Artistry in Scientific Writing

A swirling night sky with radiating orbs, whirling clouds, and a lone, glowing crescent moon; it is difficult to comprehend that Vincent van Gogh painted The Starry Night during his stay at the French asylum shortly after slicing off his ear with a razor. One of more than 800 works by van Gogh, this masterpiece is one of the world’s most recognizable paintings. What is lesser known, however, is that van Gogh painted with bursts of productivity contrasted with bouts of deep despair. His work consumed him; a distraught van Gogh would commit suicide just 1 year after creating his most famous work of art. The process and purpose of painting, however, was therapeutic and meaningful for van Gogh, and his influence was powerful. The Starry Night captivates admirers with the swirling and natural flow of the artist’s brush strokes that encourage the observer’s eyes to drift across the painting. This style is not accomplished readily but rather is the culmination of specific techniques. Whereas creativity is the process of forming ideas, artistry is the set of skills or abilities to bring those ideas to fruition. To create art, one must possess both. Van Gogh was a master of these methods and expressed his thoughts through varying colors, stroke intensity, and layering of paint. Just as painting is challenging, good writing is also a perplexing art form, especially for the novice. The basic ingredients necessary to become a good writer are the same needed to become an accomplished painter or sculptor. The best scientific writing is storytelling.1 It is the art of solving mysteries where the writer is the detective identifying problems, answering questions through experimentation, interpreting results, and communicating those results to the outside world.2 Writing an article is systematic, but it need not follow a strict template. This article shares a framework on how to write engaging articles as a form of creative expression and presenting ideas with elegance (Fig. 1).Fig. 1.: Artistry framework.DEVELOPING THE STORY Think Innovatively The first challenge in writing is deciding what to write about. In academia, publishing productivity has long been considered an objective measure of achievement that can influence the rate of promotion and academic rank.3,4 “Publish or perish” is an ultimatum well known to academics, but quantity must not be valued over quality. An article should make significant contribution to a knowledge base and field of study. More importantly, as Malcolm Gladwell states, “Great writings have endings that transport you somewhere; if you are at the same place as you were when you started, then it was not a great story.”5 Thinking creatively is necessary to form innovative ideas. Developing an idea requires identifying a problem to solve.6 One method to determine a good story is to share the idea with different people and gauge their reactions to it. Without a plan, the rate of success is low. Artists often draft a concept in their minds to prime their canvas before starting. Scientific writing is no different. One must recognize the purpose to telling the story and think creatively about how to do it. Frequently, we think a story belongs to a specific world, so we stay within those boundaries; however, that can breed dullness and miss the truth. Conversely, thinking of an analogous world that has dealt with similar questions can inspire innovative answers. For example, how did David defeat Goliath? The spiritualist believes that David, the shepherd, had the power of God behind him and thus was able to overcome and slay the fearsome Philistine giant, Goliath. It is a classic story of triumph for the underdog. However, the endocrinologist may say it was never a fair fight because despite Goliath’s size, he likely suffered from a pituitary tumor causing gigantism, sluggishness, and bitemporal hemianopia, thereby diminishing this victory of the shepherd.5 Drawing connections between seemingly disparate ideas can be key to fully developing a story. There are multiple solutions to any problem. There are also many ways to present a solution to a problem. Identifying the optimal approach to understanding an issue takes time and introspection. Artistry in scientific writing permits one’s personal style to shine and encourages readers to glean something of the writer’s thought process. Salvador Luria, the Nobel Prize winning microbiologist, once stated “the differences are not just in the writing, but in the quality of experimentation … each [leading biologist] is a unique self and projects that self into every aspect of their work.”7 PAINTING THE STORY Organize Information Preparing an outline is one of the most important steps in scientific writing. A blank sheet of paper is analogous to a blank canvas. Sketching the outline of the swirling sky, the village below, and the flaming tree gave The Starry Night structure and a sense of direction before any colors or layers were added. Organizing information is vital when sorting through the myriad data and details pertaining to an idea. Models such as FINER (feasible, interesting, novel, ethical, and relevant) or PICOS (population, intervention, comparison, outcomes, and study design), as previously published, can help guide the writer.8–10 Without an outline, writing can quickly become disorderly without clear purpose. It is important to recognize that, although an outline is orderly, it is not a template. Artistic scientific writing does not recognize monotonous templates or mundane presentations. Repetitive