creches, cribs and cots

Growing up, we always had a ceramic nativity scene (made by my Aunt Connie) on our mantel at Christmastime, and we always called it the nativity or the nativity scene. As I got older, I discovered that most other families called these things their (AmE) crèches. Until I moved away from the US (or started reading the word in non-US sources, I can't remember), that was the only English meaning of crèche that I knew. I was reminded of this limitation of AmE crèche this summer, when my mother was in town and confused by a sign for a local (BrE) crèche, which is to say a (AmE) day care center for babies. We find the 'nativity scene' meaning of crèche in the OED, but with no BrE examples after 1963. That doesn't mean such examples don't exist, of course, (you can see some at this UK Catholic gift retailer), but crèche certainly isn't the most common BrE name for such things. In fact, if one looks up 'Christmas crèche' on UK Internet sites, most hits are about (orig. AmE) babysitting/(BrE) child-minding services--or in this case, a man-minding service.

Instead, the more common BrE name for such scenes is the Christmas crib, with (BrE) crib referring specifically to a manger, as detailed by the OED:
1. A barred receptacle for fodder used in cowsheds and fold-yards; also in fields, for beasts lying out during the winter; a CRATCH. (In nearly all early quots. applied to the manger in which the infant Christ was laid; cf. CRATCH n.)
According to the OED, the extension of crib to nativity scenes was originally from the Roman Catholic church, and it may be the case that such scenes are more common in the UK in Catholic homes. In the US, they're nearly universal elements of Christmas decoration, but I don't recall seeing any in homes in the UK (yet), although there is a piece in Saturday's Guardian about the knit(ted) nativity scene (the author's term--not crib, creche, etc.--so that one seems to be dialect-neutral) that the author bought at Oxfam.

Now, of course, crib in AmE is the usual word for a baby's bed with barred sides, which in BrE would be called a cot, which in AmE means a (BrE) camp bed. But what I find funny about all this are the lyrics to the Christmas carol 'Away in a Manger':
Away in a manger,
No crib for His bed
The little Lord Jesus
Laid down His sweet head
According to cyberhymnal, the author of the first two verses is unknown, but it was originally published in a Lutheran book in Philadelphia, so we can probably assume American authorship or at least assume that Americans were responsible for the first English translation of the lyrics (if they were originally German, as the Telegraph claims). We probably should assume American authorship, since if you're a BrE speaker, the lyric seems to mean 'Away in a manger, no manger for a bed'. Nevertheless the British site carols.org.uk claims that this is "always the first carol that children are taught." (I'd like to see the research to back that up.) The only reference to 'no cot for a bed' that I've found on the web is a South African on alt.usage.english complaining "It's those damned Americans. They've even hijacked the Christmas carols". I don't see how we could have hijacked something that didn't exist before one of us made it up, but perhaps someone in South Africa should be considered a better authority on hijacking. (Oooh, Lynne's getting catty.)

Carols--particularly the ones one hears in church--vary a lot in the US and UK. The tune for 'Away in a Manger' differs in the two countries. Click here for the American tune, and here for the British one. I went to a local carol concert a couple of years ago, and found that I couldn't sing along to many of the songs, either because I'd never heard them before, or because the tunes were completely different from the ones I knew.

So...Merry (BrE informal) Chrimbo! Don't forget to nominate your favo(u)rite dialect-crossing words for the SbaCL Word of the Year!
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She gave it me

Perhaps because it's the season of giving, I've been noticing more often the BrE use of constructions like She gave it me where in my native AmE dialect I'd have to say She gave it to me or She gave me it. The last two examples are frequently discussed in linguistic theory, under the title of "Dative Alternation". So, let's start with a little terminology, just for terminology's sake.

In sentences like these, the three nouns (or pronouns, in these cases) play different semantic roles, which correspond to grammatical positions and grammatical cases in the sentences:
She is semantically the 'giver' or the 'agent (of giving)'. Grammatically, it is the subject of the sentence and in subjective (or 'nominative') case (i.e. it is she not her).

