Hold Infinity in the palm of your hand: Amniotic band syndrome

Amniotic band syndrome. Picture source: By Moscowmom – Own work, Public Domain, https://commons.wikimedia.org/w/index.php?curid=10953831

To see a world in a Grain of Sand,
And a Heaven in a Wild Flower,
Hold Infinity in the palm of your hand,
And eternity in an hour.

William Blake

This is what your hand looks like if you’re born with amniotic band syndrome.  The thought is that it happens when there’s a partial rupture of the amniotic sack and the hand gets caught up in it.  It’s supposed to be purely mechanical.  But: amniotic band syndrome often co-occurs with other congenital anomalies that aren’t even possibly remotely mechanically related, such as cleft lip and cleft palate.  This leads to another theory about where amniotic band syndrome comes from, which is that it’s related to some kind of circulatory disorder that can affect both the digits and the developing palate.

In a region where people don’t typically get very much education and the most common way of supporting yourself is manual labor, a person who isn’t treated for this congenital defect can pretty easily find themselves in a life of poverty without an obvious way out.  That means a childhood of poverty for their kids, too.  That’s a lot of suffering.

You might be thinking: having amniotic band syndrome would suck, but there’s nothing that I can do about all of those little kids who are born with it.  I’m happy to tell you: that’s not true!

There’s a group called Surgicorps that goes to various and sundry places around the world to do free surgeries for the most destitute of the destitute.  There are lots of groups like that, but there’s something special about Surgicorps: they have a hand surgeon.  The goal of surgery for something like amniotic band syndrome is to restore function to the hand.  Doing this is difficult, and requires a lot of very specialized training–the Surgicorps hand surgeon did fellowships in both plastic surgery and orthopedics.  (For doctors, a fellowship is advanced training that you do after your residency if you want to develop very specialized skills.  A fellowship can easily be five years long, and that’s on top of four years of college, four years of medical, and a three-year residency.)

Where you fit into this: Surgicorps does its work entirely on the basis of donations.  The surgeons, anesthesiologists, nurses, technicians, interpreters (I’m one of them), and others all donate their time, pay for their own travel expenses, and pay for their lodging.  Surgicorps pays for all aspects of the patients’ treatment–the surgical equipment and supplies, housing for the parents while the kid is hospitalized afterwards, the anesthesia, medications–everything.  That money comes from charitable donations.

That’s where you come in!  In the days to come, I’m going to hit you up for a donation.  I’ll tell you more about what Surgicorps does, tell you about some of the people we treat (within the bounds of privacy), and try to give you a bit of the feel of what it’s like to be in Guatemala.

Language stuff: I work closely with our hand surgeon, which means that I need to know a lot of terms related to the kinds of feelings that you might have in your hands and fingers.  Here are some of those words, in English, Spanish, and of course French.  Scroll down past them for notes on the English in this post.  Spoiler alert: in the English section, I’ll be talking about the verb to cleave, the noun digit, and the idiom to come in.