templates that only list the number of cases, their routine outcomes, and complications, without further exploration of the “why,” keep the article and reader stationary. They are not transported somewhere new, and they do not expand their knowledge. Articles must be informative, creative, and inspiring. Articulate writing is the expected paradigm in Plastic and Reconstructive Surgery. Bland writing will seem stagnant, tiresome, and certainly not enticing to readers. Use Basic Techniques Fat over lean, thick over thin, and slow-drying over fast-drying—these are the 3 rules of oil painting. Each layer of paint should be progressively more flexible, thicker, and slower drying than the layer below it. These techniques prevent the painting from cracking as the artist works and dissolving into an unrecognizable piece and guarantees only helpful—as opposed to harmful—additions of paint. With scientific writing, it is also vital to give oneself time to create an article by layering in a systematic way. Add detail slowly, incorporate statistics thoughtfully, use proper grammar, and do not add sentences that lead to cracks in the paper. Inevitably, there will be a time when a canvas scraper is needed to remove brushstrokes—entire paragraphs may need to be deleted. It is important to recognize when destructive additions should be removed from an article. Although a writer should not be rushing for a deadline, if in a hurry, it is important not to skip any steps or forget core techniques. Van Gogh frequently painted in layers without allowing the base layer to fully dry, a technique known as alla prima or “wet-on-wet,” which permitted him to complete paintings in a single sitting. Although this technique does not offer downtime between sessions, it is impossible to do without tremendous expertise. Similarly, stellar scientific writing requires a strong foundation forged through diligent practice. Without devoting adequate time and attention to establishing a strong foundation, rushing an article is a recipe for disaster. Choose Your Voice The vibrancy and fine detail of The Starry Night are consistent with van Gogh’s style. His impressionist flair and bold use of oils, impasto technique to create a lively three-dimensional appearance, and palette knife made his style unique. In scientific writing, your voice needs to be strong, clear, and simple. The more complex the topic, the clearer it needs to be presented to make the puzzle pieces fit together in a way that is satisfying for the reader. SELLING THE STORY Know the Audience A proposal process is necessary to submit art to a museum. Before embarking on this endeavor, it is important to research the history and mission of the museum, build connections in the community, and create impassioned works. Likewise, knowing the audience and specifications of a journal are vital before submitting an article. Artistry in scientific writing not only pertains to the actual manuscript but also in distributing your work. According to Aristotle, the most persuasive people do the following 3 things: (1) they think about their audience and not about themselves, (2) they make their audience happy, and (3) they speak in their audience’s language. The proposal or cover letter is a gateway to being able to tell the rest of the story; it must also be well written and requires thorough research before submission of the manuscript. Simplicity Simplicity is the essence of a memorable article. One of the most highly cited articles in psychology is “The Magical Number Seven, Plus or Minus Two,” which discusses the limits of human short-term memory and memory span—although some argue that the magical number is actually 4.11 Regardless, the one magical message to remember is the importance of simplicity. The Starry Night’s vibrant blues were perhaps the simplest expression of van Gogh’s mental health and symbolized his deteriorating mental state. Artistry in scientific writing can and should mirror this same sort of simplicity. Articles should only highlight a few main messages to ultimately cultivate ideas and bring knowledge into the world. Scientific writing must be clearly written and easily read rather than abstract or superfluous. A “good writer never makes one feel as if one were wading through mud or picking one’s way with bare feet through broken glass.”12 It is difficult to eliminate ambiguity entirely, as the range of reader interpretations is unpredictable. However, by being a skillful reader and writer, one can evoke an intended meaning and provide maximal clarification without oversimplifying the content. CONCLUSIONS Submitting meaningful manuscripts and imparting artistry in scientific writing may require a paradigm shift from a tendency to follow a template. One must develop, paint, and sell the story of which you were curious enough to investigate, experiment, shape, and thoughtfully construct. In the words of van Gogh, “it is good to love many things, for therein lies strength, and whosoever loves much performs much, and can accomplish much, and what is done with love is well done.” Artistry, whether in painting or writing, requires love and creation of elegant ideas to ultimately have an impact on your dear readers. DISCLOSURE Dr. Chung receives funding from the National Institutes of Health, book royalties from Wolters Kluwer and Elsevier, and a research grant from Sonex to study carpal tunnel outcomes. Dr. Wang has no financial relationships to disclose. ACKNOWLEDGMENT The authors thank Michael Stokes, MA, MBA, for his thoughtful contribution and useful suggestions.