{"id":50531,"date":"2021-06-25T16:00:19","date_gmt":"2021-06-25T15:00:19","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=50531"},"modified":"2021-07-02T17:07:53","modified_gmt":"2021-07-02T16:07:53","slug":"jeffrey-aronson-when-i-use-a-word-the-cat-thats-a-black-swan","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2021\/06\/25\/jeffrey-aronson-when-i-use-a-word-the-cat-thats-a-black-swan\/","title":{"rendered":"Jeffrey Aronson: When I Use a Word . . . The CAT that\u2019s a black swan"},"content":{"rendered":"<p><span style=\"font-weight: 400\">I have been looking for biomedical black swans, unexpected findings discovered by acute observation, among discoveries marked by the inclusion of relevant terms noted in the <\/span><i><span style=\"font-weight: 400\">Oxford English Dictionary<\/span><\/i><span style=\"font-weight: 400\"> (OED). In the last few weeks I have briefly covered terms in <\/span><a href=\"https:\/\/blogs.bmj.com\/bmj\/2021\/05\/28\/jeffrey-aronson-when-i-use-a-word-pharmacological-black-swans-1970-2020\"><span style=\"font-weight: 400\">pharmacology<\/span><\/a><span style=\"font-weight: 400\">, <\/span><a href=\"https:\/\/blogs.bmj.com\/bmj\/2021\/06\/04\/jeffrey-aronson-when-i-use-a-word-black-swans-in-genetics\"><span style=\"font-weight: 400\">genetics<\/span><\/a><span style=\"font-weight: 400\">, <\/span><a href=\"https:\/\/blogs.bmj.com\/bmj\/2021\/06\/11\/jeffrey-aronson-when-i-use-a-word-black-swans-in-microbiology\"><span style=\"font-weight: 400\">microbiology<\/span><\/a><span style=\"font-weight: 400\">, and <\/span><a href=\"https:\/\/blogs.bmj.com\/bmj\/2021\/06\/18\/jeffrey-aronson-when-i-use-a-word-black-swans-in-biochemistry\"><span style=\"font-weight: 400\">biochemistry<\/span><\/a><span style=\"font-weight: 400\">. But there is a large group of terms that I have previously simply labelled \u201cothers\u201d, 187 of them in all. I have now classified them roughly under 37 different headings. The top ranking categories are shown in Table 1.<\/span><\/p>\n<p><b>Table 1.<\/b><span style=\"font-weight: 400\"> The main topics into which 143 out of 273 new biomedical words first cited in the <\/span><i><span style=\"font-weight: 400\">Oxford English Dictionary<\/span><\/i><span style=\"font-weight: 400\"> between 1970 and 2020 can be classified<\/span><\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-50533\" src=\"https:\/\/blogs.bmj.com\/bmj\/files\/2021\/06\/aronson_25_june_2021.jpg\" alt=\"\" width=\"323\" height=\"223\" srcset=\"https:\/\/blogs.bmj.com\/bmj\/files\/2021\/06\/aronson_25_june_2021.jpg 323w, https:\/\/blogs.bmj.com\/bmj\/files\/2021\/06\/aronson_25_june_2021-300x207.jpg 300w\" sizes=\"auto, (max-width: 323px) 100vw, 323px\" \/><\/p>\n<p><span style=\"font-weight: 400\">Among the items that I have included in the category of devices is the CT scanner, which I might equally have included in the category of radiology.<\/span><\/p>\n<p><span style=\"font-weight: 400\">The IndoEuropean root SKAND meant to jump or climb. It gave the Latin word scandere to climb or to scan verse, climbing over its syllables one by one, and the Greek word <\/span><span style=\"font-weight: 400\">\u03c3\u03ba\u03ac\u03bd\u03b4\u03b1\u03bb\u03bf\u03bd, <\/span><span style=\"font-weight: 400\">a trap or stumbling block, something over which you need to climb. English words that are derived from these include ascend, descend, and transcend, scan, scanner, and scansion, scandal and slander, and, via a Latin variant, scalare, scale, escalade, and echelon.<\/span><\/p>\n<p><span style=\"font-weight: 400\">What was initially called computerized transverse axial tomography was first <\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/4579356\/\"><span style=\"font-weight: 400\">announced<\/span><\/a><span style=\"font-weight: 400\"> in an anonymous article in <\/span><i><span style=\"font-weight: 400\">Radiology<\/span><\/i><span style=\"font-weight: 400\"> in January 1973, antedating by one month the earliest citation in <\/span><i><span style=\"font-weight: 400\">OED<\/span><\/i><span style=\"font-weight: 400\">, a <\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/4686818\/\"><span style=\"font-weight: 400\">paper<\/span><\/a><span style=\"font-weight: 400\"> by James Ambrose and Godfrey Hounsfield (Figure 1) in the <\/span><i><span style=\"font-weight: 400\">British Journal of