“I was too well brought up to say it”BMJ 2003; 327 doi: https://doi.org/10.1136/bmj.327.7425.1208 (Published 20 November 2003) Cite this as: BMJ 2003;327:1208
Four days after her right hemicolectomy, my patient was getting on well. She reported little pain and no nausea and was getting up and about with more and more confidence. Her wound was dry, and routine observations were fine. But I was after that extra bit of information that every surgeon wants. “Have you passed any wind today?” I asked.
“Yes doctor, I… er.”
The clumsy expression flummoxed her for a moment, so I gently whispered “Farted?”
“Yes, that's right,” she said, “just this afternoon for the first time. It's just that I was too well brought up to say it.”
The verbalisation of bodily function is a daily challenge for doctors in general and coloproctologists in particular. The description of bowel habit is central to history taking, and the news that a postoperative patient has “passed wind down below” reassures the surgeon that intestinal function has returned and the anastomosis is secure. Clarity in communication is an obligation, yet we struggle to articulate these issues in plain language. Understanding quaint terms such as “bowel movements,” “motions,” or “stools” requires a solid grasp of medicalese. Patients of a genteel upbringing or well experienced in the language of doctors may have little difficulty, but having such a discussion with the average person can lead to ludicrous verbal gymnastics.
It is a pity that the words fart and turd are taboo, to use the description of Collins English Dictionary, since their routine use would save a lot of, well, farting about. Both have long if vulgar pedigrees. Fart has Middle English and Old High German roots, and the Sanskrit equivalent “pardate” places it squarely in our common Indo-European linguistic culture. Turd derives from the Old English “tord” and must surely have been a favourite of Chaucer. May I suggest that in the interests of communication and good practice the BMJ starts a campaign for the emancipation of these words from the nether regions of English vulgarity?