The Percolating Proofreader

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

Questions From Users of the Manual

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