A way with words

It is interesting how medical terms migrate into our everyday lives

As readers know, I love words. And I’m also fond of the British Medical Journal Christmas edition, which tends towards being quirky. So an article titled ‘Migration of clinical lexicon to colloquial slang’ in this season’s edition didn’t need a second invitation for me to open it up.

Written by NHS foundation doctor Nikki Nabavi, it revealed some surprising facts: It has been estimated that medical students learn 9,000 new words in their first year in college and about 55,000 over the course of their medical degree. And who would have thought that medical students learn more new words during their time at university than language students?

Not surprisingly it leads to those of us in the ‘medical club’ talking in shorthand. In relating to other medics, never again will we say coronary artery bypass graft, as CABG firmly takes root in our language centres. And while we risk confusing patients as these new words and phrases are used in our consultations or explanatory chat with relatives, until reading Dr Nabavi’s article I hadn’t thought of how our new language might leak into our broader lives.

“After commencing our careers, many of us notice how easily medical terms slip into everyday talk (‘I’ll vet that idea’),” she writes.

“This exchange is not carelessness, but creativity. Language, like medicine, evolves for efficiency and connection. When a borrowed phrase captures intended meaning more precisely, it will make its way into your personal lexicon.”

What follows are some alternative uses of terms from the common clinical lexicon, a shared phrasebook Dr Nabavi and her peers have often caught themselves using outside hospital and surgery walls.

Here are some I can identify with:

▶ Mane. From Latin, used in medical notes meaning tomorrow morning. Often found in text messages from doctors. For example, “Can I have a lift with you mane?”

▶ Acute/chronic. For example, “I’ve become acutely aware that…” or, “He’s chronically late.”

Professionally, time looms large for doctors and not surprisingly it is reflected in our day-to-day use of language. And place requires precision in medicine, which means precise terminology leaks into our references to everyday spaces. How easily do you refer to geographical location using the terms medial or lateral, which were probably burnt into our subconscious from our time in the anatomy lab?

And what about NAD and PRN – how quickly they become part of our extra-medical lives. You want to tell someone that everything is okay, so what better expression to use than no apparent disease (NAD). And if you want someone to take something as required, the faithful Latin acronym PRN slips easily into conversation.

I have become an inveterate user of +++ and +/- in my text exchanges when I need to either emphasise a point or to convey an element of uncertainty about whether something may happen or not. And which of us hasn’t adopted the word secondary outside our medical lives as a concise way to capture causality. For example, “I won’t be able to make it, secondary to the train being cancelled.”

Whether it’s generational or cultural slang, incorporation of other languages, or workplace terminology, there is endless renewal of language. Words migrate where they are needed, Nabavi notes.

A separate Christmas piece put together by Matt Morgan, an intensive care consultant, looked at medical neologisms in the form of a dictionary for medicine’s unnamed moments. It includes 25 ‘new’ words that describe situations peculiar to medical life. Here are some of the better ones that emerged.

Beeperphantom: Hearing your pager go off when it has not.

Cursorcrawl: The glacial pace of an ancient hospital computer waking up.

Exitcall: The sound of your pager going off just as you’re about to leave work for the day.

Farsilence: The distant quiet you hear on a ward at 3am, knowing it can shatter at any second.

And my favourite. Storyhold: Keeping a patient’s life story in your head so you can tell it for them if the point is reached when they no longer can.

“This is not a dictionary of pathology,” Morgan says. Rather he sums it up beautifully as “a shared language for those who have walked the coded corridors of hospitals and carried home the scent, the silence, and the strange music of a shift. If medicine is about care, then naming the unnameable is part of that care – for patients, for colleagues, and for the quiet places inside ourselves that deserve recognition.”

Naming these moments is not indulgence, he adds.  “It is clinical housekeeping for the soul.”

Well said, sir.