Radiology<\/span><\/i><span style=\"font-weight: 400\"> in February 1973. As Hounsfield described it later that year, <\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/4757352\/\"><span style=\"font-weight: 400\">also<\/span><\/a><span style=\"font-weight: 400\"> in the <\/span><i><span style=\"font-weight: 400\">British Journal of Radiology<\/span><\/i><span style=\"font-weight: 400\">, X-ray readings are taken at a multitude of angles, and tissue absorption data are calculated on a computer and presented as a series of pictures of tissue slices. The system that he described, applicable at that time only to the cranium, was about 100 times more sensitive than conventional X-radiology, so that variations in soft tissues of nearly similar density could be displayed. Those variations in density were originally transformed into numbers that could be printed out, later called Hounsfield numbers.<\/span><\/p>\n<p><b>Figure 1.<\/b><span style=\"font-weight: 400\"> Godfrey Hounsfield (left) and James Ambrose (from <em>The <\/em><\/span><em><a href=\"https:\/\/www.bmj.com\/content\/bmj\/332\/7547\/977.full.pdf\"><span style=\"font-weight: 400\">BMJ<\/span><\/a><\/em><span style=\"font-weight: 400\"> 2006; 332: 977)<\/span><\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-50534\" src=\"https:\/\/blogs.bmj.com\/bmj\/files\/2021\/06\/aronson_25_june_2021_2.jpg\" alt=\"\" width=\"606\" height=\"352\" srcset=\"https:\/\/blogs.bmj.com\/bmj\/files\/2021\/06\/aronson_25_june_2021_2.jpg 606w, https:\/\/blogs.bmj.com\/bmj\/files\/2021\/06\/aronson_25_june_2021_2-300x174.jpg 300w\" sizes=\"auto, (max-width: 606px) 100vw, 606px\" \/><\/p>\n<p><span style=\"font-weight: 400\">In his 1979 Nobel prize <\/span><a href=\"https:\/\/www.nobelprize.org\/prizes\/medicine\/1979\/hounsfield\/biographical\/\"><span style=\"font-weight: 400\">biography<\/span><\/a><span style=\"font-weight: 400\">, Hounsfield described how the invention came about. Having served in the RAF he obtained a grant to study at Faraday House Electrical Engineering College in London. Then in 1951 he joined the company called Electrical and Musical Industries, better known as EMI, and worked on radar and guided weapons and later ran a small design laboratory. He became interested in computers, primitive at the time, and built the first British all-transistor computer, EMIDEC 1100.<\/span><\/p>\n<p><span style=\"font-weight: 400\">Hounsfield then moved to EMI\u2019s Central Research Laboratories, and began to design a one-million word computer store. However, his project lacked commercial viability and he was allowed to choose another project instead\u2014exploring computerized pattern recognition, which led to the development of the EMI-scanner, as he referred to it. I first came across the term in <em>The BMJ<\/em> in August 1973, but in the form \u201cE.M.I. scanner\u201d in a <\/span><a href=\"https:\/\/www.bmj.com\/content\/3\/5876\/415.1\"><span style=\"font-weight: 400\">review<\/span><\/a><span style=\"font-weight: 400\">, by an Oxford colleague, the neurosurgeon Chris Adams, of a book called <\/span><i><span style=\"font-weight: 400\">Pituitary Tumours<\/span><\/i><span style=\"font-weight: 400\"> by John S Jenkins. The hyphenated form, EMI-scanner, also first appeared in <\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/4354488\/\"><span style=\"font-weight: 400\">1973<\/span><\/a><span style=\"font-weight: 400\">.<\/span><\/p>\n<p><span style=\"font-weight: 400\">It wasn\u2019t long before abbreviated forms started to be used. And although the original name for the technique, computerized transverse axial tomography (CTAT), was soon shortened to <\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/4354488\/\"><span style=\"font-weight: 400\">computerized axial tomography<\/span><\/a><span style=\"font-weight: 400\"> or <\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/4588582\/\"><span style=\"font-weight: 400\">computer-assisted tomography<\/span><\/a><span style=\"font-weight: 400\">, the abbreviation CAT appeared only in 1975, in the <\/span><i><span style=\"font-weight: 400\">Wall Street Journal<\/span><\/i><span style=\"font-weight: 400\">, a year after the form that is now more commonly used, <\/span><a href=\"https:\/\/pubs.rsna.org\/doi\/10.1148\/110.1.109?url_ver=Z39.88-2003&amp;rfr_id=ori%3Arid%3Acrossref.org&amp;rfr_dat=cr_pub++0pubmed&amp;\"><span style=\"font-weight: 400\">CT<\/span><\/a><span style=\"font-weight: 400\">, standing for <\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/4136606\/\"><span style=\"font-weight: 400\">computerized tomography<\/span><\/a><span style=\"font-weight: 400\"> or <\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/4609337\/\"><span style=\"font-weight: 400\">computed tomography<\/span><\/a><span style=\"font-weight: 400\">.