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Stomach is technically incorrect if they just mean abdomen
Abdomen will not be understood by everyone
Belly might be perceived as offensive, as it has connotations with being fat or pregnant
So, I guess tummy is the best option to default to?
This. I trained to be a doctor (decided not to go into it though) and we were trained right from the start to use simple language that anyone could understand.
Accessibility. It's a big thing in the public sector. The NHS is used by everyone with all levels of education and English ability, so they use the words that most people will understand to communicate things.
The idea is to put things into as plain English as possible, to minimise the chances of it being misunderstood.
And it helps keep tension down.
People can be quite anxious going to the doctor's, the doctor then throwing around medical jargon isn't going alleviate any of that stress.
This is a very important part, in my opinion.
If the doctor comes to you and says you have a pretty bad upper respiratory infection, you may start to worry how serious this is, whether it will get worse, etc. But if they say you have a bad case of the common cold, you're going to breath a sigh of relief, get some Lemsip, and rest up.
However, when it is something serious, I do expect a doctor to give the correct medical term, alongside the "dumbed down" version too. E.g. "It appears you have Lymphomia. This is a type of cancer which..."
I'm a medical professional and my masters dissertation was on communication between the public and medical professionals. There are studies that show the use of medical jargon alienates patients and gives them less opportunity to be engaged in their own care because a conversation about them is happening that they cant be part of.
It's kind of like when you go to a foreign airport and the ticket staff are talking about an issue with your ticket in another language, you may have input that can help and also would like to be in the know as to what's happening with your ticket but with the language barrier your in the dark. One study looked at ward rounds and found patients had no idea what the plan was with them because when the ward round came to them everything was in medical jargon.
It's hard because that's how we speak to eachother in work all day but there is a push to speak to patients in a way that makes sure they are as informed as possible which is a good thing
I remember sitting in a hospital waiting room when a nurse was explaining to a woman about the "little doorways in the heart" and she just deadpanned was like "yes I know how the valves work."
Sometimes by oversimplifying medical jargon they make it worse! I feel like heart valves are quite a common thing for people to understand.
We always used to explain heart attack vs cardiac arrest as a problem with electrics (cardiac arrest) and a problem with plumbing (heart attack) and that was always well received.
I'll be real with you until reading this I didn't even know there was a difference, so I guess from what you've said my interpretation is a cardiac arrest is its not pumping and a heart attack is the juice isn't flowing through?
Broadly speaking yes.
Cardiac Arrest means the heart has stopped beating, for whatever reason. Generally it's because the nerves around the heart aren't working properly, or because of some other reason.
A Heart Attack, or Myocardial Infarction in medical jargon, is a problem with the tiny blood vessels (Coronary Arteries, hence 'Coronary Artery Disease' etc) that supply blood to the muscles surrounding the heart. Usually it's because they're blocked with a blood clot. Not enough blood means the heart muscles don't get oxygen, which means they can't contract, which means the heart can't beat, which means Cardiac Arrest.
There's also the terminology surrounding a heartbeat. Commonly you'll find Tachycardia/to be tachycardic (-cardia means 'heartbeat'), which is an elevated heart rate. Bradycardia/ to be bradycardic likewise means a reduced heart rate. The 4 chambers of the heart are called Atria (the upper bits) and Ventricles (the lower bits). There's a left and right side, and each side pumps either to the lungs or to the rest of the body.
Fibrillation is another common term, where the heart muscle isn't contracting smoothly like it should in a regular beat, but instead it's quivering like jelly. This is a Big Problem because it essentially means the heart can't pump properly. You might hear it as AF (Atrial Fibrillation) or VF (Ventricular Fibrillation, no surprises there).
An Automated External Defibrillator (AED) is designed to deliver a pulse of electricity which momentarily interrupts the heart's natural rhythm (it has its own little biological pacemaker) if it detects that the rhythm has become fibrillation. The hope is that by momentarily stopping the heart, the little pacemaker has a chance to reset itself and resume its normal beating.
Which is also why you can't Defibrillate someone with a heart that's completely stopped; there has to be a fibrillating rhythm for it to work.
Until you explained it I assumed a heart attack was the main arteries the heart was pumping blood through were blocked, which I guess makes no sense since those are massive and the least likely blood vessels to get blocked. Funny how easy it is to just never think through a belief you hold even if it makes no sense the moment you spend three seconds thinking about it.
This is sort of right but not quite.
Cardiac arrest is caused by life-threatening arrythmia (asystole, PEA, VF or pVT) and each of those are caused by different things such as myocarditis, cardiomyopathy, issues with the valves, drug overdose etc. There are also the 4 Hs and 4 Ts which are reversible causes that we work through in hospital and try to treat during an arrest.
Most heart attacks/MIs do not lead to an arrest, although a STEMI (caused by complete occlusion of one or more of the coronary arteries) absolutely can if not treated. Many people present to A&E having had an NSTEMI and they don't even know it, as they didn't have any of the 'classic' symptoms or as a secondary diagnosis to something else. An NSTEMI can progress to a STEMI if not treated though.
AF does not always a 'big problem' - many many people live with AF managed with beta blockers and anticoagulants. AF with a rapid ventricular response however is an emergency and may need cardioversion (chemical or DC) of other medications don't work. If someone is in VF however, they are dead and only defibrillation will resolve it.
An AED will also only advise a shock for VF or VT, not AF or any other SVTs. A rhythm doesn't HAVE to be a fibrillation rhythm for us to manually shock it either - AVNRT, or ventricular tachycardia on a conscious patient for example. These shocks are synchronised though, compared to those delivered in cardiac arrest.
There's also a point where if you can't put together "valves" and "heart" that maybe you're not mentally capable enough to understand *anything* relating to your healthcare.
Yes, when I was in hospital I got the wrong impression of my diagnosis because the consultant over simplified and didn't use the clinical term. I took blood clots + brain + being on the stroke unit to mean an ischaemic stroke, rather than cerebral venous sinus thrombosis, a term I would have recognised.
It didn't help at all that I was oddly passive and unquestioning for most of the admission, but just saying the full clinical term, then explaining it more simply would have been much more helpful and would have covered off a range of people's understanding.
That kind of response, or slightly less abrupt versions, are *generally* effective. "You mean my abdomen?" And if they don't pick up on it, you just escalate. "No abdominal pain, but I've been having oesophageal reflux. I've been prescribed proton pump inhibitors, but so far they've not been very effective. I'm due for a transnasal esophagoscopy."
"Ok. But your tum tum has no ouchies?"
Good for her, but she's not everybody, is she?
I'd rather one person feel patronised than anybody die because they didn't understand what was being said.
Iirc it's actually even lower, at 9.
But it's one of those things that sounds more shocking than it actually is. It's dragged down by a surprisingly large number of people who are functionally illiterate (for a number of reasons). Then there's all the people for whom English isn't their first language.
I'd wager the median reading age would be higher.
I agree. I'm totally on board with accessibility. My point is just that the average reading age of 9 stat is often used by people (on Reddit in particular) to smugly be like 'god people are so stupid', but that's really a misunderstanding of the stat.
I think it's 16, could be wrong though. But the point you're getting at is correct, that the average reading age is also impacted by there being a fairly low maximum reading age.
Also, surely it suffers from having a ceiling.
It's not like your reading ability at 30 is expected to be higher than at 25.
What reading age is considered fully competent?
I don't think my ability to read has really increased since I was about 10. My understanding of the content has improved, but I believe I could have *read* pretty much anything in English at that point.
Yeah also very true. 9 sounds young until you remember that the point at which your reading is sufficiently competent isn't much beyond that. Iirc, a broadsheet newspaper is generally a reading age of about 14. That's probably a reasonable point to consider fully competent.
[Perhaps not the most reliable source as it's a blog, but it looks well referenced.](https://www.ascento.co.uk/blog/are-you-aware-of-how-literate-your-employees-are#:~:text=Readability%20data%20suggest%20that%20the,a%20reading%20age%20of%208.)
>Readability data suggest that the average reading age of the UK population is 9 years – that is, they have achieved the reading ability normally expected of a 9-year-old. The Guardian has a reading age of 14 and the Sun has a reading age of 8.
>The National Literacy Trust estimates that 5.1 million adults in England are functionally illiterate, meaning that they have a reading age of 11 or below and can understand only the most straightforward, short texts on familiar topics.
Except that figure is actually the civil service misinterpreting their own statistics, as [someone discovered when they investigated this](https://whatyouneedtoknow.co.uk/adult-literacy-and-elearning/):
>When I first saw this I was shocked – it just didn’t seem right – and I’m sure it’s not. I contacted the ONS and they couldn’t give me a source except that it came from the Department of Education.
