By Dr. Jim Ferguson

“Words are the tools we use to express our thoughts.” (I occasionally like to quote myself.) It’s probably good we can’t read each other’s minds, so we’re left with body language and our linguistic communication tools. I sit on an advisory board for the care of the aging, and was recently challenged by the word elderly. According to Mr. Webster, the word elderly refers to those sixty-five years and older, and I learned it includes me.

When I was a kid my parents would sometimes ask a neighborhood teenager to babysit my brothers and me – I hated that word. I remember this beautiful blond girl who seemed so cool and sophisticated to an eleven year old. Now, I realize this goddess was a high school junior. Perhaps “older” is just perspective. I told my son-in-law that I didn’t feel “elderly,” and he chafed at the notion his thirty fifth birthday defined him as “middle age.”

A friend of mine says we think in pictures or images to which we then assign words. I drive a red truck. I can describe my vehicle to you because we share a common vision of pickup trucks and because most of us don’t have red-green colorblindness. Figures of speech, such as similes and metaphors, help us understand each other and provide nuanced communication. However, sometimes the original meaning of a metaphor becomes lost with time and the resulting idiom is so obscure as to be unintelligible. An example is the idiom, it’s raining cats and dogs, but literally, it’s not. My Burundi church friends have trouble with this figure of speech, and others because they come from a vastly different culture.

After medical school doctors learn the practical aspects of patient care during an internship and residency. As a resident in internal medicine I was occasionally flummoxed by Memphian colloquialisms. I had to learn that a “bealed ear” had nothing to do with Beale Street, but was a local description of a middle ear infection. The locals in Memphis understood hypertension as “high-blood.”  “Low-blood” meant anemia, and “bad-blood” referred to the street term “sick as hell anemia” (sickle cell anemia), so prevalent in the black population.

I vividly remember an elderly black man I admitted to the hospital one night with congestive heart failure due to a leaky heart valve. The characteristic murmur of aortic valve regurgitation was obvious, but the timber of his heart sounds suggested dilation of the aorta, characteristic of syphilitic aortitis. My patient denied any knowledge of syphilis or treatment for this scourge. Supervision by an experienced clinician is an integral aspect of medical training. I presented my patient to the experienced staff attending physician the next day as we made hospital rounds. After hearing my presentation he examined “Mr. Jones” and then asked him if he’d ever received “shots on the green.”

“Ah, yessir, I had deem shots,” Mr. Jones replied.

I was clueless what “shots on the green” meant. After shaking Mr. Jones’ hand the senior physician led me and our medical team into the hallway and explained the idiom to us. Until penicillin was available to the public in the late 1940s, patients with syphilis were treated with arsenicals. You may recall the movie Out of Africa where Meryl Streep’s character returned to Denmark to receive arsenicals as treatment for syphilis, a gift from her philandering husband. It was not uncommon for health officials in the 1930s to give “shots on village green” to patients with syphilis.

I once devoted a Focus essay to patient’s malapropisms. I love to find the perfect word for an idea. If you don’t know this word look it up and enjoy “the word of the week.” In medical school you learn a new language, the language of science based on Latin and Greek derivations of words. I’m not critical of patients who describe pain in their “lar-n-ix” (larynx) or of others who describe “cartridges” (cartilage) in their knees or mistakenly refer to uterine fibroids as “fireballs” of the uterus. Medical terminology can be a challenge to anyone. I’m more critical of people who describe the “col-yums” on their front porch.

Concierge medicine is in vogue in Knoxville these days where it is advertised on the radio and described on television and in the local newspaper. I’ve been practicing concierge medicine two and a half years, apparently under the radar. I use Siri on my iPhone to dictate patient notes which I then print for patients’ charts. I’m “off the grid” of electronic medical records as well. However, I have to be careful with Apple’s voice activated app. Siri desires to correct my medical terms and recently changed my dictation to say that “Mrs. Jones [was intimate] with her husband all afternoon.” Siri doesn’t comprehend Latin and Greek medical terms very well, and apparently is insensitive to decorum!

Common sense is one of the four classical (cardinal) virtues which our politicians now ask us to ignore. I was given a book some years ago called “The Death of Common Sense,” and things haven’t gotten any better. Virtue is defined as adhering to a standard. But what if there are no standards and everything is relative? Or what if fundamental standards are renounced? An apostate is someone who has renounced his former beliefs. Apostates of virtue are now lauded as morally superior to others. Many have embraced the Big Lie, a term coined by Adolf Hitler in his book, “Mein Kampf” (My Struggle). And the damage done by these reprobates is compounded as they mislead the willfully uninformed and low information crowd.

This election in November is more crucial to America’s future than any before. We’ll have one of two choices since the Libertarian candidate is a wasted vote. I wasted my vote years ago when I pulled the lever for Ross Perot. I will not make that mistake again. Our choices are a loud-mouth street fighter or a dishonest career politician. Smirnoff would say, “What a country.”


(If you liked this essay, try my book of short essays called, “Well…What Did the Doctor Say?” The book is available online at Amazon and Barnes&Noble. Check it out!)