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J Gen Intern Med. 2007 December; 22(12): 1781.
Published online 2007 October 9. doi:  10.1007/s11606-007-0314-1
PMCID: PMC2219831

Medical Linguistics

Sometimes she spoke his name and he didn’t look up. Then she said doctor and he turned to her, smiling.

The change in him was quick: a sudden loss of the subjunctive, regular episodes of adjectival incontinence, the excision of dependent clauses from his vocabulary. At first, he called his work the opposite of fun. He told her residency was war, each work night a battle. He said decisions were orders, admissions were hits, teachers were generals, and interns were grunts. I can’t believe it, he said, they train us to take care of problems, not people.

Post-call, he explained, he wore rumpled day-old polyester pajamas while his teachers stood before him, freshly washed and fully clothed. Teaching was pimping, he said, and told her about the general with the big rock and bigger rack. After that, when he said pimping, she imagined breathy questions in the hushed dusk of a patient’s room, tongue-moistened rose-blush lips discharging facts along colorless corridors, a teacher’s hands caressing the long, pressed sleeves of her lab coat, a ring like the ring she wanted from him shining from her fourth left finger like a polished gold star.

As the months passed, too tired for true talk, he said instead: we got hammered. He said instead: we got hurt, we got slammed, we got killed. By we, he meant himself and his team, not himself and his patients; he meant himself and the other grunts, not himself and her. He called work scut, and then told her scut took care of patients. Patients were civilians, he added, so she would understand that patients were sometimes enemies, but also the raisons d’êtres for his sacrifices, and hers.

To have a language is an expression she often thought of as he spoke. Also—his words this time—a necessary violence, words which reminded her of every war story ever told.

For nearly a year, he thought she wasn’t listening. He thought his work alone bore the sounds, gestures, and marks of meaning. So when at last she said she’d had enough, he felt ambushed. Enough, he repeated, as if unfamiliar with the word, and she knew then that she’d have to use his language, not hers, to explain: We’re circling the drain, she said. We’re going down fast, we’re cooked, we’re finished, we’re toast. My we meaning you and me.

Articles from Journal of General Internal Medicine are provided here courtesy of Society of General Internal Medicine