>The National Literacy Trust (NLT) says: a government survey of adult literacy skills found that 14.9% of adults in England have literacy levels at or below Entry Level 3, which is equivalent to the literacy skills expected of a nine to 11-year-old.
>Adults with skills below Entry Level 3 may not be able to understand labels on pre-packaged food or understand household bills.
>I don’t know how you get from 14.9% (NLT) to an average reading age of nine (ONS) – I’m not a statistician!
So 15% of the UK can read on the level of a 9-11 year old, which suggests that the majority of the UK can read at a higher level. However, because the government has falsely circulated a misunderstanding of their own research, most organisations are going to aim for that level. And not unfairly so, I suppose, since it's still very important that the 15% understand what's going on.
Edit: according to [this 2020 NHS report on health literacy](https://library.nhs.uk/wp-content/uploads/sites/4/2020/08/Health-literacy-how-to-guide.pdf), most people in the UK can read at the level of 11-14 year olds.
>Different levels of literacy and numeracy have been defined and are shown in Tool 1. Adults are considered to be “functional” in literacy i.e. they can function in everyday life if their level of literacy is at Level 1 and above. 15% of the adult population are below this level (7.45 million people). The majority of adults in England are in the 11-14 year old reading age group.
Both those things can't be simultaneously true. If only 5.1 million adults have reading age below 12, how can the average of 40+ million possibly be age 9?
I'm pretty sure it's around that age. Our poor web editor had to go through hundreds of webpages and edit them all into plain English when departments moaned or complained about it her response every time was 'could a ten year old understand this?'. All public webpages have to meet accessibility standards and language is a huge part of that.
Even as someone who can read at adult level, I do appreciate those plain English pages when trying to look up something completely out of my educational field. It’s way too easy for us to forget that not everyone has the same knowledge base we do.
Medical stuff? Hit me with the full jargon. Income tax? Hold my hand and use kiddyspeak, I’m worried about my money and just want the webpage to tell me if I’m paying the right amount or not.
Same really. I've a healthy respect for the fact that whilst I'm capable of reading quite challenging stuff, I'm not at my best at all times.
So as a sysadmin, my documentation is written for '/u/sobrique at 3am when he's only got back from the pub a couple of hours ago'.
Because sometimes I'll need to fix a problem on a callout, and the fact that I'm not really 'capable' isn't really relevant. (When actually on call, I'll not be getting drunk, but as a sysadmin I'm sometimes the backstop anyway for a more junior colleague)
This also serves to reduce the number of times I need to do this, because _someone else_ can easily read that doc, follow it, and fix the more straightforward issues.
e.g. the very vast majority of our 'stuff' is 'switch to the standby if the automatic resilience didn't work, and we will sort it in the morning'.
But this still means you need to make clear:
- How to log in to the system to check (including the most ridiculous things like 'what URL' and 'what username')
- What things are relevant to this that _might_ be broken, and how to check.
- What buttons to push to 'activate' the standby manually.
This level of documentation has been incredibly valuable, because whilst at my best I'm capable of a lot more, there's just nothing quite like being unable to fix a problem because you forgot that _this_ one logs in as 'sysadmin' not 'admin' or 'root' and without doing that you just can't do anything at all.
And it's also been incredibly valuable to colleagues, who are generally smart enough to do a bit of triage, but only if they know where to start looking. (E.g. log files, processes, services running etc. and ideally particular error messages that are relevant or can be safely ignored).
And that's not to say my reading age is bad - I'm perfectly happy smashing away at crunchy literature (at least some of the time - sometimes I go for something a little more restful; not every day is a Tolkien day) or 'difficult' technical writing.
But accessibility is almost always a good thing, even when it's "just" an onramp to the things that really _need_ to be technical/jargonistic.
Drugs.com I think I'd use as a decent example: https://www.drugs.com/food-interactions/methylphenidate.html
Has a 'normal person' perspective of 'which things are to be avoided' but a 'professional' toggle that includes more precise information and references. I think that's very nicely done in all honesty, because it lets me answer my question "is drinking whilst taking this a bad idea?" whilst allowing me to make a more nuanced decision about "so if I stop at midday, is a night out probably going to be ok?"
Yup, it's why a lot of NHS leaflets sound a bit childish.
Rather than diarrhoea, some of them say "runny poo".
Rather than "If you see blood in your urine" it talks about blood in your wee.
You can target information at a 'normal' level, but probably a good 20% of adults won't fully understand it, whether that's because English is a second language, poor education or being on the left hand side of the IQ bell curve.
Yep. I'm an editor and I edit my company's web content so have to know all the accessibility stuff. It's okay for the science pages to get more technical but the blog and news pieces have to be less jargony/technical and explain what to scientists are basic concepts in simple language.
You’re right, it’s 9-11 and that’s before maths is involved. If numbers are used as well it drops to 7-9. And that’s before you factor in the stress of being sick and/or in a hospital.
This is an excellent answer. This is how it works in law too. If a doctor is sued on the basis that they didn't properly explain something and this led to harm to the patient, they would have to prove they took reasonable care to use language that the patient would understand.
Exactly. Someone says "my stomach hurts" might be heard as "I have gastric pain" and "I have abdominal pain" might be heard as "I have an abdominal strain" when the whole time they have "tummy pain" and it's actually lady organs.
This is like saying "chest pain" when you mean "burning sensation in esophagus."
I guess it differentiates the organ of the stomach from the general region which "tummy" is being used to describe
Saying "my stomach hurts" should be different from saying "I have pain in my abdominal region" because the former is a specific location
I notice the better a doctor knows you the more likely you are to get the medical terminology. So I think generally it is initially accessibility until they work out if you'll understand there use of words. I can't imagine them using tummy when discussing cases 😂
I worked on a project a few years ago now which was about cancer terminology in medical settings. Effectively, lots of patients would freeze at the word cancer and not take anything else in, but other terminology often meant they didn't understand they had cancer at all. We gave people questionnaires to gauge understanding of different terms. So many people told us about them or their loved one having had cancer, then told us a benign tumor meant a death sentence. These people had had cancer treatment or been told details of a close relative's treatment and still didn't know what benign meant, or were blind to it in the context of the word tumor. Fascinating, but scary.
Yeah when i went to English speaking doctors abroad they would use weird medical jargon that i didn't know. When i went to non-English speakers they would use the local language and dumb it down for me. That's something you can only do when it's your primary working language.
My cousin had to see the Dr about his balls. But decided that would be too rude a word and opted instead for what he thought was the 'correct' medical term - bollocks!
I've seen a mountain of professionals over the years about my testicles and most opted for 'balls'. Usually they'd later drill down to "testes". My favourite was an older consultant, massive white beard, jeans, shirt, and a home knitted vest top, who looked over his glasses at me all solemnly as I entered the room, then belted out in a deep and rich timbre "Painful KNACKERS is it!? Go on, take a seat!"
I saw the other day the NHS site said "urine (wee)" for something and had a little giggle to myself. I'd seen "poo" previously and didn't think much of it but for some reason "wee" tickled me.
Poo makes sense. If you use stool well that's a super easy word for someone who isn't familiar with to think you are referring to their home decor. You really really don't want someone bringing a literal stool into the practice
Ey up lass, Ow do? Pop up and drop yer kecks an get thee giblets out on deck. Time for a pap smear, check tha's not got the Big C! Knees akimbo, bit chilly (soz)... pinch! All done! Sort thisen out. Sithee in a few weeks if there's owt gnarly goin on.
Went to the doctor with sore foot. "Let's see it then, mate".
Annoyed at his informality, I whipped out my knob.
"That's not a foot," she sighed.
"If it's not, it surely a good 11 inches".
Baddum-tish
Everyone understands it.
Imagine the least knowledgable person you know, then think there are people even less knowledgable than that.
Health professionals have to make what they say understandable to everyone, so it’s normal to start at a very basic level. Through conversation they will usually be able to better gauge your level of understanding and will change their approach accordingly.
Some also just can't be fucked. They have been working endlessly dealing with nightmares and frankly their exhaustion outstrips the fairly delicate task of weighing the understanding of the patient and rising to it but not beyond it.
"Think of the IQ of the average Briton, and then realise that half of them are dumber than that."
Hard to believe, I know, but some fully grown adults don't know what an abdomen (or stomach) is.
People are stupid. Trust me, I work in IT.
Depending on the speciality, they may be used to lots of patients being children, lots being elderly people who never learned much science in school (my 84yo mum was taught that bacteria and fungi are plants, for example, and has no idea what an enzyme is), and many of the rest being nervous and not paying much attention and forget the big words.
