I’m suspicious of how medical pronunciation is basically a matter of opinion.

Sometimes I wonder where these differences in medical pronunciation come from.  I’ve heard all the high-brow explanations (We say “sontimeter” instead of “centimeter” because “centimeter” sounds too much like “millimeter”) but I don’t buy any of them.  (Since when does “centimeter” sound like “millimeter”?  What accent would you have to be using for that to be even remotely true?)

So I apologize for being incredibly cynical, but it seems to me like someone along the way just mispronounced something while in a position of power.

Famous Surgeon:  Looks like this guy has some cardiac dilatation.
Resident:  … Sorry, what?
Famous Surgeon:  Dilatation, you fool.
Resident:  Oh, haha, you mean “dilation“!
Famous Surgeon:  *Slow Death Stare*
Resident:  …. OH.  Yes.  Er,  “Dilatation.”  You’re right as always, sir.

And then everyone else had to follow suit because they were scared.  And incoming residents and medical students and nurses at this hospital were laughed at for pronouncing it “dilation” until they gave in as well, and then “dilatation” became a regional thing, and now it’s widely accepted.

The only alternative explanation I’ve heard for this one seems to be that Americans arbitrarily shortened the British “dilatation” to “dilation”.   But as far as I’m concerned, since Metropolis is in America, that should make me right and the “dilatation” people wrong, unless they’re British, which so far, they aren’t.  (Yeah, ok, I’m biased beyond belief here.   “Dilation” is a word to me, “dilatation” makes me think of a “dilletante“, which is a word that always makes me laugh.  And cardiac dilatation is not supposed to be funny.)

And then there’s duodenum.  “doo-wah-duh-num” versus “doo-oh-dee-num” is such a painful battle.  I’ve always heard the 1st pronunciation – but here we had 1 professor who used the 2nd (DAMN HIM) and now everybody thinks the 2nd one is right, so I’m the only 1st year who says “doo-wah-duh-num”, which makes me look like an idiot.

But I will stand my ground on this one, damnit.  You’ve gotta have standards.*

*  Preferably really arbitrary ones, so you can spend time getting upset about trivial things on your blog instead of studying EKGs.
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23 thoughts on “I’m suspicious of how medical pronunciation is basically a matter of opinion.

  1. Nah, dilation is common usage where dilatation is medical usage in the UK. I think it is more of a medical shibboleth, to grant you access to the club: see clopidogrel (clo-PID-ogrel not cloppy-doggrel)

    The quickest way to be crushed on a ward round is to use an americanism (epinephrine, furosemide) or worse the brand name.

    • Took me a minute to remember that you guys use adrenaline and noradrenaline! Which is interesting, because the 90% of Americans who aren’t doctors or scientists know what “adrenaline” is but have no clue what “epinephrine” is, yet the doctors here only talk about epinephrine, and have to explain to patients that it’s “like adrenaline” (although, no, it IS adrenaline).

      You really can’t make this stuff up…

  2. Our metabolism and endocrine prof is from scotland, and he says “circadian” with a short A vowel sound instead of a long a vowel sound- cirCAdian v circaaaadian.
    Also, first semester they were talking about dilatation and I looked it up- because if it’s the same thing as dilation, why wouldn’t they just SAY that?

  3. The dilatation/dilation thing has always thrown me, too. In veterinary medicine, a GDV (aka “bloat”) is usually a gastric dilatation and volvulus, and I never knew why it wasn’t just DILATION!!! But, Merriam-Webster says dilatation has been around since the 14th century, and dilation only since the 15th, so I guess dilatation is the original version.

    We have an Australian professor (everyone swoons over his accent, it’s pretty entertaining to watch) who says doo-o-DEE-num, but the only pronunciation I’ve ever heard anyone else use is doo-AH-denum.

    • I totally swoon over Australian accents. I once met a really obnoxious guy with an Australian accent, and it was so strange how I was happy to listen to anything he had to say, no matter how ridiculous… pretty cool trick.

