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 describing when his rib pain began: “I choked on a piece of meat and Uncle Walt got it out with a Heineken remover.” (Heimlich maneuver.)
A young woman on the phone on Saturday early evening, requesting medication for a vaginal yeast infection: “I need that fluke again. I’ve got Canada in my vagina.” (Fluconazole and Candida or yeast.)
Retired salesman when reviewing his medication list at his annual health maintenance visit: “I started taking an 81 proof aspirin every morning.” (Milligram.)
Patient filling me in on her recent visit to the rheumatologist: “He told me I have paranoid arthritis.” (Since the visit was to the rheumatologist, I was able to determine that she meant psoriatic arthritis rather than paranoid psychosis, though it was a close call.)
Physician contributions:
The dictated note from the emergency room physician on the patient admitted for treatment of pyelonephritis during late pregnancy: “She claims she got pregnant in Chicago which is impossible.” (A kidney - as opposed to bladder – infection during late pregnancy is a serious problem and often results in pre-term labor or urgent delivery, so accurate dating of the pregnancy is important, leading often to detailed and intrusive questions about last periods and sexual activity.)
The orders from an older surgeon for wound care after a surgical incision had become infected and had partially dehisced (opened up): “Irrigate every shift with TABS.” (A problem was discovered only after several days when the nursing student caring for the patient asked her supervisor where there was another soda machine, because the one on that floor was out of Tab. He had been abbreviating Triple Antibiotic Solutions as TABS. The patient did fine. The nursing student, not so much.)
Staff and chart contributions:
The triage nurse history in the ED noted that the patient: “Bleeds every time he whips himself.” (Wipes. I hope I didn’t really have to explain that one to you. )
From the nurse’s discharge note on a patient discharged after an angioplasty and stent for progressive angina: “The patient was carefully and extensively counseled about smoking sensations.” (Cessation.)
That’s all for this month. Contributions and comments welcome.