In which Dr Aust ponders language and its obscurities.
One of Dr Aust’s current nightly rituals is reading a bedtime story to one, or both, children.
This evening we were reading a story – one of this charming series – which contained the word:
This reminded Dr Aust of an event, over a dozen years ago now, which exemplifies the problems with language (and perhaps also cultural differences) that can turn up unexpectedly in Universities.
The story concerns an exam sat by our undergraduate medical students some time in the mid to late 1990s. Back in those days we academics used to, as they say, “invigilate” all the exams ourselves. Nowadays we have special people – often retired academics – who do this, and the word “Invigilate!” instead tends to conjure up for me a vision of someone casting a spell in a Harry Potter book. But in those days, we would be there ourselves to hand out the exam papers and terrify the students with dire announcements about the consequences of cheating, or inadvertently having any notes about your person. Then we would spend a few hours patrolling the exam room trying to look grim and/or spot students with suspect programmable calculators.
Next, you need to know what sort of exam it was. This was what we called a “Case paper”, in which the students were presented with a short medical case history. The idea was that they should try and figure out what was going on, first trying to recognise so-called “cues”, and symptoms, in the history, and then suggest what kinds of tests or investigations they would order.
The particular case in this exam paper involved a man called “Mr Polly” (sic) who kept budgerigars. The birds actually appeared in the first line, which went something like:
“Mr Polly was devoted to his budgerigars, and kept several dozen in a shed at the back of his house. They were his pride and joy.”
Now, you need to know that the word “bird” appeared nowhere in the exam paper, though “budgerigar” was in there several times.
Perhaps you can guess what happened next.
A student stuck their hand up.
Dr Aust hurried over. Students sticking their hands up in exams are not unusual, since requests for extra paper, or to be allowed to visit the toilet facilities, were a regular part of invigilating then and doubtless still are. Of course, a minute or two after the exam started was a little bit early.
Dr Aust asked the student what s/he wanted.
The student replied nervously “I don’t understand this word”.
…And pointed to the word “budgerigar”.
This put Dr Aust in a bit of a quandary. He was a fairly junior academic at the time, and was not one of the people who had actually set the exam paper, so he didn’t really feel he had the authority to just tell the student that a budgerigar was a small bird. Scanning the paper, Dr Aust hunted for something else that might offer a clue. His eye fell on a passage more or less like this:
“One day, Mr Polly felt short of breath and a bit faint – walking up the stairs was an effort. Nonetheless, he was determined to attend to his budgerigars. Whilst cleaning out his aviary, he became dizzy and breathless and collapsed. His wife found him and called an ambulance”
Dr Aust pointed at this last sentence and whispered to the student:
“This sentence should help you. Look at this word.“ he said, underlining the word aviary.
The student, who judging by appearance and accent was clearly from outside the UK, looked panic-stricken.
“I don’t know what that word means either” s/he said.
Which is an object lesson, I guess, in being careful what words to use. And in what settings. Especially settings where it is difficult for people to ask clarifying questions.
The story does have a happy ending. After a few words with the Senior Examiner who had set the paper, we decided to make an announcement to all those in the exam hall to tell them that a budgerigar was a small parrot.
It turned out afterwards that several other students had been equally flummoxed by “budgerigar” and “aviary”, though most had not put their hands up.
Over the years I have sometimes wondered if any of those flummoxed students, now doubtless many years qualified in medicine and quite possibly GPs and consultants in the NHS, have ever again encountered the words “budgerigar” or “aviary”.
PS Mr Polly’s complaint, which I dare say all my medical readers will have guessed, goes by the common name of “Bird Fancier’s Lung”, and is a form of extrinsic allergic alveolitis or hypersensitivity pneumonitis (more here).
PPS Language and comprehension is, of course, an issue in many settings in academia, and more so in medicine. Dr Aust has always (he hopes) been reasonably good at spotting – mostly from the non-verbal cues – when people working in his lab did not understand what he was saying, and adjusting his language accordingly. Not everyone does, though. One eminent Professor I knew was famous in the Department for fixing non-English-native-speaking research assistants with his most gimlet gaze and then saying, in his slowest and loudest voice:
“Do. You. Understand?”
The joke was that he often did this to people who came from cultures where to admit that you hadn’t understood the Great Man’s pearls of wisdom would be a terrible source of shame, and also a grave slight to the Eminent Professor. Thus the unfortunate subordinate would nod meekly, and the Great Man would depart satisfied that he had got his meaning across. Whereupon Dr Aust and the other more junior lab people would explain to the quivering research assistant what the Prof had been saying.
A slightly different problem arises for doctors who work in countries where the language is not their native one. Apart from just the language, they have to cope with regional accents and dialects. In the UK they also have to cope with the British talent for slang and euphemisms.
When Mrs Dr Aust first arrived in the UK to work as a junior doctor in a North West England-shire hospital, she was presented with a glossary of “local terms that your patients may use”. The list ran to a fair few printed pages. I suspect it may have had some similarities to the Yorkshire one here, which was discussed by the august British Medical Journal a while back.