I was rapidly tapping a request for an ECHO for a patient who was SOB with raised BNP and increased CTR on CXR, when I had a moment of recognition. I realised that I was rapidly disappearing up my own acronym. I had reached the apotheosis of medical speak where there were barely any recognisable words in my communique.
My mind cast back to Line of Duty, where the UCO in the OCG had gone quiet and the audiences complained that they had no idea what was going on. I briefly wondered why Jed Mercurio had decided not to ‘translate’ the lingo. It was clearly for reasons of authenticity and not wanting to patronise the viewer, but he was also drawing a line marking those in the know and the other. The club language helps to maintain the group identity, is a survival technique and distances itself from the object. It’s one thing to alienate an audience, but quite another to alienate patients. Many years of scandals and necessary introspection has led to the recognition that without effective communication, there can be no effective treatment or investigation.
It’s one thing to alienate an audience, but quite another to alienate patients
So, I was pleased to find that the health service is ditching words such as ’faeces’, ‘urine’ and ‘vomit’ in favour of ’simpler language that everyone can understand’. My insides did a little skip as I wondered whether we would finally ditch the dreaded ‘stool’. The little brown thing with four legs that sat in our kitchen and that I thought of when my GP grandmother first mentioned it to me. I went straight onto the website ‘A to Z of NHS Health Writing’ to find out what I should be doing.
Apologies to those of you having a mid-morning snack while reading this (I think I am safe). ‘Anus’ is out, as ‘we prefer ‘bottom’’ says the NHS under ‘A’. Right, OK, I mostly say that too. Moving swiftly onto ‘B,’ where there’s a plethora of scatological synonyms. ‘We do not use back passage’. Really? But how else do you describe that bit that goes from the outside to just a bit inside? I felt like I was back at school. The answer is ‘bottom’ again, and ‘rarely rectum’. I can see I’m going to have to drop my inner pedant.
Again, under ’B’ (as I said, the letter has a lot to answer for) ‘bowel movement’ simply says ‘see poo’. I can see where this is going. I scroll straight down to ‘P’, quickly taking a glance at the ‘F’, to check the fate of our old friend ‘faeces’.
Yes, it has also been liquidated – ‘see poo’. At last, I arrive at ‘P’ excitedly expectant (within reason) about the definition to end all definitions. I do have to confess to a mild feeling of anti-climax, when it simply states ‘we mostly use poo, rather than stool’. So, it was true, the little brown thing with four legs was finally out. That was good, but still I couldn’t help feeling that it had made a slightly ignominious exit.
Dr Charlotte Alexander is a GP in Surrey