When I was a young reporter in Milwaukee, comedian George Carlin was arrested for publicly performing what was then becoming a popular part of his routine - "the seven words you can't say on television." Carlin ridiculed network censors by expounding on the attributes of the seven words he claimed could not get on the airwaves.
Over a 25-year career in medical journalism and health care communications, I have developed my own list of taboo terms - all of which appear in print and on the public airwaves too frequently. I offer my own list of the seven words you shouldn't use in medical communications. I urge colleagues - both health care providers and professional communicators - to abandon their use for the sake of health consumers everywhere. I urge users of MayoClinic.com, and consumers of all health care information, to be wary of these words because they mean different things to different audiences.
Miracle lost its luster after I talked with a man who had undergone a successful lung transplant. The man had heard others describe the procedure and his outcome as a miracle. He said, "This was no miracle. Moses didn't come down and part my chest with his staff. A surgeon did it with a knife, and it hurt, and I had a lot of problems afterwards. I'm very grateful, but this was no miracle." There is no need to elevate the accomplishments of medicine to a supernatural level. They are worthy of admiration for what they are: tremendous achievements by highly-trained, caring professionals, working with health care consumers who must do their part to increase the likelihood of a successful outcome. This reality may be lost when we say "miracle."
Some health care communicators and journalists love to slap the label of "breakthrough" on many advances in medicine. The use of breakthrough would be less offensive if the writers who use it also would agree to publish a long-term follow-up - a batting average - of how many "breakthroughs" actually panned out. A warning to health care consumers: be careful about putting too much stock in any claim made by medicine or the media if it uses the term "breakthrough." True breakthroughs are better measured over years, not overnight.
I've often wondered if the phrase "promising development," used frequently in health care stories, shouldn't be reserved for the business page. The word promising means "likely to be successful" or "to give a basis for expecting." There is far too much uncertainty in medicine for this word to be applied loosely in the coverage of medicine. Unrealistic expectations are among the most dangerous forces that can exist in the doctor-patient relationship. Again, I urge journalists to document who is making the promise. It might come in handy, too, to publish the "batting average" requested above.
Dramatic discoveries seem to occur in the medical media more often than even in our television soap operas. The ancient Greeks would remind us that drama could be both comic and tragic, as can the use of the word "dramatic" to inject hype into an otherwise important piece of research news.
Veteran science writer Victor Cohn has chided medicine and the media by saying, "It seems like there's only two types of medical news stories: new hope and no hope." A woman struggling with cancer once told me she wished medical reporters would leave the word hope out of their reports and allow consumers to decide how much "hope" to assign to each story.
People hate being called a victim. (Many even hate being called patients.) "Victim" should not be applied to someone with a disease or a health condition. It should be reserved for those health care consumers and consumers of news who are victimized by claims of cures, purveyors of false hope, or by those who promise dramatic, miraculous breakthroughs.
Let's drop these misleading and dangerous words from our dialogue about health care.
Richard Horton, editor of The Lancet, a medical journal, already has begun the process by discouraging use of the word "conclusion" in scientific papers. Horton says that the notion of any single truth, or conclusion, in medicine is nonsense, and that the word, therefore, loses its meaning. "Rather," he writes, "the word interpretation implies an uncertainty that seems more appropriate. The interpretation any reader takes away from a piece of research depends upon their own background and perspective, as well as their own personal reading of the paper!"
Ill-defined, unfocused words can blur our vision as we gaze into the future of health care. This is a plea for a more disciplined selection of words by health care communicators, and for careful reading, listening and viewing by health care consumers. It's a step we might all take in our pursuit of improved health care.
February 1, 2001
© 2000 Mayo
Foundation for Medical Education and Research (MFMER).