In series three of the Netflix hit The Crown, the United Kingdom’s Prime Minister Harold Wilson (1964-70 and 1974-76) says to the Queen: “I much prefer the purity of numbers, Ma’am, compared to words which can always be twisted.” It was one of the few comments from Mr. Wilson that I agree with.

His minister of health, and a woman with an advanced degree in word twisting, Mrs. Barbara Castle, was one of the reasons we left the shores of Blighty with no subsequent regrets and came to Canada in 1975. Mrs. Castle was slagging the medical profession and telling the hospital porters to review the NHS operation lists, and if there were any private patients they were to be removed from the list!

You might think this not unreasonable, but I had by accident observed this hypocritical harridan indulging in private facial surgery in Harley Street while I had been helping (for a pittance) in an evening clinic in that den of comfortable armchairs, up-to-date magazines and second-rate doctors. I always smile when I hear the words “two-tier medicine” in Canada as an invective against any kind of private practice. I’m never sure which is the upper tier and which the lower.

Anne Curzan: What makes a word real?

Words are twisted all the time, but some twisting is subtler than others. In the next era of medicine, physicians will have to become more articulate and keep current with the meaning of words. Here’s why. 

It’s going to be a fascinating time as artificial intelligence invades the realm of diagnosis and therapeutics. In most specialties, it will be only be a matter of time before a patient’s clinical data is fed into a computer and the latest clinical trials and studies relevant to their case will outline the most effective approach. The doctor’s job will then be to tailor the diagnosis and therapy to the patient in front of them and, critically, to explain the diagnosis and therapy in a comprehensible way.

Many students and residents – even consultants – are poor communicators and writers. They are perhaps not as bad as in the TV series starring Martin Clunes as the bedside-manner-deprived Doc Martin, the hemophobic surgeon turned Portwenn family doctor, but in the coming era of artificial intelligence, doctors’ roles will shift from purveying diagnostics and therapeutics to being the final arbiters of AI diagnostic appropriateness tailored to the patient in front of them. They will become explainers and educators of diagnoses and treatments, moving to the old meaning of “doctor” – the etymology of which comes from the Latin “docere”: “to teach.” 

You’ll have to be careful what you say, and how you say it, or at least the words you use to say it. Perhaps not as carefully as author Ian McEwan’s mother, who had difficulty with words. “She never owned the language she spoke,” said McEwan. “Her displacement within the intricacies of English class, and uncertainties that went with it, taught her to regard language as something that might go off in her face, like a letter bomb.”

Words change their meaning over time, sometimes fairly quickly, like “gay” – formerly a closet word for homosexuality throughout much of the 20th century, but which came quickly into common parlance in the 1960s. But often meaning change occurs more gradually, like the word “redneck” – originally a term of pride used by Scots Presbyterians who signed the National Covenant against King Charles II to fight the appointment of bishops in Scotland. These determined, brave folk often signed the document in blood and staunched the bleeding with their neckerchiefs then wore these blood-stained scarves as badges of honor. Over time, as the original stalwarts died off, their progeny continued to wear the high-status red neckerchiefs, but, as often happens, were less impressive people, eventually evolving into die-hard ultra-conservatives resistant to any change (though still a term of pride for some folk.)

Last week, with some consternation, I had to look up the word “meme.” I consider myself an aficionado of words, but the way this word is bandied about, I must have missed something important. On the radio, in the papers, “meme” is everywhere. If you don’t know what it means you’re on the back foot, out of the loop, not au fait with the smart lingo. The same goes for “trope” – a word all the young and smart are using.

What’s going on here? Let me tell you. It’s the drift of language, the shift, often subtle, sometimes a slam, of change of meaning accelerated by the Internet. How you speak can nail you as an old white man, a boomer (“OK, Boomer!”) or worse, “an old white, boomer, colonialist” – someone whose faculties are dimming and who is responsible for all that’s ill in today’s world.

word beverage Gordon Johnson cropped.jpg
A meme is like a good joke, cartoon or image that goes the rounds. So it’s a word relevant mainly to the Internet and another generational clever-sounding up-yours.

What “meme” means (according to the Internet’s Merriam-Webster Dictionary) is “an element of a culture or system of behavior that may be considered to be passed from one individual to another by non-genetic means, especially imitation. For example, a humorous image, video, piece of text, etc., that is copied (often with slight variations) and spread rapidly by Internet users.” 

My easier definition might be: “A meme is like a good joke, cartoon or image that goes the rounds.” So it’s a word relevant mainly to the Internet and another generational clever-sounding up-yours. It was “created” by Richard Dawkins, a humorless Oxford egg-head (and author of the God Delusion) who wants everyone to become an atheist.

This gift to the language was created from the Greek root mim-, meaning "mime" or "mimic" with the English suffix -eme cobbled on to indicate a distinctive unit of language structure, as in "phoneme." Dawkins wanted a word to indicate a non-genetic “unit of cultural transfer.” But it’s an unnecessary word, isn’t it? You can just say “a fashionable popular quip doing the rounds” (or a good joke or cartoon or whatever) and then everyone knows what you mean – though “meme” gives you a trendy cloak to wear.

