Paul F. deLespinasse: Don't underestimate the emotional impact of words

Paul F. deLespinasse
Paul F. deLespinasse

We often hear people saying that something is "merely a matter of semantics." These people may be trying to say that the particular words we use to describe things are not important. If so, they are terribly wrong when we take the emotional impact of words into account.

How many people would prefer to dine on a "first-class chunk of dead cow" rather than on a "tender juicy steak"? Both expressions point to exactly the same thing.

Of course different cultures have different ideas about what can properly be eaten, but the words used to describe what we do eat can make a big difference. Few in the U.S. would order squid if offered that on a restaurant menu, but lots of us will order calamari, which is just the Italian word for squid. I can attest that calamari is delicious when properly prepared!

Terminology is also important in much more serious matters than diets, not least in describing medical problems. I can speak from personal experience, since the specific words used to describe a medical problem had important emotional consequences for our family.

For over 25 years my wife has had a condition in which her bone marrow produces too many platelets in her blood. This extremely rare condition may increase the danger of strokes and heart attacks, but when properly treated it is compatible with a long and healthy life.

Originally doctors called this condition "essential thrombocythemia" and said that although it was somewhat similar to cancer, it was not cancer. But a few years ago the medical profession decided the condition should be considered a cancer — a chronic form of leukemia.

If this condition had been called a cancer or leukemia when my wife was first diagnosed with it, in her late 50s, I know that we both would have been more upset. But by the time the doctors decided to call it a cancer, when she was well into her 70s, we were familiar enough with the condition itself that the change in the words used to refer to it did not upset us.

Incidentally, it appears that insurance companies give much better coverage of treatments for this condition now that it is officially a cancer. And grants for research into it may also be more plentiful.

Sometimes a deliberate change in the words used to describe something can help people react to it more intelligently. A discussion is currently going on among urologists and cancer specialists about whether to stop using the word "cancer" to describe small, low-risk tumors in men's prostate glands.

Apparently more than half of all men over 70 have at least a few cancer cells in their prostates, but most of these don't spread or have bothersome symptoms. But if these cells are detected and reported to the patients, many men are reluctant to allow their doctors to engage in watchful waiting to see if there is any actual danger before undergoing surgery or other radical treatments.

For many years routine prostate cancer screening for men over 70 has therefore not been recommended by the U.S. Preventive Services Task Force and the American College of Physicians. Even so around half of men over 70 still get PSA testing.

As in the case of my wife's condition, if the doctors were to stop calling this prostate condition "cancer" from the get-go, it might increase their patients' willingness to hold off on treatments — which are expensive and can cause serious side effects — unless and until they are really needed.

One suggestion is to call the condition "indolent lesions of epithelial origin" which sounds sufficiently harmless that it would not bring on panic that patients' last days were close upon them.

New terminology here might not just save older men a lot of emotional anguish and unnecessary medical treatment, but could also save the government (i.e. taxpayers) a ton of Medicare money.

What's in a word? Potentially, a lot!

Paul F. deLespinasse is a retired professor of political science and computer science at Adrian College. He can be reached at pdeles@proaxis.com.

This article originally appeared on The Daily Telegram: Paul deLespinasse: Don't underestimate the emotional impact of words