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The Write Stuff: Bad Words

The Write Stuff is a series of occasional tutorials on writing for EMS from board member, frequent contributor, and creator of clean prose Mike Rubin. 

English—what a horror. Some words are pronounced the same but spelled differently. Some are spelled the same but pronounced differently. And some are spelled the same, pronounced the same, but have different meanings. None of this makes any more sense than, say, naming girls Michael.

I know two—not to or too—girls named Michael. I know two words, too—to and too—too similar to write right always, or all ways.

See what I mean?

Mr. Peterson, one of my eighth-grade teachers, tried to make a similar point about ambiguity by calling me to the blackboard and telling me to write, There are three tos [or toos or twos] in the English language.

Pretty funny, Mr. Peterson. I still can’t do it without brackets.

Mastering English used to be a prerequisite for high school graduation. I doubt that’s still the case. So much of the business and collegial correspondence I see is loaded with errors. I’m not talking about misplaced commas or ugly fonts; I mean sloppy spelling and bizarre grammar that skew my first impressions of the authors. Sometimes that’s unfair, but it’s not unusual to be judged by one’s words.

Should any of this matter to paramedics and EMTs? It depends. If you’re sure you’ll be riding an ambulance and filing automated PCRs for the rest of your working life, and you don’t text, post, tweet, e-mail, or blog, you probably don’t have to worry much about English composition. But if you are the least bit concerned about what others think of you based on your prose, have a look at these common mistakes:

Effect and Affect

Early in my EMS career, I thought I heard a doctor diagnose a patient with an “effective” disorder. That made no sense to me. How could something bad—a disorder—be effective, and in what way?

I’d confused effective with affective—the latter meaning something related to an emotional or mental state. Looking that up after my psych rotation made me think bad thoughts about the schools in Newton, Mass., where I’d learned affect is a verb and effect is a noun. That’s still true, but so is the reverse, which is one reason native English speakers flunk English.

Not only are affect and effect verbs and nouns (“The Haldol affected her; the effect was obvious. She became docile—an affect that effected transport.”), they can both be converted to adjectives, too: effective, meaning something that works, and affective, as in the first example.

And you thought pharmacology was hard.

One Word or Two?

In the second paragraph of this piece, where I was talking about girls named Michael, I implied always and all ways mean different things. They do. All ways is like saying “in every case,” as in “All ways of applying leeches in the field are forbidden,” whereas always is short for “at all times” or “at any time.” Always is the better choice almost always.

Here are other words we sometimes split or combine incorrectly:

  • Anymore and any more: “He doesn’t have any more unfused vertebrae, which is why he’s not a medic anymore.”
  • Everyday and every day: “It’s not every day I say this, but I’d like you to be my everyday partner.”
  • Anybody and any body: “Anybody seen any body that hasn’t been autopsied yet?”
  • Into and in to: An ambulance turning in to a garage is unremarkable, but an ambulance turning into a garage means someone’s going to need another ambulance. And one less garage.

Possession or Contraction?

Whoever invented English gave us very popular and fairly simple shortcuts called contractions—compound words with apostrophes replacing some letters. Thanks to those syllable-savers, we’re much more likely to say, and even write, “I don’t care about keychains for EMS Week” than “I do not care about keychains for EMS Week.”

The problem is that some contractions sound like possessive pronouns, such as it’s (the contraction for it is) and its (the possessive form of it). The two are often written interchangeably, which is one reason to buy audiobooks.

Other common contraction infractions are:

  • Who’s (instead of whose) turn is it to drive?
  • You’re (instead of your) partner says it’s his.

Don’t get me started on they’re versus their and there.

I literally couldn’t care less—or could I?

One of my pet peeves with English is literally, the overuse of which is literally a peeve but not a pet. That’s because, contrary to modern usage, literally means actually or word-for-word and is not a substitute for “I really mean it.” Many people who say “literally” mean “figuratively,” which is literally the opposite.

Another pet peeve is the expression “I could care less.” It used to be “I couldn’t care less” before undergoing some sort of sarcastic renovation. So now whether you’re capable of caring less is hardly worth mentioning.

I Really, Really Mean It

When literally fails to make a point, some proponents of English 2.0 resort to capital letters, exclamation points, and even quotation marks for emphasis. The more we see those gimmicks, the less impact they have.

For example, “No collusion!” is enough to get our attention, but capitalize the C, and “No Collusion!” starts to look like the title of an off-Broadway musical. Supersize that to “NO COLLUSION!” and we wonder why we’re being yelled at. Go full-metal emphatic to “NO COLLUSION!! NO OBSTRUCTION!! WITCH HUNT!!” and intensity becomes diluted by repetition.

Quotation marks should never be used merely to accentuate a word or phrase. And while we’re at it, let’s ditch the written version of contrived “air quotes” (the first two fingers of each hand “bracketing” a speaker’s self-indulgent utterance). None of us are that clever, even if we think we are.

Overdoing Honesty

Prefacing a pithy remark with to be honest, the truth is, or truth be told isn’t terribly convincing. Although there’s disagreement about whether those phrases are more often distractors or merely figures of speech, I think it’s safe to say none of them add quality or value to what’s being said.

The best ways I’ve found to be establish credibility are 1) cite sources and 2) don’t lie.

I’m literally finished.

Mike Rubin is a paramedic in Nashville and a member of EMS World’s editorial advisory board. Contact him at

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