Nephrology

The nineteenth entry is em fase terminal, and the English word that looks ready to take it is the one to leave alone. « Terminal » has drifted a long way from the Latin terminus, the boundary stone. On a ward it now says that a person is dying, and dying soon: « terminal cancer », « terminally ill », « the terminal phase ». Applied to a kidney, that reading is simply wrong. Somebody whose kidneys have stopped may live on dialysis for twenty years, work, travel and raise children, and no doctor would call that a terminal illness. So English keeps a separate phrase for exactly this idea and writes it in every guideline and every letter: « end-stage », as in « end-stage renal disease », where « stage » names a point reached along a long course rather than the end of a life. Portuguese lets terminal do both jobs and leaves the noun beside it to say which is meant, so a doença renal em fase terminal passes no judgement at all on how much time anybody has. Render it as « terminal » and the sentence quietly announces a death.