The
Seven Words You Shouldn’t Use in Medical News
(First published on the predecessor to MayoClinic.com -- www.mayohealth.org -- on February 1, 2000)
When
I was a young reporter in Milwaukee, comedian George Carlin was arrested for
publicly performing what was then becoming a popular part of his routine -
"the seven words you can't say on television." Carlin ridiculed
network censors by expounding on the attributes of the seven words he claimed
could not get on the airwaves.
Over
a 25-year career in medical journalism and health care communications, I have
developed my own list of taboo terms - all of which appear in print and on
the public airwaves too frequently. I offer my own list of the seven words
you shouldn't use in medical news and health care communications. . I urge
colleagues - both health care providers and professional communicators - to
abandon their use for the sake of health consumers everywhere. I urge consumers
of all health care information to be wary of these words because they mean
different things to different audiences.
Cure always has been one of the most loaded and ill-defined
terms used in medicine or by the people who cover medicine as their beat.
Does it mean absence of disease? Does it mean no recurrence of once-existing
disease? Does it mean today, next week, 5 years, or a "normal life expectancy"?
Does it mean the same thing to doctors as it does to those they treat? The
term can be as meaningless as "expert," which has been defined as
anyone talking about anything more than 25 miles away from home.
Miracle lost its luster
after I talked with a man who had undergone a successful lung transplant.
The man had heard others describe the procedure and his outcome as a miracle.
He said, "This was no miracle. Moses didn't come down and part my chest
with his staff. A surgeon did it with a knife, and it hurt, and I had a lot
of problems afterwards. I'm very grateful, but this was no miracle."
There is no need to elevate the accomplishments of medicine to a supernatural
level. They are worthy of admiration for what they are: tremendous achievements
by highly-trained, caring professionals, working with health care consumers
who must do their part to increase the likelihood of a successful outcome.
This reality may be lost when we say "miracle."
Some health care communicators and journalists
love to slap the label of "breakthrough"
on many advances in medicine. The use of breakthrough would be less offensive
if the writers who use it also would agree to publish a long-term follow-up
- a batting average - of how many "breakthroughs" actually panned
out. A warning to health care consumers: be careful about putting too much
stock in any claim made by medicine or the media if it uses the term "breakthrough."
True breakthroughs are better measured over years, not overnight.
I've often wondered if the phrase "promising
development," used frequently in health care stories, shouldn't be reserved
for the business page. The word promising means "likely to be successful"
or "to give a basis for expecting." There is far too much uncertainty
in medicine for this word to be applied loosely in the coverage of medicine.
Unrealistic expectations are among the most dangerous forces that can exist
in the doctor-patient relationship. Again, I urge journalists to document
who is making the promise. It might come in handy, too, to publish the "batting
average" requested above.
Dramatic discoveries
seem to occur in the medical media more often than even in our television
soap operas. The ancient Greeks would remind us that drama could be both comic
and tragic, as can the use of the word "dramatic" to inject hype
into an otherwise important piece of research news.
Veteran science writer Victor Cohn once
chided medicine and the media by saying, "It seems like there's only
two types of medical news stories: new hope and no hope." A woman struggling
with cancer once told me she wished medical reporters would leave the word
hope out of their reports and allow
consumers to decide how much "hope" to assign to each story.
People hate being called a victim.
(Many even hate being called patients.) "Victim" should not be applied
to someone with a disease or a health condition. It should be reserved for
those health care consumers and consumers of news who are victimized by claims
of cures, purveyors of false hope, or by those who promise dramatic, miraculous
breakthroughs.
Let's drop these misleading and
dangerous words from our dialogue about health care.
Richard Horton, editor of The Lancet,
a medical journal, already has begun the process by discouraging use of the
word "conclusion" in scientific papers. Horton says that the notion
of any single truth, or conclusion, in medicine is nonsense, and that the
word, therefore, loses its meaning. "Rather," he writes, "the
word interpretation implies an uncertainty that seems more appropriate.
The interpretation readers take away from a piece of research
depends upon their own background and perspective, as well as their own personal
reading of the paper!"
Ill-defined, unfocused words can blur
our vision as we gaze into the future of health care. This is a plea for a more
disciplined selection of words by health care communicators, and for careful
reading, listening and viewing by health care consumers. It's a step we might
all take in our pursuit of improved health care.