Answer: "Hospital" and "Surgery" in American/British English

[chomiji]

debirlfan asked us "What are the rules for American versus British usage for 'hospital' and 'surgery'?

It's true that British usage on these common medical terms differs from what's encountered in the United States. We'll take a closer look at how these words work.

Interestingly, the fathers of two of the core cast of the manga and anime Bleach are doctors. Protagonist Ichigo Kurosaki's father, Isshin Kurosaki, runs a small private clinic that bears the family name, but Uryū Ishida's father, Ryūken Ishida, runs the town's main medical facility, Karakura Hospital.

Bleach, translated by U.S. publisher Viz, uses U.S. English:

"Yasutora-kun asked me to call you," said Dr. Ishida. "Because he's in the hospital."

Dr. Kurosaki's office was officially open from 9 in the morning until 5 in the evening, but in fact, he saw people at all sorts of times for emergencies.

The usual way of expressing these ideas would be slightly different in British English:

"Yasutora-kun asked me to call you," said Dr. Ishida. "Because he's in hospital."

Dr. Kurosaki's surgery was officially open from 9 in the morning until 5 in the evening, but in fact, he saw people at all sorts of times for emergencies.

"In Hospital" vs. "In the Hospital"

Let's look at the usages for "hospital" first. The U.S. usage requires the use of the article "the," but the British usage doesn't. For those of us accustomed to the American usage, this may seem odd, but in fact, there are a number of U.S. terms that work in the same way. For example:

"Of course I didn't notice you weren't around the house today," snapped Karin. "I was in school!"

On the other hand:

Ichigo realized, to his horror, that a Hollow was manifesting in the hallway. He had never imagined something like that would actually happen in the school.

The way "school" is used in these examples parallels the British usage for "hospital." In the second example, in school could have been used, but then the implication would be slightly different: that would have meant that Ichigo was incredulous about the idea of a malicious spirit showing up at any school, anywhere. In the example as given, he's surprised that the malevolent being has show up at his school ("the school") in particular.

The British use of "in hospital" versus "in the hospital" has a shade of meaning that the U.S. usage doesn't have in that it refers to the subject's condition. "She's in hospital" means something like "She's ill enough that she's been hospitalized," whereas "I saw her in the hospital" could be because "She's visiting someone in the hospital" or "She works in the hospital."

If you usually use U.S. English and want to make sure your use of "hospital" conforms to British use, you can try substituting "school" for a moment, to check whether you've got the correct phrasing. Other examples of similar usage in the U.S. are "in prison" – "Kira couldn't have committed that crime: he's in prison" – and "in college" – "Dr. Kurosaki was still unused to the idea that he now had a kid in college." In both cases, the implication is a little more than that the person is in a particular location: it says something specifically about their status in the world as well, as a detained prisoner or as an enrolled college student. Similarly, the British use of "in hospital" means that the person in question needs a hospital's around-the-clock medical attentions.

Surgery or Doctor's Office?

In the United States, "surgery" usually refers to the work performed by the type of medical specialist known as a surgeon, who performs operations involving cutting and stitching the patient's body. "A surgery" would mean "a surgical operation," although the term is almost always used with an adjective specifying what type of operation:

Before Dr. Ishida became the director of Karakura Hospital and turned his talents to administration, he had performed hundreds of abdominal surgeries.

Still, "operation" would be a far more common term to use.

In the United Kingdom, on the other hand, a "surgery" is the facility in which a doctor performs medical procedures ranging from examinations to X-rays to minor surgical operations, such as stitching a small cut or burning off a wart. The equivalent to the U.S. "office hours" for a doctor can be "surgery hours" (but more often "consulting hours"), and in the United States, such a facility is usually called a "doctor's office":

"Kurosaki-kun," said Dr. Ishida, "I can spare you a surgery visit in about 15 minutes."

"Surgery!" Ichigo was startled. "No one said anything about an operation!"

Dr. Ishida closed his eyes briefly and sighed. "What I meant, young man, was that I will be available to see you in 15 minutes in my office for an examination of those strange symptoms you mentioned!"

The reason to be concerned about these differences is that the wrong usage can throw your reader out of the story. If you have a British character, try to make sure her language sounds British when she discusses the medical situation, and do the equivalent for a scene set on the other side of the Atlantic with a U.S. character. And while we're at it, I may as well note also that when victims of a shooting or a road accident end up at the hospital via ambulance, they're taken to the "A&E" ("Accident and Emergency") or to "Casualty" in England but to the "Emergency Room" (or Suite or Department) in the United States.

Sources

• Week 3 Module 2 Lesson 2.4 National Identity: British and American English (Leeward Community College, University of Hawai'i)
• British and American terms (Oxford Dictionaries)
• ‘At hospital / In hospital / In the hospital (forums, WordReference.com)
• Come to set (Language Log, University of Pennsylvania)
• If a British Doctor Invites You to ‘Surgery,’ Should You Be Worried? (BBC America)
• Selected Vocabulary Differences Between British and American English (Boston University; sadly, this is an orphaned page, and its useful-looking linked siblings are gone)
• Surgery (Cambridge Dictionaries Online)

 

Comments

[pepper-field.livejournal.com]

FWIW, in the UK, it tends to differ between hospitals vs. general practice (i.e. your local doctor, within the community - are they called GPs in the US?). If you work in a hospital and are trying to track down a consultant, you often get told "They're in clinic", or "They've got clinic on Mondays". This is the session when their patients come in to discuss their illness and the treatment options, some minor treatments are given, etc - basically, the thing that House is avoiding when he says "This is Vicodin. It's mine. You can't have any. And no, I do not have a pain management problem, I have a pain problem. But who knows? Maybe I'm wrong. Maybe I'm too stoned to tell. So, who wants me? [nobody moves] And who would rather wait for one of the other two guys? [Everybody raises their hands] Okay. Well, I'll be in Exam Room One if you change your mind."

