Tuesday, March 19, 2013

Feather-weight Words

The Visual Analogue Scale (VAS) for pain is one of the first things they teach us when start clinical rotations in med school. You ask the patient to grade their pain on a scale of 1 to 10, 10 being the worst pain imaginable. More often than not, the responses varied between 6 & 8 with the oddball 9 or 10 dropping by like a diagnostic mystery for the fresh Dr.Houses to toy with. We were naive then, & took what was told to us at face value. When we started narrating the VAS scores to our residents, they asked if we really thought their pain was as severe. It seemed a stupid question - the patient is in pain, hence with us. Why would the patient lie? The resident explained - no patient lies, they merely embellish & it is your job to take into account their dramatic exuberance. They then showed us what they meant with a thirty something mother who lay in a bed nearby. I was first asked to obtain a VAS score like I normally do, by asking, "If 10 is the worst pain imaginable, how would you rate yours?". I got a 7. The resident then asked, "If 10 was the pain during your first childbirth, how is the pain now?". He got a 3. 

Being stubborn as I was, I argued that the logic couldn't hold true for all patients and the question posed was only applicable to women who had undergone childbirth. I continued to make my case stating that a patient's memory of past pain may fade. But, in hindsight, their dramatic skills also improve with time to compensate. A few years wiser, I find not all patients embellish, but that doesn't mean the physicians let down their guard. The ones that do exaggerate have various reasons for doing so - want more time with the doctor, think they'll get better treatment, if a little medicine is good then a lot must be better, & then we had the occasional  psych references. But, you'll find there is a deeply ingrained tendency to aggrandize in all of us. And it extends beyond the confines of the examination room. 

I'm not a grand old man, I'm still going through my one third life crisis. But, I still remember a time when the spoken word was taken at face value, when hyperbole was just a figure of speech, not a way of life. Since when did we collectively decide that grandiosity is a must to be heard? How often do you hear - You HAVE TO try this place, it's got the best [fill in some obscure dish here] in town!?, She looks like a million bucks, The dog that bit me was built like a wolf, I couldn't be more depressed, God hates me & my personal favorite - I love it.

To quote the ever-articulate Snow Patrol, "Those three words are said too much, but not enough". 'Love' it seems, is a word that's thrown around the most and meant the least, which puts me in a dire predicament. How does one actually profess love without being lost in a sea of hollow superlatives? Should I take the extra effort narrating the depths of my emotion, or should I in true romantic manner, hope she loves me back enough to comprehend it easily? Ok, that sounded corny. But, I'm still in a constant state of confusion - Did I make myself clear enough? When is it ok to stop? Bearded man in the sky forbid I offer an average review of [enter anything here], I'm met with bewildered looks. Since when did calling something average become an insult? And why do women take it personally when I don't agree with their choice of restaurants? Makes me wonder if there's some women-centric restaurant mafia I don't know about.

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There's an acute shortage of words in the English language. Well, that may not entirely be true, but there's definitely a paucity of words being used. "Whatever", "like" & "you know" may not be as dramatic as the ten biblical plagues, but they're definitely heralding the death of language. Add to that this incessant need to mess with the degrees of comparison, where superlative is the new comparative, comparative the new positive & positive is a long forgotten remnant of what the truth used to be. 

Speak your mind, but make sure you mean every word you say, even if it means you speak less.

We must never forget that the highest appreciation is not to utter words, but to live by them. 
- JFK 

Averagely yours,


  1. "superlative is the new comparative, comparative the new positive & positive is a long forgotten remnant of what the truth used to be. "

    Quite a genius line :D

    I don't know anything about women getting insulted if you don't like their choice of restaurants!

    I quite liked the part about the term "love" being overused, I know someone who would totally agree with you. I however, like to use the term very freely with inanimate objects and very stingily with human beings :S

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  3. Hahaha!! Wow, SS, this blog post is briliantly funky. What starts off as a serious introduction into the world and woes of clinical medicine then takes a sharp dive into the world and woes of women and restaurants! The introduction and the way the topic is introduced is brilliant. Very uniquely done, in true medic format.

    A point, though -- I may be wrong, but I'm sure Snow Patrol sing, "Those three words, are said too much, they're not enough".. not "but not enough" ?

    Also, hyperbole nowadays is killing language, yes. But you also need to consider the culture that brings about the use of hyperbole and unneessary, 'decorative' words such as 'like'. Are we trapped in a capitalist, consumerist web where our thoughts cannot extend beyond pretentious comments on restuarants, because that's all there IS in the culture we are letting ourselves breed?

    Also, some people (I like to include myself in this category) like to use hyperbole because they are genuinely enthusiastic people, and want to be enthusiastic about life. But, of course, there is always a degree, and a context.

    Would saying I love this post be the right degree in the right context? :P