ABSTRACT
How metaphors ‘work’ in medicine is poorly understood, yet is key to effective medical education. Refusal of metaphor in medicine (for example, lack of acknowledgement of the value of ‘thinking with’ metaphor for diagnostic purposes) can lead to repressed metaphor returning in a distorted form – as descriptive literalism, such as English for Medical Purposes (EMP), and as potentially malicious medical slang, where metaphors are used as an inappropriate defence against the pressures of work. EMP pervades medical education, depersonalizing patients (reducing them to symptoms) and forcing students to compress information, compromising the narrative element informing medical acumen. The public does not have access to the ‘backstage’ metaphorical events of medicine such as use of slang, but this is introduced through the scripts of television ‘medi-soaps’ such as ‘House MD’, which can act in the capacity of public engagement with medicine.
