Neville Goodman’s Metaphor Watch: leave cocktails to the bar staff

neville_goodmanCocktail isn’t a common word in PubMed®, but its prevalence increased eight-fold between 1975 and 2015. Cirrhosis is six times more common but increased only 1.3-fold, which is probably not importantly different from unity. We could conclude that a cocktail won’t give you cirrhosis, but these cocktails are not funny coloured drinks that taste dangerously as if they don’t contain alcohol.

Cocktail is a reasonable word for a mixture of things, but the definition in the COD is of a mixture of substances or factors, especially when dangerous or unpleasant [my italics], and gives the example, “a potent cocktail of drugs.” That is fine for a medical journalist writing for lay people about cancer chemotherapy, but it is unnecessary and incorrect in scientific articles. Cocktails follow a recipe, but “two parts this to one part that” is not a pharmacological description, and a bloody Mary is vodka and tomato juice plus other bits and pieces, all in one glass. A so-called cocktail of chemotherapeutic agents will be of precise doses, given as separate pills and injections, and not necessarily at the same time.

Many of the cocktails in PubMed are not drugs. The word is popular with scientists working in vitro, who describe cocktails of antibiotics, enzymes, and all manner of chemicals. The makeup of these cocktails is often imprecise, but mixture is the better word, if a word is needed: a “triple cocktail of antagonists” is a “mixture of three antagonists”; “a synergistic Rh/Ag/Au catalyst cocktail” is fine without the cocktail; “the recipient must take a lifelong cocktail of immunosuppressive medications” is better as “recipients must take immunosuppressants for the rest of their lives.”

It seems sometimes that medical writers prefer a thesaurus to a dictionary: how else to account for, “…including early repair of vascular injury in such a trauma mélange allows for a positive postoperative outcome”,  “…managed by a concoction of pre-medications like anxiolytics, analgesics and effective local anesthesia”, and “The surgeon must be cognizant of the complication potpourri…”

Sometimes, my thesaurus theory fades towards the more likely truth that some medical writers are just completely unfamiliar with and unable to write intelligible English. This sentence comes from the abstract of an article containing cocktail: “Case studies combining passive sampling devices (PSD) extracts and toxicity assessment toward microorganisms at different biological scales from single organisms to communities level are presented.” Are there words missing from this sentence? I don’t understand it. Does anyone on the editorial board of Frontiers in Microbiology, which published it, understand it?

A valid use of cocktail is in the phrase cocktail party, used in hearing research to refer to our ability to pick out individual sounds from background noise: the uncanny way that not only does one hear one’s name mentioned across the room, but hears the preceding words despite their being said before one was aware.

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.