One of my readers (I hope that there may be more than one) chastised me recently for using the American word “gotten” in my latest blog. It is not in common usage in my native England, although some do refer to “ill-gotten gains”. Maybe “forgotten” and even “woe-begotten” are also somehow connected? Who said “two countries divided by a common language”?
I hastened to research the situation and found that “Gotten was in use in England at the time America was colonized. The Oxford English Dictionary traces its first use to the 4th century. It has been used by many notable British English writers, including Shakespeare, Bacon and Pope, and is found in the King James version of the Bible”. Just saying.
That diversion led me to exploring other distinctions between US and UK parlance and practice which can confuse. For instance, why color and harbor, not colour and harbour? I read that “The American preference for color took hold in the middle 19th century thanks in large part to the simplification of English spellings by people such as the lexicographer Noah Webster”. So, Webster could not spell?
Potentially more troubling for the domestic neophyte is the simple light switch.
In USA this position is OFF, but ON in UK. Why? Just part of discarding the English yoke? No, actually it was a good idea, since the UK arrangement makes it is too easy to switch on inadvertently.
Much more pertinent and potentially hazardous is the fact that we drive on different sides of the road. How did that happen? A logical explanation for riding on the left is that, when encountering someone on horseback, it allows one to hold the reins in the left hand, whilst brandishing a sword or lance (or handshake, depending on the approaching person) in the right hand.
These early jousters seem not to have gotten the memo
So why the general change to the right side? Some say that it was the French, who always wanted (and want) to avoid English habits, or perhaps because Napoleon was left-handed? Driving on the right is now far more popular worldwide, as shown in the figure. Left-sided driving is dominant in ex-empire countries which play cricket (which does not explain Japan). From personal experience I know that trucks (“lorries”) and buses drive in the middle of the road in India.
I am aware of only one country that changed from left to right sided driving.
Sweden did so at 5am on September 3rd 1967. The Högertrafikomläggningen event appears slightly confusing in the photo, but it apparently went smoothly in typical Swedish style.
Mention of a date above brings me to another important difference between US and UK. Over here we write month/day/year, but in UK it is usually day/month/year. That fact caused me some difficulty on a rural SC road soon after I arrived in USA. My international driver’s license had 03/10/1986 as the expiry date, ie October 3rd. The traffic cop gave me a ticket for the license because he could clearly see that it had expired in March and was not convinced by my increasingly frenzied explanation (in a funny accent).
There are of course many other ways of writing the date. The three elements can be separated by / or – or . or a gap or no gap, and the month can be spelt out completely or usually just the first 3 letters. The International Organization for Standardization apparently recommends YYYY-MM-DD, like 2020-12-23, but I have increasingly used 23-Dec-2020 as the least easily misunderstood.
I mentioned “Two countries separated by a common language”. You will of course remember that it was said by Winston Churchill (who I met briefly in 1960). He said and wrote many memorable things, but it turns out that the quote goes back at least as far as Oscar Wilde, and was used later by George Bernard Shaw, Bertrand Russell and even Dylan Thomas.
One other anecdote. After giving a lecture in US I received a letter saying that my talk was “quite good”. I was rather miffed, for in English that means not much good. I later learnt that in USA it means very good. Just to confuse further, in English “quite excellent” is the tops. How dat?
Note that I have not gotten into discussing differences in pronunciation. I have adapted to American toMAYto instead of English toMARto. So why don’t Brits say potARto? La vie d’artiste c’est difficile.
All part of life’s rich tapestry.
Peter
A thought provoking article
About 40 years ago there was a students reunion at St Thomas’s Hospital, you may have been there, when the opening salvo form a lady Labour MP “you are not going to like this but the day of the generalist has gone”. There was a shuffling noise as the discomfort of those eminent specialists in the audience showed their disquiet.
Now, the only generalists left are a Geriatricians and General Practitioners (GP). The reasoning was that a person with Diabetes was best treated by a Diabetologist, for instance, and so hospitals are now full of highly trained Specialists. It all makes a lot of sense.
The College of General Practitioners was only started in 1956 (not 1546 under Henry V111) and the first Vocational Training Course (VTS) was in Exeter when it took a minimum of 8 years to become a GP. VTSs were unheard of in our day! GPs are the only generalists now.
GPs are the sort of holistic medics you mention who knows the specialists. A patient is registered with a GP and all notes since birth are returned to a central bureau when they change doctors so there is a complete record of every patient. This was essential during the recent pandemic when patients were called up for their vaccination personally rather than having to telephone for an appointment, it was just luck if you succeeded. Hence, the high uptake of vaccination in the UK (or Royaume Uni in the EU).
I am a great believer in our National Health Service where every person is entitled to proper health care at the point of need. It does not depend on whether you are rich or poor, your entitlement is the same. In USA it is big business and there are many who get no care at all unless they are insured or can pay for it. Many people cannot obtain health care at all as it can be cripplingly expensive.
You say that patients are confused about specialists, let alone doctors. In my very limited experience of USA medicine if you end up at the wrong door it can be difficult. Not all Specialists are as good as you and there are many whom I would not rate at all, in all countries.
As the son of a GP you must wonder whether USA has got it right. I would be interested in your further views on the above. I know you are very interested in research and there is of backing in USA, but what do you think of the rest?
Mike
Thank you, Mike. I agree that the US health care “system” needs substantial changes. Like many aspects of American life, it is really great for the fortunate but very problematic for those less so. I am not alone here in thinking that the lack of universal care is embarassing. The Physicians for a National Health Program (pnhp.org) has over 20,000 members, and is recruiting well amongst medical students (to whom I gave a talk recently). The main push back here is the concern about reported long wait times in UK and indeed Canada, yet most do not realise how much the citizens of both countries favor their systems. On a historical note, it is perhaps relevant that Brits are accustomed to “waiting their turn”, a national characteristic molded in and after the war, when many things were scarce and rationed. As you well know, but my American readers may not (if I still have any), there is a private health care option in Britain which anyone can purchase for a reasonable annual fee. Important to realise that this exists only for elective care, ie cool specialist consultations and planned surgery such as hips. There are no all-singing all-dancing private hospitals capable of dealing with serious acute ilness. If you get suddenly sick you are treated like everyone else in the NHS, and rather well. For less acute situations it is more complicated. Someone explained it to me that you are free to grab a passing taxi (and thus pay) if you are in a line waiting for a bus. That may sound like jumping the queue and therefore somehow a bit immoral, and indeed it was when I was working in London (in both systems). I guess ideally we would need to make sure that the taxi goes only to a different private hospital, which was not the case. Enough of that forced analogy. I do remember being concerned that having some lucky successful people (maybe 10% of adults) able to subscribe to the private plans meant that they would care less about supporting and improving the NHS. And of course many doctors (like me) enjoyed the ripe fruits of the private option….
There is no easy answer to this conundrum. No country can afford the very best and immediate health care for all of its population. There has to be some middle ground between a free for all, and formalised political rationing. Some European countries (including UK if it is still European) seem to have found a reasonable balance.
It is sad that most of US politicions (including leading doctor organizations) decry “socialized medicine”, yet they seem comfortable when it kicks in at age 65 (Medicare). La vie d’artiste c’est difficile.