You
might not want to know what some of these terms mean.
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| The Secret Language of Doctors |
Medical
lingo can be confusing—but maybe ignorance is bliss. In his new book, The Secret
Language of Doctors, Toronto-based ER physician Brian Goldman
decodes the slang that doctors and nurses use to talk about their jobs,
patients, and each other—and some of it is far from flattering.
Of
course, not all slang is derogatory. In some cases, it's a way to pack a lot of
information into a single phrase, or to warn colleagues about a potentially
difficult patient. A surgeon might say "High Five," when entering the
OR to let other staff know they'll be operating on someone with HIV. Sometimes
slang helps hospital staff sound more professional during awkward situations; a
nurse might refer to "Code Brown" during a miserable shift with a man
who is having constant diarrhea in bed.
In
other situations, the book reveals, slang is therapeutic, a form of comic
relief that builds camaraderie between overworked doctors and nurses, and which
helps them get through long, emotionally heavy days. "The inability to
laugh on rounds in an environment like our ICU, where there's very little to
laugh about, is going [to] be tragic and injurious to safety and to the quality
of care," one respirologist told Goldman. "You need to have those
moments where you take a little break and reset." In any case, check out a
selection of lingo below, all pulled from Goldman's book, so that the next time
you're in the hospital you know what your doctor really thinks of you.
The
Bunker: This is a room in the hospital where medical students, residents and
their attending physicians meet behind closed doors to rest and talk about
their days. There, one might laugh about the patient in the "monkey
jacket," or hospital gown, who had a case of "chandelier
syndrome," practically leaping up toward the ceiling in surprise when she
felt the cold stethoscope. A surgeon might cringe while recalling a
"peek-and-shriek," an operation in which she opened a patient's belly
to find something unexpected, like cancer, and quickly stitched up again.
Cowboys
and fleas: Doctors don't only badmouth their patients; they also badmouth each
other. Hospitals are full of rivalries between departments, Goldman writes.
Surgeons may be called "cowboys" to imply they operate first and
think later, while internists can be criticized as "fleas," an
acronym for "fucking little esoteric assholes," as one doctor put it.
Urologists might take offense at being calling "plumbers," and
anesthesiologists for being referred to as "gas passers." FOOBA,
which means "found on orthopedics barely alive," is another insult
suggesting that orthopedic surgeons successfully fix bones while missing other
signs of disease.
Discharged
up: After "calling it" and stopping resuscitation efforts, a
patient may be "discharged up," "discharged to heaven," or
sent to the ECU (the "eternal care unit"). Someone who is dying but
still holding onto life is "in the departure lounge" or
"entering the drain," and if he can't be saved he's "circling
the drain," Goldman writes. Doctors might note the "O Sign,"
when a person is so close to the end that his mouth stays open like the letter
"O," or the Q Sign, when his tongue sticks out.
DOMA: "day off,
my ass," when residents aren't allowed to leave work until noon and have
to be back the next day.
FLK:
funny-looking
kid, referring to the facial characteristics of a child with a genetic or
congenital condition.
Frequent
Fliers: These are people who show up at the emergency room again and again,
even for non-emergency complaints, potentially because they have nowhere else
to receive care. Frequent fliers are often homeless people, known as
"curly toes," because their toenails are so long they've curled,
Goldman writes. If they don't have insurance, they may suffer from
"nonpayoma" or a "negative wallet biopsy." If they bring a
bag with clothes, determined to stay even before receiving a diagnosis, doctors
may note with annoyance their "positive suitcase sign" or "positive
Samsonite sign," in reference to the luggage maker. When doctors
"turf," they're looking for any possible justification to refer a
patient to a different department in the hospital, and if that patient is
"bounced," they are returned back to the original department.
GOMER: Made popular by
the 1978 satirical novel, The House of
God, GOMER is slang for "get out of my emergency
room," for chronic patients who are admitted with tricky conditions that
cannot be cured and need long-term care. (Since these patients are often
elderly, GOMER can also stand for "grand old man of the emergency
room," Goldman adds.) But actually, this term is passé. "GOMER has
been used on TV shows including Scrubs and ER," he writes.
"When that happens, it's no longer insider slang, so it gets
discarded." Instead, doctors may refer to "status gomaticus," or
to the "bed blockers" who take up space in acute-care hospitals when
they really need placement in a rehabilitation or long-term care facility. They
may bemoan an elderly patient's "failure to die," inspired by the
term "failure to thrive," used for infants who are too small.
Harpooning
the Whale: Some physicians are not exactly delicate when it comes to describing
overweight and obese patients. A surgeon might use the euphemism
"excessive soft tissue" to refer to the layers of fat she needs to
cut through before reaching the muscle, writes Goldman, or she might say the
patient is "fluffy." OBGYN doctors might talk among themselves about
"harpooning the whale," or inserting an epidural catheter, which
provides pain-relief medication, into an obese woman's spinal canal during the
late stages of labor. Since it can be tough to locate the insertion point through
fat, one hospital even created a "Prince of Whales Award" for the
resident who placed epidurals "in the most tonnage in one shift,"
Goldman quotes an anesthesiologist as saying. Some doctors may say they charge
a "beemer code," slang for an additional fee to care for an obese
patient, maybe one who's "two clinic units," or 400 pounds.
Hollywood
code: From Grey's Anatomy or ER you may be familiar with Blue
Code—an emergency code indicating that someone needs immediate resuscitation.
But sometimes doctors might realize there's no way to save the patient. In that
case, they may call a "Hollywood Code," also known as "Show
Code," "Light Blue Code" or "Slow Code." Rather than
dropping everything and sprinting to the patient's bed, they stroll to the
scene, slowly check for a pulse, and begin their intervention, Goldman
explains. "It's a play for time until it's acceptable to pronounce the
patient dead," he writes.
Incarceritis:
The
condition of a prisoner who fakes an illness to go to the hospital. If that prisoner
is looking for drugs to peddle later to their cell mates, they may have ADD—not
attention deficit disorder, but "Acute Dilaudid Deficiency," with
Dilaudid being one of the strongest prescription narcotics. He might try to
"cheek" his pills, hiding it in his cheeks while the nurse isn't
looking and then saving it for later sale. Then there are the
"swallowers," people with a mental illness who sometimes swallow
objects like forks and nails.
SFU
50 dose: the amount of a sedative or anti-anxiety medication that causes 50
percent of patients to shut the fuck up.
Social
injury of the rectum: A euphemism first used in the American
Journal of Surgery in 1977, for people who wind up in the hospital after
inserting candles, billiard balls and other objects into their anuses for
erotic pleasure. One doctor told Goldman about the time he treated a patient
with a florescent light bulb up his rectum. "It broke inside of him,"
the doctor said.
Status
dramaticus: In a play on the real medical term "status asthmaticus," an
intense asthma attack that doesn't respond to an inhaler, doctors have come up
with the phrase "status dramaticus" for stressed-out patients who
believe they're extremely sick or dying but actually aren't. Patients who
exaggerate their symptoms, acting like they're in pain to get a response,
are "dying swans," an allusion to a 1905 ballet, The Dying Swan.
Or they're "a Camille," like the heroine who passes away with great
drama in her lover's arms during La Dame Aux Camélias, by Alexandre
Dumas.
Whiney primey: a pregnant
woman who keeps returning to the hospital because she thinks she's in labor but
isn't. When the baby comes, she'll be "frozen" when she receives an
epidural for her pain, and if the epidural stops active labor she'll become an "ice
cube."
