Separated by a Common Language

Editor Mark recently wrote (to) me to suggest the different meanings of pound sign (or pound symbol) as a Twitter Difference of the Day.  In the US, pound sign/symbol is usually understood to refer to this thing: #.  It is also called the number sign in AmE, where it is used to signify the word number, as in #1, which is read as 'number one'.  The use of # to mean 'number' is increasingly understood in the UK, but not often used in that way.


But, of course, if one were to say pound sign/symbol in the UK, it would be understood to refer to this: £.  Now, if Americans needed to refer to £, they would probably say the pound sign or the pound symbol or That little squiggly thing that looks like a capital L in cursive* with a line through the middle.  But since they rarely have to refer to £, they're not too bothered by the ambiguity.


The usual UK term for # is hash sign (or hash symbol), but it doesn't seem to have a long history. The OED says: 

hash sign [cf. hash-mark: prob. ult. f. HATCH v.², altered by popular etymology], the symbol #, esp. used before a numeral (as in N. Amer.) to indicate a following number; the ‘number sign’

1984 Which Micro? Dec. 12/2 Neither user-defined characters, nor the ‘*hash’ sign could be reproduced. 1986 Guardian 20 Feb. 15 Would I please therefore oblige her by using the musical notation provided (I gather that it is called a hash sign).

The (AmE) quotation marks/(BrE) inverted commas and uncertainty about the term in the quotations suggests that hash sign was only becoming established in English (British or otherwise?) in the 1980s. The hatch mentioned in the etymology is the verb sense of 'To cut, engrave, or draw a series of lines', but although one also sees hatch mark in the wild, there's no indication in the OED that this term has ever been popular.  Of course, hash sign/symbol is not restricted to the UK, and its use in the Twitterverse term hashtag will probably give hash an advantage over pound and number in some quarters.  Another term that some seem to use is the descriptive crosshatch symbol--though the OED doesn't yet include it.


I can only guess that the apparent absence long-standing name for # in BrE is due to a lack of need for it.  BrE speakers weren't using # to mean 'number' or 'pound', so it was only when (AmE, orig. proprietary name) touch-tone/(BrE) push-button telephones became widely available that they had much need for a word for that symbol. (And maybe even later--it was years after we had such phones that we got automated interactions with instructions like "press the pound/hash key twice".) 


Because American keyboards typically do not have the £ symbol, people sometimes use # to signify amounts in sterling.  My understanding of this has been that it's called the pound sign/symbol because it is used to mean the same as lb. --i.e. pounds as an imperial measurement of weight--then because it was already called the pound sign, it fell into use for the other kind of pound when need(s) be.  But Mark Liberman on Language Log has been doubting this, and so my reason for choosing tonight to blog about this is just that it's a good excuse to link to his post.

Oh, and if you don't like any of these, you can always call it an (orig. AmE) octothorp(e), which seems to have been invented in the early 1970s specifically for the phone button.

* While cursive is not marked as AmE in the OED (it certainly wasn't coined in America), it's rarely heard in the UK, where people instead tend to say (BrE) joined-up writing.

So, last weekend the hospital released me to continue my treatment as an outpatient, then two days later on my first outpatient visit , they re(-)admitted me. Now I'm released again, but have been told to bring a packed bag to my outpatient visits...so you can expect my posts to continue to be erratic for a while. The good news is that I don't actually feel poorly, so I can blog when I have access to the Internet. The bad news is that I have plenty of time and desire for blogging when in (the) hospital, but no access to the blog. Catch-22.

So, the combination of dealing with a lot of different doctors and watching daytime reruns of ER left me thinking about the differences in doctors' titles/roles in American and British hospitals. I must admit that, despite having watched a lot of medical dramas and having read a lot of medical thrillers and memoirs in my youth (the better to feed my hypochondria), I've never been clear on what exactly an (AmE) attending physician is/does or how a (BrE) senior house officer relates to a (BrE) registrar. So, with a lot of help from Wikipedia, I've been trying to teach myself the ins and outs of these titles.

Let's start before we get to the hospital ward. In the UK, your regular doctor, the one you see in their (AmE) office/(BrE) surgery, is your GP or general practitioner. In AmE, the insurance-driven name for such people is primary care physician, but most people would just call that doctor my doctor or their family doctor (who works in or operates a family practice--a term that is found in both countries, but in my experience is more common in the US). The term general practice is also known in the US, but one doesn't hear people talking about their GPs.

