ONE OF MY least favorite euphemisms is “This may pinch a little,” murmured by a doctor or a dentist who is about to do something that’s going to really, really hurt. Alternatively, “You may experience some discomfort.” Or “A little pressure.” Obviously, medical personnel don’t want to announce boldly, “This will hurt” or “A little pain,” so they resort to pinch, pressure, and discomfort as euphemisms.
Medical conditions would be difficult to discuss without recourse to euphemisms. The very word “disease” began as a polite substitute for “sickness,” one suggesting mere discomfort. (Think dis-ease.) Many substitute “ill” for “sick.” Plenty of options have developed over the years for those who would rather not admit they’re sick or ill. Instead they might be indisposed, unwell, under the weather, out of sorts, or merely a bit off. Or, if they want to sound professional, have a malady. Nowadays, we’re less likely to suffer from a disease, sickness, or illness than a complaint, condition, episode, or event.
As baby boomers age and the field of medicine expands, so does the range of associated euphemisms. After spending enough time in hospitals, we begin to talk of meds rather than “drugs.” Instead of “treatment”, we get therapy. We may not undergo “surgery” but will have a surgical intervention. Yesterday’s “face-lift” is today’s aesthetic procedure. A heart attack becomes a coronary, a coronary incident, or a coronary event. Or, when we really want to toss the medical lingo, a myocardial infarction.
Doctors are key carriers of euphemania on the health front. Their professional vocabulary serves the dual causes of medicine and obfuscation. Inevitably, some of that vocabulary seeps into common discourse, not only because patients pick it up from their doctors but also because they see it on the Internet and hear it on radio and television, especially in pharmaceutical ads that warn of “serious, sometimes fatal events.” In other words, death.
Using substitute words when discussing health matters is a long-standing practice. This is especially true when it comes to naming diseases.
I was always told that my great-grandmother, Myrtie Lacey, died of consumption. Only as an adult did I learn that consumption was a euphemism for tuberculosis. In Myrtie’s time, tuberculosis was an incurable scourge, the AIDS of its day. The very name of this dread disease was taboo. Koch’s disease it was called, Pott’s disease, acid-fast disease, apical catarrh scrofula, king’s evil, the white plague, pleural pneumonia, and phthisis (Greek for “consumption”). Since TB was the leading cause of death in nineteenth-century America, killing an estimated 20 percent of adults and infecting as many as half of all city dwellers, such verbal coyness is understandable. Medical historian William Rothstein has suggested that during the nineteenth century a reluctance to discuss tuberculosis directly was even stronger than reticence about discussing sex.
In his 1827 novel Armance, Stendhal depicted the mother of a tubercular patient who refuses to call her son’s illness by its actual name for fear that doing so might hasten his demise. A century later, Franz Kafka lay dying of the same disease in an Austrian sanitarium. In a 1924 postcard to a friend, Kafka complained about how maddeningly vague doctors there were about his condition. As the Czech author explained, when discussing tuberculosis “everybody drops into a shy, evasive, glass-eyed manner of speech.” All Kafka could get out of them were vague references to “swelling at the rear” and “infiltration.” Two months later, he was dead.
In the case of Emily Dickinson, biographer Lyndall Gordon has concluded that the reclusive poet was a closet epileptic who could only refer to that affliction obliquely. During Dickinson’s mid-nineteenth-century era, epilepsy—commonly called “falling sickness”—was considered shameful for men to have and unmentionable for women. Gordon thinks that Emily Dickinson’s poetry included frequent euphemistic references to this condition, such as “I felt a Funeral / in my Brain.” At other times, the poet wrote of “Fire Rocks” in her body and a “Bomb” in her bosom. At no time did Dickinson refer to having epilepsy (which afflicted two of her male relatives) or even to suffering from an unnamed illness.
A reluctance to discuss diseases openly is part and parcel of the primitive fear that using the actual name of something one dreads, be it a bear or an illness, might summon what is dreaded. At one time, residents of the Solomon Islands near Papua New Guinea called virulent diseases such as leprosy and tuberculosis the chief or the pretty girl, perhaps hoping to tame their fury with flattering names. A century ago, anthropologists found that smallpox, the most feared disease in New Guinea, was seldom referred to directly. Instead, residents of that region referred to this malady in terms befitting something regal that ruled their lives. “Hence smallpox is spoken of as a king,” wrote James Frazer in the The Golden Bough, “—a pretty word to hide an ugly thing, and yet an appropriate image, since the disease visits district after district, village after village, like a prince making a royal progress.”
