45. Do You Speak "Doctor"?

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[00:00:05.05] - Oliver (Host)

Welcome back to another conversational episode of English and Beyond: the advanced version of the podcast. My name is Oliver.

[00:00:14.10] - César (Guest)

My name is César.

[00:00:16.18] - Oliver (Host)

And we are language teachers. Today, we are going to talk about medicine. Now, I am not a doctor. Are you a doctor, César?

[00:00:24.23] - Oliver (Host)

I'm not.

[00:00:24.53] - Oliver (Host)

No, but we are both hypochondriacs. So I think that we probably know quite a lot about this topic in comparison to the layman, the man or woman on the street. How do you feel about your health in general, César?

[00:00:39.28] - César (Guest)

I guess I'm vigilant. Yeah.

[00:00:42.31] - Oliver (Host)

That is a very nice way to say, you know, obsessed.

[00:00:47.42] - César (Guest)

I'm a bloody hypochondriac. No, I think I got better, to be honest. Obviously, I take care of my health.

[00:00:56.07] - Oliver (Host)

Yeah.

[00:00:56.53] - César (Guest)

It is true that I don't I don't delay the decision of going to the doctor, if I think that something might go wrong or might be wrong.

[00:01:07.53] - Oliver (Host)

In a way, actually, I'm more stereotypically male than you are in that respect because there's this stereotype that men won't go to the doctor unless they're forced to. And women, generally, when there is a problem, they will go. Have you heard of this stereotype before? You have to persuade me sometimes to go to the doctor.

[00:01:27.35] - César (Guest)

But sometimes you prefer to go on Reddit?

[00:01:32.03] - Oliver (Host)

I think Reddit is an excellent resource for everything, not just for medicine. But I think that, but actually, the person who inspired this episode is a family friend of mine. He has just had both knees replaced, and he unfortunately has just found out that he's going to have to have his hip replaced as well. Probably both of them. So all of this in the space of - well, both knees within one year and the hip within six months or so. So a never-ending problem. This family friend is, although very brave, not looking forward to having yet another serious operation under general anaesthetic. Do you know what general anaesthetic is?

[00:02:19.03] - César (Guest)

I know what it is.

[00:02:19.43] - Oliver (Host)

What is it?

[00:02:21.03] - César (Guest)

It's when you're completely asleep during the operation?

[00:02:24.41] - Oliver (Host)

Yeah, well, I think that exactly. Local anaesthetic is when they give you pain relief just one part of your body. And general is where I think that you're basically unconscious.

[00:02:36.19] - César (Guest)

Yeah, I had two operations in my life, one of them with general anaesthetics and second one with a local.

[00:02:43.52] - Oliver (Host)

Tell us more, César, what operations did you have?

[00:02:46.38] - César (Guest)

It was - my history? Appendicitis, which I think is a very common surgery. What is the difference between surgery and operation? Because I always have this doubt. Is it the same thing?

[00:03:02.11] - Oliver (Host)

I would say definitely in, kind of, ordinary usage, I think that they're used interchangeably. Operation, I suppose, you'd use it in the sense of, especially when you're talking about a single event, like "I had an operation last week." You can say, "I had surgery last week." You don't say, "I had a surgery." You say, "I had surgery last week." But yeah.

[00:03:27.17] - César (Guest)

So, I had my - I have another question, actually, because I was about to say, I have my appendicitis done, or my appendix done or removed. Yeah, because I know when it's like a cosmetic surgery, you can say, I got my nose done. But I wasn't sure if you could say the same thing with your appendix, for example, or your heart.

[00:03:49.48] - Oliver (Host)

I think that if you said, "Oh, I got my appendix done", it sounds almost quite flippant. It sounds almost like a bit of a joke.

[00:03:56.20] - César (Guest)

Yeah, that's what I thought.

[00:03:57.37] - Oliver (Host)

Yeah, as if you're, "Oh, yeah, I got my appendix done, and then I got my arm..."

[00:04:03.49] - César (Guest)

It's not real beauty.

[00:04:04.53] - Oliver (Host)

Well, it's hard to describe the tone of exactly what it implies, but it's like it's something cosmetic, as you say. So appendicitis. You know that -itis bit in that word?

[00:04:18.21] - César (Guest)

It's infection, right?

[00:04:20.29] - Oliver (Host)

Inflammation.

[00:04:20.56] - César (Guest)

Inflammation.

