On literacy and language

Language is not only a tool for communication, but also about how we think

The advent of the printing press made text rather than speech the dominant force in shaping thoughts and opinions. Then came the computer age, and we are presently living in a future predicted, not entirely accurately, in 1978, when Prof Peter Wagschal of the University of Massachusetts wrote an article for The Futurist entitled ‘Illiterates with Doctorates: The Future of Education in an Electronic Age’. Complaining that print is “inherently centralised and elitist,” Wagschal looked forward to the 21st Century and “…a society in which knowledge, ability, and wisdom [will be] exceedingly widespread in a population that is substantially illiterate” because “electronic media will make everything there is to know universally accessible to all people of the globe”.

However, countering Prof Wagschal, John Simon, in his Paradigms Lost: Reflections on Literacy and its Decline (1981), highlights the folly of equating knowledge with wisdom.
Simon notes that wisdom is the ability to put information to good use: “But the kind of wisdom Wagschal intends cannot exist without thought…” Yet notwithstanding Simon’s withering criticism, I think that Wagschal’s views, at least on illiteracy in the computer age, are worth considering.

In an Irish context, the Organisation for Economic Co-operation and Development Adult Skills Survey 2023 shows that 21 per cent, or about one in five, of adults aged 16-65 in Ireland “are at or below level 1 on a five-level literacy scale. At this level a person may be unable to understand basic written information”.

Then there is the issue of using English correctly. One example of falling standards is referred to in what must be one of the most widely ignored journal articles ever written. In ‘How to improve your manuscript (or how to increase your chances of manuscript acceptance): Advice from an Editor’, published in Nephrology Dialysis Transplantation (1995,10:1103–1106), Dr AM Davison makes a valiant attempt to hold back the tidal wave of ignorance looming behind those negotiating the shoals and rapids of the English language. “The word ‘level’,” he suggests almost wearily, “means horizontal and not ‘concentration’. It can be used, however, when the concentration of a substance remains constant and unchanged.” Yet if one picks up any medical journal, most authors and editors perpetuate this universal blunder.

Such ignorance indicates the strangulation and mutilation of language, but does it really matter? Yes. First, because language is not only about communication; it’s also about how we think, a neglected skill that’s been a casualty of the information age. Second, in an Irish medical context, Eimear Nolan and Xiaoning Liang make some compelling points in ‘Determinants of cross-cultural adjustment among self-initiated expatriate medical doctors working in Ireland’, published in the Journal of Global Mobility (2022;10:289–311). In their study of self-initiated expatriate (SIE) doctors, Nolan and Liang “found that language ability influenced SIE doctors’ work adjustment. This finding is in line with past research indicating that the ability to speak the host language is important for adjustment.” SIE doctors, and other expatriate healthcare workers, can hardly be expected to acquire linguistic precision if mother-tongue speakers ignore the fact that words have specific meanings.

Jargon is an effective means of smuggling claptrap beneath the critical radar of unsuspecting readers and listeners. This was confirmed by Claude Cyr and Luc Lanthier who contributed ‘A cost-utility analysis of abolishing the law of gravity’ to the Canadian Medical Association Journal (2007;177:1536-1538), an excellent piece of nonsense on abolishing the law of gravity, which underlined the authors’ belief that “…using technological, statistical, and medical jargon gives us the opportunity to defy the laws of physics, mathematics, and medicine”.

One of my experiences of effective patient communication occurred many years ago when my elderly dad and I attended a consultation with a hospital pharmacist. Her task was to explain to the old boy why he was being given warfarin, how it would work, and how the dose would be determined. I listened to the pharmacist while looking at my dad and I knew that he could understand. I was impressed by the pharmacist’s use of everyday language, shorn of any jargon, and, crucially, by her patience and willingness to go back over ground that she had already covered to satisfy herself that my dad had a firm grasp of the points she had made.

I’m not expecting healthcare workers to be grammarians who quote Shakespeare at every turn. But, as John Simon indicates, language should be nurtured, polished, and encouraged to grow new branches – but “instead, we kick it around, blunt it, and smash it at the peril of our
very souls”.