At a time when the causes of illness were mysterious and ways to treat them uncertain, renaming such scourges seemed as good a strategy as any. In a sense it still does. By using a mild word such as “shingles” for the excruciating condition herpes zoster, we try to temper its severity. “Flu” is a less ominous-sounding contraction of the dread “influenza,” a disease that has caused so many deaths during epidemics, especially the one in 1918 that claimed some forty million lives around the world. Due to a suspicion that it originated in Spain, that strain was called “Spanish flu.” It was actually less prevalent in Spain than elsewhere but received more publicity there because that neutral country’s press wasn’t censored during World War I. Since this strain of influenza appeared first in Kansas, “Kansas flu” would have been a more accurate label. But accuracy is not the intent when diseases are given point-of-origin names such as “Hong Kong flu” and “German measles.” Ethnic biases come into play. Depending on which way the political winds are blowing, such designations are subject to change. At the peak of anti-German hysteria during World War I, “German measles” became liberty measles (and “German shepherds,” Alsatians).
The dysentery so often suffered by tourists is commonly named after settings where it’s contracted, perhaps as a form of payback. Geographic euphemisms for this condition include Bangalore bowels, Bali belly, Basra belly, Bombay crud, Delhi belly, Lahori looseness, Spanish tummy, Thai-del wave, Tokyo trots, and Tunis stomach. Burma’s Rangoon takes a double hit, with Rangoon itch being euphemistic for a penile infection contracted from a prostitute, and Rangoon runs referring to diarrhea. Montezuma’s revenge is a euphemism for diarrhea contracted in Mexico. A low point in Jimmy Carter’s presidency came when the humor-challenged president made a feeble joke about Montezuma’s revenge while visiting Mexico City. His hosts were not amused.
When Columbus’s sailors brought what we now call “syphilis” back from the New World, English speakers called it “Spanish pox.” This neatly combined the disease’s origins with British disdain for Spaniards. After French soldiers who besieged Naples late in the fifteenth century exported this ailment to France, it became known there as the Neapolitan disease. As Keith Allan and Kate Burridge note in Forbidden Words, Italians preferred French malady. Poles called it German disease. Polish disease was preferred by Russians. Because they believed it was imported from England, Tahitians settled on British disease. Turks termed it Christian disease; Japanese, Portuguese disease; and Portuguese, Castilian disease.
You see the trend.
The challenge of naming diseases is tied to political and ethnic rivalries. Nowhere can this be seen more clearly than in the area of sexually transmitted diseases such as the one brought to Europe by Columbus’s sailors. Their reputation for licentiousness made the French the most popular nationality of all when naming this disease, especially among the English. In Shakespeare’s All’s Well That Ends Well, Bertram infects a woman with “French Pox.” The Bard’s contemporaries also called this illness Malady of France or French gout. French crust, French distemper, French aches, and Gallic disease were other popular synonyms favored by English speakers during the Elizabethan era.
An epic poem published in 1530 by Venetian physician Girolamo Fracastoro featured a shepherd infected with “the French sickness.” His name was Syphilis. In time, the shepherd’s name was applied to the disease itself. It stuck. As the word “syphilis” took on the taint of the malady, however, vaguer terms such as special disease, social disease, secret disease, vice disease, Cupid’s disease, a certain disease, blood disease, and blood poison emerged. Doctors sometimes called syphilis specific stomach or specific ulcer. The great pox was another name bestowed on this ailment, to keep it from being confused with smallpox. Pox alone was often a euphemism for the sore-inducing malady. When Shakespeare wrote “A pox on’t” in Cymbeline, syphilis was what he had in mind.
The most generic name for such maladies was venereal disease. Before Columbus set sail, “venereal” simply meant “of Venus” and alluded to sexual matters in general. By the mid-seventeenth century, it referred more specifically to sexually transmitted diseases. Despite the spread of these diseases during World War I, and despite pressure from the Army Medical Corps, American newspapers would refer to this subject only in the most evasive terms. Even “venereal disease” was considered too suggestive for public consumption. A 1919 article in the New York Tribune discussed preventable diseases, social diseases, certain dangerous diseases, communicable diseases, and, simply, diseases. London’s News of the World subsequently used the term a certain illness when reporting on this subject. For the movie version of A Farewell to Arms (1932), British censors changed “venereal disease” to imaginary disease. As late as 1961, a line in the West Side Story song “Gee, Officer Krupke” that went “No one wants a fella with a social disease” did not make the journey from stage to screen.
