Why we need the lede in journalism and medicine

This post was also published on kevinmd.com

In journalism, the lede is the first part of a news story. A good lede will entice the reader to read more. It contains the key points and gives the general idea of the article. Ledes are also crucial in the field of medicine. As a graduate student in journalism and a General Practitioner, I can appreciate the value of ledes in both fields.

When health care professionals communicate with each other, we use ledes all the time. Let’s say a doctor is working in a clinic and is sending a university student to the Emergency Department. The doctor is concerned that the student could have meningitis (a serious infection around the brain). The patient, let’s call him John Doe, is confused and has a fever. His blood pressure is low but his heart rate is high. After calling 911, the doctor calls the Emergency Department to communicate that the patient is coming in an ambulance. The Charge Nurse at the Emergency Department answers the phone. Consider these two scenarios. Which has a better lede?

I just sent an unstable 21-year-old male to your department because I’m concerned he could have meningitis. His blood pressure is 86/52 and his heart rate is 120. His temperature is 39.0, he is confused and his neck is stiff. His name is John Doe and he will be there in five minutes. The ambulance just left with him.

or

A patient came into my office this afternoon. His name is John Doe and he is 21. He started feeling unwell yesterday after he got home from basketball practice. His roommates brought him to my office today because John became confused. When I checked John’s blood pressure it was low and his heart rate was high. His neck was stiff and his temperature was up so I think it could be meningitis. He just left here in an ambulance and he should arrive to you soon.

In the first example, the Charge Nurse knows from the first sentence that John’s condition is serious. Already, she is thinking about the next steps, who she needs to notify and the supplies they will need. The word unstable gives an idea about how sick the patient is. The specific numbers describing his blood pressure, heart rate and temperature indicate the severity of his illness.  

In the second example, it is not clear until the end of the paragraph that the doctor is thinking that John could have meningitis. A couple of unnecessary sentences may not seem like that much extra time, but in medicine, time can be crucial. Especially in emergencies.

Patients can use ledes too. If you are a patient seeking medical care, it is best to tell your health care practitioner what you’re concerned about at the start of the visit. For example, if you think you might have pneumonia, start by saying that you are worried about that. This gives us a clear idea of what we should be focussing on right away. It will help us to ensure we provide you with the best care possible. 

Developing good ledes, whether in journalism or in medicine, is a skill. The more you do it, the better you get. It takes time, but in the end, it is worth it. In journalism, a strong lede means that the reader gets to the end of your story. In medicine, a strong lede makes for clear, efficient communication, helping to save time, or maybe even a life.   

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