It is the 'given' or the 'patient' or 'theme' (depending on whose terminology you use) in these sentences; it is the thing that is affected/moved by the giving action. It is in accusative case, although in English, the form of it is no different in the nominative or accusative (or dative, for that matter). Grammatically speaking, it is the direct object [DO] of the sentence.

Me is the 'givee' or the 'goal' in these sentences--it's where the patient 'it' ends up at the conclusion of the described action. We say it's in the dative case, although there is no formal marking on the pronoun that distinguishes the accusative from the dative forms of pronouns in modern English (so accusative and dative can be collectively called 'objective' case in English). Grammatically, it is the indirect object [IO] of the sentence when it doesn't have the to with it, and it is the object of the preposition to when the to is there (although for various reasons, many grammarians call it the 'indirect object' with or without the to).
The thing to know about case in English is that noun case was marked in Old English, with five cases distinguished and case marking on nouns as well as pronouns. But Modern English has very little case marking--and that which it has is concentrated in the pronoun system (e.g. I versus me and my). Because Modern English doesn't mark case on regular nouns and only distinguishes subjective (nominative), objective (accusative/dative) and genitive (possessive) on pronouns, we rely on word order to let us know which semantic roles and grammatical relations the nouns are serving. On the other hand, languages that have more robust case systems (like German or Latin) allow for much freer word order. Here's what Everything2.com says about Old English dative:
Dative: The dative case is the indirect object of the sentence. The indirect object is anything that is benefited by an action, best translated as 'to' or 'for'. For example, in the sentence "I gave the keys to Alex," or more realistically, "I gave Alex the keys," 'Alex' would be in the dative case, without a preposition. It's important to note that, although in modern English the word order rules for indirect objects are quite strict (you can't say "I gave to Alex the keys," or "I gave the keys Alex"), this is not true by any means in Old English. The indirect object is clear no matter where it is in the sentence because of inflection, and thus the dative was frequently shuffled around as need dictated. Like the accusative, the dative was used with prepositions, mostly abstract, non-movemental (similarly to modern German).
In discussing Modern English, linguists write a lot about 'dative alternation', by which they typically mean the possibility of saying either:
She gave me it. or She gave it to me.
But I've seen a lot less written about She gave it me, or similar things like
About a week and a half ago I lost my new bluetooth headset. I was gutted, my wife had just bought it me as a Xmas present and I had lost it. [The Orange Place of Rich, Jan 2007]

and

The students also started asking me if I knew this or that model, offering to show it me so that we could do it later in the class... [HLT Magazine, Jan 2004],
which are found in British English.

Now, sitting at home, I'm limited in the sources that I can access on this topic, but I did find the following in a 1928 review of Jespersen's A Modern English Grammar on Historical Principles by George O. Curme (Language, Vol. 4, No. 2):
In Old English, the dative normally followed the direct object when both forms were personal pronouns. It still keeps its old position here, altho it has lost its old distinctive form: 'Show it me' (Pinero, Sweet Lavender, Act II). In America it is more common to employ here the new dative with to: 'Show it to me.' It seems self-evident here that to me is a dative, not a prepositional phrase. It corresponds to the British simple dative me. Moreover, we find in American English the old simple dative alongside the new dative with to: 'I give it to you' or 'I give it you' (Oemler, Slippy McGee, Ch. V). In this position we have two dative forms, the older simple dative and the new dative with to. The new dative is the result of our desire to give the dative a more distinctive form. In America the old simple dative is now common only before a noun used as a direct object. I gave you a book. Elsewhere we feel that the dative should have a distinctive form.
By 1937 (Language Vol. 13, No. 3), we have Frederic Cassidy writing:
To use [Jespersen's] Give it him argument to deny a word-order distinction of DO and IO, then is a self-contradiction of the worst sort. At least among nouns, there certainly is such distinction.

