Medical lexicography in the 21st century
Lexicography is the act, activity, or art of compiling dictionaries. A lexicographer is, per Dr Samuel Johnson*… a writer of dictionaries, a harmless drudge, that busies himself in tracing the origin, and … signification of words.
Medical lexicography then, is the act, activity, or art of compiling medical dictionaries. A medical lexicographer is a writer of medical dictionaries. As far as I know, there are no formal programs in higher education that specifically teach medical lexicography or confer degrees therein. However, having been engaged in writing medical dictionaries since 1984, it seems reasonable to regard myself as a medical lexicographer.
From this armchair, there seem to be two types of medical lexicographers: team lexicographers and maverick lexicographers, terms which I have herewith shamelessly coined.
Team lexicographers are employed by a medical publishing house to define biomedical and scientific terms deemed important enough by experts, consultants and contributors to warrant inclusion in the next edition of a long established* medical dictionary. Team lexicographers cobble together definitions, pass them to their physician or scientist experts to verify and validate content, then add them to next edition.
*Dorland’s Illustrated Medical Dictionary–first published in 1890; Mosby’s Dictionary of Medicine, Nursing and the Health Professions (1982), Stedman’s Medical Dictionary (1911), Taber’s Cyclopedic Medical Dictionary (1940). Parenthetically, major, built from the ground up, medical dictionaries are rarities, given the length of required to bring them to market and the uncertain ROI (return on investment). They are risky ventures at best, and financial fiascos at worst. As an example of such seemingly good ideas gone badly wrong, one can cite the International Dictionary of Medicine and Biology (IDMB) published by John Wiley & Sons in 1986. It cost Wiley millions, and required 10 years from blank page to shipped product. It was a 3-volume affair with an eye-watering pricetag–I think I paid $295 for mine–for a lexicon that had 180,000 definitions in an era when the Dorland’s had 110,000 terms for $40. The IDMB didn’t make it to a second edition. Wiley probably lost their shirts on the venture, given that they sold their entire medical division to Churchill shortly thereafter.
My term, maverick medical lexicographer (MML), refers to a physician or scientist who is typically an expert focused on a single specialty and has over their career collected terminology in that area. MMLs shoulder the bulk of the work and manage to convince a publisher to assign an already overworked editor to add the project to his/her “list” and publish it to an underwhelmed audience. One can go to Amazon’s search window and type in “Dictionary of…” to find what’s on offer by MMLs. The Dictionary of Modern Medicine began as and continues to be the work of a single MML (JC Segen, MD).
My 3-plus decades as a “harmless drudge” in ML have given me a unique perspective. I believe that the field, whilst it was relevant in the 20th century, is losing its way in the 21st century.
Issues in medical lexicography in the 21st century
• Need to improve interface and efficiency of access to data–e.g., transition of text format to database format
• Need to develop universal (interspecialty) IT-friendly syntax–e.g., muscular dystrophy—Duchenne type (good) vs. Duchenne muscular dystrophy (not as good)
• Need to expand reach of medical lexicography. Examples of terminology not traditionally included in medical dictionaries: ballistics–of interest to ER physicians; CYA–cover your ass, slang for defensive medical practice; loss-less compression–imaging and informatics; peeking–evidence-based medicine; Suicide Act 1961–British medicine and forensic medicine
• Need to replace phenotypic classifications, which are both imprecise and subjective with genotypic classifications, which are precise and objective.
• Need for a deadpool Most terms have a life cycle. The norm in medical dictionaries is to simply delete them, rather than to archive them in some way for those who need to analyse vintage medical publications
ML is like good management. When things are running smoothly, both should be invisible; medical lexicography is increasingly visible…