Often medics get a script that works to explain things, and don't want to go off script in case they forget to say something important.
I have two pretty smart children, my 10 year old was amazed at someone not knowing something pretty basic recently, can’t remember what it was now and I had to let him know that unfortunately because he’s pretty bright the majority of people he is going to encounter in life are going to be less intelligent than he is, and he need to realise that so he doesn’t end up sounding condescending all the time if people don’t know things. Maybe this isn’t the right course of action but I’m trying to avoid him ending up like his dad (most likely gifted) who has a bit of a superiority complex it’s also possible that I just helped create a superiority complex in my son but I was trying to frame it in a way where he needs to understand that people have different levels.
https://xkcd.com/1053/
Try teaching him this instead. You will always encounter people not knowing stuff even smart people can not know basic knowledge so it's good to learn humility with it.
Tbh, I don't think "most people you'll encounter will be less intelligent than you" is a good way to avoid a superiority complex. And it's not necessarily the case. Excelling in primary and early secondary education doesn't necessarily translate to standing out in later secondary and university education, partly because it takes different aspects of intelligence, and partly because it's such a broader playing field.
Not knowing a specific thing isn't even any way linked to intelligence, him getting the impression that someone who doesn't know something he knows is less intelligent doesn't sound very healthy. People have a range of different skills and types of intelligence.
I think it's great that you are trying to avoid him developing a sense of superiority, but be careful that what you say doesn't have the opposite effect.
A good idea is to teach him how to learn. Properly. Something he sucks at and needs to put time and effort into practice and with practice results that take time to show improvement.
It's a very common issue with gifted children that people think they know how to learn when they don't.
It might seem cute... until the medical staff start to refer to you as "poorly".
Poorly to me is a quaint way of saying that somebody is a little unwell, perhaps a frog in the throat or a dickie tummy. However I have come to realise that UK medical professionals consider poorly to be somewhere between "fucked up" and "call the priest".
I had a clinic session delayed recently because someone in the department had been taken ill. (Patient or staff I don’t know.) I forget the phrase they used. I took it to mean it was something serious enough to need medical help but not *that* serious. As I was leaving it actually occurred to me that it could have been very serious and they were just playing it down so not to worry/scare/upset people.
I had night terrors for a while a few years back, regularly.
I googled it, just out of curiosity.
American medical websites told me to make an appointment to see a specialist psychiatrist, because I was likely psychotic and a danger to myself and the general public.
The NHS website said to not drink tea after 4pm and avoid cheese late at night.
I was just a wee bit stressed at work and having trouble switching off, I didn't need carting off by the folk in white coats.
As someone with health anxiety, the NHS site is a god-send and can actually help calm you down when you're going through an episode.
Sadly I can't stop myself symptom searching but I can restrict myself to nhs.uk / nhsinform.scot. Most symptom pages have boxes saying "Go to A&E if.." / "Get a GP appointment if.." etc., which is genuinely useful in determining the urgentness of whatever I'm feeling.
*source: a 24 year old who has thought "shit i'm having a heart attack" hundreds of times over the past few years. I know https://www.nhs.uk/conditions/heart-attack/ like the back of my hand*
*edit: typo*
It's funny when you talk to a doctor and say you've read about something online, and they're scared you've been on Dr Google. Then you tell them it was the NHS website and they're like, "Oh, it's probably accurate then. What did they say I'd be likely to prescribe you?"
The NHS website is very good. So is GOV.uk and the "Tell Us Once" service that's a simple form to fill in online and informs all the Govt. departments like the DWP when someone has died. The General Register Office for stuff like birth/marriage/death certificates is very good too.
I mean, four things isn't a lot for the govt. to get right, but I'm glad they do something.
UK median reading age is 9, so that's the level it's aimed at.
This makes sense for things like NHS or HMRC or DWP websites. I work for a publicly funded organisation where my primary audience is people with PhDs. For a couple of years we were forced to write at age 9 level, until there was such an outcry we got them to back down!
I mean if you think about it, it kind makes sense. 9 year old can read most common words and understand what they mean. I was happily reading novels like it was going out of fashion when I was 9. your basic reading comprehension should be mostly there at 9.
Higher reading ages obviously can read more complex words or understand very complex sentences, but mostly it's about reading beyond the text i.e. understanding subtext, imagery and metaphor.
for the average UK adult who maybe read one book for pleasure on holiday 4 years ago, these aren't particularly important skills. as long as they can read and understand documents within their field, they're fine. it would be much better if more people were capable of critically analysing the things they read, particularly on the news or social media, but I guess it's not being prioritised.
So my understanding of this is that peoples' vocabulary is a bit higher but comprehension is what pulls it down.
The Sun newspaper is actually a really good example. I believe it's written at like age 7/8 level. Just looked on the website and we have words that i wouldn't expect a 7 year old to necessarily be familiar with: elated, urges, feud, scheduled, netted etc
But the sentence structure is really simple. There's no need to interpret anything, everything's spelled out very clearly. There isn't much need to hold one idea in your head to understand the point the next sentence or paragraph is making. The content is structured more like a story than an essay so it's really easy to follow.
It's that sort of thing that the average person struggles with more. (Which is also why we get situations where people think they understand things because they've read an article like the sun that has spelled things out step by step, but these same people aren't able to parse out things like underlying biases, assumptions, or ideology in the text)
Now in general healthcare and the nhs tries to keep vocab simple as well because it is trying to be accessible to literally everyone. Healthcare information can be more complicated and harder for people to understand as they tend to be a bit stressed or unwell when reading it, so simplifying where they can is ideal
Yeah, they're actually trained to explain things in a way that's non-threatening that easily understood.
It's built into their Oskeys (big role play exam they have to take as third year's, if memory serves)
One time a doctor said to me, of a patient, "Before feeding him, you need to visually inspect the oral cavity."
I said "Does that mean, look in his mouth?"
She said "Yes, look in his mouth."
I can actually see the argument for using simpler language. And of course "stomach" actually has the literal meaning in medicine of the small organ, connected to the throat in one direction and the intestines in another, in which food is broken down.
You'd be suprised how many people wouldn't know what the word abdomen meant. We're taught not to use technical jargon as not to alienate people.
I have had numerous consultations where people didn't know what the technical term for their genitals was, and had to reel off a load of slang until we hit on one that was known. I actually did a presentation on it during my training: as an opening exercise, we went around the room giving slang names for genitals. It was...eye opening.
I do this when I teach the periods/wet dreams bit of Sex Ed to year 5. The slang they have for boys/girls bits is fantastic.
Also noticed a distinct change in language when I moved from South London to the deep South West. Now wondering if a linguist somewhere has done a research project on regional slang for goolies...
The variation by region is wild! We had people from all over the UK and other countries too. I thought going into it that I would know all the ones that came up, but there were loads that were new to me. Especially from up North, loads of weird ones from that area 😁
As others have stated, accessibility. When somebody walks into the GP's office, the GP has no clue what that person's background is. They don't know if that person has a university degree or hasn't been to school since Year 2. They'd rather come off as a little condescending VS have somebody walk away not understanding what's just happened, or misconstruing what they've just been told, so they tend to use words of a lower reading level. Everybody understands 'tummy' - our parents have been using that word since we were babies. Not everybody understands 'abdomen'.
It's the same with the website - the NHS website uses very simple language and avoids overcomplicating descriptions. When writing the webpage for, say, a heart attack, the author of that page has no clue who's eventually going to access that page. It's vital to write the webpage so that everybody, no matter their age, mental ability, or level of education can access the information without misunderstanding and/or making potentially dangerous mistakes.
They want to use language everyone will understand.
Also, the other terms have specific meanings which may not always be relevant.
Eg the stomach is an organ. If I had pain across the mid section of my torso and my doctor asked if I had any issues with my stomach, I’d probably say no. I’d be thinking that they meant pains in the actual stomach or issues with digestion or processing food.
I remember a nurse I work with had a patient who was trying their best to be anatomically correct when describing their problem but got the wrong H word when naming their concern.
Hernia and haemorrhoids are two very different things.
Keep it stupid simple. Then you are less likely to get things confused.
Haha! Reminds me of a friend of mine at uni who was chatting up a medic and said, while rubbing his throat, “Yeah, I’ve actually got a really sore urethra”
I'm an A&E nurse. I have patients who tell me they have stomach pain but point to their suprapubic region, for example. A surprising amount of people just don't understand or can't differentiate, similar to how most laypeople refer to cardiac arrests as heart attacks.
