The Patient's Language

Any physician who listens to the stories of patients and explains the nature of their illness to them becomes aware of frequenit misunderstandings between patient and physician. In bedside teaching, on the presentation of patients to students, and on ward rounds one is often struck by the anxiety and confusion of patients which follow a partial or complete misunderstanding of the physician's words on such occasions. At times serious maladjustment of the patient has resulted from such inadequate communication. These are experiences every physician has had and yet no adequate clinical or experimental study of this field has been done with the exception of a paper by Romano25 in which he analysed the results which teaching rounds in the Peter Bent Brigham Hospital had on the patient. Among other items in this study, Romano investigated the patients' knowledge of medical terms and their emotional reaction to some of them. No detailed report on these data, however, is given in the publication. Interest in the role of signs and language, as one of the most important stimuli in the human environment, is increasing. Philosophers (Tarski,28 Carnap,4' Peirce,24 Meads21), linguists (Bloomfield,' Richards and Ogden,23 Walpole,29 Hayakawa'2), anthropologists (Malinowski'9), and the school of semanticists (Korzybski,'5' 16 Lee,18 Campbell3) have outlined the many practical and theoretical aspects of the problem in a general way. Korzybskil' pointed to some very important practical aspects and Crookshank7 wrote a treatise on the epistemological problem of names, concepts, and things in the medical arts. No one has contributed more to the knowledge of the function of symbols than Freud" in his analysis of forgetting, slips, dreams, and psychogenic disorders. Interesting work was done by Kretschmer"7 and Storch.27 Recent and important contributions have been made by C. W. Morris.22 This author in agreement with Carnap4 5 postulates three dimensions of semiotics: The relations of signs to other signs, or