WTAF (What's this Acronym for?)

Being a native English speaker working in Italy for many years and specialising in healthcare communications, I have become sensitive to language and how new words are created and adopted into doctors’ and patients’ active and passive vocabularies. In medicine, technology changes rapidly, and language needs to evolve to keep up.

Medical jargon is replete with acronyms. New technologies and even new diseases invariably bring with them new abbreviations and contractions. Whereas the French seem to translate English acronyms or create their own, which often leads to an inversion of the initials compared to English (VIH for HIV and SIDA for AIDS), Italian uses a bewildering mix of straight English and Italian renderings, and there seem to be no discernible patterns or rules.

For example, Italian medics use the English acronyms for some diseases (HIV, PH1, TK2D and PAH to name but four), but Italianised ones for others: SLA (ALS- amyotrophic lateral sclerosis) and BPCO (COPD) being two examples. It is not simply a case of some doctor types preferring English and others Italian, because, to illustrate how crazy and inconsistent all this is, SLA is a sub-type of Motor Neurone Disease, for which the Italians use the English acronym MND.

Those are just some of the diseases. It is the same for the medical devices used to diagnose them and the treatments to deal with them. A magnetic resonance imaging is commonly referred to as MRI, but a CT Scan is called a TAC. A man with prostate cancer may receive ADT (androgen deprivation therapy), but a woman undergoing menopause does not receive HRT, but TOS (terapia ormonale sostitutiva). So, if you are a man on hormone therapy, your treatment comes wrapped up in an English acronym, but a woman on hormone therapy gets a treatment with an Italian acronym.

And it doesn’t end with the choice of abbreviating the English or Italian term, because more fun is to be had when you try to pronounce them. There are two different ways of verbalising acronyms. Either you pronounce them as words (as in the case of AIDS), or you voice the individual letters, as in HIV, (which is called initialism). In Italy, some acronyms are pronounced as words, where their English equivalent is an initialism; SLA and TAC are two examples of this. But when it comes to initialisms, the confusion comes in knowing which language to use to pronounce the letters. For example, Italian oncologists talk about the marker PDL-1 in exactly the same way a US or UK oncologist would with the 1 pronounced one and not uno. By contrast, when talking about PH1 their nephrologist colleagues say pi-acca-uno even though the acronym itself stands for the English term for the disease (Primary Hyperoxaluria type 1) and not the Italian equivalent (iperossaluria primaria di tipo 1).

There appears to be no logic or consistency to any of this. It all seems to depend on whatever sounds better. But then languages are never logical or consistent. Perhaps that is what makes them so interesting. They are living entities and subject to conditioning and irrationality. They are eclectic (influenced by many areas), utilitarian (designed to be used) and opportunistic (they borrow where they can).