A satisfactory alternative eventually presented itself in predictable form: an abbreviation. Shortening “venereal disease” to VD provided a suitably vague name for this lethal scourge. That approach came to the rescue again when “sexually transmitted disease” became STD. After an unusually virulent new form of STD appeared in the early 1980s, the question of what to call it was complicated by the fact that this disease primarily affected homosexuals, intravenous drug users, and immigrants from Haiti. An early candidate was GRID (for gay-related immunodeficiency). In addition to being inaccurate, this acronym had a stark, ominous sound, bringing to mind gridlock or power grids. Donald Armstrong of New York’s Memorial Sloan-Kettering Cancer Center apparently was the first to suggest calling the disease AIDS, an acronym of its technical name, acquired immuno deficiency syndrome. This benign term for a deadly scourge made it an ideal euphemism. “It has an almost saintly sound,” observed David Black in The Plague Years, “as though it were the Saint Francis of epidemics.”
When a new strain of influenza appeared in Vera Cruz, Mexico, in 2009, the Centers for Disease Control and Prevention simply called it a “febrile respiratory illness.” Mexican flu was more popular among Americans but not Mexicans themselves. Since it apparently originated in pigs, this viral infection soon became known as swine flu. Unhappy hog farmers suggested hybrid flu as an alternative. The technically correct H1N1 was finally settled on as the least controversial option.
Abbreviations and acronyms are the quintessential modern form of euphemism for medical conditions: SARS (severe acute respiratory syndrome), GERD (gastroesophageal reflux disease), COPD (chronic obstructive pulmonary disease), etc. Cattle ranchers, understandably, would much rather we call mad cow disease MCD or, better yet, BSE, an abbreviation of bovine spongiform encephalopathy. This trend to identify maladies by initials owes a lot to pharmaceutical copywriters. An ad for Orencia refers to rheumatoid arthritis as RA. Plavix treats PAD (peripheral artery disease). Flomax is for “BPH, also known as an enlarged prostate.” (BPH actually stands for benign prostatic hyperplasia.)
Cancer is not named in such ads, of course. This word is simply too ominous. Ironically, its root is something of a euphemism or at least a metaphor. Twenty-five centuries ago, Hippocrates compared the veins snaking out from tumors to crabs, karkinos in Greek. Its Latin translation was “cancer.” That disease has supplanted tuberculosis as our most dreaded and hence most unnamable scourge. Its many euphemistic designations include the initial C. During a remission from the lung cancer that eventually killed him, swaggering John Wayne said he’d beat “the big C.” Australian linguist Kate Burridge once heard a cancer patient described as “having a touch of the c’s.” The c-word is a close cousin. The terrible sickness is a street euphemism for cancer; a long illness or a lingering illness, the obituary writer’s staple. Generically, any tumor can be called a lump, a growth, or a mass. Among medical personnel, it can be referred to as a protuberance, a neoplasm, or a carcinoma if it’s malignant. Mitotic disease or mitosis (referring to cell multiplication) has become a common medical term for what we’re hesitant to call “cancer.”
When Ulysses S. Grant died of throat cancer in 1885, his doctors characterized the ex-president’s affliction as an “inflammation of the epithelial membrane of the mouth.” Previously, they’d discussed his condition in terms of “epithelioma,” “malignancy,” and “infiltration.” Using medical lingo this way is a longtime strategy for trying to avoid alarming patients and those concerned about them. When an elderly W. B. Yeats returned to Dublin from a vacation in Spain, he carried with him a letter from his Spanish doctor to his counterpart in Ireland that read, “We have here an antique cardio-sclerotic of advanced years.” At Yeats’s insistence, his Irish doctor read him this ominous diagnosis aloud. When the doctor tried to mumble a bit, Yeats demanded that he read it again, slowly and distinctly. “After all, it’s my funeral,” said the poet. As the doctor repeated the diagnosis, Yeats rolled its key words on his tongue, keeping cadence with one finger: “cardio-sclerotic… cardio-sclerotic… cardio-sclerotic.” He then said, “Do you know, I would rather be called ‘cardio-sclerotic’ than ‘Lord of Lower Egypt’!”
