Appendix 25 - Medspeak

by Michael Greger, MD and United Progressive Alumni

[ Medical School Resources | Appendices | Discussion ]

"It helps greatly to use... a term not understood." - 13th century medical code of professional ethics attributed to Arnald of Villanova on how to handle the layperson who asks questions the physician is unable to answer.[299]


Author-doctor Michael Crichton wrote about medical obfuscation in a 1976 editorial in the New England Journal of Medicine. In replying to the responses he received, he wrote, "I don't agree... that medical writing is inept. I argued that it was actually a highly skilled, calculated attempt to confuse the reader."[300] Another New England Journal editorial surfaced three years later entitled "English is Our Second Language":

Medspeak [referring to meaningless words like symptomatology] is an Orwellian invention.... The consequences of Medspeak - that is the consequences of pedantry, cryptic brevity, and the use of verbal smoke screens - are funny, so long as communication is not the purpose of spoken medical language.[301]

The readership responds: "Exposure to Medspeak actually begins in the first year.... Suddenly, sweating becomes diaphoresis, vomiting becomes emesis...."[302] Red to erythematous. As one can see, medical lingo is not always syllable-sparing - the direction to "put the table into reverse Trendelenburg" means to tilt it up.[303] "The victim is the patient, who, upon asking a simple question or overhearing his doctors talking, is left impressed, intimidated and confused...."[304]

Another letter: "When do arms and legs become extremities? Why do patients ambulate, visualize, articulate and masticate when the rest of us walk, see, talk and chew?.... Little wonder that physicians are accused of dehumanizing patients."[305]

What does "essential" hypertension mean? "Self-existing," according to my medical dictionary; in other words, we have no idea what caused it. Same with the word idiopathic ("self-originating"). But "iatrogenic" is my favorite euphemism. "Physician produced"; we caused it.[306]

From "Struggling to Stay Human in Medicine":

Something that sounds fairly benign in medical language can be suddenly potent when we say it in simple English. For example, we learn in medical school that the drugs used to treat cancer may cause emesis, alopecia, ulcerative stomatitis and hemorrhagic desquamating enteritis. We all know what these words mean, but our feelings would be vastly different if we consciously thought to ourselves: 'These drugs make my patient vomit a lot. His hair falls out and his mouth becomes filled with open sores. If I'm not careful, his intestinal lining may slough off and his guts fill up with blood.[307]


[299] Crichton, M. "Medical Obfuscation." New England Journal of Medicine 293(1976):1257-1259.

[300] Crichton, M. Letter. New England Journal of Medicine 4 March 1976:564.

[301] Christy, NP. ""English is Our Second Language." New England Journal of Medicine 300(1979):979-981.

[302] Newman, TB. Letter. New England Journal of Medicine 301(1979):506-507.

[303] Fugh-Berman, A. "Med School Blues: Year Three." Off Our Backs 17(1987):15.

[304] Newman, TB. Letter. New England Journal of Medicine 301(1979):506-507.

[305] Rowland, LP. Letter. New England Journal of Medicine 301(1979):507.

[306] Dorland's Medical Dictionary WB Saunders Company 28th Edition, 1994.

[307] Reiser, DE. "Struggling to Stay Human in Medicine." New Physician 1973(May):295-299.

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