Critical but stable
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Ildhund - 16 Apr 2009 18:53 GMT Just to keep this group alive... Yet again I hear on the wireless that a victim of violence is - and has been for several days - in a 'critical but stable condition'. To my ear, these are almost antonyms, a view borne out I think by dictionaries. How do you understand it?
 Signature Noel
Peter Duncanson - 16 Apr 2009 19:43 GMT >Just to keep this group alive... >Yet again I hear on the wireless that a victim of violence is - and >has been for several days - in a 'critical but stable condition'. To >my ear, these are almost antonyms, a view borne out I think by >dictionaries. How do you understand it? I have had similar thoughts about that description.
This seems to be a relevant definition: http://medical-dictionary.thefreedictionary.com/critical
2. pertaining to a disease or other morbid condition in which there is danger of death.
Stable has its usual meaning: unchanging.
An analogy might be of someone standing at the top of a cliff very close to the edge. They are in a critical condition. Standing still, being in a stable condition, is better than wobbling about, being in an unstable condition.
 Signature Peter Duncanson, UK (in uk.culture.language.english)
Theo Markettos - 16 Apr 2009 20:03 GMT > Just to keep this group alive... > Yet again I hear on the wireless that a victim of violence is - and > has been for several days - in a 'critical but stable condition'. To > my ear, these are almost antonyms, a view borne out I think by > dictionaries. How do you understand it? Critical = "life-threatening" stable = "getting neither worse nor better"
Someone whose life is threatened can have their condition worsening or improving, while at the same time still remaining life-threatening. Consider someone whose heart is beating irregularly... it can either stop completely (getting worse) or beat more regularly but still be dangerous (getting better). Stable implies there's no change in the condition, even though that condition remains serious.
Theo
Ildhund - 17 Apr 2009 00:02 GMT Theo Markettos wrote...
> Critical = "life-threatening" > stable = "getting neither worse nor better" My understanding is presumably coloured by descriptions of the course of a feverish illness. As it progresses, the patient eventually reaches the crisis - the point of decision from which it could go either way. A crisis is to my mind a momentary situation, so a stable crisis doesn't make sense. Peter's analogy of the cliff-edge is perhaps a bit closer to what the hospital spokesman meant, but I can't help thinking that (a) the usage is a devaluation of an otherwise useful term, and (b) there must be other ways of describing the situation that don't make old pedants like me do a double-take.
 Signature Noel
Peter Duncanson - 17 Apr 2009 12:33 GMT >Theo Markettos wrote... >> Critical = "life-threatening" [quoted text clipped - 10 lines] >describing the situation that don't make old pedants like me do a >double-take. Wikipedia has an article on this subject: http://en.wikipedia.org/wiki/Medical_state
Medical states or medical conditions are used to describe a patient's condition in a hospital. These terms are most commonly used by the news media and are rarely used by doctors in their daily business, preferring to deal with medical problems in greater detail.
There are separate sections for USA practice and UK practice.
UK practice The release of patient information to the press is strictly controlled in the National Health Service (NHS). The Department of Health (DH) publishes a Code of Practice for guidance to NHS Trusts.[3] .... Each NHS Trust has its own guidance for statements to the press. The DH Code of Practice has no official definitions of the standard phrases in use. However, most NHS Trusts will specify some[4] or all[5] of the following phrases in their guidance; * Deceased * Critical * Critical but stable * Stable * Satisfactory * Comfortable * Progressing well * Discharged
USA practice
A frequently cited condition is "stable". Typically, stable is not a condition on its own; it is usually qualified with a true condition. It is commonly used to denote conditions where a patient has a favorable prognosis or stable vital signs. The American Hospital Association has advised doctors to not use the word "stable" either as a condition or in conjunction with another condition, especially one that is critical, because a critical condition inherently implies unpredictability and the instability of vital signs.[1] Despite this, "critical but stable" conditions are frequently reported, ... The use of such conditions in the U.S. media has increased since the passing of the HIPAA in 1996. Patient privacy has become more of a concern to doctors and hospitals, and they are less likely to release specific medical conditions, fearing litigious patient
 Signature Peter Duncanson, UK (in uk.culture.language.english)
Ildhund - 18 Apr 2009 18:44 GMT Peter Duncanson wrote...
