Shen-Han Lee

OK so I got a little bored and decided to do some internet browsing (and by browsing, I mean randomly clicking on any internet link that remotely of interest to me). This piece of article caught my eye – an interesting ‘editorial’ in the Annals of Improbable Research (AIR)

http://michel-lab.bwh.harvard.edu/pdfs/numberninepolcorr.pdf

Click on the link to read the scanned pdf file of the editorial. For the benefit of those who have difficulty reading the article (poor scan quality), I’ve taken the liberty to retype in verbatim the entire text of the article. I wish to reiterate that the intellectual and proprietary rights to the article belongs entirely to Dr Thomas Michel and the board of editors of the AIR, and my reproduction of the article is in no way an attempt to infringe on this right, but more so, in the spirit of good natured ‘intellectual’ humour.

Likewise, any opinion put forth in this article is solely the resposibility of the author, and does not represent my own opinion.

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The Guide to Politically Correct Cardiology

by Thomas Michel, MD, PhD        

Cardiology Division, Brigham & Women’s Hospital, Boston, Massachusetts.

The politically correct cardiologist should become aware of the evolving terminology in the field, as it seems likely that in the near future, physicians will not be able to bill for charges incurred by patients diagnosed with politically incorrect illnesses.

It has been widely acknowledged that the nomenclature of specific diagnoses applied to a particular patient’s ailment may profoundly affect the patient’s well-being, self image, and time to full recovery. It seems only logical that diagnoses should be empowering, rather than belittling. They should reflect the patient’s ability to transcend the illnesses, rather than be dominated by the judgemental, impersonal, and paternalistic semiotics of the medical profession. The nomenclature of heart disease is particular troubling in this context.

Table 1 summarizes a variety of commonly applied cardiac diagnoses, and supplies a translation into politically correct terminology.

Heart failure is probably the most common cardiac diagnosis, but the very term is belittling. It says to the patient, “Your heart has failed“. It is far more empowering to term the patient ‘inotropically challenged’ to reflect the fact that the contractile (inotropic) state of the heart shows room for improvement. Likewise, for diastolic failure, the fact that the heart doesn’t relax (lusitropy) as well as it might should not be branded as a failure.

Patients have long been termed having ‘sick sinus syndrome’ if the principle pacemaker (sinus node) cells of the heart beat too slowly. This illness sounds rather more like an upper respiratory tract infection, and applies the value judgement of sickness to a noble, organic, cardiac structure. Better to say that a patient is ‘chronotropically challenged’ or systolically impaired.

The key here is that cardiac diversity is to be celebrated, not denigrated. The term ‘aberrant’ used to be applied to drug-abusing pedophiles, whom we now simply identify to be following an alternative lifestyle. Similarly, to brand a patient with ‘aberrant conduction’ simply because the electrical impulse travel a novel pathway from the atrium to the ventricles is an unfortunate stigma. Similarly, the connotations of the word ‘deviant’ are to be avoided when describing the electrocardiographic axis of the heart (‘left axis deviation’)

The term ‘inferior myocardial infarction’ has got to go. One can imagine the scenario: a patient returns home from the hospital and curious friends ask “What kind of heart attack did you have?” To reply “My cardiologist says that I had an inferior myocardial infarction” could lead to a cynical rejoinder. Better to use the historically and anatomically correct term ‘diaphragmatic MI’

Valvular heart disease has not been spared from the application of demeaning and judgemental terminology. It is terribly insensitive to say that a cardiac valve is ‘incompetent’ or ‘insufficient’ simply because it leaks like a Washington healtcare committee. If the mitral valve leaks, thus allowing the retrograde flow of blood, would it not be better to say that the patient’s heart is ‘retrograde mitral flow-enabled’? Similar terminology can be applied to other leaky cardiac valve, as well as to the occasional defects found between cardiac chambers.

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Funny, no? 😉 (if you don’t get it, please forget ever having read this post, please? Gracias)