punctuation

About Semicolons

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Like a few others in the JAMA Network office, my other life has involved creative writing. Although you’d have to look one cubicle past mine to find someone with a Master of Fine Arts in the subject, I managed to walk fairly deep into creative nonfiction—enough to have published a bunch of essays, in fact.

My other other life has been in health research, so I’m right at home at JAMA Network. But I’m still reminded of creative work sometimes. In particular, semicolons work for me like a weird little literary siren song. No matter how technical the article I’m editing is, the sight of a semicolon tends to bring to mind the novelists Kurt Vonnegut and Aleksandar Hemon.

It’s Vonnegut who strikes first and hardest. In one of his many musings on the craft of writing, the Slaughterhouse Five author once wrote, “First rule: Do not use semicolons… All they do is show you’ve been to college.”

When I read it, I thought of how much I liked the guy—even though I actually don’t agree with his grammatical idea. I think semicolons exist for more than one reason; they serve at least 2 grammatical purposes, and the best of them can work almost like a musical note.

First, there’s the grammatical part. The purpose of a semicolon is to not only to act as a connection between 2 independent sentences that are complete in themselves. It’s also a sort of super-charged comma. It’s a way to separate clauses that already contain commas without adding any confusion for the reader.

Here’s an example from the AMA Manual of Style (which itself explains semicolon use): “Often a comma will suffice if sentences are short; but when the main clauses are long and joined by coordinating conjunctions or conjunctive adverbs, especially if 1 of the clauses has internal punctuation, use a semicolon.” That’s the first use: a semicolon that connects 2 complete sentences. (The Manual notes a similar use for enumerated lists presented in a sentence.)

Here’s another sentence, which needs semicolons even though it lacks independent clauses: “Data collection occurred at health care facilities in Hinode Mizuho, Nishitama district, Tokyo, Japan; Ålesund, Møre og Romsdal, Norway; New York, New York; and Rochester, Minnesota.” Semicolons offer clarity here. Using only commas here would make it harder to determine the number of places listed, while semicolons help the reader infer that there were 4.

The third use of semicolons is to put 2 ideas that go together close beside each other. This is less a matter of grammar than a matter of flow, speed, or style. Sometimes, connecting sentences with a semicolon means that, despite their independence, they read as a single complete thought. Here’s an excellent (nonmedical) example: “The driver’s head was cubical, vines of hair creeping up his neck; there was a gray swirl around his bald spot, not unlike a satellite picture of a hurricane.”

That’s the work of Aleksandar Hemon, the other writer who semicolons bring to my mind. Hemon is an established author and TV scriptwriter (disclosure: he has also been an acquaintance of mine). In a review of one of his books, Hemon is described as “ragingly addicted to semicolons…. You get the feeling that if he ever somehow failed to sneak at least one semicolon into a paragraph, he might suffer some kind of syntactic withdrawal—his overworked right-hand pinkie finger would start to sweat and twitch uncontrollably over its home-key, until he managed to calm himself down with the methadone of a comma splice or an em dash.” (The reviewer furnishes several amusing examples.) Notably, the review is positive, even effusive; the writer describes Hemon’s semicolon use as in part a rhythmic motif.

No word on published research into that particular disorder of semicolon withdrawal, but this makes a good point: Vonnegut can be right. Semicolons can go too far. In Hemon’s case, it’s a matter of stringing multiple sentences together like beads on a necklace. In JAMA Network journals, it’s more often a case of authors placing semicolons in sentences that need only commas (“Data collection occurred in Japan; Norway; and the United States” when “…Japan, Norway, and the United States” would do, for example).

But I can’t criticize. When my life was still centered on creative writing, I once wrote an essay about the work of Aleksandar Hemon (warning: it contains swear words and descriptions of violence). I just checked, and it appears I didn’t go light on the fancy punctuation. Vonnegut’s established disapproval aside, I’d used semicolons 6 times.—Sophia Newman

Faster Than a Sentence Fragment

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My dad held onto his old comic books from when he was a kid — Mad Magazine, Spider-Man, X-Men, and Batman. I know it’s unoriginal, but how could I not fall for the Caped Crusader? I romanticized Batman’s brand of justice: smart, deliberate, vigilante, under the cover of darkness, and always, always for Good. I read both crates of my dad’s comics when I was a boy, but Batman was the only series I came back to as I got older. I took the stories and their Good and Bad morality seriously.

