Writing an accurate and coherent feature

A health feature for a magazine or newspaper puts its most important information first, opens on its subject and angle, threads one theme through to an ending that completes it, and explains what lay readers need in plain words without patronising them. It has to be accurate without alarming, and it is revised before it goes to an editor who may change it considerably.

The inverted pyramid

An article consists of a title, perhaps with a subtitle, sometimes referred to as the strapline, an introduction, a main body and an ending, and quotes, anecdotes and photographs should illustrate the text. ¹ Its structure can be thought of as an inverted pyramid, in which the most important information must come first and the introduction must follow on from the title and subtitle, grabbing the reader's attention. ¹ A writer has at most a headline and an introductory paragraph to sell themselves to readers, who will not look at the last paragraph to see what the article is about. ¹ The inverted pyramid is often considered useful only for news pieces, but it is useful to keep in mind for all articles, including features, particularly when writing for magazines and newspapers. ¹

Medical and science writers may be used to putting the most important information in the conclusion at the end, which is not appropriate for magazines and newspapers. ¹ A scientific article runs from background information through discussion to conclusion, whereas a science or medical news article follows the opposite order: it starts with the conclusion, which journalists call the lede, followed by background information for context and, depending on the story, some details from the discussion that can interest the reader. ²

Newspapers and magazines do not have a lot of space, because of the financial need to leave space for adverts, so every paragraph must contribute to the main theme, and paragraphs are ordered by the importance of their information, the most important at the beginning and the least important at the end. ³ Newspapers often have short deadlines that leave no time for several drafts, and the inverted pyramid then helps a writer organise their thoughts and write and edit quickly. ⁴

The title and the introduction

A writer should always think of a title, even though an editor will probably rewrite it, because a provisional title helps to focus the article and give it direction. ⁵ A title must grab the reader's attention and intrigue, amuse or demand a response. ⁵ Some titles, however attention-grabbing, need a subtitle to explain them, particularly if they are likely to be misunderstood: an article titled "A spoonful of sugar", for example, could have the subtitle "Why people with diabetes need not avoid sugar". ⁵

Titles and subtitles that could be attractive to magazines and newspapers include:

• "What you should know about coughs" rather than "Useful information about coughs"
• "When your eyes itch and your nose streams" rather than "The problem of hay fever"
• "Dialling for dinner? A look at which takeaways deliver the least fat" rather than "The fat content of takeaways"
• "Are you tanorexic?" rather than "The dangers of excessive sunbed use"
• "How big is yours? Why portion sizes can make you fat" rather than "Links between portion sizes and obesity"
• "Know your body. How your monthly cycle affects your diet" rather than "Hormones and dieting"
• "Come up smiling! How to bounce back from the blues" rather than "How to cope with emotional setbacks"
• "Boost your immunity now. Your winning winter wellbeing plan" rather than "How to help your immune system this winter"

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The introduction should be brief, give a taster of the topic to come, persuade the reader to keep reading and convey the author's angle on the subject. ⁷ Its readers may be half-asleep on an early-morning train or exhausted at the end of a working day, so it has to wake their curiosity and be compelling enough that they want to go back and read the rest if they break off. ⁷ Techniques include starting with a quote, perhaps from someone the writer has interviewed, an anecdote, a shocking statement or some striking facts and figures, and the introduction must reveal the topic and the angle the article will take on it. ⁷

In a science or medical news article, the lede captures the reader's attention in the first paragraph by telling them what is new, why the article was written and what its important message is, starting with why the study being reported matters, for example because something relevant was found that may help scientists develop new therapeutic strategies. ² The title of a scientific paper will not necessarily make a good lede. ⁸ A lede that introduces a news article with the words of a study titled "Loss of Frataxin Activates the Iron/Sphingolipid/PDK1/Mef2 Pathway in Mammals" will scare readers away as too specific and too scientific; readers are far more likely to read on if it starts by saying that "a new study in mice identified the mechanism through which loss of frataxin, the protein missing in Friedreich's ataxia, leads to the death of neurons", and that the finding could help in developing potential future treatments for the disease. ^{8, 9}

One theme through the body

The main body contains the bulk of the information. ³ The main theme must be threaded throughout the article to create a unified whole, all the material must be related to it, and anything not relevant should be removed ruthlessly. ³ The article must be coherent, its material arranged logically and linked skilfully. ³ The reader should be able to get the gist of the article from the first sentence of every paragraph, so the topic of each paragraph goes in its first sentence. ³