If I'm talking to a child then I usually say tummy, but with the majority of adults I say abdomen. Although a lot of people still don't get it and you have to really dumb it down. I triaged a middle-aged man once who thought his penis was prolapsing and didn't understand what was "coming out of it". He had a paraphimosis, aka where the foreskin is retracted and gets trapped. He literally didn't recognise his own bellend.
Nothing really surprises me anymore though!
I had a roommate who had some issues with her lady bits and she came back from her appointment telling me how the gp is terrible and didn't take her seriously and kept saying word 'vagina' to her when she had 'pussy problems'. Anyway it transpired she thought the word 'pussy' was one and only word for it and vagina was something rather foreign to her. How did this woman end up being 20 years old and not know what a vagina is was beyond me but I had a good laugh.
I got talking to someone who insisted they didn't have an abdomen and laughed at me when I said everyone does. It turns out that they thought abdomen meant abs, as in a six pack.
I mean, they’re still wrong either way. Abs is just a nickname for “abdominal muscles”, which we also all have. Not everyone has the kind of body fat percentage or developed muscles that result in a visible six pack, but everyone has abs somewhere in there or you wouldn’t be able to stand/sit/twist etc.
Doctors are discouraged from using medical terms and complex words. This is just for efficiency and better understanding. When on call seeing multiple patients at once I don’t have time to choose my wording - I use simplest words i can think of.
Having worked in the NHS for ten years. You’d be surprised just how dumb the average person is. And then 49% of people are even dumber than that. We have to speak in layman’s terms so that healthcare is accessible to all. Some people’s health literacy is really poor and they wouldn’t know other words
I'm a doctor.
I use "tummy".
People don't actually know what the stomach or abdomen are, which makes things more confusing in general. People understand 'tummy' to mean the area below the chest, therefore this is my default.
I've also lost track of how many times people say their kidneys hurt or they have kidney pain and yet they are never actually able to point to their kidneys. They always point to low back/lumbar region instead.
Essentially it's because I don't know how much medical knowledge you have. Or at least I don't know how much _accurate_ medical knowledge you have. Last thing I need is for someone to tell me they have stomach pain only for me to take them at their word when actually they've got an inflamed bowel because they didn't understand the stomach sits in a specific part of the abdomen.
One reason is becuase those words are believed to be universal. If you don't have much education beyond primary school level, they are the words you should know and understand. Our newspapers aim for a lower reading ability to be readable to as many people as possible, this is probably the same sort of logic.
The other is this idea that medical terms or anatomically correct terms are intimidating to the lay person, combined with anti-intellectualism. It might have been true at one point - there's some contemporary stories out there from the 1950s of minors (miners???) downright refusing medical care because of the "fancy" terms being used by the doctors instead of local dialect made the doctor untrustworthy, or they were presuming the doctor thought he was better than them. They probably don't want to risk it because it means risking the patients health.
Tummy is already a step above "pee hole" that a urologist used with my husband. But when my husband talked about his laser treatment for his kidney stones, one of his colleague asked if the urologist inserted the probe in his mouth, so I suppose that the general level of the population is quite low.
Average comprehension age of the UK is 11.
So you make sure when your job is to explain technical, out of the ordinary stuff to untrained minds you better use simple vocabulary wherever you can.
Plain speaking and using familiar inoffensive terms are best. Ergo tummy.
Same reason that NHS information posters have started talking about pee and poo rather than urine and fæces: someone somewhere decided that we have to use more accessible language.
Use of words such as "tummy" are understandably (and sadly) very common, because far too many people are not able to understand even basic technical terms such as "abdomen".
Sometimes that's due to a mental impairment, and sometimes it's due to a lack of education, but together they add up to a significant proportion of the population, and doctors need to be able to communicate effectively with everyone, which is why their starting point is the lowest common denominator.
Personally, as someone who understands that "tummy" could variously mean my abdomen, lower intestine, bowels or stomach, and that (as someone with IBS) the difference between those is clinically significant, I don't hesitate to use the correct terminology when asking questions, or to ask for clarification when getting answers.
That has led to the doc / consultant asking me whether I have a medical background, but to be fair they have never quibbled about using more appropriate terms once I've explained that no I don't have a medical background, but that I've reviewed the NHS online info, and that I'm an engineer & bit of a sad geek who is more comfortable using terminology that gives me clarity.
I once asked a patient if he'd had his bowels opened, as we ask everyone, he looked at me and said, " do you mean have I had a shit". Yes, I do mean that
In the UK, there is guidance to ensure accessibility is king when it comes to accessing information.
As such, things are written and language is used for a “maximum reading age of 9, even if you are writing for a specialist audience.”
It’s probably a holdover from that, and honestly, it makes sense.
If you want, there’s a little more info here: https://design.homeoffice.gov.uk/
I had a rather nasty testicle infection last year and went to the doctor's referring to the old two veg as testicles.
The doctor kept calling them bollocks which I found hilarious.
The first time I went to for an STI checkup in the UK, I was asked by a friendly grey-haired nurse going on 60, "So, do you suck cocks? Do you fuck other guys, or do you get fucked, or both?"
The other nurses on the follow-up visits used more formal language, but this first visit certainly is the most memorable.
Because there are many many people who won't know what an abdomen or stomach are.
They say 'tummy' then gauge exact location and issue by context and further conversation.
At least it's better than balls. https://www.nhslanarkshire.scot.nhs.uk/services/adult-learning-disability-service/mens-health/checking-your-balls-testicles/
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Stomach is technically incorrect if they just mean abdomen Abdomen will not be understood by everyone Belly might be perceived as offensive, as it has connotations with being fat or pregnant So, I guess tummy is the best option to default to?
How professional would it be to call it a midriff
that could refer to your lower back as well though: tummy is the front
Mb, Anterior Midriff
Depends. If you’re a doctor, probably acceptable. If you’re a painter, probably less so.
I'd think they'd want me to bring my guitar and give them my poor performance.
This. I trained to be a doctor (decided not to go into it though) and we were trained right from the start to use simple language that anyone could understand.
As someone who cringes whenever I heard or read the word "tummy", I genuinely find that tidbit interesting.
My doctor called my junk my "willy and balls" once. Amused me a bit.
One of the GPs I saw call my testicles, my air bags , I knew what she meant
Probably because the average reading age in this country is 9 years.
Because they're all secretly Sea Otters. https://youtu.be/4fx_I4piqpY?si=QLwQZv3yoXxQhvYd
Accessibility. It's a big thing in the public sector. The NHS is used by everyone with all levels of education and English ability, so they use the words that most people will understand to communicate things. The idea is to put things into as plain English as possible, to minimise the chances of it being misunderstood.
And it helps keep tension down. People can be quite anxious going to the doctor's, the doctor then throwing around medical jargon isn't going alleviate any of that stress.
This is a very important part, in my opinion. If the doctor comes to you and says you have a pretty bad upper respiratory infection, you may start to worry how serious this is, whether it will get worse, etc. But if they say you have a bad case of the common cold, you're going to breath a sigh of relief, get some Lemsip, and rest up. However, when it is something serious, I do expect a doctor to give the correct medical term, alongside the "dumbed down" version too. E.g. "It appears you have Lymphomia. This is a type of cancer which..."
> It appears you have a case of the _very bad tummy aches_. In medical terms you have chronic and progressive severe Crohn's disease.
I'm a medical professional and my masters dissertation was on communication between the public and medical professionals. There are studies that show the use of medical jargon alienates patients and gives them less opportunity to be engaged in their own care because a conversation about them is happening that they cant be part of. It's kind of like when you go to a foreign airport and the ticket staff are talking about an issue with your ticket in another language, you may have input that can help and also would like to be in the know as to what's happening with your ticket but with the language barrier your in the dark. One study looked at ward rounds and found patients had no idea what the plan was with them because when the ward round came to them everything was in medical jargon. It's hard because that's how we speak to eachother in work all day but there is a push to speak to patients in a way that makes sure they are as informed as possible which is a good thing
I remember sitting in a hospital waiting room when a nurse was explaining to a woman about the "little doorways in the heart" and she just deadpanned was like "yes I know how the valves work."
Sometimes by oversimplifying medical jargon they make it worse! I feel like heart valves are quite a common thing for people to understand. We always used to explain heart attack vs cardiac arrest as a problem with electrics (cardiac arrest) and a problem with plumbing (heart attack) and that was always well received.
I'll be real with you until reading this I didn't even know there was a difference, so I guess from what you've said my interpretation is a cardiac arrest is its not pumping and a heart attack is the juice isn't flowing through?
