Medicine, Codes, and Braille

Did you know that pharmaceutical companies spend $6 billion on drug advertising in the U.S.?^[1] Why do you think they spend so much money advertising products that Americans are already seeking?

Language.

Think about it. How many times does a drug ad repeat the name of the drug? Dozens of times in every ad. It’s like pharmaceutical companies speak some sort of secret dialect that requires language lessons for any normal person to actually discuss their products.

Most people don’t want to ask for or prescribe a drug they cannot pronounce. Which makes the complex language of healthcare all the more concerning. It’s dangerous to speak a language our patients can’t understand, and it’s expensive to the tune of $6B to explain it.

But perhaps there is another option. At the age of 12, Louis Braille heard about something called “night writing,” which used a pattern of raised dots to send military messages after dark. These messages could be quickly written with a stylus and paper, and it was a dramatic improvement from the raised, wax-embossed alphabet used in schools for the blind at the time. So this young man, who was not even a teenager yet, discovered that this system was not just touch-able (and therefore readable) but it was a system that could also be quickly written: The barrier for a blind man to communicate in writing was about to come down as braille text was tested and refined into a language we still use today.^[2]

Understandably, the language of medicine is complex. While a gardener may not need to announce the Latin name for every weed they pull, an herbalist might actually need that much detail to ensure they are helping, and not poisoning, their patient. So it makes sense that the goal of most medical terminology is to be highly specific – because the consequences of generalized statements could be toxic. 

But codes and languages break down when they divide into too many variables – it becomes too much to memorize and track. Our ICD codes have subdivided over and over again to be so highly specific that they are hardly useful. 

Somehow there must be a balance between so-general-it-could-be-poisonous, and so-specific-it-can’t-be-used.

The goal of Louis Braille’s innovation was to communicate. He felt the loss of not being able to take notes, keep a diary, or read the same books that his peers enjoyed. The beginning of improved communication in medicine will most likely begin when we feel the loss of not being understood by our own patients.

When we long to clearly communicate with our patients as much as a blind 12-year-old wishes to read and write, I’m certain we will make progress.

^[1] Mole, B (Jan. 11, 2019). Big Pharma shells out $20B each year to schmooze docs, $6B on drug ads. Ars Technica. https://arstechnica.com/science/2019/01/healthcare-industry-spends-30b-on-marketing-most-of-it-goes-to-doctors/.

^[2] Petzold, C (2023). Braille and Binary Codes. Code: The Hidden Language of Computer Hardware and Software, 2^nd Ed. Pearson Education.