Now I’m an adult and a professional editor. I thought characters like Batman didn’t exist off the page. Then I heard about the Grammar Vigilante. It’s relatively old news, but I only heard about the Grammar Vigilante last month. He’s been correcting storefronts in Bristol, England, for 13 years. When he sees an incorrect apostrophe (“Amy’s Nail’s” is one example), he goes out at night with his homemade Apostrophiser to correct the mistake by covering it with a colored sticker. That’s the kind of real-world vigilante justice I can get behind, and it’s something almost anyone reading this blog can chuckle about.

Strangely, I look at the Grammar Vigilante as seriously as I did Batman. What strikes me is his belief in making these corrections despite the risks. “I do think it’s a cause worth pursuing,” he says in the video. He denies his actions are a crime, quipping, “It’s more of a crime to have the apostrophes wrong in the first place.” Despite the joke, he defaces private property and could face legal action if he is caught.

I believe in the Grammar Vigilante.  The AMA Manual of Style includes chapters on grammar, plurals, and capitalization and quite long chapters on punctuation and correct and preferred usage. As the lattermost suggests, some of these rules are up to interpretation or preference but others are simply right. The primary goal of the written word is to communicate, and that is done most effectively, with the least confusion, using proper grammar and punctuation.

I have a personal tie-in to all of this. In high school, I worked as a server at a restaurant. One day, one of the managers posted a long document about new policies and expectations with explanations for each change. I read it standing next to a coworker and said that I wished I could copy edit the sheet to fix some small errors. She turned to me and looked hurt and disgusted, told me that was insulting, and said that nobody else cares about the right way.

I felt embarrassed, and I didn’t talk about the sheet with anyone else. I didn’t have the ability to put it into words then and still struggle arguing it now, but improper grammar, no matter how small, obscures meaning and harms interpretation. Proper grammar and punctuation aids my reading just as much as it does for those who don’t know or don’t care about it.

Are the Grammar Vigilante’s corrections helpful? Or pretentious? Or even noticed by most? Is there a difference between correcting public storefronts and private postings? By Batman’s morality, is he doing Good or Bad? I don’t know, but I support what he does. He’s not a hero, but I think he’s a silent guardian, a watchful protector. He’s my real-life Dark Knight.—Kevin Brown

En Dashes

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I didn’t know what an “en” dash was until I started working as a copy editor. Somehow I’d never even noticed them before. I knew when to use hyphens and em dashes, but the en dash was so confusing, no matter how many times I read the official description in the AMA Style Manual:

“The en dash shows relational distinction in a hyphenated or compound modifier, 1 element of which consists of 2 words or a hyphenated word, or when the word being modified is a compound.”

I understood how to use it with a hyphenated modifier, but the compound modifier tripped me up. I was overthinking it, spending too much time debating what the modifier was, and placing the en dash in the wrong place. Then someone explained to me that you use it when a group of words represents a single idea and it started to make sense:

  • US army–enlisted population
  • Geographic Information Systems–based measures
  • gene-dose–dependent manner
  • B-amyloid–negative group
  • apolipoprotein E–related genetic susceptibility
  • estrogen receptor–negative breast cancer

In all of these cases, 2 or more words together represent the single thing (eg, US army, apolipoprotein E), which is your cue to use the en dash before or after the phrase.

Some style manuals recommend using the en dash for ranges, scores, or values that are related, but the AMA Style Manual reserves them for the hyphenated or compound modifier only.—Tracy Frey

Punctuation Gets Famous

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It’s great to see that copy editors are finally being given the positive attention we deserve. There are now “copyediting stars” like Mary Norris of The New Yorker; John E. McIntyre of the Baltimore Sun; Lynne Truss, author of Eats, Shoots & Leaves; and author and podcast personality Mignon Fogarty, the “Grammar Girl,” who “sparked what you might call a worldwide, syntax-driven fiesta.”

I have to admit that I am surprised as well as pleased by this trend. A while back, when I was taking a break from editing to be a substitute teacher, I wondered if texting-style spelling, the overreliance on spellcheck, and the absence of diagramming sentences in school meant that attention to proper spelling and grammar would become a lost art in the everyday world. Would people outside of scholarly publishing give a darn about, say, the serial comma?

