Defending the indefensible

I lashed two pens together to write my 500 lines: “I must not swear in the corridor.” I accepted my punishment, for I had indeed been swearing loudly and repeatedly. My school wasn’t “flipping” Grange Hill. The British are superficially a polite people, renowned the world over for apologising for things that they didn’t do nor were responsible for. But this is a mere veneer, for underlying our “Terribly sorry” we are sarcastic and rude and, from Shetland to Land’s End, given to swearing. Barbed politeness is a national treasure.

Medicine, likewise, is both polite and professional. We smile as we take the punishment of clinical work, with the beatings ever harder in the new world of consumerism and patient power. We smile at our managers as we skip through all the new regulatory hoops. But this, too, is a sham, for medicine has a private dark humour where swearing is central. I remember bursting through the doors to the hospital doctors’ mess to the sound of loud, repeated, almost stuttering swearing. Swearing was ubiquitous in theatre, in emergency departments, on ward rounds—under my breath, in my head, in my dreams. Swearing even has it own universal sign language. Swearing is an intrigue, part of the medical training and tradition. Indeed, if I could translate ancient Greek I would be surprised if swearing wasn’t part of the original version of the Hippocratic oath. Even those doctors who didn’t enjoy smoking and those with strong religious convictions enjoyed a good swear at 3 am during medical receiving.

This workplace swearing—unnecessary, loud, wanton, gratuitous, unprofessional, and, the very point of it all, therapeutic—is not to be confused with the aggressive swearing of personal attacks. It may not be big and not clever, but it is a highly effective stress buster and indeed strangely attractive, endearing, and often supremely funny.

But the old ways are dying. Swearing is viewed dimly by human resources departments and employment tribunals. Swearing is now enjoyed only between consenting adult doctors behind closed clinic doors. Young doctors now turn to dark therapeutic arts such as lavender oil, reiki healing, and saline flotation tanks. Orthopaedic surgeons are now mute at work, having lost 95% of their vocabulary and all their adjectives. I fear that the beautiful art of sarcasm and sweet cynicism, the other thundering source of medicine’s dark humour, is likewise under threat, replaced by nauseating bland positivity. Fiddlesticks and sugar to it all!