Archive for March 22nd, 2009|Daily archive page


In ALL ARTICLES on March 22, 2009 at 8:17 pm

patient-doctor-medieval-leech-saw bones-witchI am in the middle of writing an article about the benefits of stem cell therapy that I think you will find interesting. In the article I wrote the line “in my patient game of waiting for the pitch to build” I suddenly stopped dead in my tracks. In the use of the word “patient” was I referring to “one who waits for something” or was it an unintentional play on the word ‘patient’ meaning “one who receives medical attention”? As I often do when caught in a moment of reflective opportunity, I did an etymological search of the word.

Where does it come from, how does it get it’s meaning? I think you’ll be surprised. Etymology: Patient is derived from the Latin word patiens, the present participle of the deponent verb pati, meaning “one who endures” or “one who suffers”. I think it is extremely telling when the expectation of anyone seeking medical help is that they will have to endure and suffer. Was this what Hippocrates had in mind? Not likely.

Patient is also the adjective form of patience. Both senses of the word share a common origin. In itself the definition of patient doesn’t imply suffering or passivity but the role it describes is often associated with the definitions of the adjective form: “enduring trying circumstances with even temper”.

Some have argued recently that the term should be dropped, because it underlines the inferior status of recipients of health care. For them, “the active patient” (THE ACTIVE PATIENT, THE SELF ADVOCATING PATIENT, THE PATIENT WHO WILL NOT SIT BACK AND HAVE THE MOST IMPORTANT DECISIONS OF THEIR LIFE DICTATED TO THEM BY ANOTHER) “is a contradiction in terms, and it is the assumption underlying the passivity that is the most dangerous”.

Unfortunately the alternative terms also seem to raise objections: One option is “Client”, whose Latin root cliens means “one who is obliged to make supplications to a powerful figure for material assistance”, and this also carries with it an unacceptable sense of subservience. Option 2 is “Consumer” which suggests both a financial relationship and a particular social/political stance, implying that health care services operate exactly like all other commercial markets.

Many reject this term on the grounds that consumerism is an individualistic concept that fails to capture the particularity of health care systems. I think it may be time for a redefinition of the word “patient”. A quick glance into the annals of etymology lead me to the over-religious-afied term of “salvation seeker”. This is accurate by definition but imbued with too much religion and so, confusing.

Then i came upon the equally accurate but unfortunate word of salvager:

1. (transitive) Of property or people at risk, to rescue

2. (transitive) Of discarded goods, to put to use

3. (transitive) To make new or restore for the use of being saved

To rescue, to make new or restore for the use of being saved? They are both a bit too dependent on others and not a virtue or result of one’s own efforts. And after all…Holy Cross Salvager Hospital?? Doesn’t quite roll off the tongue, does it! But it sure does make you think.

The question remains…

How can we treat people humanely and with care and consideration when the very words that define their experience encompass suffering and subservience? I am still working on this and will come up with more as time goes on but the one that speaks to me the most and captures the intended je ne c’est quoi is: “autoadvocate”

Auto means self and an advocate is one who speaks on behalf of another person, especially in a legal context. Implicit in the concept is the notion that the represented lacks the knowledge, skill, ability, or standing to speak for themselves as most patients are. Therefor, a period of training is required before the “patient” can truly advocate for themselves. Interestingly, this period of training is called Devilling!

Devilling, as the period of pupillage or training to become an advocate is generally known, lasts between eight and nine months, and comprises a mix of skills training courses and time spent working with a devilmaster. This seems very similar to what a “patient” goes through to train themselves on the details of their condition or illness. The compulsory skills training courses, are spread across the devilling period and last for about ten weeks in total. For the balance of the period of devilling, devils work closely with their devilmasters.

Where we go from here, I have no idea. Tomorrow will flesh out more words and more meanings.  But it is clear that a different term for the self-advocating, self-interested, self-educated patient must be found and then the process is simple and obvious and QED.

Once we do the fairly simple task of educating ourselves about the intricacies of our diseases, research all of the available treatments, results and literature, redefine our roles in the health care system and give ourselves a new title…the easy part is over.

Now all we have to do is convince the medical establishment to treat us differently.


David Granovsky


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