A teacher's reaction to forbidden words

Dec 18 2017 Published by under Uncategorized

The CDC has just released a list of forbidden words:

Policy analysts at the Centers for Disease Control and Prevention in Atlanta were told of the list of forbidden words at a meeting Thursday with senior CDC officials who oversee the budget, according to an analyst who took part in the 90-minute briefing. The forbidden words are “vulnerable,” “entitlement,” “diversity,” “transgender,” “fetus,” “evidence-based” and “science-based.”


Other CDC officials confirmed the existence of a list of forbidden words.It’s likely that other parts of HHS are operating under the same guidelines regarding the use of these words, the analyst said.

The only reason we know this, now, is because someone leaked it. The implications are for policy decisions and budget requests for the coming year. This all feels very Orwellian (time to reread 1984 and better yet Farenheit 451).

It is not at all clear why the words are being forbidden, at the operational level (as opposed to the higher levels desires of the people in charge). I read somewhere that it was a recommendation for getting approval from either Congress/Executive Branch, which sees these as trigger words. However, it is clear that whether it is externally generated censorship, or the internal kind that comes when the author is too aware of what others don't like and self-limits, it is not going to be a good thing for science.

But censorship is censorship. And I teach at a public medical school in a purple-ish state that has had its political tilts to the left and to the right.

I use one of these words in teaching: fetus.

Fetus has a specific meaning for clinicians and developmental biologists. For OB-Gyns, and neonatologists and pediatricians. For people who work on developmental biology in mammals. For people who are trying to make life better and understand the grandeur of life.

I have taught embryology for over 25 years to various and sundry populations of students. We use the word "embryo" for the period of time called "embryogenesis" which lasts roughly from fertilization through 8-12 weeks. During this time organogenesis happens: the formation of organs from the original single fertilized cell. The next period is the "fetal period" where largely growth and maturation occurs (as opposed to new organs forming). "Neonatal" and "Perinatal" are the time around birth. There are some finer points here, and different people studying different aspects have slightly different definitions.

But, to all of us the word "fetal" means something very specific about the biology and physiology and anatomy and development of what is occurring. We use words, we define words, so that we can have a conversation about things without having to resort to extra pictures of waving our hands. Commonly defined words serves the important purpose of mistakes from happening.

As an exercise, go do the "1000 words" thing. Try to describe something using only those words. Its a fun game and ..... But it is difficult for scientists and clinicians to do this as more than a game. We use specific words. We need specific words.

And I use many of those specific words every time I teach. Not just embryo, but uterus and placenta and synsciotroph (tissue that makes the placenta possible).

If you start telling me what words I can use to teach. If you start telling everyone who teaches the next generation of clinicians, not just physicians, but nurses and physical therapists and respiratory therapists and everyone who needs an understanding of anatomy and physiology and neuroscience to take care of infants, what words they can use, we will have a generation of people who cannot do their job  as well as is possible.

One of my favorite lectures to give, and judging from feedback, one of the lectures first year med students like the best is "The Fetus as Patient". There are so many things I could talk about, but I focus on a few, to do them better than running through a shopping list of what can go wrong. I cover what are identical twins, how is a placenta formed, and importantly what is the circulatory system before and after birth. These are all sources of "birth anomalies" things that are clinical problems for infant and mother. But if I can't use the word fetus (and what comes next? pre-natal? placenta? umblical cord?), it becomes harder to give this lecture. It becomes harder to teach. It compromises what these students know and how they will take care of their patients.

Forbidding the use of words is something that never ends well. It does not make the words go away. It limits how people can communicate, and in the case of medical words, it will surely compromise the health of someone.

See also: Mike the Mad Biologist on this.


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