Perhaps it’s clear-eyed literary types such as Yeats who are best qualified to break through the euphemistic jargon of modern medicine. Novelist Diane Johnson, whose husband is a physician, compares contemporary medspeak to the magic language shamans use when casting spells. The professional vocabulary of today’s doctors is rooted in Latin and fertilized by science, creating an aura of mystery that can be wielded strategically. In some cases, a physician might want to brace up a patient with words that sound frightening. Telling one with a mild heart murmur that he has mitral valve prolapse could help scare him straight into a healthier lifestyle. Alternatively, a doctor can use medspeak to soothe and mollify. Certainly, a little spot on your lung sounds far less menacing than “a possible tumor.”
One doctor told Johnson that he was advised to use scientific-sounding euphemisms in front of patients to keep them out of the loop. Thus, an alcoholic discussed among interns in that person’s presence would suffer from hyper-ingestation of ethynol. Syphilis can be called sigma phi, shorthand for this illness based on Greek letters. For their own convenience, and when discussing cancer around patients, doctors routinely initialize it as c.a. Initials abound in medspeak. Not just ER and OR but MI (myocardial infarction), NAD (no acute distress), LOC (loss of consciousness), and DNR (do not resuscitate). A patient is a pt, a headache an HA. Patients “brought in by ambulance” are BIBA. TLC refers to the type of palliative care given to the terminally ill. Such abbreviations don’t just save time but “are used to covertly convey confidential information in a less than confidential setting,” one doctor tells me. Thus, a physician who says, “This SOB pt complained of DOE five days PTA” simply means, “This short-of-breath patient complained of dyspnea on exertion five days prior to admission.”
Not all initials are professional code, of course. Some are a cross between slang and black humor. Before it became a popular online abbreviation, LOL was a euphemism for “little old lady” in hospital corridors. When they can’t determine what—if anything—is wrong, some doctors say a patient has TEETH (“tried everything else; try homeopathy”). Out of public earshot, medical personnel use abbreviations like FLK for “funny-looking kid” (one with an odd appearance but unspecified malady), FFFF for “female, forty, fat, and flatulent,” COP for “crotchety old patient,” and DDD— “definitely done dancing”—for those who are failing. They are PBAB, “pine box at bedside”; or GFPO, “good for parts only” (i.e., transplantable organs).
There is a stark contrast between the bland euphemisms doctors use with patients and the black-humorous ones they use among themselves. Depending on the setting, some common in-house terms include gomer for a sorry, disheveled type of patient, grume for a smelly one (from “grumous,” a medical term for coagulated liquids), groupie for emergency room regulars, and buff up for improving the appearance of a patient about to be released. (“Buff” also refers to cleaning up medical records to discourage possible lawsuits.) Other euphemisms heard in hospital corridors include code brown (fecal incontinence), wallet biopsy (checking patient’s ability to pay), and positive suitcase sign for patients who arrive at the ER with a packed suitcase, suggesting no sense of urgency on their part. To understand some of these terms, one needs to be up on dated pop-culture allusions. Zorro belly refers to a patient whose abdomen has many scars from previous surgeries. A Camille is one who continually feels on the verge of dying and lets everyone know this, loudly. A dying swan feels the same way but doesn’t make as much fuss.
In some hospitals, coded is a euphemism for “died” (“That woman in 304 coded last night”), drawing on the code nomenclature commonly used in this setting, such as “Code Blue” for heart failure. One doctor was startled to hear “demise” used as a verb when he was told that a patient had demised. Professionally speaking, doctors’ patients don’t die, they experience a negative outcome, one that might have resulted from a therapeutic misadventure. Most often, doctors, like the rest of us, simply say a patient went (“she went peacefully”) or that they’ve lost a patient. The latter led one immigrant doctor to observe how odd this seemed to him when he arrived in the United States: “I wanted to say, ‘Well, we didn’t really lose your husband,’ ” this oncologist told medical researcher James Sexton. “ ‘We know where he is. It’s just that he’s not breathing any more.’ ”
Through liberal use of euphemisms, doctors shield both patients and themselves from trauma. Thoughtful physicians recognize that the many evasive expressions they use for disease, dying, and death are for their own benefit as much as that of their patients. As one put it, “Euphemisms… mitigate the macabre, but more for practitioners than for patients.” Surprisingly, studies have found that physicians are more afraid of dying than the average person. It has even been suggested that studying medicine can be a counterphobic way to deal with this fear. In the words of one young doctor, “I think it is the innate fear of one’s own death that draws a person into medicine because he feels that it is as close as he can come to conquering it.” Practicing medicine gives physicians powerful tools to try, particularly a sense of scientific detachment in the face of death as well as a sanitized vocabulary to discuss this issue. In the ways they talk of dying, doctors are no less euphemistic than the rest of us.