The word “trope” is another one I had to check, this time an old religious word (for a meaningless add-on to a Gregorian chant) that is making a trendy comeback among the young. “It was a dark and stormy night” is a “trope” for the opening words of many a forgettable story. Since everyone knows what “clichés” are, “trope” allows you to feel original and fresh while meaning roughly the same thing. It also keeps your audience in awe of your linguistic smarts.

In these days of packaged opinions, where someone’s opinion on calf-roping will likely be accompanied by predictable opinions on anthropomorphic climate change, private medical practice and Indigenous rights, one has to be careful about chosen words. Another obvious example is someone, say, in a CBC interview who uses the phrase “tar sands” or “dirty” as in oils, or uses the pseudo-word “woke.” You can be pretty sure of their opinions on the use of single use plastic bags, abortion rights, genetically modified foods and Stephen Harper. 

Other words seem to be making infiltrations and transitions in a kind of copycat, lazy change because the celebrity glitterati use them to give an aura of wisdom. No one seems to “discuss” anything anymore – they have “conversations” – a more egalitarian word implying the conversers have equal authority and the outcome will be an amiable mutual agreement. It’s the kind of love-in the AMA is enjoying in their current conversations with Alberta Health.

Another currently common vacuous word is “space,” which seems to have elbowed aside “place” or “room” in smart folks’ vocabulary, as in: “We now have a wonderful space for Hatha yoga.” My friend Alan, who recently attended a course on Indigenous literature, told me a variant of the word “space” which requires the additional adjective “ethical” when discussing (sorry, conversing with) or critiquing Indigenous works. You need to cede a modicum of “ethical space” – whatever that involves.

And while we’re conversing about Indigenous affairs, the word “nation” (in Canada anyway) has received a significant promotion to describe what previously was a mere “tribe” or “clan” as in “Mohawk Nation.” In Scotland, the clans have not yet demanded “nation” status, but I foresee before long a rash of McTavish, McDonald and Montgomery “Nations.”

The younger generations have introduced a number of cool words that are so counter-intuitive that they’re rather good. For example, “sweet” meaning something really good, exciting or well done, and “sketchy” meaning dodgy and unreliable. And of course their biggest success is the substitution of the word “like” for the much inferior “umm.” And “get” rather than “have” as in: “Can I get a burger?” which implies some illusion of assistance to the poor behind-the-counter server who still has to get the burger and hand it over.

Sometimes words have taken a 180 degree turn in their meanings. “Amazing” (a favorite of the celebrity glitterati) has now become the standard word for something that is simply OK, perhaps a little unusual, but not truly amazing. And “incredible” has become something that is quite credible, ordinary and not in the least incredible. “Awesome” has now become a reflex word of agreement similar to “yes” or “OK” among the younger generation. It denotes the opposite of a feeling of awe, usually with a shrug of agreement.

The climate activists have been busy forcing their lingo on everyone. I wince every time I hear someone using “planet” for the perfectly good word “world” – “planet” gives the impression of taking not merely a world-wide view of things, but a universal viewpoint which is less easy to challenge. And everyone knows about the critical importance of “ecosystems” (which mostly ignorant white males are bent on destroying) even when the user of the word might not actually know what an ecosystem is.

Academics insist on continuing to use the fatuous phrase “in and of itself.” If you hear that said, you know you’ve caught a blather who in and of himself is a twit.

Politicians, of course, love to glom on to new words that have had sufficient mileage to be recognizable but sound new. Take, for example, “lens.” Politicians are all looking at issues through different types of lenses – as in “looking at the Alberta oil industry through a climate lens.” And “progressive” which seems to mean something like “left leaning” (but which politicians want to mean progressive change toward societal good – though it often turns out to mean progressively bad as in something that was tried but abandoned 30 years ago.)

God knows what the word “liberal” means any more. In Canadian federal politics and in the UK, it appears to mean trying to hold the central ground whatever the policies. In Australia and British Columbia, it means “conservative.” In the USA, it has little meaning but is evolving into “big government and socialism” despite the fact that both the Republicans and Democrats both claimed to be liberal years ago, meaning a belief in the principles of freedom.

Journalism has taken a beating with the need to shout out and be heard above all the others clamoring for attention. Any unusual sports or political event is “iconic”; anyone with less common views, however sensible, can be labelled “extremist.”

All these words now appear regularly on Twitter – where every numbskull now has a platform to shout from and who in pre-social media days would have been ignored. If the tweet is suitably controversial it will now be picked up by the media and amplified full of sound and fury signifying only a lack of real news (e.g., “chair girl”).

And keep an eye on the horizon for new words – I’ve noticed an increased use of the word “plasticity” being used on the CBC.

Harold Wilson was right: numbers are pure but words can be slippery beasts with annotations and connotations meaning vastly different things to different people. Be aware of this and avoid the multitude of misunderstandings plaguing our modern world.

Editor’s note: The views, perspectives and opinions in this article are solely the author’s and do not necessarily represent those of the AMA.

Banner photo credit: Lisa Runnels,