Voices: Medical ‘wokeism’ doesn’t exist – but thoughtless language affects us all

“Woke medics are calling for a revamp of language used by doctors so it does not ‘belittle’ patients. Common medical phrases like ‘take’ a test or ‘send’ someone home may potentially make patients feel ‘childlike’,” thundered the Daily Mail recently.

OMG! The thought police are clearly moving in on Britain’s hospitals. It’s madness, I tell you. MADNESS! Next, they’re going to be sacking people for not calling we disabled people “differently-abled”. Or something.

Save us from this insanity, our dear health secretary Sajid Javid. Wait, we’re probably not allowed to say insanity. Save us from this, um… um…. just save us, already.

Please, issue a directive to stop this nonsense. That is, when you’ve finished winding up your offshore trust or making excuses for using non-dom status to pay less tax when you were rolling in Deutsche Bank’s bonus money.

This, sans the bit about Javid’s financial arrangements, was I presume the intended reaction to the Mail’s piece, which didn’t let the facts of what the allegedly “woke” medics – Cambridge University’s Caitríona Cox and Zoë Fritz – actually had to say get in the way of the story and headline.

They (because I have read their piece) were actually trying to make the point that the negative, sometimes pejorative, language frequently used by their colleagues can “insidiously affect the therapeutic relationship”. And you know what? They’re right.

Consider “claim”, which is one of the commonly used doctor-words they highlight as problematic. Those of us in the reporting trade are well aware that “claim” is typically used to imply doubt. Any half-decent style guide will tell you that. It’s why you often see “claim” attached to Russia’s dishonest and hysterical statements with respect to its brutal war in Ukraine.

The two doctors are therefore entirely correct to point out that writing “patient claims pain is 10/10” is at the very least problematic, if not actively offensive. Even “complains” doesn’t do it.

I wasn’t “claiming” 10/10 pain when I had a literal cement truck on top of my ribs before I was rescued. I wasn’t complaining about it. I was feeling it, live and in the raw. Nor have I been “claiming” or “complaining” about the agonising after-effects.

Fortunately, I have a humane and compassionate pain consultant, who hasn’t used any of the problematic terms the BMJ article cites, at least not in my hearing. Cox and Fritz are also right to raise the issue of doctors infantilising their patients.

For my sins, I also have type 1 diabetes. For the record, it is thought to be an autoimmune condition that knocks out your insulin-producing cells. It is not treatable by lifestyle changes. It requires daily insulin injections. A premium is placed on eating healthily and avoiding certain foods.

Trouble is, one of the secondary symptoms T1s – and probably Type 2 diabetics, come to think of it – experience is a lifetime of being patronised and sometimes bullied by medical staff. “There is an authoritarianism, for example, in talking about patients (not) being ‘allowed’ certain foods by their doctors,” the article states.

Although patients can find such language upsetting or frustrating, some also adopt a childlike narrative, describing the effect of being ‘naughty’ or ‘good’ on their blood sugars, or recounting being ‘scolded’ by healthcare professionals.” Ding, ding, ding, ding, ding.

Get a group of T1s together, and once the ice has broken, you will often find one or another of us quietly admitting to lying to their care teams to avoid being talked to like errant children in the 1950s. Then the floodgates open. You will hear stories of treatment that can get quite aggressive. And very unpleasant. So unpleasant that at the end you are often left thinking, “screw this and sod the lot of them, I’m off to McDonald’s for a calorie binge”. I’ve been there. I’ve told those stories.

I confess, I’ve actually been put off hospital appointments as a result of the way I’ve been talked to. Sometimes I’ve quietly cheered when the hospital has cancelled or postponed them (which is getting increasingly commonplace in today’s NHS).

As a patient, you should feel able to talk candidly to your medical team with a view to getting the best treatment and/or the best advice. The fact that this doesn’t always happen perhaps explains the doctors motivations for writing the piece.

Now, poor medical behaviour is not consistent across the piste. I’ve found it much less commonplace where I have my eyes screened. And you know what? They’ve improved lately. Though perhaps that’s bound to happen, when the people looking after you inspire confidence rather than dread.

If you read the BMJ article properly, as opposed to some of the media reports on what it says, you’ll also find that it wasn’t dashed off in half an hour to secure a cheap headline and a prominent position in the paper. It is, rather, a serious, academic analysis.

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There are 38 cited pieces of research at the conclusion. There was clearly someone in the BMJ press office with their brain in fully in gear when they saw it, because the press release accompanying it explicitly states that the authors want to be clear that using the right language – so not demeaning, infantilising or patronising patients – is “not a matter of political correctness”.

Medical language “affects the core of our interactions,” they say, calling for more research. I’d like to see that because my experience suggests they, and the BMJ’s accompanying leader column, are on to something. In the meantime, we shouldn’t be bashing these medics as “woke” or “PC warriors” or whatever today’s favoured right wing term of abuse is. We should be cheering them on.

As a patient, I came away thinking at last! At last, somebody gets it. Healthcare in Britain may improve as a result of the work of Cox and Fritz, that is if it isn’t impeded by low journalism or the sort of cheap political posturing that sometimes stems from it. Over to you, Sajid Javid.


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