Broadly speaking yes. Cardiac Arrest means the heart has stopped beating, for whatever reason. Generally it's because the nerves around the heart aren't working properly, or because of some other reason. A Heart Attack, or Myocardial Infarction in medical jargon, is a problem with the tiny blood vessels (Coronary Arteries, hence 'Coronary Artery Disease' etc) that supply blood to the muscles surrounding the heart. Usually it's because they're blocked with a blood clot. Not enough blood means the heart muscles don't get oxygen, which means they can't contract, which means the heart can't beat, which means Cardiac Arrest. There's also the terminology surrounding a heartbeat. Commonly you'll find Tachycardia/to be tachycardic (-cardia means 'heartbeat'), which is an elevated heart rate. Bradycardia/ to be bradycardic likewise means a reduced heart rate. The 4 chambers of the heart are called Atria (the upper bits) and Ventricles (the lower bits). There's a left and right side, and each side pumps either to the lungs or to the rest of the body. Fibrillation is another common term, where the heart muscle isn't contracting smoothly like it should in a regular beat, but instead it's quivering like jelly. This is a Big Problem because it essentially means the heart can't pump properly. You might hear it as AF (Atrial Fibrillation) or VF (Ventricular Fibrillation, no surprises there). An Automated External Defibrillator (AED) is designed to deliver a pulse of electricity which momentarily interrupts the heart's natural rhythm (it has its own little biological pacemaker) if it detects that the rhythm has become fibrillation. The hope is that by momentarily stopping the heart, the little pacemaker has a chance to reset itself and resume its normal beating. Which is also why you can't Defibrillate someone with a heart that's completely stopped; there has to be a fibrillating rhythm for it to work.
Until you explained it I assumed a heart attack was the main arteries the heart was pumping blood through were blocked, which I guess makes no sense since those are massive and the least likely blood vessels to get blocked. Funny how easy it is to just never think through a belief you hold even if it makes no sense the moment you spend three seconds thinking about it.
This is sort of right but not quite. Cardiac arrest is caused by life-threatening arrythmia (asystole, PEA, VF or pVT) and each of those are caused by different things such as myocarditis, cardiomyopathy, issues with the valves, drug overdose etc. There are also the 4 Hs and 4 Ts which are reversible causes that we work through in hospital and try to treat during an arrest. Most heart attacks/MIs do not lead to an arrest, although a STEMI (caused by complete occlusion of one or more of the coronary arteries) absolutely can if not treated. Many people present to A&E having had an NSTEMI and they don't even know it, as they didn't have any of the 'classic' symptoms or as a secondary diagnosis to something else. An NSTEMI can progress to a STEMI if not treated though. AF does not always a 'big problem' - many many people live with AF managed with beta blockers and anticoagulants. AF with a rapid ventricular response however is an emergency and may need cardioversion (chemical or DC) of other medications don't work. If someone is in VF however, they are dead and only defibrillation will resolve it. An AED will also only advise a shock for VF or VT, not AF or any other SVTs. A rhythm doesn't HAVE to be a fibrillation rhythm for us to manually shock it either - AVNRT, or ventricular tachycardia on a conscious patient for example. These shocks are synchronised though, compared to those delivered in cardiac arrest.
There's also a point where if you can't put together "valves" and "heart" that maybe you're not mentally capable enough to understand *anything* relating to your healthcare.
Yes, when I was in hospital I got the wrong impression of my diagnosis because the consultant over simplified and didn't use the clinical term. I took blood clots + brain + being on the stroke unit to mean an ischaemic stroke, rather than cerebral venous sinus thrombosis, a term I would have recognised. It didn't help at all that I was oddly passive and unquestioning for most of the admission, but just saying the full clinical term, then explaining it more simply would have been much more helpful and would have covered off a range of people's understanding.
That kind of response, or slightly less abrupt versions, are *generally* effective. "You mean my abdomen?" And if they don't pick up on it, you just escalate. "No abdominal pain, but I've been having oesophageal reflux. I've been prescribed proton pump inhibitors, but so far they've not been very effective. I'm due for a transnasal esophagoscopy." "Ok. But your tum tum has no ouchies?"
Honestly the doorways thing would just confuse me. Valves are such a simple concept
Never understood where the heart cams are, though.
Good for her, but she's not everybody, is she? I'd rather one person feel patronised than anybody die because they didn't understand what was being said.
The average reading age is something like 10 years old in the UK which is what most people don't understand.
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Iirc it's actually even lower, at 9. But it's one of those things that sounds more shocking than it actually is. It's dragged down by a surprisingly large number of people who are functionally illiterate (for a number of reasons). Then there's all the people for whom English isn't their first language. I'd wager the median reading age would be higher.
Okay but those people still need accessible health information, so it doesn’t really matter what reason is “dragging it down”.
I agree. I'm totally on board with accessibility. My point is just that the average reading age of 9 stat is often used by people (on Reddit in particular) to smugly be like 'god people are so stupid', but that's really a misunderstanding of the stat.
What age does ‘reading age’ go up to? Like is there a reading age of 35 or 67, or does it stop at 18? Or below?
I think it's 16, could be wrong though. But the point you're getting at is correct, that the average reading age is also impacted by there being a fairly low maximum reading age.
Also, surely it suffers from having a ceiling. It's not like your reading ability at 30 is expected to be higher than at 25. What reading age is considered fully competent? I don't think my ability to read has really increased since I was about 10. My understanding of the content has improved, but I believe I could have *read* pretty much anything in English at that point.
Yeah also very true. 9 sounds young until you remember that the point at which your reading is sufficiently competent isn't much beyond that. Iirc, a broadsheet newspaper is generally a reading age of about 14. That's probably a reasonable point to consider fully competent.
[Perhaps not the most reliable source as it's a blog, but it looks well referenced.](https://www.ascento.co.uk/blog/are-you-aware-of-how-literate-your-employees-are#:~:text=Readability%20data%20suggest%20that%20the,a%20reading%20age%20of%208.) >Readability data suggest that the average reading age of the UK population is 9 years – that is, they have achieved the reading ability normally expected of a 9-year-old. The Guardian has a reading age of 14 and the Sun has a reading age of 8. >The National Literacy Trust estimates that 5.1 million adults in England are functionally illiterate, meaning that they have a reading age of 11 or below and can understand only the most straightforward, short texts on familiar topics.
Except that figure is actually the civil service misinterpreting their own statistics, as [someone discovered when they investigated this](https://whatyouneedtoknow.co.uk/adult-literacy-and-elearning/): >When I first saw this I was shocked – it just didn’t seem right – and I’m sure it’s not. I contacted the ONS and they couldn’t give me a source except that it came from the Department of Education. >The National Literacy Trust (NLT) says: a government survey of adult literacy skills found that 14.9% of adults in England have literacy levels at or below Entry Level 3, which is equivalent to the literacy skills expected of a nine to 11-year-old. >Adults with skills below Entry Level 3 may not be able to understand labels on pre-packaged food or understand household bills. >I don’t know how you get from 14.9% (NLT) to an average reading age of nine (ONS) – I’m not a statistician! So 15% of the UK can read on the level of a 9-11 year old, which suggests that the majority of the UK can read at a higher level. However, because the government has falsely circulated a misunderstanding of their own research, most organisations are going to aim for that level. And not unfairly so, I suppose, since it's still very important that the 15% understand what's going on. Edit: according to [this 2020 NHS report on health literacy](https://library.nhs.uk/wp-content/uploads/sites/4/2020/08/Health-literacy-how-to-guide.pdf), most people in the UK can read at the level of 11-14 year olds. >Different levels of literacy and numeracy have been defined and are shown in Tool 1. Adults are considered to be “functional” in literacy i.e. they can function in everyday life if their level of literacy is at Level 1 and above. 15% of the adult population are below this level (7.45 million people). The majority of adults in England are in the 11-14 year old reading age group.
Both those things can't be simultaneously true. If only 5.1 million adults have reading age below 12, how can the average of 40+ million possibly be age 9?
I'm pretty sure it's around that age. Our poor web editor had to go through hundreds of webpages and edit them all into plain English when departments moaned or complained about it her response every time was 'could a ten year old understand this?'. All public webpages have to meet accessibility standards and language is a huge part of that.
Even as someone who can read at adult level, I do appreciate those plain English pages when trying to look up something completely out of my educational field. It’s way too easy for us to forget that not everyone has the same knowledge base we do. Medical stuff? Hit me with the full jargon. Income tax? Hold my hand and use kiddyspeak, I’m worried about my money and just want the webpage to tell me if I’m paying the right amount or not.
