Sunday, August 30, 2015

Advice to students and young professionals when you don't like a critique of your work

I've been thinking hard about whether to share what follows.  I've finally decided to do so now, at the start of the fall semester, as a form of advice to students and young professionals.  The advice is actually quite simple:  Learning to write well requires you to be open to honest criticism.  It is all right if you don't like how a professor or someone else responds to your writing, but try to put aside your personal feelings and draw whatever value you can from someone who has taken the time and made an effort to be helpful to you. Also, be gracious.

The background is as follows.  A junior faculty member at a medical school recently asked me to read and critique a book s/he had published.  I am often asked by students and other young professionals to do this, and I am always happy to pitch in, in the hope of being helpful during the formative stages of their careers.

In this case, I felt that the book was not very good. It's not that the ideas it contained were off base. Rather, the writing wasn't persuasive and clear.  I wanted to be honest in my critique, but I also wanted to do my best to make the review a good learning experience.  So, I actually consulted with a number of senior academic faculty members to get their advice on how I should approach the task.  What I wrote is what follows--but then stay tuned for the author's response, and my rejoinder.

Here's my email to the author, with items changed to protect his/her identity:

Thanks so much for sending me your book.  I think it is a great concept and, of course, timely. You asked for feedback, so here goes:

I've seen many instances, like this, where the author has a lot of good things to say, supported by powerful stories.  The problem that occurs is that your own depth of knowledge and understanding of the issues gets in the way of presenting them to readers who are not as attuned as you to the issues.  Why?  In short, because you put in too much, and it is overwhelming.

I always used to tell my students that everything you write should be considered an advocacy document.  You are trying to persuade the reader that your stories are apt and compelling, and the generalizable lessons you draw from those stories are equally apt and compelling. It is very, very difficult to do this when you are so close to the subject.


So my short answer to your feedback request is that the book could have used a major dose of editing, preferably by someone who was not familiar with the topic.  Only that kind of detached observer can tell you where you have done well and where things need to be reworked.  For example, a story might be compelling to you because you experienced it; but in the telling the power does not come through.  It might be the story itself, and it might be how it is told.  

There is also a serious need to separate your personal journey and feelings from a more detached presentation of the evidence you bring to bear in making your points. The reader will know that it is personal--after all, you wrote the book.  But if each story is made too personal, it loses its power as a potentially generalizable example.

Beyond the substance, the design and presentation of the paragraphs and other graphical issues needs major work.  The text comes across as overly dense.  Something about the font size and margins and line spacing and indentation is just wrong--making the book much harder to read.  The publisher should have provided you with better graphic arts support.  

These are general observations.  I could best illustrate them to you if we went through several pages and chapters of the book.  I'd welcome the chance to do that next time I am in your vicinity.  

I want to close with both encouragement and a warning. [Name,] you have the potential to make a big difference in this field because of your commitment to the issues and sound judgment and passion.  But, if you hope to advance in the academic world, your finished writing products need to reach a higher level.  That's certainly achievable, but it will take some work and help.

With fond regards,

Paul
--
And now the author's reponse: 

Dear Paul,

Thank you for taking time to send your feedback. I will let my current work (as well as future career work) answer your email but to be very honest, I am disappointed by your email. Of course not because you didn’t like the book, the writing style or the way I choose to generate knowledge — it’s normal that a personal book will evoke different personal responses. What you find problematic has been a guide for others.

What disappoints me is the rather linear logic you used to develop and organize your arguments.  I shared your email with my mentors, both whom are incredibly well respected and successful palliative medicine physicians in two different settings, and they were underwhelmed (and actually confused) by the email's lack of understanding of and sensitivity towards the complexity of clinical life, aging and policy issues, and health care settings in general, particularly in the context of advanced illness. They were also taken back and concerned by the email’s lack of understanding around systems (ED and hospice), system theory, qualitative methods, and communication theory. 

My own voice will continue to develop, and my mentors and I are on a mission to make a difference through understanding, learning and change, rather than endless critique and dismissal of differing points of view and voices that are always in motion.

Best of luck,
--
To which I felt compelled to reply: 

To be absolutely clear, [name], my comments were not in the least "an endless critique and dismissal of differing points of view and voices that are always in motion."  You asked for an honest critique of your writing, which is simply what I offered.  If you had just wanted encomiums, you needn't have asked.  This was not a critique of your ideas.  I'm sorry either I did not make that clear, or you did not understand.  I offered to illustrate the points to you in detail and in person, but you have chosen to cast aside that offer.  

