Buzz
Physicians don't only rely on unreadable handwriting to keep us from understanding their notes. They also use specialized terms to obscure their true meaning and prevent us from fully grasping what they’re saying.
Some medical terminology can be amusing, often used to describe quirky or humorous medical situations. Others serve to mask potentially offensive or insensitive comments. There's also a unique category of slang used to describe the state of terminally ill patients, conceal contentious medical procedures from family members, or simply to discuss the bothersome habits of those close to us.
10. John Thomas Sign
The John Thomas, JT, or Throckmorton’s sign is a medical slang term referring to the orientation of the penis in X-ray images of a man’s pelvis. A positive John Thomas sign indicates that the penis points toward the injured area, while a negative sign means it points in the opposite direction.
Some doctors suggest that the positioning of the penis in x-ray scans isn't always by chance. For example, men with hip fractures are more likely to show positive John Thomas signs. This is believed to happen because patients with hip injuries tend to rest at an angle to avoid pain, which causes the penis to point toward the injured hip. Logical? Yes. Strange? Absolutely.
9. Slow Code
Physicians may sometimes reach the conclusion that a patient is beyond saving, no matter what medical procedure is applied. In other situations, they might fear that attempting resuscitation could result in more harm than good, particularly in cases where survival would come with severe, life-altering injuries.
However, doctors don’t simply give up on the patient because doing so could lead to lawsuits, imprisonment, losing their medical license, or even worse. Instead, they initiate what is known as the slow code.
A slow code involves making a conscious but feeble effort to revive a dying patient. When carrying out a slow code, physicians deliberately avoid performing all the necessary life-saving procedures, or they do so in a slow, lackluster manner, hoping the patient will pass away before the process is completed.
The slow code often arises from the challenges of conveying a patient's condition to their family. To handle this, physicians may resort to this tactic, giving the relatives the impression that they are genuinely trying to save the patient, even though they aren't.
The slow code remains a contentious issue, even among healthcare professionals like nurses and doctors. Some believe it should only be used as a last resort, while others argue it should never be considered an option at all.
8. Medical Zebra
Medical trainees are frequently reminded with the saying, “When you hear the sound of hooves, think horses, not zebras.” The phrase uses horses to represent common diseases and zebras to signify rarer ones. The point is that you're more likely to encounter horses (common conditions) than zebras (rare ones), unless perhaps you live near an African savanna or a wildlife park.
Both rare and common illnesses often share similar symptoms, making it easy for a doctor to misinterpret the symptoms of a common condition as something more unusual. This saying encourages physicians to lean toward the common diagnosis rather than jumping to a rarer, less likely one.
Although the use of slang has likely saved countless individuals from misdiagnoses, it has also caused difficulties for 'medical zebras'—the term for patients with rare conditions. Doctors often struggle to diagnose such patients, leading to visits to multiple physicians and a series of tests before the true cause of their symptoms is identified.
7. Frequent Flyers
A 'frequent flyer' refers to a patient who regularly visits the emergency room for non-emergency issues. These individuals often arrive by ambulance or simply walk in without assistance. Their frequent visits are so well-known that the hospital staff recognizes them by name.
It's no surprise that they are also referred to as 'high utilizers,' 'super utilizers,' or 'GOMER' (Get Out of My Emergency Room), which will be discussed in the following entry.
Some patients become frequent flyers because they lack insurance and cannot afford regular doctor visits, so they rely on the emergency room for care. Others may have insurance but choose to visit the emergency room for reasons that remain unclear.
The actions of frequent flyers, however, come with a high price tag. One study showed that frequent flyers made up just 1% of the patients at hospitals in Camden, New Jersey, but their visits accounted for 30% of the hospitals' total operating costs. Another study in 2009 found that nine individuals visited a Texan hospital's emergency room a staggering 2,678 times, costing the hospital $3 million.
6. Get Out of My Emergency Room
In 1978, Dr. Steve Bergman published his novel 'The House of God,' using the pen name Samuel Shem. The novel follows a medical intern during his first year of training and is based on Bergman’s own experiences as an intern at Beth Israel Hospital in Boston from 1973 to 1974.
In the book, Dr. Bergman introduced several pieces of slang used by doctors. One of these terms is 'GOMER,' which stands for 'Get Out of My Emergency Room.'
The term GOMER is often used to describe an elderly patient who is near death—so frail they are unable to perform even the most basic functions and beyond the help of medical treatment. Despite this, they don’t die and frequently cycle in and out of emergency rooms.
Dr. Bergman also introduced additional medical slang, such as 'turfing,' which refers to transferring or referring a patient to another service. This could mean sending the patient to another hospital, a nursing home, their own home, or even a morgue. A physician who avoids admitting a patient or 'turfs' them to another service before any admission is made is known as a 'wall.'
