Neville Goodman’s metaphor watch: Let’s talk about the weather

neville_goodmanMeteorological metaphors are common in everyday speech: he was lightning fast; you are my sunshine; it’s clear skies from now on. That doesn’t make them common in medical writing, and nor are they easy to search. Most of the clear skies are literal, in articles about climate change, the ozone layer, and bird migration among others. But the first, and most recent, in January 2018, was metaphorical: Clear skies ahead: the way out of identity confusion, a commentary on how nurses in mental health see themselves and are seen.

Bad weather—storms and whirlwinds—provides the more common medical metaphors. There are thyroid storms, and cytokine storms. Someone asks if the gene-patent storm clouds are dissipating, and there are worries that there are storm clouds ahead for medical funding. In 1988, there was the possibility of storm clouds gathering at Brighton for the Royal College of Nursing annual conference. One article containing storm clouds was titled, Preheating primes pruners. Gentle warming charges up protein-chopping system in human skin cells. The first sentence of the abstract explained all: “Volunteers fill sandbags while storm clouds are brewing so the sacks will be ready when floodwaters rush in,” and in the same way skin cells prepare to deal with foreign proteins.

The perfect storm, a rare set of meteorological circumstances that leads to catastrophe, was coined in the 1930s. It was helped along when George Clooney starred in the year 2000 film of Junger’s book, dealing with the 1991 storm known as the Halloween Nor’easter. Lake Superior State University put perfect storm top of their 2007 list of overused words to be consigned to the waste bin, but there are plenty in PubMed®, most of them after 2007.

Whirlwind is the trademark of a make of wheelchair, which is unnerving, but is also a histological appearance and a radiological sign. There are whirlwinds of paperwork, consultations, and potential inpatient admissions. Whirlwinds of information are presumably on a lesser scale than tsunamis (q.v.). Yes, I think it was fair to say that winning the title of nurse of the year meant a whirlwind year, but I can’t see how the use of CRISPR/Cas9 (gene-editing) “created a whirlwind within the scientific community”. For me, that metaphor doesn’t work: whirlwinds are too chaotic.

Even more chaotic are tornados, but most tornados in PubMed are actual, meteorological events. A Tornado chart is a bar chart on its side, the longer bars at the top. The acronym TORNADO is the theranostic one-step RNA detector. There is also the neck tornado test, a screening test for cervical radiculopathy. I know what my neck looks like on MRI, and I don’t intend anyone moving my head about like that.

Most blizzards are for the Johanson–Blizzard syndrome, a rare congenital disorder named for Robert M Blizzard.

There are some blue skies, including, of course, the well known metaphor of blue sky research meaning research that has no immediate, obvious practical application. There is Blue skies or stormy weather: what lies ahead for malaria research?; and Data integration: blue skies ahead for network management. But best of all—searching PubMed for odd words is like skimming through a dictionary and coming across all sorts of interesting words that one never knew existed—was research into the composition of the blue skies and blue robe of the Virgin Mary in Cosimo Tura’s 15th century panel paintingThe Annunciation with Saint Francis and Saint Louis of Toulouse. Near-infrared reflectance spectroscopy was used to detect the organic chemicals in the animal skin glue and egg yolk binders in which the pigments were dispersed.

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

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.