I was involved with a physician in the write up of a unique case report. In May 2022 we started the project. I wrote the introduction, case reports after interviewing the patients, prevalence data after running systematic review in three databases with 10,000 papers to filter and tabulated the results of that in a 126 page document as supplementary material, hired illustrator for a diagram with my own expenses and drew a pedigree as well. The physician who is more senior than me tasked herself with writing the abstract and discussion. I finished all my tasks in May 2022 last year. Since then till now end of June 2023 I am yet to receive her parts of the manuscript and I am very frustrated at this point since I haven't worked with someone with such a bad work ethic. I have basically run around to obtain patient consent and complete ethical approval since she hasn't lifted a finger. I feel like I am stretching myself and doing everything since she can't pull her weight. I'll summarise the time line below:

June 2022- October 2022 - She blamed and cussed the radiologist for nor providing images and that was the reason for a standstill.

October 2022 she firmly promised she'd get her laptop with enthusiasm and complete the paper. Nothing came out of that promise citing being busy with work.

March 2023 she said the same thing End of the month come what may the paper would be submitted to the journal. Again excuses about having calls in hospital and not finding time to write a 1 page discussion but promises to complete it April 25th when she will take time off work.

April 25 - May 5th - She said she wrote the part but somehow didn't click Autosave and lost her progress and that she suffers from anxiety because a patient who is an addict threatened her in clinic and she can't function as a result of it. She promised in ten days time she will recover and send the manuscript to me.

May 20th - I follow up. She says she is busy at work with on calls and couldn't find time. Promises she will resign in June and that'll give her time and liberty to write the abstract and discussion

June - she says she is having a surgery and needs time to recover. Following that she says she needs to work on her visa and travel plans, packing etc and promises to send the document in another week. I followup after a week and she says the surgery has caused her emotional issues and she is packing and busy. I think I lost all my patience at that juncture and this seems like a deadbeat project. I asked her yesterday let's set a firm deadline and she accused me for not being understanding. Having had her break 7-8 promises I can't trust that she will send the document next week. If writing a one page discussion needs 14 months (May 2022 - July 2023) I offered her that I'll just do if she has difficulty in completing the task but she can retain authorship by reviewing and providing feedback to the manuscript.

Excuses or circumstances are fine if it is a one off or twice but this is a pattern now of promising and not delivering. I cannot fathom why writing a discussion takes more than 14 months. This is not a 5000 patient RCT or a 30 year cohort study.

I have never worked with anyone behaving like this in the past. I feel like quitting this project that seems that it won't reach fruition because of her behaviour. I feel like telling her next week by Tuesday deadline that I want to resign from this project and withdraw my name as a Co author. I do not want to nuke the project by suggesting that I retract all my parts of the manuscript. After that it is free reign for her to write everything from scratch up to her own convenience whenever she feels like it. I am very frustrated and annoyed at this point.

What should I do?

  • "hired illustrator for a diagram with my own expenses and drew a pedigree as well". You already showed you will do anything to get the work published, now your collaborator is quietly waiting for you to finish everything, to pay someone to proof your writing and results and then ... to be first author of that paper. I will be realist: you are doomed.
    – EarlGrey
    Jun 28, 2023 at 7:24
  • "This is not a 5000 patient RCT" ok, but there is this: "prevalence data after running systematic review in three databases with 10,000 papers to filter and tabulated the results of that in a 126 page document as supplementary material".
    – EarlGrey
    Jun 28, 2023 at 7:29
  • Thank you EarlGrey :). I am happy to push it to finish line, I'll do as both you and Dr.M suggested, complete the work and send her the manuscript for review :)
    – Free Soul
    Jun 28, 2023 at 13:19

2 Answers 2


I am sorry for your situation.

Could you give some regional details where you are based? That would help. Is she a resident or senior clinician?

I ask because I am a clinician myself and there are times where you simply cannot add additional work - simply because you are about to break. Remember that a regular clinician is on call at least once a week (24 hours or more), lacks sleep and usually the time to "block" a longer period to review papers. In addition, depending on her age, she may has to prepare for exams, etc. For many clinicians, case reports are of low importance in comparison to other papers.

Given the details you provided, I suggest to:

  • finish the case report yourself (do not offer it, simply send her a finished file)
  • send her the final file for review with one or two journal suggestions

Do not push her but push the paper You may be frustrated about the extra work but that is the way to finish it.

I have published more than 10 case reports in the last years. Some took two years or longer - simply because some overstressed co-authors did not contribute their part. The discussion of a case report differs from full papers, employ are more comparative style instead of an in-depth pathophysiological discussion.

You can do it!

  • Thank you Dr. M. I am based in the Middle East. She just finished her residency in 2021 so she'd be at the level of an assistant professor. I understand that clinicians are busy. My frustration is that promises are routinely broken instead of communicating that she is unable to complete the project etc following which I can try to complete it myself. Thank you for the solution I might just do that, my friends suggested the same as well.
    – Free Soul
    Jun 28, 2023 at 5:10

We know only your half of the story. And it is the story of someone strongly determined to push this paper (you even paid an illustrator out of your pocket!), while the co-author is having a bad moment in her life and therefore her working conditions are affected (let's hope her mental health is preserved).

Look at the goal, not at the way to get there. At this point you can take the lead and propose to write it as first author, and then put the effort in concluding it.

If you cannot do so, then for your peace of mind propose to publish it as a preprint somewhere, at least you can refer to it in the future.

Good luck and do not forget the sunk cost fallacy: no outcome of this work will pay back what you already emotionally and mentally invested in this work, be prepared to take a huge "loss" and move on.

  • Good point, OP could use his large "supplementary file" to create an own paper.
    – Dr.M
    Jun 28, 2023 at 10:33
  • Thank you EarlGrey I appreciate your comment :)
    – Free Soul
    Jun 28, 2023 at 13:18

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