author interaction

Jarring Jargon

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Theodore M. Bernstein, in The Careful Writer: A Modern Guide to English Usage, describes jargon as “meaningless, unintelligible speech,” which is how some people might describe their last conversation with their physician. In science and medicine, many barriers to clear communication exist, with jargon being one of them. In fact, it’s so difficult for physicians and patients to communicate clearly that a federal program has been created to promote simplified health-related language nationwide. The Health Literacy Action Plan is a “national action plan to improve health literacy.” The entire action plan is 73 pages (which is probably their first mistake) and it highlights the fact that we have a problem.

As editors, we know that jargon is to be avoided in medical literature. While jargon may evolve for the most innocuous of reasons, it is a vocabulary specific to a profession that sometimes is esoteric or pretentious and that can be confusing to those not familiar with it (sometimes to those familiar with it as well). “Inside talk” can be just that by design—it keeps outsiders out. Therein lies the source of the negative feelings about jargon.

In addition to being exclusive, some jargon is offensive and unprofessional. Have you ever seen an FLK? Probably. That’d be a funny-looking kid. “We bagged her in the ER” sounds ominous; what it means is that a patient was given ventilatory assistance with a bag-valve-mask prior to intubation in the emergency department. Hopefully the emergency department physician didn’t describe the patient as a GOMER. This means “get out of my emergency room” and could refer to, for instance, an elderly patient who is demented or unconscious and near death and who perhaps should die peacefully rather than occupy emergency department resources. In this example, jargon diminishes the complexity of a situation that should be dealt with in a more thoughtful way. As Bernstein writes, “All the words that describe the kinds of specialized language that fall within this classification [of inside talk] have connotations that range from faintly to strongly disparaging.”

Jargon also sometimes violates rules of grammar, eg, turning nouns into verbs, “The doctor scoped the patient,” or creating back-formations, like “The patient’s extremities were cyanosed,” instead of “The patient’s extremities showed signs of cyanosis.” Jargon can sometimes appear to depersonalize, by defining a person in terms of a disease. A “bypassed patient” may be one who has undergone coronary artery bypass graft surgery rather than one who has been overlooked. Sometimes, patients might be referred to by their organs, such as “the lung in room 502” instead of “the patient in room 502 with lung disease.”

The AMA Manual of Style lists examples of jargon to avoid in section 11.4, Jargon. Some other examples that we’ve collected over the years are listed here:

* Collodion baby is better phrased as collodion baby phenotype or “the infant had a collodion membrane at birth.”

* Surgeons perform operations or surgical procedures, not surgeries.

* Rather than say a patient has a complaint, describe the patient’s primary concern.

* Do not use shorthand (eg, exam for examination, preemie for premature infant, prepped for prepared).

* Euphemisms sometimes are not clear and should be avoided: “The patient died” is preferred to “The patient succumbed or expired”; the same holds true for killed vs sacrificed (in discussion of animal subjects).

* Patients aren’t “put on” medication, they’re treated with medication. Also, patients aren’t “placed on” ventilators, they’re given ventilatory assistance.

Certainly jargon does have its place. It is specialized, and those in the same field can use it to communicate precisely and quickly. However, when it comes to medical and scientific publications, jargon is best avoided. Bernstein ends his entry on “inside talk” with the following: “It must never be forgotten that the function of writing is communication.” Clear enough.—Lauren Fischer

Go, Embargo, Go

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So what’s an embargo, anyway? There’s the economic trade kind, but let’s stick to the news kind (much more relevant for AMA Style Insider readers). I spoke with Jann Ingmire, the JAMA and Archives Journals media relations guru, and she explained that embargoes exist primarily to give reporters the opportunity to cover a story in a more thorough way.

Here’s how they work: Embargoed material is released to members of the press prior to being released to the public, usually a few days early. This gives reporters time to do research, conduct interviews, and write a really great piece. When the embargo lifts, journalists are already prepared to report on newly published scientific studies.

Most of the time, the system works, but occasionally, an embargo is broken. Ms. Ingmire said she tries to give reporters the benefit of the doubt because, usually, it’s simple human error. Sometimes, though, the embargo break is flagrant. When this happens, reporters are sanctioned and stop receiving embargoed material.

Embargoes make it possible for everyone—from the independent blogger to the major media outlet—to have the same opportunity to gather a story. If you want to learn more, read embargowatch.wordpress.com, a blog that chronicles how embargoes affect news coverage.—Lauren Fischer

Editors’ Eyes

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The dialog box in Word suggests unironically that I should consider changing antidiabetic to ant diabetic. Is there a hyperglycemic epidemic in the insect population that I missed hearing about?

Spell-check can be a useful tool that improves the quality and readability of content. But as editors and readers know all too well, spell-check can be dangerous if wielded indiscriminately. Instead of making the role of a human editor obsolete, spell-check has only underscored the need for such professionals.

Several papers submitted to JAMA recently proved this point. I usually run spell-check after I complete my editing in case I missed something. In addition to the diabetic ants, Word suggested the following: change metformin to motormen, pertussis to peruses, autonomously to gluttonously, and PDF to puff.

I politely declined all these fine suggestions but was grateful when Word spotted terible that should have been tertile. What a difference a word makes.

Over time spell-check has become more useful because I regularly add words to my locally stored dictionary (“Add to Dictionary” in the dialog box). In addition, Dorland’s offers a medical spell-checker that can be integrated directly into Word and Stedman’s offers a medical spell-checker as well

Despite these useful add-ons, I still like to read articles word-for-word, when time permits, and not rely solely on technology to prevent errors. The ants, I’m afraid, are beyond my expertise.—Stacy L. Christiansen, MA

What Are You Trying to Say?

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In his chapter, “An Approach to Style” in The Elements of Style, E. B. White states, “A careful and honest writer does not have to worry about style.” This statement guides me as an editor, and as a writer, when I become too mired in the frustrations of dangling modifiers, passive sentences, imperfect words. I try to remember, the point of any writing is to communicate. When I ask myself what I am communicating, and get back to the simplest idea of my purpose for an assignment, the editing becomes easier, and the intricacies of style seem less of an obstacle and more of a tool.

But what happens when an editor isn’t sure what he or she is communicating? Medicine is complex, full of specialized words and obscure concepts. What happens when we don’t realize that a word is being used incorrectly, because our understanding of the concept being communicated is limited? This is perhaps the most difficult challenge I face as an editor of medical journals, and the reason we track our changes when sending them to authors. What if my streamlining of a complex sentence detrimentally affects its meaning? It’s always my fear that, in attempting to improve a statement, I will cause the meaning to be changed.

This is why I’m grateful for the author-assisted editing process. Each author who carefully sorts through my myriad comments and questions, who assesses the edits I make and comments on them, is my ally in making sure any reader, regardless of their experience with English or level of medical expertise, can use our journals in their work. Physicians are busy people, and editing is not their job. Yet, this partnership allows us to make our journal as useful and far-reaching as possible. As a microbiology student, I regularly used medical journals in my research and school assignments. Reading these studies was challenging at best, and occasionally baffling. It’s this experience that I go back to—remembering that it’s not just myself and the author who will need to understand this work, that it affects all levels of medicine—and remembering my purpose, I turn the elements of style into my tools.—Roya Khatiblou, MA