When your GP/primary care physician decides that you require more speciali{s/z}ed attention, they refer you to a specialist--but in BrE they're likely to say that they're referring you to a (specialist) consultant. The experience of such referral can be somewhat different in the two countries. Let's say your usual doctor wants you to see a gastroenterologist. In the US, they say "I'm going to refer you to Dr. Guts." Then you get an appointment with Dr. Guts and meet Dr. Guts at that appointment. In the UK, you are referred to Mr Entrails' clinic (more on the 'Mr' shortly). Maybe you will see Mr Entrails--you're likely to on the first visit, at least--but you might see someone else in his clinic team, or firm (the term that Wikipedia reports--not one I've come across in the patient's seat). The consultant Mr Entrails has overall responsibility for your care, but a variety of more junior doctors might see you. Mr Entrails' clinic will most likely be located on hospital grounds, whereas American Dr. Guts will probably see you in an office complex--often one built specifically for medical offices.

In a hospital context, there are different titles (and responsibilities) for specialist doctors at different levels of training. In the UK, there's apparently been a move to 'moderni{s/z}e' medical career paths in the National Health Service, though I've seen little evidence of the changes reported on this NHS site. It says that a new title, Specialty Registrar [StR], replaces Senior House Officer [SHO] and Specialist Registrar from August 2007. But I was being seen by SHOs and Specialist Registrars at our hospital. So, I don't know if the new title applies only to people who have started since August 2007 or whether it's been abandoned, since when one hits the link for further info on the NHS site, one gets a 'page not found' message. For a comparison of new and old titles, see the table on this Wikipedia page. I'm going to stick with the old titles, since they're the ones I've experienced. [NB: Yes, it's specialty, not (BrE) speciality. This is one of many examples of BrE medical jargon being closer to AmE than to non-jargon BrE.]

So, in the UK, you're a medical student, then once you qualify as a doctor, you go on to be a house officer (Pre-Registration House Officer in the old system, Foundation House Officer in the new). After this, the doctor has a choice of going the GP route (which involves more training, but not all the titles I'm about to reel off) or undergoing specialist training for a minimum of two years as a Senior House Officer, followed by 4-6 years of further training and increased responsibility as a Specialist Registrar. One takes exams to go from one level to the next, with the highest level being Consultant. The amount of time one needs to train for these various positions varies by the specialty, culminating in the Certificate of Completion of Training after exams from the specialist college (e.g. the Royal College of Obstetricians and Gynaecologists). All of this is overseen by the General Medical Council, which determines the standards for entry onto the specialist registers that allow one to work in hospitals as a consultant.

In the US, you're a medical student, then for your first year in the hospital you are an intern, which may or may not be considered the first year of your residency, during which you are a resident (physician). This can also be called house officer, as in the UK. After residency, one may or may not get a fellowship for sub-specialty training, before going on to be an attending (physician) [or staff physician] the equivalent of a (BrE) consultant.

[Update, 16 Sept 2024: British junior doctors have now been re-named residents. See here for context.]


In the UK, medical training begins at the undergraduate level--which is to say, people can be 'medical students' from their first year (BrE) at university. In the US, medical school is for (AmE) graduate/(BrE) post-graduate students, and the undergraduate students do pre-med degrees, which cover a lot of science, but also, like other US undergraduate degrees, a liberal arts curriculum. (Law training differs in a similar way in the two countries.)

At least, that's how I understand all this. Anyone with better knowledge is welcome (as ever) to correct me in the comments.

Now, a few words on what you call these people. In the US, medical doctors, no matter their specialty or status, are usually called Dr. [Surname]. In the UK, there's a kind of reverse snobbery, in that GPs and more junior specialists are called Dr [Surname], whereas surgeons and other consultants go back to being Mr or Mrs or Miss--though I've only met men in the consultant role so far, so I can't vouch for the actual use of Mrs and Miss. (Note that BrE tends not to put a (BrE) full stop/(AmE) period at the end of title abbreviations like Dr, Mr or Mrs, while AmE almost always does.) Here, I'll rely on Wikipedia again:

