A "True" Medical Emergency

I love language. It's the primary tool of my trade. Playing with images, searching for precise descriptions; these provide me with endless entertainment, frustration and joy. I can agonise for hours - nay, days - that this particular metaphor may be too mangled, or that analogy too abstruse, or that I have overstated my case or obscured the essence of what I wish to convey by overblown use of adjectives when a simple noun is all that's required. Writers use language but we can also very easily abuse language.

I can be reduced to a growling wretch when I see "disinterested" being confused with "uninterested" and the common modern tendency to put apostrophe's in plural's can have me grinding my teeth in despair. But of all the common abuses of language, the one I abhor most is the abuse of hyperbole. For those who're a bit rusty on such things, hyperbole is the use of exaggeration for dramatic effect.

You know the kind of thing I mean. A friend visits and you offer her a piece of cake with her coffee. She takes a bite and squeals, "Wow, that is AWEsome!!" What she really means is, of course, "Mmm, that's delicious". No matter how much chocolate it contains I cannot conceive of any bite of cake inspiring a 'sense of reverential fear or wonder'.

Hyperbole, as the Hitchhiker's Guide to the Galaxy said of Earth, is mostly harmless. But it can have negative effects. For instance, if we use 'awesome' as an alternative to 'pretty good', what word do we use to describe something which does, in fact, overpower us with a sense of awe? If chocolate cake is 'awesome' then what does that make the Grand Canyon?

Here's another example, a little closer to home.

A medical professional once stated that "genital ambiguity in a newborn represents a true medical emergency."

A "true medical emergency"? Really? So, if genital ambiguity is classed as 'a medical emergency', then, pray, what words should we use to describe a cardiac arrest? On this scale of magnitude, we would really have to use something like 'catastrophic disaster'. OK, so if we describe genital ambiguity as 'an emergency' and a cardiac arrest as 'a catastrophe', then what term do we use to describe an earthquake which kills several hundreds of people?

This devaluing of descriptive language means that we are obliged to constantly raise the stakes and make the most innocuous and trivial happenstance take on the significance of traumatic event. Everything becomes sensationalised and our descriptions of the everyday mundane events of our lives come to resemble a series of tabloid headlines.

Let's look again at that 'medical emergency' quote. Not just any old medical emergency, note, but a 'true' medical emergency. Now, I can't remember the last time I witnessed a false medical emergency. There is no such thing as a 'true emergency' - an emergency is an emergency, period. Something is an emergency or it's not. The addition of the word 'true' in this statement is an affectation used by the speaker to impress upon us that what they are saying is Very Important.

In what way does genital ambiguity constitute an emergency? An emergency is something which presents such immediate danger that action must be taken without delay. The defining element in an emergency is immediate danger. Without immediate danger, it is not an emergency. It may be a serious problem, it may contain the possibility of future danger, but unless that danger is immediate, here, now, in the present, it is not an emergency.

So, what is the immediate danger inherent in genital ambiguity? If it is not treated immediately, will the infant's heart stop beating? Will the respiratory system fail? Will brain damage result?

Let's imagine the scene -

"Oh my god, this girl has an enlarged clitoris! Quick, get the urologist - if we don't take immediate action, she won't last the night!"

Or perhaps -

"Doctor! Doctor! This boy's urethra is not opening at the tip of his penis, it's a quarter of an inch round on the underside of the shaft! If we don't operate immediately, he'll become a vegetable!"

You're right - it is absurd.

I'm a writer. I couldn't perform an appendectomy to save my own - or anyone else's - life so I don't demand that surgeons be highly literate. In saying this, I'm not being rude to surgeons, simply recognising that there are horses for courses. Cutting tissue and manipulating anatomy do not require any great knowledge of grammar or punctuation or even the ability to spell.

What I do expect, however, is that surgeons have sufficient understanding of the meanings of words to maintain a reasonable sense of proportion.

Using terms like "true medical emergency" to describe conditions which, at worst, might possibly have some social or psychological implications in later life but which pose no immediate danger to the physical health of the patient smacks to me of an attempt at manipulation - "I abhor ambiguity and so I will problematise it in such a way as to persuade you that you will be negligent, bad people unless you let me take immediate action to eradicate it".

You're right - it is absurd. But it is an absurdity which is practised on a routine basis and which carries the very real consequences of insensate genitalia, repeated corrective surgeries in later life, confused sense of identity and psychological trauma.

And those can result in "true emergencies".

© Mairi MacDonald, March 2001