"In hospital" and "In a hospital"

November 5, 2012 5:34 PM

What is the name of the technical difference between "In *a* hospital" and "In hospital"?

The British say, "The famous footballer is in hospital, after injuring his ego." The Americans say "The famous soccer player in *a/the* hospital, after injuring his ego."

What is the technical term for the different ways in which the word hospital is being used?

Is that the British are using "hospital" as a proper noun, while the Americans are not?

posted by 517 to writing & language (15 answers total)

"Hospital" is not a proper noun, article or not. There is a fancy linguistic term "anarthrous" that describes words that appear without a definite or indefinite article. So "in hospital" is an anarthrous phrase. I'm sure someone's done research on the semantics of phrases with and without articles, or why certain locations become fixed expressions: for US speakers, "in church," "in school," "in town," etc. But since it seems most people say either "in hospital" or "in a hospital," but not both in different situations, the two probably mean the same thing for people who use them.
posted by Nomyte at 5:45 PM on November 5, 2012 [5 favorites]

There's some good discussion in this previous question.
posted by cabingirl at 5:45 PM on November 5, 2012 [1 favorite]

Mark Liberman calls these "singular count nouns that can be used in a prepositional phrase without a determiner, in a non-referential or generic interpretation."
posted by grouse at 5:46 PM on November 5, 2012 [5 favorites]

The general noun "hospital" is, by definition, not a proper noun; it only becomes a proper noun when attached to a specific hospital with an official name (e.g., Manchester General Hospital; St. Vincent's Hospital).

I think it's just a quirk that British English doesn't require either the definite or the indefinite article for "hospital," while the use of the article is retained in American English. It's not much different than dropping the article for "school" (e.g., "my daughter's in/at school today" rather than "my daughter's in/at the school today").
posted by scody at 5:47 PM on November 5, 2012 [1 favorite]

It strikes me that the British use of "university" is like this, as well: "He went to university." We don't quite say it this way in the US (that I'm aware of), although curiously, we might say, "She is at college." Some institutions take on this abstract sense that doesn't require the article.
posted by SpacemanStix at 5:48 PM on November 5, 2012 [1 favorite]

"The" is a definite article, and it is used or not in rather idiosyncratic ways in both North American and British English. The usual rule is that the definite article is used when you're referring to a specific example of what the noun describes.

"I go to church." = "I attend services at some kind of church, but I'm not telling you which one."

"I go to the church." = "I go to that specific church over there, St. Mary on Tidwash-Puggle-Whee."

Both kinds of English seems to agree that it's correct to say we go to bed, go to sea, go to school, and so on, when referring to the general practice, but adding a definite article specifies which sea and which bed and which school.

(On the other hand, everyone says that we "go to sleep": few native speakers would refer to a specific night's sleep as "I went to the sleep".)

The British are probably more consistent about use of the definite article. Unless you really want to talk about a specific hospital, it makes more sense to say "He is in hospital" than "He is in the hospital". Wikipedia has a little more detail.
posted by maudlin at 5:54 PM on November 5, 2012

It's known in linguistics (specifically, sociolinguistics) as article deletion (also called zero variant), and has often been studied in tandem with definite article reduction (DAR). It's a thing, and both are features that are typically found in Northern England dialects (especially Yorkshire).

The noun 'hospital' is especially stereotypical for these features (as is 'pub' and 'shop'). So you might get phrases like, "She was in t' pub" (DAR) or "Goin' to shop" (zero variant). In the latter example, it's intended that the person is saying that they are going to the shop, and not going shopping (although they may do that there, being that's what shops are generally for).
posted by iamkimiam at 6:16 PM on November 5, 2012 [5 favorites]

At the same time, British English (as I understand it) does use the definite article in some of these cases where the subject is not acting as a patient or student, for instance. Both US and British English would say "he's a professor at the university." If he is instead described as "a professor in university," the implication might be that our academic has gone back to take a few more courses. Or as a commentator in grouse's languagelog link puts it: "When the student came to school with a knife, the police were immediately sent to the school. If the police had been sent to school, wouldn't you wonder what they were expected to learn there?"

