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Words and Gestures Never to Use in a Hospital Setting
obsessive rumination about language
I didn’t tell you about the time in the hospital when one of the residents came into Sophie’s hospital room and gestured. May I sit down? she might have said, and I would have gestured toward the folding chair, sure. The gesture made it clear that she needed to talk to me about something. Whenever a doctor sits down, you know it’s going to be something. It was something something about Sophie’s CAT scan of her lungs and how it was improving and the abscess was smaller but there was something else. Or maybe I said is there something else? and she said yes and looked super serious and even timid (initially I called her The Mouse because she seemed to doctor through the world of the ICU in stealth, quiet, blinking, reticent. I guess it’s fair to say that that isn’t mouselike and might even be doelike— but there was something lacking as far as fearlessness, and I always felt ungainly around her, angry, difficult, noncompliant, irritated. In any case, my opinion of her changed considerably after the second week in the ICU when I realized that she was, actually, kind. But back to the conversation about something else. She said, We saw what looks like a mass on Sophie’s heart. And I said, What? And she repeated herself and added that there would be a cardiologist (someone revered in the field which are, apparently, the words one wants to hear rather than meh, his reputation is mediocre) coming to see us and probably an MRI to see what the mass might be. It could be serious, she said, but we don’t know yet. I’ve forgotten much of the detail of those first weeks in the ICU at UCLA Santa Monica Hospital, but I do remember thinking that the word mass should never be used with but we don’t know yet. Once it’s out, though, uttered, well, that’s it. Right? The word is a creepy black top hat and Terror has just tipped it toward you with a shrug. Doctors should never shrug either. The mouse shrugged but, to her credit, looked suitably serious when she left.
You know the ending of this story if you’ve been reading here for a bit. She never mentioned anything medical pertaining to her heart! Did I miss a post? you might say to your long-suffering spouse or partner, someone who’s listened to you read the things that you like or that struck you as similar to your own thoughts or weird life. The ending of this particular story is that a cardiologist came to the room and said he wanted to take a look. He asked for Sophie’s cooperation in an MRI, and I told him that she would be unable to cooperate, so he said that a CAT scan would be sufficient to determine the makeup of the mass. Sophie had a CAT scan of her heart while we sat staring at the glass window in her room, the one where the Pulmonologist had drawn a picture of Sophie’s collapsed lungs during the first week, the one where we sat when they took her out intubated and wheeled her back in with a tracheostomy and g-Tube. We sat wondering for a day and then a night and another day, wondering whether the mass was a tumor and Sophie would need chemo and would we even treat her and I assure you that all of this catastrophizing is done calmly by me because the tiny little mother mind™ can chew a a bunch of words up for pretty much ever until someone someone came in to report that the mass was actually just an artifact and I finally swallowed.
Dear Reader, I thought about the words mass and then artifact for weeks and weeks, wondering, really, what it all meant as far as Sophie’s heart was concerned, wondering why a mass connotes something bad and artifact something mysterious, something almost Raiders of the Lost Arkish or is that archeology? Essentially, an artifact is something made by a human being. I looked the word up and read the second definition: something observed in a scientific investigation or experiment that is not naturally present but occurs as a result of the preparative or investigative procedure. What the hell? So the mass was in fact, not a mass but an artifact and Sophie’s heart was just fine. Also, lay folks should never use the words at least before they say anything else. You know who you are. In any case, I think both mass and artifact should be struck from the medical lexicon or at least not uttered until after the fact for the first and perhaps never for the latter.
We thought there was a mass, they might have said after a top secret investigation was finished, and they’d only bring it up because they were so relieved. No one would say at least there’s no cancer!Your daughter’s heart is amazing! they’d add and break open a bottle of champagne or some really good bourbon. We’d all embrace, and there’d be absolutely no shrugs.