A doctor’s quest for more organ emoji

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The medical world needs more emoji, according to Shuhan He, an emergency medicine physician who helped propose the anatomical heart and lungs emoji. Now, He and others have laid out the case for an even larger variety of health-related emoji, which they argue could improve communication between doctors and patients.

In recent years, emoji related to medicine and health — like stethoscopes, hearing aids, bones, and microbes — have made their way into the Unicode Standard. In commentary published last week in JAMA, He and his co-authors hope Unicode will approve more emoji that could be used in medical contexts, including emoji for more organs, like the stomach, liver, and intestines, and equipment like an IV bag, CT scan, and pill pack. He also wants more medical professionals to push for such emoji and to establish a standard for emoji usage in medical communication.

“We know in medicine that when patients say specific words, that they tend to highly correlate with specific pathology,” says He. People often describe crushing chest pain, for example, as feeling like an elephant is sitting on their chest. “We also consistently always ask people, what is your pain like: sharp, stabbing, dull, or fiery? Those are all emoji that can be represented in pictorial form rather than verbal communication.”

Emoji-like images are already widely used in medical settings, He says. The Wong-Baker pain scale shows a smiley face at one end and a grimacing or crying face at the other to signify pain levels. That scale was initially developed for children but is now used in many doctors’ offices and hospitals for patients of all ages. If smiley faces are already a part of medical communication, why not also leverage the visual language that’s standardized across people’s phones?

He sees a range of uses for emoji in medicine. Patients who can’t speak or don’t know English could use emoji to describe their symptoms. For patients who do speak English but don’t have much health literacy, a common, standardized visual language could make it easier for them to understand and follow treatment instructions. The rise of telehealth also provides more opportunities for medical staff to supplement their communications with visuals.

Jennifer 8. Lee, one of He’s co-authors, is a co-founder of Emojination, an organization that advocates for more inclusive and representative emoji. Emojination has helped proposals for a number of emoji make it through Unicode’s submission process, including medical emoji like the stethoscope, blood drop, X-ray, and adhesive bandage. (The fight for the blood drop emoji, initially proposed as a menstruation symbol, is included in a documentary about emoji creation.)

“The use of emoji in medicine is really interesting, precisely because in many cases we’re dealing with sort of high stakes, and also very strong cultural practices,” says Lee. “So the more we can move into a curated universal visual medium, the better it can be in the long run.”

Lee is also a vice-chair of the Unicode Emoji Subcommittee. She thinks there’s value in adding more major organ emoji, but she suspects she’s in the minority on that position. Though the brain, anatomical heart, and lungs emoji were all approved, it’s tricky to get other organs in the mix because they’re not necessarily as recognizable and don’t have as much demand, she says.

If medical organizations established a set of important potential emoji and pushed for them to be added, they might have more luck. “I would guess if the industry as a whole, the professional organizations, cared, they could move the needle,” says Lee.

Though a few other doctors have expressed desires for more relevant emoji, we don’t know yet how much traction He’s proposal will pick up. There’d likely need to be more studies around patient’s perceptions of emoji before medical associations throw their weight behind any formal efforts.

It might not seem like emoji should be a big priority in the medical field, but He thinks anything that improves communication between doctors and patients is worthwhile. Being a doctor “means to listen, to hear their pain and hear their struggle, and to hear exactly what they’re trying to go through, and to help them,” He says. “If we can’t communicate, then we can’t be good doctors. And so this is at the very heart of being a good doctor.”

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