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Soundings: Speech that irritates

2003; BMJ; Volume: 326; Issue: 7387 Linguagem: Inglês

0959-8138

George Dunea,

Interpreting and Communication in Healthcare

Professors of medicine exposed to case presentations by generations of house officers might be forgiven if they eventually develop an aversion to certain overused expressions. Perhaps most annoying among these is the constant use of “multiple,” which has completely replaced the older English adjectives “few,” “several,” and “many.” In the context of a skimped medical history, “multiple operations” means more than one, less than 20, nobody knows, nobody bothered to ask, and nobody cares. Perhaps a profession that once spoke in Latin retains a need to imbue its pronouncements with a certain degree of solemnity. Also highly irritating is “basically,” such as in “he basically has diabetes and heart failure.” This attempt to encapsulate a complex problem in a few words is highly contagious and I find I must be constantly on guard against using it. But used repetitively it acts like Chinese water torture and gives rise to hitherto dormant homicidal impulses. Other irritants are terms reminiscent of the Spanish Inquisition and suggesting that thumbscrews were applied during the anamnesis: “The patient denied haematuria” or “he admitted having epigastric pain.” Better sentiments are expressed when a “patient deserves to have a liver biopsy,” a fine reward for an obedient, compliant patient. Or when “we elected to do a biopsy,” possibly with a two thirds majority. Also troubling is “diagnosed with lupus,” what Jacques Barzun in Simple & Direct (Quill Press, 2001) calls “the nonsense that springs from with,” “an unidiomatic sleazy way of linking two statements that refuse to be more closely linked,” such as “married with three oldish children and a wife that preferred his absences.” Then there is the overuse of statistical terms: “The patient was significantly weaker than yesterday.” But was a paired t test carried out? Pomposities: “a biopsy was performed.” Did the audience applaud? “The patient developed a cough and presented with haemoptysis”—perhaps difficult to avoid. Finally there is emergent—correct according to the dictionary, supposed to be different from urgent, with which it rhymes, but truly a distinction without a difference. Whenever I hear it, it conjures in my mind the image of something unpleasant emerging from the dark miasmic swamps of the underworld.