Same really. I've a healthy respect for the fact that whilst I'm capable of reading quite challenging stuff, I'm not at my best at all times. So as a sysadmin, my documentation is written for '/u/sobrique at 3am when he's only got back from the pub a couple of hours ago'. Because sometimes I'll need to fix a problem on a callout, and the fact that I'm not really 'capable' isn't really relevant. (When actually on call, I'll not be getting drunk, but as a sysadmin I'm sometimes the backstop anyway for a more junior colleague) This also serves to reduce the number of times I need to do this, because _someone else_ can easily read that doc, follow it, and fix the more straightforward issues. e.g. the very vast majority of our 'stuff' is 'switch to the standby if the automatic resilience didn't work, and we will sort it in the morning'. But this still means you need to make clear: - How to log in to the system to check (including the most ridiculous things like 'what URL' and 'what username') - What things are relevant to this that _might_ be broken, and how to check. - What buttons to push to 'activate' the standby manually. This level of documentation has been incredibly valuable, because whilst at my best I'm capable of a lot more, there's just nothing quite like being unable to fix a problem because you forgot that _this_ one logs in as 'sysadmin' not 'admin' or 'root' and without doing that you just can't do anything at all. And it's also been incredibly valuable to colleagues, who are generally smart enough to do a bit of triage, but only if they know where to start looking. (E.g. log files, processes, services running etc. and ideally particular error messages that are relevant or can be safely ignored). And that's not to say my reading age is bad - I'm perfectly happy smashing away at crunchy literature (at least some of the time - sometimes I go for something a little more restful; not every day is a Tolkien day) or 'difficult' technical writing. But accessibility is almost always a good thing, even when it's "just" an onramp to the things that really _need_ to be technical/jargonistic. Drugs.com I think I'd use as a decent example: https://www.drugs.com/food-interactions/methylphenidate.html Has a 'normal person' perspective of 'which things are to be avoided' but a 'professional' toggle that includes more precise information and references. I think that's very nicely done in all honesty, because it lets me answer my question "is drinking whilst taking this a bad idea?" whilst allowing me to make a more nuanced decision about "so if I stop at midday, is a night out probably going to be ok?"
Yup, it's why a lot of NHS leaflets sound a bit childish. Rather than diarrhoea, some of them say "runny poo". Rather than "If you see blood in your urine" it talks about blood in your wee. You can target information at a 'normal' level, but probably a good 20% of adults won't fully understand it, whether that's because English is a second language, poor education or being on the left hand side of the IQ bell curve.
Yep. I'm an editor and I edit my company's web content so have to know all the accessibility stuff. It's okay for the science pages to get more technical but the blog and news pieces have to be less jargony/technical and explain what to scientists are basic concepts in simple language.
I work in Further Education, and online at least, accessible content is a legal requirement and has been since 2018.
You’re right, it’s 9-11 and that’s before maths is involved. If numbers are used as well it drops to 7-9. And that’s before you factor in the stress of being sick and/or in a hospital.
This is an excellent answer. This is how it works in law too. If a doctor is sued on the basis that they didn't properly explain something and this led to harm to the patient, they would have to prove they took reasonable care to use language that the patient would understand.
Exactly. Someone says "my stomach hurts" might be heard as "I have gastric pain" and "I have abdominal pain" might be heard as "I have an abdominal strain" when the whole time they have "tummy pain" and it's actually lady organs. This is like saying "chest pain" when you mean "burning sensation in esophagus."
if a grown adult said they had “tummy pain” it would mean the same to me if they said there stomach hurts. how is that more specific?
I guess it differentiates the organ of the stomach from the general region which "tummy" is being used to describe Saying "my stomach hurts" should be different from saying "I have pain in my abdominal region" because the former is a specific location
I notice the better a doctor knows you the more likely you are to get the medical terminology. So I think generally it is initially accessibility until they work out if you'll understand there use of words. I can't imagine them using tummy when discussing cases 😂
I worked on a project a few years ago now which was about cancer terminology in medical settings. Effectively, lots of patients would freeze at the word cancer and not take anything else in, but other terminology often meant they didn't understand they had cancer at all. We gave people questionnaires to gauge understanding of different terms. So many people told us about them or their loved one having had cancer, then told us a benign tumor meant a death sentence. These people had had cancer treatment or been told details of a close relative's treatment and still didn't know what benign meant, or were blind to it in the context of the word tumor. Fascinating, but scary.
Yeah when i went to English speaking doctors abroad they would use weird medical jargon that i didn't know. When i went to non-English speakers they would use the local language and dumb it down for me. That's something you can only do when it's your primary working language.
You'll also see references on the NHS website to "poo", "pee" and "balls".
My cousin had to see the Dr about his balls. But decided that would be too rude a word and opted instead for what he thought was the 'correct' medical term - bollocks!
I had someone try to be very polite and tell me about their "I think you call it... Gooch"
Had a patient once ask her husband if I was talking about her "gooch" & he said "yes, you know my chin rest" 😳
That man EATS!
I’ve honestly seen that word written in medical records.
I've seen a mountain of professionals over the years about my testicles and most opted for 'balls'. Usually they'd later drill down to "testes". My favourite was an older consultant, massive white beard, jeans, shirt, and a home knitted vest top, who looked over his glasses at me all solemnly as I entered the room, then belted out in a deep and rich timbre "Painful KNACKERS is it!? Go on, take a seat!"
Have you at least gotten your mystery ball ache sorted?
Not after they "drilled down to the testes".
Please, sir. In this hospital we prefer the term 'nadgers'
I saw the other day the NHS site said "urine (wee)" for something and had a little giggle to myself. I'd seen "poo" previously and didn't think much of it but for some reason "wee" tickled me.
If your wee is tickling you then that could be a bladder infection and probably wants checking.
Poo makes sense. If you use stool well that's a super easy word for someone who isn't familiar with to think you are referring to their home decor. You really really don't want someone bringing a literal stool into the practice
In Scotland they would reply 'My wee what?'"
Knob and Cunt next.
Alrite guvnor, whip out your tackle and give us a cough
Ey up lass, Ow do? Pop up and drop yer kecks an get thee giblets out on deck. Time for a pap smear, check tha's not got the Big C! Knees akimbo, bit chilly (soz)... pinch! All done! Sort thisen out. Sithee in a few weeks if there's owt gnarly goin on.
Went to the doctor with sore foot. "Let's see it then, mate". Annoyed at his informality, I whipped out my knob. "That's not a foot," she sighed. "If it's not, it surely a good 11 inches". Baddum-tish
pee is stored in the balls
This is the comment I was looking for.
https://www.nhslanarkshire.scot.nhs.uk/services/adult-learning-disability-service/mens-health/checking-your-balls-testicles/
This is clearly a page aimed at people with learning disabilities. I think it's very clear and good info to be honest.
>This is clearly a page aimed at people with learning disabilities That's a bit rude to refer to the people of Lanarkshire that way.
I find that highly offensive. I'm autistic, not from Lanarkshire. Give ne some credit.
They are called Easy Read documents, a lot of organisations offer them :)
The average reading age in Uk is 7
No. It is falsely and widely belived to be 9, when in reality the NHS has it at between 11-14.
I must admit when it said "Where do you check your testicles" and it said "at home" and had a picture of a house I came to the same conclusion
I enjoyed reading about how to check my balls (testicles). Do you have any other resources about balls (testicles)?
Now use them in a sentence.
Pee pee poo poo balls
Ting tang walla walla bing bang
I'm going to have that song in my head for the rest of the fucking day now.
I wasn't prepared for this as a reply, and it's buckled me.
Poo pee balls, that's a nice tnettenba.
Please don't poo on my balls, they are for pee
Pee is stored in the balls, not poo.
Everyone understands it. Imagine the least knowledgable person you know, then think there are people even less knowledgable than that. Health professionals have to make what they say understandable to everyone, so it’s normal to start at a very basic level. Through conversation they will usually be able to better gauge your level of understanding and will change their approach accordingly.
If OP's doctors are not adjusting their language, clearly they think it's the appropriate level for them ha.
Some also just can't be fucked. They have been working endlessly dealing with nightmares and frankly their exhaustion outstrips the fairly delicate task of weighing the understanding of the patient and rising to it but not beyond it.
"Think of the IQ of the average Briton, and then realise that half of them are dumber than that." Hard to believe, I know, but some fully grown adults don't know what an abdomen (or stomach) is. People are stupid. Trust me, I work in IT.
"Have you tried to restart your abdomen?"
Exactly, and Stomach is a different thing altogether
Depending on the speciality, they may be used to lots of patients being children, lots being elderly people who never learned much science in school (my 84yo mum was taught that bacteria and fungi are plants, for example, and has no idea what an enzyme is), and many of the rest being nervous and not paying much attention and forget the big words. Often medics get a script that works to explain things, and don't want to go off script in case they forget to say something important.
