I read with interest Dr. Donnelly's essay on the problematic language practices in case presentations and reports in teaching hospitals [1]. Dr. Donnelly suggests that during group discussions, patients should be presented as "Mr. John Jones" rather than "37-year-old male." I do not know whether he is talking about a fictitious name, but real names are routinely withheld to preserve a patient's privacy.

Another phenomenon is worth mentioning; we like to call it group countertransference. The presentation given in the morning report or during hospital rounds goes something like this: "This is a patient who signed out AMA [against medical advice] twice and failed two clinic appointments" or "this is a frequent flier who is here every week with an asthmatic attack." When speaking these words, the presenter usually wears a sarcastic grin. Beyond that, the patient is treated as the biggest sinner on the planet. Nobody tries to explore the possibility that the patient might have missed the appointments because he recently lost his son or because his wife had had a heart attack. No one goes an extra few yards to find out whether a frequent flier visits the hospital so frequently because we are not managing her asthma properly. All of this is the direct result of problematic language practices, and it can have painful consequences for the patient.