Foreword: On the Noxious Puffery of Institutional Jargon
To understand the modern dialect of healthcare organizations, it helps to begin with David Foster Wallace’s brilliant 2001 essay, Tense Present. In it, he ruthlessly dismantles the word utilize, arguing that it accomplishes nothing that use doesn’t, except to make the writer seem “either like a pompous twit or like someone so insecure that [they’ll] use pointlessly big words in an attempt to look sophisticated.” In the decades since, that linguistic insecurity has metastasized into a pervasive contagion, corrupting both public and professional discourse.
We encounter the low-stakes symptoms of this disease long before stepping into a hospital or clinic. Lately, while listening to people order lunch, I’ve noticed a phrase with increasing frequency: “I’ll do the chicken salad.”
In a literal sense, “I’ll do” foreshadows an act of copulation with a thoroughly unremarkable lunch option. No judgment, of course, toward either party.
The speaker simply means, “May I please have the chicken salad?” Yet somehow, that perfectly serviceable phrase has been replaced with a clipped approximation that communicates no additional meaning while saving the speaker exactly two words. The waiter nods approvingly and replies, “Perfect,” a response that somehow feels like the final flourish in this quiet collapse of ordinary language.
Inside healthcare organizations, however, this erosion becomes something far more consequential.
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Here, language is not merely flattened. It is weaponized. Bureaucratic jargon systematically replaces raw clinical realities with sanitized abstractions, stripping words of their moral weight until patients become processes and physicians become units of production. This is not simply an academic concern. Language shapes thought, and thought shapes behavior.
The result stands in direct opposition to Immanuel Kant’s Categorical Imperative, which insists that human beings must always be treated as ends in themselves, never merely as means to an end. Corporate healthcare performs the opposite maneuver. It converts profoundly human experiences into bloodless administrative vocabulary, allowing institutions to distance themselves from the ethical consequences embedded within the words they choose.
Dismantling these polished euphemisms requires precision, a healthy dose of cynicism, and an uncompromising commitment to calling things what they are. Consider this lexicon a field guide to the resulting wreckage. Side effects may include a sudden allergy to corporate emails and a diminished tolerance for PowerPoint presentations. Optimism alone cannot confront an apparatus that quietly transforms neighbors into metrics and suffering into workflow.
Reclaiming our language is one small step toward reclaiming our humanity.
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The Dictionary of “Corporate Kant”
We (pron.)
The Deception: A pronoun of inclusion suggesting shared effort, collective agreement, and unified purpose. In practice, it is remarkably elastic, granting the illusion of consensus to unilateral decisions, diffusing accountability for unpopular mandates, or simply functioning as a corporate variation of the Royal We.
The Consequence: A physician, midway through a twelve-hour shift, has charts returned with reminders that “we” must all work harder to document tobacco-cessation counseling, satisfy another quality metric, or check one more compliance box.
The Cost: This is linguistic identity theft. The sender cloaks themselves in collective moral authority while shifting responsibility for yet another bureaucratic exercise onto frontline clinicians. The pronoun manufactures solidarity where none exists, leaving physicians to feel personally responsible for institutional mandates they neither created nor control. Meanwhile, the author of the email remains comfortably insulated from the work itself.
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We’ve Always Done It That Way (phr.)
The Deception: An appeal to institutional tradition masquerading as wisdom. The phrase reframes stagnant processes as time-honored virtues, as though longevity alone were evidence of value.
The Consequence: A single administrator invokes the authority of a collective “we” that was never actually consulted, successfully halting meaningful change by equating innovation with inconvenience.
The Cost: The phrase demands the surrender of clinical curiosity. Translated into plain English, it means: Please stop examining this absurd redundancy. I learned to tolerate it years ago, and I’d rather not revisit the question.
Cultural Touchstone: The Backstreet Boys’ 1999 hit, I Want It That Way, provides the perfect soundtrack. Both are polished, highly choreographed declarations that collapse under even modest scrutiny. Pressed for an explanation, the speaker eventually admits there isn’t one, yet somehow the chorus continues.
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Throughput (n.)
The Deception: The conversion of a human being into a flow metric. A patient ceases to be someone receiving care and becomes an object moving through a system.
The Consequence: An older patient with mild cognitive impairment is medically cleared of a urinary tract infection at 1:00 a.m. They are exhausted, have no reliable transportation, and nowhere safe to wait. But because the clinical boxes have been checked, keeping them on an Emergency Department stretcher past midnight turns the department tracker red.
The Cost: Treating throughput as an absolute strips away the real-world context that medicine demands. The question is no longer whether it is humane to discharge a vulnerable person into the middle of the night. Here, the lexicon performs the moral sleight of hand, acting as a polished, pixelated proxy to exact a vulgar reality: the behind-closed-doors mandate to “move the meat.” This is the secret, ulterior motivation the corporate apparatus cannot afford to admit. By hiding this brutality behind a metric, the system transforms an ethical dilemma into the movement of a colored icon across a screen.
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Expired (v. / adj.)
The Deception: The electronic medical record standardizes death not as “deceased” or “died,” but as “expired.”
The Consequence: A physician steps out of a chaotic resuscitation bay and into a quiet family room. Looking a spouse in the eye, they say the words every physician dreads: I’m so sorry. Your husband has died.
They sit with the silence that follows. They answer questions. They absorb grief that has nowhere else to go.
Ten minutes later, that same physician opens the chart and enters the patient’s final disposition:
Expired.
This is the very word physicians are explicitly taught not to use when speaking with families. Every communication seminar, every lecture on death notification, every patient-experience workshop reinforces the same lesson: people die. They do not expire.
The Cost: Milk expires. Parking meters expire. Magazine subscriptions expire.
People die.
By embedding the word expired into the digital infrastructure of healthcare, the software quietly transforms the final chapter of a unique human life into an inventory event.
The Hospice Contrast: Hospice and palliative care offer a striking counterexample. Rather than reducing death to an administrative status, many clinicians speak of a patient’s transition, recognizing the moment as profoundly human rather than merely procedural. While one system records an expiration, the other acknowledges a life reaching its natural conclusion.
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The Post-Mortem
By embedding the word expired into the digital infrastructure of healthcare, the software quietly transforms the final chapter of a unique human life into an inventory event.
