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  1. #1
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    Default comma before "and which"?

    Hi, I am not a teacher, just a student learning medical transcription and have some questions that have to do with the grammar usage and was hoping you could help me out here.

    Was wondering if we put a comma before "and which" in a sentence? I know we are supposed to do it for "which" but not sure on this one. Check this example out:

    She describes prolonged latency, which began during her second pregnancy and which persists.

    Should it be:

    She describes prolonged latency, which began during her second pregnancy, and which persists.

    ?

    Also, should "when she was postpartum' be considered supplemental here:

    This began in 1997 when she was postpartum and developed irritability, mood swings, tearfulness, anhedonia, feelings of being overwhelmed, guilt, and increased fatigue.

    and so add two commas:

    This began in 1997, when she was postpartum, and developed irritability, mood swings, tearfulness, anhedonia, feelings of being overwhelmed, guilt, and increased fatigue.

    Add these two commas, or no?

    Thirdly, is there a comma before 'subsequent to..' ? Check out this example:

    At this time, she describes multiple acute stressors subsequent to her husband losing his job.

    Should it be:

    At this time, she describes multiple acute stressors, subsequent to her husband losing his job.


    ?

    Fourthly, is there a comma after 'Denver' in this example?

    Subsequently, they moved to Denver where he is currently employed with Janus Investments.

    Should be:

    Subsequently, they moved to Denver, where he is currently employed with Janus Investments.

    ?

    And lastly, do you think "individual and couples therapy" is capitalized?

    individual and couples therapy versus Individual and Couples therapy ?

    I saw it written both ways when I did a search on Google so I wasn't sure..


    Thanks in advance for any help..

    Last edited by pinkwarrior235; 03-Nov-2008 at 11:54. Reason: to add info at the top

  2. #2
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    Default Re: comma before "and which"?

    She describes prolonged latency, which began during her second pregnancy and which persists.


    No need for a pause, so no comma. There is a unity between 'which began' and 'which persists', as opposed to: 'which began with all the hopes of the nation riding on its wake, and all the determination that he, as an individual, a majority of one, could muster to stem....'

    This began in 1997, when, postpartum, she developed irritability, mood swings, tearfulness, anhedonia, feelings of being overwhelmed, guilt, and increased fatigue.
    The emphasis is on what developed, not on 'when she was postpartum'.

    At this time, she describes multiple acute stressors subsequent to her husband's losing his job.

    Subsequently, they moved to Denver, where he is currently employed with Janus Investments.

    Individual and Couples Therapy
    (Trust me - I was a therapist.)

  3. #3
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    Default Re: comma before "and which"?

    She describes prolonged latency, which began during her second pregnancy and which persists.


    No need for a pause, so no comma. There is a unity between 'which began' and 'which persists', as opposed to: 'which began with all the hopes of the nation riding on its wake, and all the determination that he, as an individual, a majority of one, could muster to stem....'

    This began in 1997, when, postpartum, she developed irritability, mood swings, tearfulness, anhedonia, feelings of being overwhelmed, guilt, and increased fatigue.
    The emphasis is on what developed, not on 'when she was postpartum'.

    At this time, she describes multiple acute stressors subsequent to her husband's losing his job.

    Subsequently, they moved to Denver, where he is currently employed with Janus Investments.

    Individual and Couple Therapy
    This is if in a heading/title.

    If in the body of text, then Individual and Couple therapy/counselling.
    (You will see this as 'Individual and Couple's therapy', which does not make sense - why pluralize 'couples' and not make it 'individual's'? Seems to me this is an admixture of pluralizing, and some misguided idea of the need for possessive case: Individual and Couple's therapy.)
    Last edited by David L.; 03-Nov-2008 at 13:28.

  4. #4
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    Default Re: comma before "and which"?

    Ok, great help on all of what I asked! except for one thing:

    The sentence...

    "This began in 1997 when she was postpartum and developed irritability, mood swings, tearfulness, anhedonia, feelings of being overwhelmed, guilt, and increased fatigue."

    ...is something I can't change. In your reply, you reworded the sentence, but since I am a transcriptionist, we can't reword what the dictation person dictates, so the sentence has to have the same words. We can, however, add commas where we are suppose to put them. So knowing this, how would you put commas in the above sentence? (without rearranging or taking words out)

    Also, one last question. Is there a comma before "who" in this sentence:

    Parents in good health, except for her father who has mechanical back pain.

    or:

    Parents in good health, except for her father, who has mechanical back pain.

    ?

    Thanks, you're a great help...

  5. #5
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    Default Re: comma before "and which"?

    "This began in 1997, when she was postpartum, and developed irritability, mood swings, tearfulness, anhedonia, feelings of being overwhelmed, guilt, and increased fatigue."

    Then, as revised. My previous rephrasing serves purely to show that this doctor don't phrase himself proper.

    I'm being unkind. I know what it's like when dictating notes. My secretary would fix up my lapses. Only those without a smudge may be smug.
    Last edited by David L.; 03-Nov-2008 at 13:49.

  6. #6
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    Default Re: comma before "and which"?

    oh i see, you were just explaining it for me and using that as an example for your explanation! got it..heh

    yeah..i wish we could fix what the dictator says, but we can only do it when it's phrased so poorly that it's grammatically incorrect. In this case here, the phrase works but's a bad way of putting it.

    oh, almost forgot, put a comma before 'who' or no? (see above)

    Also..i'm struggling whether i should add apostrophe s to Couples therapy or take of the 's'. I think i'm supposed to put the 's' in though if the dictator says it.

    Thanks again for your help!
    Last edited by pinkwarrior235; 03-Nov-2008 at 15:36.

  7. #7
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    Default Re: comma before "and which"?

    Actually, I think it's: "Individual and Couples' therapy" with the apostrophe being after the 's'. I did a search on google and the first thing I saw in the list was this type of format...

    What do you think? You think that makes more sense?

  8. #8
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    Default Re: comma before "and which"?

    Then it would also be Individual's Therapy. NOT.

    It is 'Individual Therapy'
    It is 'Couple Therapy'; and "Individual and Couple Therapy", capitalized.
    You will see some Americans writing this as 'Couple's'. You won't find it at the Tavistock Centre!

    Couple Therapy Unit Adult Department, Tavistock Clinic

  9. #9
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    Default Re: comma before "and which"?

    Well the dictator on my sound file clearly adds an 's', so i have to put that in, so I guess I'll just write:

    "Individual and Couple's therapy"

    you said above that if it's within the text, then it's okay to have therapy with a lowercase 't'. It's not a title or anything in my sound file, so I'll leave that be.

    Should i put a comma before 'who' on the above example or no?

    Thanks man...

  10. #10
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    Default Re: comma before "and which"?

    re the 'who' and a comma - I'd omit.

    Also, I notice now that you are in Kansas, where your dictator, and others, may well use 'Couple's' for 'Couple'.

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