Medical Linguistics Failure

    I have a problem with any medical conversation that utilizes the term “Failure” in it.

Acute Renal Failure
Hepatic Failure
Congestive Heart Failure
Failure to thrive ( A personal favorite)
Respiratory Failure
Premature Ovarian Failure
(Name your body part) …Failure.

As an internist where most of my patients have chronic conditions, I deal with many of these “failures” daily. I usually have a pretty good grip on handling the medical aspect of such conditions. It’s the psychological component of such a diagnosis and the counseling necessary, that’s harder.

In my efforts to be an empathetic physician, I’ve likened the experience to as follows.

Let’s say I really like my car, but I don’t know much about how it works. The car starts breaking down for a variety of reasons (partly my fault, which I feel terrible about). Its slower, less fuel efficient, makes all kinds of weird noises, leaks random fluids and generally just doesn’t look as good as it used to. So I take it to my trusted mechanic who after extensive work up tells me I have Name your vital auto part Failure. He offers me this prognosis. Instead of maybe 20 years, the car will last only about another 10 years if I’m lucky. And in those 10 years, I can expect frequent mechanic trips, and I may not have access to that car for weeks at a time. I can expect to try a lot of fixes, some of them quite expensive with questionable efficacy. It’s also our only car, and my family relies on this car for anything and everything.

This would be really upsetting, especially when I connect the dots and come to the conclusion that my car is basically dying.

Patients know what vital organs are, and the term “Failure” implies its demise. Every week, I see patients, anxious and upset about these diagnosis mentioned in passing during hospitalization, by specialists or anyone else with an opinion. So in addition to managing the actual conditions, I have to do psychological damage control by trying to put a positive spin on the situation.

Thank goodness, we are now referring to acute renal failure as acute kidney injury. Besides being a more medically accurate term, it’s so much easier to explain to patients. They are less likely to ask about dialysis now and more likely to ask what injured their kidneys and what they can do to prevent it. 

I move to abolish the term “Failure” from all medical terminology.
It’s medical hyperbole that is unnecessary and frankly makes my job a lot harder! 🙂



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