Jargon Alert!

Last week, my normally ravenous and quickly-growing little cat refused to eat for several days, and started throwing up little watery cat-pukes around the apartment.  Naturally, I found her feline anorexia/bulimia unnerving.  Caring and responsible feline mommy that I am, I dutifully took her to the vet.  The vet did a physical exam.  It turns out, without being able to ask the patient where the pain is, when it started, have they eaten anything out of the ordinary lately, etc., a “physical” consists of poking the patient’s tummy, shining a light in its ears, and peering intenting at the edges of the patient’s eyeballs.  It also turns out that poking, shining, and peering makes for a rather difficult process of diagnosis. 

And so my cat was admitted to the hospital for x-rays, blood tests, and observation.

 Two days (and several hundred dollars) into this period of observation, Dr. McSpensive* called to let me know that zero progress had been made.  Blood tests were normal, IV fluids had been given, x-rays showed nothing abnormal.  Still the darling patient was acting lethargic and peckish, and refusing to eat.  Would I mind if they pumped the cat full of barium and took an MRI of kitty’s GI tract?  This would be expensive, but they didn’t know what else to do.  Of course (responsible mommy!), I agreed.

The next day, I received a call at work saying the problem had been resolved.  Because the cat (after $600 worth of veterinary intervention, I must remind you) pooped out a shoelace.   You heard me.

And herein lies the Jargon Alert!  When I went to pick the cat up, understandably miffed at having spent a large amount of cash for a medical problem that wound up being solved in what can only be described as “the old-fashioned way,” my ire was met with a huge wall of jargon.  Remember the tummy-poking of the physical exam?  No, no.  That was “palpating.”  As in, “I suspected she had ingested something, because there wasn’t any isolated tenderness when I palpated her abdomen.“  Fine.  But then I got a lecture, because it’s a very dangerous thing for “felines to ingest linear foreign bodies.” 

I greeted this egregious use of jargon with an icy stare, and the vet came back with, “that is, when cats eat string.“

There a couple of different reasons for people to engage in this kind of jargon-heavy talk.  Among professionals, it’s just the way you communicate.  In my office, we bandy about “SPMI” (pronounced “spimmy,” the misleadingly cutesy term for Severe and Persistent Mental Illness) as though it’s a normal word.  From a professional to an outsider though, the reason is usually more pointed.  Using jargon asserts that you are a professional.  It sets up the conversation so that the jargon-user is coming at it from a position of authority. 

And that’s fine.  “Linear foreign bodies” reminded me that Dr. McSpensive is an expert, a trained professional, and that I’m just a lowly cat owner (and an irresponsible one at that – what kind of mommy lets their feline ingest a linear foreign body so that they have to go to the vet and be palpated?)  Just as they were intended to, the big words put me in my place.

 I went home with my newly-recuperated kitty to relax, crank up my podcast and listen to the soothing sounds of News Hour with Jim Lehrer.  And was unexpectedly hit with another load of jargon. 

The topic was the Medicare Doughnut Hole, which is not as delicious as it sounds.  I imagine that very few of my readers are over the age of 65 and using several prescription medications, so you may be unfamiliar with this term.  Like “spimmy,” this cute name refers to something that is not only un-cute, but which is a pretty serious problem.  In an effort to move to more “consumer-driven” prescription drug plans, Congress changed the Medicare plan last year, and these changes created the Doughnut Hole.  Here’s the story of the Doughnut Hole, in broad strokes.**

 If you’re on Medicare, and your prescription drug costs are between $250 and $2000, you pay only around 25% of the costs.  Fine.  (Under $250, you pay it all, but whatever, that’s the deductible, and we’re talking about the Doughnut Hole.)    But then, when costs hit $2,251, you fall into the Hole of the Doughnut.  And it is not full of tasty pastries, it is full of you not getting your meds paid for.  Coverage kicks in again when total costs $5100, at which point Medicare pays 95% of the total costs.  Where these numbers came from is beyond me.  Why the program will fund you at 75% of costs for $2,200 worth of meds but 0% for $2,252 is doesn’t make any sense to me.  And so, in attempting to explain it, government representative turn to, what else?  Jargon.

 Which reminds me, jargon has a third important use.  It not only comes in handy as shorthand among professionals and to assert authority over lay-persons.  It’s also great for explaining nonsense.  Well, not so much explaining, as seeming to explain.

 Which is how Health and Human Services Secretary Mike Leavitt employed it on the News Hour.  In response to the Doughnut Hole, Medicare enrollees have almost 50 plans to choose from.  These plans are supposed to keep seniors from falling into the Hole.  According to Secretary Leavitt, this signals the success of providing a government benefit through the private sector.  Or, “One of the things that a market does, an efficient market, is that, when there is a desire on the part of consumers, they march to it and find it, and the market responds.“

 I get nervous when policymakers start using Econ101speak.  Consumers!  Efficient Markets!  Come on, Mike, just say it, you know you want to…. talk about the Invisible Hand!  When the Secretary of the Dept of HHS starts talking this way, I get a couple of take-home messages.  One – Mike Leavitt took Econ 101.  Excellent.  I feel good knowing my policymakers have a solid liberal arts education.  Two – the good folks at HHS are thinking about The Market.  This I feel less good about, because we weren’t talking about The Market, we were talking about The Doughnut Hole.  You can talk about The Market all day long, but the Doughnut Hole still don’t make no sense.  It just doesn’t.  I know Mike Leavitt isn’t responsible for it, and I don’t mean to blame him for it.  But I do feel the need to call him out on this, because there must be a reason for the establishment of this policy.  And you can’t throw us off the scent by using a couple of three-syllable words from your freshman economics syllabus. 

Or maybe you can, because I listened to the rest of the show and still never got a straight answer.  At least my vet had the courtesy to look me in the eye and say, “that is, when cats eat string.”  Leavitt offered no such hole in his impenetrable armour of wonkspeak.

The whole thing left me feeling confused, and with a bit of a tummy-ache.  I guess I should go get palpated. 

 

* Vet’s name has been changed to protect the expensive, yet generally innocent.

** Those requiring a more in-depth description of the Doughnut Hole are advised to get a hobby, but also to visit this website.