: I don't know how others read, but when I saw This man, this monster, has done something despicable. I did pause before the word monster. I read, in my head, as I speak, and the need

@Moriarity138

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I don't know how others read, but when I saw

This man, this monster, has done something despicable.

I did pause before the word monster. I read, in my head, as I speak, and the need for emphasis requires a pause to get the mouth into the right shape to punch the word out. So, I'd stick with italics in that case.

But in the case

I was expecting the president to be a middle aged man and then this boy comes in.

You're looking at using the pause to indicate surprise, but in this case the fact that the president is a boy is surprise itself. I'd leave the emphasis off and let the word itself do its job.

If you need the pause to indicate a reluctance to utter a certain term, one which the reader, or listeners in the scene, might take exception to, why not em-dashes.

I was expecting the president to be a middle aged man and then this -- doll -- comes in.

though I think these are more than brief pauses.

Not a definitive answer, just my own opinions and usage.

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