Using a ‘Devils Dictionary’ as a means of debunking definitions in a particular field of study is far from new. While the American satirist Ambrose Bierce was able to apply his unparalleled cynicism to the full lexicon of cant and political double-talk, others such as the Washington Post’s Nicholas Von Hoffman have been content to do so within the more limited world of business and high finance. Adopting this format in healthcare should have some novel appeal and has the aim at least of deciphering codes, identifying scoundrels, and offering different meanings to terms and issues as they are constructed within policy circles.
One of the main functions of language in such circles is repetition: use a term often enough and it becomes common sense as to what is both viable and desirable. The aim of this dictionary is to counterbalance such methods. Observers will notice the recurrence and interchangeability of much of the contents and cast of characters but rest assured this is intentional. The repetition of the same concept within a different framework will hopefully lead to a more nuanced and critically embedded view of that concept. And while this dictionary can’t promise the wit and concision of Bierce or Von Hoffman, it will do its immodest best and hopefully serve as a useful tool for activists in understanding some of the parameters of healthcare policy.
The dictionary will read like a work in progress. As that’s what it is. But comments, contributions and examples of particularly shabby behaviour in any of the areas under examination will be most welcome. As Bierce was fond of satirising florid poetry to aid definitions, space may be offered to similar examples.
Dod Grile was Bierce’s pseudonym during his stay in London in 1872, and for several of his books. Mark Twain, in reviewing one of these, said, “There is humor in Dod Grile, but for every laugh that is in his book there are five blushes, ten shudders and a vomit. The laugh is too expensive”. We’ll do our best to reproduce this ratio. We’ve changed the name slightly so as to avoid an overly slavish approach to Bierce’s work though we have to admit to being in thrall to the man. It may also not be legal.