> Wikipedia has an article on this subject: > http://en.wikipedia.org/wiki/Medical_state ...
> most NHS Trusts will specify some[4] or all[5] of the following > phrases in their guidance; ...
> * Critical > * Critical but stable ... Thank you, Peter. I think it's very sad that established authorities perpetuate the bad language they never learnt to recognize.
 Signature Noel
Peter Duncanson - 18 Apr 2009 19:53 GMT >Peter Duncanson wrote... >> Wikipedia has an article on this subject: [quoted text clipped - 8 lines] >Thank you, Peter. I think it's very sad that established authorities >perpetuate the bad language they never learnt to recognize. I sympathise with your point but I also sympathise with the authorities. They need to have words and phrases that communicate the desired general concepts to the general public. These words and phrases need not be pedant-proof.
At least they aren't using a colour code for the conditions.
Let's see what I can invent:
Black: Deceased Double Red: Critical Red: Critical but stable Double Amber: Stable Amber: Satisfactory Green-Amber: Comfortable Green: Progressing well White: Discharged
 Signature Peter Duncanson, UK (in uk.culture.language.english)
Molly Mockford - 18 Apr 2009 19:59 GMT At 19:53:59 on Sat, 18 Apr 2009, Peter Duncanson <mail@peterduncanson.net> wrote in <9q7ku4put8vh649k2v8b4a59naiej8qcvp@4ax.com>:
> Black: Deceased > Double Red: Critical [quoted text clipped - 4 lines] > Green: Progressing well > White: Discharged Only a man could combine the concepts of "white" and "discharge" to mean "everything is OK"...
 Signature Molly Mockford They that can give up essential liberty to obtain a little temporary safety deserve neither liberty nor safety - Benjamin Franklin (My Reply-To address *is* valid, though may not remain so for ever.)
Peter Duncanson - 18 Apr 2009 23:25 GMT >At 19:53:59 on Sat, 18 Apr 2009, Peter Duncanson ><mail@peterduncanson.net> wrote in [quoted text clipped - 11 lines] >Only a man could combine the concepts of "white" and "discharge" to mean >"everything is OK"... "Discharged" is an administrative or organisational status rather than a state of health. It doesn't describe a patient's health so doesn't really fit into any colour coding that is based on a patient's condition.
I chose "white" having in mind a blank sheet of paper symbolic of the hospital having nothing to say on the patient's state of health.
 Signature Peter Duncanson, UK (in uk.culture.language.english)
Molly Mockford - 19 Apr 2009 03:20 GMT At 23:25:39 on Sat, 18 Apr 2009, Peter Duncanson <mail@peterduncanson.net> wrote in <o4kku45cgi7ss0en7o22b7ija70ol8tpeo@4ax.com>:
>>At 19:53:59 on Sat, 18 Apr 2009, Peter Duncanson >><mail@peterduncanson.net> wrote in >><9q7ku4put8vh649k2v8b4a59naiej8qcvp@4ax.com>:
>>> White: Discharged >> [quoted text clipped - 8 lines] >I chose "white" having in mind a blank sheet of paper symbolic of the >hospital having nothing to say on the patient's state of health. I rest my case, m'lady.
(And I am, I suppose, rather pleased that Mr Duncanson has never encountered a white discharge.)
 Signature Molly Mockford They that can give up essential liberty to obtain a little temporary safety deserve neither liberty nor safety - Benjamin Franklin (My Reply-To address *is* valid, though may not remain so for ever.)
Peter Duncanson - 19 Apr 2009 10:31 GMT >At 23:25:39 on Sat, 18 Apr 2009, Peter Duncanson ><mail@peterduncanson.net> wrote in [quoted text clipped - 21 lines] >(And I am, I suppose, rather pleased that Mr Duncanson has never >encountered a white discharge.) Only pus from an infected pore on my right arm.