When it comes to death, the euphemistic fog becomes nearly impenetrable. The dead are no longer with us. They left the building. Kicked the bucket. Bought the farm. They’ve gone home, or south, or west, or to the last roundup. They’ve laid down their burden. They’re pushing up daisies. Noting that the equivalent French expression manger les pissenlits par la racin literally means “eating dandelions by the root,” Hugh Rawson comments in his Dictionary of Euphemisms and Other Doublespeak, “It would be the French, of course, who would think of death in edible terms.”
It wasn’t always so. When death was more routine, so were the words we used to discuss it. Imagine a marriage ceremony that included “Till a fatal event do us part.” Or a prayer that went, “If I should expire before I wake.”
In the unsentimental Middle Ages, death was discussed freely, openly, candidly. Confronting death directly in word and spirit seemed to help our medieval ancestors cope with its prevalence. Works of art—paintings, statues, stained glass windows—brimmed with images of the dead and dying. Dancing skeletons were a common motif in the folk art of southern Europe (and still are in Mexico and other countries south of the U.S. border). Some early clocks were shaped like skulls to remind their owners that time was slipping away; death was on its way. Icons on tombstones didn’t gloss over what lay beneath them; they glorified it. A British church luminary named John Wakeman, who died in 1549, was buried beneath a monument adorned with a mouse, snakes, and snails feasting on his corpse. Well into the eighteenth century, skulls were the most common icon on New England gravestones.
This willingness to face death squarely extended to language. One 1615 book for housewives discussed how to deal with “Child dead in the womb” and offered counsel for a woman who “by mischance have her child dead within her.” A comparison of the 1662 Church of England funeral liturgy with its revision in the year 2000 found revealing differences. In the 1662 version, reference was freely made to “the Grave,” “the Body,” and “the Corpse.” Three-hundred and thirty-eight years later, “the corpse” became the deceased. Prescribed proceedings three centuries ago included this biblical passage: “And though after my skin worms destroy this body, yet in my flesh shall I see God.” Its modern counterpart deleted those words. Typical of the newer liturgy was the passage “Like a flower we blossom and then wither: like a shadow we flee and never stay.” Guy Cook and Tony Walker, who compared the two versions, dryly noted “an absence of reference to the physical facts of death” in the contemporary Anglican funeral service, which they attributed to “an unwillingness to confront the physical nature of death.” In America too, as Gary Laderman notes in The Sacred Remains: American Attitudes Toward Death, 1779–1883, modern Protestant theology treats the physical remains of the dead as “persona non grata, so to speak.” Avoiding direct contact with dead bodies, Laderman concludes, “became a fundamental dimension of life and death in American culture during the twentieth century.”
Before the twentieth century, death usually occurred at home, the dying person surrounded by relatives, friends, and neighbors, including children. Contact with dead bodies was commonplace. Decades after the fact, suffragist Frances Willard recalled being held aloft by her father when she was four (in 1843) so she could get a good look at the body of a next-door neighbor laid out in his Oberlin, Ohio, home. Following the advent of photography, pictures were taken of the dead as a remembrance for those left behind. For an event this ubiquitous, there was no need for flowery, evasive language. Folks died. They were dead. Their bodies were corpses.
As recently as the mid-eighteenth century, there was little attempt to sanitize the language on tombstones. What could be simpler than this inscription on a Beverly, Massachusetts, tombstone:
HERE LYES THE BODY OF Mr. John Blowers
WHO DIED JULY Ye 13th 1748
IN THE 38th YEAR OF HIS AGE
Gradually, however, the words chiseled into granite began to change in concert with a shift in our attitudes toward death. For a time, the two concepts—approach and avoidance—coexisted, as can be seen in another Beverly tombstone inscription:
In Memory of Mrs. LOIS BARRETT consort of Mr. THO BARRETT, who departed this life Sept 5th 1789, aged 29 years. Also Betsey their Daughter who died June 9th 1796, in the 7th year of her age.
