Words to Ban

Someone in the support group posted a link to this article, which is over a year old, but which provoked some interesting conversation nonetheless. It's from Oncology Times, and is written by Dr. Robert Miller. The name of the piece is "Speak Up: 8 Words and Phrases to Ban in Oncology."

Dr. Miller describes reading something that invited people to write about what they thought the world could do without -- a kind of massive spring cleaning project. So he offers some words and phrases that he thinks the field of oncology could do without. Mostly, they have to do with the ways doctors and patients interact. An example:

* “OK?” I call this the Great Word of Medical Coercion, most often heard being used by housestaff or fellows on rounds and spoken in pseudo-interrogatory form (usually at the end of a sentence) when trying to convince a reluctant patient to undergo a particularly unpleasant test or treatment. Regrettably, this dialogue sometimes passes as informed consent. Have you ever heard this (one-way) conversation: “Next we are going to do a bone marrow biopsy and aspirate to see if your lymphoma has spread there, ok? Then we will send you to Radiology where they will draw out some spinal fluid to see if there are any lymphoma cells, ok? Then we will have another radiologist put a device in your chest to draw blood and give you the chemo, ok? Then we will start you on Hyper-CVAD chemo, ok?” Usually not ok.

It's a thought-provoking piece, one that calls out oncologists in some ways. One of his suggestions was the phrase "well-tolerated," as in a report on a treatment or trial saying "The treatment was well-tolerated, except for certain toxicities." Someone in the support group pointed out that "well-tolerated" doesn't mean "enjoyable." Personally, I tolerated Rituxan very well, at least in medical terms -- a drop in white blood cell counts, but few other long-term or severe short-term side-effects. But the sharp stomach pains, the chills, and the overall anxiety? I suppose I tolerated them, but did I have a choice? You could even say I tolerated them "well," if that means I didn't try to strangle anyone with my IV line. "Tolerated" is a funny word, implying that I made an active decision to put up with my situation. That's different from making the best of it.

The point is, sometimes we need to re-evaluate the words that we use, based on the situation they are used in, and the people they effect. I can certainly appreciate this, given that my job is to study the way language is used.

The article first appeared in print, so there's no Comments section the way there would be for, say, a blog entry. But it would fascinating to know how oncologists reacted to the piece.