As for Code Green, that should not be interpreted as a description of the patient's colour either. Greenness of a patient is not a sign that all is well.
 Signature Peter Duncanson, UK (in uk.culture.language.english)
Peter Duncanson - 19 Apr 2009 12:47 GMT >Only pus from an infected pore on my right arm. Make that "left". It was decades ago.
 Signature Peter Duncanson, UK (in uk.culture.language.english)
Mike Barnes - 18 Apr 2009 20:21 GMT In uk.culture.language.english, Peter Duncanson wrote:
>>Peter Duncanson wrote... >>> Wikipedia has an article on this subject: [quoted text clipped - 13 lines] >concepts to the general public. These words and phrases need not be >pedant-proof. In a slightly different context, I cringe every time I hear schools inspectors and the like, going on to the effect that for a school to be "satisfactory" isn't good enough. Do they ever stop to think what the word actually means?
 Signature Mike Barnes
Ildhund - 18 Apr 2009 21:40 GMT Peter Duncanson wrote...
> They need to have words and phrases that communicate the desired > general concepts to the general public. http://news.bbc.co.uk/onthisday/hi/dates/stories/march/24/newsid_2785000/2785265.stm describes Queen Mary's last day:
A bulletin released at Marlborough House at 1140 GMT was the first warning that her condition was causing some anxiety. A second bulletin, framed like the first and hung on a screen of corrugated iron protecting stonework repairs to the front of the gateway, was issued at 1340 GMT. It said: "During the past hours Queen Mary's condition has become more grave. There has been a serious weakening of the heart action which gives rise to increasing anxiety." The third bulletin, at 1900 GMT, was brief: "Queen Mary's strength is ebbing, but Her Majesty is sleeping peacefully." The fourth and final bulletin was to announce her death.
This seems to me to communicate the general concepts perfectly adequately, using terms which anyone should be able to understand, even pedants.
 Signature Noel
Peter Duncanson - 18 Apr 2009 23:59 GMT >Peter Duncanson wrote... >> They need to have words and phrases that communicate the desired [quoted text clipped - 13 lines] >ebbing, but Her Majesty is sleeping peacefully." The fourth and >final bulletin was to announce her death. That is true, but that gives too much information for an NHS hospital statement about a patient. Those cryptic descriptions of a patient's condition are given in response to enquiries from the press. A patient's relative or other representative can give more detailed information if they so wish.
I imagine that it is relatively easy for a hospital spokesperson to discover a patient's condition in terms of the seven or eight standard categories. To get more detail it might be necessary to take up the time of a appropriately senior doctor to get an assessment of a patient's condition and to agree suitable wording.
There is also the point that a patient or relatives might be happy to have a cryptic condition statement issued but would not want more details to be published.
>This seems to me to communicate the general concepts perfectly >adequately, using terms which anyone should be able to understand, >even pedants.
 Signature Peter Duncanson, UK (in uk.culture.language.english)
Molly Mockford - 19 Apr 2009 03:38 GMT At 21:40:09 on Sat, 18 Apr 2009, Ildhund <jnllb@removemsn.com> wrote in <gsddra$mqs$1@news.motzarella.org>:
>A bulletin released at Marlborough House at 1140 GMT was the first >warning that her condition was causing some anxiety. A second bulletin, >framed like the first and hung on a screen of corrugated iron >protecting stonework repairs to the front of the gateway, was issued at >1340 GMT. Since we were not informed as to the style of framing of the first bulletin (was it gold, or gilt, or plain black wood?) this more detailed description of the second bulletin is somewhat lost on us.
However, I am pleased to hear of the corrugated iron protecting stonework repairs to the front of the gateway, even though these were apparently screened from view; these days, the opportunities for honest British working men to exercise the skills of their craft are fewer, and farther between.
(Because no bugger will pay them.)
