|
Doctors Cut
with Medical Jargon I’m not talking about words
that doctors use intentionally as black humor, like GOMER (for Get
Out of My Emergency Room). Nor about ridiculously impenetrable
medical jargon. Or even the understandable, but dehumanizing
shorthand like, “Go see the gallbladder in room 3.” To me, cutting words are at
their worst when they are unintended, that is, when they
inadvertently reveal what the speaker – the doctor – really
thinks. There are lots of them. Take
“incompetent cervix.” Granted, this is a succinct way to
describe a cervix that can’t keep the womb properly closed
throughout a pregnancy. But we never hear the term “incompetent
penis,” do we? Want to bet that “incompetent cervix” was the
brainchild of someone who doesn’t have one, competent or
otherwise? Far worse is the common
phrase, “The patient failed chemotherapy.” Who or what really
failed here, folks? Why not say, “The therapy failed the
patient?” It’s not only kinder, but more accurate as well. Then there’s that old
chestnut, “non-compliance,” which doctors use when a patient,
like a balky, disobedient child, did not obey the doctor’s
orders, like not taking a prescribed drug. “Compliant” isn’t
much better – it still puts the patient in a one-down,
infantalized position. Another bad one is
“denies,” as in, “The patient denies alcohol use.”
Sure, it lets one doctor know that another has asked a
patient about this, but the not-so-hidden connotation is that the
patient is a liar. The term “adverse
reaction” to medications bothers Linda De Benedictis, the
founder of the New England Patients’ Rights Group. “It implies
the drug is okay, the patient was wrong,” she says, as if the
patient is the one in one million people for whom the drug is
harmful. “Then you talk to 10 other people and they’ve had the
same problem,” she says. To be sure, patients, too,
sometimes, patients use terms that grate, on me, at least. Like
“breast cancer survivor.” Obviously, this is a respectful way
to describe someone who’s fought a frightening disease, but
there’s something so P.C. and pink-ribbonish about it. What
about all those people with cancer who don’t survive. Were they
were any less heroic? Some doctors also have their
own pet peeves. For
Kay Jamison, author of
“An Unquiet Mind,” a book about her own experience
growing up with manic-depression and “Night Falls Fast,” about
suicide, it’s “failed suicide attempt,” which makes it sound
as though a person was not only despairing but incompetent to
boot. “It’s like the Puritan
ethic – you were unsuccessful at suicide,” says Jamison, a
professor of psychiatry at Johns Hopkins University School of
Medicine. Just as bad is “suicidal
gesture,” says Dr. Andrew Leuchter, vice chair of the department
of psychiatry at the UCLA Neuropsychiatric Institute. What looks
to doctors like a half-hearted suicide attempt may actually be a
serious attempt by someone who simply doesn’t know how to do it.
Less offensive but silly is the phrase “past medical history,”
adds Leuchter. What kind of history is there, other than
“past?” In an article called “Words
That Main, Words That Heal,” scheduled to be published in a
leading medical journal, Dr. Susanna Bedell, an internist at
Brigham and Women’s Hospital in Boston, dissects the meanings of
many medical terms that are unnecessarily insulting. A classic for sheer
insensitivity, she says, is “widow maker,” used to describe a
man with severely clogged coronary arteries. Just as awful, she
adds, is “deforming arthritis, used for patients with severe
rheumatoid arthritis. As a much-published poet, Dr.
Rafael Campo, a primary care physician at Beth Israel Deaconess
Medical Center in Boston, is exquisitely attuned to the potential
damage – and the healing power – of words. Doctors often say the patient
came in “complaining of ” something, which makes the patient
sound whiney, like “an adversary,” Campo believes. “It’s very
pejorative.” “I
am interested in poetry as an antidote to the medicalese that
seems like a weapon inflicted on a patient,” says Campo, the
author of “The
Healing Art: A Doctor’s Black Bag of Poetry.” Campo encourages
his patients to write about their medical experiences in their own
words. “Go back to what happened, in your mind,” he tells
them. “Write me a story or poem.” Perhaps most galling of all
the unfortunate medical phrases is one often used as a patient is
dying, says Dr. Lachlan Forrow, director of ethics programs at
Beth Israel Deaconess. When people talk about withdrawing life support, he says, they often say “withdrawing care.” In reality, Forrow says, “We never withdraw care. ..We just stop the respirator if it is no longer a caring thing. That is the opposite of withdrawing care.” Judy
Foreman is a Lecturer on Medicine at Harvard Medical School. Her
column appears every other week. Past columns are available on www.myhealthsense.com.
|
