Tag Archives: New England Journal of Medicine

Professional Writing 101: Dealing with Rejection

This is how it goes.

You read, gather background information, do research, and carefully write a manuscript. You put in so many hours or days or weeks that you lose track of how much time you’ve put in—which is a good thing. You re-read, edit, get feedback, revise, and do your best to produce an excellent manuscript. You upload it a portal where it magically finds its way to a professional journal editor. Then, because you can only submit a manuscript to one journal at a time, you wait.

A month passes.

You keep waiting.

If you’re lucky, you hear back from the journal editor via email within two months. You click on the email with a mix of anticipation and dread. Then, ta-da, you learn your manuscript was REJECTED.

The editor is polite, but pointedly informs you that this particular journal doesn’t recognize the magnificence of your work. To add insult to injury, your rejection is accompanied by critiques from three different reviewers. These reviewers were apparently named by Dr. Seuss: Reviewer 1, Reviewer 2, and Reviewer 3.

Some rejections are worse than others. Maybe it’s because your hopes were too high; or maybe it’s because the journal’s impact factor rating was so low. Getting rejected when the journal has an impact rating of “0” can bring down your self-esteem to a similar level.

And then there are the reviewers.

It’s important to remember that reviewers are busy, fallible, human, and unpaid volunteers. They’re also purportedly experts, although I’ve had experiences that led me to question their expertise. Many appear to have a proverbial axe to grind. Perhaps because they experienced scathing critiques in their professional childhood, they feel the need to pass on the pain. Sometimes they just seem obtuse. I’ve wondered a time or two if maybe a reviewer forgot to actually read the manuscript before offering an off-point “review.”

If you sense bitterness, it might be because over the past several years I’ve experienced an extra-large load of rejections. When the New England Journal of Medicine (NEJM) rejected my manuscript in less than a week, I was disappointed. But because the NEJM is the most prestigious journal on the planet, I didn’t linger much on the rejection, because rejection was expected. But when a decidedly less-prestigious professional group rejected all my proposals to present at an annual conference, I was deeply hurt, saddened, and angry. Reading the reviewers’ comments didn’t help.

At one point last summer, in a fit of self-pity, I decided to count up my two-year rejection total. I got to 20, had a flash of insight, and stopped. It was like counting cloudy days. My advice: Unless you’re especially serious about depressing yourself, don’t count up your rejections. If you’re into counting, put that energy into counting the sunny days.

One time, back when I was immature and impulsive, I received an insensitive and insulting rejection from a low tier journal. My response: A hasty, nasty, and indignant email lambasting the editor and his single reviewer for their poor decision-making process and outcome. Sending the email was immediately gratifying, but, like many immediately gratifying things, not reflective of good judgment. I never heard back. And now, when I see that editor at conferences, it’s awkward.

More recently, I responded to a rejection from a high-status conference with humility along with a gentle inquiry about re-consideration. Less than 24 hours later they discovered “one more slot” and I was in! It was a paid gig, for an excellent conference, and at a convenient venue. Bingo. Let that be a lesson to me.

Last month I received a different sort of journal rejection. It was an invitation to “Revise and Resubmit.”

Put in romantic terms, revise and resubmit is lukewarm and confusing. The message is, “I kind of like you, and you have potential, but I’m not ready for a commitment.” But if you’ve been casting out and reeling in a raft of rejections, revise and resubmit is a welcome flirtation.

I had submitted a manuscript focusing on suicide risk assessment to a reasonably good journal. It was a good manuscript. In fact, Reviewer 3 recommended publication. But Reviewer 1 spoiled my day by offering 23 substantial and picky suggestions. The editor, who wrote me a long and rather nice email, decided to go with Reviewer 1’s opinion: revise and resubmit.

Given that I’ve been reviewing the suicide risk assessment literature for a couple decades, I assumed I was well-versed in the area. But when I read through Reviewer 1’s suggestions I was surprised, humbled, and eventually pleased. Reviewer 1 had many excellent points.

Looking back and forward, I think this is what I like best about submitting manuscripts to professional journals. Basically, you get a free critique and although some reviewers are duds, others are experts in the field who provide you with a fabulous educational opportunity. There’s always so much more to learn.

The moral of this story and blog post is that the attitude we have toward rejection is far more important than our fragile egos (at least it’s more important than my fragile ego). In response to the revise and resubmit verdict, I’ve graciously accepted the feedback, engaged a co-author to help me, and we have now systematically plowed through the 23 recommendations. The result: Last week we re-submitted a vastly improved manuscript.

Now we wait.

Although I have hope for success, I also realize that Reviewer 1 may have a bit more educational feedback to offer. But this time around, I’m looking forward to it.

 

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