But even among pronouns what is the true situation? The normal word-order is the same as among nouns, and almost without exception the reverse word-order holds only when it is the DO. In short, this exceptional order is not a free pattern, but a 'bound form' or petrified phrase [...]. It never became an active pattern; neuter it being usually DO and therefore needing no word-order distinction, could violate the ordinary pattern under pressure of rhythmic or other considerations. The nominal order, on the other hand, is a living pattern, permitting all possible combinations of nouns and pronouns and when new words are used, we follow this pattern.
Now, I don't know how Cassidy's claim that DO-IO order is restricted to it DOs relates to Curme's claim that DO-IO order was the usual order for pronouns in Old English. (Did Curme overlook the fact that it was usually it in that position, or was them equally likely to occur in that position in OE?) The it observation remains true in BrE today, though. There are about 6000 UK Google hits for bought it me (once I sorted out the ones that were about buying something called It's me or the dog), but only three for bought them me.

Looking for advice on how to use these forms, there's not much via the Internet. (If I'm going to continue to blog from home, I should really bring my style books back from the office!) The Columbia Guide to Standard American English doesn't acknowledge the existence of the DO-IO order:
Dative is the grammatical case that marked Old English (and Latin) nouns and pronouns functioning as indirect objects or the objects of certain prepositions. Today the preposition to accomplishes periphrastically the dative function as indirect object, as in I gave the keys to him, or syntax does the job alone by putting indirect object before direct object: I gave him the keys.
Then we have a Swiss English-teaching site overtly denying the existence of the DO-IO object order:
The simplest way to look for remnants of dative case in English is to ask yourself whether the preposition "to" is being used or whether there is a verb present which would normally require the use of the preposition "to". For example - "give" is the easiest to remember. You don't say "give it me", rather "give it to me". In this case the verb "to give" is said to be a dative verb, and "me" becomes dative. Note that me is exactly the same in accusative and dative case - this is why dative and accusative are said to have merged into what many people call "object case". [[English] Grammar primer part 2: Dative and Genitive Case]
Within BrE, there is the perception that the DO-IO order (without to) is (in Better Half's words) "common". The Teaching Grammar site at University College London lists Give it me as 'non-standard' but acceptable in some dialect(s), but doesn't say which ones.While BH associates it with London working class, there's more discussion of it on the web as a feature of Lancashire speech. (Very far away from London, in case English geography is not your strong point.) On the BBC Lancashire site, it says:
Lancashire is a rich area in which to study accent, dialect and grammar as Willem explains: "If I were say, playing with my pen in a very annoying way, and you were to take the pen away from me, I might tell you, "Hey, that's my pen, give it me!" but there's also speakers who wouldn't say "Give it to me!" but who would say "Give me it!" and then there's also speakers who would say "Give it me!" This last order "Give it me!" is not very common in Britain in general, but what we find in Lancashire is it's actually the preferred pattern."
The reason I was moved to blog about this phenomenon is that I was hearing it a lot on television last week. One instance was in an ad(vert) for Somerfield supermarkets, in which a woman is complimented on her dress, and she replies "Nigel bought it me". Whether there's been an increase in DO-IO orderings on the television, I cannot say for sure. Still, it strikes me as a symptom of increased tolerance of different dialects on British television and of the increase in use of regional dialects in advertising in particular, where 'northern' can translate into 'trustworthy' or 'down-to-earth'. For more on that point, see voiceover artist Emma Clarke's blog...
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physicians' titles

So, last weekend the hospital released me to continue my treatment as an outpatient, then two days later on my first outpatient visit , they re(-)admitted me. Now I'm released again, but have been told to bring a packed bag to my outpatient visits...so you can expect my posts to continue to be erratic for a while. The good news is that I don't actually feel poorly, so I can blog when I have access to the Internet. The bad news is that I have plenty of time and desire for blogging when in (the) hospital, but no access to the blog. Catch-22.

So, the combination of dealing with a lot of different doctors and watching daytime reruns of ER left me thinking about the differences in doctors' titles/roles in American and British hospitals. I must admit that, despite having watched a lot of medical dramas and having read a lot of medical thrillers and memoirs in my youth (the better to feed my hypochondria), I've never been clear on what exactly an (AmE) attending physician is/does or how a (BrE) senior house officer relates to a (BrE) registrar. So, with a lot of help from Wikipedia, I've been trying to teach myself the ins and outs of these titles.

