The Secret Language of Doctors

In the firmament of admirable doctors, Brian Goldman is a shining star.  I’m not just talking about this TED talk–Doctors make mistakes. Can we talk about that?–which has had over one million views. More generally, he shines a light on aspects of the practice of medicine that are so embedded and pervasive that they are scarcely noticed.

So, it was with anticipation that I read his new book, The Secret Language of Doctors (to be published on April 1, but available for pre-order now.)  It turns out that you can read this book on two levels.  One is the way it’s described in its squib:

In The Secret Language of Doctors, bestselling author Dr. Brian Goldman opens up the book on the clandestine phrases doctors use to describe patients, situations and even colleagues they detest. He tells us what it means for someone to suffer from incarceritis, what doctors mean when they block and turf, what the various codes mean, and why you never want to suffer a horrendoma. Highly accessible, biting, funny and entertaining, The Secret Language of Doctors reveals modern medical culture at its best and all too often at its worst.

Yes, on that front, what’s presented is entertaining, giving the reader a vicarious view of the inside culture of hospitals.

But I suspect that Brian’s goal goes beyond entertainment.  The book presents a warning to the profession that the argot it employs is indicative of educational and structural problems.  Brian slips these points into the middle of his stories.  You could almost miss them.  At one point, he pauses to talk about efforts to create “slang police” to solve the language problem he has documented so well.  Instead, he says, we should “listen for trends that indicate problems that need to be addressed.”  Here are some examples:

Doctors call obese patients whales because they aren’t being taught that obesity is a disease.  They aren’t given equipment to transport bariatric patients safely. They arem’t given the tools to operate on these patients effectively.  Instead of [trying to ban] the slang, why not provide the education and support needed to diagnose and treat bariatric patients?

Instead of condemning slang such as cockroach and frequent flyer, teach ER physicians and nurses to attack the underlying reasons patients visit ERs over and over and over again.

If ERs have trouble with geriatric and psychiatric patients, then maybe the solution is to give such patients ERs of their own.

Better places for undesirable patients, better training and better equipment only go so far.  The greater challenge is how to get young doctors to want to treat them.  Both medical schools and hospitals need to recruit leaders and other role models who enjoy caring for twenty-first-century patients.

The alternative?

If doctors don’t take up the call, then the other solution is to find different health professionals who like these patients more than doctors do. [For example,] nurse practitioners are salivating at the chance to pick up the slack.

This is all worth a look.  The book will appeal to the lay public. But, I’m hoping that lots of doctors read it, too, to help them think about the underlying meaning of what they are saying in the corridors, break rooms, ICUs, and ORs.