“Just a word”

In an official Medical Society Blog the following words were recently used in response to thoughts that I had submitted on a medical subject.  These singular words were put in inverted commas by a most senior healthcare professional who does not know me.

The Medical Society involved has since removed the post:

I share the view of Barrack Obama that we should all try and engage in debate with those who may have different views.

I would suggest that such “one word” approach [with words used to stain] may not encourage helpful debate.

To learn from and cherish

In the Scottish Herald on the 1st October 2016:

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reminded us all that:

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and suggested that we:

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Rebecca McQuillan  worried, as I do, that:

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Our treasured NHS and those who educate us might consider:

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As an NHS doctor for those who I value and respect I worry about the promulgation of a reductive language of loss. I often hear our older generation described as a “challenge” and that complex, and unique situations have been reduced to a single word, such as “frailty”, “capacity” and “delirium”. Language evolved over tens of millennia to avoid such simplification.

Rebecca McQuillan closes beautifully:

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I shared this post with the British Medical Journal. There was 
an interesting reaction on social media to my post and to those made 
by others by the original columnist:

"some truly bizarre responses to what was a mainstream common 
on acute frailty"

"I am thinking of changing my BMJ column from 'acute perspective' 
to 'everybody must get Stoned'"

The mechanical language of Health Improvement

The following words appear frequently in the language of Health Improvement:

ToolsTraffic Lights Dashboards toolkits

It is my view that Healthcare Improvement needs to consider the potential consequences of the widespread use of such mechanical language.

An Interview

For the first time in 13 years I attended a job interview. I had feedback after my interview which indicated that the panel had felt I was “too personal” in my manner and that the panel had wanted me to be more emphatic: to give crystallised answers to the complex questions asked.

It occurs to me that the two areas of feedback I received return to the use of language. This is an aspect of self.

I am proud of my self.

I am of the view that an effective medical practitioner should be true to himself. I prefer not to play-act a professional role. My view is that being true to oneself is important to healing. Others agree with me: Psychiatric Bulletin, August 2014: “Openness, transparency and candour”

Openness1

Reflecting today, many months on from my interview, I am wondering if my experience presents another example of a cultural shift in the “professional” use of language?

At my interview I may not have been attune to the current language of healthcare. Equally possible, perhaps it was the interview panel that struggled to attune to my language that has developed in my wider reading of science, in medical humanities and in the arts.

Whatever may be the case, I am of the view that we must be careful in categorising language as “pathological”. This is because what may be determined to be “pathological” may not be the same for all people. I have come to appreciate that the cultures of Arts and Sciences, for example, may approach our use of language quite differently.

“Pathological” language: on what basis and decided by who?

This post is about our use of language.

Recently I made a film called “language is the dwelling place of being” about the poet and artist Ian Hamilton Finlay who is recognised as one of Scotland’s most internationally renowned poet’s.

Language is the dwelling place of Being from omphalos on Vimeo.

In his letters, Ian Hamilton Finlay describes, without fondness, several periods in hospital. Ian Hamilton Finlay’s earlier periods of psychiatric hospitalisation were described in “Selections” by his son Alec.

In middle to late life, but not right up to the end, Ian Hamilton Finlay lived his life in exile, in his kingdom of “Little Sparta”

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Hamilton Finlay was an artist and wordsmith. His ideas were conceptualised in the form that he termed “concrete poetry” which he defined as: “a model of order, even if set in a place full of doubt”

Hamilton Finlay’s creative ability with language developed into a whole new form of language as an art form in itself. Such ideas, explored with other poets and artists were developed in Poor.Old.Tired.Horse. a journal published by Finlay.

POTH-5

I have often wondered what my colleagues in psychiatry made of Ian Hamilton Finlay. My suspicion is that they might have designated his language as “pathological” I say this as I was taught in my medical training that “language disorder” can be a cardinal feature of mental illness. Indeed in psychotic illnesses, one form of this “disorder” is described as “loosening of associations” and another form, the making of new words “neologisms”. I once heard an eminent professor and his wife, who had met R D Laing at a conference, say “well we think he was mad, he used to Clang a lot”. To Clang is another form of “pathology” and is defined as: “a mode of speech characterized by association of words based upon sound rather than concepts”

Hamilton Finlay used to describe his garden “not as a retreat but an attack”. I now wonder if he was attacking the “pathological” view of psychiatry and/or medical reductionism. If this is the case, I for one, welcome Hamilton Finlay’s attack.

POTH21

A year or two back, I attended an NHS meeting that had a mixture of senior medical staff and senior managers. I struggled at this meeting to follow some of the language of medical and managerial discourse. I gave up trying to understand and thus simply recorded (as much as I could bear) the language used in the meeting:

“Sign-off the work done to date and migrate into RAG report”

“We need to use the same mapping & gapping analysis”

“It is all about generic input with cognizance of those factors that tie-in to the Work Plan or GAP analysis that we have agreed in the Improvement Team. I am happy to populate that.

Below is a short extract of text from Julian Barnes novel “Talking it over”odd-word

I would argue that this sort of language could also be considered “pathological” but those at the meeting would surely resist any label of “mental illness”.

My own pet-hates are mechanical metaphors which are now everywhere in “healthcare improvement work”: toolboxes, dashboards, kits, route maps etc. These words imply that we can be treated as machines.

I am wondering if the language of my profession is changing to become more detached.