Let's start before we get to the hospital ward. In the UK, your regular doctor, the one you see in their (AmE) office/(BrE) surgery, is your GP or general practitioner. In AmE, the insurance-driven name for such people is primary care physician, but most people would just call that doctor my doctor or their family doctor (who works in or operates a family practice--a term that is found in both countries, but in my experience is more common in the US). The term general practice is also known in the US, but one doesn't hear people talking about their GPs.

When your GP/primary care physician decides that you require more speciali{s/z}ed attention, they refer you to a specialist--but in BrE they're likely to say that they're referring you to a (specialist) consultant. The experience of such referral can be somewhat different in the two countries. Let's say your usual doctor wants you to see a gastroenterologist. In the US, they say "I'm going to refer you to Dr. Guts." Then you get an appointment with Dr. Guts and meet Dr. Guts at that appointment. In the UK, you are referred to Mr Entrails' clinic (more on the 'Mr' shortly). Maybe you will see Mr Entrails--you're likely to on the first visit, at least--but you might see someone else in his clinic team, or firm (the term that Wikipedia reports--not one I've come across in the patient's seat). The consultant Mr Entrails has overall responsibility for your care, but a variety of more junior doctors might see you. Mr Entrails' clinic will most likely be located on hospital grounds, whereas American Dr. Guts will probably see you in an office complex--often one built specifically for medical offices.

In a hospital context, there are different titles (and responsibilities) for specialist doctors at different levels of training. In the UK, there's apparently been a move to 'moderni{s/z}e' medical career paths in the National Health Service, though I've seen little evidence of the changes reported on this NHS site. It says that a new title, Specialty Registrar [StR], replaces Senior House Officer [SHO] and Specialist Registrar from August 2007. But I was being seen by SHOs and Specialist Registrars at our hospital. So, I don't know if the new title applies only to people who have started since August 2007 or whether it's been abandoned, since when one hits the link for further info on the NHS site, one gets a 'page not found' message. For a comparison of new and old titles, see the table on this Wikipedia page. I'm going to stick with the old titles, since they're the ones I've experienced. [NB: Yes, it's specialty, not (BrE) speciality. This is one of many examples of BrE medical jargon being closer to AmE than to non-jargon BrE.]

So, in the UK, you're a medical student, then once you qualify as a doctor, you go on to be a house officer (Pre-Registration House Officer in the old system, Foundation House Officer in the new). After this, the doctor has a choice of going the GP route (which involves more training, but not all the titles I'm about to reel off) or undergoing specialist training for a minimum of two years as a Senior House Officer, followed by 4-6 years of further training and increased responsibility as a Specialist Registrar. One takes exams to go from one level to the next, with the highest level being Consultant. The amount of time one needs to train for these various positions varies by the specialty, culminating in the Certificate of Completion of Training after exams from the specialist college (e.g. the Royal College of Obstetricians and Gynaecologists). All of this is overseen by the General Medical Council, which determines the standards for entry onto the specialist registers that allow one to work in hospitals as a consultant.

In the US, you're a medical student, then for your first year in the hospital you are an intern, which may or may not be considered the first year of your residency, during which you are a resident (physician). This can also be called house officer, as in the UK. After residency, one may or may not get a fellowship for sub-specialty training, before going on to be an attending (physician) [or staff physician] the equivalent of a (BrE) consultant.

In the UK, medical training begins at the undergraduate level--which is to say, people can be 'medical students' from their first year (BrE) at university. In the US, medical school is for (AmE) graduate/(BrE) post-graduate students, and the undergraduate students do pre-med degrees, which cover a lot of science, but also, like other US undergraduate degrees, a liberal arts curriculum. (Law training differs in a similar way in the two countries.)

At least, that's how I understand all this. Anyone with better knowledge is welcome (as ever) to correct me in the comments.