[00:04:21.27] - Oliver (Host)

So anything like, for example, if you have - one form of irritable bowel disorder or irritable bowel disease, sorry, is colitis, so an inflammation of the colon, for example. Do you think that appendicitis is, to use our advanced vocabulary, do you think it's an acute or a chronic disorder?

[00:04:45.53] - César (Guest)

It's an acute disorder. If you happen to have it, you need to get a solution very quickly because otherwise it might get worse and it ends up in - how is it called? Peritonitis, I think it's called. When the appendix explodes.

[00:05:08.04] - Oliver (Host)

Interesting.

[00:05:08.27] - César (Guest)

Yeah, and it's very dangerous.

[00:05:11.00] - Oliver (Host)

Okay, well, so I don't know very much about that. Obviously, the -itis, again, is inflammation, and it will be of the peritoneum, I suppose. I think that's how that's pronounced. But I have to say I'm actually a bit ignorant of that. But appendicititis is, as you say, generally an acute disease. So it's one where there is a sudden onset and it's not a long-term condition. We call it chronic when it's something that is like a lifelong disorder or lifelong disease. You can actually have chronic appendicititis.

[00:05:42.02] - César (Guest)

Can you? You can. Oh, I didn't know that.

[00:05:43.17] - Oliver (Host)

Which probably sucks. But it's got a different set of dangers and presentations of symptoms.

[00:05:51.21] - César (Guest)

Are you sure you're not a doctor?

[00:05:52.52] - Oliver (Host)

Yeah, I'm not. You know in lots of American things-

[00:05:56.42] - César (Guest)

Disclosure.

[00:05:56.42] - Oliver (Host)

Yeah, they say this is not medical advice.

[00:05:58.50] - César (Guest)

It's just, the only purpose of this podcast is to teach English.

[00:06:03.05] - Oliver (Host)

Yes, exactly. So if you're in a... Well, I suppose actually you could come to the UK or you could come to an English-speaking country and say, "Well, I have a chronic disease that I need help for."

[00:06:17.50] - César (Guest)

I'm thinking that some people might find this episode less engaging or interesting than other episodes you've done. But actually, every time I went to the doctor, almost every time I went to the doctor in the UK, I had to do my research and look at words on the dictionary because I was like, How do I explain this sensation or feeling or pain in English?

[00:06:43.25] - Oliver (Host)

Yeah, that's a good point. And I think it's also actually quite interesting in terms of language because doctors' language has become simpler and simpler over the years. A lot of the time when they talk to you, they use quite amusing euphemisms for the actual words. So sometimes they will use words like tummy instead of stomach. So you just mentioned actually, César, that you've had to look up symptoms... Well, not symptoms, but how to express a disease.

[00:07:14.39] - César (Guest)

Yeah, things like, I think I've got tonsillitis. I didn't know the word for tonsillitis the first time I went to the doctor in English, in England. So you have to, more or less every time you go, in order to describe the symptoms or if you know what you you might have or specify where the pain is located in your body.

[00:07:38.27] - Oliver (Host)

And part of the reason, I suppose, for you needing to look these things up is because you want to go in and not have to waste any time describing things. You just want to be able to say, "This is the word", partially because you definitely feel when you have an appointment with the GP, the general practitioner, that's the kind of family doctor, that you're under pressure, right?

[00:08:00.37] - César (Guest)

Yeah, well, I know they're very busy. I think it's 10 minutes per patient. That's the average they can spend with you. So I try to be as efficient as possible in terms of my delivery of my symptoms and all, yeah.

[00:08:15.46] - Oliver (Host)

I always, I feel the same way. I think everyone is very aware of the NHS in the UK, right? It's a source of huge national pride, and we will do episode specifically about the NHS. I think that for other European countries and for other countries in general, they're a bit bemused by the obsession in the UK with the NHS, to the extent that, for example, the NHS was a huge part of our opening ceremony for the -

[00:08:49.17] - César (Guest)

London Olympics.

[00:08:49.49] - Oliver (Host)

Yeah, the Olympics. Exactly, for London 2012. So no other country, as far as I'm aware, has ever celebrated their health system in an opening ceremony.

[00:08:58.36] - César (Guest)

I don't think you've said, but the NHS is the acronym for National Health Care.

[00:09:05.47] - Oliver (Host)

National Health Service.

[00:09:07.13] - César (Guest)

Health Service. Okay, thank you.