Another term is 'sieve,' which describes a doctor who only admits a limited number of patients, even though they are capable of accepting more. Such doctors are often viewed as problematic. The term 'bounce' or 'bounceback' refers to a patient who is readmitted. There is also 'LOL in NAD,' which stands for 'Little Old Lady in No Apparent Distress.'
5. July Effect
It is often advised that people should avoid allowing their friends or family to undergo surgeries at teaching hospitals during the month of July. This caution is due to what physicians refer to as the 'July effect.'
Each July, newly graduated medical students begin their internships at teaching hospitals. Their lack of experience can lead to mistakes—many mistakes—which results in an unusual increase in patient mortality during this time.
Researchers from the University of California confirmed the reality of the 'July effect' after analyzing over 62 million death certificates in the United States from 1979 to 2006. Their findings revealed that teaching hospitals typically experience a 10% rise in deaths during the month of July.
4. Normal For Norfolk
'Normal for Norfolk' (or N4N) is a slang term used to describe a peculiar individual. It originated as a medical term for a patient who either struggled to accurately describe their symptoms or was simply odd in some other way. It was also used to refer to a patient from a rural region.
The term 'Normal for Norfolk' is believed to have originated in Norfolk County, UK, although its precise origin is unclear. One version suggests that doctors at Norfolk & Norwich University Hospital coined the term to describe patients with intellectual disabilities. Another source claims that the phrase was created by doctors from outside Norfolk, who expressed concern about the eccentricities of people from the region.
The stereotype surrounding Norfolk was likely fueled by bizarre news stories. For example, a report once told of a driver in Great Yarmouth, Norfolk, who was detained by police for transporting a wardrobe on top of his car, held in place only by bubble wrap. Other reports mentioned Norfolk farmers hiring humans as scarecrows. Perhaps a British reader can offer further insight on this in the comments.
3. Social Injury Of The Rectum
Sometimes people stick weird things up their anus. And some of these items get so deep they reach the rectum and become irremovable, prompting a visit to the emergency room. Physicians call these sort of incidents “social injury of the rectum.”
Patients with social injury of the rectum often require surgery to remove whatever got stuck up there. Physicians have operated on patients with pens, beer bottles, bowling pins (WTF?!), baseballs, electrical tapes, wine corks, flashlights, cucumbers, fruits and light bulbs stuck in their rectums.
Physicians have also removed larger items like wooden rods, ice picks, a soy sauce bottle, a peanut butter jar, the head of a Barbie doll and a bed post from the rectum of patients.
For understandable reasons, most patients only complain of abdominal pain and refuse to reveal the real issue whenever they get admitted. They only partly confess after x-rays reveal they have got some other weird stuffs up there. We say partly because they sometimes deny putting anything in their anus and provide hilarious suggestions to explain how those items ended up there.
An elderly man reported that he was attempting to use an ice pick to push his hemorrhoids back when the ice pick accidentally ended up inside his rectum (I guess that’s one way to apply Preparation H). Another person mentioned trying to use a flashlight to assist in defecating, only for it to end up in his body. A third patient shared that while sleepwalking, he somehow managed to get a light bulb lodged in his rectum. Finally, a fourth individual explained that he fell onto a cucumber while showering.
Doctors note that not all instances of people inserting strange objects into their rectum are for sexual purposes. Some individuals do it for the sensation of having something removed by a physician (though isn’t that kind of sexual?). Others end up with unusual items in their rectum after accidentally swallowing them—so aspiring sword swallowers, consider yourselves warned!
2. Funny-Looking Kid
The term 'funny-looking kid' (FLK) refers to a child with an undiagnosed growth or mental condition, often recognizable by an unusual appearance. These children might have features such as flat nose bridges, protruding foreheads, or odd-looking lips. In some cases, their facial features may appear normal but they lack expression, resulting in a blank or vacant look.
To clarify, when doctors use the term 'funny,' they don't mean it in the sense of being humorous. Instead, they use it to describe something that seems odd or abnormal. Despite this, the term is widely regarded as derogatory.
The term 'funny-looking kid' is specifically used for children with abnormal facial features caused by unidentified medical conditions. It is not applied to children with more well-known conditions, such as Down Syndrome. If a parent has a similar appearance, they may be referred to as a 'funny-looking parent' (FLP).
1. The Daughter From California
The 'Daughter from California' (or 'Son from California' for men) is a term used for a person who unexpectedly shows up at a hospital and insists that doctors perform life-saving procedures for a dying relative. Sometimes, physicians replace 'California' with 'New York.'
The Daughter from California is often angry and frustrates the medical staff. They reject treatment recommendations, even from other family members, and continue to press their own ideas on everyone. Physicians label this behavior as 'Daughter from California syndrome.'
Typically, the Daughter from California is a distant relative who hasn't seen the ailing family member in a long time. They are often shocked by the severity of the condition. Physicians believe that feelings of guilt for being absent from the sick relative’s life contribute significantly to the Daughter from California's actions.
