Four-letter words

Christopher Holmes
University of Tokyo Faculty of Medicine

15 March 2006

Some words you didn't study for the exams
(because everyone thinks they're too simple)


I know what you have in mind when you hear the term "four-letter word." Have no fear: you will be put at ease.
Bear in mind that quadriliteral words, so tiny, may seem easy, even flat or dull. Yet it is rare for the nonnative user to deal well with this puny part of the vast English vernacular -- even though we know full well that the four-letter word is the very soul of the Anglosaxon tongue.

"Medical English" is more than the terminology (long words from Latin and Greek, etc.); it is a foreign language, even for native speakers of English.
If non-native speakers are to master medical English, they must put the basics first: Learn to walk before you run!

WHY basics? Because basics are
Not simple,
More than terminology or vocabulary, they are also skills.

The presentation on March 15 also attempted (albeit unsuccessfully) to demonstrate a method of teaching (and of learning):

HOW? EMIT: Explanation (by the instructor) + Memorization (by students) + Imitation (by students) + Testing (by the instructor to ensure that students have assimilated new concepts correctly).
(Note: This summary omits Imitation and Testing.)

Memorization + Imitation = Activation of passive vocabulary (using words that you understand but have never used)

KEY WORDS: many, much, more, less (or fewer), than, even, also, good, poor, easy, hard.



E.g.: many (+ plural countable noun)
"Many" is used as an adjective in both affirmative and negative sentences:
"I had many chances to deliver short presentations."
"I didn't have many chances to sing." (= "I had few chances to sing.")

"Much" (+ uncountable), on the other hand, sounds natural only in negative sentences:
"I don't have much time."
"We didn't have much trouble with the procedure the second time."

So how do you express the idea of "much" with uncountable nouns in a positive sense? Answer: "a lot of..." E.g.:
"We got into a lot of trouble."
"Do you use this term a lot of the time?" (Incidentally, this has a positive sense even in the question "Don't you use this term a lot of the time?")

(Note also: Despite what is said above, "much" can be used in natural sounding positive sentences after another adverb. E.g.: "I work too much." "She likes him very much.")

The restrictions on the usage of "much" as an adjective apply also to "much" as an adverb.
"She doesn't perform cardiothoracic surgery much."
"I haven't seen that word used much by doctors."

I like "a lot" a lot. "A lot" can be used as an adverb naturally, flexibly, and easily, in both negative and affirmative sentences:
"I don't drink a lot, but I do talk (a lot!)."
"We all admire him a lot, but not one of us envies him."

MORE & LESS (+ uncountable nouns [volume, not number])

"Now they give me more work but less money."
"Having given it more thought since then, I have less enthusiasm for the idea than before."

MORE & FEWER (+ countable nouns [number, not volume])

"I want more perquisites and fewer responsibilities."
"The world needs more Macs and fewer PCs."


Which of the following is better?
"It is better to give than to receive."
"To give is better than to receive."
"To give is better compared to to receive."
"To give, compared with to receive, is better."
"Giving is better compared with receiving."
"Compared to receiving, giving is better."
"Comparing receiving and giving, the latter is maybe better."

How to use "than":
Omit needless words. (Rule 17 from The Elements of Style)
Keep related words together. (Rule 20)
"More people are put to death in Texas than in Japan."
"Beef is cheaper in Texas than in Japan. So is human life."

EVEN MORE about "more"

Further degrees of comparison

What's more than "better (or more or bigger) than"?
Answer: even better, yet more


"Also" is shorter than "moreover." It is also more common.
"Also" sounds more natural than "moreover." It is also shorter.
"Also" is found more often in real English than "moreover." It is also less stuffy. (Stuffy means affected.)
"Also" is a better word than "moreover." It also gives a better impression.
(It's a pity it isn't long enough to impress the people who write English proficiency exams in Japan.)

Knowing what "easy" and "hard" mean is easy.
What's hard is knowing when to use them and when not to use them.

Don't say: "I'm easy" or "I'm hard"!

Instead, say:
"I am at ease." "I am uncomfortable."

But you can say:
"I'm easy to get along with."
"He's hard to deal with."
"Make your writing easy to read and hard to criticize."


Even some good students don't realize that "good" has several meanings.
Many Japanese students think the only opposite of "poor" is "rich."
"Good writers should never write poor English."
"Many good people are poor."
"Many evil people get rich by robbing the poor."
"Why shouldn't you want to take my good advice?"
"Book learning is a poor substitute for experience."

BOTTOM LINE: Beginners must master the basics to write and speak natural-sounding English. It is not hard, it is easy, and it is also a good idea.

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