English Spanish French
numb entumido, entumecido engourdi, insensible
sleepy/numb adormecido
itchy hormigoso qui démange, qui gratte
tingly corrientazo qui picote
  • cleft: this is the past participle of the super-interesting verb to cleave.  What’s cool about to cleave: it is its own opposite.  That is to say: it has two meanings, and they are each other’s opposites.  (Quotes from http://www.quotationspage.com, http://www.brainyquote.com, http://www.mechon-mamre.org, Jewish Publication Society, and http://www.sattor.com.)
    • One meaning of to cleave is to forcefully split something, or (intransitively) to split, especially along a natural line.  This is the origin of the name of the kind of heavy knife called a cleaver
      • One swallow does not make a summer, but one skein of geese, cleaving the murk of March thaw, is the Spring.  Aldo Leopold.
      • Hamlet thou has’t cleft my heart in twain.  Shakespeare, Hamlet.
      • I tend to foster drama via bleakness. If I want the reader to feel sympathy for a character, I cleave the character in half, on his birthday. And then it starts raining. And he’s made of sugar.  George Saunders. 
      • When I was at Babbo, I was covered in scars and scabs and burned bits – melted hair, ribbed burns I got reaching across the top of a hot skillet… I sliced off the tip of my finger. I cleaved my forehead – a deep, ugly wound. Luckily, it regenerated.  Bill Buford
      • Like Honeycrisp, SweeTango has much larger cells than other apples, and when you bite into it, the cells shatter rather than cleaving along the cell walls, as is the case with most popular apples. The bursting of the cells fills your mouth with juice. Chunks of SweeTango snap off in your mouth with a loud cracking sound.  John Seabrook.  (This is the intransitive use.)
        Cupid’s arrow, Hafiz’s heart tore and cleaved
        I see his verses, with their wet ink, bleed. 
        Khajeh Shamseddin Mohammad Hafiz Shirazi
    • The other meaning of to cleave is to stick to something.
      • Cleave to no faith when faith brings blood.  Arthur Miller, The crucible. 
      • She counted to ten as she had been taught when about to deliver a big speech, but when she tried to force some words of outrage from between her teeth her tongue clove to the roof of her mouth and the most she could do was make a small cry of protest deep in her throat. (British National Corpus.  Like that past tense?  J’adore!)
      • We all are originally sinners as Adam and in Adam, his leprosy cleaving faster to us than Naaman’s did to Gahazai, so that even the infant, before it has seen the light of the world, has this blemish inherent in its unborn members.  John Wycliffe.  (A little language/interpretation connection: Wycliffe Bible Translators, the biggest Bible-translating group in the world, is named after John Wycliffe.)
      • Therefore shall a man leave his father and his mother, and shall cleave unto his wife, and they shall be one flesh.  God, Genesis 2:24.
         תִּדְבַּק-לְשׁוֹנִי, לְחִכִּי–    אִם-לֹא אֶזְכְּרֵכִי: Let my tongue cleave to the roof of my mouth, if I remember thee not.  Psalms 137:6.
    • I ran into this example in the British National Corpus, and I have no idea whatsoever what it means: The horse shied a little and the butt cleaved into the side of my head, almost taking my ear off.
  • digit: you know that this can mean a number, but it can also mean a finger or toe.  From the post: This leads to another theory about where amniotic band syndrome comes from, which is that it’s related to some kind of circulatory disorder that can affect both the digits and the developing palate.
    • Painful, rapidly growing tumor in the subungual area of the first digit of the right hand.  Perelló-Alzamora et al.
    • Surgical amputation of the digit: an investigation into the technical variations among hand surgeons.  Li et al.
  • to come in: this idiom has a few meanings.  Here’s the definition for the way that I used it, from Merriam-Webster: to assume a role or function <that’s where you come in> From the post: That’s where you come in!  In the days to come, I’m going to hit you up for a donation.


Dictionaries and sexism

One day a friend and his wife dropped by my office to share the good news that they’d just seen an ultrasound of their baby-to-be.  They didn’t speak English, so we spoke Spanish.  Is the baby a macho or a hembra?, I asked-a boy, or a girl?  My friend and his wife cracked up (American English for “started laughing hard,” although it can also mean “to go crazy”–be careful).  It turns out that macho and hembra are used only in what you might think of as a biological sense–that is, to refer to male or female animals.  A baby boy or baby girl human is a niño or niña.  There’s a similar set of words in French for describing biological sex, as distinct from gender, and that set of words can come in handy. We’ll see more on this below, but first some big-picture issues.

Most dictionaries today are descriptive, rather than prescriptive, meaning that their goal is to describe how language is used, rather than to try to prescribe the way that the editors think that it should be used.  With that goal in mind, what should the editorial stance be towards the ways that language reflects society, and in particular, shitty things in a society–say, sexism in America and the United Kingdom?  Here’s an article on the subject from the New Yorker, and if you like it, be sure to follow the link in it to Deborah Cameron’s article–she is an amazing linguist.  (Full disclosure: I took sociolinguistics from her as an undergrad.  Favorite quote: “Well, that rather fucks the theory up, now, doesn’t it, Kevin?”)


Relevant French vocabulary, with a quote from the French Wikipedia page on sexism:

Le sexisme est une attitude discriminatoire adoptée en raison du sexe.