Now, a few words on what you call these people. In the US, medical doctors, no matter their specialty or status, are usually called Dr. [Surname]. In the UK, there's a kind of reverse snobbery, in that GPs and more junior specialists are called Dr [Surname], whereas surgeons and other consultants go back to being Mr or Mrs or Miss--though I've only met men in the consultant role so far, so I can't vouch for the actual use of Mrs and Miss. (Note that BrE tends not to put a (BrE) full stop/(AmE) period at the end of title abbreviations like Dr, Mr or Mrs, while AmE almost always does.) Here, I'll rely on Wikipedia again:
In the United Kingdom, South Africa, Australia, New Zealand, Canada and other areas whose culture was recently linked to the United Kingdom, the title Doctor generally applies to both academic and clinical environment. "Registered medical practitioners" usually do not have a doctorate; rather, they have the degree of Bachelor of Medicine (usually conjoint with Surgery). Cultural conventions exist, clinicians who are Members or Fellows of the Royal College of Surgeons are an exception. As an homage to their predecessors, the barber surgeons, they prefer to be addressed as Mr, Mrs, Ms or Miss, even if they do hold a doctorate. This is first because they have normally achieved another degree - that of Master of Surgery (MCh from the Latin magister chirurgiae) from a university. When a medically-qualified person passes the notoriously difficult examinations which enable them to become a member of one or more of the Royal Surgical Colleges and become "MRCS", it is customary for them to drop the "doctor" prefix and take up "mister". This rule applies to any doctor of any grade who has passed the appropriate exams, and is not the exclusive province of consultant-level surgeons. In recent times, other surgically-orientated specialists, such as gynaecologists, have also adopted the "mister" prefix. A surgeon who is also a professor is usually known as "Professor", and similarly a surgeon who has been ennobled, knighted, created a baronet, or appointed a dame uses the corresonding title (Lord, Sir, Dame). Physicians, on the other hand, when they pass their "MRCP" examinations, which enable them to become members of the Royal College of Physicians, do not drop the "Doctor" prefix and remain doctor, even when they are consultants. In the United Kingdom the status and rank of consultant surgeons with the MRCS, titled "mister", and consultant physicians with the MRCP, titled "doctor", is identical. Surgeons in the USA and elsewhere may have the title "doctor".

So, there we go. Probably a topic that interests me much more than you, but what are blogs for, if not self-indulgence?

Oh, and by the way, one of the registrars has added to the Canadian count. So, that's 12. The nurses just asked where I was from. Score one for the nurses!
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Words of the Year 2007

Apologies for my silence over the past couple of weeks. I’m afraid that I’ll be silent for a while longer, as I’m a guest of the National Health Service, having been in (the) hospital for two weeks now, and expecting to be here for a while longer. Everything’s going pretty well so far—I feel well-cared-for. What would be great is if I could use the time for blogging, but although there is an internet connection on the bedside television, almost any site you’d want to use is blocked—including Blogger, SbaCL and, oddly enough, my doctor’s (BrE) surgery/(AmE) office.

So, the very kind Better Half has brought me his laptop so that I can type a little message and he can post it for me. While there are many things that I could blog about these days (my backlog will get back into ridiculous mode, I’m certain), let’s turn it over to you for a while with our second annual SbaCL Words of the Year competition. (Since I can’t get to my blog, I can’t do nice links to past postings, so please hit on the tags below to get to related posts, including last year’s WotY discussions).

Last year, we had three categories for WotY. I’ll keep the third category for the time being, but will reserve the right not to make an award in that category if there isn’t a clear winner. The categories are:

1. Best AmE to BrE import
2. Best BrE to AmE import
3. Best word coined by a reader of this blog (on this blog)

For the first two categories, the word doesn’t have to have been imported into the other dialect in 2007, but it should have come into its own in some way in the (popular culture of the) other dialect this year.

How it works: you nominate words—preferably with arguments for their WotY-worthiness—in the comments to this post. From those nominations, I will choose the winning words—at the end of 2007, or the beginning of 2008, depending on how this hospital business goes.
In the meantime, I will not be answering e-mails. You’re welcome to continue sending requests for coverage of BrE/AmE issues, but please don’t expect any quick responses, and please use the comments section, not the e-mail option, for nominating words.

All best wishes for the holidays!
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Abbr.

AmE = American English
BrE = British English
OED = Oxford English Dictionary (online)