Phil Hammond's funny old ward

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Final Year Exam: Obstetrics and Gynaecology. 1. Discuss the aetiology, pathogenesis and epidemiology of menorrhagia.

OK, so it's not the most riveting way to start a column, but could you do it? More to the point, is it the sort of question you'd like your progeny to be able to answer? Before you nudge them toward the nearest medical school, spare a thought for what it's going to do to their brains. The person who set this question was once a medical student. He entered the profession full of high ideals and comprehensible sentences and now seems incapable of writing plain English. Worse still, he has an unhealthy obsession with schoolboy Greek. What sort of a life is that?

Menorrhagia, if you're interested, comes from "men" (month) and "rhegynai" (to rush out). To a doctor, these are heavy, regular periods. To you, if you're a woman, they're an awkward situation in Waitrose. On the topic of periods alone, there's also dysmenorrhoea (painful periods), oligomenorrhoea (infrequent periods), amenorrhoea (absent periods) and - wait for it - polymenometrorrhagia (frequent, heavy, irregular periods). Travel an inch or so and you can have dysuria (painful weeing), haematuria (bloody wee) and polyuria (lots of wee). Hippocrates has a lot to answer for.

To be fair, a lot of schoolboy Greek is also plain English; diarrhoea and gonorrhoea are within most people's grasp, and to attempt to simplify them further isn't easy when you're trying to sound like a professional ("Do you still have the squits, Mrs Corkhill?" or "I see you have the clap again, Mr Beavis"). Some doctors do manage to speak in the vernacular - generally trendy GPs and the minuscule percentage of working-class students who get into medical school - but many medics like to retreat into jargon and defend their right to do so vigorously.

In the first two years at medical school, we learn more new words than a student of Russian. A charitable view might be that it allows fellow professionals to communicate effectively and quickly - "Mrs Simpson is oriented times three, PERLA, cranials 11 to XII intact, LF's clear, JVP not displaced, Heart Sounds 1 plus 11 plus nil, Abdo NAD, TPCSR in RUL equals LUL equals RLL equals LUL." It sounds like tosh (all it means is that she's fit to be turned out into the community), but if you can say it with a straight face and you know where the hospital laundry is, you can impersonate a doctor for life.

To the cynic and the Consumers Association, all this jargon just serves to make medicine a cosy, elite world that the patient can't penetrate, but to doctors, it reminds us how long these problems have been around. "I wonder how Hippocrates would have handled polymenometrorrhagia," we ask ourselves in a rare moment snatched between patients. A silly word allows senior consultants to pause on their rounds and hark back to a time when a harsh but fair grounding in Classics was thought essential to the practice of medicine, when every student was from Charterhouse and called Stinky Wilkins (son of Professor Stinky Wilkins), when nurses were your handmaidens and when the porters brought you bacon and eggs in bed. Those were the days.

Even today's students get a perverse buzz out of reeling off three sentences of gobbledegook without stammering. You can mystify your old school chums, impress your mother and - if you have a very sad life - watch endless medical soaps in the hope of pointing out a mispronunciation. Patients, being generally frightened and in awe, tend not to ask for an interpreter when doctors lapse into jargon, which is probably why half of them come out of hospital not knowing which bits have been removed and why. With the new age of consumerism, it shouldn't be long before you're given bedside cattle prods to help clarification: "Speak English or I'll zap you again."

The medical profession in its current form, like the Royal Family and the Magic Circle, relies for its success on mysticism and linguistic secrecy. We are all-powerful monopoly providers of silly diagnostic labels, of which the best is undoubtedly borborygmi (tummy rumbles). Doctoring, like many complex jobs, is very hard to do well but quite easy to get along doing so-so (and occasionally diabolically). Success is great but there's also a fair dollop of failure, side-effects, accidents, errors, uncertainty, boredom, underfunding, unrealistic expectations, time pressure, fatigue, tough decisions and very strong emotions. If you fancy copping out of the difficult bits, the easiest way is to reduce everything to labels and bypass any feelings. It's far less demanding to treat "a TI2 transection" than "a married postman and father of three who was knocked down by a drunk driver on the way back from visiting his mother at the hospice and now can't use his bowels, bladder or legs".

Of course, we wouldn't get away with it without the complicity of patients, many of whom like a bit of gobbledegook. There's a basic human need for magic, and as scientific medicine is endlessly demystified in the media, people are flocking back to complementary therapies. "I've got too much jitsu in my tsubo, you say? That'll do nicely - here's pounds 50". Also, there are a fair few people out there who enjoy being sick; for them, a fancy diagnosis is essential. "You've got a sore shoulder," is no use at all but "you've got a supracapsular bursitis" is wonderful. It gets you out of sex, work and the washing-up for at least a fortnight. Thank God for jargon.

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