This site is intended for health professionals only

It’s all Greek to me – and to them

Here’s a message for any consultants who might be reading: Γιατί επιμένουν να στέλνουν τους ασθενείς επιστολές που δεν μπορείς να κατανοήσουν γιατί είναι γεμάτο φρασεολογία, σας? Καθυστερημένους.

In other words, why do you insist, when you’re writing me a technical letter full of medical jargon about a mutual patient, on ‘copying in’ the punter? Dickheads.

That’s probably what I’ve said, anyway. It’s possible that I’ve just ordered some loukaniko from a proctologist. I’m relying on Babel Fish here, after all.

The point is, it’s all Greek to me, see? Which is, of course, what it is to patients, too. So why do specialists do this? No doubt it’s trust policy, and if asked to justify it, some suit will claim it’s all about sharing information and improving communication with patients. If they could see beyond
their reflex platitudes, they’d realise this is utter όρχις.

And it’s time-consuming όρχις, too. Just this morning, I spent an entire consultation listening to a perplexed plumber with chest pain asking why his consultant had asked him to arrange – and here he waved a letter and pointed to some words, which I read out for him – a ‘dobutamine stress echocardiogram’. CORGI approval is good, but it doesn’t extend to that.

It was, of course, a letter the cardiologist had written to his nurse lackey, and ‘copied to the patient’. There it was, ‘cc patient’ at the end. Obvious, really, so long as you can read size eight font, have a sound knowledge of the conventions of letter-writing annotation and aren’t paralysed with anxiety about a potentially knackered ticker.

Straight after him, I found myself desperately trying to explain how ‘non-specific and insignificant ischaemic changes’ on a brain MRI in someone being checked out for MS and who had received a copy of her scan in the post – without clarification and with no follow-up – was actually good news.

Whereas, a week before that, I was trying to interpret sentences like: ‘There was no lymphadenopathy or hepatosplenomegaly. The lymphocyte panel shows good proportions of the various lymphocyte subsets but for reasons that are unclear nearly all her T cells are of naive phenotype’. All that contained in a letter from a centre of excellence, cc’d to the child’s parents. 

You know I’m not making this up, because even in the maxed-out random gobbledygook-generator mode that I use to medically explain physical symptoms to patients with medically unexplainable physical symptoms, I couldn’t come up with such impenetrable garbage.

How oblivious to reality/stupid do you have to be not to realise that copied letters between health professionals are, to the average lay person, at best incomprehensible and at worst terrifying? Consultants are confusing information with communication – and it’s lazy, arrogant, thoughtless and uncaring. Provide a translated version, for Chrissakes, or don’t do it at all.

Because, inevitably, the fallout ends in my lap. And, while I’m OK being physician, counsellor, social worker, shoulder to cry on, citizen adviser, advocate, family therapist, commissioner and educationalist, being a translator is a hat too far. Especially when it’s a Greek hat.

Now, where the σκατά is my loukaniko? I ordered it ages ago.

Dr Tony Copperfield is a GP in Essex. You can email him at and follow him on Twitter @DocCopperfield