La critique du sexisme dénonce l’idée selon laquelle les caractéristiques différentes des deux genres masculin et féminin impliqueraient l’attribution de rôles, droits et devoirs distincts dans la société. Elle dénonce cette construction de la société qui attribue un caractère, un rôle, des prédispositions physiques et affectives selon le sexe. La notion de sexe n’est alors plus une notion de sexe biologique (mâle et femelle) mais une construction sociale du genre féminin et du genre masculin limitant par là même le développement de l’individu sur les plans personnel, affectif, professionnel et social.

  • dénoncer: to denounce or condemn; to back out of, to renege on.
  • le devoir: duty, obligation; homework, assignment.
  • affectif: emotional.
  • le mâle: male, in a biological sense.  Slang: studmuffin.
  • la femelle: female, in a biological sense.  Slang: bitch.

None of this stuff is simple or straightforward. As a sociolinguist once said to me: if a language reflects sexism, homophobia, or whatever other nastiness, that’s data. The claim of some of the people interviewed in the article is that when a lexicographer includes sexist language in a dictionary, they’re not just describing it, even if they think that that’s what they’re doing–they’re endorsing it. A good descriptive lexicographer would protest against that claim–see this recent post. How does the person on the street see it? Is the interviewee right in asserting that people perceive the dictionary as an authoritative stamp of approval on the language, rather than seeing it as descriptive of the language, like the lexicographer does? That’s an empirical question, and I don’t know the answer. If you go out and do a survey on this, please let the rest of us know the result…

It’s tough to be dispositive about dispositif

In which a French word means nothing like the English word that it looks like, and I remain puzzled even after looking it up.

dispositif?” Read this post and you’ll see why it strikes me as funny. Picture source: cover of the book by Giorgio Agamben.” The title of the book means “what is a dispositif?” Read this post and you’ll see why it strikes me as funny. Picture source: cover of the book by Giorgio Agamben.

In France, I often ran across the word dispositif, but somehow never got around to looking it up.  I see now why I had trouble even guessing at its meaning–besides looking like an English word that it has nothing in common with semantically, it has a number of quite different meanings.  Here’s how it showed up in an email at work one day:

Nous avons commencé une expérience sur la collaboration et cohabitation des deux utilisateurs dans un même dispositif immersif (EVE) et on cherche toujours des participants.

In the context of where I work, it’s likely that the intended meaning is a “device, machine, apparatus,” as in this example from WordReference.com: C’est un dispositif de chauffage très perfectionné “It’s a very sophisticated heating device.”

If you’re talking about the police or the military, it would translate as “presence,” as in this example from WordReference.com: L’Etat a prévu un gros dispositif policier pour le prochain G20 “The government has organized a significant police presence for the next G20.”

It can also mean “plan.”  Here’s an example sentence, again from WordReference.com: Le dispositif de défense aérienne est revu tous les ans “The air defense plan is reviewed every year.”

The meanings can be more diverse than that, though, including things like “measures,” “system,” and others.  Here are some examples from linguee.fr:

  • Pour les véhicules équipés d’un dispositif antiblocage…  For vehicles with anti-lock systems… (Source: europarl.europa.eu)
  • Le Fonds monétaire international (FMI) participera au dispositif de financement et devrait fournir un montant correspondant à la moitié au moins de la contribution de l’UE.  The International Monetary Fund (IMF) will participate in financing arrangements and is expected to provide at least half as much as the EU contribution. (Source: consilium.europa.eu)
  • Ce sera probablement la mise en place d’un véritable dispositif de financement This will probably entail setting up a real funding scheme.  (Source: rencontres-montblanc.coop)

So, what’s the English word that I was confusing this with?  Dispositive.  Something is “dispositive” if it brings something to a resolution–it “disposes” of the issue, in essence.  Here are some examples from the enTenTen corpus (19.7 billion words of English):

  • The dispositive issue in these cases, simply put, is whether, for purposes of allocating its finite resources, a state has a legitimate reason to differentiate between persons who are lawfully within the state and those who are unlawfully there.
  • First, particularly in a highly hierarchical employment setting such as law enforcement, whether or not the employee confined his communications to his chain of command is a relevant, if not necessarily dispositive, factor in determining whether he spoke pursuant to his official duties.
  • To the recently admitted student: embrace your cultural heritage, and know that test scores and GPA were not dispositive factors in your acceptance.
  • One data point is not dispositive.
  • The Court found it dispositive, for instance, that 1-40-121 did not regulate candidate elections, and that the risk of corruption so prevalent in such elections was minimal in the initiative context.

