Thursday, August 19, 2010

Euphemisms, Politics and the English Language

This is a good article,

A while ago I blogged about the tendency to substitute customer or client for patient and how it is subtly affecting medical practice. This article comments on our tendency to substitute less loaded words for loaded words such as substituting "unhealthy weight" for obese. Substituting "hearing impaired" for deaf and "visually impaired" for blind are other examples. It also points out that there is a drift with euphemisms gradually acquiring a loaded meaning. I am just waiting for the guy in front of me at the football game to call the ref visually impaired.

A few years ago I saw a patient with low back pain and dictated a consult in which I referred to her as mildly obese. Her family doctor showed her my consult and she arrived in ill humour at the next visit. "What do you mean I'm obese," she asked,"and how do you define obesity" I told her the I defined obesity as anyone fatter than me. This defused things, she is still seeing me and has lost a significant amount of weight (unlike me).

I still remember 1st year university English. This was a disaster for me. Although I was trying to get into medical school, my chosen career was to be a writer and medicine was just how I was going to support myself until I got published. I loved reading and thought I was going to do well in English. Unfortunately while I love reading, I really can't give a shzt about whether Robert Frost was contemplating suicide in "Stopping in woods...", whether Ophelia and Hamlet were lovers or what was "the theme of language" in Camus' "The Plague". I struggled through with a 66% which was my lowest mark until medical school.

One important thing I did learn in English 100 was the lessons in George Orwell's "Politics and the English Language" which was in our essay book. It still should be mandatory reading for anybody in any position of power or authority.

Orwell of course wrote 1984 and Animal Farm which some commentators have taken as his dismissal of socialism and communism, something the life long member of the British Socialist Party and anybody who has read any of his other books would disagree with.

Orwell's thesis if I remember it, was that people hide their unclear thinking behind overblown language. He also mentioned how politicians misuse the English language for their own malicious ends. "Shot while escaping" was a post WW2 example he gave. We have in the succeeding 50+ years come up with many by own our political and business elite. Laid off becomes downsizing which becomes right-sizing; torturing becomes extraordinary rendition. I could go on.

Healthcare has become a living example of Orwell's thesis. Patients have become clients who have become customers. Doctors, nurses, physios all noble professions with much to offer are lumped in as Healthcare professionals. We all talk about stakeholders, I don't even know what stakeholders used to be. Now that I attend more and more meetings, I find myself slipping into this bizarre newspeak. I have to sometimes step outside and slap myself in the head.

Orwell had a number of rules.

(i) Never use a metaphor, simile, or other figure of speech which you are used to seeing in print.

(ii) Never us a long word where a short one will do.

(iii) If it is possible to cut a word out, always cut it out.

(iv) Never use the passive where you can use the active.

(v) Never use a foreign phrase, a scientific word, or a jargon word if you can think of an everyday English equivalent.

(vi) Break any of these rules sooner than say anything outright barbarous.

The interesting thing is that reading Orwell's essay written over 60 years ago, one gets the sense that it could have been written last week. We have learned nothing. It is interesting that many of todays leaders in politics, business and administration are contemporaries of mine who probably studied "Politics and the English language" in 1st year English. It was in the Norton Anthology afterall.

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