Friday, September 28, 2007

The Currency Of Language

Throughout the history of civilization, human beings have used a variety of means to communicate thoughts and images. Primitive societies depended on gestures, drawings, rhythm, sound, and an early form of telecommunications known as smoke signals. More advanced civilizations developed motion into dance, drawings into art, rhythm into music, and sound into language. Over the years, telecommunications have evolved from smoke signals to semaphore, from wireless to satellite technology.

Many people are drawn to medicine because it promises an exciting career. But what makes medicine so exciting is not just the challenge of helping people manage their health. There is also the element of change. Medicine does not change simply because of new diseases. Nor are changes in the language used by medical practitioners merely influenced by the release of new drugs into the marketplace. New words -- and new uses for old words -- reflect how language is being used in society at large. For example: Since 1970, two new uses for the word waste have entered our vernacular.

1. To get wasted (on drugs or alcohol).
2. To waste (kill) someone.

Quite frequently, new terms and phrases make their way into the vernacular from a variety of subcultural sources. Terms like “hip-hop,” “frug,” “rave,” “scat,” and “reggae” emerged from the music and dance worlds and were popularized through radio. Rock bands like the Dead Kennedys or Butthole Surfers chose their names for shock value and/or marketing purposes. Current events often lead to the coining of peculiar phrases to describe the news of the day. For example: A series of fatal incidents led to the terms “disgruntled postal worker syndrome” and “going postal.”

Slang most frequently originates among teenagers whose sense of alienation from older generations inspires them to concoct words of their own. The ultimate irony is that the words once thought to belong to the cutting edge soon become a mark of how dated a person’s references might be. Terms like “disco bunny,” “feminazi,” “Trekkie,” “shrimper,” “far out,” “Deadhead,” “dudette,” and “Beemer” can pinpoint a person’s age, interests, and sensitivities (or lack thereof) with cruel precision.

A society’s language changes as that language must continue to reflect the population it serves. The more diverse and multicultural a society becomes, the more diverse the language of medicine becomes. With each change in the practice of medicine (as with any changes in our society), words must be created or chosen to define what is happening and to communicate new thoughts. In order to produce a coherent patient record, these words must be clearly articulated by the dictating physician and understood with the same clarity by the medical transcriptionist.

If any profession is filled with people who love words, it would have to be medical transcription. Perhaps even more than in publishing and editorial endeavors, medical transcriptionists form a nationwide army of wordsmiths. People who enjoy seeing how words are put together. People who enjoy seeing how words relate to each other. People who enjoy seeing a word used in its proper context. People who can find the same kind of joy and excitement in the discovery of a new word that they experience upon biting into a chocolate truffle and -- as the soft, creamy filling titillates their taste buds -- savoring the exotic flavor within.

If one were to examine common traits found in medical transcriptionists, they might include:

  • Curiosity

  • Strong reading skills

  • A passion for crossword puzzles and anagrams

  • A genuine love of language.

So why not let these people have some fun with their work? During the past 25 years, the words contained in Group A have become assimilated into our common language. Some are medical terms, some are terms from the vernacular:

Group A

ATM machine





satellite dish



shrink wrap

compact disk


sound bite



spin doctor








nose ring

target marketing


on-line service



outplacement counseling


freeze dried



frequent flyer miles

politically incorrect



relational database


global economy

salad bar


Suppose you try an interesting exercise: Spend some time with a physician who is 25 years older or younger than yourself. Analyze these terms by asking each other the following questions:

  • What does this term mean to me?

  • How does the proper use of this term reflect changes in the world in which I live?

  • How does the proper use of this term affect me from a personal standpoint?

  • How does the proper use of this term affect me from a professional standpoint?

  • If this term did not exist, how would I describe the phenomenon it identifies?