Zipf’s Law as applied to the vocabulary of pizza

When people visit me in Paris, they’re always surprised to see a wide variety of non-French restaurants—Chinese take-out abounds, as does Thai and Indian food.  The same is true here in Guatemala—the restaurants include a Mediterranean place, a Mexican place, a Korean tea house, and some really amazing bakeries.  My first meal in Guatemala this time was at a pizza joint that some of my coworkers like.  Zipf’s Law affects the vocabulary of pizza as much as the vocabulary of anything else.  Here are the words that I had to look up in order to understand the very first, most basic pizza on the list:

  • rodaja: a round slice; also a disk or a caster.
  • albahaca: basil.

There’s an excellent Guatemalan restaurant in town called Tres Tiempos.  I spent an evening there eating tamalitos and a sort of Guatemalan hotdog and looking up the words on the menu.  How could repollo possibly not mean “chicken”??

  • repollo: cabbage.  You probably learned the word col—so did I.  Don’t know where this one comes from.
  • rebozado: battered.

Incidentally, if you’re into language and you’re into food, you will want to check out Dan Jurafsky’s latest book, The Language Of Food: A Linguist Reads The Menu.  Dan received a MacArthur Genius Grant for his fascinating work in natural language processing, and his talk on ketchup at a NAACL meeting is probably most people’s favorite keynote speech ever.  If you start out at smile.amazon.com, you can donate part of the purchase price to Surgicorps.

The hand surgery screening interview in Spanish

The first day of a Surgicorps visit to Guatemala is taken up with screening all of the people who show up hoping for surgery for their children or themselves.  The surgeons and anesthesiologists are quite heroic, and will see everyone who shows up.  (People also trickle in through the back door all week—I haven’t seen the surgeons refuse to examine anyone, regardless of whether or not they come on the mass screening day.)  Some people are there from early in the morning until deep into the evening, waiting in line with their little children, or elderly mother, or just themselves, undoubtedly hungry and anxious about the outcome of the screening.  Similarly, the physicians mostly skip lunch and work until everyone has been seen.  It all makes for an intense day, and for the interpreters, it’s the busiest day by far, as well as the most unpredictable one in terms of what you’ll need to interpret about.

I prepped for this trip by focusing on the vocabulary of hand anatomy and hand surgery, and had the good luck to end up working with the hand surgeon on intake day.  I enjoyed working with him last year, in part because he’s as kind, patient, and sweet as you can imagine a person being, and in part because after a patient described what he was there for, the hand surgeon would almost always begin his response with “We can make this better,” and I LOVED translating that—every time I translated it, I felt less crushed by the weight of all of the pain and deformity around us and more buoyed by the possibility that people’s lives would be improved by our visit to Guatemala.  Despite my preparation, I had to learn to translate nine English words into Spanish, and one Spanish word into English, plus two more Spanish words or expressions into English when I got finished with the hand screening and moved into the anesthesia screening room.  These words are notable in that the list contains not just one, but two, counterexamples to the “one context, one meaning” hypothesis, which claims that ambiguous words are not ambiguous if you can establish the context in which they are being used:

  • rotate: hacer girar.
  • espina: thorn.  This came up in the context of a patient explaining that he had embedded a thorn deep into his hand.  It also turns out to mean “spine,” in the anatomical sense.  So much for the “one context, one meaning” hypothesis.
  • stabilize: estabilizar.  This was a tough one—it’s not even in my dictionary, and I had to go home and check WordReference.com to find it.  Related word: estable “stable.”
  • claw: so, this is a really tough one.  There are four (four) nouns that translate the English noun claw, and three of them have come up so far this week.
    • Pinza is a claw like a crab or lobster claw.  This one came up in the context of “claw deformity”—we saw a couple of patients with claw deformities of the hand (see photo, from Tumblr).tumblr_lymznxfkf11r8vrhxo1_500
    • Garra is a claw like an eagle’s claw or a lion’s claw.  This one came up in the context of giving instructions for a hand therapy exercise.
    • Uña is the nail itself—this one came up in the context of a woman who wanted her toenails removed.  (Long story—they did need it.)
    • Finally, there’s another word, zarpa, that I haven’t figured out how to use yet.