Your comment about my lack of "understanding of and sensitivity towards the complexity of clinical life, aging and policy issues, and health care settings in general, particularly in the context of advanced illness" is off base.  You know nothing about my experience or knowledge of those issues.  Ditto for my knowledge of system theory and the like. My last bit of advice to you, for future correspondence with others, is that you do little in offering a persuasive retort by attacking the supposed knowledge and experience of the reviewer.  

I'm so pleased you will continue in your efforts to bring greater light to this important field, and I wish you the best.

Sincerely,

16 comments:

Marie Bismark @mbismark said...

From Twitter:

It's hard to hear criticism of anything we've poured our hearts into. Can only hope for feedback as fair & constructive as yours.

e-Patient Dave deBronkart said...

Paul, I'm writing this in the knowledge that your correspondent may read it. (For those who don't know, I've known Paul since college, though we hardly ever crossed paths between then and when he was CEO of my hospital, starting around 2003. So we know each other but it's not like we've been lifelong drinkin' buddies.)

Paul, when I first read your email, honestly they felt brusque. That's not to say they shouldn't be, but if they'd been to me I personally would have felt rejected somewhat harshly. I imagine it's because of your use of the direct "you," which again is not inherently wrong. If you were my instructor in a course, and we knew each other face to face, I'd expect that, but it felt blunt to me. (Again, that's not to say it shouldn't be.)

Anyway: your correspondent's response strikes me as WAY off base.

First, s/he seems to have been raised with too much of a self-esteem mentality: "How dare you not understand how wonderful I am?? Are you an idiot??"

Second, you're right about the ad hominem and other responses, not to mention the sheer defensiveness ("other people said I'm good so you must be wrong"): totally inappropriate.

Correspondent, you should just stop asking people for free advice if you have no interest in hearing it. I mean, think about it - what were you thinking when you asked? Honestly, were you just looking for praise, or really looking to improve what you sent? You gotta admit, if that's what you wanted, it was a little disrespectful to ask someone to spend a bunch of their time. Please think about it.)

And isn't it a little idiotic to choose someone you respect, ask them to donate time to you, then tell them they don't know what they're talking about?? (Who suggested you ping Paul? THAT person is evidently giving you bad advice, in your opinion. Think about that.)

Every year since I got into my current line of work I've avidly sought out wise advisors, begged for their time, and I have FOLLOWED EVERY WORD OF THEIR ADVICE, to the extent I was able. I asked for advice because I knew I didn't know what I needed to do. What other reason is there to ask for advice?

Paul, as to the substance of your criticisms: absolutely. Correspondent, I'm a 65 year old who came up in a world where people would actuallyl read long written pieces, but those days are gone, unless you write as compellingly as Atul Gawande or Oliver Sacks. That was the world before YouTube and the incredible shrinking attention span. Did you know TED Talks used to all be 16-18 minutes, and even THOSE amazing things are now half as long? (I just checked the home page of TED.com ... half the featured talks are less than 9 minutes.

The lesson: you may be writing really great sh1t but it's not going to get read if it's longer than necessary. And that means the excess is not going to make any difference, and that means it was a waste of your time.

The following is going to sound snarky but it's honest: It might be different if you plan to spend your life in academia. I know a lot of people there who write a lot of long things that nobody much reads; it's a different world where people praise each other for being interesting, and nobody gets fired if the world never changes, as long as the papers get published. People can have a good life that way.

But if you want to change the world, you damn well better think about whether anyone will read or listen to you, not to mention whether they'll DO anything about it.

I myself am taking the time to write this because I had this beaten into me (or out of me?) early in my career, and because I've known smart people who ended up bitter because they gotzero frickin points for being smart with nobody listening.

Trust me, it hurts to be ignored. Get out of your ego and start worrying about whether anyone will read what you write.

Norma Sandrock said...

From Facebook:

Asking for a critique AFTER a book had been published was fishing for praise, not looking for constructive comments. It's sad that the author turned his or her disappointment at your critique into a personal attack on you. (At least you won't be asked to slog through any more of this author's poorly edited work.)

e-Patient Dave deBronkart said...

(Ugh, sorry for my typos! If it were my own blog I'd go back in and fix them.)

Paul Levy said...

No worry, Dave, and if Blogger gave me a way, I'd do it for you!

Anonymous said...

Whatever s/he might have thought of your advice, such a poor and utterly ungracious reaction is totally uncalled for when someone has taken the trouble to review something at your request, and then taken the time to think about how best to provide an honest assessment and write it up. If s/he really had an issue with the feedback, a better approach would have been to call and seek to understand better, particularly given your offer to do just that. If not, a simple "Thanks for the feedback" would have sufficed.

