
I have been told that there is a tribe in South America which has 40 words to differentiate shades of what we might, in a single word, describe simply as ‘green’. And in a country without sign posts they use these shade words to direct people on forest paths. For example travel on the path for …. (distance) until you see a tree of …. (shade of green) then turn left. in about …. (distance) you will see a bush of …. (shade of green) there turn right. etc – you get the idea. No doubt this has worked well for centuries and still does, but what a mess a traveller would be in if someone purposefully substituted the word for a different shade of green.

I looked up ‘shades of green’ on google search and the list is long and interesting. Usually just saying green is enough but sometimes we need to be more specific. And this applies to many other words. And we can get into or cause trouble by unintentionally or intentionally using a shade of meaning which the speaker or author didn’t intend. There are about a million words in the English language but I am told that the average word usage of the common person is only in the thousands – 10 to 20,000. I looked up the word ‘guilty’ in google search. This is part of what I read…
guilty/ˈɡɪlti/ Learn to pronounce adjective
- culpable of or responsible for a specified wrongdoing.”he was found guilty of manslaughter” Similar: culpable, to blame, blameworthy, blameable, at fault, in the wrong, responsible, answerable, accountable, liable, censurable, reproachable, condemnable, reprehensible, erring, errant, delinquent, offendings, felonious, iniquitous, criminal, convicted, peccant
- Opposite:innocent.
- justly chargeable with a particular fault or error.”she was guilty of a serious error of judgement”
- conscious of, affected by, or revealing a feeling of guilt.”he felt guilty about the way he had treated her “Similar: ashamed, guilt-ridden, conscience-stricken, remorseful, sorry, regretful, contrite, repentant, penitent, rueful, abashed, shamefaced, sheepish, hangdog, mortified, discomfited, distressed, uncomfortable, in sackcloth and ashes, compunctious. Opposite:unrepentant

Let us say that the little baby pictured above died. That is not true, he did very well after his emergency surgery. He recovered quickly and was sent home well, but with a lot of growing up to do. But picture this scenario: –
He came in with an obstructed gut. He was operated upon and the condition corrected. On being woken up from his anaesthetic he vomited, inhaled his vomitus, but after that treated well according to the book but over the next 24 hours dies. A distraught parent accuses me of killing the baby and says that they hope I feel well and truly ‘guilty’. Should I feel guilty? I had made the correct diagnosis and done the right operation. My name was still on the end of the bed as the responsible surgeon. I had seen him and ordered several things post operatively. I was not the anaesthetist. Measures should have been taken by the anaesthetist to reduce the risk of him vomiting to a minimum, which he did not take. But I was by then in a side room writing up the case record. The mistake having been made I raced back into the operating room and did all I could to correct the situation.
But that accusation is that I have killed him and should feel guilty. I don’t think that it is fair to say that I have killed him, even if in a court the lawyers would have tried hard to push that all the responsibility of the anaesthetist fell back on me as the team leader so….? Now coming to the guilty word I have to confess that maybe I should feel guilty. I’ve seen that anaesthetist make similar mistakes before and because it was after midnight and I was tired I chose to do what was legal but maybe not wise i.e. do the rest of my legal paperwork and hopefully get home to bed. I had previously spent time on several occasions explaining the right way and watched him through several operations. I had since then stayed in the room on several occasions making sure that he did the waking up procedure correctly. But he was still relatively inexperienced. Because of the hour should we have waited until the morning, accepting that he may have died overnight and would certainly have been medically worse by the next day. If everyone had rested he might have lived and grown up to be a healthy man.
Would that label me guilty? I understand why the parents did, and I have to struggle hard to say that I bear no guilt. But I reject that I should feel guilty of murdering him or even of having done the wrong thing. Surely there must be a synonym in there for my feelings at this moment. Blameable? – but surely it is not my responsibility to do someone else’s work correctly. Ashamed? – because in the world there is such inequity between what we have in my home country cf my adopted land. Remorseful? – that I didn’t stay in the operating room until the child was wide awake. But then I knew that the post-op care workers often slept on their duty time – so should I have watched him overnight? Am I to bear the whole weight of the medical inadequacies on my shoulders.
Often when I use a word I have to depend on my reader/hearer to discern the context into which I am using it. It is not easy for the user or the recipient of a word to be sure of the correct meaning and I guess we have to settle for being honest, generous and understanding in our assessments.

Dominic Cartier
A complicated situation, but no one person can carry the inadequacies and quirks of medicine..
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In the scenario you set, there would be no way that you could be guilty of a child’s death in those circumstances. A decent person would canvass all the questions you raised, think them all through, and then a rational person would say, not guilty. It is not that simple in reality, but if people like you, who do so much for humanity, become consumed with guilt, how can they continue with their humanitarian work.
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Excellent Dominic excellent. When I was studying law I came to the conclusion that the idea of killing someone is so abhorrent that no one will kill another without a degree of provocation. There are of course exceptions. But leaving these exceptions for side I always thought there was room for me to become a defence lawyer. That’s not how I write worked out but the point is still valid I believe.
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I think society expects perfection from anyone in the medical field. They forget doctors, nurses etc. get tired, can have a bad day and are only human.
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