The New ‘Victorian’ Language Makes the Original Seem Rather Blunt
Our correspondent has come down with an inability to suppress a smile.
These days, the first requirement of editors of medical journals is an ability not to laugh at the circumlocutions that writers now employ.
For example, in a recent article in the New England Journal of Medicine about the increased levels of interpersonal violence that the Supreme Court ruling on abortion rights expected by the authors, I found terms such as people who can become pregnant and people of childbearing age, as if childbearing and pregnancy were distributed equally and at random between what were once known as the sexes. It is also as if the New England Journal of Medicine isn’t quite sure where babies (or perhaps I should say pre-adult humans) come from.
The New England Journal of Medicine is not alone. Indeed, in a world of conformist genuflection to recently discovered pieties, one wouldn’t expect it to be. Recently in the Journal of the American Medical Association, I found “persons living with female breast cancer,” and increased rates of breast cancer in “people [who] delay childbearing.” For the Journal of the American Medical Association, it is breast cancer that is female, not the person who “lives with it” as if it were a lodger.
The term gender assigned at birth is now de rigueur, as if doctors, midwives, or parents simply spun a coin as to whether the new-born were a boy or girl, and there were no objective correlative of their choice. There are occasionally — rarely — indeterminate or intermediate states, but it is characteristic of our age that the marginal is turned into the central.
The strange circumlocution is not without political consequences: in Britain, a person can change the sex that is written on his or her birth certificate. Even Stalin, who had no hesitation in changing the past, would have balked at this. He would never have suggested that Trotsky was a woman at birth.
Heroin and other opiate or opioid addicts are now people “with opioid use disorder.” They do not even abuse such drugs any longer, for such a word would be stigmatizing: we no longer expropriate the expropriators, à la Marx, we stigmatize the stigmatizers. For the medical journals these days there is no right and wrong use of opiate drugs, there is only use that sometimes causes the user problems, as would a computer on the blink.
The user has done nothing wrong, or made bad choices; he is the victim of the drug, the circumstances, the government, society, bad policy, etc. This is because there is a thirst for pure victimhood by what might be called the rescuing classes. If a person is in any degree the author of his own downfall, he is no longer a pure victim, and the rescuing classes feel cheated of their prey, like a gazelle that escapes a cheetah. Of course, treating such a person as a pure victim has the advantage of turning him into compassion fodder.
For the medical journals, fat people are no longer obese, they are people with obesity. Obesity is another thing that just happens to people, without their having done anything to make it happen. Let me here add that I am sympathetic to very fat people: to see them laboring to walk, even to breathe, is heart-breaking, and surely they cannot be happy in their skins.
Many of them may have been overfed in childhood, and once very fat it is difficult (though not impossible) for a person to lose weight. This is not the same, though, as saying that they have done nothing to account for their state, as the expression persons with obesity (like persons with a harelip or a club foot) implies. Even people who have undergone bariatric surgery are advised and encouraged to conduct themselves in a certain way with regard to food if they want to maintain their weight loss.
And now, for the medical journals, people are not homeless, they are people with homelessness. Again, homelessness descends on such people as, say, hypothyroidism once descended on me. It is a medical condition, and just one of those things that cannot be helped (except, of course, by taxation and a certified bureaucracy).
People with homelessness are victims of forces beyond their control, especially economic ones: this is established by the fact that their numbers are increasing. Let me point out one surprising thing. In Britain, the poorest ethnic group is that of relatively recent Bangladeshi immigrants, but I have never seen a homeless Bengali living on the streets, though I have spoken to quite a few children of the white middle classes who do so.
Social phenomena, then, are not just vectors of forces, like the trajectories of billiard balls struck by other billiard balls. Reading medical journals makes one feel that there is a contemporary miasma of untruth that makes Victorian euphemism seem frank by comparison.