In the Time of the Bad Prefixes


Are we living in dystopian times?

Why do I feel so dismal during this disastrous pandemic?

“Don’t diss me, man.”

I first heard the slang diss in the 1980s, probably from 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. Was the slang term actually born in the land “down under?”

Because of my hospice work, I hear similar-sounding prefixes. Instead of diss, I have learned other uses of the prefix dys on a regular basis. I recall a patient care meeting where a nurse explained—clinically and efficiently—the long list of comorbidities for a new hospice admission. The patient also 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” described, it wasn’t gonna be a good thing.

The prefix dys (featured in words I’m more familiar with like dystopia, dysfunction, dyslexia) has roots in the ancient Greek language. It means, no surprise: bad, ill, or abnormal. Dis the prefix is the Latin cousin. When added to the front of a word, dis doesn’t mean bad, but apart, separate from. We find it in dislike or disagree or disgust. (Though I’m not sure what a gust is?)

Dys as a word’s first syllable is not a positive start.

Dystonia, 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 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’s speech may be “slurred or slow.”

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 could resent that condition even more than physical pain.

I’ll share a final dys to fashion a complex, frustrating trinity of symptoms recently impacting my hospice’s patients. Some of our patients have 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! Alas, the dismal dysphoria is a “mood of general dissatisfaction, restlessness, depression.” It’s no surprise that hospice patients, confronting their mortality, might 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-to-me dys seems to appear every week, like another flashing warning light in the fog of diseases for patients. 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 depressed 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: Please, don’t diss them*. Regardless of where disrespect’s slang term originated—in the hip-hop world of the 80s or Australia eight decades earlier—every hospice patient needs compassion and respect. In other words, I’ll go with Aretha Franklin, the Queen of Soul, and her R-E-S-P . . .

Sing it loud and proud for me.

As this pandemic continues, try to find the ways to connect. Not only patients, but every family member and hospice staff deserves respect without the dis. Especially in our unsettling, dysfunctional shelter-in-place world.


*Although this prefix’s meaning is likely a sad, current reality for certain hospice patients, families, and caregivers. With the Covid-19 restrictions, some must remain physically apart. Separate.

(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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