LAUSR

In a brilliant point of view paper, a large, heterogeneous group of expert nephrologists contested one of the proposals of the new nomenclature proposed by KDIGO, that was published recently, first by Kidney International and then by several other specialized journals including our own [1, 2]. A similar shorter commentary was recently published in Kidney International [3]. The paper was submitted to our journal at a time when the second COVID-19 wave was challenging our resilience, and my first reaction to the Shakespearean citation was to label it “much ado about nothing”. In fact, when the nomenclature paper was first published, some of us chuckled at the idea of calling our journal “The Journal of Kidneylogy” and some joked that having three words (renal, kidney, nephrology) to choose from, allowed the increasing number of nephrology (renal medicine/kidney medicine) journals to at least have different titles names. The call to preserve “renal” and “nephro” in the glossary of kidney health and disease is not trivial, however. While the authors may make us smile by stretching the idea of systematically preferring words of Anglo-Saxon origin, suggesting for instance that “peritoneal dialysis” could be replaced in medical writing with “belly-wall membrane blood purification”, they also make us reflect on what language is and does, in particular the English we use in medicine. In medicine, we read in English, we write in English, we communicate in English, but for very few of us it is our first language, our mother tongue. On more than one occasion we all have heard jokes about the fact that non-native speakers’ “broken English” has become the official congress language, and for many of my generation using this language correctly was even more of a challenge than putting together our first multivariate analysis. The result of these arduous efforts is a shared medical language that enables us to communicate, but is often poor or oversimplifies our ideas. In fact, on a few occasions, my team and I received negative comments about a “flowery” or “unscientific” presentation because the cultivated American-born lady who reviews our papers tried to transform our mistakes, Latinisms, and convoluted constructions into something readable, but not devoid of elegance. When, almost simultaneously in Europe, English became the common medical language, and “the web” gave us access to abstracts of papers from a growing number of journals in real time, allowing us to abandon our late evening searches in dusty libraries, we were all urged to learn, if not to speak, at least to read English. In the same period, Kidney International, which had initially published its abstracts in both English and French, unsurprisingly became an English only journal. Attitudes towards language change, and it is through trial and error that languages evolve, not only in medicine. The first common language in the western world, Latin, progressively diverged and developed into what are now known as the Romance languages. No language is exempt from this dynamic balance between converging into an often rigid and impoverished common language and diverging into lively and colorful new ones. The Word software programs currently available propose UK, US and Australian English; Canadian French is not spoken in Paris. The same complexity certainly holds true for Mandarin and Arabic. In his Nobel Prize talk the poet Derek Walcott spoke about languages, and how living things became words, and words living things: “All of the Antilles, every island, is an effort of memory; every mind, every racial biography culminating in amnesia and fog. Pieces of sunlight through the fog and sudden rainbows, arcs-en-ciel. That is the effort, the labour of the Antillean imagination, rebuilding its gods from bamboo frames, phrase by phrase.” And in the banquet * Giorgina Barbara Piccoli [email protected]