Defining the Words of Healing (and Hurting)

Medical Dictionary

By Caroline Yount

As far as scholarly passions go, Marie O’Toole has a weighty one.

O’Toole, senior associate dean of academic and faculty affairs and professor at the Rutgers School of Nursing–Camden, has spent the last 20 years as editor of a definitive medical dictionary.

“I do it because I want to make a difference in how professionals communicate. Words make a difference,” she says.

Marie O'Toole

Marie O’Toole, senior associate dean of academic and faculty affairs and professor at the Rutgers School of Nursing–Camden

At an impressive 2,005 pages and weighing about six pounds, the 10th edition of Mosby’s Dictionary of Medicine, Nursing and Health Professions (Elsevier, 2017) is a labor of love for O’Toole. An electronic version is also available.

“It is a part of my life. Working on the dictionary energizes me and I am very proud of it,” she says. “It has been a great way to discipline myself and to inform myself about different areas of scholarship.”

O’Toole works on the dictionary most nights when she goes home and the next edition is already underway. New editions are released every two to three years.

She credits “innumerable collaborators” and a strong editorial board of medical and academic professionals with helping ensure the dictionary achieves its overarching goal to “assist the user to understand how words and phrases commonly encountered in the health care literature and clinical practice are used and have been used in the past.”

“It is important to use the terms as they are meant to be used and especially as they are used in different areas. A challenge is making sure you don’t use just what you are familiar with,” she says.

For instance, the word potency is in common usage, but has a unique meaning in embryology:

Potency: 1. (in embryology) the range of developmental possibilities of which an embryonic cell or part is capable, regardless of whether the stimulus for growth or differentiation is natural, artificial, or experimental. 2. a measure of the strength of the active chemical components contained in an herb or herbal preparation. Standardized products ensure the consumer of receiving a dosage containing a consistent potency.

It is a good example of a word a student might encounter when studying that they are familiar with, but does not make sense in that context. The dictionary can help the student understand the context, O’Toole explains.

She thanks the Rutgers–Camden community in her editor’s foreword and in a recent interview about the dictionary. She is grateful to colleagues and students in the Rutgers School of Nursing–Camden for reviewing materials, answering questions, and providing “just the right suggestion to assist me in making each and every definition and image maximally useful.” Two students, Steven Hale, who worked with O’Toole on an independent study focused on the language of health care, and Dzianis Sulkouski, who provided a review in the database, were specifically named for their contributions to the work.

Each edition sees the addition or deletion of words for a host of reasons. Words are taken out, O’Toole explains, because they have become commonplace or obsolete, such as medications or a pump that is no longer manufactured. The 10th edition marks the first time that the term “mental retardation” has been removed from the dictionary. It was replaced with “cognitive impairment.”

In her role as editor, O’Toole is aware of “the impact of words and what they mean to other people. Are the words insulting or demeaning?” Such was the case with “mental retardation,” which was under consideration for a few years before its removal for this edition.

While some words don’t change from one edition to another, every entry has to be reviewed and scrutinized. And when adding a new word, O’Toole says care is taken to determine that the word is widely used in a professional context. “We want to make sure that new words and phrases used in health care are not transient colloquialisms or slang,” she says.

The demands of editing are constant, she says. “You have to always keep up with it.” O’Toole has a notepad with her at all times so she can jot down comments on spoken words. She also has access to all of the electronic resources of the publisher, Elsevier, facilitating review of the written literature. She updates the database at least daily.

O’Toole is always happy to hear from readers with questions or suggestions for new entries. As she handed a tome to a visitor recently she said, “Let me know if there is anything you don’t see in it.”


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