Minding our words
BMJ 2016; 352 doi: https://doi.org/10.1136/bmj.i361 (Published 21 January 2016) Cite this as: BMJ 2016;352:i361
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Dear Dr Bamji
Thanks for your rapid response. The article I was asked to illustrate only mentions the American Civil War - not the person who researched the condition nor who published accounts later - nor the battles that gave rise to the theory. Hence I chose an image of soldiers in the Civil War.
I am impressed by your knowledge of the actual setting of the photograph. Even if I had had the information about the actual troop I would disagree that mounting a siege in the conditions of the time was not stressful - not least due to bad water causing dysentery and the ever present threat of ambush.
Although it may have been worse to be a Confederate soldier on this occasion.
If anyone has more information on the actual battles that gave rise to the theory I would be interested to know .
Competing interests: No competing interests
The illustration accompanying the "from the Archive" article on "Soldier's Heart" seemed an odd choice; other pictures for this feature have all been something directly to do with the First World War, but this one appears to show a group of Union soldiers following the (successful) siege of the Confederate forces at Corinth in 1862. Well - sort of successful; the Confederate forces managed to escape pretty well intact.
A connection? Only that the condition was first described in the American Civil War, although it took a lot longer to identify that the symptoms were largely psychosomatic. But I suspect the soldiers shown would have been pleased with their success, and stress-type symptoms might not have been particularly in evidence right then! Perhaps a photograph of the main WW1 researcher into the condition, Sir Thomas Lewis, might have been appropriate.
Competing interests: No competing interests
Choosing words carefully does not get rid of misunderstanding when the words themselves are a jargon masquerading as everyday usage.1 For example, the expression of hospital mortality as a ratio of actual (Observed) to hypothetical (Expected) death rates (HSMR) is conveyed in the Media as incontrovertible, rather than provisional, regardless of explanations to the contrary. Unfortunately, there is no convention in the printed language that picks out statistical jargon, which partly exonerates news-hungry journalists for their overstatements. It also adds inadvertent weight to any associated arguments.2
Of course, a similar overlap has bedevilled the use of significant, although in that case a tendentious comparison between the actual and hypothetical is not relevant. An explicit textual identification of jargon might have avoided some of the collateral damage to institutions that followed the reporting of HSMRs after the Mid-Staffs furore (they are now presented, in a fall back position, as the smoke that might just signal an undetected fire).
The ‘statistics establishment’ have not taken any effective initiative to avoid this Media and lay misapprehension of statistical statements. Might that be part of the reason for the ‘carelessness’ in the corridors of power around quotidian death rates? The limited survival in English of any indication of things hypothetical or uncertain, through the subjunctive verbal mood, especially given scientific and journal shorthand, allows little scope for escape from this problem through conventional grammar. Is it not time that we should expect capitalisation, italics, parentheses or some such for statistical entities in print?
1. Abbasi K. Minding our words. BMJ 2016; 352: i361
2. Will EJ. Surfing the wave of misrepresented hospital death rates – a reticence of the well informed? BMJ 2013;347: f5367
Competing interests: No competing interests
Monolingual but unequal, and fluent but incongruent, British and Yankee accents are metrical opposites. Brits use iambic meter (short-long), while Yanks use trochaic meter (long-short). Take for example, the words "corollary" and "controversy". Brits say co-ROL-la-RY and con-TROV-er-SY, while Yanks say COR-ol-LAR-y and CON-tro-VER-sy. British iambs and Yankee trochees convey accents with both cadence and character. Brits sound cultured, while Yanks sound common, because iambs sound lambent, while trochees sound truculent. Accents are poetic, and prosody is noetic, if not prophetic.
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Words can obfuscate rather than communicate. Two examples are redundancies and oxymora. Redundancies distort reality with synonyms; while oxymora distort reality with antonyms. For example, redundancies include obsessive thoughts, compulsive behavior, hunger pangs, and childish games; while oxymora include open mind, free will, common courtesy, and common sense. As the building blocks of language, words can also create roadblocks to communication.
Competing interests: No competing interests
Re: Minding our words
MINDFULNESS OF OUR WORDS
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Our words, whether they are ' spontaneously ' blurted out or 'deliberately ' constructed , close scrutiny reveals their origin to be in the mind and caused by an obvious or blivious perception.
The mind is a multilayered, hierarchically functionable phenomenon.
If any words produced are damaging, the damage control could be effected by the mind itself by employing the wand of mindfulness. Although the responsibility lies in the subject , external factors can influence this process.
Being mindful of one's words is a virtue that can be cultivated.
Competing interests: No competing interests