Forecaster Forum: Learning to be a doctor, speaking a new language

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I lost my words.

Regular words like touch, chest, hips and aspirin have been replaced by palpate, mediastinum, innominates and acetylsalicylic acid.

My professors warned me that I would look at people differently after studying medicine; that my brain would start differentially diagnosing strangers walking down the street just based on what I saw. Does an uneven gait suggest an inflared innominate, or a person’s yellow tinted skin indicate a diseased liver?

They forgot to mention that in addition to my eyes seeing differently, my mouth would also speak a new language.

This language includes 14,000 new scientific words that a medical student reportedly learns in the first year of school. No wonder the beautiful words I read in undergraduate literature courses and wrote as the news assistant at The Forecaster, even the words I spoke in everyday normal conversation with family and friends, were displaced from my working memory to a far distant and dusty corner of my brain.

This transformation in thinking and speaking took only a few short months. In fact, during my first practice physical exam on a simulated patient, the only feedback he provided was that my language was too technical, and I should work on using simpler terms that my future patients will know. Before attending medical school, my concerns dwelled on transitioning from a creative writer and communicator to a methodical scientist. After three short months of medical school, my communication skills were overtaken by medical jargon. I explained to my simulated patient that I was palpating any potentially enlarged or tender cervical lymph nodes, but I forgot that he wouldn’t know what “palpate” meant, nor did he know that cervical means neck. I had forgotten that not everyone had been immersed in this new medical vortex of vocabulary.

Medical jargon can actually pose an unintended barrier between doctor and patient communication. I just finished reading “The Lost Art of Healing” by Dr. Bernard Lown, who spoke at the University of New England College of Osteopathic Medicine’s commencement. He wrote, “words are the most powerful tool a doctor possesses, but words, like a two-edged sword, can maim as well as heal.”

When he was a cardiology fellow at Brigham & Women’s Hospital, he treated a 40-year-old patient with a narrowed tricuspid valve. The attending physician “barked out that this was the worst case of TS” (medical jargon for tricuspid stenosis). The patient interpreted “TS” as “terminal situation” and had an anxiety attack. Her lungs filled with fluid and she died later that day.

But words can also heal. Dr. Lown later treated a man recovering from a myocardial infarction that destroyed half of his heart muscle. The man was certain to die from congestive heart failure before leaving the hospital. But one morning, he felt better, his vital signs improved and he was discharged in good health. Dr. Lown had no medical explanation for this sudden turnaround, but the patient returned six months later to explain his “miraculous recovery.” In the hospital, when Dr. Lown examined the patient, he insisted that his residents listen to this patient’s “wholesome gallop.” The patient decided that if his heart could have a healthy gallop, he couldn’t possibly be dying and willed himself to get better (little did he know a gallop indicates a failing heart). But it didn’t matter; the patient took the doctor’s “wholesome” description to heart.

I hope I have stories to tell one day of healing patients through my words. But, as medical training goes, I have a long time before I can actually practice this. First I need to balance learning thousands of new medical vocabulary words with remembering the non-medical language I use with patients.

But even once I do this, I am not sure there will be any words to adequately describe the experience of juggling the knowledge that comes with medical jargon and the reality of taking care of patients. Over the course of this first year, I was often speechless when trying to explain what it was like to learn what I was learning. How do you explain with language, medical or sentimental, the adrenaline rush of holding a human heart in your hands? Or learning that it starts beating 22 days after conception?

I doubt words of any kind can explain the awe of the human heart or the study of medicine, but I will continue to look for them, along with the other words I lost.

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pnms-forum_hayes-070809.jpgThe author lives in Topsham and is a former news assistant at The Forecaster. She just completed her first year of medical school at the University of New England.