The English Patient

Remember the poet and novelist Michael Ondaatje’s Booker Prize-winning best-seller made into an Academy Award motion picture, sometime in the mid-1990s? I thought I would look at English and the Patient, by wearing a historical lens. An interesting connection unfolds and needs to be shared.

The word patient is both a noun and an adjective. The meaning is different but I have attempted to draw a connection and parallel between the two. The word patient first appeared in English as an adjective in the 14th century from the French and ultimately Latin in which it expressed the idea of enduring hardship. The word developed and started being used in a broader and expanded sense, also associated with virtues such as being tolerant, obedient and enduring. Somewhere the word patient spun around and took a new shape also evolving as a noun, meaning a person bearing difficulties without complaint.

Once it got to that use, it did not take much for it to be pulled in by the medical profession to describe somebody with an injury or disease, who is undergoing medical treatment – patiently, of course. By the 18th century, medical (as a noun) and the non-medical (as an adjective) meanings were coexisting and being used freely. But as doctors appropriated and narrowed the meaning of patient, the word’s reference to someone suffering in any sense other than medical, somehow vanished.

This phasing out was almost complete by the end of the 19th century. The final demise can be attributable almost entirely to the institution called the hospital. Although hospitals have existed since antiquity, the idea that they were the best places to treat the sick, only took hold towards the end of the 19^th century. After that, hospitals became the accepted site for any serious medical treatment. The hospital inmates were now known as patients and hospital management made rules regulating the behavior of these people, who were meant to respond cheerfully to their treatment.

By the 20th century, the comprehension of patients had proliferated to include such terms as inpatients and outpatients. Nevertheless, the word patient still largely implied a grateful recipient of medical care. Over the last 50 years or so, most evident after World War II, the continuity of the word as a non-medical adjective, has made a highly energized return. As life became more complex, the old established virtues of behaving patiently, being tolerant and obedient, also resurfaced visibly in a broader need-based sense.

Today, irrespective of the use of the word whether as a noun or an adjective, for a clinical encounter or waiting in a long line at the security check at the airport, the spirit that the word signifies is still of endurance, bearing difficulty and exhibiting calm without complaint. It is at this meeting point, when the patient – the noun and the adjective – join hands and echo a single voice, reflecting a common spirit.

This is also when the Patient truly becomes English.