It turns out they do. Witness the case of the Oakhurst Dairy in Maine. The Maine Legislative Drafting Manual does not approve of the serial comma; therefore, there is none in the state law regulating overtime: “The canning, processing, preserving, freezing, drying, marketing, storing, packing for shipment or distribution of: (1) Agricultural produce; (2) Meat and fish products; and (3) Perishable foods.” The ambiguity created by the lack of a comma after “shipment” resulted in Maine truck drivers winning a lawsuit that could cost Oakhurst Dairy $10 million. Some folks may find the serial comma superfluous—but I say that a little symbol that could save a company $10 million is nothing to sneeze at. That fact that so many articles were written about this case show that there is an interest in such topics.—Karen Boyd

Waffling on the Internet: To Cap or Not

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When I signed up to write a blog post on the decision this year by the New York Times and the Associated Press to stop capitalizing the term internet, I thought it would be a good way to come to terms with the decision by The JAMA Network to follow this style. My first thought had been, “Internet’s gotta be capitalized!” I’ve been capitalizing this word for a long time—since Google was invented and people could “surf” on it. I felt that it wasn’t right to use lowercase.

When the word is not initial capped, the wonder that is the internet seems somehow diminished. Reading about pros and cons, I discovered that feelings can run high on this subject, and people have very definite ideas about Internet vs internet. On the Grammarist’s website, people point out that there can be many internets—interconnected computers—but there is only 1 Internet, a kind of internet that would be hard to live without.

Alas, the internet is no longer a magical place—it’s something mundane, like radio or television or cable. But I am old enough to remember when it did feel magical. There weren’t many things to look up or opportunities to surf, but you just knew those days were coming.

On the one hand, as several Grammarist commenters pointed out, originally Internet referred to the internet delivered by the Internet Engineering Task Force and the Internet Corporation for Assigned Names and Numbers—it was a very specific institution. Its precursor was the ARPANET, which dates back to the 1960s. One the other hand, according to Wikipedia, “the designers of early computer networks used internet both as a noun and as a verb in shorthand form of internetwork or internetworking, meaning interconnecting computer networks.”

I see both sides of the argument. Although old habits die hard, ultimately, one has to has to go with the flow, especially in the workplace. The internet, if nothing else, is all about change and updates.—Karen Boyd

 

 

Quiz Yourself

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Which of the following sentences is correctly punctuated?

We conducted a randomized placebo-controlled trial.

OR

We conducted a randomized, placebo-controlled trial.

ANSWER:

We conducted a randomized placebo-controlled trial.

When fewer than 3 modifiers are used, avoid adding a comma if the modifiers and the noun are read as one entity, such as randomized placebo-controlled trial.—Laura King, ELS

The Percolating Proofreader

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Editor’s Note: Here begins an occasional series by one of The JAMA Network’s favorite overcaffeinated proofreaders, David Antos. He has a deep affection for parts of speech, punctuation, and widows and orphans. (See what I did there?)

Twice in the past week I’ve done the unthinkable, which, however, I found my mind was eventually willing to grasp, as if the unthinkable could be thought through without losing its privileged status of noble ignorance. Less like a raccoon’s grasping a crayfish than a raccoon’s washing pastry till it dissolves, my mind was the beneficiary of an organic shampooing so dense and luxurious that I got a little smarter right there in the shower. No blinding insight in my trickle-down acuity, but a soft perception that there was meaning to be had in twice forgetting to close a parenthetical expression, which is the horror I’d committed.

Do you call parens open/close or opening/closing? Or left/right? I tend toward overexpression, so you can imagine I favor the suffix, but, to keep this clean and tidy, like my hair, let’s do open/close, even though “close” reminds me of “clothes,” which I was bereft of in the shower though in polite society am usually not. Which is the point my shampooed mind was shoring into, that society becomes impolite when punctuation falters. In 2 emails I’d sent that week I’d properly initiated a parenthetical expression that, when gotten to the end of, nakedly submitted itself to the rest of the sentence without so much as a stitch of close. Well, actually, the 2nd email contained a couple bracketed morsels at its conclusion, and the close paren was likely forgotten in the heat of bracketing. No excuse that, but a circumstance lending a ray of thought to the unthinkable. I’d also preemptively included in each of those emails the assertion that, in the interests of sending them in a timely fashion, I was not going back to proofread before hitting the button of no return. I had my out, yet when, after sending, I did proofread, I felt guilt, shame, inner filth, as if I were Michelangelo’s socks when he finally crept down the Sistine Chapel’s ladder. I’d poured my soul into words and left out the close parens, rendering that soul holier than the aforementioned socks. And not in a good way.

