The Power of a Word

At my age, I often find myself struggling to find the word for a concept I want to share. Mostly that’s how I think of words, as things to use to designate ideas or concepts in communicating with others. It can work the other way around, when hearing a word makes you realize there is a concept you never even thought about.

This struck me when I first read the word “heteronormativity.” It is a real word; Microsoft Word’s spell-check function recognizes it. I had to look it up. Heteronormativity refers to the notion that heterosexuality is considered the norm. Before hearing the word, I never paid much attention to how much heteronormativity there is in our society. After hearing the word, the concept of heteronormativity crystalized for me.That heteronormativity is simply one possible norm, and not necessarily a good one, became much clearer to me.

We use words in dermatology to create categories of diseases. It used to be that blistering diseases were all just pemphigus. Creating the concept of pemphigoid was a major step forward, helping establish prognosis and tailor appropriate treatment for patients who had different types of blistering diseases. Soon we will likely have different words to define the vast array of different bli tering diseases caused by antibodies to or genetic diseases in the many structural proteins that keep skin intact.

Words about how patients use their medication can help us achieve our ultimate goal—giving our patients better outcomes—by making us aware of new ways to get patients to use their treatments better. Having a mental focus on “compliance” or “adherence” helps us go beyond just making the right diagnosis and prescribing the right treatment. Hearing the terms “primary nonadherence” and “secondary nonadherence”—referring to patients never starting on therapy and to patients using medications poorly after starting—made me realize that we can (and have the responsibility to) do a variety of different things at different stages of treatment to help patients start on therapy to get well and to stay on therapy to stay well.

These are powerful concepts. I happily look forward to learning new words and concepts that will help me do an even better job caring for patients.