American spelling and other stories . . .

BMJ 2014; 348 doi: https://doi.org/10.1136/bmj.g1239 (Published 05 February 2014) Cite this as: BMJ 2014;348:g1239

We have Noah Webster of Yale to thank for the way that Americans spell things slightly differently from the British. His American Dictionary of the English Language (1828) features the word “smolder” to describe what we spell as smoulder. And in 1980, the New England Journal of Medicine first described a condition called “Smoldering multiple myeloma,” so perhaps that is the definitive spelling for what remains an ominous diagnosis. Until recently, we knew of no way to stop it from blazing up into true multiple myeloma, but with the coming of regimens based on dexamethasone and lenalidomide this no longer applies to the highest risk group. However, the authors of a new review of this condition (Blood 2013, doi:10.1182/blood-2013-08-520890) point out that the annual cost of treatment is around $100 000, not including the extra monitoring required for patients on active treatment and management of adverse events. Costs like these for life extending drugs make Minerva smoulder.

Olmsted County sits …

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