Commonly Misused Phrases

Let's have some fun today. Here's a list of commonly misused phrases and what the correct phrase should be.

If you've used the phrase on the left, uh-oh, better get it right next time!

Uh-Oh	Yes, Please
It's a pigment of your imagination	It's a figment (imagined story) of your imagination.
It's a mute point.	It's a moot (of little practical value) point. (Of course, if you're Joey Tribbiani, the point is moo.)
That's a bold-faced lie.	Nope, sorry, it's a bald-faced lie. (For the history of this phrase, see http://i.cx/1hn)
We need collaborating evidence.	You more likely need corroborating (confirming) evidence.
It's a doggy-dog world out there.	I don't know where you live, but where I live it's a dog-eat-dog world.
She's just a font of wisdom.	If she's that smart, she's a fount (fountain or spring) of wisdom. Leave the fonts (typefaces) to us publishers.
Let's hone in on the problem.	I'd much rather home (to navigate) in on it, thank you very much.
He must be lack toast and tolerant.	Are you kidding me? If you've said this, just go home now.
Don't let your jealousy reel its ugly head.	Hey, now, jealousies don't reel, they rear.
She scarred the heck out of me!	If she burned you or cut you up with a razor, then surely she did scar (cause lasting tissue damage) the heck out of you. But I'll bet she just scared (afraid) the heck out of you.
He tripped over a wheel barrel.	Aaaaaaaaaaargh! NO! He tripped over a wheelbarrow. People, people, do you never go to a Home Depot?

For more, visit http://eggcorns.lascribe.net/browse-eggcorns/.

Common Confusables: Preventative & Preventive

In healthcare we’re always talking about preventing illness and accidents. The magazine Prevention focuses on steps people can take to prevent illness and accidents.

But when it comes to preventive and preventative or, heaven help us, preventatativeness, we get into trouble.

Does preventative mean the same as preventive? Or is there a difference?

Yes, and yes.

Okay, here’s the deal.

You’ll hear from some folks that preventive is an adjective, as in “preventive medicine,” and that preventative is a noun, as in, “The herb is a preventative.” Those folks may cite the use of preventative as a noun and preventive as an adjective since the 17^th century, and they would be correct.

Another group of folks insist that the terms possess identical meanings and can be used interchangeably. They as well would be correct.

Language is constantly evolving, and this is one of those evolutionary instances. When the experts can’t agree, as in this particular case, then the meanings are so close as to be essentially non-existent and the usage so mixed that no clear “winner” emerges.

So use whichever one you like. If someone calls you on it, believe me, you’ll find more than enough experts backing up your choice.

For me, I like preventive. I like how it sounds. To me it seems a bit more medical than preventative.

But that’s just me.

Using Similes and Metaphors to Help Patients Learn

Similes and metaphors can act as cool, brisk breezes on a sweltering summer day. They can soothe a patient's frayed emotions, clarify a confusing concept, or build support for difficult lifestyle changes.

The trick is to use them wisely, not toss them about willy-nilly.

First, though, definitions.

Definitions

A simile is a comparison of two unlike things, typically marked by use of "like" or "as." Here are a few examples:

• The skin on his shin was as smooth as polished marble.


• He has a face like an open book.


• The dressing absorbed the fluid like a sponge picks up water.

A metaphor is an indirect comparison between two or more seemingly unrelated subjects, often taking a " blank is a (or an) blank " form. Examples:

• Think of the urinary tract as a set of waterworks.


• Your illness is a real puzzle.


• The skull caved in.

Similes and metaphors can convey a great deal of information in just a few words. They can also help make complex information more meaningful to the patient, thus enhancing learning and, one hopes, improving health outcomes.

Although these literary constructs generally shouldn't be used in clinical documentation, they can be invaluable in talking with patients, explaining procedures, discussing at-home care, and in similar situations.

Examples

Imagine a healthcare professional, while discussing how new capillaries form in the heart when a vessel becomes partly blocked, says to the patient, "The capillaries grow around the blockage like ivy around a fence post."

You can just feel the patient learning and see the light bulb flashing over his head.

A few more examples:

• It's the kind of itching that feels like ants running around your leg.


• Please squeeze this ball gently, like it's a squeeze bottle of ketchup.


• It sounds like the "ping" in a ping-pong match.

Just be careful and make sure the imagery is positive, not negative. Consider these examples as the kind you should avoid:

• Cancer therapy as a "war"—This is a rather masculine, power-based, and even violent metaphor and may be misconstrued by the patient as if the war can be won if only she fights hard enough.


• Comparing an arthritic knee to an old car—Don't try this one, especially if the person is, um, significantly life-experienced. (Read: Older.)


