What does this diagnostic conversation mean? That I watch far too much House? Perhaps, although if you recognized it as a discussion with Talb that means you are just as guilty. But why the jargon? Why does medical and biological science operate with such esoteric terms? Especially given that many of these terms have commonplace synonyms available. Why say humerus when you can say arm bone? Why encephalon instead of the brain? Is it like the raised platform at the pharmacy or the white physician’s coat? Are terms such as renal arterial stenosis really necessary?
It is just big words!
Learning the anatomy and physiology of the human body is just big words. I just used two of them. Medicalese is not a language, it is a system. We need not become bilingual, but learn to use a dynamic system which concisely explains bodily components and events. This became clear to me after sitting through the Western Civ course. Alright, I will admit I was actually playing Tetris, but I did cram the night before the final. The Greeks of 5th century BC were among the first to begin the rational study of medicine. Thus most, about 75%, of today’s medical terms were created by Grecian scholars. Roman scholars, such as Galen, added their own considerable Latin-based input as well. That we continue to use these foreign words is not out of historical courtesy but out of functionality. The rules of Greek, and to some extent Latin, as a language lend themselves easily to compound building (ref: Banay, 1948). For example:
Hypochondria. One can suffer from hypochondria. We can call this person a hypochondriac because they show hypochondriacal symptoms. English is not quite as modular. Someone who is sick does not suffer from “sick”. It is incorrect to say they are “a sick”, nor do they show sick symptoms. Unless you are an adolescent suburbanite the word sick is not an adverb.
Medicalese is a system composed of these, ancient, modular terms. Take my example above, renal arterial stenosis. Renal comes from the Latin word renes (kidney). Perhaps you have heard of a Nephrologist (a doctor that specializes in the kidneys). The title comes from the Greek word nephros which means — drumroll — kidneys. Stenosis is derived from the Greek word for narrow, stenos. We all know what an artery is and by this point I think you can guess which ancient civilization the word came from.
Alright so I get where the words come from and I see how they are modular. But can’t we spare the memorization and just say a narrowing of the arteries of the kidney instead of renal arterial stenosis? The image below is the physical exam portion of an Ontario Ambulance Call Report (ACR), sometimes called a run sheet.
Picture yourself sitting in the back of an ambulance travelling, lights and sirens, to a hospital. Your 58 year old patient is undergoing the worst chest pain he has ever felt. You must attempt to take a set of vitals whilst avoiding his third round of vomit, the flailing arms of his terrified wife and the IV needle you just dropped. With just the overhead lights. In a blizzard. Now staying in character which of these two statements would you choose to abbreviate into the above boxes:
58 year old male, sweating, blue tinged fingertips and earlobes, extreme chest pain in behind the front of his chest, low blood pressure , fast heart rate and a breathing rate quicker than normal. I think something may be causing the muscles of his heart to not get enough blood.
or: 58 year old male, diaphoretic, cyanotic, retrosternal chest pain, hypotensive, tachycardic, tachypneic. I think he is suffering some form of cardiac ischaemia, perhaps a myocardial infarction.
Tachy means fast (brady means slow), opnea means of the lung (tachy-pnea), myo means muscle, kardia means heart and ischaemia is greek for slowing of the blood. I think I would choose the second one, and what just pricked my foot?