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“Do I have cancer?” The patient asked

or

"Do I have cancer?" the patient asked

Should the word "the" be capital or small in this context?

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With quotations, there are a number of different punctuation styles. In some cases you have to refer to a specific style guide, for example this one from the Associated Press. Note that the AP recognizes there is a difference between British and American quotation style

Fortunately, it seems like every style guide agrees that the words following a complete quotation are considered part of the sentence, and you can ignore any punctuation within the quotation. Examples:

"Is it dinnertime yet?" the boy whined.

"Ding-dong, ding-dong!" went the doorbell. Susan rushed to answer.

Although many quote Patrick Henry and claim, "Give me liberty or give me death!" few seem truly willing to risk their lives for an abstract principle.

Naturally, if the quotation ends the sentence, the following word should be capitalized as usual:

The boy whined, "Is it dinnertime yet?" His mother patiently sighed, "No, not yet."

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    +1 especially for the contrasting case at the end. The next word is capitalised, as usual, only if it begins a new sentence. – IanF1 Aug 6 '18 at 20:34
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    I think you should start a new paragraph for "His mother patiently sighed ..." in the last example, but (hehe) I'm sure you can find a style guide that says you shouldn't :P – Au101 Aug 6 '18 at 21:12
  • @Au101 I agree. It's just an example. – Andrew Aug 7 '18 at 2:29
  • If the quote ends the sentence then it should be followed by a full stop (and the next sentence started with a capital). – user5505 Aug 7 '18 at 6:03
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    At times, it depends on what you want your character to do. Let me give you an example: What's the difference between these two sentences? (1)‘Help me, help me!’ she shouted, as she fell back. (2)‘Help me, help me!’ She shouted, as she fell back. (1) She shouted a call for help at the same time she is falling back. (2) She calls for help. And then she shouted (Eeeeeek!, or something like that). And then he falls back. And then ... – a.RR Aug 7 '18 at 7:02
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When to use capital letters: To start a sentence

There are no exceptions to this rule. This means that, after a full stop, we often use a capital letter.

If the previous sentence ends with a question mark or exclamation mark, you should also use a capital letter, ? and !, like full stops, indicate the end of a sentence.

Now let's get straight to the point:

I think if the quote ends with a period, you would write:

"He never knew that," she responded.

If the quote ends with something other than a period, put that in place of the comma and do not capitalize the word after:

"He never knew that?" she asked. "He never knew that!" she replied.

.

Some useful examples:

  1. ‘Help me!’ she yelled hysterically.
  2. I yelled out, ‘Here I am!’
  3. Will Kay come?’ ‘She may do.’
  4. ‘You forgot all about it.’ ‘No, I didn’t.’
  5. ‘I want to go home.’ ‘So do I.’ 6.‘You should have warned me.’ ‘But I did warn you.’

However if in the sentence you have a clause in parenthesis (brackets) or sequence separated by dashes, and if these end with a question mark or exclamation mark, you should continue with lower case after the second bracket or dash.

e.g. Is it always necessary to use capitals to start a sentence? The answer is definitely yes.

e.g. She told herself – was it acceptable to talk to oneself? – that the answer was obvious.

The use of a capital after a colon (:) varies depending on whether you are writing in British or US English, just as the spelling of 'capitalisation' and 'capitalization' are different in British and US English.

You should use a capital letter after a colon with US spelling but not with UK spelling.

Read more at scribendi.

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    "You should use a capital letter after a colon with US spelling but not with UK spelling." My response: this is false. – Acccumulation Aug 6 '18 at 22:27
  • If the colon introduced a bullet or numbered list of sentences, those sentences would be capitalized. But the word after a colon within a single sentence would not be capitalized. – fixer1234 Aug 7 '18 at 0:38
  • @fixer1234 When deciding whether to capitalize the first word of a bulleted or numbered item, consider whether the item is an independent or a dependent clause. If the item is an independent clause, capitalize the first word (Becker, 2011, para. 3). If the item is a dependent clause, do not capitalize the first word (para. 3). For examples, please see “Lists, Part 5: Bulleted Lists from the APA Style Blog. – a.RR Aug 7 '18 at 5:50
  • @Acccumulation "In British English, the first letter after a colon is capitalized only if it’s a proper noun or an acronym; in American English, the first word after a colon is sometimes capitalized if it begins a complete sentence." These are not my words. – a.RR Aug 7 '18 at 5:55
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    Example 7 raises an interesting point. In my opinion, if the word "that" is present, the quote is inside the parenthetical, and having "that" be lower case makes sense. But if the word "that" is omitted, then the second emdash can also be omitted, so the word "The" starts a new sentence, and it makes sense to capitalize "The". – Jasper Aug 7 '18 at 6:54

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