    So much for the “one context, one meaning” hypothesis, once again!  Note that the previous example was ambiguous in the direction of Spanish to English, while this one is ambiguous in the direction of English to Spanish.

  • deformity: la deformidad.
  • ayuno: fasting.  Related expressions, which did come up later, over the course of the week: en ayunas or en ayuno (yes, the gender is different): “fasting,” or “before breakfast.”
  • trompa: in the context of anatomy, a duct or tube.  Trompa de Falopio: Fallopian tube.
  • hormigoso: ant-like; full of ants; ant-eaten; or, in this context, itchy.
  • cosquilloso: ticklish.
  • buzz: zumbar.
  • dissolve: disolver.

If you’ve read this far: how about a donation to Surgicorps?  It’s a wonderful group that does great work.

“Dialect” means pretty different things in English and Spanish

One of the first lessons of Linguistics 101 is: “Everyone speaks a dialect.”  We all come from somewhere, we all belong to some social class, we all have some gender, and all of these—plus many more things—affect our language.  To a linguist, there’s no such thing as a “standard” dialect any more than to a surgeon there’s such a thing as a “standard” anatomy—everyone varies.  To a linguist, there’s no real difference between a language and a dialect—as the redoubtable Ilse Lehiste put it, “A language is a dialect with an army and a navy.”

To a linguist, the term dialect generally refers to a form of language that is associated with a particular geographic area.  Although the terminology varies from linguist to linguist, we have other words for varieties of language associated with particular social groups (sociolect), people who share very specific activities (jargon), levels of formality and specific social contexts (register), and so on.  How you will speak at any given time is an interaction between the tendencies of your dialect, sociolect, the register, and so on.

Back to dialect: there is a cognate term in Spanish, but the denotation is quite different.  In Spanish, dialecto typically refers to an indigenous language.  As one of our surgeons, a native speaker of Spanish, put it the other day, referring to a patient in the recovery room: “even though I speak Spanish, I don’t understand him, because he speaks a dialect.”  This was a patient who spoke one of the indigenous languages of Guatemala.  Most of these languages belong to the Mayan language family.  There are about 29 Mayan languages, of which 21 are spoken in Guatemala by the large indigenous population—about 70% of Guatemalans are native.  (The rest are called Ladinos.)  The Mayan languages are about as similar to or different from each other as English and German or Spanish and French.  Patients who speak one of these languages and don’t also speak Spanish must bring someone who can interpret between their language and Spanish, and then one of the Surgicorps interpreters interprets between Spanish and English.  I’ve seen four patients like that so far in the past three days.

This leads to the question: if the Spanish word dialecto means an indigenous language, how do you say “dialect” in Spanish?  I don’t know the answer.  The Spanish Wikipedia page for dialecto discusses it as a technical term in linguistics, with the same basic meaning as the English sense.  (Note that as is the case in English, there is sometimes a large difference between the technical meaning of a term and the meaning of that term in the general language.)  There is a Spanish term jerga that translates roughly as “jargon.”  The Spanish Wikipedia page for jerga distinguishes it from “dialect” in that a jerga is associated with a social group or a profession, and is used either to obscure communication with out-group members (slang) or to enhance communication on technical subjects (jargon).  The search continues.

Guatemala is funny if you’re Bulgarian, but maybe not otherwise

Arrived in Guatemala Saturday morning after two flights spent obsessively studying medical vocabulary and reading about health care interpreting.  I almost made it out of the airport without having to check a dictionary, but Zipf’s Law humbled me in baggage claim, i.e. before I even made it out of the airport.  Oh, well.

Getting to Antigua involves about an hour and a half drive.  Much of it is through Guatemala City and its suburbs.  The road is pretty much solidly lined with small businesses, many of them with hand-painted signs–Guatemala City has some very, very low-income, rough areas.  (In general, travellers are advised by guidebooks to just stay out of Guatemala City and go somewhere else.)  I amused myself on the drive by taking pictures of words that I don’t know—there were far more such words than I could capture on my cell phone camera.  Probably the most linguistically interesting was a huge advertisement for vaginal suppositories that was notable for the fact that it used a vosotros verbal form, which you don’t often see north of here (I don’t, anyways).

