From Common Ground, December 30, 2007

The philosopher Ludwig Wittgenstein proposed, “The limits of my language mean the limits of my world,” an intriguing proposition, begging the question: “Do our words shape the way we think about things?”

It’s a question at the centre of a 50-year-old, controversial hypothesis, initiated when the concept of “linguistic determinism” hit the scientific world. You can’t deny that words shape our experiences and that there are some situations, such as our health, where precision in how we use words is indescribably important. Does the carelessness with which we sometimes speak affect how we think and what we expect from our physicians and our healthcare system?

I was reminded of this burning question by Dr. Ralph Fagotter, a friend and family physician in South Australia. He runs a busy general practice but finds time to tend several acres of ginkgo biloba trees and philosophize on his little plantation north of Adelaide. He takes the time to think deeply about medicine and his own place in it. Writing in a late-night email last month, he asked, “Imagine what it would be like if the word kilometre meant 100 metres when used in one context and 1,000 metres when used in another context?”

Ralph continued: “Well, there would be public outrage at the stupidity and disastrous imprecision of it all wouldn’t there? An expert committee would quickly be appointed to redefine and clarify the meaning of the word kilometre and everyone would have to accept the standard meaning.” What is implied, of course, is that confusion would reign and we simply couldn’t live in the resulting chaos of double meanings. Yet Ralph’s late-night monologue invoked the fact that we do this in the medical world all the time, changing the meaning assigned to the same word. If I were to stand on a street corner in Victoria and ask a sample of people walking by to tell me what an “effective” drug is, they might say, “Oh, it’s something that works” or that “It works much of the time.” If I were to go further and ask them to quantify what this means, I expect most people would say, “Well, it works between 80 to 90 percent of the time.” In other words, effective to them means most of the time. 

Entire article is here