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Thoughts on Meeting the Devil: Health Care Jargon, the Art of Note Taking





The title piece of this fine collection is by Hilary Mantel, and it begins thus: "Three or four nights after surgery — when, in the words of the staff, I have 'mobilised' — I come out of the bathroom and spot a circus strongman squatting on my bed." I was immediately reminded of a healthcare book I edited in which the word mobilise occurred repeatedly. I was meeting this usage for the first time, but instinctively recognized it as jargon. On some occasions in the book it was used in everyday contexts where I thought plain words would be a better fit. For instance, I felt I had to question something on the lines of "the patient should not mobilise around the house without assistance" with the query "Can we change 'mobilise around' to 'move around' or 'walk around'?" The answer was no. The book was written for healthcare professionals, so I can understand that.


However, when communicating with patients, healthcare workers should minimize jargon, as this language tip for healthcare workers from Occupation English Test (OET) explains: https://www.occupationalenglishtest.org/language-tips-wow-mobilise/.



From "Early Mobilisation in Hospital: A Guide to Help Your Recovery — Information for Patients" by NHS Foundation Trust

An NHS booklet issued to patients shows how a balance can be struck between jargon and everyday language. The term mobilise is explained at the outset (see above), after which both the term and everyday words are used — which, I think, is reasonable. It is not wise to shield users completely from jargon, as they will inevitably be exposed to it. The practical approach is to first explain jargon and then use it in moderation, setting in motion the process of familiarization. (The word mobilise seems to have crept into the hospital setting from physiology, where it is used like this: "hormones that mobilize calcium from bones" [https://medical-dictionary.thefreedictionary.com/mobilize]).


OK, back to the LRB collection. I'm about halfway through it, and the piece I like best is "Working Methods" by the medieval historian Keith Thomas. The title did not sound very promising, but I was happy to be proved wrong. Keith's profession requires intensive note taking, and his essay describes his paper-based methods — developed before the advent of PCs — in great detail. It's a topic that is unlikely to resonate with the general reader, but this essay works well because (1) it's a topic that is close to his heart; he takes notes as though his life depends on it (and as you read, you feel the urgency too; such is the power of his writing) and (2) there are delightful historical excursions, rich in anecdote, on great note takers of the past, such as Lord Acton and Robert Southey. Take this, for instance:


It is possible to take too many notes; the task of sorting, filing and assimilating them can take for ever, so that nothing gets written. The awful warning is Lord Acton, whose enormous learning never resulted in the great work the world expected of him. An unforgettable description of Acton’s Shropshire study after his death in 1902 was given by Sir Charles Oman. There were shelves and shelves of books, many of them with pencilled notes in the margin. ‘There were pigeonholed desks and cabinets with literally thousands of compartments into each of which were sorted little white slips with references to some particular topic, so drawn up (so far as I could see) that no one but the compiler could easily make out the drift.’ And there were piles of unopened parcels of books, which kept arriving, even after his death. ‘For years apparently he had been endeavouring to keep up with everything that had been written, and to work their results into his vast thesis.’ ‘I never saw a sight,’ Oman writes, ‘that more impressed on me the vanity of human life and learning.’

Keith feels guilty because he suspects there's more than a little of Lord Acton in him. Also, the digital revolution has arrived, and he feels embarrassed by his paper-based methods when he sees how easy digital note taking has become. But it's too late for him to digitize his notes, and so he must continue to battle the paper tiger. However, he finds consolations in paper: "The thousands of dead envelopes themselves give me a good deal of nostalgic pleasure; they remind me of old friends, of institutions with which I have been associated and of the secondhand booksellers who have sent me catalogues over the years." I'm familiar with this feeling, as my parents never threw anything away, and I've spent many a pleasant afternoon browsing the old letters, notebooks, files, bank pass books, check books, receipts, bills, envelopes, greeting cards, wedding cards, negatives, photos, etc., that they left behind.


I learned a new term from this essay: the commonplace book, which is a notebook into which excerpts from books one has read are copied and fleshed out with one's own annotations. Commonplacing was especially widespread in the Middle Ages and the Renaissance, and it has its devoted adherents today, some of whom insist that it has to be a physical repository — which is, I think, going a little too far. I always make notes as I read. The first such app I used was an online bookmarking service called Spurl; when it shut down, I found Diigo, which I still use (along with Pocket). I also made notes in an offline journaling program called Advanced Diary. I then found Evernote Web clipper, which allowed me to save text from Web pages along with the URL, article title, etc. Later, I switched to CintaNotes (which has the advantage that it can clip text from anywhere, not just from Web pages) and AllMyNotes Organizer. Today, I also use a note-taking application called Obsidian (https://obsidian.md), which stores all notes as text files (Markdown, actually) on my PC. On the phone, I use iaWriter, which saves my notes in the same Dropbox folder as Obsidian. I have been using OneNote for the past couple of months, and love its Web page clipping capabilities. My current favorites are Obdidian and OneNote on the PC, and iaWriter on the phone. Yes, I suppose I'm fighting the digital tiger.


It's evident that Keith has dipped into his own commonplace notebook while writing "Working Methods." He cites, among others, the following books: "the splendid recent autobiography" History of a History Man by Patrick Collinson, The Footnote by Anthony Grafton, My Apprenticeship by Beatrice Webb, The Sociological Imagination by C. Wright Mills, and Southey's Common-Place Book. He also quotes several authors:


"A commonplace book contains many notions in garrison, whence the owner may draw out an army into the field on competent warning." Thomas Fuller.
"Go on reading until you can hear people talking." G. M. Young.
"One man's notes will little profit another." Francis Bacon.
"What tho' his head be empty, provided his common-place book be full?" Jonathan Swift

There is one last quote, which I was reminded of when reading General McKenzie's "sincere" apology for killing ten civilians (including seven children) in a drone attack in Kabul:

"Where error is irreparable, repentance is useless." Gibbon


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