[00:09:08.35] - Oliver (Host)

That's a good point, actually, exactly. So the idea is that it's free at point of use.

[00:09:13.49] - César (Guest)

And universal.

[00:09:14.55] - Oliver (Host)

It's universal, exactly. So universal healthcare, free at point of use, so you don't have to pay for an appointment. Because I think in some other countries, not just the US, although everyone is obsessed, obviously, with US healthcare, but in countries like Australia, I think that you pay to go to the GP. You might get that money back.

[00:09:32.09] - César (Guest)

You get a small amount of money or something. Then you pay for your prescription, if you work, you pay for your prescription, but you pay a small percentage of the real price.

[00:09:42.12] - Oliver (Host)

Well, there's inconsistent, inconsistencies across that as well. Prescriptions are the medications that you are prescribed by the doctor. But interestingly, lots of people that have chronic diseases won't pay for that prescription. And if you have certain diseases that you don't have to pay for, you don't have to pay for any prescription. But it's very inconsistent because there are lots of other chronic diseases that shouldn't be different, but basically, you still have to pay for them anyway, and you don't get that discount for everything. So there's a lot of tension about that, but it's not going to change because the NHS is under so much financial pressure. So it's a huge political football in the UK, the NHS. Everyone is obsessed about it. Everyone has an opinion on it. I feel like they say that in polite British society, you shouldn't talk about money, politics, or religion. And I would add the NHS, basically. So you had an operation for your appendix to be removed. And what was the other operation you had?

[00:10:52.27] - César (Guest)

I had...

[00:10:55.07] - Oliver (Host)

Oh, god. Okay, you're - I'm going to bleep that to preserve your privacy, César. I will move on.

[00:11:07.41] - César (Guest)

Well, it's a medical condition.

[00:11:09.13] - Oliver (Host)

It's a medical condition, but one that I'm not sure that we're going to talk about.

[00:11:11.43] - César (Guest)

I don't know. Okay, I'm fine.

[00:11:14.23] - Oliver (Host)

Let's move on.

[00:11:14.56] - César (Guest)

Let's move on, but I think there shouldn't be any taboo about things like that.

[00:11:19.32] - Oliver (Host)

Yeah, but-

[00:11:20.35] - César (Guest)

Because it's actually very common.

[00:11:21.30] - Oliver (Host)

But you might regret one day talking about these things. So anyway, and it's nice to have a little bit of mystery in the podcast. At the risk of using you totally as a guinea pig for this podcast, you have another chronic condition as well, right? I do have his permission to talk about these things. What is that chronic conditi-, condition.

[00:11:45.35] - César (Guest)

But do you know what it is?

[00:11:46.35] - Oliver (Host)

I do.

[00:11:47.03] - César (Guest)

Okay. I've got asthma.

[00:11:49.37] - Oliver (Host)

Exactly. And to use one of our words, what is the prognosis for asthma?

[00:11:56.17] - César (Guest)

What is the prognosis? The etymology of the word.

[00:12:00.54] - Oliver (Host)

No, prognosis. Do you know what prognosis means?

[00:12:03.16] - César (Guest)

No, I don't.

[00:12:04.13] - Oliver (Host)

Okay, so it's actually linked to... What is it called when a doctor works out what disease you have? And they tell you what that is.

[00:12:11.40] - César (Guest)

The condition, the resolution of...

[00:12:14.16] - Oliver (Host)

No, when they work it out and they tell you.

[00:12:18.34] - César (Guest)

Diagnose.

[00:12:19.29] - Oliver (Host)

Exactly. So the diagnosis, that 'gnosis' bit, diagnosis, is from the Greek word for knowledge. So 'pro' means, kind of', 'in front of'. So knowledge in front of. So basically, it's like, what is the future for this disease?

[00:12:38.23] - César (Guest)

For me or?

[00:12:40.17] - Oliver (Host)

For anyone. So any disease, you say, so basically, you run into the doctor and you find a loved one or someone, I don't know, they're in a hospital bed, and the doctor delivers the diagnosis to you. And then you can say, What's the prognosis? It's basically telling you what's happening. Okay, so what therefore, César, is the prognosis of asthma? Well, this is really becoming like a little quiz, isn't it?

[00:13:08.25] - César (Guest)

Yeah. Actually, the only thing I know about my asthma is that it's allergic, so it's caused by allergies.

[00:13:16.59] - Oliver (Host)

Oh, interesting.

