Diss, Dys, and Hospice

btm0idnrkehdvvrcu5ok“Don’t ‘diss’ me, man.”

I first heard the slang diss in the 1980s, probably in a film or on TV. I’d always assumed it began in the raucous hip-hop music movement. An abbreviation of disrespect, the shorter diss made for easier rhyming and—at first—insider language for the hip-hop world. But lexicographer Jonathon Green found a reference for diss in a 1906 Australian newspaper. Could the slang term have actually emerged from the land “down under?”

Because of my hospice work, I think of different phrases. Instead of “diss,” I learn new-to-me appearances of the prefix “dys” on a regular basis.

“Don’t ‘dys’ me,” I might wish for our patients, but dys never disappears for too long as we confer about our patients’ health issues. In a meeting this week, a nurse explained—clinically and efficiently—the long list of comorbidities for a new hospice admission. The patient had, the nurse said, dystonia.

Dystonia . . . dys-what?

My first thought was predictable: I’d never heard of it before. A second thought quickly crowded into my mind: whatever “dystonia” was, it wasn’t going to be nice.

The prefix dys (appearing in words I’m familiar with like dysfunction, dyslexia, and dysentery) has roots in ancient Greek, and was eventually filtered through the also ancient Latin language. It means . . . bad. Or ill. Or abnormal. Dys is rarely good.

Layout 1Dystonia, according to the Mayo Clinic, is when “muscles contract involuntarily, causing uncontrollable repetitive or twisting movements of the affected body part . . .” Most people have experienced twitching, when a muscle in the arm or leg—from over-exertion, or lying too long in an awkward position—unexpectedly jerks. It feels weird, but soon stops. However dystonia is not there one moment and gone the next. Patients in certain stages of Parkinson’s, along with other neurological diseases, will often be faced with dystonia.

Dysarthria is also not nice. Many weeks before hearing a nurse mention dystonia, I’d jotted “dysarthria” on my notepad during a patient care meeting. I didn’t look it up right away, though—even with my plentiful ignorance—knew it would also be bad. Often, especially after a stroke, a patient may have “slurred or slow” speech.

Slurred speech? Hey, I remember fellow students in college, after long nights of guzzling booze instead of studying books, doing quite a bit of slurring with their silly (and pathetic) attempts at conversation. But dysarthria can’t be blamed for a hangover and then be forgotten by the next day. A patient with dysarthria will struggle to communicate, and may resent that condition even more than physical pain.

I’ll share a final dys to fashion an unholy, unsettling trinity of symptoms recently impacting my hospice’s patients. It was no surprise to learn one (actually much more than one) of our patients had dysphoria. The word opposite of this condition is likely more familiar. Ever felt euphoric? Ah, euphoria, with its enthusiasm, optimism, and giddy fictional practitioners like Pollyanna and Mary Poppins! However the dismal dysphoria is a “mood of general dissatisfaction, restlessness, depression . . .” It’s no surprise a patient in hospice, vividly aware of her or his mortality, could be “dysphoric.”

Medications may reduce these conditions. Whether a patient has the involuntary twisting of a muscle, or is emotionally overwhelmed and spirals downward into depression, the nurses and doctors in hospice will try various dosages to help control the symptoms.

A new dys seems to appear every week, like another flashing warning light in the fog of diseases for patients. And, whether or not I’m familiar with a dys, none remain only isolated ailments. Someone with muscles uncontrollably twitching may become ashamed of their body. Someone with slurred speech may stop making any effort to communicate. Someone who never feels not sad, may sink deeper into despair.

Though not a medical person, I understand one possible way to reduce the anguish a dys creates for a patient or caregiver.

51Lxt6HBBzLDon’t diss them. Regardless of where disrespect’s slang started—in the hip-hop world of the 80s or Australia eight decades earlier—every hospice patient deserves compassion and respect. In other words, I’ll go with Aretha Franklin, the Queen of Soul, and her R-E-S-P . . .

Sing it or say it loud and proud. Not only patients, but every person deserves respect.

(Hospice vigorously protects a patient’s privacy. I’ll take care with how I share my experiences. Any names used are fictitious. Events are combined and/or summarized.)

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  1. Enjoyed your analysis of the differing meaning of “dys” down thu history to the present day. I liked the relationship between “diss” and “dys” both still in negative territory. I had never realized the distinctive nature of the meaning of the words. Thanks for making it clear, an excellent study. Its application in hospice was instructive.

    • John . . . thanks! I do hope I can help make a few words “clear.” When someone is considering hospice, or already in the care of hospice, all the “new” words can be overwhelming.

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