April 2nd, 2006

ozarque figure

Linguistics; medical language; the term "MDeitySpeak"

There's been a bit of friction about the term "MDeitySpeak"; for example, lyonesse wrote: "i must say i find the term "mdeity" quite snide, and i don't think it's polite." I don't know whether it's possible to straighten this out -- probably not -- but it seems to me that I should at least make an attempt to clarify the issue.

There is a certain manner of speaking -- a register -- that occurs almost exclusively within the practice of medicine. It has clearly identifiable characteristics: a particular vocabulary, a particular set of bodyparl items, a particular set of metamessages, and so on. It can be described and analyzed; it is as recognizable as the register used by NASCAR drivers, or by pastry chefs, or by gymnastics coaches, or by Star Trek fans ... and so on. A great deal of research has been done on the subject; there's a large literature. Not everyone who writes on the subject of the medical register uses the term "MDeitySpeak"; some of us do, some don't.

(The term is not original with me, by the way; I don't remember who coined it, but it wasn't me. The term "Academic Regalian" -- for the register characterized by a set of shared linguistic features common to most U.S. college and university professors -- is mine, but somebody else came up with "MDeitySpeak.")

The primary function of MDeitySpeak is to establish and maintain dominance, and it works extremely well for that purpose. It's a tool, in the same way that a scalpel is a tool, or a medication is a tool. Doctors in the U.S. mainstream medical system, working on very tight schedules, trying to attend to large numbers of patients in a single day, often having only five minutes to spend with a patient when they would prefer to spend half an hour, face a real dilemma. If they are to manage their time with patients the way their administrators or their partners demand that they manage it, they have to be in control of the conversational floor when they're talking with patients. This is not their fault; it's the fault of the U.S. healthcare system. MDeitySpeak has that name because its metamessages are metamessages of godlike omnipotence and omniscience.

Not all doctors in the U.S. use MDeitySpeak. There are doctors who are so personally charismatic that they inspire unquestioning trust and respect in their patients; they may never feel a need to use MDeitySpeak in their entire professional lives. There are doctors who switch to MDeitySpeak only in emergencies, when it seems to them that no other manner of speaking is going to work with a particular patient or colleague. And then there are doctors who don't feel safe unless they are using MDeitySpeak, and who rely on it almost exclusively, sometimes to such a degree that they use it with friends and family as well as with patients and colleagues.

I respectfully disagree with lyonesse in this matter (which is fine); I don't believe that it's any more rude to identify a specific doctor's register as MDeitySpeak than it is to identify a doctor's native dialect as Ozark English. I also believe that MDeitySpeak is beginning to disappear. Young doctors and medical students are now learning new and better ways to communicate -- especially in medical programs where they are given the opportunity to practice communication with actors filling the patient role and then to review and discuss videotapes of their interaction after it's over -- and I hope that trend continues.

Finally ... one item left over. There are cultural groups in the U.S. who will be distressed if MDeitySpeak disappears, because they find it comforting and appropriate; for them, it is the way a doctor is supposed to communicate, and the way a doctor can be identified as competent and trustworthy.
ozarque figure

The term "MDeitySpeak"; let's call the whole thing off.

With regard to the discussion of the acceptability -- or lack of acceptability -- of the term "MDeitySpeak" as a label for a particular medical register: This is clearly one of those situations in which agreement is never going to be reached, and it is therefore a waste of everybody's time to go on discussing it.

I'm surprised -- baffled, in fact -- by this development. Doctors are extraordinarily powerful and privileged individuals in the United States of America; their status cannot conceivably be threatened or diminished by a punning label used to refer to a particular fashion in which some of them choose to communicate.

However. This world is full of real problems. Global warming. Global poverty. Drug-resistant tuberculosis. Torture. Fraudulent elections. Government corruption. Wars and plagues and pestilence and famine and hurricanes and earthquakes and droughts. Rampant injustice from one end of the world to another, and no end in sight. The threat U.S. doctors might face from the term "MDeitySpeak" fades dramatically by comparison.

Under the circumstances, I'm not willing to waste my time or yours in wrangling over the dagblasted thing any longer. I give you my word: I won't bring it up again.

I appreciate your comments, both positive and negative; thank you for posting them.