  • If this phenomenon did not exist, how would my life be different?
While you have your colleague’s attention, tell him you need his help in understanding some words from the following scenario:

“An ‘urban aboriginal’ patient who has been shooting speed comes to the Emergency Room complaining of burning on urination. As the patient is examined, the physician notices a variety of tattoos and body piercings, including a stainless steel stud piercing the tongue, a pair of nipple rings, a gold navel ring, a Prince Albert, and a guiche. In addition to the patient's urinary tract symptoms, there is concern about the possibility of the patient developing an abscess or infection.”

Look the physician straight in the eye and ask him to explain the terms “Prince Albert” and “guiche” to you. Ask him to draw you a diagram, if necessary, and articulate how he would describe any other body ornaments while dictating this patient’s physical exam.

What’s the point? Why bother?

It’s easy to throw words around just to make noise and try to impress people. It’s much more difficult to use words properly. Whether someone is wealthy, self important, or a figure of authority, a critical weakness in language skills can have serious repercussions in the workplace.

One of the main characters in the film The Opposite of Sex is a high school English teacher who has been having an affair with a much younger man. No matter how much emotional pain he is subjected to by his lover’s selfishness and thoughtlessness, the teacher cannot stop himself from correcting the young man’s sloppy grammar. Each time this occurs, there is a peculiar poignancy attached to the teacher’s unwillingness to let the language he loves be abused with such recklessness.

I remember how, when re-entering the field of medical transcription after a 15-year career as a freelance writer, the woman who was mentoring me warned “This is about working on a production basis. If you’re having trouble hearing what a doctor says, listen to it three times and then leave a blank. Move on to the next sentence. This is not about creating art.”

Yet any teacher can tell you that there is a stunning difference between math, science and language arts. One of the most interesting reality checks being delivered to today’s new generation of “knowledge workers” has to do with the use of search engines on the Internet. It’s all well and fine to want to search for information. But if you don’t know what you’re looking for – and don’t know how to define the parameters of your search – you might not get good results.

More to the point: if the word you type into a search engine’s data entry field is misspelled, the results of its search will be meaningless.

This can be a real “bummer” for people who are functionally illiterate and/or driven by a need for instant gratification. But them’s the rules, folks. You have to spell the word correctly if the search engine is going to function properly. If you don’t use a word to communicate its proper meaning, you are failing to communicate. With that thought in mind, let’s examine the terms in Group B that have become part of our popular vocabulary:




Neptune Society





gene splicing


artificial intelligence


significant other


Hemlock Society

sky pager



surrogate mother

CAT scan

intraocular lens


cochlear implant

in vitro fertilization


crack head






digital sound




MRI scan

virtual reality

extended family

needle exchange


Once again, try to spend some time with a physician who is 25 years older or younger than yourself. Analyze these terms by asking each other the following questions:

  • What does this term mean?

  • Was this term commonly used when I was in medical school?

  • How did this term come into existence?

  • How did this term become popularized in our culture?

  • How does the proper use of this term affect me from a personal standpoint?

What you will soon discover is the power of words to help or hinder communication. The lesson to be learned is that unless we understand the words we are using – and how those words may be interpreted by the person who hears us use them – we may easily fail to communicate with each other.

Compared to how medicine was practiced at the beginning of the century, the technology at our disposal is quite remarkable. Syphilis and polio are no longer major diseases. Organ transplants have become routine procedures. Laser keratotomies can be done in the office. Laparoscopic techniques have had a dramatic impact on the surgical suite.

Despite our technological sophistication, new diseases keep surfacing. Among those identified in the past 25 years have been Legionnaire’s disease, carpal tunnel syndrome, AIDS, chronic fatigue syndrome, and toxic shock syndrome. Although a cure has yet to be found, there is a much more sophisticated understanding of Alzheimer’s disease. Drugs such as Sustiva, Celebrex, Aricept and Viagra have entered the marketplace while many more are undergoing clinical trials.

Accompanying all of these medical breakthroughs are new words -- and new uses of old words -- to describe and enhance the practice of medicine. My suspicion is that if physicians, risk managers and hospital administrators were more impressed with the power of language -- and the love medical transcriptionists share for words (which, after all, are the basic building blocks of language) – then medical transcription itself might be regarded very differently by the powers that be.

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