Hemingway and Faulkner: Simple Insights on Composition for Medical Writers from Two Iconic American Novelists

I must preface this article by admitting that I am neither a literary expert nor am I endorsing the lifestyle choices of either Hemingway or Faulkner. But, through my leisurely reading, I have identified essential features related to sentence structure and word choice that medical writers can learn from these two famous 20th-century novelists.

Today, we live in a plethora of writing styles. For much of the 19th century, however, American writers like Melville, Hawthorne, and Fenimore Cooper upheld earlier European stylists' extravagant and winding approaches. This began to shift in the early 20th century with the advent of a new era in American composition. One author, Ernest Hemingway, sparked the interest of fiction readers for a fresh type of prose. Rather than employing lengthy, intricate sentence structures filled with complex vocabulary, Hemingway distinguished himself through concise, punchy sentences and straightforward language.

Some might say that a fifth grader could have written such simple English as Hemingway—which is probably true. But the magic of his writing comes from his stylistic simplicity: the blend of brief yet descriptive sentences allows readers to create a vivid mental picture of the characters and scenery. Further, this also enables readers to easily follow the plot and not get lost in complicated sentences. This is evident in Hemingway's works, including the novels The Old Man and the Sea and A Farewell to Arms, which I have recently read.

Despite Hemingway’s popularity, William Faulkner, another early 20th-century American author known for several well-regarded novels such as The Sound and the Fury and Absalom, Absalom!, also captivated readers. As an antithesis to Hemingway, Faulkner became famous for his lengthy, meandering, complex sentences reminiscent of earlier European writers—his longest sentence exceeded 1,000 words. It has been said that Faulkner’s ornate and convoluted style likely reflects his life in the open, flowing countryside of the South, where he wrote most of his work. This contrasts Hemingway—who cut his writing teeth as a journalist—whose pithy, blunt style perhaps better mirrors his extravagant, cosmopolitan lifestyle.

Examples of each might better illustrate my point. This first excerpt is from Hemingway’s 1936 short story, “The Short Happy Life of Francis Macomber": “There was a good smell. He was tired. The sun was shining.”

It’s hard to envision a simpler sentence structure. Elementary-aged writers could certainly craft such straightforward prose. Yet, we can’t help but picture a man with droopy eyes soaking up the sun while enjoying a pleasant aroma. In contrast, here’s a passage from Faulkner’s The Bear:

“The dogs were there first, ten of them huddled back under the kitchen, himself and Sam squatting to peer back into the obscurity where they crouched, quiet, the eyes rolling and luminous, vanishing and no sound, only that effluvium which the boy could not place yet, of something more than dog, stronger than dog and not just animal, just beast even.”

This provides a more elegant expression than saying, “They bent down and saw some smelly dogs,” which, for many readers, and in contrast to Hemingway, presents greater sophistication and invites a broader range of interpretations.

The two were also known to have feuded. A famous example of this is when Faulkner said critically of Hemingway. “He has never been known to use a word that might send a reader to the dictionary,” to which Hemingway replied, “Poor Faulkner, does he really think that big emotions come from big words?”

These icons are undoubtedly exemplars of literary excellence, regardless of their style. I have come to understand, however, that many readers tend to prefer one over the other; some resonate with Hemingway’s simplicity, while others fawn over Faulkner’s elegance. But, effective writers need to know how to craft both types of sentences. How can medical writers use these two figureheads to model their sentence structures? The answer largely depends on the kind of writing and the intended audience.

Many types of medical writing—including regulatory submissions, manuscript and abstract publications, medical news, and CME writing—are intended for the eyes of regulators, scientists, and clinicians, all of whom have saturated schedules with little time for fluff. Therefore, a Hemingwayesque sentence structure might be, I think, more effective for engaging this type of audience: utilize data to tell the story instead of using elaborate language.

This does not mean, however, that there isn't a place in medical writing for Faulknerian prose. A prime example of this is narrative reviews—especially those that aren't intended to be overly technical. This form of writing engages the reader by presenting an intriguing story about a medical topic, such as immune checkpoint inhibitors, pulsed-field ablation, or acute myeloid leukemia. Consequently, someone who picks up a narrative review manuscript will likely appreciate a more complex, flowing sentence structure—à la Faulkner.

For medical writers, sentence structure and word choice selection primarily rely on personal preference, the type of deliverable, and the intended audience. In his seminal work, On Writing Well, William Zinsser asserts that great writers are shaped by “imitating” their favorite authors. I believe both Hemingway and Faulkner are intriguing authors to read, regardless of one's literary taste, and they can provide valuable insights into developing one’s writing style.