In 2002 a public health director in Newark asked me whether I knew the word nosocomial. I did not. Nor did any of the graduate students in the room I taught the following week. Nosocomial means hospital acquired. It names the illness a patient walks in without and walks out carrying, and medicine has owned the word for more than a century and worn it smooth. This episode is about what a word like that is built to do. Say hospital-acquired infection often enough and it becomes a line item. Call a death a mortality outcome and you have moved it into a spreadsheet, where it can be totaled and compared and discussed on a Tuesday afternoon without anybody's voice breaking. That is cultural code. It replicates, it gets taught, and every time it is spoken it lets decent people look straight at a horror and feel almost nothing. From there the episode goes to Vienna in 1847, to a basin of chlorinated lime, and to a doctor whose colleagues destroyed him for proving that they were the weapon. Then it follows the shape out of the hospital and into the prison, the asylum, the classroom, the parish, and the faith that promised to carry its people out of the world and kept that promise the only way it could. One note on the failed test in this episode. Failing my own rule made the finding harder on hospitals than my original claim was. If that portion of the infection rate is not an irreducible floor, then more of it can be prevented than I had credited, and the institutions have less cover than I gave them. The longer account is in the blog piece is available on BolesBlogs.com DO HARM: Nosocomial Disease and the Institutions That Manufacture the Harm They Promise to Cure is available now from David Boles Books in Kindle and paperback, with a free PDF edition to download. Facts matter.