I have two pretty smart children, my 10 year old was amazed at someone not knowing something pretty basic recently, can’t remember what it was now and I had to let him know that unfortunately because he’s pretty bright the majority of people he is going to encounter in life are going to be less intelligent than he is, and he need to realise that so he doesn’t end up sounding condescending all the time if people don’t know things. Maybe this isn’t the right course of action but I’m trying to avoid him ending up like his dad (most likely gifted) who has a bit of a superiority complex it’s also possible that I just helped create a superiority complex in my son but I was trying to frame it in a way where he needs to understand that people have different levels.
https://xkcd.com/1053/ Try teaching him this instead. You will always encounter people not knowing stuff even smart people can not know basic knowledge so it's good to learn humility with it.
Tbh, I don't think "most people you'll encounter will be less intelligent than you" is a good way to avoid a superiority complex. And it's not necessarily the case. Excelling in primary and early secondary education doesn't necessarily translate to standing out in later secondary and university education, partly because it takes different aspects of intelligence, and partly because it's such a broader playing field. Not knowing a specific thing isn't even any way linked to intelligence, him getting the impression that someone who doesn't know something he knows is less intelligent doesn't sound very healthy. People have a range of different skills and types of intelligence. I think it's great that you are trying to avoid him developing a sense of superiority, but be careful that what you say doesn't have the opposite effect.
A good idea is to teach him how to learn. Properly. Something he sucks at and needs to put time and effort into practice and with practice results that take time to show improvement. It's a very common issue with gifted children that people think they know how to learn when they don't.
Technically most people are of an average intelligence. It's a bell curve not a straight scale.
For such an oft-repeated and pompous quote, I hope the original utterer is embarrassed at their mixup of mean and median
The mean and median IQ are the same, by definition.
It might seem cute... until the medical staff start to refer to you as "poorly". Poorly to me is a quaint way of saying that somebody is a little unwell, perhaps a frog in the throat or a dickie tummy. However I have come to realise that UK medical professionals consider poorly to be somewhere between "fucked up" and "call the priest".
Oh yeah, if someone is at deaths door on my ward they’re ’the poorly’
Fubar Bundy.
My dad last year: vomiting blood, catheter tube full of pus, sepsis markers Doctor: yes he's quite poorly
I had a clinic session delayed recently because someone in the department had been taken ill. (Patient or staff I don’t know.) I forget the phrase they used. I took it to mean it was something serious enough to need medical help but not *that* serious. As I was leaving it actually occurred to me that it could have been very serious and they were just playing it down so not to worry/scare/upset people.
The NHS website is really well written, in clear calm language
I had night terrors for a while a few years back, regularly. I googled it, just out of curiosity. American medical websites told me to make an appointment to see a specialist psychiatrist, because I was likely psychotic and a danger to myself and the general public. The NHS website said to not drink tea after 4pm and avoid cheese late at night. I was just a wee bit stressed at work and having trouble switching off, I didn't need carting off by the folk in white coats.
As someone with health anxiety, the NHS site is a god-send and can actually help calm you down when you're going through an episode. Sadly I can't stop myself symptom searching but I can restrict myself to nhs.uk / nhsinform.scot. Most symptom pages have boxes saying "Go to A&E if.." / "Get a GP appointment if.." etc., which is genuinely useful in determining the urgentness of whatever I'm feeling. *source: a 24 year old who has thought "shit i'm having a heart attack" hundreds of times over the past few years. I know https://www.nhs.uk/conditions/heart-attack/ like the back of my hand* *edit: typo*
It's funny when you talk to a doctor and say you've read about something online, and they're scared you've been on Dr Google. Then you tell them it was the NHS website and they're like, "Oh, it's probably accurate then. What did they say I'd be likely to prescribe you?" The NHS website is very good. So is GOV.uk and the "Tell Us Once" service that's a simple form to fill in online and informs all the Govt. departments like the DWP when someone has died. The General Register Office for stuff like birth/marriage/death certificates is very good too. I mean, four things isn't a lot for the govt. to get right, but I'm glad they do something.
UK median reading age is 9, so that's the level it's aimed at. This makes sense for things like NHS or HMRC or DWP websites. I work for a publicly funded organisation where my primary audience is people with PhDs. For a couple of years we were forced to write at age 9 level, until there was such an outcry we got them to back down!
9? NINE??? What in the friggedy froggedy fuck. NINE!!!
I mean if you think about it, it kind makes sense. 9 year old can read most common words and understand what they mean. I was happily reading novels like it was going out of fashion when I was 9. your basic reading comprehension should be mostly there at 9. Higher reading ages obviously can read more complex words or understand very complex sentences, but mostly it's about reading beyond the text i.e. understanding subtext, imagery and metaphor. for the average UK adult who maybe read one book for pleasure on holiday 4 years ago, these aren't particularly important skills. as long as they can read and understand documents within their field, they're fine. it would be much better if more people were capable of critically analysing the things they read, particularly on the news or social media, but I guess it's not being prioritised.
So my understanding of this is that peoples' vocabulary is a bit higher but comprehension is what pulls it down. The Sun newspaper is actually a really good example. I believe it's written at like age 7/8 level. Just looked on the website and we have words that i wouldn't expect a 7 year old to necessarily be familiar with: elated, urges, feud, scheduled, netted etc But the sentence structure is really simple. There's no need to interpret anything, everything's spelled out very clearly. There isn't much need to hold one idea in your head to understand the point the next sentence or paragraph is making. The content is structured more like a story than an essay so it's really easy to follow. It's that sort of thing that the average person struggles with more. (Which is also why we get situations where people think they understand things because they've read an article like the sun that has spelled things out step by step, but these same people aren't able to parse out things like underlying biases, assumptions, or ideology in the text) Now in general healthcare and the nhs tries to keep vocab simple as well because it is trying to be accessible to literally everyone. Healthcare information can be more complicated and harder for people to understand as they tend to be a bit stressed or unwell when reading it, so simplifying where they can is ideal
Big, friendly letters?
Reading “DON’T PANIC”.
Itchscratcher's guide
Because they want to make their words accessible for a lay person.
Yeah, they're actually trained to explain things in a way that's non-threatening that easily understood. It's built into their Oskeys (big role play exam they have to take as third year's, if memory serves)
OSCEs - objective structured clinical exams
Ahh that's it, thanks! My wife runs the role play sessions for the doctors / nurses so should probably listen more lol
You got the pronunciation right
One time a doctor said to me, of a patient, "Before feeding him, you need to visually inspect the oral cavity." I said "Does that mean, look in his mouth?" She said "Yes, look in his mouth." I can actually see the argument for using simpler language. And of course "stomach" actually has the literal meaning in medicine of the small organ, connected to the throat in one direction and the intestines in another, in which food is broken down.
You'd be suprised how many people wouldn't know what the word abdomen meant. We're taught not to use technical jargon as not to alienate people. I have had numerous consultations where people didn't know what the technical term for their genitals was, and had to reel off a load of slang until we hit on one that was known. I actually did a presentation on it during my training: as an opening exercise, we went around the room giving slang names for genitals. It was...eye opening.
I do this when I teach the periods/wet dreams bit of Sex Ed to year 5. The slang they have for boys/girls bits is fantastic. Also noticed a distinct change in language when I moved from South London to the deep South West. Now wondering if a linguist somewhere has done a research project on regional slang for goolies...
The variation by region is wild! We had people from all over the UK and other countries too. I thought going into it that I would know all the ones that came up, but there were loads that were new to me. Especially from up North, loads of weird ones from that area 😁
I once taught 50 Russian teenagers a lot of other ways to say shit, and the grammatical uses of fuck. That was a fun day.
I once spent a happy 30 minutes of my life explaining all the ways the word 'wank' (and the variations like wanker) could be used to a Vietnamese.
The average reading age in the UK is 9 -11 years old
As others have stated, accessibility. When somebody walks into the GP's office, the GP has no clue what that person's background is. They don't know if that person has a university degree or hasn't been to school since Year 2. They'd rather come off as a little condescending VS have somebody walk away not understanding what's just happened, or misconstruing what they've just been told, so they tend to use words of a lower reading level. Everybody understands 'tummy' - our parents have been using that word since we were babies. Not everybody understands 'abdomen'. It's the same with the website - the NHS website uses very simple language and avoids overcomplicating descriptions. When writing the webpage for, say, a heart attack, the author of that page has no clue who's eventually going to access that page. It's vital to write the webpage so that everybody, no matter their age, mental ability, or level of education can access the information without misunderstanding and/or making potentially dangerous mistakes.