It strikes me as odd, too, that the writer would start the response by suggesting that other unnamed mentors agreed with what s/he thought of your letter. It smacks of someone unable to hold his/her own ground without running to some kind of backup benevolent parent figure. Certainly not a good trait for someone who intends to succeed in academic medicine, or any other field of endeavor. I also wonder if those "mentors" are doing this young person a service. It could be that they supervised the work and are therefore unable to reconcile the feedback themselves. In any event, they certainly led their mentee down the wrong path, or were perhaps misunderstood themselves.

Finally, as someone who's worked at BIDMC, I think that for anyone to suggest that you lack "understanding of and sensitivity towards the complexity of clinical life, aging and policy issues, and health care settings in general, particularly in the context of advanced illness" is laughable. It's an immature, unprofessional, and unfounded retort.

I hope that this unpleasant interaction with this young person won't make you think twice about providing honest feedback to others!

MauraZebra said...

I am underwhelmed by this young person's response. Her inability to understand what you wrote and to respond to your suggestions appropriately doesn't speak well for her potential as a researcher or a writer. Your suggestions are the basic tools that we all use when evaluating and revising (and evaluating and revising) our own work.

In addition, I wish she would stand on her own two feet. Her advisors may indeed think she's the bees knees - or maybe they find her so insufferable that they are setting her up for a fall -- but her reliance on what the two of them think vs what the one of you thinks doesn't speak well for her research skills either.

Oh, well.

Anonymous said...

Well, the writer's poorly constructed (not to mention poorly thought through!) response speaks for itself, doesn't it?

Carole said...

Perhaps she/he was less than truthful about what was claimed they said, or maybe no such conversation ever took place afterwards.
"Just saying that - trying to protect ones pride"!
Sad reality for this person is, if they can't handle a kind and thoughtful opinion from someone like you with integrity, the not so nice ones will crush them and probably unfortunately cause them to quit. I would hope if you are ever bravely asked again (because it WAS appreciated after all) you'd give them another chance wanting them to improve or better themselves. Maybe we'll read this in a future post from you:)

Anonymous said...

Sadly a typically entitled medical student grad whose never been criticized…..I once had an intern who we gave a rather outstanding evaluation to, but we noted that “he could accept feedback more constructively”. He chose to argue with us over that, wanted it changed as it was unfair and untrue. He had zero insight into the irony, even when pointed out to him.

Cherie Miot Abbanat said...

From Facebook:

In my experience with critiquing writing, it takes a couple of semesters or years for the student to realize the importance of your study of his/her writing, your constructive criticism focused on writing vs. content and the offer to move the writing to the next level. When the realization hits, it's such a great moment for student and teacher... By the way, I remember one of your comments on my writing that ended up zapping me out of some wrong thinking and helped me be more concise "Cherie, much said about nothing..."

Paul Levy said...

And you were so much more gracious!

Anonymous said...

Paul,

While I agree with many of the comments above - and also am put off by the writer's response - I have to say I'm quite dismayed that you would publish these communications on your blog, even deidentified. I appreciate your blog - and your shared perspective on many complex and hard hitting issues, but this was a private communication in a safe space. I worry this thread may make some think twice about having candid dialogue in the future. Please keep up the great writing and great work, but felt this was a view that needed to be shared.

Paul Levy said...

I see your point and also gave it great thought before publishing for that very reason. I finally decided that the lesson warranted exposure.

By the way--in what you would might likely describe as "two wrongs don't make a right"-- please note that my critique was not held in confidence by the author, as it was shared with others without my knowledge, and with my name attached.

G. B. Miller said...

As a sometime writer of fiction, I found your critique to be on the money. I did find it extremely odd that the person presented the book to you after it had been published (self-pubbed I presume).

Most people usually present the manuscript/story to others (i.e. beta readers) for critique and feedback prior to publication. Certainly that is what I did for my writing. Accepting feedback and applying what you can to your writing is the only viable way to improve on any story that you write.

The truly sad part is that that particular writer will probably not learn thing one about writing, so probably 20 years from now, his correspondence will turn people off. In this day and age, you have to be able to get your point across w/o being longwinded.

e-Patient Dave deBronkart said...

In case the writer (or any of us) is learning from this discussion, I'll add something that's apparently been around for years, though I only learned of it last month: TLDR

It's something people post on online forums, and sometimes in email threads: Too Long; Didn't Read. It matches my point that writers today, for better or worse, have a responsibility to hold the reader's attention to earn it continuously, to get to the point or at least to build continuing suspense - that inescapable curiosity about "Huh - how is this going to turn out??"

Except in academic papers, where one may indeed get brownie points just for saying one thing after another.