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Neuropoppycockology
  1. Christopher H Hawkes
  1. Correspondence to Christopher H Hawkes, Honorary Professor of Neurology, Neuroscience Centre, Institute of Cell and Molecular Science, Barts and The London School of Medicine and Dentistry, 4 Newark Street, London E1 2AT, UK; chrishawkes{at}msn.com

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When I was in training at the prestigious Royal Infirmary of Edinburgh, you questioned nothing. Ward rounds were an occasion for keeping your mouth shut and doing what you were told. Thus if your consultant said their patient was suffering from “essential hypertension”, we all nodded sagely and made sure the treatment was correct. Have we moved on much from those days—some 40 years back? Well “yes” and “no” as they still proclaim in the Civil Service. It is said that nature abhors a vacuum, and indeed, so do human minds. Thus if we have no clue about the nature of something—illness in our case—we invent a word, preferably derived from ancient Greek, Latin or mediaeval English to plug that intolerable gap in our self confidence. So let’s look at some of these unacceptable words that clutter our minds and conversations

Cover-up words

Idiopathic

According to Wikipedia, this word comes from the Greek, Embedded Imageδιος, (one’s own) + παθος (suffering). It means approximately “a disease of its own kind… where the medical community cannot establish a root cause for a large percentage of all cases”. In his book The Human Body, Isaac Asimov refers to it as “a high-flown term to conceal ignorance”. Similarly, in the American television show House, it is remarked that the word “comes from the Latin, meaning we’re idiots, because we don’t know what’s causing it”. Neurologists use this term frequently when referring to “idiopathic” Parkinson’s disease. A much better term is classical Parkinson’s disease where we do not have to confess ignorance each time we say it—at least to our colleagues—but maybe the word “idiopathic” impresses some patients (and lawyers?).

Primary

Another non-word, conveying ignorance. Consider its use in that variety of motor neuron disease—primary lateral sclerosis. The other major types (amyotrophic lateral sclerosis, pseudobulbar palsy, progressive bulbar …

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