Enormity

English gains and loses words all the time. It's easy to see where new words come from. We find or invent a thing or idea and need a word. When a thing or idea is discarded or falls into disuse, the word still exists, but dictionaries eventually label it archaic. ‘Governance’ was just such a word, until it was resurrected by big business for ‘corporate governance’, and then purloined by the NHS for ‘clinical governance’, a phrase famously described by one of my colleagues as ‘impossible to translate into any other language, including English’.

More interesting are words lost by misuse. Dictionaries record usage; they are descriptive not prescriptive. If a word is misused often enough by enough people, then its meaning will change. If the word is useful, those who care about words will try to prevent the change, but eventually it is more important that those who are careful with their words adjust to the new meaning. ‘Parameter’ has been so abused that it is now, in common speech, entirely devoid of meaning, which has to be inferred from its context. What are the parameters of health care? It depends — although the commonest (but technically incorrect) meaning is limits.

Only in the interaction of mathematics with other sciences is the loss of the proper meaning of parameter important. ‘Disinterested’ is more serious. The first meaning of disinterested is not uninterested, which is its most common usage, but impartial. A judge should be disinterested but not uninterested, but how many people reading of a disinterested judge would worry rather than applaud? Disinterested is a lost word. Careful people should now use ‘impartial’ or ‘unbiased’.

But at least disinterested has synonyms. ‘Enormity’ has none, and the loss of the word is a real loss. Enormity is not the noun corresponding to enormous; an enormity is a dreadful criminal or immoral act. After the Indian Ocean tsunami, many commentators spoke or wrote of people's shock at its enormity. The disaster caused massive and terrible loss of life, and even more of homes and livelihoods, but enormity does not apply. Enormity cannot apply to random acts of nature, however terrible. We have our own example of enormity: Harold Shipman. But, more or less coincidentally with the tsunami, we have a reminder of the worst of enormities: Auschwitz, which was liberated 60 years ago. It is a shame that we are in danger of losing a word that allows us, in a word, to express not just the horror, but the scale of the horror, and the human responsibility for it.

• © British Journal of General Practice, 2005.