Friday 22 January 2010

In [The] Hospital

Apparently something political has happened in America which will have some sort of effect on how Americans pay their hospital bills, a subject towards which I am passionately indifferent. The only important aspect of the debate, which nobody else seems to have touched on, is linguistic.

There is a tiny difference between the ways that we in Britain and they in America talk. If an Englishman is injured he ends up in hospital, the same goes for Canadians and Australians. If an American is injured he ends up in the hospital.

You can confirm this little tic with a few country-specific google searches for the specific phrase "the hospital". Here are Britain, USA, Canada, Australia. The USA does have some uses of "in hospital" but they're always in the headlines where definite articles can be omitted anyway.

This made me think about the other places you can be in without a definite article. As an Englishman I can be (and usually am) in the pub. I am at the shops. I spend an evening in the cinema. The only unarticled places are school and prison, both of which are paid for through taxes.

Americans also spend time in school and prison without a the and in America both of those are also provided by the government. The reason that I brought in Canada and Australia earlier on is that there seems to be a direct correlation between government funding and the definite article.

This is especially odd as Canadian English is usually dominated by their mutinous neighbours to the South. But all healthcare in Canada is public (except on Indian reservations, which is because of clauses about medicine men in ancient treaties that can now be splendidly profitable).

So here's my theory (and it is only a theory): if you usually pick and pay for your hospital (or anything else) you will tend to think of it as a far more specific thing than you would if it were a ubiquitous and remotely funded service. The definite article is part of the market system.

As I say, it's only a theory; but it fits facts, especially Canada. Howls of derision in the comments, please.

Canadian medical policy getting sorted out


  1. What about the post office and the job centre? We'll have to settle this in court.

  2. I think that school, prison and hospital also have in common: that they are institutions in which you would be spending a significant period of time. You are institutionalised to the extent that being in school, prison or hospital becomes a sort of state of being. For example, if I was having a minor operation and was going to be in and out of the hospital in a day, I'd probably say - "I'm at the hospital". Whereas if I had to stay for more than a couple of nights I would be "in hospital". And children are "in school", but when their parents visit for parent-teacher evenings they are "at the school". I don't think it fits your theory but it's a distinction worth pointing out. Work can be either "in" or "at" - saying someone is "in work" would usually refer to an ongoing state of affairs, but could also simply mean they are at the office.

  3. Very interesting. My husband works in the health care industry in America so we are not passionately indifferent about the subject. I will certainly share this with him.

  4. I'm Canadian, and I say "in the hospital". I'm surprised at all those Canadian hits for "in hospital".

  5. Goofy,
    That's surprising. Unfortunately, although I've been to Canada several times, it's always to been to visit my relatives who are British-born doctors, which rather slopes the linguistic playing field. I was only able to work on google news search, which is of course fallible.
    However, that at least appeared to be pretty conclusive. There are 1,000 "in hospital"s against 390 "in the hospital" and most of the latter are either in headlines or in phrases like "in the hospital's front lobby", which would be normal in England too.
    As I say, though, you, unlike me, are on the ground with proper first-hand evidence, and Google is not God (although I hear they're planning a merger).

  6. I have some insider knowledge that confirms Mrs. Malaprop to be half american - perhaps subconciously she adds a definite article from time to time.

  7. I'm from Canada... I say "in the hospital." And everyone that I know says that as well, at least to my recollection. Now, I'm a western Canadian, and there is some difference in the way that westerners speak compared to those in Ontario or eastern Canada. So, perhaps that's what you're referring to.