Monday, September 7, 2009

The role of jargon

I wonder why we need little sub-languages within English? To make those who understand it feel better?  To decieve those who do not understand? Because it’s easier, shorter, quicker?

There is exclusive jargon in all fields of study. Words that baffle us and halt our understanding. Simple concepts become impenetrable to the newcomer because they do not ’speak the language’ and need a translator in order to understand. In the Netherlands, students can’t even apply for medical school unless they have previously studied Latin!

Recently a friend of mine studying primary education was being taught the concept of the atom in the most ridiculously highbrow way. We sat around my kitchen table one afternoon drinking peppermint tea, eating strawberries, making silly analogies, drawing atoms and colour-coding her periodic table, that she commented “oh my god, this is so simple – why do they have to make it sound so hard?” She is going to be a fantastic teacher because she can simplify concepts into analogies fit for a five year old. So why can’t her lecturers do the same for her?

A research proposal assignment that we are doing at the moment is like gobledegook to me but Dutchboy is promising to explain it because he says “It’s really easy – just made to sound hard”. What is the motivation for this? Do people who know the jargon just want to use it to sound sophisticated? Educated? What is wrong with breaking it down? Why do we have to write our exams & report back in class in technical, medical jargon when we will be explaining things to patients in THIER languages anyway?

The article below has a different take. It describes how the role of jargon, in medicine, can be a self-preserving mechanism. Insulating doctors from having to deal with the emotional reality, in order to give them space to think, clinically.

From page 25 of the 7th edition of the Oxford Handbook of Clinical Medicine:

By some ancient right we assume authority to retell the patient’s story at the bedside – not in our own words but in a highly stylised medical code: “Mr Hunt is a 19 year old *caucasian male*, a *known case* of Down’s Syndrome with little intelligible speech and an IQ of 60, *who complains of* paraesthesiae and weakness in his right *upper limb*…he *admits to drinking 21 units per week* and *other problems are…”

Do not comfort yourself by supposing this ritualistic reinterpretation arises out of the need for brevity. If this were the reason, and we are speaking in front of the patient, all that is in bold above could be omitted, or drastically curtailed. The next easy conclusion to confront is that we purposely use this jargon to confuse or deceive the patient. This is only sometimes the case, and we must look for deeper reasons for why we are wedded to these medicalisms.

We get nearer to the truth when we realise that these medicalisms are used to sanitise and tame the raw data of our face-to-face encounters with patients – to make them bearable to us – so that we can *think* about the patient rather than having to *feel* for him or her. This is quite right and proper – but only sometimes. Usually what our patients need is sympathy.

These medicalisms enroll us into a half-proud, half-guilty brotherhood, cememted by what some call patrongage and others call fear. This fear can manifest itself as intense loyalty so that, err as we may, we cling to our medical loyalties unto death (that is of the patient, not our own). Language is the tool unwittingly used to defend this autocracy of fear. The modulation of our voice & the stylised vocabulary, in the above example of Mr Hunt, ensures that we take on board so little of our paitent that we remain upright and afloat, above the whirlpools of our patients’ lives. In this case, not a case at all, but a child, a family, a mother worried sick about what will happen to her son when she dies, a son who has never *complained of* anything, has never *admitted* to anything, expresses no *problems* – it is our problem that his hand is weak, and his mother’s that he can longer attend riding for the disabled, because she can no longer be away from home and do her part-time job.

So, when you hear yourself declaim in one breath that “Mr Smith is a 50 year old caucasian male with crushing central chest pain radiating down his left arm”, take heed. What you may be communicating is that you have stopped thinking about this person. Pause for a moment.

Look into your patient’s eyes: confront the whirlpool.

[Via http://shesmedicallyblonde.wordpress.com]

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