'He's A Fighter!' Medical Words That Hurt

[Medlife Mini] Some thoughts about the words we use in medicine, after reading about Jeff Bridges' lymphoma diagnosis and Ed Yong's superb article about "being strong" when it comes to illness.

There are some archaic offensive terms in medicine, there are other words that are part of a long-standing culture of dark humour - this video is about neither. It's about terms that fly under the radar, that we use on a regular basis as actual medical diagnoses.

It was recorded on the morning of Saturday 24th October without much planning - there are loads more I could've mentioned, especially within mental health. But these were just a few that came to mind.

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More Medlife Crisis:

[MedlifeCrisis]

Another word that hurts: vlog. Use it at your peril.

[peterlavery]

Only a doctor could make his earphones look like a stethoscope

[LeoStaley]

The Onion did a wonderful interview with a man who courageously refused to accept that he had cancer.

[Craznar]

As a long time sufferer of mental illness - the one that gets me is "help is always available", when in fact that is not true.

[Grim_Beard]

With cancer, you're not a combatant, you're the battlefield.

[vinko]

"I'm not a doctor, but I guess that when you die, the cancer dies with you at the same moment. I wouldn't call that a loss. It's a draw."
Norm McDonald, the best comedian ever, who recently had a draw with his cancer after a quiet fight of 9 years (he told the joke while sick)

[lydiacopes]

My mother had pancreatic cancer, an awful diagnosis. Saying she “fought hard but the cancer won” is awful to me. Her death wasn’t about how hard she “fought, ” it’s that we don’t have good treatments for pancreatic cancer.

I have both incurable and genetic disorders. Many people tell those of us with chronic, incurable conditions that they are rooting for us and we are strong and can fight it, but when we keep being sick, eventually they get frustrated and tired of it. I’ve even had doctors tell me I’m not “trying hard enough” which is the opposite of helpful. The times I have tried to “fight” and keep pushing myself have made me substantially worse. Managing my conditions takes work and effort, but part of that is reducing stress, not increasing it. I don’t want to have to “fight” my body for the rest of my life, that’s miserable and untenable.

[drbettyschueler]

I have had metastatic breast cancer for 27 years. I've never gone into "remission" but my oncologist has stopped treatments, periodically, when a treatment started feeding rather than hindering the growth and spread of the cancer. Fortunately, new treatments keep being developed so I've managed to survive far longer then anyone ever expected in their wildest dreams. And I've definitely been a "noncompliant" patient when my oncologist wanted to run tests to see how the cancer was "progressing" but had no treatment plan to offer if the cancer had spread to yet another area. I view my efforts to control the cancer as an epic adventure that offers lots of opportunities for personal growth. No matter what the final outcome is, I win because I've made major, positive changes to my life.

[tiburcio]

A friend of mine died of cancer when he was 30. I remember he saying that "he had to be strong", but eventually he felt "he wasn't strong enough". That was unfairly harsh on himself.

[GorgeDawes]

Oh boy, obstetrics could really do with updating a lot of it’s terminology. Telling someone who has just lost a pregnancy that they’ve suffered a “spontaneous abortion” really puts the cherry on the less-than-splendid day they are already having.

[ForumArcade]

I'm mesmerized by the triangles in the background.

[MrCmon]

I was diagnosed with leukemia, but I went until my hair turned blonde and then hadoukened the cancer to the shadow realm.

[samanthakerger]

This reminds me so much about the use of the word “disability” and how widely it’s usage gets debated. From disabled folks/folks with disabilities, the way abeled people use (or in my experience, refuse to use) it, and the way people with invisible disabilities vs people with visible disabilities use the word.

