Why do consultants write such scary, incomprehensible letters?

There is a kind of letter designed to bewilder, upset and possibly terrify its recipient, and this is the standard letter sent by specialist medical consultants to the victims of disease. Actually, the letter is usually addressed to the sufferer’s GP, but a copy is always sent to the patient as well; and because of this it usually begins with a flattering personal reference just to soften him up (‘It was a delight to meet this charming old gentleman’, or some such phrase). Thereafter, it may propose some little variation in the person’s treatment, but its main purpose is to describe in lurid and impenetrable detail the symptoms of his disease. Of course, the patient knows very well what those symptoms are, as does his GP; but the consultant seeks to describe them with words that no ordinary person can understand but that provide reassuring evidence of his scholarship in his chosen field.

I have written before about my elder brother John, who lives next door to me in Northamptonshire, and about his Parkinson’s disease. This is a disease that affects people in different ways, but in John’s case its only major impact is on his mobility. He finds it hard to get in and out of chairs, and he walks with difficulty, but in most other respects he is in rather good shape for someone who is soon to be 87 years old; his mind, in particular, functions very well. Still, every now and then he likes to have a check-up with a Parkinsonian specialist, and recently I took him to see one in hospital. I waited outside the room during the consultation, and afterwards John asked the specialist to brief me, his brother, about his condition. No need, she said, for all would be made clear in the letter she was going to send.