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September 10, 2008, Vol 300, No. 10 >

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A Piece of My Mind | September 10, 2008

Extremities

Robert Hirschtick, MD
JAMA. 2008;300(10):1125-1126. doi:10.1001/jama.300.10.1125.
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A medical student was presenting the story of the patient she had admitted the previous night: “ . . . he also complained of increasing edema in his bilateral lower extremities . . . .”

I was struck by the phrase “bilateral lower extremities.” Three words. Ten syllables. Bi-lat-er-al low-er ex-trem-i-ties. Why not “both legs”? Two words. Two syllables. Why had this student, like virtually every student I’ve worked with recently, chosen this unwieldy phrase?

That the student chose to go long and convoluted rather than short and direct was striking given that contemporary students generally prioritize speed and efficiency in their communication. They are of the instant messaging (IM) generation that communicates via acronym and initialism. Indeed, her generation is defined by the single letter “Y.” Had she said “BLE” I wouldn't have understood but I wouldn't have been surprised.

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