In the United Kingdom, South Africa, Australia, New Zealand, Canada and other areas whose culture was recently linked to the United Kingdom, the title Doctor generally applies to both academic and clinical environment. "Registered medical practitioners" usually do not have a doctorate; rather, they have the degree of Bachelor of Medicine (usually conjoint with Surgery). Cultural conventions exist, clinicians who are Members or Fellows of the Royal College of Surgeons are an exception. As an homage to their predecessors, the barber surgeons, they prefer to be addressed as Mr, Mrs, Ms or Miss, even if they do hold a doctorate. This is first because they have normally achieved another degree - that of Master of Surgery (MCh from the Latin magister chirurgiae) from a university. When a medically-qualified person passes the notoriously difficult examinations which enable them to become a member of one or more of the Royal Surgical Colleges and become "MRCS", it is customary for them to drop the "doctor" prefix and take up "mister". This rule applies to any doctor of any grade who has passed the appropriate exams, and is not the exclusive province of consultant-level surgeons. In recent times, other surgically-orientated specialists, such as gynaecologists, have also adopted the "mister" prefix. A surgeon who is also a professor is usually known as "Professor", and similarly a surgeon who has been ennobled, knighted, created a baronet, or appointed a dame uses the corresonding title (Lord, Sir, Dame). Physicians, on the other hand, when they pass their "MRCP" examinations, which enable them to become members of the Royal College of Physicians, do not drop the "Doctor" prefix and remain doctor, even when they are consultants. In the United Kingdom the status and rank of consultant surgeons with the MRCS, titled "mister", and consultant physicians with the MRCP, titled "doctor", is identical. Surgeons in the USA and elsewhere may have the title "doctor".

So, there we go. Probably a topic that interests me much more than you, but what are blogs for, if not self-indulgence?

Oh, and by the way, one of the registrars has added to the Canadian count. So, that's 12. The nurses just asked where I was from. Score one for the nurses!

The Shorter Oxford Dictionary (6th edn) recently made the news for deleting a lot of hyphens that had been in the previous edition. According to the AskOxford website:

Drawing on the evidence of the Oxford Reading Programme and our two–billion–word Oxford English Corpus, we removed something like 16,000 hyphens from the text of the Shorter. So it's double bass, not double–bass, ice cream not ice–cream, makeover instead of make–over, and postmodern rather than post–modern. [Italics added because it was driving me crazy that Oxford hadn't marked the self-referential use of these words!]

Now, I neither have the two editions of the Shorter Oxford, nor would I have the time to look up all of the de-hyphenated words if I did have them, but it's long been my impression that British dictionaries (and possibly BrE speakers--we'll come back to this below) and American dictionaries (and speakers?) differ in their relationships with hyphens. When the Association of British Scrabble Players switched over to the international dictionary (including the former US and UK Scrabble dictionaries), one thing that struck a lot of players was how many more verbs could take the re- prefix. (As in relocate or reassemble. I'm afraid I don't still have my old dictionary to tell you which ones weren't allowed.) This was in part because of the BrE tendency to put hyphens between the prefix and the base verb, especially in cases in which not to do so would involve the same letter repeated twice at the end of the prefix and the beginning of the base word. So, BrE prefers re-elect, which is happy without a hyphen in AmE: reelect. The same thing happens with the prefix co-, especially before another o, so that BrE tends to prefer co-ordinate and co-operate, whereas AmE prefers coordinate and cooperate. So, I wondered, do the changes in the Shorter Oxford reflect more AmE-like use of hyphens? I found the following examples of de-hyphenated words in the Shorter Oxford 6 from news items and commentaries about the change: this BBC article, this New York Times article, World Wide Words and the aforelinked OUP press release. Then I compared them to the American Heritage Dictionary, which happens to be on my desk.

Shorter Oxford 5 (2002)	Shorter Oxford 6 (2007)	American Heritage 4 (2000)
fig-leaf	fig leaf	fig leaf
pot-belly	pot belly	potbelly
pigeon-hole	pigeonhole	pigeonhole
leap-frog	leapfrog	leapfrog
double-bass	double bass	double bass
ice-cream	ice cream	ice cream
make-over	makeover	makeover
post-modern	postmodern	postmodern
hobby-horse	hobby horse	hobbyhorse
fire-drill	fire drill	fire drill
water-bed	water bed	waterbed
test-tube	test tube	test tube
bumble-bee	bumblebee	bumblebee
cry-baby	crybaby	crybaby
low-life	lowlife	lowlife
up-market	upmarket	upmarket

The bold entries in the table show the three cases in which the change in SOED6 is a change in the opposite direction from the AHD4 entry. (And I have to take issue with the AHD's one-word status for hobby horse. Not how I would spell it. I'm less-than-sure about potbelly too.)

Does this mean that BrE is becoming more like AmE?

NOT NECESSARILY!

These changes probably have at least as much to do with the SOED looking more carefully at how these words appear in printed language as they do with any actual language change. After all, there have been only five years between the editions--that's an awful lot of hyphens to bite the dust in such a short time. The NYT article notes, "That ice cream and bumblebee ever had hyphens to begin with suggests an excess of fussiness on the part of older lexicographers" and BrE-speaker Michael Quinion at World-Wide Words says, "The new SOED lists many hyphenless words such as leapfrog, bumblebee, crybaby, pigeonhole, lowlife, and upmarket, which will be a relief to those of us who have been spelling them like that all along."

