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.
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