The language of medicine is highly evolved and complex and allows clear, detailed, specific and unambiguous descriptions. Except when it’s not.
Here is this month’s collection of mangled medicalese, culled from charts I have read, patients I have treated, colleagues and friends. I will continue to post a selection monthly until my supply runs out. If you have a contribution to make, you can add it in comments below (login required) or send it to me for a future installment. I will explain only those where explanation seems necessary to understand either the phrase or the humor. The rest will stand - or fall - on their own. If you have questions or alternative interpretations, please don’t hesitate to use the comments.Patient contributions
A patient, when asked about his parents’ health, said ‘My mother, she’s fine, by my father, he died during humor dialysis.’ (hemodialysis)
A mother brought her 4 year old in for eye problems she described as ‘Every morning he has crustaceans coming out of his eyes.’
A teenager was worried that he might have mononucleosis because he had ‘lots of limp nodes in my neck.’
Physician contributions
A physician’s description of a patient’s skin: ‘Absent but normal.’
A medical student (me) who admitted two demented elderly males from the same nursing home, both with ‘VDD’ (vomiting and diarrhea with dehydration) got pieces of the exam confused when writing two chart notes and described ‘normal AJs (ankle jerk reflexes) and down going plantars’ and a patient with bilateral BKAs (below the knee amputations). The error was made painfully (to me) public on morning rounds when the attending looked at the notes and then told our group that we were headed to the bedside so that I could demonstrate a hitherto undocumented physical sign. For the rest of the rotation – and some time thereafter – he would ask medical students if a finding he doubted was an example of the ‘recently discovered Elias sign?’
Nursing, chart, and other staff contributions
The nurse called about a patient who was rapidly deteriorating and said that she was making sleeper rounds (passing out sleeping medications around 9 pm, or just after most patients have fallen asleep) when she found him unresponsive and chain stalking. (Cheyne-Stoking, an abnormal respiratory pattern often seen in patients with severe cardiovascular disease). Her phrase was confirmed with subsequent review of the chart notes.
The chart in the ED noted that the patient’s CC (chief or presenting complaint, the reason they are there, preferably in their own words) was ‘hernia replacement.’
The HPI (history of present or presenting illness) as transcribed in the chart: ‘The patient was found unresponsive in the crotch with the car running.’ (The patient was found unresponsive in the garage with the car running.)
Any to add?