Personally, as someone with invisible disabilities, I have zero problems with people describing me as disabled in the appropriate settings. “Sam needs this accommodation because she’s disabled” is all true and fine. For me disabled isn’t a morally/emotionally negative word, it’s just a state of being. I can’t run a mile, I’m disabled. I wear sunglasses inside stores and headphones even if there’s no music playing because of my disabilities. It’s just a state of being. But I’m aware part of that is because I’m invisibly disabled, and I’ve had to fight to get people to take my disabilities seriously. And I understand why someone with visible disabilities would really like to just jump to the part where they’re a person first because to have your whole identity be “that girl in a wheelchair” would be pretty exhausting I imagine. And I think that specific debate and the nuance of the word is really interesting and I love talking about it, but what never fails to make me want to yeet myself into the nearest body of water is hearing abeled people get all squirmy and weird about the word disability. “Oh she’s just differently abeled” and sentence variations thereupon never fail to make me go from perfectly calm to just. Rage. Because so often it’s being used by someone who looks at the disabled community at large as inspiration porn, particularly those who are forced to brute force their way through a world that isn’t made for them to succeed in instead of just....giving them the accommodations they need.

[ksharma]

I remember making a terrible mistake by buying a novel written by "cancer warriors" who survived and "beat the illness" for my mother at the start of her illness. She was dealt a terrible hand and suffered from two different types of cancer. Before she passed, living with family members who would constantly shove toxic positivity down her throat became infuriating. She couldn't stand the "stay positive, you've got to fight" right after a PET scan. As a doctor, she knew what would happen. As a doctor, I did too. Loved ones mean well, but them forcing you to fight against the natural course of the disease was equivalent to denying the disease presence altogether. Which was pointless and rather immature. I was the only one she could be truly miserable with, which allowed her the time and comfort to accept the inevitable.
Once again, great content Dr Rohin!

[deekircher]

The doctor at the hospital told me to “move on” after my son was stillborn. I thought that was uncool.

[ST-gdeq]

As a medical scribe, I saw a lot of this language that painted the patient as an antagonist. "The patient denies, " "the patient claims, " "the patient refuses." I always made it a point to use non-judgmental words such as "the patient does/does not state/report." The chart may never be read and I may be the only one who ever sees it, but if we are to change a culture, we must first change ourselves.

[nursetobee.]

At the beginning of nursing school I made the mistake of asking cancer patients, , how are you " but after multiple people answered that they feel shit because of their situation.I changed it to, , how are you today" and it made a huge difference because it focuses on the current status .

[christinecannibal]

I seriously love this video. I recently was talking to my fiance about this. His father passed last year from cancer. He was a fighter, personality wise. He did not give up, he didn't die because he didn't fight hard enough. Some people are unfortunate and find out they have cancer in the late stages and theres literally nothing you can do. Also I absolutely do not like some of the terms they use in OB. failed maternal effort?? Good God...

[lindsaysheffield]

Love this. I’m disabled and I constantly feel like people are saying I’m not “doing enough” when they use language like this or offer unsolicited advice, and when I keep having to shoot down their ideas I know it sounds like I am just arguing but it’s like yeah, I’ve tried that stuff, or it’s not applicable, or the situation is more complicated than they realize/I want to go into.

I have dysautonomia and my BP/HR were wonky and a new friend was like “shouldn’t you go to the hospital?” And I said no, this just happens, I have meds for it but it’s not quite time yet. And he’s like “sometimes meds aren’t the answer - you shouldn’t always reach for meds” and I was like...what do you think they’re going to give me at the hospital? Cardiologist and I have a plan in place to AVOID sitting in the ED for hours.

[grey_aria]

This is interesting. I have severe depression and I've been told by family and friends many times that I'm stronger than my depression and that I shouldn't let it beat me etc. etc. which has led me tend to hide it rather than be upfront with it because I don't want to appear weaker and more of a failure than I already feel. I never really thought about how the language of the people around me ( who usually mean well) might change the way I view myself.

This also reminds me of back in the day (1990's) when I was a kid and young adult (early 2000's), I used to use 'gay' the same way I say 'that sucks' as an adult. I didn't realize how hurtful it was until I said it to a coworker who was a lesbian.

She just looked at me and asked me straight out if I thought there was something wrong with being gay. I was taken aback after stammering out that no, I didn't think there was anything wrong with being gay, she said that I shouldn't use it to describe that something was bad. She walked away from me after that and while I apologized, our relationship was rather cool after that.

It's one of the most important lessons I've ever learned, and I'm a little ashamed that I didn't make this connection already myself.