Aargh, getting manuscripts is soooo depressing and I'm just going to go aaaaarrrrrrgh for a little while until I get it all out and get over it and send it somewhere else. Aaaaaaarrrrrrgh.
Actually, the process for this particular journal was very efficient. The assigned editor sent a few questions for me to resolve before she sent it out for review (and even getting to review is a good sign from this journal -- they do a quick reject on stuff they're sure they don't want). From the time she sent the paper out, it only took 8 weeks for 3 reviews to come back and get assembled and sent to me. That's pretty good.
The reviews fell into 3 categories, in descending usefulness: 1) Suggestions for reorganization or clarification; 2) Comments about flaws in the study design; and 3) Suggestions for lengthy additions, even though the paper was already right at the word limit (and it's not really that kind of paper).
In the first category, it's always useful to know what doesn't make sense to other people or what is incompletely described, even if it sometimes seems like maybe people didn't read closely. If people are missing something important, it usually means the presentation can be better.
The second category is difficult, because you can't change the study design once it's done, but reviewers ought to keep deficient studies out of the literature, but not every study can be perfect. I can try to do the best job possible of hedging my conclusions and implications with a nod to the study flaws.
The third category just annoys me. Are you really asking for the intro to be as long as a dissertation chapter? Because maybe you should flip through the journal and notice that most intros are a few paragraphs, and refer to the author instructions for the word count. If I add that, what would you suggest I cut? Some suggestions in this category can be used, but a lot of them have to be ignored, because the reviewer is asking for a different paper from a different author with different skills.
I did not run into a major aggravation of these kinds of review processes, which is when some half of reviewers love the paper and think it's the seminal contribution to the field this decade and the other half just can't hate you and your stupid paper enough and they hope you find some other calling please. All three reviewers in this case settled on the same level of kindly phrased but significant disdain. And it was also clear that all three reviewers spent serious time on the paper, which I appreciate.
(WRT my last post, I did get the med bump [which is actually the start of another entire post about doctor-patient communication and clinical decision making], which is why I'm actually so glib and resilient about this rejection, instead of deeply depressed and funked out like I would have been 6 months ago. Although I reserve the right to moments of pouting/hedonistic release for the rest of the day).