Obtunded.

I was reading a New Yorker story about the recent Portland heat wave when I hit the sentence:

Medical staff referred to some of the patients as “obtunded,” meaning they were unable to respond at all.

I wasn’t familiar with the word, though my residual Latinity (thanks, Brother Auger!) gave me a general idea that it meant ‘beaten’ or ‘struck’ (it’s from Latin obtundo), so I looked it up and discovered something of a morass. The OED, s.v. obtund (updated in March 2004), says:

Chiefly Medicine.

 transitive. To blunt, deaden, dull the sensation of; to deprive of sharpness or vigour.

[…]
1999 Canad. Jrnl. Anaesthesia 46 368 Fentanyl..helped to obtund the hypertensive response to intubation.

Similarly, Merriam-Webster has “to reduce the edge or violence of.” But those definitions don’t seem to match the sense “unable to respond at all.” Googling turned up the useful page The Difference Between Lethargy, Obtundation, Stupor, and Coma, which says:

There is a spectrum of impaired consciousness that goes from full arousal to complete unresponsiveness. Coma, which is a state of unarousable unresponsiveness is the worst degree of impairment of a patient’s arousal and consciousness.

Words like lethargy, obtunded, and stupor all describe various degrees to which a patient’s arousal is impaired. However, these terms are imprecise. In a clinical setting, it is more useful to describe the patient’s responses to specific stimuli.

They say obtundation “is a state similar to lethargy in which the patient has a lessened interest in the environment,” while stupor means that “only vigorous and repeated stimuli will arouse the patient”; the New Yorker description sounds more like stupor according to that list. I have to agree that “these terms are imprecise.” I trust, however, that in a given setting the medical personnel all agree on what they mean by a term.

Comments

  1. obtundation

    Shouldn’t that be obtusion?

  2. There is such a word; the OED says:

    Chiefly Medicine. rare.

    The action of blunting or dulling; the condition of being blunted or dulled; (now, Medicine) = obtundation n.

  3. David Eddyshaw says

    I’m just off to the pub to get thoroughly obtunded …

  4. The verb obtund was in the OED First Edition, along with its derivatives obtunding and obtusion, with citations showing a long history in medical English. On the other hand, obtundation and obtunded (adj.) were new entries in 2004. Their first citation for obtundation is 1967; Google Books easily antedates that to 1895, though the ngrams also show that it was rare then and didn’t start to take off until the mid-1960s, while obtusion remains as rare as ever.

    Obtunded as an adjective is a bit harder to find in a machine search, since it has to be distinguished from verb forms. From a glance over the first few pages of 19th-century results, it seems that it did exist (e.g., “We prefer an exalted sensibility to an obtunded one”, “from harrowing and constant repetition they pass to obtunded sensibility”), but was a lot rarer than it is now.

  5. I suspect doctors like it because, unlike “lethargy” and “stupor,” it’s unintelligible to the layman.

  6. >The verb obtund was in the OED First Edition, along with its derivatives obtunding and obtusion,

    So maybe we could just go with obtuse.

  7. Those who remember high-school geometry would take “obtuse” to be the opposite of “acute,” and so confuse “obtuse” with “chronic.”

  8. Oh, don’t be obtunded!

    JK. Not least because I think you were joking too.

  9. not to be confused with orotunded, which mostly applies to doctors…

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