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">Profits earned from the Beatles <\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/10659438\/\"><span style=\"font-weight: 400\">enabled<\/span><\/a><span style=\"font-weight: 400\"> EMI to fund scientific research, and although they did not fund Hounsfield\u2019s work completely they did give him the freedom to choose his topic. It has been <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC8175000\/\"><span style=\"font-weight: 400\">pointed out<\/span><\/a><span style=\"font-weight: 400\"> that an American neurologist, William Oldendorf, had invented a <\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/13730689\/\"><span style=\"font-weight: 400\">similar system<\/span><\/a><span style=\"font-weight: 400\"> in 1960. However, the response from a manufacturer of x-ray equipment was disappointing: \u201cEven if it could be made to work as you suggest, we cannot imagine a significant market for such an expensive apparatus which would do nothing but make a radiographic cross-section of a head.\u201d It took Hounsfield and Ambrose to spot the black swan.<\/span><\/p>\n<p style=\"text-align: left\"><span style=\"font-weight: 400\"><em><strong>Jeffrey Aronson<\/strong>\u00a0is a clinical pharmacologist, working in the Centre for Evidence Based Medicine in Oxford&#8217;s Nuffield Department of Primary Care Health Sciences. He is also president emeritus of the British Pharmacological Society.<\/em><\/span><\/p>\n<p style=\"text-align: left\"><strong>Competing interests:<\/strong> none declared.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-50535\" src=\"https:\/\/blogs.bmj.com\/bmj\/files\/2021\/06\/aronson_25_june_2021_integer.jpg\" alt=\"\" width=\"698\" height=\"2546\" srcset=\"https:\/\/blogs.bmj.com\/bmj\/files\/2021\/06\/aronson_25_june_2021_integer.jpg 698w, https:\/\/blogs.bmj.com\/bmj\/files\/2021\/06\/aronson_25_june_2021_integer-82x300.jpg 82w, https:\/\/blogs.bmj.com\/bmj\/files\/2021\/06\/aronson_25_june_2021_integer-281x1024.jpg 281w, https:\/\/blogs.bmj.com\/bmj\/files\/2021\/06\/aronson_25_june_2021_integer-421x1536.jpg 421w, https:\/\/blogs.bmj.com\/bmj\/files\/2021\/06\/aronson_25_june_2021_integer-640x2334.jpg 640w\" sizes=\"auto, (max-width: 698px) 100vw, 698px\" \/><\/p>\n<p>1) <a href=\"https:\/\/blogs.bmj.com\/bmj\/2021\/04\/16\/jeffrey-aronson-when-i-use-a-word-new-and-not-so-new-medical-words\">https:\/\/blogs.bmj.com\/bmj\/2021\/04\/16\/jeffrey-aronson-when-i-use-a-word-new-and-not-so-new-medical-words<\/a><br \/>\n2) <a href=\"https:\/\/blogs.bmj.com\/bmj\/2021\/06\/11\/jeffrey-aronson-when-i-use-a-word-black-swans-in-microbiology\">https:\/\/blogs.bmj.com\/bmj\/2021\/06\/11\/jeffrey-aronson-when-i-use-a-word-black-swans-in-microbiology<\/a><br \/>\n3) <a href=\"https:\/\/blogs.bmj.com\/bmj\/2021\/04\/26\/jeffrey-aronson-when-i-use-a-word-a-difficult-infection\">https:\/\/blogs.bmj.com\/bmj\/2021\/04\/26\/jeffrey-aronson-when-i-use-a-word-a-difficult-infection<\/a><br \/>\n4) <a href=\"https:\/\/blogs.bmj.com\/bmj\/2021\/05\/14\/jeffrey-aronson-when-i-use-a-word-omics\">https:\/\/blogs.bmj.com\/bmj\/2021\/05\/14\/jeffrey-aronson-when-i-use-a-word-omics<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>I have been looking for biomedical black swans, unexpected findings discovered by acute observation, among discoveries marked by the inclusion of relevant terms noted in the Oxford English Dictionary (OED). [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2021\/06\/25\/jeffrey-aronson-when-i-use-a-word-the-cat-thats-a-black-swan\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":419,"featured_media":38359,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[5762],"tags":[],"class_list":["post-50531","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-jeff-aronsons-words"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Jeffrey Aronson: When I Use a Word . . . 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