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Language exercises a powerful impact on medical care as the words that physicians use with patients have the power to heal or harm. The practice of medicine is shaped by the potent metaphors that are prevalent in clinical care, especially military metaphors and the words of war that bring with them unfortunate consequences for patients and physicians alike. Physicians who fight disease turn the patient into a passive battlefield. Patients are encouraged to remain stoic, blamed for "failing" chemotherapy and sadly remembered in heroic obituaries of lost battles. The search for disease as enemy shifts the doctor's gaze to the computer and imaging technologies that render the patient transparent, unseen and unheard. Modern treatments save lives but patients can be the victims of collateral damage and friendly fire. In The Language of Medicine, Abraham Fuks, physician, medical educator, and former Dean of Medicine at McGill University, shows us how words are potent drugs that must be tailored to the individual patient and applied in carefully chosen and measured doses to offer benefits and avoid toxicity. The book shines a light on our culture that deprecates the skill of listening that is, paradoxically, the attribute that patients most desire of their doctors. Societal metronomes beat rapidly and compress clinic visits into stroboscopic encounters that leave patients puzzled, fearful and uncertain.Building on research about physicians in practice, the experiences of patients, stories of medical students as well as the history of medicine, Dr. Fuks promotes an ideal of clinical practice that is achieved by humble physicians who provide time and space for listening, select words with care, and choose metaphors that engender healing.
Abraham Fuks, MDProfessor of MedicineMcGill University, Montreal
Introduction I Language in Context 1. The Lens of Language 2. From Words to "Making Up People" 3. The Nature of Metaphor II The Military Metaphors of Medicine 4. The Militarized Arena of Medicine 5. Sources of the Military Metaphor 6. Consequences of the Verbal Wars 7. Resilience of the Military Metaphor III Frames and Choices 8. In Other Words9. Listening 10. A Pharmacology of Words IV Healing the Language and the Language of Healing 11. The Physician-Patient Relationship 12. Choosing Metaphors Afterword
From one of our wisest senior scholars of medicine comes this penetrating examination of the power of language in medical practice. Dr. Fuks combines his expertise in medical history, linguistic theory, and moral reckonings of the meaning of illness to uphold a profound respect for the patient and to deepen the physician's capacity to heal.