The Definition

“The chief virtue that language can have is clearness, and nothing detracts from it so much as the use of unfamiliar words.”
– Hippocrates –

The first important act in discussing any disease is to define what you are talking about.

Pay attention on your rounds to how doctors communicate with their patients. Does the patient have a clear concept of what ails them and what is being done? Could the discussion have been briefer and clearer? Effective communication skills are one of the most important qualities of a good doctor, but sadly they are often found wanting. Improvement can only come with practice.

In order to help train our brains to speak to patients so they can understand us, the card system lays out a number of ‘laws’ for definitions. These lays teach us to speak in layperson’s terms. They foster the quality of brevity. They contain a verbal rule to eliminate those annoying ‘ums’ and ‘ahs’ that infiltrate our language and frustrate and confuse our audience. Finally, they encourage us to return to first principles when faced with a question – where the thinking mind always goes. Alternatively, of course, you could just follow
this advice from Osler!Look wise, say nothing
and grunt, speech was given
to conceal thought.Sir James Paget. (1814-1899) The 8th child in a family of 16, Paget rose to achieve phenomenal success in medicine. He had a great understanding of disease as well as a charming personality. He showed his aptitude as a first year medical student by describing the first case of trichinosis, having found some worms in the muscle of a cadaver he was dissecting. He held numerous important academic posts throughout his career, but his fame rests upon his contributions to the study of pathology and his many descriptions of diseases. The most famous of these descriptions is the bone condition that bears his name.

He was described as a slightly built man with a long face and bright eyes. He greatly admired brevity, and was famed for it. He equally disliked smart-aleck cleverness and held an aversion against epigrams and slogans, even though he used some himself: “To be brief is to be wise.” A gifted orator, he was regarded as the finest lecturer in his field. He was a noble man who received the greatest respect from his colleagues. He died at the age of 85, and the service was conducted by his son, who was Bishop of Oxford.