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Going to Hospital
by Lionel E. Deimel

HospitalIn a story I recently heard on the radio about medical care in Uganda, a woman spoke about “going to hospital.” This is standard British usage. All the native American speakers I know, however, would say “going to the hospital.” Is this difference in idiom completely arbitrary, or is there some significant linguistic phenomenon worth analyzing here? I think there is something interesting suggested by these related expressions.

Not being well-versed in British English, I had best concern myself primarily with American English. Consider seemingly similar usages in America. We “go to school,” “go to college,” “go to church,” “go to jail,” “go to court,” and “go to town,” but we “go to the country,” “go to the suburbs,” “go to the playground,” “go to the head of the line,” “go to the airport,” “go to the mall,” “go to the theater,” and, of course, “go to the hospital.”

Some insight is to be had by considering related phrases with and without the definite article. To “go to the school” is never quite the same thing as to “go to school,” and it likely means something quite different. Likewise, to “go to the jail” is not the same as to “go to jail.” In American speech, the phrase with “the” always seems to make sense, whereas the phrase without “the” only sometimes makes sense.

Consider the difference between “go to college” and “go to the college.” In the first instance, the meaning of “go to” is really “attend,” and “college” does not refer to a particular school. In the second phrase, “go to” means either “travel to” or “attend.” In either case, however, “college,” in the phrase containing “the,” refers to a particular institution, and it is a definite place, rather than the enterprise of education, that is stressed in the phrase.

This suggests a general, if perhaps not a universal, principle. In the absence of the article, “go to” emphasizes not a physical destination, but participation in some process that takes place at such a destination, which is often an abstract “place.” We go to school to learn, to church to worship, to jail to be punished, to court to obtain (or avoid) justice, and to town to experience urban life. (This last example may be a stretch, but “go to town” is decidedly different from “go to the town.” It also has the seemingly unrelated meaning of “engage in vigorously.”) Apparently, whatever goes on at the airport, the playground, or the mall has not acquired the same sense of specific, iconic, ongoing process needed to justify omission of the article and conversion to a standard idiom.

So, what about “going to [the] hospital”? If my analysis is correct, perhaps Americans should speak of “going to hospital” if, for example, they are checking in to have an operation. If they are just visiting, on the other hand, they are surely “going to the hospital.” Perhaps Americans do not use the the British idiom out of an unwillingness to admit the process they are about to experience. I have no idea if the British make this distinction.

— LED, 2/6/2007

Hospital patient and visitor

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