My colleague Dr. A. lost a patient last week, which is to say that the patient died. Any doctor worth his or her stethoscope-and Dr. A. happens to be one of the best and most caring doctors I know-finds the death of a patient painful, but this death was particularly painful to Dr. A. The patient was a young woman, a mother of young children, who had struggled with an illness which looked, at times, like it might be conquered but to which, sadly, the patient succumbed. In her grief, Dr. A. found the e-mail notification of the patient's death (the hospital e-mails physicians when their patients leave the hospital, alive or otherwise) especially galling. The e-mail stated that the patient had "expired."
Knowing my interest in language and literature Dr. A asked me if her reaction to this euphemism was justified. "Food products and vaccines have expiration dates," she said. "Human beings are born and die." She wondered if it might be worth speaking to the folks who set up the automatic e-mail notifications in our hospital, to get them to change the wording. I reflected on the dozens of similarly dehumanizing jargon terms we use in medicine. For example, we refer to patients as "males" and "females" (aren't they men and women?) or, even, "cases." I told Dr. A to forget it, to just keep being a compassionate doctor and not worry about the language. But I wonder if I gave her the right advice. In 1946 George Orwell argued, in his essay "Politics and the English Language," that language can be improved by our thoughtful and deliberate use of it. In medicine we've seen "cretinism" and "hysteria" go by the wayside because they dishonored, respectively, mentally challenged people and women. Maybe it is time, too, for "expire" to expire and to allow ourselves and our patients to grieve the dead.