I was intrigued by the title “The Word That Shall Not Be Spoken” (NEJM 2013; 369; 177-78).

According to the author the word is “suffering.”  He notes that clinicians do not like to use this word. Some of the reasons:

• It is not “actionable”..it is “too heterogeneous, too complicated”
• It reminds us that we are “powerless against so many of our patients’ problems”
• Because “the idea of taking responsibility for it overwhelms us as individuals –and we are already overwhelmed by our other duties and obligations

His conclusion: “in truth, I’m less interested in the words we use than in what we actually do, and what we organize ourselves to do. Collectively, we should not shy away from work that can never be completed.  For our organizations, relief of suffering does seem like the right goal, endless though the work might be.”