those writers addicted to dialogue tags, especially in scenes with only two characters, where you theoretically don’t even need them, I bet this will be a revelatory reminder that you’re explaining too much.

Generic Description

I’ve written before about generic words that don’t add much in the way of specific emotions. Now I’m on to generic descriptions that don’t add anything to scene. For example:

The teenagers congregated at the store, listening to music on their devices. They wore various outfits, featuring the most popular brands.

I’d imagine this is the type of sentence that would appear in a textbook for an alien about humans. They’d have a lot of knowledge about us, but because they’re outsiders, they’d speak more in generalities than specifics…getting close to an accurate depiction, but without any of the detail that makes the knowledge realistic or engrossing.

The issue with this type of generic description is that the reader will already have a vague imagine their minds. As soon

as you say “shopping mall,” the reader paints a place-holder picture that’s very much like my example sentences.

Your job as a writer, then, is to take that vague image and embellish it with detail that’s specific to your world, your characters, and your story. The purpose of description is to take the generic and sharpen the image. So a reasonable replacement for the example would be:

They headed to the shoe store so Nikki could get another hot pink pair of kicks to match her screaming neon yellow yoga pants. Josh cranked his Shuffle. Whatever song came next would be better than the Taylor Swift blaring from the speakers.

Now, I’ve written about specific references in a manuscript (like the Taylor Swift line), but I decided to do that here just because I’m targeting vagueness. I hope that you can see how painting a more specific scene, with some emotional overtones, clarifies the scene more than simply inserting arbitrary-seeming narration.

Making vs. Following Fate

Here’s something I’ve been thinking about a lot recently. In my work with editorial clients, I often see two types of stories. This can extend to the offerings on the shelves. Sometimes there are stories about making fate, and sometimes there are stories about following it. Both are valid and interesting, but there are unique considerations to each.

What is your protagonist setting out to do in the story? Is their future an open book or are they bound by some sort of mechanism to a specific outcome?

In the example of “making fate,” I’d say that your protagonist has something that they absolutely, positively want (objective) and they set out to get it. They are more active throughout, and they drive the events of the story by pursuing whatever it is. They are the tip of the arrow, and the plot follows from them. They will encounter obstacles, certainly, and they will be frustrated in their pursuits, but if I look on the page, I will see someone who is spearheading the story. The character leads the plot, more or less, with usually some wrenches thrown into the mix.

In the example of “following fate,” I’d say you’re writing about a character who may or may not be in charge of dictating where the story is headed. One very common version of this is the “Chosen One” or “prophecy” story style, where the protagonist has something they’re bound to do, whether they like it or not. This is usually sprung upon them at a very inopportune time in their lives, and has dire consequences if they reject the fate or fail at their mission. In this case, the protagonist isn’t as much the leader of their destiny as they are a follower, and in stories like this, the plot leads the character’s development instead of the other way around.

Both story types are valid. But they have a lot to learn from one another. I think that, in the long run, a strong character has more potential than the one that’s simply following orders, training, learning their mission from a dusty piece of parchment or oracle, etc. etc. etc. So when there’s a “Chosen One” plot on my desk, I suggest that the writer find some agency for the character and let them lead certain events, rather than spend the bulk of the plot being groomed by others to fulfill a prophecy.

If you’re worried that this might be describing your plot, here’s a previous post on how to make the character more active, someone who manages to steer, regardless of their circumstances. And take heart, though this story type has the potential to lie flat on the page, and I see it a lot in aspiring manuscripts, two of the most famous heroes in children’s literature have started in this situation. Katniss in The Hunger Games and a little wizard named Harry both had their destinies planned. Katniss was to die as a Tribute in the Hunger Games, and Harry had the double pleasure of first facing the destiny of being forced into an ordinary Muggle life, then being forced into a very extraordinary wizard’s life. While he does end up filling his extraordinary wizard shoes (the prophecy of the Boy Who Lived comes true), he does it in his own way.

While I don’t often see this issue, a “making fate” character can run into trouble as well. When these stories go south, it’s because they can be all personal conflict (internal) without too much plot tension (external), because that decision-making protagonist tends to be the end-all and be-all within a story.

What’s the conclusion to this line of thought? The usual. It’s all about balance. If your plot is driving your character, give your character some moments of choosing her own destiny. If your character is driving your plot, let their relentless drive forward take a few unexpected left turns, courtesy of an enhanced plot.

Interruptions and Trailing Off

I was working on an edit this morning and it reminded me of a small writing issue that I see way too often in manuscripts. Now, some people have called me very strict when it comes to dialogue formatting, and I’d agree. I have very low tolerance for excessive dialogue tags, too much gesture/action clogging up scene, improper formatting, and fancy “said” synonyms or adverbs. What I’m about to discuss here is another one of my pet peeves. The good news is, it has a very intuitive fix, which you can begin to implement as soon as you’re aware of the issue.

This week we’re talking about proper formatting for interruptions and trailing off in dialogue. Let’s first look at examples of this done the wrong way:

I began to say, “You just never let me finish any…” when Mom interrupted me.

“That’s because there’s nothing you can say,” she moaned. “What you’ve done is so…so…” She trailed off.

Here we find both an interruption and a trailing off description (with a bonus fancy “said” synonym). We also find, and I hope this popped out at you, a lot of excess description of pretty obvious stuff. This dialogue is currently bogged down in logistic. Instead, it should really move quickly and fly off the page.

The good news is, you can accomplish that with punctuation that exists for just this purpose.

To create an interruption that everyone will recognize as such, use an em-dash where you want to end the dialogue. You create an em-dash by typing two hyphens, and most word processing programs will tie them automatically into the longer dash.

To indicate a person trialing off from their train of thought, whether in speech or narration, use an ellipse. You create one by typing three periods in a row with no space before and sometimes a space after. If there’s a pause within a sentence…like this, you don’t need a space after. If there’s a pause between sentences, use a space… And that’s really all there is.

Now we can use both of these punctuation tools to revamp the example:

“You just never let me finish any–”

“That’s because there’s nothing to say. What you’ve done is so…so…”

You’ve cut the whole “I began to say” business, and the “Mom interrupted me” because it’s all right there in the punctuation. Wham, bam, thank you, ma’am!


Category: Bank

Similar articles: