{"id":40435,"date":"2017-10-20T16:20:05","date_gmt":"2017-10-20T15:20:05","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=40435"},"modified":"2017-10-20T16:20:05","modified_gmt":"2017-10-20T15:20:05","slug":"neville-goodmans-metaphor-watch-tectonic-shifts","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2017\/10\/20\/neville-goodmans-metaphor-watch-tectonic-shifts\/","title":{"rendered":"Neville Goodman’s metaphor watch: Tectonic shifts"},"content":{"rendered":"

\"neville_goodman\"<\/a>When I equated the quantum leap to the big bang<\/a>, I overlooked another term borrowed from another science: tectonic<\/span> shift<\/span>. The adjective <\/span>tectonic<\/span> is older than modern geology; it comes from the Greek, meaning pertaining to building or construction in general (OED). We are familiar with it for its application to the tectonic plates underlying the oceans and continents, which, driven by deep currents in the mantle, cause earthquakes and volcanoes. The idea of <\/span>these <\/span>mobile <\/span>tectonic plates developed during the 1960s, although the term <\/span>tectonics<\/span> had already entered geology, referring simply to the structure of the Earth\u2019s crust or changes affecting it. <\/span>Paradoxically,<\/span> a <\/span>tectonic shift<\/span> occurs very slowly, but the subsequent events can be catastrophically sudden.<\/span><\/p>\n

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The geological term has been borrowed by medicine in ophthalmology: it is a form of corneal surgery. And<\/span> also<\/span>, as very many terms have been, in genetics, where Tectonic is a protein in the Hedgehog-mediated patterning of the neural tube. Anyone searching for metaphorical uses will have to wade through a large number of these uses, as well as geol<\/span>ogical and ecological articles. Most metaphor<\/span>ical uses ignore<\/span> the slow process and the catastrophic result, and mere<\/span>ly mean<\/span> very big. There is often an overtone of difficulty, although there is nothing in the dictionary definition (COD: a very significant or considerable change or development) <\/span>to imply that<\/span>. <\/span>Thus, i<\/span>n its occasional application in medicine, the slowness is usually ignored; the <\/span>tectonic shift<\/span> is just, like the <\/span>quantum leap<\/span> and the <\/span>big bang<\/span>, something from which authors want you to infer that something terribly important <\/span>is<\/span> happen<\/span>ing<\/span>.<\/span><\/p>\n

Here are three examples: \u201c<\/span>The advent of epigenetics brought in a tectonic shift in the understanding of molecular basis of complex diseases<\/span>\u201d; \u201c<\/span>our understanding of the intricacies of gene regulation has undergone tect<\/span>onic shifts almost every decade\u201d; \u201c\u2026<\/span>has resulted in a tectonic shift in the way physicians and the general population perc<\/span>eive infertility and ethics\u201d. Is <\/span>tectonic shift<\/span> any better than<\/span> <\/span>\u201cgreat change\u201d or \u201cimportant advance\u201d? <\/span><\/p>\n

But sometimes <\/span>the<\/span> metaphor is necessary. Rudolf Klein <\/span>used it well when he <\/span>wrote about how to reform <\/span>US healthcare<\/span><\/a>:<\/span> <\/span>his<\/span> abstract <\/span>ends<\/span>, \u201c<\/span>Importing systems from countries with different histories and institutions would require a tectonic shift in the American political landscape<\/span>\u201d<\/span>;<\/span> and <\/span>his<\/span> article <\/span>ends <\/span>with, \u201c<\/span>For the United States, the lessons learned are therefore likely to depend on whether increasing inequality, linked to increasing economic turbulence, produces a tectonic shift in the country\u2019s political scenery<\/span>\u201d. <\/span>Yes, a tectonic shift: big forces, consummate effort, unshakeable resolve.<\/span><\/p>\n

I quite liked a <\/span>description<\/span><\/a> of changes to the Declaration of Helsinki as significant but not tectonic<\/span>, although it implied to me that the authors were\u2014to use a word the OED labels as <\/span>humorous<\/span>\u2014underwhelmed. However, I have no idea what the authors\u00a0<\/span>of an article on training the brain meant when they wrote that their paper provided \u201c<\/span>a tectonic integration and synthesis of cognitive training approaches.<\/span>\u201d<\/span><\/p>\n<\/div>\n<\/div>\n

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Neville Goodman<\/strong>\u00a0is a retired consultant anaesthetist and a writer. He is co-author of a book on medical English.<\/em><\/p>\n

Competing interests:<\/strong>\u00a0I 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.<\/p>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

When I equated the quantum leap to the big bang, I overlooked another term borrowed from another science: tectonic shift. The adjective tectonic is older than modern geology; it comes […]<\/p>\n

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