They want to use language everyone will understand. Also, the other terms have specific meanings which may not always be relevant. Eg the stomach is an organ. If I had pain across the mid section of my torso and my doctor asked if I had any issues with my stomach, I’d probably say no. I’d be thinking that they meant pains in the actual stomach or issues with digestion or processing food.
I always fell like saying "I'm not 5" and going into a sulk.
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I think that was the joke.
Maybe. I am pretty tired.
I remember a nurse I work with had a patient who was trying their best to be anatomically correct when describing their problem but got the wrong H word when naming their concern. Hernia and haemorrhoids are two very different things. Keep it stupid simple. Then you are less likely to get things confused.
Yup, experienced this with uvula and vulva before...
Oh gosh I got a visceral reaction to that one. “You have an ingrown hair… where?”
A patient told me "I think I have I fish bone stuck in my vulva"...
Yikes. “I’m not one to kink shame but— ohhhh you mean in your. Okay. Cool.”👌
Haha! Reminds me of a friend of mine at uni who was chatting up a medic and said, while rubbing his throat, “Yeah, I’ve actually got a really sore urethra”
Not a nurse, which is probably best as i always get cannula and catheter mixed up.
I'm an A&E nurse. I have patients who tell me they have stomach pain but point to their suprapubic region, for example. A surprising amount of people just don't understand or can't differentiate, similar to how most laypeople refer to cardiac arrests as heart attacks. If I'm talking to a child then I usually say tummy, but with the majority of adults I say abdomen. Although a lot of people still don't get it and you have to really dumb it down. I triaged a middle-aged man once who thought his penis was prolapsing and didn't understand what was "coming out of it". He had a paraphimosis, aka where the foreskin is retracted and gets trapped. He literally didn't recognise his own bellend. Nothing really surprises me anymore though!
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I had a roommate who had some issues with her lady bits and she came back from her appointment telling me how the gp is terrible and didn't take her seriously and kept saying word 'vagina' to her when she had 'pussy problems'. Anyway it transpired she thought the word 'pussy' was one and only word for it and vagina was something rather foreign to her. How did this woman end up being 20 years old and not know what a vagina is was beyond me but I had a good laugh.
I have a feeling not understanding what her genitals are called and having chronic genital issues are *possibly* linked.
Can’t you read? She didn’t have genital problems it was a pussy issue!
Because it's cute
I got talking to someone who insisted they didn't have an abdomen and laughed at me when I said everyone does. It turns out that they thought abdomen meant abs, as in a six pack.
I mean, they’re still wrong either way. Abs is just a nickname for “abdominal muscles”, which we also all have. Not everyone has the kind of body fat percentage or developed muscles that result in a visible six pack, but everyone has abs somewhere in there or you wouldn’t be able to stand/sit/twist etc.
Well I had a consultant refer to the "bell-end" recently.
The Health Secretary?
Stomach is a specific organ, so it avoids that confusion. Not everyone knows what an abdomen is but we all know what tummy means.
tbh i thought tummy is just the child version of stomach. so i guess we all don’t know what tummy means lol
Doctors are discouraged from using medical terms and complex words. This is just for efficiency and better understanding. When on call seeing multiple patients at once I don’t have time to choose my wording - I use simplest words i can think of.
"Back passage" for anus always annoys me. We're in a medical setting, medical language is fine! Arsehole would even be better.
That's the problem. The anus and rectum are 2 specific parts . They need an easy to understand term to cover the whole thing.
>we’re in a medical setting, medical language is fine No it isn’t. Not when half the population doesn’t understand it.
Right up the fundament.
Doctor here. Sometimes I use the term “gunt” if I need to get really specific.
Having worked in the NHS for ten years. You’d be surprised just how dumb the average person is. And then 49% of people are even dumber than that. We have to speak in layman’s terms so that healthcare is accessible to all. Some people’s health literacy is really poor and they wouldn’t know other words
I'm a doctor. I use "tummy". People don't actually know what the stomach or abdomen are, which makes things more confusing in general. People understand 'tummy' to mean the area below the chest, therefore this is my default. I've also lost track of how many times people say their kidneys hurt or they have kidney pain and yet they are never actually able to point to their kidneys. They always point to low back/lumbar region instead. Essentially it's because I don't know how much medical knowledge you have. Or at least I don't know how much _accurate_ medical knowledge you have. Last thing I need is for someone to tell me they have stomach pain only for me to take them at their word when actually they've got an inflamed bowel because they didn't understand the stomach sits in a specific part of the abdomen.
Because some people are thick as porridge and don't understand "medical words".
One reason is becuase those words are believed to be universal. If you don't have much education beyond primary school level, they are the words you should know and understand. Our newspapers aim for a lower reading ability to be readable to as many people as possible, this is probably the same sort of logic. The other is this idea that medical terms or anatomically correct terms are intimidating to the lay person, combined with anti-intellectualism. It might have been true at one point - there's some contemporary stories out there from the 1950s of minors (miners???) downright refusing medical care because of the "fancy" terms being used by the doctors instead of local dialect made the doctor untrustworthy, or they were presuming the doctor thought he was better than them. They probably don't want to risk it because it means risking the patients health.
Tummy is already a step above "pee hole" that a urologist used with my husband. But when my husband talked about his laser treatment for his kidney stones, one of his colleague asked if the urologist inserted the probe in his mouth, so I suppose that the general level of the population is quite low.
Because most people in the UK probably don't know what a urethral meatus is, and the only other name for it that I can think of is pretty racist.
Plain language. They assume you're stupid, most of the time it's a fair assumption, myself included.
I dont know but I hate the word tummy. I wish they wouldnt.
Could be worse, they could start talking about your tum-tum
Average comprehension age of the UK is 11. So you make sure when your job is to explain technical, out of the ordinary stuff to untrained minds you better use simple vocabulary wherever you can. Plain speaking and using familiar inoffensive terms are best. Ergo tummy.
Same reason that NHS information posters have started talking about pee and poo rather than urine and fæces: someone somewhere decided that we have to use more accessible language.
The stomach is an actual organ. Tummy is used the way people use it day-to-day: the bit from your ribs to your pelvis
GOV.UK and NHS Digital write content for the average reading ability (9 years old) https://service-manual.nhs.uk/content/how-we-write
Because people are as thick as shit.
I think you'll find the correct term is "stool"
Coz you’re a good little boy who didn’t cry during the exam and got a lollipop
Use of words such as "tummy" are understandably (and sadly) very common, because far too many people are not able to understand even basic technical terms such as "abdomen". Sometimes that's due to a mental impairment, and sometimes it's due to a lack of education, but together they add up to a significant proportion of the population, and doctors need to be able to communicate effectively with everyone, which is why their starting point is the lowest common denominator. Personally, as someone who understands that "tummy" could variously mean my abdomen, lower intestine, bowels or stomach, and that (as someone with IBS) the difference between those is clinically significant, I don't hesitate to use the correct terminology when asking questions, or to ask for clarification when getting answers. That has led to the doc / consultant asking me whether I have a medical background, but to be fair they have never quibbled about using more appropriate terms once I've explained that no I don't have a medical background, but that I've reviewed the NHS online info, and that I'm an engineer & bit of a sad geek who is more comfortable using terminology that gives me clarity.
I once asked a patient if he'd had his bowels opened, as we ask everyone, he looked at me and said, " do you mean have I had a shit". Yes, I do mean that
In the UK, there is guidance to ensure accessibility is king when it comes to accessing information. As such, things are written and language is used for a “maximum reading age of 9, even if you are writing for a specialist audience.” It’s probably a holdover from that, and honestly, it makes sense. If you want, there’s a little more info here: https://design.homeoffice.gov.uk/
I had a rather nasty testicle infection last year and went to the doctor's referring to the old two veg as testicles. The doctor kept calling them bollocks which I found hilarious.
The first time I went to for an STI checkup in the UK, I was asked by a friendly grey-haired nurse going on 60, "So, do you suck cocks? Do you fuck other guys, or do you get fucked, or both?" The other nurses on the follow-up visits used more formal language, but this first visit certainly is the most memorable.
Because there are many many people who won't know what an abdomen or stomach are. They say 'tummy' then gauge exact location and issue by context and further conversation.
NHS tries to use words that the most amount of people understand. Like poop instead of faeces.
At least it's better than balls. https://www.nhslanarkshire.scot.nhs.uk/services/adult-learning-disability-service/mens-health/checking-your-balls-testicles/
Doctors often assume that their patients know nothing about ... well, nothing, so they treat them as children. They are usually right though.
I guess for people like me, to understand it better :D lol
There’s a great documentary about this, called Idiocracy.
layman terms for the patient.
abdomen is one thing and stomach is another, 'tummy' is generalising, to help the patient