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Harvard Commentaries
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Harvard Commentaries
Reviewed by the Faculty of Harvard Medical School


What Your Doctor Is Saying What Your Doctor Is Saying
 

The Many Ways To Say 'Normal'


September 12, 2012

By Robert H. Shmerling M.D.

Beth Israel Deaconess Medical Center


When you talk with your doctor about your health and medical care, much of the discussion may focus on bothersome symptoms and concerns you have about your health.

But much of what doctors see everyday is normal, whether it's during a routine physical examination or while investigating symptoms. So, it should be no surprise that doctors use a number of medical terms to describe normal results. Learning a few of them can help decipher what might otherwise be confusing.

From Blood Pressure to Blood Sugar

When a test or measurement is normal, you may hear it described one of several ways depending on the condition under consideration. Here are a few of the most common:

  • Normotensive — This term refers to normal blood pressure, in contrast to hypertensive (high blood pressure) or hypotensive (low blood pressure).
  • Normocytic — This term means normal sized cells. It’s often used in describing anemia because it provides a clue to the cause. For example, iron deficiency tends to cause anemia with small (microcytic) red blood cells while a normocytic anemia is more common with kidney failure or diseases marked by chronic inflammation (such as rheumatoid arthritis).
  • Euglycemic — As a prefix, "eu-" means normal, and "glycemia" means "sugar in the blood." So this term means normal blood sugar, as opposed to hyperglycemia (high blood sugar, a hallmark of diabetes), or hypoglycemia (low blood sugar).
  • Euvolemia — A doctor may use this word to describe a person who has just the right amount of fluid in the body; that is, they are neither hypervolemic (too much fluid, as in heart failure) nor hypovolemic (as in dehydration).
  • Atraumatic — This means "without trauma" as the "a-" prefix means that whatever follows is absent. This term is typically used to describe a person who appears normal, without bruises or other injuries that might explain the symptoms under evaluation.
  • Afebrile — From the Latin febrilis meaning fever, this term means "without fever," as opposed to febrile (with a fever), hyperthermic (high temperature) or hypothermia (low temperature).
  • Aseptic — This term combines the prefix "a-" with "septic," which comes from the Greek word septikos and describes a rotting process that occurs when infected tissue is broken down by microorganisms (especially bacterial infections). So "aseptic" describes something that's clean, free of bacteria or not infected. Surgeons, for example, use "aseptic technique" when they scrub their hands or put on surgical gowns and gloves; the term aseptic is similar to "antiseptic," a term often used to describe soaps and scrubs that kill bacteria.

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Beyond Your Doctor's Office

Words ordinarily used in medical situations are used in normal conversation such as:

  • Euthanasia — "Eu" means good and "thanatos" means death in Greek. This term refers to the act of mercy killing or hastening the painless death of a person or animal that is suffering when death is already near.
  • Euphoria — The original use of this word was a medical one, to describe feeling comfort even in the face of illness; current use refers to elation or a heightened sense of well-being.
  • Norm, normative and, of course, normal — These terms have the same root as normotensive for good reason; all derive from the Latin, normalis, meaning "the same as others" or conformity.

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Normal Is the Norm

Believe it or not, many doctors see more healthy people than sick ones. Even people who feel unwell often turn out to have a minor illness or a temporary problem that promptly resolves. While it’s true that many doctors focus on illness, disease, and abnormal test results, a normal state is more common than we think. That's why there are so many medical terms to describe what is quite usual. (For a discussion of non-medical terms doctors use to describe normal test results, see the earlier commentary, Medical Test Results: Are You Normal, and Is That a Good Thing? )

The Bottom Line

Normal results — in whatever words your doctor uses to convey them — are almost always better than the alternative, even when they don't explain symptoms or help clarify a medical situation. (Even so, I've met many patients who were disappointed to receive normal results because it meant their symptoms remained unexplained.)

While normal results aren't rare, it is rare to have two doctors use the same language to describe them partly because there are so many ways to express the state of normalcy. Chances are good that at some point in your life you'll hear normal results from your doctor. Being familiar with these terms will help you understand what your doctor is saying.

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Robert H. Shmerling, M.D. is associate physician at Beth Israel Deaconess Medical Center and associate professor at Harvard Medical School. He has been a practicing rheumatologist for over 20 years at Beth Israel Deaconess Medical Center. He is an active teacher in the Internal Medicine Residency Program, serving as the Robinson Firm Chief. He is also a teacher in the Rheumatology Fellowship Program.

 

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