The surgeon dictates it in his scrubs, phone held close to his face.
ok so second night is the bad one. everyone thinks day one is worst and it isnt, the blocks still working on day one, it wears off overnight and then you feel it. take the painkillers before it hurts not when it hurts, by then youre chasing it. stairs, good leg up bad leg down, up with the good down with the bad, people forget this every single time. the knee will swell up like a balloon for weeks thats fine thats normal. but if your calf gets hot or sore or you get a temperature you call us straight away, dont wait till morning. i mean it.
That shouldn’t be published. No capitals and the sentences run into each other. He speaks like a man who has to deal with three more knees before lunch.
Everything a patient would need to hear is present. Why pain waits until the block wears off. Which leg goes first on the stairs. How much swelling is allowed, and the two things that mean call now.
Then it goes to review.
Legal first, they take “worst”, because it sounds like an outcome, and they take “that’s normal” because it sounds like a promise. “Don’t wait till morning” goes as well, that implies somebody picks up at 2.
Clinical governance softens it all. Some patients may experience. Take medication as prescribed.
Then comes Brand, they find it a little too plain and add a closing line about a dedicated team. The Agency then puts words in, words that rank and help in SEO and GEO and the three newly coined acronyms they are excited about.
Some patients may experience discomfort in the days following surgery. Please take medication as prescribed and follow the advice of your physiotherapist. If you have any concerns, please contact the clinic. Our dedicated team will support you at every stage of your knee replacement recovery in Dubai.
The calf and the fever line, the lines that could help get a man to hospital in time are now “any concerns”.
Everybody in that chain was careful. They made the edits their desks exist to make.
Here is what I might have done.
For most people, the hardest night will be the one when the nerve block wears off. It usually is the second night. You will feel the knee properly for the first time by that time. Make sure to take the painkillers before the pain builds, do not let it arrive first or you will be chasing it. When climbing the stairs, lead up with your good leg and come down with your new one. Your surgeon’s shorthand for this is: up with the good, down with the bad. The knee will swell a great deal, for weeks and often months, and that is to be expected. If your calf gets hot or sore, or you develop a temperature, call us straight away. Don’t look at the clock.
Every fact survives and the surgeon’s rhythm stays his. This is the version that I would want folded in my pocket as I take a taxi back home.
It is also missing “i mean it.”
I cut it, I did not notice I had cut it. A treatment page can not carry a line like that, there is no author and no capital letter, it might even look like a dead typo. It was the line that would have made a man ring up at 2 in the morning because his calf burns. Without it, he would just wait and see.
Gordon Lish cut Raymond Carver’s stories, most of them more than half. The book that came out of the cutting was what made Raymond Carver who he is today. Carver wrote to him, begging him to stop production. They were both right, and I think that is where the trouble with editing lies. I was the fifth desk. I sanded the paragraph down for readability, and in doing so, I lost the three most important words. “i mean it”
A writer’s job in that chain happens before any writing begins. Twenty minutes with the surgeon and a recording, so there is an original to go back to when the sanding starts to take too much. The surgeon in quotes, saying what he tells every patient he operates on, is his to stand behind, and it would read differently at the legal desk.
The pages I write for a psychotherapy practice here go to its clinicians before anything is published. I know what clinical review does to a paragraph. The line worth fighting for is the least polished one. Mark it before the meeting, with a reason next to it, or it comes back as “any concerns”.
I still don’t know how to put “i mean it” on the page.
The patient got the approved version.
He worried on the second night, when he didn’t need to. On the fifth, when he did, he waited till morning.
Second Draft is a series on the writing healthcare actually publishes, taken apart one specimen at a time. Every specimen here was written by me; no clinic’s copy appears here.
I write patient pages and physician profiles for clinics, reviewed by their clinicians before they go live.