In the newsletter last week, I said that I had been thinking about a new language pet peeve of mine and asked for yours. The one that has been troubling me: the use of "overweight" as a noun. As in, "a patient with overweight." With overweight what? Overweight is an adjective! That missing noun grates at my soul. It's like the opening scene from one of my favorite movies, "It's a Disaster," in which David Cross' character turns off the radio just at the finale of the "1812 Overture," leaving Julia Stiles' character feeling "unfulfilled psychologically." You can't do that. There are rules. A person is overweight. A person does not have overweight. Now, yes, some online dictionaries I've found do say that it can be a noun. But really, have you ever heard anyone who isn't fluent in jargon use it as a noun? We as a society must come together and stop it now before it becomes more widespread. The time is now.
I heard from many of you about your greatest (worst?) pet peeves. Dave D. Edwards and I agree on this one: "Acronyms!! Far too many, used too often," he emailed me. It's so true. I am constantly editing acronyms and initialisms out of essays. Just spell it out! If a piece looks like alphabet soup, my eyes start to glaze over a little. I think readers' eyes do, too.
Eileen Natuzzi, who does important and fascinating work on health capacity building in the Solomon Islands, pointed to one I've heard about a lot: "My biggest health language pet peeve is 'health care providers.' This generically lumps doctors, nurses, nurse practitioners, and physician assistants together. We are not all the same, our jobs differ, and as a surgeon I spent years on my medical education and surgical training. Am I better than nurses or PAs? No, but definitely different with different responsibilities and skills. In the U.S. there has been a systematic devaluing of physicians, and the term 'health care provider' has contributed to that."
Unfortunately I only have space to share one of the three pet peeves shared by geriatrician (among other things!) Joanne Lynn: "Calling trainee physicians 'residents.' That reflects the long-ago practice of these folks living in the hospital, but now, it gets confused when those folks serve people who live in nursing homes or assisted living, where they are 'residents' not 'patients.'"
Law professor Charles M. Silver co-wrote a particularly spicy First Opinion this week, so I shouldn't be surprised that his linguistic pet peeve made me think about something that hadn't occurred to me: "I believe that everyone should strike the word 'reimbursement' from their health care vocabulary. Providers are paid for delivering services, not reimbursed for shelling out cash. I haven't looked into the matter, but I suspect that the use of the word 'reimburse' has its roots in old ethics rules that discouraged docs from talking about their charges. Of course, discussions of fees should have been encouraged, not discouraged. Regardless, we should stop using a euphemism to describe providers' compensation."
And Kip Sullivan argued that much health care jargon "is designed to manipulate rather than enlighten. The problem began with the invention of the misnomer 'health maintenance organization' in 1970 by Paul Ellwood. Since then we've had to endure numerous other labels that imply the thing labeled actually does what the label says it does: managed care (really means 'managed cost'), 'pay for performance' (even though 'performance' can't be measured accurately and third parties will be in charge), 'patient-centered medical home' (implying doctors are 'centered' on something other than patients), 'preferred provider organization' (as opposed to, 'an organization that limits your choice of doctor'), 'accountable care organization' (leaving unanswered: accountable for what and to whom?), 'integrated' this and that (usually signifying horizontal and/or vertical mergers),and last but not least, 'Medicare Advantage.'"
All of these raise the point that jargon is most often to someone's benefit. Who might that be, in the case of "overweight" as a noun? I first came across it in a pharmaceutical ad that mentioned "people with overweight." Perhaps it's part of the shift toward seeing obesity as a medical condition rather than something to be ashamed of. That's great, but can we please just say "people who are overweight"? Or come up with a new word altogether? Even "overweightedness," clunky as it is, would be better. Please. Save me.
Recommendation of the week: Every couple of years, when I'm feeling low, I read one of my all-time favorite longform articles: Wells Tower's 2013 "The Old Man at Burning Man" from Esquire. Tower, his 69-year-old father, a cousin, and a Canadian economics professor emeritus named James Dean travel to Burning Man. What follows is touching and uproarious and pretty NSFW and just perfect. See also Tower's 2008 Outside article on traveling with his father to Iceland and Greenland.
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