      If we had an Australian for a professor, I feel like I’d listen to his lectures more carefully, it’s true.

  4. We just learned about cardiac dilatation in my physio class! I remember my professor was like, “So…it’s called dilatation. You will remember that on the exam as the dumb and unnecessary word for dilation that is used in medical terminology. Okay, moving on.”
    And all of us just sat there, a little confused.

  5. I am going to be so screwed when I get back to the Americas…just a few I’ve noticed creeping into my pronunciation:

    trick-EE-yah (trachea)
    eX-ema (eczema)
    oh-dEE-ma (oedema/edema)
    con-junc-TIVE-al (conjuctival)
    caul-yew-m (column)

    and my favorite

    eh-pit-osis (apoptosis)

    Apparently the North-American way of pronouncing the second “p” sounds “a little gay” according to one of the micro profs.

    • Ahahahaha… That last sentence is hilarious.

      (If it makes you feel any better, your pronunciations for conjunctival and eczema are totally a common useage in the US, or at least in the northeast!)

    • ABB — All the cell bio people around here say apo-ptosis (like you’d say ptosis for an eye). I thought it sounded really pompous for a long time, but then I got over it.

  6. The French pronounce the word cent as ‘sont’, so that may be where the use came from. The whole ‘too close to tell apart’ BS, is just that. Even in french, the two words aren’t smilar sounding.

    • Oooh, French? That’s cool! (Now whenever I have to say “sontimeter”, I should totally use a French accent, so it feels justified.

      … Although unfortunately my fake French accent is indistinguishable from my fake Italian accent, so.. maybe not.)

  7. HAHAHAHHAAA!!! You should’ve seen the consternation that spread across my classmates’ faces the first time a professor used “sontimeter” in class, when “cm” was CLEARLY printed on his slides. I sit towards the back, and it was hilarious to watch the flurry of google searches for “sontimeter” pop up on laptops in front of me.

    Also…it took me about a month to realize that they really were saying dilatation. It was in my notes as “dilation” EVERY TIME. I still mentally say “dilation” because I think it’s the better term!!

  8. As a British med student who’s done rotations in the States, I just can’t get my head around the abbreviation of electrocardiogram to EKG.
    If you are to have EKGs, surely they should be reviewed by a kardiologist, who would then do kardiac katheterization.
    Following on from this, the ‘th’ should be replaced by a z, and ze American Kollege of Kardiologists should ally itself more closely viz ze one in Deutchland.
    I also notice the same Germanic method of spelling Krispy Kreme. Is this part of the same move to Germanicize the language, so that soon it won’t be referred to as American English, but instead Amerikan German?

    • THANK YOU!

      I have gotten into several fights with people about this. Yes, the ECG was invented by a German guy, but here in the English speaking countries, we talk about CARDIOLOGY, so it should be an ELECTROCARDIOGRAM

  9. An interesting post you’ve got here…made me think of some strange moments from several different places. I’ve heard both pronunciations for “duodenum”; I’m guessing, however, that no matter which way you say it most people outside of the medical community or the biological sciences would say, “What the heck is that?” As for dilat(at)ion, I always thought the extra syllable a bit strange and unnecessary, since the root verb is “dilate” and not “dilatate”. Another medical term from my own experiences that has been frequently mispronounced is “hydrocephalus”; I’ve heard several people say “hi-dro-se-FAL-us”, and the standard pronunciation I’ve always heard (from medical professionals anyhow) is hi-dro-SEF-a-lus. (There should be no “phallus” in the word, after all!) EKG/ECG is a weird one; it only goes to show the peculiarities in how so much of English was borrowed from other languages.

  10. The two things that freaked me out the most in vet school (where we had a HUGE population of Brit-speaking residents) aside from those already listed were “truh-KEY-uh” for trachea, and “yo!” for ewe – that last came from a canadian lecturer and I think it was 20 minutes into the lecture before my class realized that she wasn’t just trying to be funny and she was in fact talking about sheep and not mocking us for our accents (I went to Penn….)

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