The grapheme <a> is used as a symbol for the phoneme /a/ when it is pronounced as the low front unrounded form of the vowel, as in the Scottish pronunciation of “back.” In the International Phonetic Alphabet (IPA) it is called Cardinal vowel number 4. The grapheme that looks like a handwritten version <ɑ>, Cardinal […]
Category: Columnists
Richard Smith: Is informed consent impossible at the end of life?
Informed consent is impossible at the end of life, said a British palliative care physician last week at a conference on Heybeliada, one of the Prince’s Islands in the Sea of Marmara, close to Istanbul. Could he be right? Before I reflect on the question, I want to say a little about what was an […]
Jeffrey Aronson: When I use a word . . . The story of ough
Violet Elizabeth’s “croth-word puthle,” composed for William to solve in Richmal Crompton’s William—In Trouble (picture further below), contains two three lettered words crossing at the centre letters. The first clue is “Wot you hav dropps of” and the answer, of course, is “COF.” Violet Elizabeth can’t have been the only child to have been troubled […]
Desmond O’Neill: Surprised by beauty
Like most doctors, my conference schedule is usually mapped out well in advance, anticipating the complex leave requirements of trainees and colleagues in an ever busier department of geriatric and stroke medicine. This year, while on a 12 month secondment to the rapidly evolving Irish programme in traffic medicine, the constraints on my timetabling are correspondingly […]
William Cayley: To doctor is to diagnose
I appreciated Richard Smith’s recent discussion of mental models—too often, I think, we simply carry on with practice as usual (or, “life as usual”) without sufficient critical attention to the paradigms on which we rely to organize our thinking and doing. I would beg to differ with him, however, on the argument that “diagnosis is […]
Richard Smith: “Diagnose, treat, and cure” is largely dead
I don’t suppose that the people who taught me at medical school thought that they were promoting particular mental models. They were trying (and sadly failing) to make me the best doctor they could. But just like the man who didn’t know he’d been speaking prose all his life, they were promoting mental models. One […]
Jeffrey Aronson: When I use a word . . . Medical logos
“Grapheme” is defined in the Oxford English Dictionary as “The class of letters and other visual symbols that represent a phoneme or cluster of phonemes” and “in a given writing system of a given language, a feature of written expression that cannot be analysed into smaller meaningful units.” The dictionary gives an excellent example: the […]
Richard Smith: Time for GPs to be leaders not victims
General practitioners are overworked, underappreciated, and perhaps underpaid. Politicians are unsympathetic to their plight and expecting more of them. Hospital doctors dump work on them. Nurses are after their jobs. Patients are demanding and ungrateful. Bureaucrats and regulators are making their professional lives a misery. General practitioners have replaced farmers as the profession that complains […]
Jeffrey Aronson: When I Use a Word … Phonetic alphabets
So, there are phonemes and graphemes. A phoneme is a basic indivisible unit of sound, the linguistic atom. A grapheme is a symbol that represents a phoneme. Each grapheme in any well-defined system represents a single phoneme. However, there are several different systems, and a grapheme can represent several different phonemes, depending on the system […]
James Raftery: Cancer drug prices and olaparib
NICE’s provisional rejection of Astra Zeneca’s olaparib (Lynparza) for a genetic subset (BRCA1/2 gene mutation) of ovarian cancers has several themes which have not been commented on. One is that Astra Zeneca may have handled matters poorly. In particular it withdrew olaparib from consideration by the cancer drugs fund in December 2014. The reported reason […]