  • faja: This was the word for the thing that your baggage comes in on–more specifically, faja de retiro de equipage (baggage claim carrousel).  Faja has a variety of meanings in my dictionary, none of which is “carrousel.”  They mostly have to do with things that go around something–sash, girdle, bandage, newspaper wrapper. 2014-08-09 13.50.10
  • cuota: I think this was meant (see photo) in its sense of a fee or dues.  It can also mean a quota or share of something, as well as a tuition fee.2014-08-09 14.31.01
  • capilla: An interesting word, and I don’t know how to interpret it in this case (see photo).  One meaning is a chapel.  However, my dictionary says that another is a “death house”—I’m not sure what that actually means, but I think it has something to do with people who have been condemned to death.  There are additional, quite different meanings, and each of these has related words and expressions:
    • hood, cape: a related word is capillo, meaning a baby cap, a baptismal cap, a hood, a cocoon, or a cigarette filter.  Note that this is an example of two words that differ only in gender and have different meanings.
    • death house: an expression related to this meaning is estar en capilla, which can mean “to be in the death house,” but also “to be on pins and needles.”
    • chapel: a related word is el capiller, a churchwarden or sexton.
    • proof sheet: not sure where this one comes from, and I don’t know of any related words.2014-08-09 14.31.47
  • almacén: I knew this word in its sense of “warehouse,” but it turns out that it can also mean store or department store, which was probably the intended sense here (see photo).2014-08-09 14.36.10
  • ladrillo: a brick or tile. 2014-08-09 14.46.46Why Guatemala is funny if you’re Bulgarian: Guatemala is a mountainous country with lots of curvy roads.  Curvy roads are marked with the word curvas (curves).  It will immediately be obvious to you why this is funny if you’re Bulgarian, or, indeed, from any Eastern European country that I’m aware of, Slavic-speaking or not.  If you’re not Bulgarian: it’s not blog-appropriate, so write to me if you want the joke explained.


Today’s headlines in Guatemala

According to Wikipedia’s page about Guatemalan newspapers, the most widely read paper in Guatemala is Nuestro Diario.  Let’s see if I can make it any further in this paper than in a French newspaper… Nope, can’t even get past the headlines.  Let’s see what new words Zipf’s Law brings us today.  Nuestro Diario is a tabloid, so not surprisingly, the headlines are all about violence and Miss Teen Guatemalan Mayan.

  • baleado: shot down, shot dead.  Headline: Baleados en la terminal.
  • arrollado: mown down, swept along, dragged underneath.  Headline: Mueren dos hombres arrollados por camión en Guanagazapa.

The anatomy of the hand in Spanish

I can make it through the first sentence of the Spanish-language Wikipedia page on hand anatomy, but by the second sentence, Zipf’s Law strikes…  Here are the first two sentences:

Las manos forman parte de las extremidades del cuerpo humano, siendo el cuarto segmento del miembro superior o torácico, están localizadas en los extremos de los antebrazos, son prensiles y tienen cinco dedos cada una. Abarcan desde la muñeca hasta la yema de los dedos en los seres humanos.

  • abarcar: in this context, to span.
  • yema del dedo: fingertip.  Other meanings of yema: talking about eggs, it’s the yolk; talking about plants, it’s a bud or a shoot.


The risks of hand surgery

Informed consent is important anywhere that you practice.  Getting informed consent includes explaining the risks of the surgery to the patient.  Zipf’s Law applies to the vocabulary of surgical risk, of course (although I don’t know if it applies to the actual adverse effects themselves or not).  Here are some words that come up in the discussion of risks of hand surgery on this web page about hand surgery:

  • conllevar: most of the meanings are in the area of entailing or bringing (as in power bringing responsibility), conveying or carrying (as in a feeling), or implying or involving.  Another sense is to bear or put up with.  La mayoría de las cirugías conllevan los riesgos de la anestesia y de hemorragia.
  • la sensibilidad: feeling, sensitivity.  Pérdida de sensibilidad o movimiento de la mano o los dedos.
  • coágulo: clot, blood clot.  Pueden formarse coágulos de sangre.




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