Over the last few weeks I have seen usual advice for healthcare professionals more often than normally. Doctors should speak the language which is understandable to their patient. Just like with ‘It’s OK to talk’, I dislike this kind of advice, I think it’s meaningless, pointless and patronising. And this is what I want to write about.
Last time I saw this advice/appeal was a few days ago. I was walking to a meeting on the grounds of a large hospital and as I was passing what looked like a seminar room, I saw a PowerPoint slide saying:
If you don’t speak their language they won’t hear you.
A group of young people (doctors or nurses?) were listening intently. I, on the other hand, thought something like: when will they end this nonsense? Why? Well, because, to be honest, I have no idea what it means, as it constructs patients as half-witted idiots who simply have no possible access to the wonders of doctors’ language.
So, will you be using particular syntactic structures? Or perhaps you will consider using certain morphosyntactic features? What about phonetics? How about adopting my lexis? In other words, will you be dropping plural in favour of singular (“There’s places” I recently read in an academic announcement). Will you be saying “you was” as I might, or perhaps “you’m”? Will you swear as I do (I sometimes really wish you would say: “That must be a f.cking nasty pain”?). Will you be adopting my (apparently) posh accent and my use of the subjunctive? You might even consider saying “if I were” rather than ‘if I was”. How does it all sound? Mind you, these are only a few examples, I really could go on defining ‘my language’. Of course, you will need to make an assessment within a few moments and adjust accordingly.
Ahhhh, I understand, you don’t mean ‘my’ language, you mean ‘our’ language, that is to say, “our, the patients’” language. But then has it ever occurred to you that patients do not form one big homogeneous group? And I speak differently from my mother who speaks differently from a 6-year-old who speaks differently from….
Time to get serious, isn’t it? In fact, the appeal does not refer to ‘language’, it really refers to words and not even all words, just medical terminology (which is often referred to as ‘the jargon’), a perhaps a few other words which are perceived as difficult/posh, like ‘diatribe’ or ‘parsimonious’ or ‘aplomb’. Gosh, just writing them made me sweat.
So, let’s consider the essence of the appeals to speak ‘my language’? Well, in my view, it consists in a request to ‘dumb down’ what and how doctors say things. Doctors are asked to use vocabulary that we, the patient minions, are assumed to understand, as it is only doctors who understand medical terminology and use the ‘posh words’. Moreover, the wonders of objectivity and precision which you (obviously) find in doctors’ language are juxtaposed with the imprecision and subjectivity of patients’ language. Even if it is put nicely as in the tweet I quoted in the previous post:
Advice to health researchers: absorb the incidental, accept language is imprecise and loaded with resonance/meaning.
You can see how, shall I say, ‘untamed’ our language is. And as the doctors must deal with our language, they must also adjust their language to suit us. Otherwise we will not understand them. After all, how could we possibly understand words such as ‘hypercholesterolemia’? To make matters worse, the doctors’ task is, as a psychologist once wrote, ‘extract’ the true meanings as we, the patients, don’t really know what we want to say, so we just mumble along.
To be honest, I find the appeals to speak ‘our language’ not much more than patronising.
However, before I continue, I’ll tell a story. When I was a child I had severe strabismus. I had to wear thick glasses, sometimes with one side covered. This was time when very few children wore glasses, let alone glasses like mine. I was so visible! And, believe me, it was no fun. All the nicknames I was getting were based on my glasses and eyes and ‘four-eyes’ was the mildest of them. Although I am way past any trauma and emotionality related to it (those with psychoanalytic affinities are asked to stop it!), I still remember it and they are not fond memories.
Now, once in a while I have my eyes checked here in the UK. Before the test I normally say that I have a history of strabismus and once or twice I was irritated that the doctor or optometrist said something like:
Oh, you had a squint.
The first time I let it slide, the second time I reacted, politely saying that I had strabismus not ‘a squint’ and that I prefer medical terminology. Yes, I was looked at with some disbelief and a look like ‘What the….are you on about?!, but I don’t care. Squint is too colloquial for me. The bad memories are kept in check by strictly medical terminology.
It seems that the appeals do not consider such problems, just like the problems with all sorts of other more or less ‘embarrassing illnesses’, where I would be more than happy to learn a few more terms just to avoid the ‘patients’ language’.
There is more, though. The advice to speak ‘their language’ constructs two separate groups of people, one needing to adjust to the other, one speaking a ‘different language’ than the other, we speak the sophisticated language, they speak a simple (simplistic?) one. Even the appeal which probably does mean to help me, actually constructs me as very different from my doctor, as if the consultation were really not ‘ours’, as if it were not our joint responsibility to make it work. Yours and mine.
Needless to say, I am not suggesting that doctors should now start speaking in medicalese. Of course not. I am making two points. The first point is that there isn’t any ‘patients’ language’ and patients will have very different ways of speaking, different ranges of vocabulary and different needs related to them. Incidentally, believe it or not, that also applies to doctors! The second point is that any all-or-nothing rule how to speak or not to speak makes no sense. Medical, scientific, ‘posh’ terminology has its uses. I would even say more: it actually might make sense to say things that I will not understand!
But let me end with one final thought. I am yet to see a doctor who is afraid they might not understand the sophistication of a patient’s language.