Later, I washed my hair and, as a person does when feeling hair and contemplating sin, reflected on the week that was and the week that will never be. I thought of the close parens that were not allowed to see the light of another’s eyes and of the violent omissions recounted in the week’s headlines, and it began not to seem out of place to think that faulty punctuation is at the heart of a world gone wrong. Not that a sloppy email is to blame for unthinkable atrocities, but the sense of purpose, order, and unblinking inclusion punctuation provides mirrors the sense of moral rectitude we only occasionally achieve in our dealings with each other. Punctuation is never evil, just misplaced or missing, and as I stepped out of the shower I cheerfully anticipated my next trip on public transportation, for I would no longer regard the other commuters as merely people but as pieces of punctuation, possibly shoveled into a seat of crumbs or wedged pielike into each other, but innately good, even angelic. —David Antos

Ch-ch-ch-changes

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To pass the time between stylebook editions, the JAMA Network staff keep an in-house file of little tips, tricks, guidelines, and style changes that have occurred since the last time the manual was published. Here is a small peek inside that file—2 things from this past summer.

The terms multivariable and multivariate are not synonymous, as the entries in the Glossary of Statistical Terms suggest (Chapter 20.9, page 881 in the print). To be accurate, multivariable refers to multiple predictors (independent variables) for a single outcome (dependent variable). Multivariate refers to 1 or more independent variables for multiple outcomes. (This update was implemented June 1, 2014.)

Cross-section, as a verb or adjective should be capped in titles as Cross-section; cross section as a noun should be capped in titles as Cross Section. (This update was implemented August 4, 2014).—Brenda Gregoline, with help from John McFadden

Questions From Users of the Manual

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Q: I can’t find anywhere in the AMA Manual of Style guidance on having back-to-back sets of parentheses in running text. Here is an example:

 The mean duration of surgery for the computerized-navigation group was 52.6 minutes longer than that of the control group, resulting in a statistically significant difference (P < .05) (Table 1).

I would prefer to see something like this:

The mean duration of surgery for the computerized-navigation group was 52.6 minutes longer than that of the control group, resulting in a statistically significant difference (P < .05; Table 1).

But does the manual have a preference?

A: Short answer: The style manual does not include anything about a pref on use of back-to-back parens, so this is something to think about including in the Punctuation chapter for the 11th edition. (Also, as you’ll see from the few examples below, because we don’t have a policy on this, it has not been handled consistently in our publications.)

Longer answer: Although our first response to your specific example was that we liked the avoidance of back-to-back parens and would favor (as you do) the inclusion of both items in a single set of parens, or would find either version OK, on further thought we decided that this answer was too easy and that often both sets of parens should be retained. Reasons: (1) Although in the example provided it makes sense to combine and use the semicolon, in more complicated sentences it might not be the best choice. (2) Table and Figure citations might be easier to find if not combined with other info.

Below are a few examples from The JAMA Network Journals that might illustrate where combining the information in parens might not be as desirable as keeping the parenthetical items separate.

A significantly higher incidence of SSHL was noted in the HIV group compared with the control group, with an incidence rate ratio (IRR) of 2.17 (95% CI, 1.07-4.40), particularly for the male participants, who had an IRR of 2.23 (1.06-4.69) (Table 2).

Here, keeping the table citation separate makes it clear that the table citation relates to BOTH values given in the sentence, not just the second one. Note that in our journals the first citation of a table or figure is set in different type (here, heavy boldface) to make it stand out.

In this example, where info was combined, it would probably have been better to also have kept the table citation separate as it applied to both bits of info in the sentence:

Mean mandible defect lengths were similar for patients undergoing FFF and LSBF reconstruction (7.8 and 7.7 cm, respectively); STFFs were used to reconstruct significantly shorter defects (mean, 6.0 cm, P<.001, Table 1).

And in this example, which does not include a table or figure citation, similar logic would also probably have made retention of back-to-back parens a better choice since the hazard ratio and P value apply to both, not just the second “n”:

Significantly more patients (n=174) withdrew from the placebo group compared with the chelation group (n=115; hazard ratio, 0.66; P=.001).

Splitting or lumping parentheses should depend more on content than strictly on style.—Cheryl Iverson, MA