Saturday, May 23, 2009

What is 'a complete remission'?

I go back to the Dr Barlogie transcript and I read with ferocity.

I must pin down every word.

It is a wonderful idea to record consultation when you are going for your check up. Everyone should. How can you listen, really listen, as you sit in a strange room and dice over your own life with a doctor you have not met before?

Dr Barlogie
: The first step of any cancer treatment is to achieve what we do refer to as a complete remission.

I see that Dr Barlogie uses words with care.

There is a linguistic signal here: what we do refer to as indicates that there is a medical meaning that is different from normal use. The basic meaning of remission is spiritual : it means forgiveness of sin or absolution. That is why in the Bible record, Jesus after healing the 38 years man of infirmity,later said to him,Behold, thou art made whole: sin no more, lest a worse thing come unto thee (John 5:14) ("You are now enjoying health; stop sinning or some thing worse will happen to you.") (also John 8:11)

But there is also a medical meaning, first recorded in 1685 : 'A Continual Fever has its times of Remission and Exacerbation, but none of Intermission.' The fever lowers, remission. It gets worse, exacerbation. But no intermission. It does not go away. The point is that the disease is not cured : it is a 'continual' fever.

The spiritual and medical meanings of remission are, in a sense, opposite to each other. Spiritual forgiveness is total: you are cured. But in medical remission you are not cured: the disease is static.

It seems to me that adding complete to remission increases the problem of misunderstanding. Complete suggests the end of struggle and pain, a cure. The reality of remission, however, is aptly put by an American patient in a book that I read later : 'remission, that horrible word that denotes it's going to come back' (C.Hirshberg and M.I. Barasch, Remarkable Recovery,p.82)

Today, doctors might note with regard to these medical words, what Helen Rollason, the sport presenter, wrote about the cancer that was to kill her in 1999:
Initially my ignorance about cancer was almost boundless. I did not even know what an oncologist was until the day one came to see me. If the question had been thrown at me in a quiz, I would probably have guessed at something to do with pigs. (Life's Too Short, pp.34-5)

If a BBC(British Broadcast Corporation) professional is unfamiliar with these terms, what hope is there for the general public?

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