Dr. Phillips is a Professor of Radiology, Director of Head and Neck Imaging, at Weill Medical College of Cornell University, New York–Presbyterian Hospital, New York, NY. He is a member of the Applied Radiology Editorial Advisory Board.

A few years back, I wrote a little blurb about saying something was “normal.” Perhaps you remember… Okay, so you don’t remember, but it was about how you can call something normal, but people always seem to want you to comment on just one other MAJOR item that concerns them.

“Yes, that CT is normal, and, no, by the way, there is no hemorrhage.” That always seemed part of “normal” to me.

Well, it seems that normal no longer has the clout it once had. I’ll bet you that normal is pretty perturbed about all this. I was talking to normal just the other day.

“Dude, it seems you’ve become pretty meaningless.”

“Well, Doug, aren’t you just a ray of sunshine. I prefer to think of it as more focused.”

“No, normal, I’ll tell you this, you’re getting pretty much impossible to use any more. I’m looking for other friends.”

I’ll tell you who has made normal no longer of consequence as a word, or likely as a concept. The kindly government folks who gave us PQRI, or whatever the current word salad is for what we say on reports. We are now mandated to report presence or absence of mass, hemorrhage, or acute infarctions on head CT studies. Not that that isn’t a good thing, but if you say “normal,” isn’t that the absence of bad stuff? Can the study be “normal” with a big mass? Or a hemorrhage? I defy anyone to show me a “normal” CT with a hemorrhagic mass that has infarcted. Seems that someone wants to cheapen and abuse the word normal. I was wondering what normal did to deserve this. Must have been pretty heinous.

Personally, I’m trying to eradicate the term “normal” from my grammar. I’m starting to define things more as to what they are not. So, instead of saying, “That looks pretty normal to me,” I’m saying “That looks pretty non-mass-like, non-hemorrhagic, and non-infarcted to me.” Friends sometimes look at me a little oddly, but I’m used to that.

Mahalo.