>The third bulletin, at 1900 GMT, was brief: "Queen Mary's strength is >ebbing, but Her Majesty is sleeping peacefully." The fourth and final >bulletin was to announce her death. What I, me and I remember is not the death of (HMS) Queen Mary, but that of King George VI (pronounced "vee-eye" by those who are accustomed to refer to "One Clavdivs").
I remember the occasion vividly.
It occurred, with no prior consultation (to be fair, they didn't consult his elder daughter either, although she was rather embarrassingly up a tree in Kenya at the time), when I was a couple of months short of four years old - *and they cancelled "Listen With Mother" because of it*. Now, c'mon! Even I, a pre-school bairn, knew that the King would not have been paying attention to "Listen With Mother" even if he hadn't died.
For decades, I wanted to raise the matter with his widow. Or with his daughter. I never had the opportunity for the former; I was, once, in company with the latter, but (I am ashamed to say) bottled out. Let's face it - when you turn around, all unsuspecting, and find yourself confronting a wee wummin, five foot tall, with inch-thick make-up, a large hat, and an expression well-schooled in trying not to look bored - well, you just kind of fling yourself underneath the nearest trestle table, don't you?
(Those who have, somehow, never found themselves in this specific situation are not required to answer. Those who actually are eligible to reply should confine themselves to one side of foolscap.)
 Signature Molly Mockford They that can give up essential liberty to obtain a little temporary safety deserve neither liberty nor safety - Benjamin Franklin (My Reply-To address *is* valid, though may not remain so for ever.)
Peter Duncanson - 19 Apr 2009 10:27 GMT >At 21:40:09 on Sat, 18 Apr 2009, Ildhund <jnllb@removemsn.com> wrote in ><gsddra$mqs$1@news.motzarella.org>: [quoted text clipped - 26 lines] > >I remember the occasion vividly. The similar occasion I remember most vividly (at least aspects of it) was the last few days of Winston Churchill's life. His personal physician Lord Moran would appear in public to deliver the latest health bulletin. He was dressed smartly like a character from an Edwardian drama, most notably wearing a wing collar. He pronounced "bulletin" with the final syllable as "teen".
 Signature Peter Duncanson, UK (in uk.culture.language.english)
John Hall - 19 Apr 2009 11:10 GMT >What I, me and I remember is not the death of (HMS) Queen Mary, but >that of King George VI (pronounced "vee-eye" by those who are >accustomed to refer to "One Clavdivs"). I don't recall the death of George VI, but I do remember a tremendous fuss about something called a "coronation" when I was four years old. I never discovered what a coronation was until much later.
 Signature John Hall "Hard work often pays off after time, but laziness always pays off now." Anon
David - 19 Apr 2009 12:44 GMT > >What I, me and I remember is not the death of (HMS) Queen Mary, but > >that of King George VI (pronounced "vee-eye" by those who are > >accustomed to refer to "One Clavdivs").
> I don't recall the death of George VI, but I do remember a tremendous > fuss about something called a "coronation" when I was four years old. > I never discovered what a coronation was until much later. It's when someone gets coronated - as I once heard on that charming US TV proggy about three witch sisters.
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Peter Duncanson - 19 Apr 2009 13:14 GMT >> >What I, me and I remember is not the death of (HMS) Queen Mary, but >> >that of King George VI (pronounced "vee-eye" by those who are [quoted text clipped - 6 lines] >It's when someone gets coronated - as I once heard on that charming US >TV proggy about three witch sisters. The lucky person is connected to a very high voltage source of electricity. Their hair will stand on end and they will be surrounded by a glow - a corona discharge.
 Signature Peter Duncanson, UK (in uk.culture.language.english)
David - 19 Apr 2009 12:47 GMT [Snip]
>Let's face it - when you turn around, all unsuspecting, and > find yourself confronting a wee wummin, five foot tall, with > inch-thick make-up, a large hat, and an expression well-schooled in > trying not to look bored - well, you just kind of fling yourself > underneath the nearest trestle table, don't you? Doesn't that count as lese-majesty?
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