Cabbage and the Antichrist

I’ve been giving the Antichrist, specifically the car accident variety, a lot of thought today.

On a report one of my coworkers edited today, our speech recognition program had translated a patient’s chief complaint of “I was in a car accident,” as “I was in a car antichrist.”

First question that springs to mind, of course, is “why would a medical program even KNOW the word ‘antichrist?’” I understand that thousands of words were programmed into these systems, and obviously that each individual word could be looked at critically to judge whether it deserved to take up space in the program’s vocabulary--how likely would it be for the word to appear in a medical report? So there will be a lot of superfluous words, words the system “knows” but will never likely use, in its vocabulary, as is true for most of us speakers of a language.

Still . . . . My computer desktop occasionally tells me that there are unused icons on my desktop, do I wish to dispose of them? I would think that, given what I understand to be the fact that speech recognition programs depend on complex mathematical probability models and so forth to make its decisions concerning “le mot juste” in any given context, after producing thousands of documents I would think the program would begin periodically purging itself of the clutter of thousands of words it never, ever uses, or so very rarely that it’s not worth holding onto, if only to avoid embarrassments like calling an accident an antichrist.

We are told that these speech rec systems “learn,” and it’s true, to some degree. But we are also supposedly able to “teach” them. One of my favorites from the medical world is CABG, the acronym for “coronary artery bypass graft.” That particular acronym appears in a significant percentage of reports I transcribe. Speech rec invariably (so far) reproduces it as “cabbage.” The way the system’s “learning” theoretically operates, if “cabbage” gets edited to “CABG” three consecutive times, the system will forget all about cabbage and stick strictly with the bypass. Unless there are a lot of medical transcriptionists out there who REALLY think the heart surgeon is talking about a coleslaw ingredient, the system just cannot grasp acronyms pronounced as words (CABG is pronounced cabbage. Nobody ever says C A B G--if they did, the system doubtlessly would get it).

But I still halfway expect to see, come March 17, a flurry of speech rec produced reports of ER visits all over the country concerning some poor wretch, maybe even the Antichrist, who choked on his “corned beef and CABG.”

Similarly, the same system that invariably spells “Advair Diskus” as “Advair Discus,” come track season or the Summer Olympics, start reproducing lines like, “The spectator unfortunately was hit by a flying Diskus.” “Discus” probably appears in medical reports with approximately the same frequency as “cabbage,” after all.

Getting back to the Antichrist, maybe it’s only that speech rec is developing an ego and wants to autograph its work once in a while.