Working from conclusion to background means leaving out details that may not be relevant to a non-scientific reader, who, unlike a scientist, will not care whether a study was published in Nature or Science, or whether its authors used the latest microscope technique or the correct statistical tests. ⁹ A scientist's experience makes it tempting to explain everything in detail and leave little room for misleading conclusions, but for a non-scientific audience the writer needs to select what is truly important to the reader: are these results trustworthy, do they add anything to the research done in this disease, will they lead to a new treatment and if so when, and can they potentially help patients in any way? ⁹ Sorting the wheat from the chaff means addressing those questions while preparing the article and leaving out anything superfluous that may distract or confuse. ⁹

A writer must stick to the length they have been given, plan in advance how many words each section will get, and if they exceed it, edit by removing anything that does not support the main theme, however interesting or well written. ⁴

An article for a lay audience is broken into manageable chunks with plenty of headings, written from the outline prepared before starting, with the content then fitted around them. ^{10, 11} Headings give the writer a framework and a focus, make the article easy for the reader to digest, signpost a change in topic and help the reader find specific information. ¹⁰ Summary information goes in boxes, with plenty of bullet points where necessary, and an editor may break the material up further, taking quotes from it and putting them in boxes and sidebars. ¹⁰

Boxes of text or bullet points often appear in magazine articles and should not be overused. ⁴ Headings that can be considered for such sections include:

• When giving information: Did you know?; It's a fact
• When giving advice: Top tips; Helpful hints; Three golden rules; Dos and don'ts; Four ways to help
• When challenging misconceptions: Fact or fiction?; True or false?; Beliefs and myths
• When encouraging action: You need help if; Get help if; Warning signs; Call a doctor if; Ask your pharmacist if

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The climax and the ending

The climax of the article should satisfy or stir the emotions or thought and leave the reader with a lingering feeling, which helps make the article memorable, particularly if it has also said something important. ¹² The introduction and the end of a feature should work as a partnership that shows the reader where the writer is going and where they have arrived in examining the topic. ¹² An effective ending gives the reader a sense of completeness and reinforces the intention the writer stated in the introduction. ¹² If the feature suggests a question, the article should answer it and the ending should point to the answer or solution. ¹²

Language for a lay reader

Magazine and newspaper articles are usually written in an easy-to-read style of short, simple sentences in the active rather than the passive voice. ⁴ Adapting style not only to a lay readership but also to publications with different target populations is not always easy, and writing that is clear and follows the style of the publication has less chance of being changed. ¹³

A writer should beware of a fine, fluent, pompous or grandiose style whose sentences wash over the reader but say nothing: an article should flow and read well, but it must convey information, explanation and opinion, so that readers gain knowledge, understanding and insight from it. ^{4, 11}

Readers may have limited knowledge and experience of a topic, which affects the type and amount of information a writer gives and the choice of language, although the public is becoming increasingly informed about health and more familiar with medical jargon. ^{13, 11, 4} People who have a rare disease the writer is covering will have a vast experiential knowledge of it. ¹³ A writer should never patronise, with phrases such as "something we pharmacists call pharmacokinetics", and a term the reader may not understand that has to be included is explained clearly and simply. ^{4, 13}

One former science and medical news writer found the trickiest part of the job to be preparing a piece that is accurate, easy to follow and interesting to read until the end. ⁹ A scientist's background knowledge makes it tempting to resort to jargon and specific language to guarantee accuracy, along with the constant effort to avoid generalisations and the omission of important details that might produce misleading narratives. ⁹ It is especially tricky to report specific terms that are hard to put more simply, or the uncertainties and nuances that arise from a study's results analysis and statistics. ⁹ Specialised language is nonetheless discouraged for a non-scientific audience, who will likely find it difficult to understand and even boring. ⁹ Lay communication, in Joselita Salita's phrase, is not just taking out jargon and replacing it with more understandable text but a complete repackaging of the scientific message. ⁸ Replacing words is not enough to make a piece both informative and compelling; the enthusiasm of reporting must still be there. ⁸

Accurate, sensitive and slanted to the reader

Information must be accurate and up to date, because any error or ambiguity in a health or medical feature can kill. ^{13, 11} Messages given through newspapers and magazines can have a greater impact than those in professional journals, so the writing should not be alarmist. ^{13, 11} It should be sensitive enough for someone who has the condition to read, since it may be easy to frighten someone with a serious disease who has no knowledge of its implications, though this does not mean that writing about serious conditions should be avoided. ¹³

Selling copies is an overriding concern for newspapers and magazines, and it influences their viewpoint, style and content, so an article may need a slant that attracts the target readership, which may mean identifying with and bolstering the readers' sociological and political views. ^{13, 11}

One science writer holds that attempts at balance and fairness without analysis and context may paradoxically be misleading and mischievous. ¹⁴