We wouldn't call that a "surgery", probably because, in hospital, actual surgery is a distinct possibility and so the likelihood of confusion is greater. If I was trying to find a consultant and was told "They're in surgery", it would be because they were a surgeon and were currently cutting someone open.

I think "clinic" has the same useage in the US, but I could be wrong...?

Whereas everyone refers to "GP surgeries" for the same thing but in the community. "Surgery" in this case refers to both the place ("My GP surgery address is...") and to the session ("My GP holds surgeries at 8am").

Just to add a further level of confusion. ;)

(Knowledge from: I work in a hospital in the UK and a lot of my day is spent trying to track down consultants, only to be told they're in clinic.)

[chomiji]

All this terminology is constantly evolving.   :-)

In the U.S., a "clinic" is a much smaller sort of business than a hospital. It may be a regular, free-standing operation. For example, the "Health Unit" at my workplace could be called a "clinic": it provides 'flu shots, allergy shots, dietary counseling, weigh-ins for those trying to lose weight, and even has an actual doctor a couple of afternoons a week; otherwise, the services are provided by Registered Nurses.

A "clinic" can also be a one-time or periodic temporary event: "The Health Unit will be holding a Glaucoma Screening Clinic next week," for example.

I see that you use "clinic" the way that I expect a person from the U.K. to use "hospital." In the U.S., I'd expect "a clinic" or "the clinic": "That's a nasty cough. Better run down to the clinic and see whether they'll prescribe something."

Although it's certainly possible that some U.S. hospitals refer to the time when the doctors will see walk-in patients as "clinic," I'm much more accustomed to hearing that as "office hours," as opposed to being "on call" at home, for emergencies, or "on shift" or "in surgery" at a hospital: "Dr. Slater will be in surgery Tuesday and Thursday afternoons; her office hours are Monday, Wednesday, and Friday, nine to four-thirty. She is on call, for emergencies only, after hours and on the weekends."

I have heard of a doctor in a larger U.K. facility (a high-quality nursing home, in this case) referring to a medical exam as a "surgery visit," meaning that the patient would visit the doctor's examining room for a full physical workup.

Most of my U.S. hospital knowledge is from being a member of a family with multiple serious health issues, requiring that I spend a lot of time in a variety of hospitals, either as next of kin or a patient myself. Actually, nowadays, a lot of the less invasive procedures are performed in "outpatient surgery centers" or other clinical settings, especially in high-population areas like mine. You have your op or other under-anesthesia procedure (e.g., colonoscopy) and are sent home for recovery.

[azure-chaos.livejournal.com]

With regards: I see that you use "clinic" the way that I expect a person from the U.K. to use "hospital."

Clinics are held in a hospital by specialist departments (they're never walk-ins always by appointment/referral only - the only exception to this is the audiologist who will take walk-ins for people needing batteries changed in hearing aids lol).

Example:
"I've got a hospital appointment," John told Sherlock.

"Oh really? Who with?" Sherlock asked, trying to sound like he was interested.

"The eye clinic."

You'd never say "I have a clinic appointment," but you might say "I have an appointment for the eye clinic at the hospital," and you could also say "I have an appointment for Mr Ball's clinic," when booking in at the hospital (or simply, "an appointment with Mr Ball" but often you don't get to see that consultant but one of their team that works in their clinic). Note: He's "Mr" Ball because he's a consultant (though some consultants still like to be called Dr, they just all like confusing us, I think).

It's not always that simple though, sometimes the 'clinic' is dropped/implied.

"I've got a hospital appointment," John told Sherlock.

"Oh, really? Who with?" Sherlock asked, trying to sound like he was interested.

"It's with ENT." [Ear, Nose & Throat]

That's on top of the example pepper_field gave.

"Where's Mr Ball," Sherlock demanded impatiently as he glared at the man's secretary.

"He's in clinic until 2. And he won't see you without an appointment."

And to add further confusion about the use of 'surgery', when Members of Parliament hold consultations in their local areas (constituency) they call it a 'surgery' too. So "John Doe MP holds a surgery on the first Monday of every month."


I have a feeling that I may have just made things even more confusing. lol.

[chomiji]

:D

I expect that there are lots of specialty uses like that. In the U.S., the sub-unit of a hospital that specializes is almost always called the [Specialty] Department (for example, the Radiology Department) or, if it involves inpatients, the [Specialty] Unit (foe example, the Cardiology Unit ... I guess that would be the Cardiology Ward on your side of the pond?). And as you said for the U.K., it can also just be called by the name of the specialty: "You'll find her up in Oncology."

In the U.S., the term "clinic" now sometimes extends to other opportunities to consult with experts and maybe get things repaired: a "sewing machine clinic," for example, or a "computer clinic."

[azure-chaos.livejournal.com]

Yeah, Radiology is usually 'department'. Unit vs Ward, there seems to have been a shift in recent years to unit for some things. Like you'll have Surgical Ward but High Dependency Unit, Cardiology seems to be one of those that's shifting to unit, at least in my observations, actually I think the one near me goes by "Cardiac" unit. Intensive Care in some places has become ITU (intensive therapy unit). And, as you say, there's always the fact that sometimes we're too lazy to say even department/unit/ward and it just becomes the name of the specialty, "Mr Jones is in Cardiology" vs "Mr Jones is on the cardiology ward/unit" (oddly I've not see that used where it's 'cardiac' so I would wonder if it's mostly an '-ology' thing). And of course, it's not always 'pathology' but sometimes the 'path-lab' where we go to get our blood tests done. lol.

I've seen that use of clinic here too, for computers at least.