[00:13:18.14] - César (Guest)

But I still need to get treatment every day. So every day I get two puffs.

[00:13:23.44] - Oliver (Host)

Yeah, okay.

[00:13:25.00] - César (Guest)

I use my inhaler every day. And the other thing I know is that it's actually under control. I've never had any asthma attack, so it's actually I'm quite lucky. I mean, it sucks the fact that I need to carry my inhaler everywhere.

[00:13:43.28] - Oliver (Host)

It's a chronic disease.

[00:13:45.10] - César (Guest)

It is chronic.

[00:13:47.57] - Oliver (Host)

But you don't suffer any... You're not immunocompromised because of it.

[00:13:52.29] - César (Guest)

No, I don't think I am.

[00:13:53.38] - Oliver (Host)

Okay, fine. So your immune system is fine, it's not affected in any way, and therefore you don't find yourself with other problems. You don't have any other diseases?

[00:14:07.01] - César (Guest)

No. Allergies. I've got allergies.

[00:14:08.59] - Oliver (Host)

Allergies. The reason I ask is simply to use another one of our advanced words, which is comorbidity.

[00:14:15.38] - César (Guest)

What?

[00:14:16.09] - Oliver (Host)

Comorbidity.

[00:14:16.40] - César (Guest)

I have no idea. I've never had that word before.

[00:14:19.58] - Oliver (Host)

So it's kind of 'co' and 'morbidity'. Morbidity in the idea of... It comes in the Latin word for illness, 'morbus'.

[00:14:28.05] - César (Guest)

Like obese, morbid obese.

[00:14:30.30] - Oliver (Host)

Morbidly obese. That means that... I think a lot of the time people assume that morbid is to do with death. And in English, there is definitely an implication of it, but morbid actually is just disease or illness. So comorbidity is having more than one disease at a time.

[00:14:50.26] - César (Guest)

Is it common now in the UK? Because I feel like it's more common in Spain now paying for your private health insurance.

[00:15:00.35] - Oliver (Host)

To have private health insurance, I think, is increasingly common. I think that what lots of people do is they don't get health insurance, but they will pay for certain things as a one-off. If they have a minor ailment, a minor health problem.

[00:15:18.13] - César (Guest)

What's the word?

[00:15:20.01] - Oliver (Host)

Ailment.

[00:15:20.49] - César (Guest)

Ailment?

[00:15:21.40] - Oliver (Host)

Yeah.

[00:15:22.30] - César (Guest)

It's a small condition.

[00:15:24.04] - Oliver (Host)

Yeah. I think it's just any medical condition. But generally speaking, you would use it for unimportant things. There are certain things you're never going to get covered on the NHS. Anything that's cosmetic or something that is not really going to cause you any real problem.

[00:15:44.04] - César (Guest)

Like your feet.

[00:15:45.24] - Oliver (Host)

Like, I have, for example, hammer toes, and they cause me no pain at all. So I think that you can get them broken. I have no idea I can't say about that, actually. It's a funny one. I could probably get it done on the NHS if I went to them and said it was causing me pain.

[00:16:05.38] - César (Guest)

Get it done.

[00:16:06.44] - Oliver (Host)

Get it done on the NHS. If I said to them it was causing me pain. But I think that if I told them the truth, then they would probably say no. So I would say in general that most of the time that people pay for something, it's either because the NHS won't cover it or the NHS will take such a long time to do it, that it's, kind of, worth financially just paying for yourself. But obviously, people can't afford to pay most of the time for significant things. You'd never pay out of pocket in the UK, or at least I've never heard of anyone paying out of pocket for something really significant, like a knee replacement. I'm sure there will be people that do, but I've never heard of someone doing it either not on NHS or with health insurance. But I guess it would be possible just to rock up with, I don't know, £20,000. I don't know how much a knee costs. So, César, that has been a really bizarre race through lots of very advanced medical vocabulary.

[00:17:20.27] - César (Guest)

I hope it's useful.

[00:17:22.24] - Oliver (Host)

Well, you've actually learned some words today.

[00:17:24.01] - César (Guest)

I have. Yeah.

[00:17:25.21] - Oliver (Host)

So that's good. So if anyone finds themselves in the UK and in need of understanding how the NHS works a bit more and also talking about their chronic ailments, then hopefully this episode has helped. So thank you very much, César, for being here to talk to me about it. And thank you very much, listener. Bye-bye.

[00:17:49.43] - César (Guest)

Bye.