Personally, I like to chalk it up to a British preference for bureaucracy and large, systems-driven processes. In British English, hospitals and universities are large, all-consuming institutions of a scale large enough to drive away the definite article. Just as a prisoner isn't merely resident "in the prison," a patient has been swallowed up by the hospital and his/her entire state of being is now "in hospital." Come to think of it, this state of affairs probably better describes modern American health care compared to the NHS, but language moves slowly sometimes.

grouse's languagelog link above is fascinating on how this practice extends to certain communities and disciplines. Often, actors come "to set" and "to rehearsal," but the plumber called in for an emergency repair needs to get himself "to the set" in a hurry. Similarly, the busy litigator is "in court" this Thursday, but I'm just planning on going "to the court[house]" to watch the trial. The courthouse janitor isn't "in court" when he's refilling the soap dispensers either, unless he's on trial in the restroom for some unlikely reason. There's an element of being "in <noun>" that encompasses not just physical place, but one's role and behavior while there, and clearly certain professions have adopted that convention for themselves as a way denoting their given roles.
posted by zachlipton at 6:37 PM on November 5, 2012 [7 favorites]

this practice extends to certain communities and disciplines

That's the key line form the very good responses above: it's not some fundamental difference attributed to a broad American vs. British binary, it's a subtle difference between much smaller groups. Outside of "in hospital" and "at university," there aren't altogether that many differences in the article deletion or anarthrousness of the mainstream American and British English varieties.

Most English-speakers can go through this list and pick out a few that seem unnatural to them and a few that are ambiguous -- but most will seem normal to English-speakers anywhere. Though where they do find unnatural-sounding ones, individuals will not always end up with the same list as other speakers of their approximate English variety.

to bed /in bed
to school /in school
to church
to class
to market
at camp
on campus
in court
at home
went by bus/train/car
on break
go on vacation
go to school
go to work
go to college
go to church
to the store
down cellar
end of the semester
the flu
go to hospital
go to university
go on holiday
at the weekend
end of term
posted by Mo Nickels at 7:47 PM on November 5, 2012 [1 favorite]

Somewhere in here, it must be explained why there are people who say they're going "to prom" instead of "to the prom" -- the former being something that sounds so wrong to me that it has ruined the watching of some movies and TV shows. (Yes, someone is wrong on the internet...and on my TV.)
posted by The Wrong Kind of Cheese at 9:11 PM on November 5, 2012 [2 favorites]

Somewhere in here, it must be explained why there are people who say they're going "to prom" instead of "to the prom" -- the former being something that sounds so wrong to me that it has ruined the watching of some movies and TV shows. (Yes, someone is wrong on the internet...and on my TV.)

I was thinking about that earlier as one of the examples of this. My feeling is that "going to prom" is such an all-consuming activity that it transcends simply the event of "the prom" itself. After all, the complete package includes the asking each other out bit, the tux rentals, the dress shopping, the shoe shopping, the limo rental, pregaming, photo-taking, dinner, "the prom" itself, some silly prom court ritual, the after-party, the after-after-party, the trip to the emergency room, etc... The appearance at "the prom" itself is such a small portion of the event that it really isn't accurate to use the definite article to describe the evening. Anyway, if it makes you feel better, pretend that they are using a shortening of the verb "to promenade," which rather makes the whole thing sound a touch quaint and charming instead of obnoxious.

And interestingly, while Americans wouldn't describe an inpatient as "in hospital," we have no problem describing someone (surgeon or patient) as "in surgery" and wouldn't use "the surgery" unless indicating a specific surgery or procedure among many.

The best use of this exact distinction comes from The Eagles "New York Minute" (as further popularized by one of Aaron Sorkin's West Wing episode titles):

Somebody going to emergency
Somebody's going to jail

posted by zachlipton at 9:50 PM on November 5, 2012 [1 favorite]

I agree with the above posters that it is secondary to the need to be specific. You don't say I'm going to my bed, you just say you're going to bed because it's implied. Going to hospital or university in UK is a pretty standardized process.

So I think it has to do with the massive differential in quality and cost that is available in medical care and education in the United States. The NHS is pretty good in being consistent what with the NICE criteria whereas in the United States is a massive crapshoot so people actually want to know which hospital.
posted by hobo gitano de queretaro at 10:58 PM on November 5, 2012

As an aside, this happens in other languages. In Latin, I was taught (hopefully correctly - Looking at you, Mr. Mann), that you can "go home, go Rome and go country(side)."
posted by Atreides at 9:48 AM on November 6, 2012

In Latin, I was taught (hopefully correctly - Looking at you, Mr. Mann), that you can "go home, go Rome and go country(side)."

Well, as I understand it, Latin doesn't have definite articles, so the situation is a bit different there.
posted by zachlipton at 1:48 PM on November 6, 2012 [2 favorites]

I don't know if this is related, but in England, people say: "I'm going to bed," in Scotland they say: "I'm going to my bed." Always wondered why.
posted by penguin pie at 2:56 PM on November 6, 2012