There’s a Massachusetts nurse practitioner I sometimes encounter in the course of my work who always closes her reports with, “If you have any questions about this dictation, dial . . .” and she gives a number. “Dial?” To judge from her voice, which is really all I have to go on, at most she is very early middle age, probably in her thirties--does she even REMEMBER rotary phones? I’m pretty slow to adopt new technology, but even I had a touch-tone phone back in the days when there was still an extra charge for it on the phone bill--1980s. Has she ever “dialed” a telephone number?
Then again, I’ll still have people ask that a “carbon copy” be sent somewhere. “Carbon copy?” I think I last used carbon paper in typing class in the mid-1970s. Photocopiers pretty much ended “carbon copies.” The “cc” at the bottom of a document or piece of correspondence now pretty much means “courtesy copy.” Granted, some of the doctors, etc., doing the dictating are long enough in the tooth to remember “carbon copies,” although I’m sure none of them have seen such a thing in more years than they can remember, aside from maybe some forms (but even those are mostly “NCR”--no carbon required--these days). That doesn’t really explain why, say, a medical resident born in the mid to late 1980s would ask for a “carbon copy.”
What I suspect is that at some point they learned that “cc” was an abbreviation for carbon copy; having no reference point, really, to them, “carbon copy” means simply, “copy.”
I get the same feeling sometimes about all the acronyms we use, or that medical professionals use--it is as if the acronym has become the de facto “name” of a given disease entity. COPD--chronic obstructive pulmonary disease--is perhaps my favorite example because I’ll often hear people talk about “chronic COPD,” apparently forgetting what the C in the acronym stands for. As transcriptionists, of course, in certain sections of reports--diagnosis, etc.--we have to expand all abbreviations, and we are also supposed to transcribe “verbatim.” Somehow I’ve never managed to convince myself that it would be okay, even preferable, to type “chronic chronic obstructive pulmonary disease.”
I cannot remember ever hearing a psych professional refer to post-traumatic stress disorder as anything but PTSD, or attention deficit hyperactivity disorder as anything but ADHD, although I’m sure it happens.
I suppose that it really doesn’t matter, in any real sense, whether something is called “CLL” or by the polysyllabic mouthful, “chronic lymphocytic leukemia” (although there are other expansions of that particular acronym, which could conceivably lead to confusion): The physician presumably knows what he’s talking about, and calling it one thing versus the other won’t alter his treatment plan.
Still, sometimes the increasing use--and, to my mind--overuse and over-reliance on acronyms threatens to reduce “medicalese” to a kind of pidgin English, in the same way that a similar process has reduced much “on-line” communication to the same.
I first went on-line in 1996, about a month before AOL (anybody remember AOL?) went “unlimited”--that is, started charging a monthly flat rate rather than a per-minute charge for on-line usage. All the acronyms so widely used now, all the “wtf” and “lol” and “roflmao” and “fml” and so on, were born in the days of per-minute charges. People held on to that language even after the advent of “unlimited use,” when you no longer had to worry about every character you typed into an “instant message” or a chat room costing you money. It evolved somehow from “necessity” to “cool.”
Medicalese seems to have followed a similar progression. What makes me think that is that I hear so many “lay” people--people who are not medical professionals--slinging the acronymic lingo, as if it makes them part of the medical crowd, or something. The “medical crowd” reinforces it by talking to lay people--you know, “patients”--in the same lingo, the same pidgin. Interestingly, nurses seem to be some of the worst offenders. While the nursing profession has gone to great lengths, or so nurses have told me, to develop a language “separate” from that of physicians--a “laceration” becomes an “disruption of skin integrity,” or something like that, a nurse practitioner once told me--once they become advanced practice nurses, they embrace the medical pidgin with gusto, and speak in nothing BUT acronyms unless it cannot be avoided.
This is sometimes problematic from a transcriptionist point of view, of course, especially when so many spoken sounds can be so difficult to distinguish from each other (“f” and “s,” for instance, “m” and “n” to a slightly lesser extent; c and e and d, falling in the middle of a hastily blurted acronym, can be virtually indistinguishable from each other--sometimes all you can really hear is a sort of an “eee” sound).
Acronyms, in online communication or in the medical field, were originally designed as “shortcuts” that would enable us to communicate more information, faster and more efficiently, and they’ve succeeded.
Still, I cannot help but wonder sometimes if, after passage of a generation or two, we are not shortcutting ourselves out of any ability to communicate meaningfully with each other at all.
Random side-note regarding rotary phones: It occurred to me while pondering this stuff today that songs like Glenn Miller’s “Pennsylvania 6-5000” and Tommy Tutone’s “867-5309” could not be written now. Somehow, “613-814-5000” or “913-867-5309” just wouldn’t have the same, um, ring to them.
Gotta love progress!
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