Doctors' Jargon

Physicians have long used medical jargon to impress gullible laymen. As far back as the 13th century, the medieval physician Arnold of Villanova urged colleagues to seek refuge behind impressive-sounding language when they could not explain a patient's ailment. "Say that he has an obstruction of the liver," Arnold wrote, "and particularly use the word obstruction because [patients] do not understand what it means." Such deceptions may still occasionally be practiced on patients, but this does not account for the impenetrable prose in contemporary medical journals, which are read mostly by doctors.

To unravel that alphabet soup, Author-Physician Michael Crichton (The Great Train Robbery, The Andromeda Strain) recently looked over some back issues of the New England Journal of Medicine. Crichton, who wrote novels even during his days at Harvard Medical School (class of 1969), was appalled by what he read. The style, he reported in the Journal, was "as dense, impressive and forbidding as possible." Examples:

-- Redundancy: The most common form is paired words, for example, "interest and concern," when one would serve nicely.

-- Wrong words: purely for only.

-- Too many abstractions: "Improvement in health care is based, to an important extent, on the viability of the biomedical research enterprise, whose success, in turn, depends..."

> Ambiguity: "Corticosteroids, antimalarial drugs and other agents may impede degranulation, because of their ability to prevent granule membranes from rupturing, to inhibit ingestion or to interfere with the degranulation mechanism per se."

-- Unnecessary qualifications:

"Many, but not all, of the agents also have valuable analgesic effects." "It is usually wise, unless there is good reason to the contrary..."

Even as late as the 19th century, Crichton says, physicians were writing with strength and conviction. Now, however, "voices are passive, modifiers are abstract and qualifying clauses abound. The general tone is one of utmost timidity, going far beyond sensible caution." Crichton finds it all very puzzling. "An eminent surgeon strides purposefully into the operating room each day," he says, "but to read his papers, you wonder how he finds the courage to get out of bed in the morning." Crichton has a theory about the use of obfuscating medical language. In explaining it, however, he unwittingly demonstrates that jargon is highly contagious: "Medical obscurity may now serve an infra-group recognition function, rather like a secret fraternal handshake. In any event it is a game, and everybody plays it. Indeed, I suspect one refuses to play at one's professional peril."

This file is automatically generated by a robot program, so viewer discretion is required.