From infancy to riper years I grew
Perhaps as certain of my life as you;
But now in silent accents hear my cry,
You soon like me within the Tomb shall lie.
During the early nineteenth century, the words and icons on tombstones became more euphemistic. Now the dead had commenced rather than completed a journey. They passed over. They’d gone to a better place. They went home. Death was “God’s call,” the prominent clergyman Henry Ward Beecher assured antebellum Americans. “Come home.” Soothing words such as these were translated into optimistic inscriptions on tombstones accompanied by sculpted angels, cherubs, lambs, and urns with willow branches.
As mortality declined and a sense of propriety rose, squeamishness about death created fertile ground for euphemizing. This shift could be seen in newspaper obituaries (a euphemistic name for what used to be called “death notices”), with their increased emphasis on evasive language. An analysis of obituaries in Irish newspapers during the 1840s found a steep decline in the use of words such as “die” and “death.” As for tombstone inscriptions, the new vocabulary clustered around themes such as embarking on a journey (gone to her eternal rest), entering a better world (abode of peace), taking a rest (from the labors of a well-spent life), and earning a reward (enjoyment of that peace and bliss that await the virtuous and the good).
On both sides of the Atlantic, the concept of a “good death” emerged, one that took place in the presence of loved ones, the dying person confident of salvation, while murmuring a few memorable last words. Such deathbed scenes were featured prominently in Victorian literature. Death was being sentimentalized.
In America, the Civil War interrupted this process. How good can a death be when it’s far from family, in the midst of horror and carnage, with no loved one present to record last words, even if any were murmured? No terms softer than “die” and “dead” had enough gravity to describe the nearly seven hundred thousand soldiers who died during this conflict, 2 percent of the entire population (equivalent to six million fatalities today). As Drew Gilpin Faust recounts in This Republic of Suffering: Death and the Civil War, Yankees and Confederates alike became consumed with what they called a “harvest of death.” In this context, using euphemisms for dying would have seemed nearly obscene.
Letters from the front to families of the dead relied on phrases such as “I was a witness to his death.” They assured parents that their son “was not afraid but willing to die.” Anticipating his own demise, one Confederate soldier who was mortally wounded during the battle of Gettysburg wrote his mother, “I died like a man.”
Nurses did their best to fill in for mothers far away. Clara Barton carried a notebook in which she recorded the names of dying soldiers and any last words they might utter. A ballad at the time paid tribute to battlefield nurses like her:
Bless the lips that kissed our darling
As he lay upon his death bed,
Far from home and ’mid cold strangers
Blessings rest upon your head
* * *
O my darling! O our dead one!
Though you died far, far away
You had two kind lips to kiss you,
As upon your bier you lay.
Following the war, as Americans tried to put its horrors behind them, death-related euphemisms returned with a vengeance. Obituaries, once graphic in their descriptions of death and its causes, now reported that the deceased died of “short,” “protracted,” or “lingering” illnesses. Depictions of deathbed scenes that used to be common in such news accounts became a thing of the past. This was symptomatic, concluded Janice Hume in her book Obituaries in American Culture, “of a society running away from death.” Our forced embrace of death during the Civil War prompted an unwillingness to even discuss the topic directly afterward. “Corpses” now were cadavers; “tombstones,” markers; “coffins,” caskets (adopting the name of jewel boxes). Nathaniel Hawthorne considered the latter “a vile modern phrase, which compels a person of sense and good taste to shrink more disgustfully than ever from the idea of being buried at all.” Richard Meade Bache, whose father, General George Meade, commanded Union forces at Gettysburg, seconded Hawthorne’s motion. “What trifling with a serious thing it is to call a coffin a casket!” wrote Bache.
What would Bache and Hawthorne have made of the fact that by the turn of the century, undertakers had promoted themselves first to funeral directors, then to morticians (a term introduced in an 1895 issue of Embalmer’s Monthly), presumably because it sounded like “physician.” Throughout the twentieth century, members of the burgeoning funeral industry struggled to banish “death” and related words from their lexicon. The onetime “death certificate” was now a vital statistics form. Those who used to “die” now expired. They were deceased, not “dead.” Their remains weren’t “hauled” to funeral homes; they were transferred. The “hearses” used for this purpose became professional cars. Bodies that used to be “buried” during “funerals” were now interred during services.