I do get the feeling, however, (and this is just a feeling) that BrE favo(u)rs keeping words more separate. We can describe a hierarchy of 'one-wordiness' or 'joined-up-ed-ness' of English compound nouns, like this:

fully integrated: lifeboat, prejudge
semi-integrated: sit-in, semi-integrated
not integrated: ice cream, throw up

Using this hierarchy, I'd suppose that BrE writing tends toward(s) non-integration--that is to say, keeping words separate, or at least hyphenated, whereas AmE is happier to have more fully integrated compounds. It's just a hypothesis, though, and you're welcome to test it. (Hey, final-year students! There's a project!) Part of the reason I've formed this hypothesis is the widespread habit in BrE writing of treating some prefixes as separate words. Here are some examples, in which in AmE I'd have to have at least a hyphen, if not a single word, but which one sees not infrequently as separate words in BrE:

over- as a verb prefix
On the other hand, children are very good at expressing what motivates them in a learning context but perhaps over egg the custard a little when it comes to saying that what they find boring. --Scaife & Rogers, 'Kids as Informants'

post- as a prefix meaning 'after'
Public Health Advice ? Post Flood
Before re-occupying your home
The flood water affecting your home or other property may have been contaminated with sewage and other contaminants... --Bridgnorth District Council

sub- as a prefix meaning 'below'
Sub normal growth rate (usually a height velocity below the 25th centile usually. equates to less than 5 cm per year in a pre pubertal child). --from an NHS [Wales] diagnostic guide

And so forth. This is the kind of thing I find myself 'correcting' constantly in student work in the UK (never as much of a problem in the US), so much so that I started to wonder whether I was the one in the wrong in my new dialect-land (as has happened before). But no, my New Oxford Dictionary of English treats all of these as prefixes, requiring hyphens or full integration with the base word. Fowler's Modern English Usage (3rd edn) doesn't mention the writing of prefixes as separate words, and in its entry on hyphens recommends the use of hyphens with prefixes--as opposed to full integration--in the cases where the prefix joins to a proper name (anti-Darwin) or where the same letter is repeated (re-elect) or an ambiguity ensues (as in the pro-verb/proverb case that I mentioned a while ago).

But before you go any further in thinking about this, I give you the following cautionary quotation, cited on the American Dialect Society e-list recently:

If you take hyphens seriously you will surely go mad.

--John Benbow, Manuscript and Proof, 1937

I've noticed that the readability of recent posts is significantly undermined by my fondness for parenthetical comments. This is not a new thing for me. Here's an excerpt from an anonymous review of a book proposal I submitted some time ago:

The tone is nicely academic. However, (like many academics (including me)), the author is given to parenthetical remarks, which tend to interrupt the flow of the sentence or paragraph, and often seem to me to convey non-critical information. At first I thought, hmmm, well, I suppose this being a textbook she wanted to avoid using footnotes... but then I discovered that footnotes were indeed in use. I would recommend eliminating many parentheticals, and replacing some of those that shouldn’t be eliminated with footnotes.

Happily the proposal was accepted and I'm merrily writing drafts full of parentheticals, then editing them out at a later stage. It's just the way my brain works. But reflecting on my parenthetical life/style/lifestyle led me to think a bit about the terms for the things that go on either side of a parenthetical comment. You could call them parentheses--I certainly would, but BrE prefers brackets--so much so that a second-year, native-English-speaking university student listed parentheses as a word she didn't understand in an assigned reading last term.

These brackety things come up a lot in my work, since in semantics one is wont to write or read things like:

[_Event GO ([_Thing ], [_Path IN ([_Thing ])])]
(= a Conceptual Semantics way of representing the meaning of enter)

Here the ( )s and the [ ]s represent different kinds of things, so it's important for me to be able to distinguish them when I talk to students. In Montague grammar, one uses a lot of these things: < >. And in formal logic, I was taught to use these things as well: { }. AmE uses different names for all these things, but in BrE, they tend to be referred to generally as brackets, with different modifiers:

	AmE	BrE
( )	parentheses	(round) brackets
[ ]	(square) brackets	square brackets
{ }	braces	curly brackets
< >	angle brackets	angle brackets

Now, I'm not actually claiming that the words listed as "AmE" here are dialect-specific. They are the correct printing terms in BrE as well. The difference is that people don't tend to use these words in general BrE, which is particularly noticeable in the everyday reference to parentheses as brackets.

I believe I've just written a blog entry that is free of parenthetical comments! Do I get a prize?