The mitochondrion was termed the “powerhouse of the cell” in a Scientific American article in 1957 by Philip Siekevitz, who died in 2009. I suspect that anyone with biological knowledge would recognise the phrase instantly, and it’s an appropriate metaphor, so it’s odd that I couldn’t find it in any of the obituaries and articles of appreciation I looked at on the internet. Without wanting to accuse the obituary writers of snobbery, is it because the phrase and the journal are not “proper science?” Put the phrase into an internet search engine, and there are pages and pages of mitochondria.

The phrase doesn’t crop up in PubMed until 1992, when it’s the title of an editorial in the journal Ultrastructural Pathology. It appears again at the turn of the millennium, since when there have been about 100 articles. I suspect the phrase is used more by the authors of textbooks: I do wonder why the author of an article in Biochemical Society Transactions in 2015 found it necessary to write, as the first sentence of the abstract, “Mitochondria are the powerhouse of cells as they produce the bulk of ATP which is consumed by the cell.”

Half of PubMed’s powerhouses are mitochondrial. Other powerhouses are mostly literal ones—diseases suffered by powerhouse workers—or institutions or groups of people aiming to effect some large change. The few remaining are sometimes inappropriate or trite, and one is definitely incorrect: Drosophila melanogaster is not a “powerhouse genetic system.” A different metaphor is needed: the workhorse.

There are far more workhorses than powerhouses in PubMed, and there is far more variety of application: null hypothesis significance testing, gadolinium contrast agents; there is a particular love of the metaphor by plastic surgeons applying it to all sorts of muscle and bone flap. The point of a workhorse is that it works long and hard over a long period, which is true for all these things. I’m not sure what is meant when an enzyme is described as a “workhorse enzyme of carbohydrate metabolism.” Is it any more or less a workhorse than any of the other enzymes in the glycolytic pathway?

But there is a tendency for workhorse to become simply a synonym for commonest, routine, or best treatment. It risks elision with that worst of clichés, the gold standard.

In the US, “the mitochondrion is the powerhouse of the cell” has become a meme used by pupils to complain about their perceived inadequacy of the American school system: every pupil knows it, but it is “pointless trivia to anyone not pursuing a career in the sciences.” It certainly illustrates that some pupils do not gain what they should from their education, but it is the typical argument of the immature, and impossible to answer until they are no longer immature.

Competing interests: I have read and understood BMJ policy on declaration of interests and declare that my only competing interest is my co-authorship of a book about medical English.

Neville Goodman is a retired consultant anaesthetist and a writer, and co-author of a book on medical English.