The most fertile ground for euphemizing is one where open discussion of a topic is taboo. So it was with sex in the Victorian era, and so it became with death thereafter. This topic was driven underground, as it were, becoming the great unspoken. Children who could easily hear sexual issues discussed in some detail on radio and television seldom heard the end of life discussed openly. In a society where death is treated as a taboo topic, observed Elizabeth Kübler-Ross in 1969, “discussion of it is regarded as morbid.”
Dying came to be seen as rather indecent, nearly obscene, and “death” akin to a four-letter word. Postwar advice books counseled parents to avoid talking about this subject with their children. A mid-twentieth century survey of 126 British parents found that nearly half—fifty-six—said they’d never discussed death with their offspring, and forty-two said they’d only done so euphemistically. Went to sleep became the most common euphemism for “died” when parents talked to their children about this subject. As a result, said one hospice social worker, not only did it not surprise her when children feared sleeping, but “it amazes me that children ever go to sleep at all.”
Euphemisms are important bricks in the walls we’ve built to keep the dead from making us uncomfortable. Having done our best to avoid actual contact with the dying and dead, it would stand to reason that we’d replace associated expressions considered too stark and direct with soothing alternatives. Passed away is the most prevalent synonym for “died,” or simply passed. A writer in the New England Journal of Medicine went further, proposing that we call the dead nonliving persons. The British Medical Journal published a suggestion that bodies with organs eligible for transplant be called non-heart-beating donors. Those suggestions didn’t take, but doctors do still talk of losing vital signs and negative patient-care outcomes.
Our discomfort with this topic is reflected in the sheer volume of alternative words for death and dying. Some are quite inventive. Linguist Louise Pound once compiled hundreds of death-related euphemisms such as counting daisy roots, left a vacant chair, and turned up his toes. Whimsically macabre versions included food for worms and crow bait. Some were unique to particular professions, as when butchers dropped off the hook, actors took one last curtain call (“curtains”), or reporters went 30, “30” being the numeral typed by journalists to indicate that they’d reached the end of their copy. Since Pound created her list, this process has continued. Boxers take the last count, gourmands lay down their knife and fork, gamblers cash in their chips, computer programmers go off-line.
Growing interest in death and dying during recent decades, spearheaded by authors such as Elizabeth Kübler-Ross (On Death and Dying) and Sherwin Nuland (How We Die), suggests a greater willingness to face the topic squarely in print. This willingness is not reflected in everyday discourse, however. Collecting new death-related euphemisms such as taking a dirt nap, biting the biscuit, in the crisper, and reformatted keeps website proprietors busy. Oldies but goodies remain in constant use. When Barack Obama’s grandmother died on the eve of his election as president of the United States, Obama announced that “she has gone home.”
With today’s trend toward nontraditional funerals, some involving green or woodland burials in natural cemeteries, a new euphemistic nomenclature of death is emerging. Bodies are buried in alternative containers; boxes or bags used instead of coffins. The increasing preference for cremation has led to inurnment of cremains. Online funerals are the latest development, attended by distant parties with the help of what some call “cremation cams.” Virtual cemeteries are another modern wrinkle, as are memorial websites and online grieving communities created by friends of the deceased. Funeral directors have had to step lively to keep pace with this rapidly changing scene, recasting themselves as funeral facilitators, grief facilitators, or memorial counselors who engage in memorialization activities.
Another modern wrinkle is elaborate memorialization of dead pets by bereaved owners. Of course, the word “owners” is an offensive anachronism to animal rights advocates who propose guardians as a preferable designation for this group, and companion animals for what most still call “pets.” Many of these advocates are vegetarians who also think we should restore candor to the language surrounding edible animals by calling poultry, birds (“You gonna eat that bird?”), and meat, flesh (as in flesh eater). From this perspective, many of the words we use for meat are euphemistic, evasive terms relied on to distract us from what we’re actually putting in our mouths. Those who would have us dispense with soothing words for meat are rowing against the tide of history, of course. When it comes to food consumption, the trend is to euphemize more rather than less—especially the names of foods that make us a bit queasy.