Choosing the Right Words in the Curriculum and Beyond

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Excerpt

Growing up with friends and family with neurodevelopmental disabilities, we were always frustrated to hear the “R word”: retarded. When our peers or others in society used this word, it was frequently meant as a biting insult. It devalued people with disabilities with no regard for their inherent worth. Years later, during our first year of medical school, we were immersed in the ideal of patient-centered care. Integral to this concept is providing care that is respectful of each patient’s individual situation. And yet, we noticed some inconsistency in our curriculum. The “R word” kept appearing in our lecture materials. Over and over, this medical-term-turned-slur was projected onto a screen in front of our entire class.
We met later in the year to discuss the prevalence of the “R word” in our curriculum. The term “mental retardation” appeared over 130 times in our preclinical curriculum and 47 times in our clinical material. We reflected on how the “R” word had been repurposed from medical terminology into a tool used to denigrate millions of people. The problem was not the word itself but, rather, the social connotation that came with it. As the word entered the common vernacular, it became synonymous with insults like “idiot,” “stupid,” and “useless.” To continue to use a word in our medical education that cast aspersions on an entire group of people was unacceptable. We decided to take action, and drafted an appeal to our school’s administration to strike the word from our curriculum. We encouraged our classmates and peers to sign our petition, and garnered significant support.
Weeks went by with no response, and suddenly an answer came. The administration had resolved to strike the use of the “R word” from our curriculum. Instead, they would use the updated term “intellectually disabled” as per the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition. We were ecstatic. We hoped that, in a small way, this would influence the outlook of medical students for years to come, and that other institutions would follow suit. Our words matter; our words have power. They can afford us dignity and respect, or they can attempt to strip us of our worth. Our patients will come to us from a diversity of backgrounds, ideas, and abilities. As clinicians, we are not only expected to be healers but to respect the dignity of each patient that comes through our door. The first place we can start is with our words.
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