• Disease as a "pit bull" or some such—Yikes! We may think that way as healthcare providers, but that doesn't mean the patient should.

Planning ahead

Most people can't think of really good similes and metaphors in healthcare right off the top of their head. So do this.

If you find yourself describing certain procedures or treatments frequently, sit down and think of three solid, clear metaphors or similes that won't scare a patient. Memorize them, and then use them the next time you're performing the procedure.

Then you'll be as ready as Custer was at Bull Run. Wait, what? That's not right, is it? Hmm, I'd better keep thinking of a good simile.

____________________

I'm indebted to two key sources for this post, and I thank them profusely.

• The Mind, Metaphor and Health, by Penny Tompkins and James Lawley (http://www.cleanlanguage.co.uk/Mind-Metaphor-Health.html)
  


• Military metaphors upset some cancer patients, The Nation's Health (http://www.apha.org/publications/tnh/archives/2005/02-05/WebExclusive/283.htm)
  

How to Use Fewer Words and Still Sound Intelligent

One of my favorite movie lines is from the oldie Amadeus, in which Emperor Joseph II, after hearing one of Mozart's rapid-fire pieces, tries to tell the young composer why the piece just isn't suitable for a concert.

"There are simply," the rather haughty emperor says, "too many notes."

He was wrong, of course; this was Mozart, after all. But for the vast majority of us, using too many words never leads anywhere admirable.

I think a lot of unnecessary words and unnecessarily long phrases come from our own insecurities. We want to sound more intelligent, more officious, more leaderlike when we use big words. Too often, though, we come across sounding rather pretentious.

Here are a few common instances in which we tend to use too many words and how to cut back on 'em.

• Rather than "prior to" or "in anticipation of," just use before.
  
• Rather than "subsequent to" or "following on," use after.
  
• Rather than "at the same time as" or "simultaneously with," use as.
  
• Rather than "it is crucial that," "it is necessary that," "there is a need/necessity for," "it is important that," "it is incumbent upon," or "it cannot be avoided," just use should or must.
  
• Rather than "is able to," "has the opportunity to," "is in a position to," "has the capacity for," or "has the ability to," just use can.
  

If you do this, I promise that you'll still sound intelligent and no one will think less of you.

Well, an emperor maybe, but who cares about them?

Neutralizing Your Words

Documenting a patient encounter—whether you're a medical assistant, nurse, physician, or whatever—demands objectivity and professional language.

Consider this notation in a patient's chart: "Patient became rude, difficult, and uncooperative."

Those three words (adjectives, in this instance) are dripping with bias, like frosting on a warm cinnamon bun. (Ooh, yummy!)

Who's to say what's "rude" or "difficult"? Maybe the patient considered himself standing up for his rights, that he was being assertive, not difficult.

Using words that contain inherent bias may work well for a novel but are completely out of place in a medical record. They open the healthcare professional to charges of unprofessionalism and inappropriate patient care.

There's a simple test for determining whether a word or group of words carries bias. Ask yourself, Can someone argue with this?



Let's say you're a student who notices strange trembling in a patient's hands. You go to your instructor and say, "Ms. Jonquin's hands are tremulous."

That's a good word because no one could argue that your observation is correct. Sure, your instructor could check Ms. Jonquin and make a more accurate observation, such as, "You're right, she's tremulous. But do you see her fingers? They look like they're rolling a pill. That's called pill-rolling tremors, a classic sign of Parkinson disease."

Those words are more accurate, but so is your word, tremulous.

But you'd better believe she would argue with your word choice if you charted, "Ms. Jonquin is scared because her hands are shaking."

"Scared" is a judgment you're bringing to the situation, not something you observed.

Similarly, words such as angry, upset, sad, or any other term describing an emotion (unless the patient says it herself) are judgments about a set of objectives observations. Anyone could argue with words like those, just as they could argue with these words: attack, threaten, argue, scream, and yell.

Stick with words of objectivity that no one could argue with, that no one could contradict.

Take great care in using words that could be considered inflammatory, lest you find yourself on trial without a tremulous leg to stand on.

Common Confusables: Lose & Loose

I can't tell you how many times people blow this one. So let's see if we can't get it right.

When you provide a Las Vegas casino with additional revenue, you say, "Gee, I hate to lose money at the slots."

When the knot you've tied comes untied, you say, "Gee, I guess I tied that knot kind of loose."

So, any LOSS gets a single o — LOSE.

Anything that isn't tight gets a double o —L O O S E.



(And while we're sort of on the topic, I'd like to tell the otherwise wonderful comedian, Jim Gaffigan, that he needs a wheelbarrow to carry a Cinnabon, not a wheel barrel. Sheesh, Jim, get with the program!)