Novel Medical Treatments - The Editors' Weekly

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People with serious health problems are often subject to novel treatments. But that shouldn’t mean being treated like they’re in a novel.

Health problems are human problems, and they can be important stories about real things affecting real people. But often, in telling them, we create another problem, because we make the story conform to our expectations for a narrative: A protagonist meets an enemy or endures a trial and prevails, displaying virtue and imparting a moral lesson. We use words that signal this paradigm: A person who has a life-threatening condition or injury is a hero who is brave in fighting (or struggling with) it. The hero’s story is inspiring. Perhaps the resolution comes by a medical miracle. Perhaps the hero is lucky in having avoided even greater hardship.

Sure, it makes good storytelling. But a person who is facing a serious health problem is not doing it so we can be inspired. An inspiring hero is someone who makes a choice to leave a normal, comfortable life to help others. That’s a lot to load onto someone who didn’t choose to have a health problem and who really just wants to get back to a normal, comfortable life. They didn’t ask to be the star in our inspiration porn. They didn’t get sick so we can feel better.

Fighting can be a useful self-image for some people trying to get healthier, but that doesn’t mean we should force a sick person into the role of a warrior. Struggling with is worse — it tends to imply that the person is not winning. It gets used a lot with mental health problems. And what image does struggling bring to mind? Perhaps something like Houdini trying to escape from a straitjacket? Not helpful.

Hero, brave, and inspiring automatically add a dimension of moral virtue. Recovering from illness or injury does not have a moral dimension. Health is not a token of individual moral merit. Suggesting that it is implies bad things about people who are not able to be as healthy as we think they should be. It makes it easier for us to view certain health conditions — troubles with physical fitness or mental wellness, for instance — as signs of moral failing. If we make heroes of those who prevail, we make failures of those who don’t.

Likewise, the combined efforts of many people using science and their wits to beat the odds in a medical crisis do not constitute a miracle. A miracle is a divine intervention and implies blessing, which has a strong moral dimension — and it implies less divine favour for others who didn’t experience a miracle.

Lucky assumes a storyline in which the precipitating bad event is already a given. But wouldn’t they prefer not to be cast in that storyline at all? It isn’t lucky to come out of an accident with two broken legs instead of being killed, or to miss two weeks of work or school instead of a year with a serious infection.

All of us, when we have a health problem, want to solve it. We don’t need the implication that it has anything to do with our moral character, or that we shouldn’t complain because it could be worse. When talking about health crises, let’s try to stick to the facts: the problem, the available options for dealing with it, the stage of recovery. Leave the novel treatments for the doctors.

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James Harbeck will present “Translating medicalese into everyday English” at Editors Canada’s Conference 2019 in Halifax, June 7 to 9.

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Patti Simmons says:

June 4, 2019 at 6:51 am

Thank you for this important post, James, about the potential dangers of narrative. See you in Halifax!

Phyl Good says:

June 4, 2019 at 2:06 pm

I like the idea of removing moral judgments and “inspiration porn” from descriptions of those experiencing health problems. I’m actually one of those myself right now, recovering from unexpected, very swift liver surgery four weeks ago.

But I’m not sure what sort of language to use in place of the “inspirational” or “moral judgment” language. Are we left only with very prosaic phrases like “dealing with two broken legs” or “surgery recovery?” I think some of that type of language can go the other way and sound like it’s really downplaying or being dismissive of what the person is actually going through.

Do you have suggestions about ways to acknowledge what people are going through while still not using their experience to suggest moral judgment or make ourselves feel better? I wish I could attend your presentation on this. 🙂

Anne Brennan says:

June 4, 2019 at 2:45 pm

Thank you for writing about this, James. It’s been bothering me for a long time.

Phyl makes a good point, though. One solution may be to refer to the person as “experiencing” or “recovering from” an injury or illness . . . but how do we refer to someone who isn’t recovering? Is there anything beyond “has been diagnosed with”?

Hope to see you in Halifax!

James Harbeck says:

June 10, 2019 at 7:09 am

In most cases, I think the bare facts produce quite an impression. “Hospitalized for six weeks with two broken legs” doesn’t really need an “unfortunately” or any other evaluation; we generally know that it’s not a state we’d want to be in. Sometimes we need to make sure we’re including enough facts for people to appreciate the gravity of the situation – as one friend who was recently hospitalized with pancreatitis told me after, she learned that “a serious attack could land a person in the ICU and in hospital for a year. … Didn’t realize pancreatitis was life threatening.” None of that includes unnecessary narrative-pushing or morally freighted terms, but it sure makes the weight of the issue clear.