Revising before submission

A first draft should never be submitted to an editor, since that is the best way to get a rejection. ⁴ The writer should print the article and reread it several times, leaving it at least overnight even when experienced, and delete sentences that seemed good when written but on rereading do not fit the theme. ⁴ Reading the article aloud makes awkward word order, rambling sentences and jarring transitions obvious, and any sentence that has to be read twice may need rewriting. ⁴ A layperson can be asked to read the draft and give an honest opinion on whether it is clear, readable and understandable. ⁴ Magazines usually have longer deadlines than newspapers, which gives the opportunity to polish the writing. ⁴

When writing, reviewing and editing their own work, writers can ask themselves:

• Are the content and length of the article the same as agreed with the editor?
• Is the organisation logical?
• Is the article consistent in theme and tone?
• Does the writing contain strong verbs and precise words?
• Are there too many adjectives and adverbs?
• Is the writing free of clichés and other well-worn phrases?
• Do the headline and introduction grab the reader's attention?
• Do the headline and introduction connect with the rest of the article?
• Do all the quotations add to the story, or are they there for padding?
• Are all quotations properly attributed?
• Does the first sentence of each paragraph summarise the content of that paragraph?
• Could the reader get the gist of the article from reading the headline, introduction, first sentence of each paragraph and ending?
• Do the ideas and the writing flow?
• Does the article read beautifully but say nothing?
• Does the ending complete the story?

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The questions should be answered brutally and the necessary changes made, and the finished article is submitted in the format the editor requested; in 2007 most editors accepted electronic submissions, usually in Microsoft Word or a similar format. ¹⁵ Deadlines must not be missed: newspapers may have only a short time to prepare, whereas magazines plan features months in advance. ¹³

What happens to the piece after submission

In 2007 magazines and newspapers considered readers much more important than authors and went to considerable effort to present content the way they thought readers would like, so a writer's work could be changed considerably, which could lead to disagreements with an editor, and a writer who did not like the changes had to look for other outlets. ^{13, 11} Unlike academic and professional journals, magazines and newspapers have no peer review system: an editor may seek a further opinion, but informally, so the writing has to please mainly the editor. ¹³ Few magazines send proofs, which editors may consider time-consuming and not worth the effort and delay to catch a couple of typographical errors, so a writer may not see the changes made to their article. ¹³

Award-winning features

"Life Lessons: Gravely Ill Patients Teach Medical Students about Listening and Compassion", a freelance article by Debra Bradley Ruder published in Harvard Magazine in January–February 2006, won AMWA's Eric W. Martin Award in the lay article category in 2007. ^{16, 17} It described a class that matched first-year students at Harvard Medical School with patients facing cancer and other life-threatening illnesses, which gave students an intimate view of the patient-family experience, teaching them how to be "a healing presence in the face of suffering", and gave the patients who volunteered a chance to help educate the next generation of doctors at a time when they themselves felt most diminished. ¹⁶ Ruder had written briefly about the class for Dana-Farber Cancer Institute, where she worked, and wanted to explore it more deeply, so with the faculty leaders' permission she observed the semester-long course in the spring of 2005 and interviewed both participants and outside experts in end-of-life care. ¹⁶ In crafting the article she focused on five particularly compelling student-patient pairs, and the magazine endorsed the project by giving it ample space and hiring a skilled photographer whose black-and-white portraits added drama to the spread. ¹⁶ The article was optioned for television. ¹⁷

"Outpacing Cancer", published in Nature Medicine in 2009 and given an Eric Martin Award in 2010, was written by Kirsten Dorans while she was an editorial intern at the journal. ^{18, 19} Assigned the topic of cancers evolving resistance to drugs, she focused on gefitinib and lung cancer as illustrative of that challenge in targeted cancer therapy. ^{18, 19} A little more than ten years before the feature, gefitinib became a new treatment for non-small cell lung cancer and initially worked remarkably well in some patients, but within a year some of them relapsed. ¹⁹ The feature told the story of some of the researchers working to uncover how tumours develop resistance to gefitinib and developing strategies to outpace evolving cancer. ^{18, 19}

Bridget Murray Law received an Eric Martin Award in 2010 for "New Attitude: More Doors Open for HIV Survivors", published in HEMAWARE in 2009, a retrospective piece highlighting the challenges faced by children who grew up with HIV in the 1980s. ¹⁹ In developing it she spoke to three young men who had been diagnosed with HIV when they were 4 to 11 years old, one of whom was kicked out of elementary school and one of whom grew up with family members afraid to hug or kiss him, and she found their stories a lesson in how people overreact and how ignorance creates fear. ¹⁹