Wednesday, December 31, 2014

The Decline Of Medical Neologism

Medicine has always been good at inventing new terms to describe the human condition. Traditionally the words were based on Greek and Latin roots. That's why we get words like "hypokalemia" that can still stump new medical students, National Spelling Bee contestants, and electronic medical record software engineers alike.

Later on, the French made their contributions to the medical dictionary with lyrical terms all their own. Phrases such as peau d'orange (to describe the orange peel looking skin of advanced breast cancer) and cri-du-chat (the crying cat sound a child makes when he or she suffers from chromosome 5p- syndrome) flummoxed our less savoir faire young doctors. However, they do make the speaker seem more sophisticated and worldly if he can easily slip French words into a medical conversation.

American medicine has been in ascendency for the last couple of centuries. Therefore it is appropriate that American English words (not equivalent to British English) would make its way into a doctor's dialogue. Unfortunately we have not been quite as creative at inventing new elegant sounding phrases like the French.

For instance, we have descriptions like "cobblestone" to characterize the look of the intestinal mucosa of a patient suffering from inflammatory bowel disease. Or we get a contribution from the uniquely American melting pot with a term like "schmutz" to represent nonspecific debris on the body. Descriptively accurate? Yes. But decidedly pedestrian.

All of which leads me to a head turning note I saw on a patient in our hospital computer. It would seem that despite millenia of development of medical terminology, some young doctors feel they have to come up with new words to truly chronicle the plight of their modern patients. Thus the appearance of the phrase "stably-sick".

Now some purists would say that doctors should never refer to patients as stable. Stables are where one beds down horses for the night. But since it has been universally used to refer to patients who are neither deteriorating nor improving, I'm not going to quibble with it. But then this doctor can't quite bring himself to say the patient is stable. The patient is also very ill as illustrated by the need for IV pressors to maintain blood pressure. So is the patient progressing or sinking? Hmm. Let's think about this for a minutes. Since we can't make up our minds, let's just mash two words together and broadcast to every doctor and nurse who reads this note that despite our years of medical training we are too indecisive to truly understand this patient's medical condition.

Maybe medical schools should include a semester of French as part of the curriculum. That way if these new doctors are going to start making up words and putting them into legal documents, they can at least sound educated, not like graduates from the generation that gave us "twerking".

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